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Diagnosis of Public Hospitals
A few days before Health Secretary Francisco Duque visited the Bicol Medical Center (BMC) last
Nov. 8, the hospital underwent repair and refurbishing but only its frontage, some hallways and
the garden near the auditorium where Duque dialogued with hospital employees. The rest of the
hospital remained glaringly untouched. Such is the state of public hospitals that they could not
even get a proper repair and repainting.
BY AUBREY SC MAKILAN
Bulatlat
The Bicol Medical Center (BMC) is Bicols regional
hospital and located in Cadplan, Pili, Camarines Sur
(465 kms south of Manila). The hospital, particularly
its psychiatric wing, the former Don Susano
Rodriguez Memorial Medical Hospital (DSRMMH),
is a mirror of the sad state of public hospitals.
In 1982, it was integrated with the Bicol Medical
Center (BMC), formerly the Camarines Sur Regional
Training Hospital which serves as the regional
hospital. Since then, DSRMMH has served as the
BMC mental ward unit.

MAKING DO WITH SO LITTLE: Three female patients of the Rodriguez
Memorial Medical Hospital rest inside a makeshift strapping area.
PHOTO BY AUBREY MAKILAN
BMC is a typical provincial hospital that suffers from lack of funds, lack of doctors and nurses and dismal facilities.
Overworked nurses
Nurse Hermie Ataiza has been with the DSRMMH for 10 years now. Nurse Annabelle Rahmatulin, on the other
hand, joined the hospital only two months ago. Both share the dream of someday being able to work abroad.
Rahmatulin is actually an accountancy graduate at the University of Nueva Caceres in Naga City (449 kms south of
Manila). Hearing of the big demand abroad for nurses, she went back to school and took up nursing. She finished at
the Arellano University last March 2005 and passed the licensure exam in June.

RESTING AREA: Patients at the Rodriguez Memorial Medical
Hospital kill time inside a dilapidated resting area which they lovingly
call "Glorietta," after a high-end mall in Makati City. PHOTO BY
AUBREY MAKILAN
Ataiza, who is in her 40s, is just one of the five nurses
who attend to more than 300 psychiatric patients.
Although she works with nursing attendants, a supervisor
and a senior nurse during her shift, Ataiza said the main
responsibility for the care of the 300 patients rests on her.
Nursing attendants help in feeding, bathing and,
sometimes, give patients their medicine. But she does the
professional nursing tasks. She is ensures that patients
are given anti-psychotic drugs in the morning and a
tranquilizer at night.
Ataizas shift lasts eight hours. But if her reliever does not arrive, she works for 16 hours straight.
Often times, they have the well-behaved patients helping them clean, assist take care of their fellow patients, and
even buy some supplies outside the hospital.
That is, she said, she appreciates the work of loyalty nurses, like Rahmatulin. Loyalty nurses, sometimes called
apprentices, offer voluntary services to hospitals to train and gain experience.
Rahmatulin, however, said that despite the free service they render, they are required to pay a placement fee to the
hospital. In her case, she paid the hospital P500. She said some hospitals charge more. The St. Lukes Medical
Center, for example, charges as much as P4,500, she said.
Ataiza used to be assigned at the Bicol Medical Center (BMC), formerly Camarines Sur Regional Training Hospital.
In 1982, it was integrated with the DSRMMH. Since then, DSRMMH has served as the BMC mental ward unit.
Lack of doctors
Meanwhile, Dr. Benedicto Aguirre, consultant at the DSRMMH, said that they also lack doctors. At present, there
are only three of them who work on rotation. However, one of them has to be based at the BMC to screen patients
with mental illnesses before admission to the DSRMMH. Thus, they have to schedule the check up and screening of
patients only from Monday to Thursday.
Aguirre, who started as a physician at the DSRMMH in 1976, said the hospital has been facing financial problems
since the integration took place. Before 1982, the hospital used to get a budget of about P3 million from the local
government. But it was reduced to a million after the integration. Considering the high inflation rate, it should be
getting around P12 million, he said.
The big discrepancy, said Aguirre, could have helped them in improving the mental ward.
Dismal facilities
The DSRMMH was built to accommodate around 200 patients but, sometimes, the number of patients reaches up to
390. Patient admission peaks during summer because of the hot weather and the numerous celebrations
like fiestas (feasts), during which mental ill persons get affected and become hyperactive.
