Real budgetary priorities

GMA’s bout with gastro-enteritis, complicated by stress and fatigue brought about by a largely self-imposed punishing pace of work, brings to mind more serious medical afflictions which the government has neglected over the years.

If P1 billion can be appropriated for the fight against insurgency and terrorism, it seems to me that less than a hundred million pesos can be spent for medical facilities which can save lives, particularly those of our impoverished youth who would otherwise die within the first few years after they are born.

Last time, we dealt with Dr. Benjie Abela’s eye cataract project, a charitable endeavor supported by the First Gentleman’s foundation and private donations but which, he says, may not be sustainable in the long run, principally because of the usual financial constraints brought about by "donor fatigue."

We wrote about Dr. Abela’s suggestion that the pork barrel of congressmen, and perhaps the Internal Revenue Allotment of local governments, be tapped to fund a self-replenishing Trust Fund to be administered by PhilHealth.

This time, it’s another project I had in mind: the establishment of a comprehensive liver transplant program that would be capable of both deceased and live donor transplants for adult and pediatric, or very young, patients.

I never realized how big a problem this was for our country until my station, ABS-CBN, and the Bantay Bata Foundation got involved in several cases of children, no more than babies really, afflicted with a life-threatening disease called Biliary Artresia. The disease causes death within the first few years of life. The only treatment is replacement of the diseased liver with a healthy one. The liver can either be harvested from a healthy donor or from a dead one, provided the organ is healthy and undamaged.

The list of patients desperately waiting for transplants is depressingly long and many children have actually died, either while waiting for an organ donor or while their parents struggled to raise the enormous funds required for a transplant.

There are two huge problems: One is that the transplant procedure has to be done abroad. The most readily available medical center with adequate facilities is in Kaoshung in Taiwan. More significantly, the amount of P3 MILLION is needed to fund the operation, not counting airfare and living expenses during recuperation. That was the price a few years ago. I don’t know if the cost has gone up since.

Some parents, in their despair, have quit jobs to devote full-time to fund-raising since the amount required is well beyond the capacity of government institutions and even normally generous private donors. Many parents humiliated themselves by begging for small change from complete strangers in shopping malls. Despite this Herculean effort, it was just too late for many children.

Then, one discovers a couple of what I deem supreme ironies. The doctor who headed the transplant team in Kaoshung was a Filipina, Dr. Vanessa de Villa. She also happened to be the head of a liver transplant project at the Philippine General Hospital.

It appears the government hospital has set aside a separate area for the delicate liver transplant procedures. However, that area remains empty! There is no equipment there. Despite promises that a facility, perhaps in the same category as the Heart Center or the Kidney Center, both working if severely overstressed and always under-funded government facilities (which is another story altogether), would rise, the liver transplant department at PGH is a sorry, scandalous white elephant!

And yet, the sad fact is that if built up with proper equipment and manpower, a PGH program can perform liver transplants not only for pediatric Biliary Artresia cases, but also for adults with hepatitis virus-related liver cirrhosis, with or without cancer.

And it could do so for less than P1 million, not the P3 million required for treatment in Kaoshung. How many lives could be saved with that reduced cost! For indigent patients, who cannot hope to access private hospitals, raising the needed amount, while never easy, would be more feasible. Traditional donors such as the Philippine Charity Sweepstakes Office and PAGCOR, would be able to deploy their funds more efficiently. PhilHealth might also be able to cover major operations like this in its insurance programs, even if additional premiums were to be charged.

The urgency of this project is manifest, and not only because lives are being wasted because of the constant relegation of this project to the bottom of the priority pile, well below such "preferential" demands as the payment of our foreign debt and the need to satisfy the legislators’ and local officials’ insatiable gluttony for pork.

We are also losing the medical expertise we have had for so long to handle the problem ourselves. Remember Dr. Vanessa de Villa, the head of the PGH liver transplant program who is so respected abroad she is regularly tapped to head transplant teams in foreign medical centers specializing in such procedures? She performed the successful transplant for at least one lucky Filipino boy who has since been living a normal life.

Well, about three months ago Dr. de Villa left the PGH for a position in Hong Kong, largely out of a legitimate concern that her continued growth as a professional requires the activity that only regular work as a surgeon can provide. However, if and when the PGH facility is up and running, PGH officials suspect she might welcome an invitation back.

Now for the nuts and bolts: Acquisition of the equipment necessary to initiate operations is estimated to cost about P45 million. Training of specialized nurses, the organ donation program and renovations to the physical plant will require another P8 million or so. The total cost can be programmed over two years.

Compared to the billions charged to pork barrel, such as for useless "infrastructure" deliberately designed to disappear with the first typhoon of the season, an expenditure of less than P54 million seems like a pathetic drop in the bucket. And yet, the impact of that amount is beyond question.

One is often amazed at the priorities of politicians, despite their typically pious statements about their passion to serve the nation. But it doesn’t harm to challenge, in fact the people should constantly challenge, those priorities. After all, it’s our money!