It goes without saying that pre-hospital care can be life-saving for patients with acute life-threatening conditions. Few, if any, emergency conditions will have a good prognosis if it takes 3-4 hours before the patient is even triaged by an ED nurse.
Two important aspects of pre-hospital care that come to mind are disease recognition and actual patient transport. Both require multisectoral cooperation not limited to public health, education, infrastructure, and communication. People should be able to at least recognize that something is wrong. They should be able to identify or deduce aggravating factors and avoid them accordingly. They should be able to judge which conditions require expert intervention or at least be able to immediately consult someone more knowledgeable. Ideally, every household, sitio, and barangay would have 24/7 access to a healthcare worker; that can be via landline, mobile phone, internet, or in person which requires electricity, cell towers, roads, healthcare personnel, among others.
“… Marami ka pang makikita na … gusto mong tulungan pero para kang may tanikala.”
Dr. Marjorie Vizconde’s words succinctly describe the feeling I get every time we’re asked to watch this documentary. Even with the paucity of our patient interactions in PGH, I, too, have felt this sense of futility.
“Alam kong hindi mapapagaling ng isang araw ang batang ito. Alam kong hindi masosolusyonan ng isang tableta ang sakit ng mga taong nasa bundok. Alam kong hindi lang gamot ang lunas sa isang malalim na sugat. Pero hangga’t may mga taong handang tumulong, hangga’t may mga handang magmalasakit, hangga’t may mga balikat at paa na handang maging ambulansya, hindi natutulo ang pag-asa.”
While I understand that Kara David’s final words aim to put a positive spin on this all-too-common depressing situation, I can’t help seeing it is a misplaced message of hope. I agree; our efforts can't end with building hospitals and providing medicines. These short-term solutions that politicians often tout to get elected do nothing about the underlying cause of our problems. However, the onus to improve access to healthcare should be on society as a whole with the government taking charge rather than on communities and individuals. At this point, it seems that even LGUs are helpless without the national government’s support.
The status quo should be disturbing all of us, especially those in positions of power who can readily do something about it. Doctors shouldn’t feel weighted down by our society’s shortcomings and malprioritizations. Patients and their families should never spend half the day climbing down a mountain only to find out no one can see them. None of the changes we need can come from one person or one department alone. We need informed policymaking directed at developing the capabilities of healthcare personnel, retaining healthcare personnel, and improving the capacity and reach of healthcare facilities. We need policies that account for individualized needs of communities. A sitio found in the mountains won't have the same issues as one on an island. As long as the list may be, it’s good we know what problems we have. That way, we know where to focus our efforts.