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To the people of a province
too young to even build its own capitol building, neglect
is a twin sister they have to contend with. Mustering the
courage to separate from the mother province of Zamboanga
del Sur to make a niche of her own is like learning to run
before she can even learn how to walk. But it is a
decision borne out of despair. Long been neglected in the
share of the largesse for development by the mother
province, this one-year old province of Zamboanga Sibugay
decided to make it on her own. This young province has
calculated the odds wisely and has drawn on the strength
of the people hoping to cope with the ever-growing needs
of the time. Zamboanga Sibugay may have been cut from the
umbilical cord of Zamboanga del Sur, but the hope to
survive is greater now.
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| To the people of
a province too young to even build its own capitol
building, neglect is a twin sister they have to
contend with. |
Dr. Rolando Olmoguez, head of
the Health District Management Team (HDMT) of the Alicia
Integrated Health District is one of the provincial
employees who has lots to worry but with less time to
think about them in this peculiar situation of an infant
province. He feels that the new provincial leadership is
not keen on extending the term of office of this highly
specialized health project coordinated and partly funded
by the Government of Belgium thru the Belgian Integrated
Agrarian Reform Support Programme (BIARSP) and partly by
the provincial government. But he casts the worries aside
to focus on the more important task of achieving the
objectives of the programme.
HDMT is a concept first
adopted by the old province where the political leadership
in coordination with the BIARSP focused on the ten most
depressed municipalities for the effective delivery of the
health services system. With the separation of these
municipalities to a new province of Sibugay, the new
leadership is looking at the project with hawk eyes and
stingy purse to pursue other priority thrusts. This is
something that worries Dr. Olmoguez.
Dr. Olmoguez cannot really
blame the new leadership for their prevarication. With
little resources and money left for infrastructure and
lots of monetary headaches facing them in almost all areas
of governance and service delivery, they must look for
measures to cut costs at all corners and his "special
department" is a sore thumb sticking out.
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Aside from the increase in consultations, which
indicates increase health care awareness in the
locality, the local Municipal Health Office is also
setting up a municipal-level information system,
which records patents' medical data and could easily
track down medical history of all patients for
future reference. |
Dr. Olmoguez can only bring
with him the data to the capital town in Ipil, to convince
the new leaders why his special department should stay.
After all, he rationalizes; health delivery is just as
important as bridges and roads, or in this case, a new
capitol building.
"I am re-inculcating in the
leadership the age-old saying that health is wealth," he
smiles wanly. Dr. Olmoguez ticks off all the reasons for a
continued existence under the concept drawn up by the
Government of Belgium. Since its inception in 1999, until
this date, the new province has in place, 10 municipal
health offices in 10 municipalities including 3 in the
island municipalities of Olutanga, Talusan and Mabuhay.
Dr. Olmoguez can't thank the BIARSP enough for a very
convincing support system worthy of note.
As the concept went, the HDMT
is responsible for the two-fold objectives of preventive
health care and direct health services in the 10 pilot
areas. Towards this objective, the BIARSP has financially
and logistically supported the HDMT in convincing the
local municipal government to employ a complete complement
of medical staff to attend to the health needs in their
municipalities and even in the most inaccessible barangay
within its scope of influence.
"Complete complement" means a
doctor, a rural health nurse, a midwife and a sanitary
inspector shall be employed and working in every
municipality listed as pilot health areas as stipulated in
the Memorandum of Agreement between the Government of
Belgium and the Government of the Philippines.
Lobbying and persuasion talks
were employed with the municipal leadership in order for
them to fund the salaries of the medical staff complement
and some of the support logistics needed to run a working
rural health office. After all, BIARSP has committed
funding support to those who can come up with the required
counterpart funds at the municipal level.
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Dr. Rolando Olmoguez, head of the Health District
Management Team (HDMT) of the Alicia Integrated
Health District is one of the provincial employees
who has lots to worry but with less time to think
about them in this peculiar situation of an infant
province. |
Of the 10 municipalities
originally identified, none has come up with a doctor at
the onset. Two years after the BIARSP intervention and
persuasiveness, 6 municipalities have already employed a
complete medical team, paying them from out of their own
municipal coffers, 1 municipality has 1 doctor now waiting
for the processing if his appointment papers and 3
municipalities have already earmarked in their budget the
position of a doctor but unluckily hit the snag when no
doctors are interested as yet.
