The Philippine Online Chronicles

Loren Legarda is running for vice president of the Philippines on the crest of a “green platform of governance.”

A green platform is normally esoteric to the masses.  It is not for them a gut issue like  unemployment, poverty,  lack of shelter, food shortage, low wages, prices of commodities.

But  on the aftermath of the great deluges that took place last year, it became apparent that climate change and global warming are gut issues after all.  When people, due to ignorance, despoil the environment and the environment hits back, when the government leaders fail to enforce laws that  will safeguard the ecological balance from further havoc  and mismanage the infrastructures that will protect people from calamities – who but the poor emerges as the biggest victim?

Thus, Legarda is on target when she presents herself as a green candidate.

Many agree.

Popular columnist Julie Yap, in her usual irrepressible style, insists that if one scrambles Loren Legarda’s  name, the word “green” appears clear as daylight.

According to a Manila Times editorial, Legarda has become “the national teacher on environmental health and the dangers of climate change, with her campaign in the Senate and the community on tree planting, forest parks, solid-waste management, disaster mitigation, and climate change adaptation. “

Loren Legarda seemed to have made a good account of herself and the country at last year’s Copenhagen talks as well.  According to Al Pedroche of Pilipino Star Ngayon: “Si Senator Legarda ang kaisa-isang mambabatas sa Asia-Pacific region na binigyan ng tsansang magsalita sa inter-parliamentary meeting ng UN Climate Change Conference. Hinamon niya ang Pangulo ng pinakamalakas na bansa sa buong mundo, si US President Obama, na tuparin ang mga pangakong kikilos ang US para maibsan ang problema sa climate change at hindi puro salita lamang.

Another Loren advocacy

Lesser known is another advocacy of the senator-vice presidential hopeful – uplifting the plight of the health workers in the country.  This is again, at first glance,  far from being a popular cause.  But maybe we should look again.

Take a medical resident.  One has to be the parent or sibling or fiancé/partner/spouse  or best friend of one to know that medical residents are among the most overworked, overexploited, and underpaid workers in the country.

Typically a medical resident goes on a 24 to 36-hour duty every three days and still reports the rest of the week for more than eight hours a day and be at the patients’ and nursing staff’s beck and call. Rest on Sundays, holidays, birthdays? --   they might as well reach for the moon.  Television, movies, hobbies, dinners out, nights out? – they might as well be in another planet bereft of all leisure activities.

For this, a medical resident, who has taken up at  least 10 years of schooling (including the requisite pre-medical degree in some branch of science and also including two years of unpaid work as medical intern), receives an allowance ranging  from P12 to P20 thousand a month -- minus tax!    Usually, a big chunk of this allowance goes to board and lodging in some apartment or boarding house near the hospital where they train so they could report very early in the morning as they are required to.

Hospital Slave – a case story

A blogger who calls himself “Hospital Slave” tells his story of how it is to work as a medical resident:

When he began residency, he begins,   “I expected to be spending most of my time almost living inside the hospital and most of my thoughts turned to reading medical books, specialty journals, untangling patients’ dilemmas, and understanding the politics of hospital training.”

As it turned out, he was disappointed to be burdened with tasks -- some of them menial --  he didn’t expect to perform – filling up charts on top of attending to patients in the hospitals, performing duties of interns, attending conferences, staying in the hospital after office hours even when no longer on duty.

When he lagged behind filling up discharge summaries of patients, his allowance was suspended, he laments.  He was at his wit’s end surviving without food and transportation money, he says. It had been months now.

He expected that his seniors would understand his plight and help him, having been junior residents themselves not so long ago.  But they turned a blind eye and a deaf ear.

How this practice had been perpetuated without any individual or group making waves or rocking the boat he could just surmise.  Like him, most other residents didn’t want to lose their slots in the hospital they are training in. After all, there are more applicants than residential posts.

Meanwhile, “Hospital Slave” waits and wonders if he could proceed with his “inquiry”on his suspended allowance without endangering his medical career.  It seems to him the sensible thing to do is to patiently suffer, finish the program, and then do something to help the future residents when he has established himself as a doctor.

Or is the system so formidable and well entrenched it cannot be challenged? -- he wonders.

Other stories

Another blogger who calls himself “Evil Resident” takes exception to the long clinic hours medical residents are required to put in. “Doctors are, for better or for worse, human,” he says implying that they are prone to fatigue.  “Health care professionals who are tired and sleepy increase morbidity and mortality,” he cautions.

A resident doctor I know narrated, half in dismay, half in amusement, how he fell asleep in the process of injecting IV to a patient.  Fortunately, the patient was kind and seemed to have understood and simply nudged him awake.

My own daughter, who has just started her residency, feels jittery too.  She tells me she is enjoying her hospital experiences. She likes interacting with patients, diagnosing their sickness, seeing their condition improve or stabilize. She also feels lucky that the senior residents she is working with are exceptionally kind and considerate. But sometimes, she finds it tough to accept she wouldn’t be having a “life of her own” for the three or more years she would be in training.  She is also afraid to make mistakes.  “As residents, we are now responsible,”  she says grimly.  As they are no longer interns, the buck stops with them, in a sense.

“If only there is time to recharge,” wishing for a day off after duty.   Then, she and her peers would have something to look forward to after a long stretch of work. “Then, we are energized to take on our responsibilities the next day and be less prone to mistakes.”  She continues:   “If only we are assigned only so many patients at a time – a number  we can realistically look after  with the attention they deserve.  Then we would be more effective in caring for our patients.”

Legarda’s Action Plan

If she will have her way (if she wins), Legarda wants to put a stop to the exploitation of medical residents and other health workers.

In a speech to the Alliance of Health Workers recently, the Senator spoke of the need to upgrade the salaries of doctors and nurses in government and private hospitals which at current rates are at starvation level.

“Health workers have been performing their vital job under challenging, even brutal and hazardous conditions," said Loren, perhaps alluding to the long hours they put in and the life-and-death responsibilities they assume.

Most workers receive no overtime pay, night shift differential, holiday pay, and other perks most workers in other sectors receive as a matter of course.  Because of this, they leave, depriving the country of the doctors and nurses it sorely needs for its own sick population.

Among reforms Loren plans for the health sector are:

• State health investments fulfilling the five per cent of GDP investment benchmark set by the United Nations.
• The genuine primacy of education and health in the yearly budget allocation exercise.
• A crash program to fill up unfilled health position plantillas, the modernization of hospitals, the attention to basic and primary health care.
• And, a five salary grade increase for all state health workers up front, along with a promise to further upgrade their compensation package, plus, a year-long training and retraining program, including fellowships and scholarships in prestigious medical institutions overseas.

These proposals graze but the tip of the so-called iceberg.  Further and in-depth studies in aid of policy (and legislation) will lead to other issues that cry for other reforms that will humanize working conditions.

She might find it useful to review HB 05222 also known as Medical Residency Act of 2008, authored by Rep. Carlo Oliver Diasnes, among other House bills now pending in Congress.

Photo: “DSC_3161” by , c/o Flickr. Some Rights Reserved.

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