November 13, 2015
Woke up at around 1230PM to find out that the 2PM schedule had to be moved to 4PM. I informed the client. I left the house at 230PM. Traffic was so bad I reached Shaw Boulevard at 415PM. The client waited for more than an hour.
We got to the clinic just as the doctor arrived. There were other patients waiting already so we had to wait. Finally patient N was asked to go into the doctor’s office. It was a short consult when the doctor called me in. Patient was being recommended for confinement. We were asked to decide where as the patient had no enough financial means to go for a private hospital.
I told the client to ask his friend to go home and get his things, instead of the client going home and then back to the hospital down south. We had to transfer to a nearby Starbucks where I waited, Good thing
@arkipoz also happened to be at the ciinic and he waited with me while the client waited inside the car to rest. @edbusim was on his way, the friend was stuck somewhere since traffic, as always, was bad. @edbusim arrived. We had dinner and shortly, the friend arrived. We were soon on our way to the hospital. Shaw boulevard. Mandaluyong. Edsa. Expressway. We got there, finally.
I had to drop the client off right in front of the E.R. The short walk he had earlier when he crossed the street to have dinner dropped his oxygen saturation/status to 51. We didn’t want to take the risk of asking the client to walk all the way from the parking area. I parked and went back to the E.R. I was surprised because they said there weren’t any isolation rooms available with three other pending patients waiting at the E.R. All the time we were talking to the nurse at the desk near the E.R. door. The doctor walked over, read the referral form and left. The nurse was saying since it was a case of PCP, he was suppose to have an isolation room–which they didn’t have.
@edbusim and I went out to call hospitals. @edbusim called San Lazaro. He got through the E.R. line, and was transferred to the Pavillion 6 line. He was referred to the Infectious Disease line where he was told that the E.R. will decide whether or not patient will be admitted. We decided to go there.
We got there before 1 in the morning. Dropped them off in front of the E.R as I parked. I got back and I was told it’s a no go. No f*cking way, I told myself. They kept saying the patient was endorsed to the South, so they cannot take the patient in for admission. To add to the stress, the boyfriend came with his two girlfriends– all drunk. Breath, I told myself. It took a lot of prodding but the doctor eventually gave in, he allowed the patient to be admitted.
@edbusim and I finally went home at around 4 in the morning.
The Central Culture
One particular practice we noticed at this hospital was that there seemed to be a “normal” take of HIV. The med students asked the boyfriend if he too, was positive. The doctor asked me and
@edbusim if we were positive. @edbusim had an interesting theory that they are in this ideal balloon where in their universe, HIV is but a common infection. Like rabies, tuberculosis or pneumonia. Well, we had to come up with that theory rather than be stressed with what already was a stressful patient management system.
Health Management in the Philippines
One would wonder why such difficulty to have someone admitted. I mean, this patient had an oxygen sat of less than 70 and no one at the first hospital bothered to check. The 2nd one did but only after x-ray. There seems to be an air of “my patient, my hospital”– very territorial. But when life is at stake, when does this all end? Or If I were someone “popular” in the community bringing someone in for admission, would I be declined?
Is this the first time?
No, the same hospital down south rejected a patient a few months back due to the same reason, there weren’t any bed space available. The patient ended up walking along Kamuning when he finally called me up. We got to refer him to the general hospital in Quezon City. Long story short, he died in two weeks.
I am not making any generalization, my experience may have been specific to mine alone. But how many “my experiences” will have to be re-enacted until we finally have a better health care management around here? It’s sad, it’s frustrating since I knew that if I were to be in the patient’s shoes, I know I would have just gone home instead. It’s sad but this is what happens. I know of at least five hospitals who have declined patients due to a variety of reasons, two of which were simply because they were HIV positive.