Monday, July 13, 2009

My Wife, Myself and the Prince of Wales Hospital

(Our continuing adventures at the Prince of Wales Hospital)

I am no stranger to hospitals having inhabited several of them myself, on one occasion it was for a period of two months. At one time or another I have broken both legs, crushed my right foot in a motorcycle accident, broken fingers, most of my toes and my nose, three times. Therefore, I am no stranger to pain, distress and blood, both my own and that of others.

In the late 90s I worked part time as a Dive Master and as such had to undergo Medic First Aid training; at one time I was even a MFA instructor. It was while I was working as a Dive Master that one of the novices under my care managed to hit himself over the head with a scuba tank. It was quite fascinating and it all happened so fast I am unsure, to this day, how he actually did it. At the time I was tempted to ask him to do it again so that I could see how it had happened, but I didn’t think he would appreciate the request. Fortunately it was a minor scalp wound but like all scalp wounds it bled profusely. Since then I have assisted accident victims on numerous occasions without any squeamishness or trouble on my part. It is therefore a problem for me when I become completely unglued when dealing with the staff at the Prince of Wales Hospital.

My readers will know from my previous work that my wife, Quirina, is a dialysis patient. A few weeks ago 'Rina phoned me from the hospital to say that she was unwell and asked if I would pick her up after her dialysis exchange. I duly did so and took her home where, she told me that she was going to have an early night. It was the following morning that 'Rina complained of chest pains and I immediately took her to the hospital. This is where things started to go wrong and I have come to realise that there is some mystical, perhaps esoteric juxtaposition in the relationship between 'Rina, myself and the Prince of Wales Hospital.

The journey from our home to the hospital is one that we have made countless times. We found a taxi outside the village and I gave the driver the location in Cantonese. “Wai yee see”, (The Prince of Wales Hospital) and “yat lao”. Yat lao technically translates as 1st floor but where hospitals are concerned is a euphemism for Accident & Emergency (which are always on the ground floor so that ambulances can offload patients quickly and efficiently). It never occurred to me that this driver didn’t know that and on arrival at the hospital he took us up the vehicular ramp to the 1st floor. I then had to virtually carry 'Rina through the lift lobby down to A & E where I sat her down on a chair at the triage station and then went to complete the admission procedure. There was only one reception window open and before me was an ambulance attendant who was registering on behalf of an accident victim he has just brought in. Apparently the poor victim was unconscious and therefore unable to assist with any of the usual questions. All the attendant had was the fellow’s identity card; there was no proof of address and no contact details for the next of kin, all vital information to the procedure. Meanwhile there was 'Rina sitting in the triage station clutching her chest.

Finally it was my turn. Having been through this so many times I knew exactly what was required. I presented 'Rina’s identity card and $100, the admission fee for local residents. Nothing more was required because they already had her records in their computer. Just to be on the safe side, however, the clerk asked me the usual questions about address and telephone.

Now you have to remember that here we were in the Accident & Emergency area of a hospital, my wife was at the triage station in full view of the admission desk, obviously in distress, and I was hopping from one foot to the other waiting for something to be done. It was at that point in time that the clerk asked me, “Do you want to see a doctor?”

I was silent for a moment, unable to be sure that I had actually heard the question. Several responses came to mind, for example: no, I’d like a pint of beer and a packet of crisps, or, no, I’d like a Big Mac and French Fries. Eventually however, my response came in the form of a question that was aphoristic in nature and I will leave the reader to imagine what it might have been. The clerk turned pale and handed me the paperwork.

'Rina went through triage in record time. As soon as they found that she was suffering chest pains they pulled out all the stops and she was seen within moments by the house doctor. She was X rayed, had an ECG, blood samples were taken and she was warded within less that 30 minutes. 'Rina was good hands. I, on the other hand, was a blithering wreck.