"We need to sweeten the pot,
in the rural areas, especially in these three
municipalities," Dr. Olmoguez reasons out.
Of the 6 municipalities with
the complete medical staff, the municipal health center
under the direct monitoring of the HDMT has so far reaped
tremendous successes. The Municipal Health Office (MHO)
had institutionalized consultation for the ordinary health
problems like respiratory illness and common infections
not discounting the treatment of slight traumatic wounds
related to farm works. It has also credited the presence
of the complete medical staff to the early detection and
referral of chronic illness to much better equipped
hospitals and has drastically reduced suffering and
mortality in these areas.
Dr. Olmoguez points out that
the mere presence of the medical staff has bolstered the
confidence of the populace in these depressed areas. "Now
they can have the much-desired professional medical
assistance for them to alleviate their sufferings and
fears. Something that was never attempted to in the past,
much less attended to," he says.
Aside from the increase in
consultations, which indicates increase health care
awareness in the locality, the local MHO is also setting
up a municipal-level information system, which records
patents' medical data and could easily track down medical
history of all patients for future reference.
Dr. Olmoguez also boasts of
the medical supplies and equipment provided by BIARSP on a
'cost recovery scheme' to the municipalities.
"We have made the municipal
health office not only a place of consultation, but also a
pharmacy, so people can buy their medicines at affordable
prices. Traditionally, a patient is attended to by a
municipal-based doctor, which is seldom, and is given a
prescription for his illness. He then goes to the
sari-sari store for his medicine, pharmacies being rare
fixtures in these municipalities. It would be lucky
though, if the corner store could serve out the prescribed
medicine. The patient then either chooses to just dismiss
the illness or spend thrice the cost of the medicine in
fare money to go to the more urban municipality where
pharmacies can be found.
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It
would appear that with the bold innovation adopted,
the municipal health office has now a stockroom
which doubles as a pharmacy. The medicines were
bought by BIARSP as base level inventory of
medicines which can be sold at low cost. |
"Now, such dilemma has been
addressed, thanks to the intervention of BIARSP thru its
Primary Health Care component," Dr. Olmoguez gives the
government of Belgium full credit for the innovation.
It would appear that with the
bold innovation adopted, the municipal health office has
now a stockroom which doubles as a pharmacy. The medicines
were bought by BIARSP as base level inventory of medicines
which can be sold at low cost.
Dr. Olmoguez browses on his
record of the exact amount of the inventory of drugs -
PhP600,000 worth of drugs distributed equally to each of
the ten municipal health offices of the province, for a
total of PhP6 million.
"It has enhanced patient's
compliance to drug therapy and has solved the perennial
health problems of the locality," he quips.
"For what good is a doctor's
prescription when the patient cannot buy the medicine?" he
philosophically admits.
The concept of a botica
(pharmacy) as a cost recovery store is spreading like
wildfire in the municipality. It has tremendously changed
the concept of foreign grants as dole-out and has
revolutionized the psyche of the residents.
Initially, the cost-recovery
system was met with mixed emotions by the local folk who
thought everything could be had for free. Some were
grateful, others lukewarm and most were not interested.
"But as soon as we convinced the rural folk that the
sooner they accept that there is only a base inventory of
free medicines and in order for the program to continue
they have to par for what they consume so we can have
funds to replenish them, the better for all of them. We
are on our way to sustain it," Dr. Olmoguez beams.
"Unavoidably, we still have
indigent cases. We either refer them to the municipal
heads for donations, or give them the medicines on a
charity treatment. We discourage the practice as much as
humanly as possible through," Dr. Olmoguez sadly admits
too.
Dr. Olmoguez could not be
happier to report the "sidelights" of the programme, too.
He says on a periodic basis, the BIARSP sponsors the human
resource development of the medical staff under its sphere
of intervention.
"Seminars, trainings and other related fora
are made available to the medical staff enriching not only
their technical expertise, but also their interpersonal
relationships with the co-workers and their patients,
too," he adds. Learning from the seminars and fora are
then applied or re-echoed by the participants to the
people in the municipality.
(Excerpt from STREAM, BIARSP Bi-annual Publication) |