It has five male wards, a strap room and an isolation room. But due to overcrowding, the isolation room usually
contains four to five patients, usually elderly patients. For female patients, there are two wards and a strap room. The
latter however has been converted into another ward to accommodate more patients. The resting area has been
converted into a strapping area.
Meanwhile, inside the wards, the patients sleep on the floor.
Ataiza said the nurses station is located in what used to be the garage. She said that they neither have a pharmacy
nor an infirmary. Sick patients are transported to the BMC.
When the hospital is overloaded they send the well-behaved patients home. But they have to conduct regular visits
and provide the patients with maintenance medicine continuously for a month. Aguirre however said that due to lack
of funds and shortage in personnel, they had to shorten the monitoring visits and give medicines only for three to
seven days. In some cases, they could not even visit or provide medicine, he said.
Unfortunately, if the patient has been abandoned by their relatives, they have no choice but to bring the patient back
to the mental ward.
BMC
The health workers and patients of BMC face the same problems as DSRMMH.
The BMC is a tertiary hospital that serves as the regional hospital in Bicol, the seventh most populous region in the
country. It also has the seventh highest death rate, based on the Philippine Health Statistics of 2000.
BMC however operates like a private hospital, said Rey Dacuno, president of the BMC Employees Union-Alliance
of Health Workers (BMCEU-AHW).
Dacuno said that the BMCs objectives mirror that of private hospitals. Dacuno cited two objectives of the hospital
which as posted in BMCs website: To increase hospital revenues by 20% of CY 2003 actual income of P30 M
and To improve hospital facilities in order to encourage PhilHealth patients.
Dacuno said that although there is no plan to privatize the hospital, these objectives and the rates it charges show
that the priority of BMC is to earn profits.
Johnny Bermejo of BMCs Wellness Program, confirmed this. Nagtataka nga rin kami. Pagpasok mo
ng emergency room, may babayaran ka na. Tapos tests sa laboratory may bayad din, pati sapharmacy. Lahat
ng departments na pupuntahan mo halos merong bayad.(We were surprised. Patients are charged upon admission
at the emergency room. Patients are also asked to pay for simple laboratory tests such as a urinalysis, which used to
be free. Almost every department charges the patients for their services.)
BMC patients are categorized based on their income. Class A and B patients pay for their bills. Class C-1 patients
pay 75 percent of their bill, Class C-2 pay 50 percent, Class C-3 pay 30 percent and Class D do not pay anything.
Bermejo, who has been in the hospital for almost 18 years, said he tries to find ways and means to lower the bills of
poor patients. He refers indigent patients to politicians with funds or to the Philippine Charity Sweepstakes Office
(PCSO).
Bermejo however said that even if the patients are classified as class D, with supporting documents certifying that
the patient belongs to the poorest of the poor in his/her barangay, some are still made to pay 30 percent of their total
bill.
Bermejo supports the House bill filed by Rep. Raul Del Mar of Cebu City seeking to prevent the undesirable
practice of hospitals and medical clinics of preventing the release of fully recovered and/or dead patients for non-
payment, either partially or fully, of hospital bills. The proposed bill was approved by the House on June 7, and
transmitted to the Senate July 25. Sen. Ralph Recto introduced the counterpart bill in the Senate, and it has been
referred to the committees on health and demography, and social justice, welfare and rural development.
Meanwhile, a few days before Health Secretary Francisco Duque visited BMC last Nov. 8 for the launching of the
campaign against Filariasis an illness characterized by the enlargement of the entire leg or arm, genitals and
breasts caused by thread-like, parasitic filarial worms the frontage of the hospital and some hallways were
repainted. Rep. Luis Villafuerte of Camarines Sur reportedly donated the paint.
The landscape near the auditorium where Duque dialogued with hospital employees was also brushed up.
Employees were reportedly made to work on the garden Nov. 4 even though it was a holiday to prepare the
grounds for the secretarys visit.
Dacuno said the back of the hospital remained glaringly untouched.
Effect of devolution, neglect
In the morning of Duques arrival at the BMC, an old woman was catching her breath in front of the emergency
entrance of the hospital. After being seen by a doctor, she was told to buy medicines for her respiratory problem.
