The painful reality of public health

We hear about it, we read about it, but the painful reality of public health in the Philippines is so horrible I now understand why many poor people end up staying home to die.

This story is about the painful, unbelievably complicated and expensive travails of “Narding,” our caretaker and childhood friend. His story is not unique and it teaches us that even if money was available, the truth is our provincial public health system is seriously lacking or damaged and patients pay in pain.

Two weeks ago, Narding complained about stomach pain and after a few days of grinning and bearing it, the OTC pain killers were no longer helping, so they went to the Ospital ng Lipa City which is relatively new at 23 years of existence. The hospital has always served the people of Lipa adequately, but they referred Narding to a private hospital because the machine at the Lipa hospital was not functioning due to a broken “arm” used for scanning (attention Mayor Eric B. Africa).

Narding was transferred to the Villa Memorial Medical Center where he underwent two different types of CT scans to check his gall bladder, bile duct and pancreas and stayed approximately three days. From what I was told, the two scans cost Narding P51,000. Whether we will get any refund from PhilHealth only God knows. Only then was he told that he needed to undergo an MRCP or Magnetic Resonance Cholangiopancreatography which VMMC did not have.

So, he was told to transfer to the Batangas Medical Center, the regional hospital that has the MRCP machine. After the bill shock of P51,000 plus room charges etc., we reached out to barangay captain Miguel Olgado of Inosluban to avail of free ambulance transfer to BATMC, which he provided immediately.

Narding arrived at BATMC around noon and was stuck in a wheelchair in the ER and hoping and praying for a room until after 5 pm. The harsh reality in a major public hospital such as BATMC is money can’t get you a room. They have far too many patients and very limited number of beds. I had sent sufficient cash to the family, but I realized that I had to knock on heaven’s doors.

So, I went to my Facebook account and received a river of prayers and a miraculous chain of action starting with my friend Jerome Brian Tang, who started calling other people all the way to a doctor who was in Canada. I praise God for sending good Samaritan doctors like Doc “Kiko” Gonzales, a urologic surgeon and medical director of the Gonzales Medical and Children’s Hospital in Tanauan City, Batangas, and Dr. Michael “Mecs” Mendoza of BATMC. That wave of action got Narding his bed for the night and pain killers. I later got to talk to head nurse Jenny and Dr. Arvin Julius Mendoza, both of whom explained the difficulties everyone was facing.

Former senator now Batangas Congressman Ralph Recto also sent two staff members to see what could be done to assist Narding, whom he has also known since childhood and when Recto first ran for congress. If you think all that crowd sourcing and joint effort was more than enough, well it still wasn’t. The situation reminds me of Humpty Dumpty and all the king’s men.

We had the cash, we had the doctors, we even had a lawmaker and kababata on our team, but there was only one MRCP, so many patients and the machine does not operate 24/7! It does not even operate on Saturdays and Sundays. Never mind that you are in extreme pain or with possible serious complications, you simply must wait.

The following day, Saturday afternoon, Congressman Recto’s staff Ken Tolentino advised me that Narding will have to be brought to RMC, yes, the Rizal Medical Center here in Pasig City. RMC is the very same hospital I always go to and passionately promote for being a center of excellence in terms of equipment, services, consultants and management under Dr. Rica Lumague. That was great news but first they had to find a suitable ambulance because all the ambulances of the BATMC were not available or not in service.

So, after nearly two weeks of not getting the actual medical attention he requires, after spending several bundles of cash, traveling from one hospital to another, to another and to yet another, what I discovered a day later was that Narding needed an ERCP procedure, a combination of Endoscopy and X-ray to treat problems in the bile and pancreatic duct. It was not an MRCP machine we needed but trained physicians in endoscopy that the regional hospital which serves at least five provinces does not have. They need to send an SOS to RMC to send a team every time there are five to 10 patients waiting or refer patients to RMC.

After this I hope to convince Congressman Ralph Recto to push for a bill requiring that all equipment sold to hospitals must include a maintenance contract for the full lifetime of the hospital equipment and ambulances. Maybe he can push for a total overhaul and expansion of BATMC to include fellows for ERCP.

It would also be good to investigate claims that certain hospitals, including provincial hospitals, have a reputation for “biyak ng biyak” or opting for immediate C-section over natural births, hospitals who don’t have doctors on staff or rely on on-call MDs and technicians, resulting in longer hospital stays for patients waiting to be tested or to get results.

Senator Bong Go might also want to upgrade his Malasakit program to include patient rights advocates in all hospitals because many poor people are ignorant and are bullied or ignored. They need knowledgeable people to teach them and also to speak for them.

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