Fabella ‘modernization’ feared to worsen maternal death rate

‘It is the government’s Constitutional responsibility to improve, develop and modernize public hospitals and public health services. But for the service of the people, and not for profit-oriented investors.’


MANILA – Sixteen-year-old Jolina, a first-time mother, still feels weak after delivering her baby at the Dr. Jose Fabella Memorial Hospital in Manila. But after three days in the hospital, she and her newborn are finally going home to Taguig City. They paid P1,500 ($33.22) for her hospitalization.

Dr. Jose Fabella Memorial Hospital, popularly known as Fabella, is a 90-year old maternity hospital that delivers almost a hundred babies per day. Dubbed as “baby factory,” Fabella is a tertiary maternity hospital preferred by the poor. For women like Jolina whose husband is jobless, she said she delivered at Fabella because of its relatively affordable services.

But what awaits poor families when the only affordable maternity hospital is modernized and the cost of giving birth becomes more expensive?

“The poor would become even more pitiful,” Jolina told Bulatlat.com.

Fabella is another government hospital to be “modernized” under the administration of President Benigno S. Aquino III. Although Health Secretary Enrique Ona said there is no final decision yet on implementing Fabella’s modernization, various progressive groups have opposed the said modernization.

In June 11 last year, the Department of Health (DOH) has bid out the modernization of Fabella for P743 million ($16 million), according to the Alliance of Health Workers (AHW). The winning bidder, J.D. Legaspi Construction (JDLC), has done projects with government such as the allegedly overpriced President Diosdado Macapagal Avenue.

In an article, Health Undersecretary Teodoro Herbosa said the modernization of Fabella would mean more beds, more equipment such as ultrasound machines, incubators, and ventilators for infants and more jobs for doctors, nurses, and other health workers.

But contrary to Herbosa’s claims, the modernized Fabella, which would be transferred from its current location in Sta. Cruz, Manila to the DOH compound, will only have 400 beds, based on data gathered by the Alliance of Health Workers (AHW). Bulatlat.com tried to confirm this with the DOH media relations office which referred us to the National Center for Health Facilities Development, which in turn told us to call the Fabella hospital, which unfortunately, has not yet answered any of our calls.

Fabella has 700 beds and often, two mothers share one bed with their babies. (Bulatlat.com file photo)
Fabella has 700 beds and often, two mothers share one bed with their babies. (Bulatlat.com file photo)

“How can modernizing the Fabella hospital be beneficial for the poor mothers if the new hospital will have only 400 beds?” asked Jossel Ebesate, national president of the AHW.

As if reduced bed capacity is not enough, health workers’ security of tenure will also be imperiled in the supposed modernization of Fabella, Ebesate warned.

“They are lying when they say they will create more jobs. With only 400 beds, how can they accommodate all the present employees? It could only mean retrenchment. Either the DOH will offer early retirement or make the employees choose where they would be reassigned,” Ebesate said.

Maternal death rate to worsen

Ebesate feared that the way the modernization of Fabella is panning out, it could result in the increase in maternal death rate.

He said that the modernization of Fabella, plus the DOH’s No Home Birthing policy which prohibits midwives from entertaining mothers seeking assistance in home birthing, only marginalize the poor more.

“Not all hospitals in Manila have free services. Jose Reyes Memorial Hospital, the Philippine General Hospital and the Ospital ng Maynila have corresponding fees in their maternal services. Like in PGH, patients have to pay $33.22 as maternity package not counting yet the medicines, dextrose, needles used, etc. In Fabella, services are free or if not, patients are asked to pay only a small amount for their hospitalization,” Ebesate said.

(Bulatlat.com file photo)
(Bulatlat.com file photo)

In a statement, Gabriela Women’s Party Rep. Emmi De Jesus shares the view that the reduced bed capacity in the supposedly modernized Fabella will likely increase maternal mortality rate, which she say would render the Philippines a major failure in the Millennium Development Goal (MDG) of reducing risks of pregnancies and births.

De Jesus warned that with the Fabella hospital “modernization,” more mothers would be forced to give birth in more unsafe places.

“The government is already banning home births and passing city ordinances penalizing midwives who provide home birthing services. Almost every week we hear of women giving birth in taxis and trains. With this eventual privatization of Fabella, we are sure that poor mothers will experience further hardships in seeking inexpensive natal care for their families. Expect more babies to be born in pedicabs and convenience stores,” De Jesus said.

The No Home Birthing Policy purportedly aims to also lessen maternal and neonatal death for the Philippines to achieve its commitment to the Millennium Development Goals (MDG). By 2015, the Philippines is supposed to achieve its commitment in MDG to lower maternal mortality rate by 52 per 100,000 live births. But data from the government itself show that it is far from reaching this goal. According to National Statics Office, 162 mothers die from 100,000 live births in 2009. This even increased to 221 in 2011.

Privatization means inaccessible services?

Ebesate said there is nothing wrong in modernizing government hospitals but he said it should be done as part of government’s responsibility. Government hospitals are in fact in need of improving its facilities since the government has gradually stopped allotting funds for Capital Outlay (CO) for government hospitals since 2011 while there is no significant increase in funds for Maintenance and Other Operating Expenses (MOOE).

Women from the labor group Kilusang Mayo Uno protest against Fabella's impending privatization last Feb. 3, Monday. (Photo courtesy of Kilusang Mayo Uno)
Women from the labor group Kilusang Mayo Uno protest against Fabella’s impending privatization last Feb. 3, Monday. (Photo courtesy of Kilusang Mayo Uno)

De Jesus also said: “It is the Constitutional responsibility of the government to improve, develop and modernize public hospitals and public health services but doing this should be in the service of the people, not for the interests of profit-oriented investors and rich clients.”

Ebesate said privatization of government hospitals has resulted in exorbitant fees.

According to the AHW, experiences show that in government-owned and-controlled corporation (GOCC) hospitals such as the Philippine Heart Center, Lung Center of the Philippines (LCP), NKTI and Philippine Children’s Medical Center (PCMC), the involvement of private investors in government programs and projects has resulted in the increase in cost of services.

For example, dialysis in NKTI costs P3,000 ($66.35) per session, and it even increased in 2012 to P3,500 ($77.41) while there were no more charity services available.

“No pay, no hook” is also being implemented in NKTI, which means patients without money cannot be entertained there.

In LCP, a patient needs to deposit P10,000 ($221.16) before being admitted while in PCMC, a patient needs to make an initial deposit of P5,000 ($110.58) before being admitted.

Charity services have also become more difficult to avail because of a large number of indigent patients. In PHC, the allotted beds for charity went down to 20 percent of total bed capacity from 70 percent when the hospital was established in 1975.

Even class C or D patients have to shell out money to pay for PHC procedures or operations.

“Six out of 10 sick people are dying without seeing a doctor as of now when not all government hospitals have been privatized. How much more when all the government hospitals are privatized?” asked Ebesate.

The peoples’ opposition to policies like privatization exposes the bankruptcy of Aquino’s touted righteous path, Ebesate said. He added that if the President is no longer servicing the poor, there is no reason then why we should continue supporting this government. “Therefore he should be ousted.” (https://www.bulatlat.com)

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