Saturday, January 26, 2008

Cheaper Medicines Bill

Everytime I call my mother and ask her about her health, she would complain to me not because she suffers from anything, but because of the cost of her medcines for hypertension, asthma, hypothyroidism and elevated cholesterol levels. All in all she spends 300 pesos a day for medicines only. That amounts to 9,000 pesos a month. She once resulted to taking them every other day just to save money until I found out about it because her blood pressure was not controlled after two months of medication. Since then I made it a point to check on her and count her medicines when I visit. I make sure that she has the exact number of tablets so she wont crimp on taking them.

With the cheaper medicines bill, my mother said its about time that such law is passed. But I doubt if the cost of her midicines will change since all her medicines have no generic counterparts. With all the medical conditions she has with their side effects being balanced out by the other, the danger of passing the decision of which drug to take to the user becomes a recipe for disaster.

Is this the real answer to the health problem of the country o pampapogi na naman ba ito? I work in a government hospital. I see indigent patients who cannot afford even the cheapest available medicine like a one peso paracetamol. Patients who cannot afford an intravenous set and fluids for hydration that would cost around one hundred fifty pesos. Government hospitals run on empty. Personnel make do of what is available and resign helplessly as they lose their patient because they cannot do anything else.

The Philippine government's budget for health is one of the lowest in the entire world. Government hospitals do not have provisions for free medicines. Only a small portion of the population has health insurance that do not cover for catastrophic cases.

Health has never been a primary concern of the Philippine government. It only looks upon it on outbreaks where endless witch hunts are conducted by the media to find faults on almost all personnel.

The congress has not spared the health sector. In fact it is its favorite scapegoat when they want to make papogi. Time and again it issues punitive laws that does not have any logic enough to look at the actual situation of the country's health delivery system.

Take for one, government hospitals cannot add personnel unless congress makes a plantilia or opens a position for a new doctor or nurse. A ward for sixty patients is usually manned by one doctor, one nurse and one midwife. And yet congress occupies itself with bills that seems self serving to its constituents, who are owners of generic drug distributorships or those being lobbied by multinational companies.

The honorable congressmen argues that the same brand manufactured in countries like India and Thailand cost a hundred times cheaper that the ones here in the Philippines. Point well taken. I want to know why? Is it because of the tariff paid by these companies to the government? Is it because of the cost of advertising? Is it because of the added cost of doctors junkets?

The innovative vaccine prevenar costs the company wyeth P320 to manufacture. Before it was marketed in the Philippines, the company already recovered all its overhead for research from marketing in first workd countries. Here, it is marketed to the consumer between 5000 to 6000. The difference from hundreds to thousands in cost benefits the manufacturer, the distributor, the doctors and most of all the government. With all the taxes the manufacturer, the distributor and the doctors have to pay, the government gets half of that final price.

I dream of a time when I dont have to consider cost when I am treating a patient. I dream of a time when I dont have to worry if I get paid or not, but rather enjoy the beautiful profession of healing. But that is just a dream here in the Philippines. Here you don't just heal, you become a counsellor, a social worker, a philantrophist, a charity foundation donor. And most of all a scapegoat for a governments inadequacies.

I look at the receipt after buying my mother's months worth of medicine. I cringed at the cost. There was VAT. I paid 900 pesos to the government for keeping my mother healthy. What do I get in return from the government? A bill prohibiting me from using experience and what I have learned in treating my patients.

Tuesday, January 22, 2008

Matters


I thought I have been strenghtened by all those years in training seeing premature babies die. But each new one becomes my son or daughter and as I guide them through the rough road of the first days of their lives, they become a part of me. And it still hurt seeing some of them go.

Today I lost another one after a long battle with difficult feeding which turned out to be an obstructed bowel, he underwent an exploratory laparotomy. He was doing fine the first two days, but a hospital acquired infection set in quickly and spread like fire burning paper. The medicines could not alter the course and in four hours, he succumbed to death. I admired most his mother who despite two abortions and a neonatal death, she was calm and composed. It was me who wanted to cry. I have lost another one. I have another angel in heaven. I hope my angels would all help me now so I can save the lives of their brothers and sisters to come.

Friday, January 4, 2008

Happy New Year from The Next Big Thing - Bukidnon






It has been a back breaking trip, driving through the roads of Mindanao. One time you are surrounded with paved roads and bustling vehicles the next you are stuck in long stretches of coconut plantations or rice fields as far as your eyes can see. It's amazing now when I think about it how many mountains we traversed during this travel from Zamboanga City to Davao City. There are roads that curve around mountains and there are those that cut through the mountains. The coast line is breath taking much more if seen on top of the mountains. It's like an ancient road trip where you see the view of a city emerging like an oasis from tops of mountains, from a blind curve over the hill, from rolling plains and winding roads of a plateau.

Of course, the best place in Mindanao, hands down is Bukidnon. If I am to be given a choice, I would not think twice. It has the almost perfect weather like Baguio. It has the rich fertile soil. It is quiet. It can be busy if it wants to. Without even trying, it is a piece of paradise cut off by its steep roads from the menacing clutches of modernization. Alas the roads are already built and slowly development and commercialization are threatening to spoil this last peice of paradise.

I suggest a visit as soon as possible and enjoy. Recommendations include:

1. For good coffee and pastries if you are longing for home after a long trip, go to Mint Leaf. Tucked away on the end of a side street in Malaybalay. They serve coffee and lemon squares and a ambiance to match.

2. The best place to stay is the Pines Hotel on the Malaybalay main road. The walls are filled with works of modern Fiilipino artists. The interiors are a blast from the eigthies but a good place to stay with running hot water. Try their restaurant which serves good pork ribs and steaks.

3. The Catholic Church on Malaybalay, built like a huge barn. Dedicated to San Isidro Labrador. Across is the city park.

4. The Monastery of the Transfiguration. Perched on top of a hill. Designed by the National Artist Leandro Locsin, the Church stands as a pyramid amidst the background of green lush fields and mountains. Home to the famous designer turned Benedictine monk, Noli Hans. You will be thankful going there and start believing again. The monks sell organically grown strawberry, coffee and peanuts.

5. The famous Sumilao farms. Home to farmers who walked from Bukidnon to Manila to ask for their rightful ownership of the land they till.

6. Del Monte Clubhouse in Cawayanon. They have a reputation for serving the best steaks. You will forget you are in Mindanao and think you are in Camp John Hay.

7. The roads are the best for a pleasant road trip. Except for the slow moving huge trucks the ride over roads that dip and rise and over tall bridges with fantastic views of gorges, waterfalls and mountains is worth it.

8. The road from Bukidnon to Davao. Not as zigzaggy like Baguio but almost like it. With clouds drifting by the car window as you pass by children lined along the road with one hand outstreched asking for money.

In the next few years, as the politicos are snaring investors into the area, these places will drastically changed. As with Boracay and Bohol, I bet progress will go unchecked and what this beautiful area has now may change forever. So go now and enjoy while it lasts.
The International Breastfeeding Symbol

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