Cast & Curious

Tag: Politics

  • Taming a Firecracker Craze Nation

    Filipinos should get rid of another culture we imbibed from colonizers – the love for the new year, firecracker bang. It is said that new years eve revelries isn’t “happy new year” without a loud, ka-boom in our backyard.

    The firecracker lighting habit, will supposedly ward off  bad “spirits” and bad luck in the coming year.  An entirely huge  business market (legit or otherwise) emerged from this  habit. This , together with our superstition,  fuel a culture of indifference that is dangerously playing with life threatening injuries.

    Legit firecrackers makers says it’s a problem with implementation of regulations, the illegal ones say they’re just “earning a living”. Department of Health noted there is a yearly reduction of firecracker injuries (17% this year) and proposes a selective ban of firecrackers. The national overnment on the other hand  let the local government impose its own “rules” on their constituents. What does the ordinary Juan dela Cruz say? 

    No (credible) survey has been made on this yet. If ever there will be, will you be for a total ban on firecrackers or selective ban? Please comment below for your answers.

    As a physician, I had my stand on this since 2009- a total ban, and I’ve said my reasons years ago in the same post. In a country where imposition of ‘selective” laws is wanting (selective logging ban, remember?), another selective law is a joke. (Ironically, some of our esteemed authorities was caught on camera squabbling to get their hands on firecrackers confiscated after their photo-ops!).

    Loss of fingers and hand functions from a firecracker (Photo by Phillip Ko)
    Loss of fingers and hand functions from a firecracker (Photo by Phillip Ko)

    From a physician and surgeon who deals with firecracker injuries every new year, even a single firecracker injury is unacceptable. It is one totally avoidable surgical condition and expense. Be realistic? Look at Davao City, who had a total firecracker ban for many years already and have zero firecracker injury case for 4 straight years. How much did the local government saved on the medical expense of treating firecracker injuries? of fires brought about by firecrackers? Of cleaning up trash? Treating bronchitis from smog of firecrackers?

    Firecracker reduction and statistics are for bureaucrats who deal with laws.  I deal with extremities, with functions and quality of life. That is obviously a minus for those who were victims of firecrackers! Thus I repeat, a single firecracker injury is unacceptable. Total ban on firecrackers should be imposed.

     

  • Do we need a law that protect healthcare providers if they disclose or confess medical errors?

    Central to correcting medical errors is accepting one first, if it did happen. Improvement in healthcare delivery will only happen if we learn from our mistakes and make concrete, active steps to rectify it. This is what we actually do during mortality and morbidity conference- analyze medical events and cases to help improve delivery of healthcare services.

    The health care industry accepted the occurrence of medical errors decades ago. But disclosing medical errors publicly is unpopular even in countries where litigation is relatively not so common. Why? No one really knows. In our society however, publicly apologizing for one’s true medical mistakes is akin to killing your medical career. I guess it’s a bit easier to admit moral turpitude publicly than let’s say admitting you misdiagnosed a patient. The acceptance is just too low.

    But what can we do? First, we should create an environment of open-mindedness among medical peers and enact laws that will protect disclosures of medical errors publicly. That way, we can freely examine medical errors to institute appropriate corrective actions based on acceptable and evidenced based medical practice.

    This is what John Hopkins University Hospital is doing since 2001. Their  Disclosure Policy  protects and actually encourages employees to confess or report medical errors. This is partly the reason why JHUH  litigations have continually decreased ever since the policy has been implemented.  John Hopkins is the top ranked hospital in the US for 20 years already.

    Medical errors simply don’t surface over time. For us, providing a “medical whistle blower” law might just be the first step in improving delivery of healthcare services. Don’t you think so?

     

  • Blind Eye: Unabated rising number of motorcycle accidents

    Last Monday, on my way to Davao City, I was again a witness to two road accidents  involving motorcycles. In one roadside, a lifeless body, lay on the ground after he and his motorcycle drove straight underneath a hauler truck.  In another road just several miles away, another motorcycle rammed into another motorcycle head on.  Broken glass and blood are splattered all over the road. Both drivers were rushed to a hospital.These gory sights shocked even surgeons like me.

    Motorcycles accidents top the list of vehicular accidents in our country today. This is according to the Trauma Registry of the Philippine Orthopedic Association. In my orthopedic practice, approximately 60-75% of cases I’ve handled are related to motorcycle accidents.  In government health care institutions, more than half of the ward patients are victims of motorcycle accidents.

    A "shredded" motorcycle and its driver.(Photo from this site http://www.vf750fd.com/motorbikes/crashes/accident/motocrash.jpg)
    A “shredded” motorcycle and its driver.(Photo from this site http://www.vf750fd.com/motorbikes/crashes/accident/motocrash.jpg)

    The type of injuries that motorcycle accidents bring are not only complex, but also unique. These injuries pose great challenge to our surgeons and require costly, repeated operations that exhaust both the patients and health care providers.  I bet if the health care community do a cost analysis of treating motorcycle injuries and the amount at which government spend to save this patients, we’d be all shocked.

