How sick are the Filipinos in the time of Duterte?
One year into his presidency, President Rodrigo Duterte's promise of change has yet to be fulfilled.
One year ago, the Filipinos’ seething indignation over the inefficiency and insensitivity of the then Aquino administration helped catapult Rodrigo Duterte into the presidency. His campaign slogan, Change is Coming, captivated the Filipinos who have long been anxious for a genuine and meaningful change in society.
But one year into his presidency, Duterte has not much to show to realize the change that he had promised, especially in terms of improving the lives of the impoverished Filipinos. He has terrorized them instead with his brutal and bloody war on drugs and counterinsurgency campaigns.
Full of bravado
Critics and observers say he is full of bravado and is acting on his ideas without thinking through the consequence of his actions. Some say he has little to show in terms of significant reforms offering simplistic solutions to complex problems.
The health sector shares the same observation: Duterte is good on words and promises but he does not have real plans to fulfill them. There has been no genuine implementation of health reforms.
This is how the Coalition for People’s Right to Health (CPRH) characterized the Duterte administration’s performance in addressing the chronic health problems in the country.
To assess Duterte’s performance over a year in the office, CPRH led by TWHA partner, Council for Health and Development, held a forum at the Science Hall of the Philippine General Hospital (PPGH) in Manila last week.
The choice of the venue, the PGH (a state-owned hospital, is the biggest in the country and is generally known as the hospital for indigent patients), could not have been more appropriate to illustrate Duterte administration’s piecemeal and ineffective ways of addressing the root causes of the country’s health problems.
Main Speaker, Dr. Edelina dela Paz, one of the convenors of the CPRH and the Philippine Coordinator of the People's Health Movement, cited how one of Duterte administration's program called Lingap sa Masa or Libreng Gamot para sa Masa (Free Medicines for the Masses) has not addressed the problem it supposedly aims to solve but instead exacerbated the already grievous daily drudgery of PGH's overworked doctors, nurses, and other personnel.
The program carries out Duterte’s directive to provide free medicines to indigent patients who need treatment for illnesses and injuries. It, however, identified only six hospitals in the entire country that will implement the program, one of which is the PGH. PGH receives 100 million a month in fund to implement the program.
The problem with the program, according to Dr. Dela Paz, is that the fund is strictly allocated for medicines only. When they learned about the program, sick people all over Metro Manila and other provinces have since been swarming PGH. The hospital’s doctors, nurses, and other personnel have been overwhelmed with more people and more work.
Overworked hospital personnel
Unfortunately, since the fund is only intended for free medicines, the hospital cannot use it to acquire additional manpower and services. The already overworked hospital personnel cannot do anything but withstand more works that they can handle. Those who could not bear the burden were forced to resign.
“Yes, there is an inpouring of funds in PGH, courtesy of President Duterte, but it only aggravates the miserable condition inside the hospital. We now have an overcrowded hospital with a few doctors and nurses to take care of the patients. And since PGH is a government hospital, it cannot refuse to admit every sick person,” Dr. Dela Paz said.
How sick are the Filipinos in the time of Duterte?
Dr. Dela Paz went on to enumerate the indications to prove that the country’s health situation has not improved in the time of Duterte:
- still, seven of ten Filipinos who die are without medical attention
- doctor to population ratio is 1:24,000 against World Health Organization's recommendation of 1:400
- many of those who have seen a doctor cannot afford to begin or sustain treatment
- malnutrition among children is worsening – from 30.3 percent in 2013 to 33.4 percent in 2015
- HIV/Aids cases continue to rise – 25 per day
- infectious diseases such as tuberculosis and pneumonia kill 100,000 people a year
- around 2,000 mothers die every year while in pregnancy or during childbirth.
She asserted that health care services remain inadequate, selective, expensive, and hospital-based citing the following attributes of health care system under Duterte’s administration:
- primary health care has not been strengthened
- health care is still concentrated in urban centers
- government implements the same old neoliberal policies such as privatization and corporatization
- there is inadequate public health budget
- there are inadequate Maintenance and Other Operating Expenses (MOOE) for public hospitals
- Philhealth (social health insurance) is still being brandished as the primary solution to the people’s health problems
- the government continues to implement No Home Birthing policy that punishes poor women who cannot afford hospitalization.
Health secretary did not learn from Cuba’s visit
She criticized the Department of Health Secretary Paulyn Ubial’s strong endorsement of Philhealth and corporatization of government hospitals as solutions to the health problems of the Filipinos as absurd saying that the secretary did not learn anything from her recent visit to Cuba to learn about its widely-acclaimed pro-people health care system.
Dr. dela Paz said the health secretary should learn from former health secretary Esperanza Cabral who criticized Philhealth program as reinforcing health inequity in the country. In an article she had written for the Philippine Journal of Internal Medicine, Cabral said: “It can even be said that the greater national health insurance coverage of the population has increased health inequity in the country. The well to do are the greatest users of the national health insurance program and the greatest claimants are the modern and expensive hospitals that they patronize. In effect, the government is paying for the health care of the rich by subsidizing the health insurance premiums of the poor.”
Intensify campaign for people’s right to health
At the end of the forum, the NCPRH vowed to intensify its campaign for the people’s right to health in the second year of Duterte’s presidency. It will lead the progressive social movement in the campaigns for the increase of the national health budget and salaries of health workers. It will continue to oppose privatization and corporatization of government hospitals, no home birthing policy, budget cut on the MOOE of public hospitals and the contractualization of health workers. It is now leading a campaign for the protection of the human rights of doctors and health workers as cases of killings of doctors and health workers serving in the far-flung areas continue to rise.