Lack of comprehensive solution to periodic dengue outbreaks decried

“Every life is valuable,” Remy Maltu, union president of the San Lazaro Hospital, said, adding that whether less or more are becoming afflicted today by dengue, the patients still need medical services which public hospitals are becoming more and more constrained to provide with cuts in their budgets.


Sidebar: Community health workers criticize government’s inadequate response to dengue

MANILA — Michael Hamor, 6, looked alright when he came home from school Tuesday last week, said his mother. But when night came he developed high fever. By Saturday, his worried mother had packed some of their belongings and brought him to San Lazaro Hospital in Manila because, she said, “there seemed to be more private than public hospitals in Cavite,” where they live.

In public hospitals like San Lazaro Hospital, the charity ward and doctors’ fees are free; it bills the dengue patients for the cost of IV fluids, and other medicines and laboratory procedures they may need such as antibiotics, X-ray and other laboratory exams including blood exams and bags of blood for transfusion.

Because the charity ward and professional services in public hospitals are free, more patients have been flocking to it. But in San Lazaro Hospital, for example, during outbreaks, patients like Michael have to share a hospital bed with another child dengue patient, Archellis Bolivar, 4, from Tondo, Manila.

A young dengue patient gives the bed he shares with another patient a break, while a ‘watcher’ takes a nap.(Photo by Marya Salamat /

In their room in the pediatric ward, most beds have two patients on it striving to find comfortable positions amid the cramped condition. And the dengue outbreak has only begun, based on the observation of the leaders of the San Lazaro Hospital Employees Association (SLHEA-AHW).

According to Ulysses Arcilla, 39, head nurse at this hospital’s adolescent ward and vice-president of San Lazaro Hospital Employees Association-Alliance of Health Workers (SLHEA-AHW), such is the situation in the hospital with the rainy season which has also come to mean a deluge of dengue and leptospirosis cases.

As of Aug 15, the 500-bed capacity San Lazaro Hospital has 144 dengue cases, up by a hundred in just two days, noted the San Lazaro Hospital Employees’ Association-Alliance of Health Workers (SLHEA-AHW). Arcilla said that leptospirosis cases seem also to be on the rise. Though not yet as many as the dengue cases, he pointed to their adult male ward where about four in ten patients confined now are suffering from leptospirosis.

In times of such periodic epidemics, the publicly operated hospital’s resources are stretched to the limit, the hospital employees union said. To better cope and to give more services to the public, they have been urging the Aquino government to increase the hospital’s budget rather than slash it.

Protesting the scant budget for too many dengue cases

“We remain steadfast in our duty to provide services to our patients afflicted with dengue. But how can we serve effectively if the government is cutting back our hospital’s budget?” asked Remy Maltu, president of SLHEA-AHW.

They protested with community organizations and the Council for Health and Development before the health department, last Wednesday, the public hospitals’ meager budgets and budget proposal for next year. For a 500-bed hospital, San Lazaro gets P322.08 million ($7.6m) this year, a third of which goes to maintenance and other operating expenses, P50-million ($1.17m) to mandatory expenses (electricity, water, communication, cooking gas) and P55.7 million ($1.31m) to medicines, supplies and procedures.

Maltu said this budget allots a measly P305 ($7.16) per patient per day for food, medicines, supplies and procedures. But even this amount is at risk next year, because under the health department’s proposed budget, San Lazaro’s will be cut by more than six million pesos to P315.7-million ($7.41m).

A public hospital’s pediatric ward at the start of a dengue outbreak (Photo by Marya Salamat /

Speaking for their patients, the health workers are worrying over the majority of patients coming to their hospital, because “it is they who would suffer more from the weak response to health by the government,” said Maltu.

DOH very weak vs dengue

“The DOH is exercising a very weak management over dengue,” Maltu told “Why does the dengue affliction grow worse every year?” she asked. She scoffed at the reporting that dengue this year seems not as worse as last year.

“Every life is valuable,” Maltu said, adding that whether less or more are becoming afflicted today by dengue, the patients still need medical services which public hospitals are becoming more and more constrained to provide with cuts in their budgets.

She doubted also the DOH tack of claiming that the cases this year seem not as worse as in the past. “Dengue has just begun,” the SLHEA officers said.

The health workers’ association accused the DOH of having “no comprehensive solution” to the yearly dengue problem. Malta said that is why the dengue outbreaks continue to happen.

If the DOH has a comprehensive solution to dengue, “we would have seen it even in bloodletting, but no, poor patients have to scrounge for bags of blood (for transfusion in worse cases of dengue), or pay for the ‘processing fee’ when they brought blood donors,” said Arcilla.

“Twin sharing” patients at San Lazaro Hospital (Photo by Marya Salamat /

A comprehensive approach on dengue should have meant preparing the hospitals, too, for the surge in patients. But as shown by the experience of patients having to share beds when the outbreak is “just beginning”, that is obviously not the case, said Maltu.

To public health workers, coping with the dengue breakout also stretched the capacity of the hospital employees, as their patients increased but not the employees’ numbers. This meant increased workload or increased overtime, not necessarily with pay.

Harassing health workers

The next time you see a picket protest of health workers calling for improvements in health such as higher budgets for public hospitals, look again because they have been doing it at pains or risks of being harassed by the management of hospitals.

Unfortunately, speaking for the welfare of the patients and the hospital employees could earn an outspoken union member the ire of the hospital management, which could result in various forms of harassments, the union said. “The management is harassing the health workers against holding such activities. ‘Do not be active in the union’ or they will pick on you at work,” said Arcilla. He admitted that some of their members get terrorized by such threats.

In fact, as the SLHEA-AHW is pressing the government to increase the hospital budget for the sake of its patients and for a more humane working condition of its workforce, the government through the hospital management has been leading efforts to divide and deceive the employees. According to Maltu, a management-led effort to challenge their employees’ association before the labor department is afoot.

Maltu said the SLHEA-AHW is about to start negotiations for a new CNA (Collective Negotiated Agreement) with the hospital management, but it has to be postponed now after the management-led supervisors and some of its doctors have, for the third time, made some of the employees sign petitions for certification elections challenging the status of the SLHEA-AHW as the employees’ sole bargaining unit.

The officers of the challenging minority reportedly came from management-level or supervisory level employees in the hospital. Aside from the SLHEA-AHW, other hospital unions are now facing the same from DOH-instigated or hospital management-led formation of unions. “They are promising the health workers thousand of pesos in incentives which they could not really give,” the AHW said in a statement last June. The alliance has, in fact, been struggling for an increase in pay of health workers and professionals over the years, but the government has yearly responded with budget cuts and partial privatization.

As these developed, health workers from different public hospitals, such as San Lazaro Hospital, are demanding P90-billion ($2.12b) for health budget for 2012, twice the proposed P44.4-billion ($1.05-b) proposed by the Aquino government. The health workers said the “alternative budget will cover increases in allotment for maintenance and other operating expenses, as well as additional plantilla for health workers for all public hospitals nationwide. (

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  1. kung ang gobyerno ay walang ginagawa para sa ikabubuti ng ating mamamayan then magsama sama tayo na tulongan ang ating kababayan sa abot ng ating kakayahan, sa ganitong pamamaraan ay maipakita natin sa ibang bansa na tayo ay di puro pagkomento ang ginagawa, may aksiyon din po tayo. salamat po. jovy lang po ng anakpawis…

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