Several weeks ago, I was scolding a patient who hasn’t come for follow-up in more than 10 years despite his uncontrolled high blood pressure and diabetes. He was rushed to the emergency room with a severely failing heart and by God’s grace he survived. He told me he deemed it useless to see me regularly for checkup because he couldn’t afford to buy any of the medicines I used to prescribe to him, despite my conscious effort to give him what were cheap but effective generic medicines.
He said that his family’s life hasn’t really changed and he doesn’t see any hope that this would change in his lifetime.
Miserable partners
It seems poverty and poor health come as miserable partners. They make a highly invasive and vicious social cancer that can’t be treated effectively with just half-hearted resolve and partial cure.
On a national scale, any government can’t possibly hope to automatically solve the healthcare situation by just focusing on poverty alleviation. An ailing nation can never prosper. And the leaders of any impoverished and ailing nation will need to adopt measures addressing both simultaneously and effectively.
This is the essence of the Millennium Development Goals (MDGs) with specific objectives to reduce significantly extreme poverty and worst forms of human deprivation, especially the lack of access to adequate healthcare. We’re just three years away from the global MDG deadline in 2015. It is to be remembered that in September 2000, the Philippines made a pledge with 191 other member-states of the United Nations to achieve eight MDGs by 2015 for poverty alleviation and healthcare improvement.
Based on the Philippine Family Income and Expenditures Survey, more than half of the population could not afford to pay for complete healthcare services due to their low income and high cost of medical care. Inequities in healthcare provision is glaring, which hopefully the government’s Kalusugang Pangkalahatan will be able to effectively address before P-Noy’s term ends. At this time, though, although we have a surplus of nurses who are unable to work abroad, there is still an utter lack of healthcare manpower, especially in far-flung areas. This is one irony so difficult to understand.
We’re looking forward to an updated progress report of the government on whatever MDG gains we have made so far. We need accurate figures to show if we really have a decrease in the proportion of people living in extreme poverty and visible improvements in the target indicators for household and population poverty incidence, health status and quality of life.
The health yardstick has to be regularly assessed. We welcome the recent news that six more provinces in the country are expected to be declared malaria-free, making a total of 30 provinces. The current malaria situation in the country shows a large and steady reduction, with a 53-percent decrease of malaria cases in 2011 compared to 2010 statistics.
Too early for rejoicing
Although it may be too early for rejoicing, anything in the right direction toward our MDGs should be worth patting our government’s shoulders for. But malaria is just a small part of the gargantuan healthcare problem our country has.
We read reports that the government has achieved some reduction in the infant deaths per 1,000 live births, but this is still not good enough to meet our MDG target. The decline in the number of maternal deaths per 100,000 live births has also slowed down, and at the rate we’re going, one cannot be too confident that the 2015 target of 52 deaths in the maternal mortality ratio (MMR) could be met.
The prevalence of human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) may still be below the national target of one percent of the population but the DoH also reports that the rate of increase is alarming with record peaks being noted this month.
Fate of RH bill
Meanwhile, both the Senate and House are dragging in deciding the fate of the Reproductive Health (RH) bill. Access to reproductive healthcare for married women is improving but at a snail’s pace, and it’s unlikely that the 2015 target of 100-percent access could be achieved. Every month that the RH bill is delayed only increases the likelihood of failure in this part of our MDG scorecard.
With barely three years to go, it’s obvious that it’s not going to be a walk in the park for us to meet our MDG deadline. It’s imperative to re-enlist the commitment of the national and local governments, academe, private sector, the international development community and all those who can help us achieve our MDGs at a double pace.
Economic and health policies have to be continually reviewed and necessary reforms promptly instituted. But all the policies and reforms become meaningless unless they’re effectively implemented, and are expressed as sustained and equitable impact on the whole population. As it is, though, we still have continuing indicators of inequity and disparities such that the same number of families still complain of hunger and lack of optimism that signs of economic progress have truly cascaded down to their level.
This is the real-life challenge the government needs to hurdle—to be able to translate improvement in statistics to concrete enhancement of the quality of life of the poorest of the poor Filipinos. Sometimes, achieving metrics is doable, but we could get lost in the translation somewhere.