MARK RUSSELL CARANZO ||

In fear of contracting COVID-19, soon-to-be mother of three Katherine Bulatao chose to give birth in their home in Caloocan. However, she suffered intensive blood loss which demanded immediate medical intervention. After being refused admission by six hospitals amid profuse bleeding, 26-year-old Katherine passed away—five hours after giving birth.

This incident does not only speak of an unfortunate circumstance solely distinct to Katherine. Instead, her death reflects a bigger issue pertaining to a problematic healthcare system and a demarcating line separating our society into the privileged and the oppressed.

Katherine’s husband received disparate reasons from the hospitals they had sought. These included the lack of resources and demand for initial deposit. Hence, it would be substantial to address each one.

Firstly, Republic Act No. 8344 states that in cases of emergency wherein there is inadequacy in necessary facilities and/or supplies, it is the responsibility of the hospital to direct patients to nearby health institutions capable of providing the medical care these patients require. However, the transfer could only be done once the receiving hospital has agreed and emergency support has been administered. However, taking the husband’s claims as accurate, the aforementioned procedures were apparently unfulfilled. Instead, the hospital where the patient was referred also refused admission citing the shortage of available rooms. Furthermore, the husband claims that the hospitals did not bother to check his wife’s vital signs.

Secondly, the patient’s right to appropriate medical care and humane treatment, as specified by the Department of Health (DOH), was indiscriminately violated after a hospital allegedly asked for a thirty thousand-peso deposit. The DOH has long inculcated that discrimination deserves no place in public healthcare especially with regard to a patient’s financial capabilities. The act was also in grave contrary to the Anti-Hospital Deposit Law, which took effect in 2018. 

Katherine’s case has indubitably unveiled prevailing issues in the Philippine healthcare system that are in dire need of attention.

For one, the country lacks health facilities, medical supplies, and healthcare providers. For instance, the World Health Organization (WHO) recommends 20 beds per 10,000 people. Nonetheless, the Philippine Statistics Authority (PSA) reported that the hospital beds in the country only stagger at 9.9. On the other hand, the WHO recommends 1:1000 doctor to population ratio but the Philippines falls short at 1: 33,000. In terms of community healthcare service, only 47% of barangays have operational health centers. This undeniable deficit has become highly conspicuous when the system was overwhelmed with the pandemic. The availability of ventilators has dictated the maximum capacity of hospitals to save lives.

In the midst of this lack, one thing is certain: justice needs to be served.

Therefore, the government needs to examine the case closely in order to identify blatant violations. If proven guilty, the hospitals should be held liable to ensure that future similar incidents would be prevented. Otherwise, the enforcement of pertinent laws would be rendered ineffective.

In addition, the case is a negative externality of the government’s low prioritization of health sectors as evident in the national budget. The over-all share of the sector has plummeted from 4.9 to 4.5 percent. This has cut the budget of essential projects such as the Health Systems Strengthening Project by 6 billion pesos. Hence, the government must increase the budget of health sectors for the betterment of healthcare services in the country.

It is indeed disheartening to witness unnecessary deaths in a time when saving lives is critical. Undeniably, Katherine is just one of the many Filipinos who are victims of a poor system. Thus, mandated by the Constitution to uphold public interest at all cost, the government must work hand-in-hand with Philippine hospitals to ensure that healthcare is no longer just a right for the privileged nor a luxury for the oppressed.

Mark Russell Caranzo ||

Incarcerated behind the bars of indifference and selective justice, human rights worker Reina Mae Nasino, mourned in jail over the death of her three-month-old baby, River, amid constant pleas for release. Oblivious of her pregnancy during the onset of detention for supposed illegal possession of firearms and explosives, Nasino gave birth and nursed baby River in the Manila City Jail before she was separated from her child a month after. River’s health deteriorated fast after the separation. Despite Nasino’s appeals to allow her to take care of her terminally ill child, the court remained apathetic to the mother’s request. 

River’s death speaks volumes of how the Philippine justice system has failed to serve public interest once more. In the first place, the court did not consider the urgency of the situation when the National Union for People’s Lawyers (NUPL) requested to grant Nasino the opportunity to stay with her baby for at least a year, more so when the baby was reportedly sick. In fact, the court junked such petition citing inadequate resources to ensure she remains detained while nursing her baby. However, with the country in the pandemic’s stranglehold forcing lockdown for all its citizens, a case for Nasino’s “escape” from authorities is flimsy at best. 

Moreover, Nasino’s case was an apparent juxtaposition of court decisions that were previously ruled out to VIPs and other influential persons. For instance, if the Sandiganbayan granted Sen. Bong Revilla a five-hour furlough to visit his sick father last 2015, then why can a lower court not do the same? As stated in the Human and People’s Rights Declaration of the Philippines, every person must be treated equally before the law. Therefore, it is undeniable that the concerns regarding selective justice that netizens have voiced out are all well founded.

In order to prevent another case such as this from happening again, what then needs to be done?

First, the amount of time allowed for children in custody to be with their mother (which is currently one month in the Philippines) should be extended. For reference, other countries such as Malaysia allow detained mothers to be with their children for up to four years. Looking at the Philippine context, such one-month rule poses a problem as according to psychoanalyst and parenting expert Erica Komisar, mothering is very crucial to the first three months of a child. She added that intense closeness and skin-to-skin relationship remain critical for up to three years, things which both River and her mother were sadly deprived of.

In line with this, the government must also invest in bettering jail facilities for inmates with specialized needs such as pregnant women. For instance, based on a report by the American College of Obstetricians and Gynecologists, incarcerated pregnant women must not be compromised nutritionally, and must instead be given full access to prenatal care through regular obstetric visits, among others. At the same time, the Birth Companion charity has emphasized that postnatal facilities are also of tantamount importance. The group argued that well-ventilated breastfeeding sections, antenatal clinics, and regular family visits must be seen as prerequisites. It is therefore obligatory for prison systems to give highly vulnerable Persons Deprived of Liberty (PDL) the appropriate treatment that they deserve.

In conclusion, it is undeniable that deliberate indifference and selective justice played a significant role in the death of baby River. As Atty. Edre Olalia of the NUPL said, “What kind of justice system, nay, society, do we have to let this inhumanity and injustice to mother and child happen?” Unfortunately, more of these accounts are bound to happen, unless the Philippine justice system becomes an equal playing field. Indeed, baby River was a victim of a problematic system, yet every Filipino must be aware that this system would continuously exist and persist, unless otherwise challenged and rectified.