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Response of the Non-Government Organization Sector to the Public Lecture of DOH Sec.Manuel M.Dayrit on Health and Population by Eleanor A. Jara, M.D.
February 27, 2004
Greek mythologies are often replete with tragedies. Tragedies that would never have occurred if not for the whims and caprices of the gods and goddesses of Mt. Olympus. Tragedies that shouldn’t have come to pass, if only they cared enough to leave their lofty palace and mingled with ordinary mortals.
As a community-based health program practitioner, I am well aware that the people’s health is far from improving. Aside from the prevailing socio-economic and political conditions in the country, the lack of genuine pro-people government health policies spell doom for the people. Secretary Manuel Dayrit’s speech proved that if there’s one thing the Department of Health is good at, it is in producing technical papers that could impress technocrats and professionals alike. However, whether the contents of his speech actually do good to the people remain debatable.
While Sec. Dayrit harped on the government’s alleged major achievements while keeping mum on the government’s health policy frameworks, we in the NGO community based health programs (CBHPs) throughout the country could cite countless specific instances to prove our assertion that the people’s health continues to worsen. Secretary Dayrit mentioned that under President Gloria Macapagal-Arroyo’s administration, the Department of Health and the private sector have unified their TB treatment protocols. But what does it mean for the thousands of TB patients who haven’t received treatment yet? Or haven’t even been diagnosed? The World Health Organization’s 2002 report said that the Philippines has the 7th highest TB rate in the world and the 2nd highest number of new cases in the Western Pacific region. The high occurrence of TB in the country is due in part to the inaction of the government. A study conducted by international TB expert Dr. John Peabody found that only 45 percent of cases are diagnosed, while only 38 percent of cases get treated in our country.
TB is one of the top killer diseases in this country, yet the government’s actions against it remains inadequate, to say the least. It is no wonder then that other communicable diseases remain as rampant as ever. A few years ago, a measles epidemic struck Mangyan communities in Oriental Mindoro. In one tribe, out of 25 children, only one survived. When this happened, government doctors from the province were nowhere in sight. It was through the efforts of people’s organizations and other concerned doctors and individuals that medical relief missions were held in some of the affected areas. Less than two months ago, another 25 indigenous children died of measles in Mindanao.
Amidst the worsening health conditions of the people, health services remain beyond the reach of the majority of Filipinos. Instead of allotting a bigger budget for health, the health allotment even decreases. The government has even institutionalized the collection of fees for service, medicines, diagnostic tests and supplies in government hospitals. The Health Sector Reform Agenda, coupled with the devolution of health care, are virtual Pandora’s boxes that bring more deaths and hardships to an already sick population. The Department of Health itself admitted that eight out of ten Filipinos cannot afford the health care they need. At the Philippine Heart Center for example, a transplant costs P300,000. Charity patients needing transplants have to wait for six months to three years. Many die before their turn comes.
The government said that PhilHealth would help ordinary Filipinos cope with the continuing commercialization of health care. But who pays for the premiums? As it is, the people cannot even afford to buy their basic needs. Even if they could pay for the premiums, the coverage of the PhilHealth is not enough to offset the costs of health services. Sources from the DOH said that PhilHealth covers only 30 percent of the health care costs of an insured person. For every P1 contribution, only 22 centavos go for the actual health care expenses.
When the provision of health services was devolved to local government units, the national government reasoned out that it would make health policies more responsive to the people’s needs. Today, the opposite is happening. In Isabela, Governor Faustino Dy Jr closed down ten health centers, affecting more than 300,000 residents from 164 barangays and 18 towns. The closure quickly resulted in the death of a young mother who died of hemorrhage due to placental retention. Since the nearest hospital where the woman lived was closed down, she was brought to the Provincial Hospital 35 kilometers away from her home. How many more suffer the same fate?
These incidences are just some of the realities that our brothers and sisters are forced to bear. In this regard, the Philippine health situation is very much like a Greek tragedy. The comparison ends there, however. Unlike Greek tragedies, our tragedies are all too real. Greek tragedies teach us about human foibles and the vanities of the gods and goddesses. Our tragedies teach us about the follies of government politicians and technocrats. Comfortable in their lofty positions, government officials refuse to acknowledge and feel the gravity of the health situation, as how ordinary mortals feel and experience it. Coupled with the prevailing socio-economic and political mess we are in, the prognosis of the people’s health remains grim.
To say otherwise would be to perpetuate the myth that the people’s health situation is improving.
To insist otherwise would be to turn lies to truth.
Dr.Jara is the executive director of the Council for Health and Development, the national organization of community-based health programs (CBHP). Since its inception 30 years ago, thousands of community members have received health trainings to become community health workers.
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