THE murder of a young doctor, Dreyfuss Perlas, last month has provoked deeply felt grief and outrage from medics throughout the country. Perlas, a municipal health officer with the government’s Doctors to the Barrios program, worked among people living in the small towns and scattered villages of Lanao del Norte in northern Mindanao. He was shot dead by a gunman as he rode his motorbike home. Anyone with a shred of right-minded decency would rage against the senseless murder of a young person, especially when that person was committed to a good and useful life helping others. But the loss of one brave and idealistic doctor who served the rural poor in some of the country’s most out-of-the-way places, and who did so with quiet selflessness and dedication, is a tragedy of truly epic proportions.
The killing of Dreyfuss Perlas does not just mean a loss to those communities and to the medical profession of which he was a member. It is an assault on our nation’s progress and the dream of a fairer and more equitable society.
I might well be accused of fetishizing the Dreyfuss Perlas murder case and magnifying his death out of all proportion. But the fact of the matter is, here was a doctor who took his calling with the kind of honesty and steadfast, dogged seriousness that is lacking in too many of our country’s current crop of morally bankrupt politicians. He may not have thought of himself as such, but Perlas by all appearances was, to use that dirty word, a progressive. He was bringing his skills and knowledge of modern medicine to the dangerous backwaters of the archipelago. It is a job that has been hard to do since the mid-19th century. His killing exposes so much that has gone wrong in a society.
Our developing middle-income status has deformed our notions of health care. A great chasm separates the diseases afflicting the rich and poor. If WHO 2004 data is to be relied upon—and a more up-to-date figure has been surprisingly difficult to find—there is 1.11 doctor per 1,000 population, a statistic which puts the Philippines almost on a par with Malaysia. Rich women are able to attain their reproductive health goals, and heart disease, stroke, cancer and diabetes are the leading diseases putting people into hospitals. At the same time, however, unsafe drinking water and poor basic sanitation remain the fundamental causes of preventable major infectious diseases—typhoid fever, tuberculosis, bacterial diarrhea, hepatitis A, dengue and malaria.
It is staggering to think that no government since independence has determinedly pursued and prioritized universal health care. Of course, there have been lots of noises and a few gains made. Most recently, the much-touted National Health Insurance Act passed in 2013, and patterned after Obamacare, has sought to give, through Philhealth insurance schemes, primary health coverage to all poor Filipinos and their families, senior citizens, people with disabilities and street children. The Kalasugan Pangkalahatan program put together in 2010 by then Health Secretary Enrique T. Ona under President Aquino, provided full immunization to all poor children, and allotted some P43 billion to the construction and renovation of health care facilities.
But as everyone recognizes, entrenched social inequity will poison every initiative. A brief report on universal health care published in 2012, the lead author being Alberto G. Romualdez, Jr., talked bureaucratically about “equity goals,” restructuring health financing, improving stakeholder inputs and such. He needs to take a leaf out of Aneurin “Nye” Bevan’s book. The Welsh socialist health minister and creator of Britain’s National Health Service (NHS) put it more plainly: “No society can legitimately call itself civilized if a sick person is denied medical aid because of lack of means”. Established in 1948, the NHS has admirably stuck to three key principles of health care: that it is based on need and not the ability to pay, that it is free at the point of use, and that it meets the needs of everyone.
The Philippines has long thought this to be a simply brilliant idea and has for many years supplied the NHS with trained medical personnel. After Britain, the Philippines sends the highest number of nurses and midwives to the NHS. Filipino nurses number 8,094 out of a total of 309,529, and make up the third highest number of NHS staff overall, with 12,744 Filipinos employed by the NHS, according to a 2014 Guardian report.
We will never know whether Perlas harbored aspirations to go abroad. The few reports that say something about his personality tell of a much-loved son, brother and colleague. He was a modest, collegial man from small-town Philippines who obtained his qualifications from a humble, little-known university, the West Visayas State University. At his most extravagant, he liked to eat imported chocolate. He had a hankering for chunky Toblerone and M&Ms.
It was his name that I found the most eye-catching. Dreyfuss with its soft “f,” a sound not especially easy for local Filipino tongues to enunciate, and the additional “s” to give an unconventional hiss at the end, is an unusual and rare name for Filipinos. Its obvious etymological link is to “Dreyfus,” with a lone “s,” an old Ashkenazi Jewish name from Alsace and Lorraine, the northeastern provinces of France that were seized by Germany in 1870 as part of the spoils of the Prussian War.
Historians will think of the “Dreyfus Affair.” Alfred Dreyfus was a young Jewish artillery officer and family man wrongly convicted of treason in Paris in 1895. On the flimsiest of evidence, Dreyfus was torn from his wife and children and court-martialed. He was stripped of his medals, his sword broken into two, and humiliated and degraded before a venomous crowd. He was then sent away to a tiny island in the middle of the Atlantic where he was condemned to live out the rest of his days rotting in a jail cell specially constructed without a view of the ocean.
Alfred Dreyfus was innocent. He was the victim of anti-Semitic hatred and bigotry during an era in Europe distinguished by progress and modernity, bright-minded optimism and outward-looking cosmopolitanism.
Any parallels that can possibly be made between Alfred Dreyfus and his contemporary Filipino namesake, Dreyfuss Perlas, would sound like a forced, trite conceit, except for the fact that there are at least two valuable lessons that make this seemingly odd juxtaposition worthwhile.
Dreyfuss Perlas was a good man murdered in cold blood. At its core the Dreyfus affair, as American lawyer and author Louis Begley reflects, warns us how fragile the standards of civilized conduct prove to be in moments of national panic and that every accused person should be able to face his accusers in a fair trial.