Second Class Citizens

by Jose Ma. Montelibano


I decided to take on the objectionable posture of a government agency, the Philippine Regulatory Commission, in trying to apply guidelines and provisions over foreign medical missions that discourage rather than facilitate. It is this posture of PRC that reeks of utak wang-wang, that places people of authority disdainful of the plight of the poor.

Unfortunately, that posture does not limit itself to the commissioners of the PRC. It is a long journey from an elitist, and traditional, sense of entitlement among people in position to true public servant-hood. Maybe, with the help of others who want to push the same journey, I can help move it faster.

While I am not a doctor, I have long been interested in the field of healing, especially where poverty and/or remote areas deny access to modern health care. It never ceases to depress me that many among us, and especially government officials, so casually regard the hungry and sick among our very poor. Imagine a hunger incidence and healthcare-denied population of 20 million or more Filipinos in the 21st century, in the first Catholic and democratic nation of Asia. Have we become that calloused that we feel no acute sense of shame over this?

Perhaps, the very poor have become faceless and nameless, so impersonal to us like old furniture long stacked up in a dark corner. Or, there have always been a greater number of the less poor, so much so that the most needy could hardly be seen and felt below them. We have too long been servants to foreign masters, even to the first Filipino governance that had adopted the same traditional attitude. Truly, the poor mean little and have not deserved their proportionate value in society.

But we are now in the 21st century, we have discarded a dictatorship, removed a sitting president for plunder, now detaining the previous president for more plunder or election theft, and under a new president who is trying to bring us to the righteous path. Our journey ahead is almost a mission impossible with so much authoritarianism and corruption in our history, but there is no other journey. Whether P-Noy insists on it or not, our own sense of right and wrong should lead us to the matuwid na daan.

While I began by condemning the PRC for representing the utak wang-wang attitude which gives more value to everyone else over the health needs of tens of millions of our poorest brothers and sisters, I will be asking others to join in the effort to pinpoint areas where the un-served await the generosity of fellow Filipinos here or abroad. We must be introduced, or at least officials of the PRC, to the very poor whom our government has admitted it lacks the resources to give health care to. We must go to and ask the barangay officials to identify their constituents who cannot afford medical treatment and medicine. The inventory of the very poor must be a national initiative if it is true that our society and government will not dismiss them anymore as second class citizens.

After that, we will ask PRC how to facilitate health services to them. Since the agency seems to have the distinct capability to make it difficult, it should have the same capacity to make it easier.

The government should not be surprised that inside the most populous cities in the Philippines are many of the very poor who cannot afford medical treatment. It has been a lazy excuse or outright alibi used by the anti-foreign medical missions that many of these missions go to the wrong places. The truth is that the objectors have no idea where the right places are. They are armchair commentators, or decision-makers, who cannot even read relevant surveys. How many in PRC, or DOH for that matter, follow the quarterly SWS surveys on hunger incidence? Can’t they see that even Metro Manila has its horrible share of hunger incidence? Well, do they think that people who cannot afford to buy food can afford doctors’ fees or medicine?

In the midst of so many debates about how to control medical missions, I have yet to hear about national and international discussions on how to facilitate and expand them. This leads me to conclude that control is priority, not facilitating access to what the sick needs. Many have said in relative muteness, for fear of economic reprisal, that the Philippine Medical Association and the pharmaceutical industry have pressured both the DOH and the PRC to make it difficult, instead of easier, for foreign medical missions to serve the poor whom the same Filipino doctors and drug stores cannot serve for free. I hope that these are just unfounded rumors because, if true, they deserve to be identified and should harvest the worst of public condemnation.

Now, for the DOH. I know the budgetary constraints that limit the services it wants to render and the upgrading of hospitals it wants to do. Our provinces, even many cities, are full of horror stories about the state of many of their hospitals. These hospitals desperately need improvement.

Abroad, Filipinos in developed countries often have access to used but fully operational medical equipment. Many of these Filipinos are doctors or medical professionals who have good relationships with hospitals and clinics that are willing to donate these equipment. Maybe the DOH and the management of all these ill-equipped hospitals can consolidate a wish list and coordinate with Filipinos abroad to solicit the necessary supply for free. The Department of Finance and the Bureau of Customs can then facilitate the entry without duties and taxes to be paid by either the donors abroad or the beneficiary hospitals. These amounts can be inputted in government books as non-cash budgets for the DOH.

Mine are mere suggestions. There will be better ones when government sets the context and the pace that prioritizes the well-being of the un-served poor ahead of all other concerns. What is important is that the people, starting with the very poor, are treated as the Boss, not subordinates.

We are still in a class struggle. I simply wish that it will not be a war. And Filipinos abroad, especially those in the medical profession who are eager to help, can be powerful healers in more ways than one. I salute them.

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