More than willing to take the medicines immediately for her comfort, she neither had money to buy the drugs nor to
be admitted in the hospital. Left with no choice, she stayed in the waiting area in front of the Emergency entrance
for almost half of the day waiting for her daughter who might have the means for her admission.
The old woman was not alone. Relatives of other BMC patients were there, too, thinking of ways to get help to pay
for their bills. Some were asking who among politicians gave the larger assistance funds.
Since the hospital has been striving to support its own operations as aimed by the devolution, Dacuno said these
scenes are just ordinary occurrences not just at BMC but in several rural hospitals were poor patients could not
shoulder the cost of hospitalization.
The DoH stressed that devolution, through the Health Sector Reform Agenda, aims to improve the health status of
the Filipino people through greater and more effective coverage of national and local public health programs,
increase access to health services especially for the poor, and reduce financial burden on individual families.
But with the decreasing budget for health, the devolution of health services to cash-strapped municipalities, and the
privatization of government hospitals, how can the poor access the necessary services? asked Dr. Gene Nisperos,
secretary general of the Health Alliance for Democracy (HEAD).
Moreover, the devolution, Nisperos said, only reflects the governments abandonment of its responsibility to
promote and protect the peoples rights to health.
The peoples health should not be compromised, he said. Nor should the quality and availability of health
services be made contingent on the peoples capacity to pay. Bulatlat
DOH chief defends increase in family health budget
By Christina Mendez (The Philippine Star) Updated August 11, 2011 12:00 AM Comments (0)

MANILA, Philippines - Secretary Enrique Ona yesterday defended the increase in allocation for the family
health and responsible parenting program of the Department of Health (DOH) that jumped from P731 million
this year to P2.503 billion for 2012.
Ona admitted the increase in the allocation for the program for next year would be for the purchase of
condoms and contraceptives.
During yesterdays hearing on the DOH budget at the Senate, Ona outlined the programs for the P2.5-billion
family health budget, mostly allocated for supplies.
The Senate is deliberating on the proposed P42-billion national outlay for the DOH.
Ona mentioned during the budget hearings that most of the DOH budget would include the purchase of
vaccines for senior citizens, micro-nutrients, maternal-child nutrition, newborn screening, rural units with
birthing facilities, and obstetrics and neonatal care program.
Ona though did not mention the programs for population control or the purchase of condoms and
contraceptives, which earned the ire of pro-life advocates, including Sen. Vicente Sotto III, during the
budget deliberations.
Ona later admitted after the hearing that the DOH had included the budget for condoms in the 2012
budget.
When we talk about family health and responsible parenthood, there are many aspects about it, so we did
not physically put a percent or even an amount, Ona explained.
Ona was also vocal about his support for Reproductive Health (RH) bill, which he says is in the context of
responsible parenthood.
I also want you to know that we are very clear by the fact that we are against abortion, Ona told
reporters.
Sotto clarified he wanted to know from Ona if the programs and goals of the DOH in line with the Millennium
Development Goals (MDGs) are in place and if they are successful.
Apparently, they are successful and there is much to be desired in the enhancement of health facilities...
but they are getting there, Sotto said.
Sotto said the DOHs programs on family health and responsible parenting could be the best argument
against the passage of the RH bill.
The DOH is the best argument against RH bill because they are practically doing everything that the RH bill
wants to do. This is in place already, he said.
Sectors apparently supported Ona and called on lawmakers to heed the clamor for a comprehensive
reproductive health program.
Ramon San Pascual, executive director of the Philippine Legislators Committee on Population and
Development Foundation, Inc. (PLCPD), said results of the recent Social Weather Stations survey reaffirm
the need for government to act on the reproductive health needs of Filipinos.
Surveys have been consistent for two decades now in showing that the majority of the Filipino people want
the government to provide RH services, particularly family planning methods, San Pascual said.
He said the government should adopt a law to implement mechanisms and resources for family planning.
San Pascual said the RH bill has undergone numerous public consultations and exhaustive discussions since
the proposal was filed in the 10th Congress.
Elizabeth Angsioco, chair of the Democratic Socialist Women of the Philippines (DSWP), said more people
are getting convinced about their right to choose and make decisions for themselves on family planning
matters.
The high public approval rating for government-funded family planning program is a very strong
reinforcement of similar results from previous surveys conducted by prestigious survey institutions such as
SWS and Pulse Asia, Angsioco said.
