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Medical ‘brain drain’ comes back to haunt virus-stricken Philippines

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A medical worker wearing a protective mask sleeps inside a free shuttle service for health care workers following the suspension of mass transportation in Metro Manila to contain the spread of coronavirus disease 2019 (COVID-19), in Manila, March 30. -- REUTERS

By Beatrice M. Laforga
Reporter

WELLA, a 20-year-old fresh nursing graduate, chose to stay and work at a private hospital in Manila that’s caring for several of the more than 2,000 coronavirus-stricken patients in the country.

“The government doesn’t care about its overworked and underpaid health workers,” she said in a chat message. “Hopefully my experience would prepare me for a better-paying job overseas once this health crisis is over.”

The Philippines has had to deal with the lack of test kits for patients and personal protective gear for workers on the frontline of battling a novel coronavirus that has sickened more than 1,500 and killed at least 78 people, mostly on the main island of Luzon.

Soon, it will have to face the reality of years of brain drain that led to the exodus of Filipino doctors and nurses to first-world countries including the US and UK.

“China is the second-richest country, so they have enough capacity not just in terms of money, food and equipment,” Socioeconomic Planning Secretary Ernesto M. Pernia told radio DZMM last month. “They also have a number of scientists and health workers, which we lack.”

Local nurses earn a measly P15,000 to P20,000 a month — lower than what a starting call center agent gets, and much lower than the P120,000 salary of a Filipino nurse in the UK, Wella said.

The Philippines had about 41 physicians, nurses and midwives for every 10,000 Fiipinos in 2015, slightly lower than the threshold recommended by the International Labor Organization and World Health Organization, according to the Philippine Institute for Development Studies.

“That said, the supply of the different cadres of healthcare workers are highly uneven when we consider their geographic distribution within the country,” the government think tank said in a December 2019 report.

This is apart from the fact that a number of local health care professionals end up working overseas, it said.

More than 92,000 nurses left the country to work overseas from 2012 to 2016, or about 18,000 leaving each year, according to the Philippine Overseas Employment Agency (POEA).

AN INSULT
Poor compensation and health insurance coverage, work overload and limited opportunities have driven health workers to pursue opportunities abroad, according to a 2007 research by the Health Services Research.

Lack of local opportunities have also driven many workers, not just in the health sector, to leave.

The plight of local health workers came into the limelight this month after Mr. Duerte’s government called out for health care volunteers, promising to pay them P500 daily.

Critics called the offer, which gave free lodging but no benefits except for insurance that will pay P1 million to the family of a nurse or doctor who gets the virus and dies while on duty, a pittance and an insult.

A health worker who gets a severe COVID-19 infection and doesn’t die will be paid a much lower insurance of P100,000.

President Rodrigo R. Dutere locked down the entire Luzon island on March 17, suspending classes and public transportation to contain the COVID-19 virus.

The so-called enhanced community quarantine, which bars people from leaving their homes except to buy food, medicine and other basic goods, seeks to slow the spread of the virus and prevent the collapse of the country’s health care system.

Infections could rise to more than 92,000 by April 12 — the last day of the month-long lockdown — if social distancing protocols were ignored, according to Bacolod-based chemical engineer and research consultant Paulo Emmanuele Betita.

This worst-case scenario could leave almost half of coronavirus patients to die, with little or no medical attention, Mr. Betita said via Messenger chat.

Strict social distancing measures have put the Philippines along a “flat curve” scenario, delaying the peak to the latter part of May, when cases will have reached 35,000, he said.

“This is below the country’s bed capacity of 43,000 but we could not afford to go off the curve,” he added.

The Department of Health (DoH) earlier said that as many as 75,000 Filipinios could get infected in two to three months without the Luzon-wide lockdown.

“Before this pandemic, the health care work force was already overworked and understaffed,” Ely, a 21-year-old nurse at a private hospital in Manila, said. “Now, our work force is on the brink of crumbling because some don’t want to work anymore for many reasons such as transportation problems and the hazard that comes with the job.”

‘DEBILITATING OVERLOAD’
Twelve Filipino doctors have died fighting the COVID-19 pandemic, according to the Philippine Medical Association.

Ely said she works for as long as 16 hours daily “on really bad days” at her 600-bed hospital, which is now overloaded.

Metro Manila and the entire country’s health care system might be “headed towards a potentially debilitating overload” as cases continue to shoot up, according to a report by political consultancy firm PUBLiCUS Asia, Inc.

The country, it said, only has 106,000 hospital beds — not enough for the 125,000 patients it expects to get infected by the virus that has a “conservative” 5% infection rate.’

The government should have built makeshift hospitals earlier because unlike China, it doesn’t have the capability to build hospitals overnight, PUBLiCUS Executive Director Aureli C. Sinsuat said.

“At the very least, the government should work double time to expand the bed capacities of its designated COVID-19 hospitals and stock them with needed equipment,” he said in an e-mailed reply to questions.

As if the sacrifices of its workers weren’t enough, the Makati Medical Center at the heart of the country’s business district was forced to quarantine medical staff after a senator violated his quarantine when he took his pregnant wife to the hospital.

Senator Aquilino L. Pimentel III, an ally of Mr. Duterte who tested positive for the coronavirus, has apologized for the blunder that further reduced the hospital’s already depleted work force.

Other countries hit hard by the virus such as the US, whose national death toll of 4,000 has surpassed China’s, have tried to lure health workers from other countries.

In a March 26 advisory, the US Department of State’s Bureau of Consular Affairs urged foreign medical professionals with an approved US nonimmigrant or immigrant visa petition or/and those eligible in an exchange visitor program to arrange a visa appointment or extend their stay in the country, “particularly those working to treat or mitigate the effects of COVID-19.”

Wella, the fresh nursing graduate, wishes that the coronavirus crisis that has infected about 860,000 and killed more than 42,000 people worldwide will be over soon. “My decision to leave is firm, hopefully when the virus is totally gone.”





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