Thursday, July 2, 2009

The cost of ill health in the Philippines

Guest Commentary Published: May 12, 2009 by UPI Asia

Hong Kong, China — I am not a frequent visitor to the Philippines; I visit once every two or three years, despite the fact that my wife and I own property and a house in Cebu City. On every visit I notice an improvement in the country’s infrastructure. The roads, the communications and the public services have all improved over the years since my first visit in 1983.

Unfortunately, this cannot be said for the country’s health services to the needy, or even for those in the provinces who could afford them.

On my first visit, I was taken to my father-in-law’s farm in the hill provinces of Cebu; Bulak Dumanjug in those days was a village that ran less than half a mile along a dirt road. There were a general store and several small shops that sold daily-need items. There were no communications, and transport to and from the village was by a jeepney that did two trips a day – when its wheels were not falling off, that is.

There were no health services apart from the so-called witch doctors, who diagnosed every illness as having been caused by a spirit. For a few pesos they were willing to bless a candle, the burning of which would drive the evil out.

On the evening of my first day, relatives carried in a young man who had a cyst on his hip and asked me to help him. The cyst was by this time the size of a tennis ball. Although I was not medically trained at that time – I later went on to become a first aid instructor – I could see that hot compresses could reduce the swelling until the puss was extracted.

If there had been no doctors for miles around I might have been willing to at least try something. However, even today I would not be willing to risk a person’s life in the knowledge that there was, in fact, a doctor in the vicinity. Why did they not call him, I asked? The answer, even today, leaves a sour taste in my mouth. The doctor would not come, as the patient had no money to pay him.

I will pay him, I said, still unable to come to terms with the fact that a medically trained physician, who had taken the Hippocratic oath, refused to treat a person because he could not afford to pay him. I will pay him, I said, but I had no intention of speaking with him or even acknowledging his existence.

In a short while the doctor arrived. He was a young man who carried his equipment and medicines in a black leather bag. When he arrived, the first thing he did was to take his fees and only after that he looked at the patient.

It was a quick operation; an incision to drain the puss, suturing, bandaging and a few pills to ease the pain. The patient healed quickly and within a week was back on his feet. What is terribly sad is the fact that even today, despite all the roads, electricity and televisions, there are still scant medical services available in the hill provinces of the Philippines, and the few available demand payment first.

On a later visit, my wife and I went to the only hospital in the seaside town of Barili, a beautiful little town that has retained a great deal of its Spanish influence. The hospital is on the outskirts of the town. The person we went to visit suffered from diabetes and the disease had caused gangrene in his leg, which had to be amputated.

By the time we visited he had recovered from the operation and was sitting up quite cheerfully in bed. He was grateful for our visit and we spoke for some time. During the discussion a nurse came in to give him his antibiotics and it was then that the patient’s wife unlocked the cabinet beside the bed and withdrew the medicine for the nurse. The nurse administered the injection and returned the unused portion to the wife, who locked it up and went away.

When I asked why the medicine was locked up in the cabinet, the wife explained that patients had to supply their own medication. Was it not supplied by the hospital, I asked? It could be, came the answer. But the quality and supply is unreliable and so it is better to personally get it if one can afford it.

This is the state of healthcare in a country where the rich and famous, who travel in chauffeur-driven cars, accompanied by minders and government officials of the health department travel overseas to conferences in which they seek international aid for their health schemes.

It is almost 26 years since my first visit to Bulak Dumanjug. The road is slightly better, with fewer potholes, and villages have electricity by which to watch television. But there are still no medical facilities, no doctors and no clinics. Yes, the jeepneys run more frequently and can transport a sick person to Dumanjug, the nearest town, or the hospital in Barili – but only if one has the money.


(Stewart Sloan works for the Asian Human Rights Commission. He is the author of three works of fiction based in Hong Kong, where he has lived all his life, and a collection of anecdotes about the Royal Hong Kong Police Force, whom he served as a civilian for 11 years. His connection with the Philippines spans 27 years, thanks to his wife, Quirina, who was born in Cebu. His recent interest in the country has focused on the extrajudicial killings that have been a feature of the Arroyo regime).