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Jun 04

The Explainer: PGH at 100

That was a scene from Monty Python’s “Life of Brian,” and really, every colonized people sooner or later asks, what did the colonizer do for us?

As John Cleese pointed out in that scene, there’s always public health. And there’s no greater symbol of past and present public health efforts, than the Philippine General Hospital. The PGH in its centennial year, and what you can do to help it along, is our topic for tonight.

 

I’m Manolo Quezon. The Explainer.

 

I.  

 

Explainee, in doing research for this show I cam across an article from 1916, in Harper’s Magazine. The title of the article was, “An American Who Made Health Contagious.” It has a delightful opening paragraph. Would you like to read it?

In the Orient they have a new and significant name for Manila, the capital of the Philippines. They call it “the city without odors.” Only people accustomed to Asiatic cities can adequately understand the tribute comprised in these words. The phrase is more than a tribute to Manila; it is a tribute to a new idea in Oriental civilization. Manila has taught not only the Philippines, but China, India, and the entire East a truth which they had never suspected; that is, that filth and disease are not necessarily a part of existence. For ages smallpox, cholera, plague, beriberi, leprosy, and other diseases had seemed to be part of nature’s regular order in the Philippines. In the last ten years these scourges have disappeared or been controlled. Manila is not only the cleanest and most beautiful city in the Orient, but it is one of the healthiest in the world.

 

Soon after our independence was achieved in 1946, A.S. Arguelles, then director of the Bureau of Science, wrote glowingly on “Progress of Science in the Philippines,” which he generally accepts as having begun with the onset of the American occupation of the Philippines. This is not to say that the Spanish regime was a dark age when it came to scientific achievement (although very many people—perhaps even Jose Rizal himself might have said so: who has not laughed over the absurdities of the physics lesson presided over by an ignorant Dominican in the Noli); however most developments were in the areas of botany, zoology, metallurgy, geology, and observations of the weather (that good old Jesuit, Padre Faura). In terms of scientific progress in other fields that have helped usher in the Industrial Age, the Philippines remained an 18th century backwater.

Victor Buencamino, who helped establish the University of the Philippines College of Veterinary Science, supported Arguelles’ view. Buencamino wrote in the 1930s that the scientific age began when –would you like to read a snipper from Buencamino’s memoirs, Explainee?

 [The scientific age began when] a small building situated on the banks of the Pasig River was commandeered and the first laboratory of the Philippines was established with First Lieutenant R.P. Strong of the US Army in charge.

 

A Commission for the study of Tropical Pathology from the Johns Hopkins Hospital arrived soon after, signifying the thrust of scientific efforts in this new colony for the next decade and a half—to make the Philippines safe for Americans to live in (while, nicely enough, making it a more healthful place for the natives, too). As Arguelles put it, “We can state that scientific work in the first decade of [the] American regime was largely devoted to the control of tropical epidemics.” One of the first acts of the American authorities was to fill-in the malaria-infested moats of Intramuros—to the eternal gratitude of today’s golfers!

The makeshift laboratory of 1899 was improved and became a municipal laboratory and, by 1901, an independent Bureau of Government Laboratories upon the initiative of Dean Worcester. This eventually became the Bureau of Science. By 1906 scientific papers were already being written and published in the Philippine Journal of Science (which is still being published to this day under the auspices of the Department of Science and Technology). As it battled hog cholera, surra, amoebic dysentery, dengue, malaria, cholera, and smallpox, the bureau naturally found itself devoting its efforts to the creation of vaccines and the monitoring of public health and foodstuffs; the Bureau implemented the Pure Food and Drugs Act and aided the bureau of Health and the quarantine service.

Arguelles provides a list of the scientific achievements of the bureau in the technological field: the manufacture of vaccines and sera; the production of an extract of rice bran (tiki-tiki extract); the production of soybean milk; and the propagation of canning methods for fruits and vegetables (which would culminate with the most exciting prewar canning innovation: the canned adobo of the 1940s!).

Scientific achievements of the health-providing sort were undeniably tremendous; at the end of his life Victor Buencamino wrote in his reminiscences that, as far as he was concerned, “The Philippines’ greatest contribution to the world of science” was the elimination of rinderpest, which first manifested itself in the wake of the massive importation of livestock that took place as a consequence of the decimation of the livestock population in the wake of the Revolution and the Philippine-American War. The rinderpest epidemic was reminiscent of the way hoof-and-mouth disease became a serious health issue in the 1990s. An aggressive drive to eradicate the disease began in 1906, which included the development, testing, and use of a serum to immunize animals: all of which was accomplished by Filipinos and Americans. The elimination of the disease was “a saga that took all of 30 years and one in which Filipino veterinarians took a progressively more important role as the campaign was intensified.”

