The spiteful fangs of Putol

November 17, 2023

by Minerva Jane San Miguel

There is a bully who enjoys terrorizing others at our residence. I meddled in one of his fights one day, and he ended up attacking me. No, he is not a young thug you could talk out of his rebellious phase. He is a cat – a stray alpha cat. And his name is Putol.

Little did I know that my run-in with Putol would put me through the stresses of the Philippine health system.

Putol was attacking our house cats and bit me hard on the leg when I tried to protect my cats. At first, I ignored the wounds since I’m used to getting bitten and scratched by my own cats. But the wounds were too deep, and blood was dripping down my leg. My mom and I had to dash to the nearest facility – the Animal Bite Center of the Quezon City General Hospital (QCGH).

The center had run out of anti-rabies vaccines. I was asked to jot down my name and contact number on a list with ten people ahead of me. The personnel at the center said they would notify me once the vaccines were available, although when this would happen was uncertain.

The nurse was at least kind enough to recommend other hospitals that might have anti-rabies vaccines available. It was already 11:00 PM at this point so we decided to just look for other hospitals first thing in the morning. On our way home, we came across a private hospital just in front of the QCGH. I felt like it was screaming at me, “We can provide anything public hospitals cannot!” That gave me hope that I could get the treatment I needed right away.

My mother, as brazen as she is, went inside the private hospital to inquire how much anti-rabies doses would cost. They said that we would need Php14,000 for the first visit, and the nurse on duty estimated that I would need two to three more follow-up visits. That would be at least Php42,000! We went home.

The next morning, we braved the downpour of Typhoon Hanna and went to another Animal Bite Center, this time at the National Children’s Hospital (NCH). I was diagnosed with “Puncture wound and abrasion secondary to cat bite and scratch category III”. The hospital staff administered two anti-tetanus and two anti-rabies vaccines in both shoulders, two skin tests in both arms, and one shot of anti-rabies medicine on each of the 20 open wounds – all for free as mandated by law. But the shortage of vaccines was apparent – my mom and I had to buy our own anti-tetanus vaccines, and on my third scheduled vaccination at NCH, there were no more anti-rabies vaccines available.

I tried to get my third round of shots at the East Avenue Medical Center (EAMC). Yes, it is a government-run tertiary general hospital. But it is under-budgeted and overflowing with indigent patients, and there’s a fee for each shot.

I witnessed the mothers, fathers and children crammed inside the hospital premises. I could not help but wonder how many of them lost their daily wages because of the time they spent waiting in the hospital. How many of them lost their budget for food because of the high cost of being sick in the Philippines? In so many ways, stepping inside a public hospital feels like your life is slowly being taken away from you. I realized I was already getting tired and sicker, not with Putol’s rabies, but with the toxicity of the public health system.

After two days of not getting my third dose, I found myself inside a private clinic exclusive for animal bite treatments. I learned there that the vaccine brand I was given at NCH is not being supplied to drugstores, private clinics or private hospitals. It is delivered to public hospitals, but dispatch is oftentimes slow. But then if I switched to another brand available at private hospitals or clinics, I’d have to start the cycle of doses all over again. There are also possible complications from mixing vaccine brands.

I repeated the cycle. Somehow, my mom and I could still afford what the private clinic was charging. But health care should not be a privilege like that. I know that many others would be forced to forgo proper treatment, as out-of-pocket spending would mean not being able to buy food and other needs for their families. But health care is a basic human right that the state should uphold.

My anti-rabies shots saga is but a simple example of the decrepit and neglected public health system and how Filipinos are simply driven to expensive and unaffordable private health care. In the House-approved Php5.78 trillion national budget for 2024, the health sector receives a lower allocation of Php325.4 billion compared to the previous year, while infrastructure, defense and debt servicing get huge increases. Patients’ out-of-pocket spending remains the single biggest source of health expenditure, bigger than government spending and its limited, corruption-riddled health insurance program. Practically, the government is forcing the poor – the destitute, jobless and low-income families – to die if they can’t fend for themselves.

My wounds from Putol will heal. My memories of the pain from his bites and the sting of the vaccine needles will also pass, later to be looked back to with amusement. But there is nothing amusing with the Philippine health system. Putol’s fangs will not hold against the bite of a more ferocious and deadly reality – that the Philippine public health system leaves so many Filipinos ill and unattended.