These results show a very clear statement favoring the passage of the 16-year old reproductive health bill
still pending in Congress, she added.
The RH bill, now being debated in Congress, promotes sex education and allows for both natural and
artificial means of family planning, among others.
The measure is strongly opposed by the Catholic Church and other pro-life groups.
Former University of the Philippines president Francisco Nemenzo warned the Church is playing a
dangerous game in pushing moral responsibility on the lawmakers supporting the RH bill.
It is very dangerous for the church to use the state to impose their version of morality. I respect the right
of the bishops and priests to promote their teachings of morality but they have the pulpits for that,
Nemenzo said.
Nemenzo said the Catholic Bishops Conference of the Philippines (CBCP) may have its version of what is
moral but putting pressure on politicians to attain its end on the controversial measure is not a good political
move on the part of the Catholic hierarchy.
They (bishops) should have used the pulpit and other media accessible to them. But not pressure on
congressmen and senators. If youre politically weak, you dont let the votes for you be counted in public...
it would have been better if it (CBCP) avoided getting entangled in an issue like this, Nemenzo said.
With Helen Flores, Reinir Padua
Approved 2012 budget skewed vs peoples needs


Approved 2012 budget skewed vs peoples needs
PUBLISHED ON DECEMBER 2, 2011
85 9 ShareThis101Email4

Meager spending for social services show that the 2012 budget is anti-people and far from being a
reform budget. Vencer Crisostomo, national chairman of Anakbayan.
By ANNE MARXZE D. UMIL
Bulatlat.com
Sidebar: Filipinos get P1.25 for health, P6.55 for education per day
MANILA Regina Decangchon, 18, failed to enroll for the second semester in the University of the
Philippines-Manila because of previous unpaid tuition. Sadly, she may no longer go back to studying.
My parents can no longer afford to send me to school, Decangchon told Bulatlat.com.
There are more than 8,000 out-of-school youths like Decangchon who expressed fears that more and
more students will be forced to abandon their studies due to high tuition. State universities and
colleges are increasing tuition fees to survive because the government is continually reducing the
budget for social services like education.
On Nov. 29, Decangchon and other students, teachers, health workers and health professionals,
migrants and women linked up to show their rage at the swiftly approved 2012 national budget.
Calling the said budget as anti-people, peoples organizations under Kilos na Laban sa Budget Cut
and Coalition for Health Budget Increase marched from Espaa avenue to Chino Roces Bridge
(former Mendiola Bridge) carrying banners condemning the anti-people national budget.
It is sad that teachers and students have to take a leave from work and be absent from their classes;
that they have to march under the scorching sun all because the President is not listening to the call
of the Filipino people, said Prof. Ferdinand Bondami of Polytechnic University of the Philippines
(PUP).
On Nov. 22, the Philippine Senate approved the P1.816 trillion ($41 billion) proposed national
budget for next year. It was greeted by Days of Rage protest actions held Nov. 24 to 25 reportedly
to show disgust over the railroading of 2012 budget in the Senate.
But a week later, on Nov. 29, the national budget for 2012 was ratified by the Bicameral Committee.
It is now expected to be signed two weeks later, or by Dec. 15, by President Benigno S. Aquino III. If
that happens, it would be just the second time in 11 years that the succeeding years national budget
was approved before the current year ended.
In the approved 2012 budget, P30 million ($687 thousand) was heaped additionally to the budget of
the Department of National Defense (DND), as payment for a property of the Philippine Navy in
Puerto Princesa and another P25 million ($572,715) for reconstructing and renovating the General
Headquarters of the Armed Forces of the Philippines and buildings of the Philippine Military
Academy.
On the other hand, the budget for the Department of Health (DOH) was slashed by P224 million
($5.1 million). The budget of the Department of Labor and Employment was slashed by P91 million
($2 million). The budget reduced from that of DOLE was earmarked for operations of Filipino
centers abroad. Sen. Franklin Drilon said the Overseas Workers Welfare Administration funds can
be used for this instead.
Social services got P575.8 billion ($13 billion) or 31.7 percent of the entire General Appropriations
Act (GAA) chiefly for implementing dole-out programs, according to protesters. Economic services
got nearly as much, P438.9 billion ($11 billion) or 24.2 percent of GAA; debt servicing got P356.1 ($8
billion) billion, while defense got P113.1 billion ($2.5 billion).
