Sunday, December 8, 2019

PDI Opinion: Normalized inhumanity

My fourth piece for Inquirer-Opinion is dedicated to my alma mater--the website link here.

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Normalized inhumanity


There aren't enough beds to go around in our public hospitals. And if you think the country is in a hurry to fix this problem, think again.

At the Philippine General Hospital (PGH), where I was once a postgraduate medical intern, it is normal to see some admitted patients in the emergency room (ER) being accommodated on Monoblocs. In the charity wards at night, the bantays--the patients' assigned companions, sleep either on chairs or on cardboard sheets spread beside or under the patients' beds.

And that's only scratching the surface of the Philippine public health situation.

The old PGH labor and delivery room, before it was torn down to give way to what has become a protracted reconstruction, could get so crowded it resembled a parking lot: women on steel stretchers placed side by side, with just slivers of space in between for careful movement. Oh yes, charity patients used--and still use--uncushioned stretchers, usually outfitted with just a thin sheet of cloth to separate the woman's body from the cold surface.

At least the patients just stay in bed. I'd been in numerous in-house emergencies where the bantays had to push the drastically deteriorating, bedbound patient alongside the physician on duty all the way from the ward to Radiology. Where was I? Running--in a place where life is oftentimes a literal race to get things done--to have the needed scan approved and scheduled instantly by the radiologist on duty. Where was the hospital aide whose job it supposedly was to push the bed? Pushing another patient's bed.

And yet, there aren't enough voices demanding the provision of more items from the government to employ more health care personnel. There isn't enough outrage at the fact that what is supposed to be our best government hospital still persists in primitive conditions.

It's reasonable to believe the people with the money and power to actually change things don't even grasp the ground-level reality of our public hospitals. Look at how our leaders justify their splurge on a multimillion-peso scam of an ornamental cauldron for the Southeast Asian Games, after having slashed next year's national budget for health by an infuriating percentage. In times of sickness, they inhabit a world of their own: plush suites that can give luxury hotels a run for their money, the bantays with their own beds, and massive TVs and high-speed internet access to pass the time. Even the apathetic middle class have a myriad of private hospitals to choose from; should they opt to go to PGH, there are still air-conditioned private quarters to check into.

The state of hospitals such as PGH is nothing new. In fact, it has been like this for so long, we hear the depressing anecdotes and instinctively think, "That's just the way it is."

As I write this, a hallway continues to substitute for the ER lobby of PGH, threatening to burst during peak hours with all the sweaty, tired bodies jostling for the attention of an overwhelmed team of medical professionals. A single converted ward--the main stand-in for what used to be a multi-part complex--is stretched ridiculously thin to accommodate almost all the patients admitted for emergency care. And these patients on their stretchers have spilled over into neighboring hallways and even a portion of the hospital's central elevator lobby.

We've heard again and again how our doctors are overworked and underpaid; how our nurses are overworked and even more underpaid. When a doctor tweets, "Ubos na ubos na ako (I'm totally spent)," it's now somehow taken as a fact of life and fodder for after-work conversation.

But at least resident doctors who go on 24-hour duties every three days get to go home to a bath, a warm meal and a soft bed at the end of it all. Ditto with nurses who drown in paperwork alone every shift. The luckiest even have well-appointed call rooms to retreat to during down times.

Our patients, on the other hand, have no choice but to endure the deplorable conditions of our government health care facilities, for lack of more humane and accessible choices. Suck it all up, to put it bluntly.

For our patients, it's already a battle just to be seen at the ER. In the wards, bantays continue to sleep on the floor, waiting for that day when the patient finally gets discharged or dies. Behold, this normalized inhumanity.

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