By MARYA SALAMAT
MANILA — “Health workers are some of the Philippines’s most self-sacrificing employees.”
Given the continuously shrinking share in the national budget for health compared to the increasing population that needs to be served, health workers — especially those in the public sector — “have been forced to work amid a perennial lack of equipment and supplies, high patient to health professional ratio, low salaries and inadequate benefits and hazard pay,” said Jossel Ebesate, chief nurse at the Philippine General Hospital (PGH) who is also secretary-general of Alliance of Health Workers (AHW) and vice-president of the All-UP Workers Union. PGH is under the University of the Philippines system.
In the Philippines, the bulk of employed health workers and professionals are in the public sector. But over the years, the effect of government neglect on health, such as low wages and deplorable working conditions of health workers, coupled with the government’s active labor export policy, have combined to shrink the number of the country’s employed health professionals and workers.
Health activists denounce low governor budget on health services. (Photo courtesy of Council for Health and Development)
The Philippines is now the No. 1 exporter of nurses. In the past decade, 85 percent of the total employed Filipino nurses are working abroad in 20 countries. Only 15 percent are working in the Philippines. And yet, nurses are indispensable in hospitals.
In a country where 7 out of 10 Filipinos die without ever seeing a doctor and where public health services are either lacking or are inaccessible, committed health professionals from nongovernment organizations such as the Council for Health and Development (CHD) and Community Medicine Development Foundation (COMMED) have been training volunteers who would like to become Community Health Workers (CHWs) regardless of their educational attainment.
According to Dr. Eleanor Jara, executive director of CHD, it is their mandate to bring health into the people’s hands. “This means, our health professionals and health workers go out of their way to reach underserved communities, organize health committees and train Community Health Workers. That way, the people themselves can prevent and cure common illnesses and practice First Aid even without government services in their communities,” Dr. Jara explained.
Along with conducting such training, the country’s health workers’ unions and alliances are actively campaigning for increases in the national health budget and with it, increases in their pay and improvements in their working conditions. This, they say, can also help prevent the “brain drain” in the country’s health professionals.
RP Seems More Inclined To Export Its Nurses
Nurses comprise the bulk of employed health professionals in the Philippines, even if their number is still inadequate relative to the need. According to Dr. Leah Paquiz, in a press conference of the Alliance of Health Workers (AHW), the Department of Health’s plantilla position for nurses remain pegged at 20,000 from 1985 up to now. This is not fully filled up.
In 2008 there were 27,000 employed nurses in the Philippines (compared to more than 80 million Filipinos) according to the National Institute for Health (NIH). Five years before, in 2003, locally employed nurses were 29,467.
Much of the decline in the locally employed nurses came from the government-employed. They decreased from 19,052 in 2003 to 17,000 in 2008.
The working condition and wage levels of the locally employed nurses especially in public hospitals are increasingly becoming deplorable as the budget allotted by the government continuously shrinks, Ebesate said. Under the health sector reform agenda, public hospitals are also increasingly being turned into “competitive” hospitals that can generate income and profits. Those that do not generate much income, such as small hospitals in provinces, have either been scaled back or closed down over the years.
In Isabela for instance, the government has closed down at least five district hospitals.
Nurses and health workers have been organizing themselves not only to have a collective voice in improving their working conditions but also to help improve the government’s delivery of health services. “That is the distinguishing feature of our genuine trade unionism,” Ebesate said.
Indeed, the AHW, for instance, and the All-UP Workers Union, have not only pressed for wage hike and increased budget for health but often engaged the government on issues related to the privatization and commercialization of hospitals. Privatization, they say, has made health services more expensive to mostly poor Filipinos.
Ignoring the Nursing Act and Magna Carta for Public Health Workers
Years of struggle for an increase in the public nurses’ salaries succeeded in 2002 when the previous Philippine Nursing Act was amended. It expressly stipulated that the nurses’ entry-level salary grade (SG) would be elevated to SG-15 from SG-10.
But this rise in salary grade was never really implemented. Amid the public sector employees’ continued calls for long-delayed salary increases, benefits and hazard pay, the Salary Standardization Law-3 (SSL3) was passed last year. It was touted to respond to the state health workers’ plea.