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Philippines 2019: Healthcare is a Privilege

(Charlene) As I see it, health care is a privilege.


Every interview I conduct with a patient, there is always a point where they turn a blind eye to their progressing
increase in blood pressure, a worsening wound on their feet, an eye literally turning more blind by the second, just
for them to be able to put something on the dining table every meal.
Our usual reaction is usually to be upset, sometimes even question the patients for their poor judgment of their
situation and their decision to forgo treatment until the 11th hour.

(Mai) “Why just now?”


“Why did you let it get this bad?”
….consulting only when they are about to lose a limb, only have half a lung, lose a liver or worst - balancing on the
scythe of death itself.

(Ian) But if we look at this closely – the problem does not necessarily lie on the sick, but on a much bigger issue,
one that three weeks of intravenous antibiotics will not be able to cure.

(Stephanie) Health care is an important determinant in promoting the general physical and mental health of
people. However, in the Philippines, being a 'developing country', the issue facing the field of medicine is the case
of accessibility. (Kae)This is caused by rampant horizontal inequalities in the country such as unequal access to
assets and employment, with most people in the country falling under the 50% of the population which do not
contribute to the economy - most of whom incidentally are victims of this inequality.

(Theeya) Did you know that six out of ten sick Filipinos die without seeing a doctor? Six out of ten.
This brings me to a thought, can you afford to get sick? For us Filipinos, the question becomes quite literal.

(Hanani) The secondary effects of capitalism - keeping the elites economically safe but the rest sitting on financial
uncertainty. In healthcare this means most of them sitting, waiting for their looming, painful and tragic
death. (Ian) A stark contrast to Bimby Aquino's little headache being treated aggressively and instantly while
about 2 million indigents will choose to be able to eat twice a day instead of seeking help for their chronic
diseases that they try so hard to ignore.

(Jenny) Moreover, the reported budget cuts for healthcare in 2019 further exacerbates this issue. This then makes
it apparent that the issue of accessibility is also added to personal financial incapability, corruption and clear lack
of financial prioritization from the government.

(Jhicel) Patients in the Intensive Care Unit come and go, most of them go - not because of death - but choosing to
die without a bill or without a debt that ticks ever so increasingly under their hospital bed whenever they receive
treatment.

(Stephanie) They choose to die.


Let that sink in. Choosing to die because one doesn't want to burden their family financially or physically.
Seeing themselves as living tumours - pabigat.

(Joshua) They choose to die in their house, slowly and painfully, even if it’s against their doctor’s advise. It is
called HAMA, or Home Against Medical Advice. It’s always an awful thing to see, knowing that death is just
around the corner, waiting. But you know what? those who get to see an intensive care unit consider themselves
lucky enough to be able to.

(Charlene) The problem of accessibility runs deep, however. It doesn't only lie on the financial or moral choices of
patients regarding their treatment but extends far into the healthcare system and its limitations.
(Danah) The Philippines, unfortunately, has a doctor to patient ratio of 1:33,000. One in every rural municipality.
Imagine that. Also, the Philippine Medical Association (2016) stated that there are about 130,000 licensed
physicians but only 70,000 are active in profession, the deficit being caused by these medical professionals turning
to nursing and working overseas.

(Rachelle) Imagine, being sick, along with your whole barangay of three hundred people, and with some, needing
much more attention than you do.

(Theeya) Being immersed in this field, it’s ironic, that though I fight for everyone’s right to their own health, I
understand when they choose not to have it. That dying is just the easier way to go. Isn’t that sad?

(Joshua) Over 1000 clinics and hospitals has closed over the past decade due to the shortage of personnel and
funding, most of them in rural parts of the country…. in contrast to the increasing number of 7-elevens. This has
led to overcrowding in hospitals with rooms reaching overcapacity and patients sleeping in beds situated in the
hallways.
(Danah) Some people cannot sleep at night without closing their bedroom doors – but these people, sick and
incapacitated, are sleeping outside doors, in the hallways… let that sink in.

(Kae) The ethical imperative of health care is then to allocate necessary resources and opportunity as equally as
possible to all individuals under their care. (Hanani) It is important not to be misguided with this as purely even
distribution of resources, but rather the complex balancing act of giving each individual as optimal of care as
possible with the most efficient minimization of the resources necessary to do so.

(Mai) This… this is more than just a narrative, more than just a rant to all who are here right now. This is an eye-
opener, a promise, an encouragement.

(Jhicel) Us, the aspiring doctors to the underprivileged, underserved communities,

(Rachelle) fighting for a new generation of health care,

(Charlene) aiming to usher in health that is not a privilege but a right and necessity that every single person in this
country can access.

(all) Maybe you are one of us.

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