Salamat po, Doc (at Nars)!


BELOW THE LINE

By AMBASSADOR JOSE ABETO ZAIDE

Ambassador  José Abeto  Zaide Ambassador José Abeto Zaide

When was the last time you said, “Thank you” to your attending physician?

The best reason to increase subsidy for our hospitals and medical facilities is the when we are taken ill. When we are in the pink of health, we take for granted our vim and vigor and we go on our merry ways, forgetting what keeps us in state of health.

It takes being bed-ridden ...or being locked down…for us to brood about important things…like appreciating those who keep us in state of good health.

In the interregnum and in between the long open space of doing nothing… thanks to coronavirus… I got a telephone call from my classmate Oscar Violago, who said that we owe the frontliner doctors and nurses a debt we can never repay.  He asked, “How do we make known to everyone that, when the world stood still, there was a corps of men and women who braved the outside world to bring succor to the sick and to the needy?  When we could not…would not venture outside our homes?”

Oca said that we should recognize these hardy souls who responded to succor, often at most difficult and the most challenging hours. They have been doing this, and we have become universally aware of their dedication, only now.  It was all in a day’s work.These frontliners do their work with confidence and dedication…at great risk to themselves…and sometimes even to their own family.

Oscar says that money cannot buy the accolade that spontaneously breaks to recognize their sacrifice.  But he wants to catch the moment.  We all recognize those who brave and risk everything to save us against coronavirus. With a prayer that this calamity will not be upon us again, he said that these men and women are our “heroes of the century.”  He said that, more than our applause and cheers, perhaps our country should come up with a testament for our frontliner heroes and heroines so that our country would never forget what they have done for us.


I give my space to Senator Ralph Recto, who recalls the blood, sweat, and tears that go into our pursuit of medical care.  He recalled a medical diploma on a friend’s home “that is worth as much as the Manansala next to it.”  (And that is even before adding up the years of training and specialization, including periods of unpaid OJT.)

Senator Recto says that of our 130,000 licensed doctors, 70,000 are in active practice. This translates to one doctor for every 33,000 Filipinos.  But this ratio is skewed by the concentration of doctors in cities. The higher the poverty incidence, the fewer doctors. Which means that parts of the country are in virtual limbo.

The Department of Health tries to remedy this with a Doctor to the Barrios program.  (Akin to Jesuit vow of poverty; but we cannot depend on “missionary doctors to attend to the last, the least, and the lost.”)

RoI: State medical colleges are tuition-free, and other fees are affordable.  But since these are not the only costs to medical education, Senator Recto introduced Senate Bill No. 1530, the Medical Scholarship Bill.  It establishes scholarship for deserving Filipino scholars, premised on egalitarianism: becoming a physician is a function of intellect, not how much your daddy is worth. It enables the best and the brightest from the lower social rungs to become doctors.

The bill has two objectives:  The first is the One Town, One Doctor formula.  A scholarship program for the upper 30 percent of a graduating class of pre-Med course.  One medical student scholar per town: Scholarship covers tuition, laboratory, miscellaneous fees, textbooks, supplies and equipment; clothing and uniform allowances; traveling, subsistence and living expenses. (If no one from a town qualifies, the slot is given to qualified scholar from another town in the same province.)

RETURN ON INVESTMENT.  On graduating, the scholar returns to serve in his town for four years.

Second objective of the Medical Scholarship Bill: to finance the training of doctors.  Tertiary education will breach P100 billion in 2020; P38.9 billion for the free college program; and P73.7 billion for the operation of SUCs.  We should include the study of medicine among priority courses.

FACT: For 2020, DOH’s medical scholarship budget is P167 million for less than 2,000 students in eight SUCs. Many agencies are vital to democracy. But why are medical scholarships categorized as nonessential or add-ons? Consider some expenditure:

  • 6 billion Intelligence and Confidential Fund.
  • 1 billion Travel Fund.
  • 2 trillion Personal Services budget.
  • Philippine Military Academy spending P4.2 million to produce one graduate.
Commenting on that last entry, Senator Recto says that for half the cost of PMA scholarship we could graduate a doctor from the “Philippine Medical Academy.”

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N.B: The top 10 countries with the most doctors per capita are: Qatar (77.4), Monaco (71.7), Cuba (67.2), Greece (54), San Marino (51), Spain (49.5), Austria (48.3), Russia (43), Norway (42.8), and Georgia (42.7).  Qatar takes the first place with 77 doctors per 10,000 inhabitants, mostly with expat doctors. The next batch of countries to complete the first 20 are Georgia, Lithuania, Portugal, Switzerland, Andorra, Belarus, Sweden, Netherlands, Germany, Bulgaria, and Argentina.

The Philippines didn’t make it to the list, not even among the first 20.  Even in the ASEAN ledger, we do not come out No. 1: Brunei (1.8), Indonesia (0.4), Cambodia (0.2), Laos (0.5), Malaysia (1.5), Myanmar (0.9), Philippines(1.3), Singapore (2.3),Thailand (0.8) and Vietnam (0.8). Singapore, Brunei and Malaysia come before us (after taking importing foreign doctors and nurses).  But our doctors and health care givers would be exponentially far higher if we count the number of doctors and nurses we send to USA, Europe, and to the rest of the world.

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The logical partner program to Senator Recto’s program for doctors is a recruitment program for nurses.  Where is the doctor able to operate without a good nurse? Our nurses are the job multipliers. Nurses are the natural helpmates and partners of doctors.  (My Tiya Fina was able to give prescriptions just listening to her two doctor nephews.) In my first foreign posting to Bonn, I had an cyst removed by a freshman doctor, who operated on me following the instructions of the head nurse.)

Nurses and health workers are seen today to spend the most critical hours doing what they were trained for.  They are the tender loving care that has become the sobriquet of Philippine medicine.

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