Despite widespread protests, the budget remains in favor of debt servicing, profits, dole-outs and
the military. Meager spending for social services show that the 2012 budget is anti-people and far
from being a reform budget, said Vencer Crisostomo, national chairman of progressive youth
organization Anakbayan.
Impoverished services
Students complained about the impoverished education system in the country. Every year, the
government is reducing the budget for social services and the budget for state universities and
colleges. And every year, the system of education is becoming more rotten, a student said.
The health sector accused the government of President Benigno S. Aquino III of being heartless and
callous when it slashed the already paltry budget of public hospitals. Robert Mendoza, convenor of
Coalition for Health Budget Increase and secretary-general of the Alliance of Health Workers, said
budget cuts actually push for privatization amidst increasing incidence of illnesses and
inaccessibility of medicines, supplies, public health services among poor patients.
The Department of Health (DOH) budget for 2012 was slashed by P200 million ($4.5 million). There
are six hospitals in the National Capital Region (NCR) that got budget cuts for 2012. These include
Dr. Fabella Memorial Hospitals, National Center for Mental Health, Philippine Orthopedic Center,
San Lazaro Hospital, Tala Leprosarium and Las Pias General Hospital. There are also five other
hospitals in NCR and 18 more in the provinces that got no increase at all in the allotment for
Maintenance and Other Operating Expenses (MOOE).
If this is Aquinos straight path, then we should block this because it only leads to more illnesses,
suffering and untimely death among Filipino patients, Mendoza said.
Questionable priorities
When a mother budgets for her familys expenses, she instinctively knows the main priorities
these are education, food, house rent and utilities. Mothers know their priorities, said Joms
Salvador, deputy secretary-general of Gabriela. In the Aquino governments 2012 budget, this
common sense listing of priorities seemed reversed, Salvador noted. Instead of putting social
services on top, the Aquino government has done the opposite.
Gabriela denounced the approved 2012 national budget as essentially a reflection of the Aquino
governments neo-liberal policies of privatization.
The budget is anti-poor and pro-business, said Salvador. She explained that even as this budget
deprives the poor of their right to social services, the Aquino government is giving the private sector
much leeway to expand businesses in sectors defined under social services.
The approved national budget for next year also does not have a clear allotment for housing services
for the urban and rural poor, noted Gabriela. A minimal budget of P7-billion ($160 million) was
reflected in the budget of agencies on housing, purportedly for MOOE. But how this MOOE
translates in real life is hardly a cause for celebration. As currently practiced, the private sector is
contracted by the government to provide so-called low cost housing for relocated urban informal
settlers, Salvador said. And then it requires the relocatees to pay for housing far beyond their
means especially since livelihood or job opportunities are scarce in the vicinity of relocation sites.
The woman leader finds it ironic that urban poor settlers are being violently shooed away to far-
flung relocation sites while in the place of their demolished communities a housing purportedly for
the poor is being constructed.
The recent demolition of urban poor communities at the BIR Road illustrates how the government
hoodwinks the public into swallowing the line that it is alright to destroy the roof over the poor
peoples heads if they are not paying up, and then to squeeze out more money from them by re-
selling housing units to them for a much steeper price.
Gabriela rejected the Aquino governments emphasis on Pantawid Pamilya Pilipino Programs (4Ps)
coupled with budget cuts on social services, saying it will only worsen the plight of poor families.
The increase of Filipinos suffering hunger in the previous quarter should have forewarned the
Aquino government of the failure of such programs, but it even increased the budget for Conditional
Cash Transfer Program, Salvador said.
The government is not giving us what we need. Who will not fight for the peoples welfare?
Salvador asked.
Camp-out on Dec. 6
Groups under Kilos na Laban sa Budget Cut vowed to continue protesting the budget cuts. They
announced plans to camp-out at Chino Roces Bridge on Dec. 6. Crisostomo of Anakbayan said
similar actions are set to take place across other regions. Inspired by upheavals from the Arab
Spring to the European Strikes to the Occupy Movements, students, workers, teachers will strike and
walk-out from campuses, communities, workplaces and camp-out at Mendiola to rock the nation
with days of outrage and protests.