In our collective hearts, we really dream of the day of translation and transition. That our sustained growth rates would really translate into improved lives across the board. Then, we take the next step, that inevitable transition into a status just a few notches from developed country ranking, as dynamic as our neighbors. Thailand maybe, but very close to Singapore. Who does not dream of having a tertiary educational system like the world-class National University of Singapore?
There is only one problem. At the precise moment we seem to be very near to attaining that dream, something develops to dash the dream and send our collective hopes of moving up into the world crashing down. Today, as we are supposed to march into that true “ Golden Age,” one resting on very strong economic foundations, the newspaper headlines bring us back to surly earth. The screaming headlines of today, all on the declaration of a national dengue epidemic, also scream of the obvious — a dengue epidemic does not happen in a society where citizens have access to decent medical care and live in a relatively clean environment.
Simply put, a dengue epidemic is depressingly Third World.
Dengue deaths are a scourge of Third World countries, not countries with functioning healthcare systems. The World Health Organization (WHO) says dengue is widespread, and its presence has been reported in about half of the world. But there is a caveat. In First World countries, where citizens have access to proper medical care and where the environment is not conducive to the spread of the dengue vector, dengue deaths can be limited to 1 percent of the dengue cases or less. Obviously this is not the case of dengue, in the context of healthcare-challenged PH.
From January to the first week of August, dengue deaths — the reported ones — totaled 622. What about the dengue deaths that had been unreported in the far-flung areas? What about the deaths that had been reported under the category of “high fever”? How can we have an accurate picture of the dengue epidemic in the far-flung barrios of Zamboanga Sibugay, where many roads are rendered impassable during the rainy season? Or do not have roads at all? Or in the Islamic State-influenced areas of Muslim Mindanao?
The 146,062 dengue cases reported from January 1 to July 20 represented a 98-percent increase in dengue cases for that same period last year. The Health department described the level of dengue cases as “staggering,” and that maybe an understatement. The dengue outbreak in Hawaii in 2015 reported a total of 181 cases.
We not only have failed to limit the dengue deaths to 1 percent of the reported cases. It also appears that among the top 1 percent in the economic bracket, dengue is almost non-existent. The reason: They live in safe environments and they have the money for the best medical care.
If you map the country according to dengue deaths and dengue cases, Cavite is the only progressive province covered by the epidemic. Areas in the Eastern Visayas, Western Visayas, North and South Cotabato, the Zamboanga Peninsula, and the Bangsamoro Autonomous Region with dengue cases are not exactly in the upper tier of the country’s most progressive local government units.
The Department of Health’s budget for 2019, and this does not include the budget of the Philippine Health Insurance Corp., totals P98.57 billion. Yet the big funding does not seem to make any dent in the current effort to contain the epidemic. The newspaper photos showed only a depressing optic: public hospitals overrun and unable to cope out with the outbreak. Public hospitals and related institutions are the first line of defense against outbreaks. The news photos showed a strain on services so severe that even hospital chapels in Cavite province have been repurposed to accommodate the dengue-stricken patients. That is Cavite, a first class province.
What portion of that P98.5 billion is for containment of dengue, measles and the like? And what part of that is for primary healthcare and with focus on impoverished communities with no access to pricey private health institutions? And what portion of that is for “health infrastructure,” which would be at the mercy of thieving legislators? The severe strain on public health facilities at the moment points to one thing — no dramatic improvement or expansion in the quality and quality of public healthcare institutions.
What we know is that the Health department has a hoard of undistributed drugs worth P18 billion, with P368 million of that about to expire. It can’t distribute drugs on time. Its fund utilization record is worse. All of these mortal sins are taking place in a healthcare-challenged environment.
A few months back, at the opening of the school year, the recurring and age-old problems of public schools were a depressing sight. Public elementary students using comfort rooms converted into “classrooms.” Two classes of 50 students each cramped like sardines in one classroom. Worse, classes held in open areas shaded by trees. Overburdened teachers waiting for a pay increase promised three years ago. The acute shortage of textbooks, chairs and laboratories was a minor problem compared with the classes held under torturous settings.
Education and healthcare , not gross domestic product (GDP) growth and stock market surges and other related indicators, are the universal measurement of the state of well-being of a society. The truth is regressive healthcare and educational systems in a regime of sustained GDP growth are suggestive of something worse: an unequal society for the few, by the few and of the few, a sure constant in Third World countries.