It is well to note that an underlying motive—besides, of course, natural, humanitarian ones—can easily be detected when it comes to American efforts: after all healthy, happy Filipinos are happy, productive Filipinos; just the sort of people who would be vital, considering the goals of the next stage in scientific efforts, which Arguelles succinctly described as “the study of the different raw materials for industrial purposes and the exploitation of our natural resources.”

Explainee, there’s a fascinating book titled Colonial Pathologies: American Tropical Medicine, Race, and Hygeine in the Philippines, by Warwick Anderson. It’s a fascinating book… 

But you know, whatever their motivations, one institution that made the American concept of public health very much a vibrant and idealistic Filipino one, was the PGH. The PGH then and now, when we return.

 

II.

 

Since 1907when PGH opened its door to the public, the hospital has been providing the widest range of healthcare services, especially to indigent patients. While its considered the biggest tertiary hospital in the Philippines serving the greatest number of patients and training the largest number of health professionals nationwide, It has not been getting enough government subsidy to meet the increasing demands of its programs and services thereby preventing its doctors, nurses,technicians and other hospital workers from providing the best possible care to our people.

Every year, PGH serves more than 600,000 patients from all over the country. The biggest bulk of these are outpatients (81.2%), which are all charity cases. However, patients who are not qualified under the medical social service program of the hospital are required to pay for laboratory tests, medicines and other health care needs.

Of the patients admitted to PGH, about 75%  are charity patients. These patients are constantly faced with the problem of where to get funds for their medicines and laboratory examinations.

Here’s a patient profile for the PGH:

81.2% Outpatients

11.1% Emergency Patients

5.2% Charity Inpatients

2.5% Pay-patients

TOTAL: 665,206

 

Like most service institutions of the government , PGH also suffers from inadequate funding given the rising cost of medicines, hospital supplies, equipment and machines, not to mention for the maintenance of physical structures. Even with the internal generating scheme of PGH such as the pay ward and main pharmacy, funds are still lacking. With an average of 6000,000 patients a year of whom 80-90% belonging to the low-income bracket, more support are needed. An average budget short fall of 200-300 million a year satisfactorily meet patient’s need is what the PGH administration has to contend which each year.

THE PGHMFI was founded in 1997 thru the initiative of Dr. Antonio Montalban, Former Director of PGH However, it became dormant for a time until 2002 until Dir. Juan Ma Pablo Nanagas reactivated the foundation thru Dr. Merli Odi as chair of PGH Resource Generation Committee. The Foundation started its operation with new sets of board of trustees, officers and members in May 2003

The new officers and board of trustees are mostly health professionals affiliated with PGH and UP manila, but also honored by the active participation of some well known personalities from media and business.Director Carmelo Alfiler is the chairpersson of the Board of Trustees while the First President of the foundation since 2003 is Dir. Gregorio T. Alvior Jr. A retired Ob-gyne specialist and a graduate of UP College of Medicine , Class 1962. In April 2004 , PGH recognized the foundation as an official support agency and fund raising institution of the hospital.

The foundation shares the vision of PGH of excellence and leadership in health care as its hope to be significant instrument in realizing PGH’s vision for continuous services to its indigent patients. The objectives of the foundation is primarily to raise funds to augment the hospitals capability to deliver quality health care and support emergency medical services to low-income patients of the hospital.As such, it undertake activities that will generate additional sources for PGH’s numerous and critical needs that are not supported by government subsidy.

Within only four years of operation with a handful of dedicated volunteer officers and very minimal staff support, the Foundation has provided additional free medicines (mostly expensive antibiotics) to hundreds of in-patients referred by the Medical Social Service and millions of pesos worth of medicines supplies were given to the central pharmacy for needs of other confines charity patients. Through generous support of friends, the Foundation facilitated the donation of instruments, equipments, mattresses, linens and other needs to the Cancer Institute, Ob-Gyne, Medicine, Pediatrics, Ophthalmology and Radiology departments.

The hostipal prioritizes its budget for direct health care and personnel salary while funds are inadequate for training needs of competent health personnel and the critical administration work. It is for these needs that relevant training and office equipment such as computers, printers, LCD projector and copying machines were provided to the ENT, Nursing, Administration departments and Director’s office. The Foundation was also able to provide funds for improvements, renovations and construction of hospital facilities. The rehabilitation and modernization of the Main pharmacy was a major project through its “Alay sa PGH” campaign launched in August 2004. In addition, it has also assisted forthe repair of elevators at the central block, physical improvements of the director’s conference room and for comfort of watchers staying in the Bantay Antayan., a television set and some wall fans were donated. In 2006 the foundation funded the renovation of the OB-GYN Admitting Complex which included the delivery rooms, treatment rooms and OR complex. At present, the foundation is spearheading the renovation of ward 15 (O-GYN Ward) and a breastfeeding lounge for nursing mothers.

And with that overview, when we return, let’s meet two people involved in the fund-raising for the PGH in its centennial year,

 

My view

 

Help PGH! Help it now!

 

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