Yearender: 2005 sees changing of guard at DOH

The year 2005 witnessed a changing of the guard at the Department of Health (DOH).

Former Health Secretary Manuel Dayrit announced he was resigning effective May 31, but stopped short of saying that President Arroyo had pressured him to do so. He claimed he simply felt it was time to move on after being in the Cabinet for four years.

When pressed, Dayrit admitted that he and Mrs. Arroyo were already discussing "transitional changes in the government" as early as August 2004.

Mrs. Arroyo appointed her protégé, former Philippine Health Insurance Corp. (PhilHealth) president Dr. Francisco Duque III, as Dayrit’s replacement.

Observers suspected that Duque’s appointment was a political "payoff," as Philhealth cards had been distributed to indigent Filipinos at the height of the May 2004 election. This supposedly helped boost Mrs. Arroyo’s bid for a fresh six-year term.

At present, Dayrit is a commissioner of the World Health Organization (WHO) Commission on the Social Determinants of Health in Switzerland.

Also in 2005, various groups sounded the alarm on the increased exodus of Filipino doctors seeking more lucrative jobs abroad.

Rather than practicing their profession abroad, these doctors typically end up working as nurses in foreign hospitals abroad. In the Philippines, hospital doctors are paid around $300 to $800 while those working as nurses in foreign hospitals earn as much as $4,000 a month.

According to former health secretary Jaime Galvez-Tan, around 3,000 doctors have migrated from 2001 to 2004 and another 3,000 are now enrolled in various nursing schools.

"This exodus actually came into our consciousness, I think, three years ago when it was found out that those topping the board examination for nursing were mostly doctors. We became alarmed," Tan told The STAR.

He has been studying the migration of doctors in his capacity as executive director of the University of the Philippines’ National Institute for Health (NIH). His term ended recently.

Tan said the turning point came in 2001 when around 18,000 nurses found employment abroad. Doctors saw the huge demand for nurses in other countries and this encouraged them to take up nursing.

"Never in our history have we exported that many (health workers). There was no stopping since," he noted.

Attracted by the huge salary and the opportunity to be granted immigrant status offered by countries such as the United Kingdom, Australia, Canada and the United States, doctors went there in droves. They were also driven away by the unstable political and economic environment in the Philippines.

Duque earlier admitted that while tax incentives, housing and other strategies might be offered to doctors, local hospitals could never match the salaries given by foreign hospitals.

"It’s farfetched. We cannot afford that because we don’t have adequate funding for that," he said.

Duque, however, assured that the DOH is doing its best to improve the lives of those in the healthcare industry.

One of these efforts is asking Congress to increase the DOH budget for 2006 by P5.2 billion, mostly to increase the wages of health workers in DOH-run hospitals by 30 percent. For 2005, the agency received only P10 billion and much of it went to the salaries of officials and employees.

To address the issue, the Philippine Medical Association held the first Philippine Medical Summit last September, during which doctors sought a better compensation package.

They also demanded the adoption of a bilateral agreement between the Philippines and the countries hiring Filipino doctors and nurses, guaranteeing an "equitable compensation" for every medical practitioner that the Philippines loses to foreign hospitals. This will be used to improve the health services and medical education in the country.

But Jossel Ebesate, secretary general of the Alliance of Health Workers, warned that the country’s healthcare system might collapse in two to three years if the massive exodus of doctors and nurses is not abated.

Ebesate noted that many health centers are now unmanned because no doctors and nurses want to work there. Hospitals are also becoming understaffed because few are applying to fill vacancies.

He added that most of those leaving are the more experienced and skilled ones so if the problem is not addressed soon, Filipino patients would be left in the care of novices.

Aside from the exodus of doctors, the government also had to deal with the threat of avian influenza in 2005.

Mrs. Arroyo created a multi-sector task force to map out a preparedness plan to keep the virus away and mitigate its impact in case of an epidemic.

But while Philippines remains free from the H5N1 strain, which causes bird flu, the country is considered at "high risk" because the disease has already swept across neighboring countries like Cambodia, Thailand, Vietnam and Indonesia.

Sometime in July, the virus was feared to have crept into the Philippines when three ducks at a small farm in Calumpit, Bulacan tested positive for the disease. The ducks were about to be exported when the buyer performed the preliminary tests.

But thorough examination conducted by Australian Animal Health Laboratory (AAHL), which functions as the referral center of WHO and the Food and Agriculture Organization for bird flu, showed that "no active infection" was present in the ducks.

The AAHL ruled that the Philippines was still free from "any highly pathogenic" strain of avian influenza.

For Dr. Luningning Villa, program manager of the DOH’s Emerging Diseases Unit, it is a combination of luck and vigilance that keeps the disease at bay.

"We are bird flu-free because of our geographical isolation. We don’t share land borders through which infected live birds could come in," she said.

Villa said while the virus could be brought in by migratory birds, "the wild geese and swans which got sick of bird flu in other countries don’t come to the Philippines."

She also attributed the country’s bird flu-free status to the continuing ban on the importation of poultry products from affected countries.

"We are also closely monitoring some 20 bird sanctuaries across the country because infected migratory birds could come in and infect local poultry," Villa added.

The year 2005 also witnessed better public awareness of malaria following the death of broadcaster Reyster Langit, son of veteran broadcaster Rey Langit, and his cameraman Arnold Tanare from cerebral malaria in June.

The two contracted the illness while doing a documentary on the mysterious death of Tao’t Bato tribesmen in Palawan. Langit, 33, was brought to a hospital in the United States where he passed away.

Recently, the DOH and WHO renewed an offensive against malaria, which puts around 11 million Filipinos at risk. The disease is endemic in 66 of the country’s 79 provinces.

WHO hopes to declare the Philippines malaria-free by 2020 by beefing up campaigns in endemic areas. The strategy is to reduce cases by 53 percent by 2010, until the target is achieved 10 years later.

Last Aug. 15, the DOH also declared a "nationwide alert" for dengue after cases reached a total of 14,142 from January to Aug. 11. Clustering of cases was then observed in more than 100 barangays nationwide.