    Some observations I have regarding motorcycle accidents:

    1. Drunk driving or driving under the influence of alcohol. Illegal but rarely enforced.
    2. You only need Php 2,000.00 downpayment to get and drive your new motorcycle. The motorcycle industry is a huge market. Motorcycle makers really made acquiring motorcycles easy.
    3. Lukewarm or almost non existent enforcement of motorcycle laws and regulations.
    4. It’s very easy to get drivers license in the Philippines. Some say, in the Philippines, even a blind person can get a driver’s license.
    5. Teenagers sneakingly drive motorcycles and they drive like road kings.
    6. Some schools give parking spaces for students with motorcycles. I mean, do they check if these kids have driver’s license?
    7. Approximately half of motorcycle drivers nowadays have one violation or two in their motorcycle ” papers”. No or expired registration, etc..
    8. In the Philippines, because we are culturally magnanimous, we still shoulder medical expenses of motorcycle accident injuries  even if it was the motorcycle driver’s fault.
    9. Motorcycle injuries in my city dropped when there was a rise in motorcycle theft and deaths.
    10. Motorcycle injuries also dropped when the gasoline prices rose sky high.

    There I’ve said it. Well, authorities can simply deny all these and more and say we’re all fine. Lack of budget and manpower seem a pretty good excuse I suppose. But the fact still remains, motorcycle related  accidents keeps on rising. Just watch your TV channels evening news and you’ll know what I’m talking!

  • Where’s health and education now Mr. President?

    I had mixed feelings after reading the text of  your recent State of the Nation Address (SONA) Mr. President.

    On one part, I got excited when you detailed some of what many of  your countryman (which you gracefully called your Boss) knew years ago- corruption is rampant among many of the government agencies. That however, is old story to us Mr. President. My eardrums has thickened hearing all those  exposes that ended up in the waste can for “lack of evidence” and so many legalese gobbledygook. Put the corrupt officials behind bars and recover the peoples money and we will be all excited and happy. Including my eardrums.

    The other part of me had this bad feeling about what might happen to your other priorities mentioned in your campaign. Your tone on corruption is very much aligned with your campaign tag line, but you spoke less on health and education. Where are they now in your priorities Mr. President?

    Yes, the statistics on Philhealth coverage is confusing. But so is our health care system. You mentioned correcting the coverage statistics and expanding Philhealth coverage  to every Pinoy. It sounds good on our ears but personally Mr. President, its not enough to heal the woes of our health care system. Many of your Boss, cannot survive Philippines with Philhealth coverage alone.

    And education? I can barely make anything of what you mentioned, yet. Frankly,I spent half of my lifetime in school and yet I barely can put food in my table. That’s why i doubt prolonging  years in school actually translate to a quality life.

    I understand you’re trying to paint a picture of a negative starting point for your term. (Give thanks to the previous administration by the way, they made that painting an easy task for you with all those nauseating scandals). But that is the same reason we put you in charge now Mr. President. We believe you can be a good president even if you start from a negative starting point. We believe you can save us,  your boss,  from lingering in the kamote fields.

    You asked for our support. If you noticed, there are many uprisings we supported in one way or another-rebellions, coups, edsa and even green revolutions. The people have shown their support to the presidency in so many times already. The people rallied to support so many crusaders but most of them failed us in many respect. Look at us now, we’re back to square negative. Maybe its high time you give us results already. You are the president. You weave power enough to do all of these reforms. Results is all we’re after now.

    In all of this Mr. President, my prayers is with still with you. Give back health and education to the people .  Make them your priorities. And give us results.

    You cannot fail us. We forbid you.

  • Top Five Health Care Priorities Needing Immediate Positive Action

    What are our healthcare priorities?

    Health care issues that have been there before he ascended into office. Pres. Benigno Aquino III, my president, if health is one of your top two (other is education) thrust for governance, these are the issues that needed your immediate attention and resolution.

    1. Realistic, workable and universal health care reform policy that covers ALL the stakeholders in it.
    2. Control population growth explosion vis a vis the reproductive health care law implementation.
    3. An national health insurance system that is expanded and will benefit not just patients but to health care providers as well.
    4. Implementation of Magna carta’s for patients, magna carta for health workers, including the freedom of the “Morong 43”.
    5. Restructuring of the medical education act and the policies governing education of our health care workers.

    Too much?Impossible? Hard definitely. But not impossible. Six years enough?I took Ninoy his life to give us our freedom. Whether you like it or not, that will be our standards for your performance.