Integrated Clinical Clerkship in Emergency Medicine AY 2021- 2022

Patients with life-threatening conditions, especially those in far flung areas, will benefit the most if access to health care and pre-hospital care was improved. Access to health care is not only just constructing local clinics or hospitals in some remote area, but also improving the roads, availability of emergency transportation, and insurance coverage for those who need it. The main reason why ambulances can’t reach these areas is because of the road being basically dirt in the dry season and mud in the rainy season. They will just get stuck while going there therefore; people rely on “duyan” to carry the sick down the mountain. If only politicians bothered to finish their projects rather than just leave it behind when the budget had ran out or election is over, roads will be paved and there are so many people that ambulances might be able to reach. Another hindrance to people lacking access to healthcare is the lack of insurance. Despite the Universal Healthcare Law being signed, there is no insurance coverage to those who can’t pay monthly contributions thus; people who don’t have it are forced to pay out of pocket. With these kinds of people who just eat corn or root crop three times a day to survive, money is a big issue for them. That’s why they are reluctant to get admitted because they know, they will not survive the aftermath. Improvement in pre-hospital care involves having a physician go to those remote areas to check on them regularly, and manage them with primary interventions and send them to the hospital if necessary. It also involves having access to basic medications which can be given to these people to treat conditions which are treatable when managed right. If this is done, we will not frequently see patients who are already terminal because they have been managed beforehand. However, that is not the case. There is a physician shortage; doctors prefer to go abroad or to the city to practice because the government does not give enough incentive to healthcare providers when they go to these areas. Pre-hospital care is important, but it is being ignored, especially by the government who are supposed to do things that are for the benefit of its constituents.