by Faith Joan Mesa
He was lying on the steel, cold
stretcher-bed only weakly able to move the right side of his body.
Luckily, his speech was not affected unlike most patients I get to see
on a regular day at the Philippine General Hospital Emergency Room who
come in unable to articulate their pain.
His wife said he found him
inside the men's room slumped in the toilet seat. He felt dizzy and
had a headache after walking for hours to 00 his medical benefits,
rather unsuccessfully. He had previously suffered a stroke and wasn't
able to work since then.
After a brief yet thorough
examination I confirmed their worst fear that he had another stroke
and will need a cranial CT scan immediately. I knew they would not
afford the steep cost but I still urged her to find the means to pay
(It will be my headache if she doesn't). I handed her a prescription
which she held nervously in her hand and begged in a soft voice, "Doktor,
wala ho kaming kadala-dala P50 na lang po pamasahe pauwi. Maawa na po
kayo," And tears started rolling down her cheeks.
I've heard the line uttered a
hundred times before but at that particular moment I had to suppress a
tear that started to swell in my eyes. Instead I heard myself sigh.
The same month last year I was
in Parang, Maguindanao, one of the sites of massive evacuations
following military assault against MILF rebels. Numerous families
found themselves spending cold nights in makeshift tents in classrooms
and unfinished gyms with meager belongings. During the medical mission
one child was referred to me.
He had been febrile for the past
three days and suffered a chill the night before. He lies sideways to
share the limited cemented stairs in Plaza Gym, Parang, Maguindanao
with his sister who is also running a fever. His mother cuddles his
younger brother in soiled linen who keeps on having watery stools.
Unmindful of the flies feasting on wounds on his head, he slips to a
probably dreamless sleep.
Children aged 2-6 years old are
the most vulnerable. The Lanao mission found that they usually suffer
from communicable diseases such as upper respiratory tract infection,
diarrhea and even tuberculosis. When people evacuate to temporary
shelters or evacuation centers, overcrowding, poor health and sanitary
conditions facilitate the spread of many diseases. Diarrheas and
dehydration, measles and respiratory disease account for the majority
of deaths while in temporary shelters. However, in the evacuation
areas visited no deaths were reported.
The Cotabato mission similarly
found that the common diarrhea was significantly higher ill the 0-4
years of age. Some of the potential factors, which can contribute to
these findings, are poor hygiene practices, inadequate water supply
and poor breastfeeding practices. Most of the pregnant women do not
have sufficient knowledge on breastfeeding.
Symptoms of headache, difficulty
in sleeping, behavioral problems among children may point to post
traumatic stress disorder or anxiety disorders. The trauma experienced
by children creates deep rooted feelings of helplessness and
undermines the child's trust in others. In evacuation areas in Pikit
and Parang, children were still in the stage of denial. Anger,
frustration and fear, which pervade their consciousness, were clearly
expressed in their drawings. If these emotions persist, severe
psychological scars, social isolation, violence and reduced creative
potential may result. Thus, there is a need for short and long term
intervention in this area. This issue was not satisfactorily addressed
during the Lanao mission.
That day my superior remarked,
"Ako naniniwala na dapat magbayad ang mga pasyente sa mga
laboratoryo." Would he have uttered these words to my patient's
wife or to the countless other patients who literally sell their most
precious belongings, just to bring their patients to an institution
they believe can care for their needs? Sometimes, it may just be too
easy for health managers who sit in the comfort of their swivel chairs
to decide on the fate of our poor patients by brandishing figures and
What my experience in Mindanao
has taught me still rings true. Primary and preventive health care
even at the remotest and poorest village must taken care of.
Development and peace will only be brought forth by healthy