Heart problems

Tomorrow being the Day of Hearts, my story is about the heart – the real one, that is, and the difficulties in keeping it healthy.

Someone I know went to the Philippine Heart Center for an exam last week. She called her cardiologist, one of the best, but only to make sure the doctor would be on duty. Like most doctors, this one does not set specific schedules for seeing patients; it’s first come, first served.

The clinic hours are 2 to 5 p.m. The patient arrived at past 1 p.m., just to make sure she would be in line. Being among the first, she didn’t have a long wait for her consultation.

But then the doctor told her she needed an electrocardiogram and a Two-Dimensional Echocardiography. The woman got the ECG quickly, but for the 2D Echo, she was 44th and last in line. Because she lives on the other side of town, the woman thought going back would be even more trouble and decided to wait.

She got her 2D Echo before closing time and staggered home after a long slog through Metro Manila traffic before 9 p.m.

After spending an entire day sitting around in a hospital, she must return to the Heart Center this week to get the test results and have them explained by the cardiologist.

Even in private hospitals, long waits for most afflictions are the norm in doctors’ offices, and the woman’s story is not unique. The ordeal can be stressful enough to give you a heart attack.

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The longest waits, however, are in government hospitals, especially in the charity and partly subsidized wards.

I know someone who waited in line the whole day at the Research Institute for Tropical Medicine in Muntinlupa to get an anti-rabies shot at subsidized rates after being accidentally bitten by her cat. Late in the afternoon she was told that the facility was closing for the day and those who were still in line should just come back the next morning. The woman instead went to the RITM’s pay facility so she could get her shot, but had to fork over the full fee of over P1,000.

It’s a government hospital and the P1,000 is still very cheap compared to the P40,000 paid by one of my colleagues for anti-rabies shots in a mid-range private hospital for a dog bite.

Another woman, accidentally bitten by a kitten, waited the whole day at the RITM, but at least didn’t have to wait another morning for her shot, at subsidized rates.

You can’t believe how many people get bitten by dogs and cats in this country. In remote areas far from health care facilities and where P1,000 is a fortune, people use folk medicine against rabies and apply crushed garlic on the bite. They swear it works.

Maybe it’s not just folk mumbo-jumbo. Government scientists have conducted research on the medicinal properties of several local plants. They should conduct public information campaigns about this especially in areas with little access to state health services.

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The campaign should include warnings about the lack of definitive studies on the medicinal properties of certain plants such as tawa-tawa, a weed that has gained popularity for bringing down dengue hemorrhagic fever when taken regularly as a tea.

Health officials have said they would not stop people from drinking the infusion, but evidence of the weed’s medicinal properties remain anecdotal.

For millions of poor Pinoys, however, even anecdotal evidence will do, considering the prohibitive cost of getting diagnosis and treatment for dengue. Between a widely available weed and medical treatment that can cost up to P100,000 in a private hospital, the choice is obvious for the poor.

Rural folk do as the herbolarios advise and take oregano infusion for colds and mild fever, lagundi for cough, unripe guava for amoebiasis and duhat and ampalaya for high blood sugar. A new trend these days is okra tea or puree for diabetics.

So far there is no herbal medicine for managing cholesterol levels and cardiovascular problems. For those suffering from such illnesses, there is no choice but to wait in line for an entire day at the doctor’s office and hospital laboratories, and then wait another day to have the test results explained.

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Now that the private sector is pitching in to set up drug rehabilitation centers, President Duterte can turn his attention to the acute lack of general health facilities all over the country.

He has health problems himself so he should have a keen grasp of this serious inadequacy in the provision of public health care.

Poor health among the citizenry is also a drain on public funds, as the government shoulders the cost of much of the medical services.

PhilHealth now partly covers treatment for cardiovascular problems, but the subsidy can’t be enough. This is an expensive affliction even for the middle class.

A heart bypass, installation of a pacemaker or a stent is out of the question for millions of Filipinos; they just wait for the worst to come. Kidney dialysis has become cheaper but it’s still beyond the reach of the poor.

Cancer is generally a killer, but its early detection can prolong life. I know cancer survivors who are still around after several decades and remain strong. But they are those who know enough to get an early diagnosis and can afford the expensive and often lifelong treatment.

Health is wealth, but you need wealth to be healthy. Millions of Filipinos are struggling at both.