A nurse’s plight under health care system ruled by patronage politics

“If you do not have that certification, you cannot avail of hospital services.”

By ANNE MARXZE D. UMIL
Bulatlat

MANILA — For the past five years, registered nurse Marylou Anto, 27, worked as a volunteer nurse at the Camiguin General Hospital (CGH) and received P2,000 ($21) a month. After more than a year of working as volunteer nurse at the CGH, she worked as community nurse under Department of Health’s RN Heals program for a year and received at least P8,000 ($163) a month. She worked again in CGH with a status of job-order and on March 1 this year, she was finally appointed as a regular nurse in the CGH with a salary of P14,500 ($295).

But just three months later, her hard-earned job status came crashing down because of a single picture.

On June 29, Anto was terminated after the picture she took of a document in the patient’s file circulated in social media. It was a photo of a barangay (village) certification, which stated that the patient is a “true and real supporter” of the Romualdo administration.

Anto’s case typifies the situation faced by Filipino nurses under a devolved system, which puts them at the mercy of the local powers-that-be. The Filipino Nurses United (FNU) has criticized that the devolution of health services affects not only the management of human resources, but also the delivery of services, which are often used to promote political patronage.

Anto’s legal counsel Homer Mabale said patronage politics has been the norm in the island for many years. “If you do not have that certification, you cannot avail of hospital services,” Mabale told Bulatlat in a phone interview. Those who do not have certificates are referred to a hospital in Cagayan De Oro, he said.

The Romualdo family has been in power in Camiguin Island since 1987, a report by the Philippine Center for Investigative Journalism said.

When the devolved system began to be implemented in 1992 under the Local Government Code of 1991, basic services like health were decentralized from the national government to the local government units, mostly ruled by political clans such as the Romualdos. (Read also: Devolution and Corporatization of Health Services)

The FNU believes that the devolution of health services is one of the major factors why seven out of 10 Filipinos are dying without seeking medical attention.

“With inaccessible health care and widespread poverty, patients go to hospitals in worst stage of diseases, requiring them more intensive level of care,” FNU said in a statement.

Members of the Filipino  Nurses United picketing in front of the Philippine General Hospital during the Philippine Nurses' Week last October. (Photo grabbed from FNU official Facebook page)
Members of the Filipino Nurses United picketing in front of the Philippine General Hospital during the Philippine Nurses’ Week last October. (Photo grabbed from FNU official Facebook page)

They added that the “role of local governments are undeniably of extreme importance in health delivery, in primary as well as advanced level of care, alongside with the relevance and responsiveness of health human resources.”

Humiliated and degraded

In a phone interview with Bulatlat, Anto said she had no intention of circulating the photo of the certification as she, too, had to obtain such certification to be able to work in the local government hospital. It has become a sort of requirement, she said, not only for their employment but also to avail of the medical services.

Anto sent the photo of the certification to a person close to her just to share the policy in their province. She did not have any knowledge that the photo she sent was again passed on and was disseminated. Anto was shocked upon learning that the photo of the certification circulated in social media.

She said when the Romualdos had learned about the circulation of the photo of the certification, an angry Governor Jurdin Jesus Romualdo berated employees during the flag ceremony. She eventually admitted to her superiors that she was the one who took a photo of the certification so that her co-employees would not be wrongfully accused.

On April 27, Anto was called to the “mansion” of the Romualdos where she was humiliated and degraded by the governor, along with his son, Congressman Xavier Jesus Romualdo. She said both cursed her in front of other people.

“They were really angry, and they asked me why I ‘leaked’ the photo. I said I did not have the intention to do that,” she said. The two government officials threatened to have her fired.

Back at the hospital, the management told Anto to submit an incident report, while the grievance committee asked her to submit an affidavit signed by her lawyer but her counsel advised her not to do so. She said a dialogue was held with the grievance committee only once and was told that an investigation will be conducted. On June 29, she was shocked to receive an order of termination, issued and signed by Governor Romualdo, stating that “the act of taking picture of the barangay certification constituted breach of confidentiality and unsatisfactory conduct.” Anto was dismissed through official order No. 13 also issued by Gov. Romualdo dated June 30. She said she did not receive any copy of the said ‘investigation’ conducted by the grievance committee.

Violation of a public worker’s rights

Mabale said her termination is an outright violation of RA 7305 or Magna Carta of Public Health Workers, particularly Section 12 which states that “In every disciplinary proceeding, the public health worker shall have:

a) The right to be informed in writing of the charges;
b) The right to full access to the evidence of the case;
c) The right to defend himself /herself and to be defended by a representative of his/her choice and/or by his/her organization, adequate time being given to the public health worker for the preparation of his/her defense;
d) The right to confront witnesses;
e) The right to appeal;
f) The right to reimbursement;
g) Such other rights as will ensure fairness and impartiality during the proceedings.

Mabale said they filed an appeal before the Civil Service Commission Region 10. They have also charged Romualdo with grave abuse of authority before the Office of the Ombudsman.

Making a stand for change

Anto said she had no regrets about taking a picture of the certificate, because it only showed the inequality that the people of Camiguin have been enduring for many years.

Anto has two sons, age one and seven years old. Her husband works, but his income is not enough to cover all their expenses. She thought about working abroad to support her family but, she said, she could not turn her back on her community who are in dire need of health services.

She said the hospital does not only lack nurses, but also medicines and doctors. “When there is no doctor, the patients are referred to Cagayan De Oro. What if the patient has no more money for transportation?” she said. The CGH is a tertiary level hospital in Camiguin Island.

Anto is now with the Kilusang Pagbabago, a civil society organization formed by Mabale that is clamoring for genuine change. Mabale said the people of Camiguin want change as they have been ruled by the Romualdos for the past 30 years, “The people want to be free, they are just afraid to talk,” he said.

Meanwhile, Anto is encouraging all nurses who are overworked, underpaid and are experiencing harassment and exploitation to come forward and talk. “There will be organizations like the FNU who are willing to help you,” she said.

The FNU hoped there will be reforms for nurses. “With the new national administration’s promise of change, we hope that the ‘abnormal’ and the unjust conditions would no longer be the norm.”

The group said that the past 25 years of devolved health care only proved that social services like health should be under the national government “which has the state responsibility and accountability for people’s health as well as the welfare of nurses.”

“FNU believes in a health care system that cares for its nurses, cares for its people.”

On the commemoration of Philippine Nurses Week last October, the FNU gave its “highest recognition to the hard-working nurses, who are struggling daily to attend to thousands of patients in an ill-equipped and demoralizing health care working environment.”

They also reiterated their call for government to observe their right to job security, just compensation, and adequate benefits. ()

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