‘INDI NA NAMON KAYA’: Rural Health Units (RHUs) struggle as some hospitals ‘reject’ dengue patients

By: Emme Rose Santiagudo

THE dengue outbreak in the region is taking a toll on the inadequate health facilities in the province of Iloilo.

With limited medicines and overworked health personnel, Rural Health Units (RHUs) in Iloilo, particularly in the town of Maasin, are struggling to respond to rising dengue cases as provincial and regional hospitals reject their referrals.

In an exclusive interview with Daily Guardian, Maasin Municipal Health Officer Dr. Mae Albacete cried out for help, especially from provincial hospitals to accept their overflowing dengue patients.

Albacete said they cannot cope with the dengue cases as all they can do is to manage the patients.

“Indi kami equipped nga mangin hospital, asta lang gid kami ya sa community-based management. Batunon nila tani ang gina-refer namon kay indi na namon makaya,” she appealed.

A visibly stressed Albacete particularly expressed frustration on the refusal of Western Visayas Medical Center (WVMC) in Mandurriao, Iloilo City to accept four dengue patients from the town who are suffering from low platelet count.

She fears that the body count in the town will rise if hospitals refuse the patients they refer.

“As of subong, wala sila gabaton kay wala pa kuno signs of shock. Te, indi na kami gusto nga ma-dengue shock pa ang pasyente kay malayo kami. More than 30 minutes kami away from the hospital. Apat na amon patay, hulaton pa namon mag-pulo para maghulag kami sang pasyente,” she lamented.

Daily Guardian is still trying to reach the WVMC management for comment as of this writing.

According to Albacete, the RHU can only serve as a hydration unit on orders of the Department of Health (DOH) and cannot fully respond to dengue patients already suffering from low platelet count.

“Ang last resort kun indi magbaton ang district hospitals is ang Western Visayas Medical Center. Te indi kuno sila magbaton kay wala pa kuno signs of shock. Sa subong may ara na kami patients tani nga inog-refer with platelet ranging from 50 to 88,” she said.

Due to the refusal of WVMC, the three patients from Maasin were referred to Ramon Tabiana Memorial District Hospital while another was referred to the Western Visayas Sanitarium in Santa Barbara, Iloilo.

 

‘DON’T REFUSE PATIENTS’

Albacete’s ordeal is in contrast to the recent statement of DOH-6 Regional Director Marlyn Convocar where she emphasized that all hospitals should accept dengue patients.

“Wala man requirement, i-treat gid nila once it is referred sa hospital. Indi gid sila mag-deny sang patients,” she said in a press conference on Monday.

In fact, Convocar said even private hospitals are allowed to exceed their bed capacity in the face of the outbreak just to accommodate the dengue patients.

“In times of outbreak like these, gina-allow naton sila mag-exceed sa ila bed capacity kesa nga indi nila ma-cater ang patients. We could not turn down any patients nga nagakadto in times of outbreak like this. Iban pwede man ibutang sa alley or sa conference room. Pero as much as possible, i-accommodate gid naton ini sa gobyerno nga facilities,” she added.

The town of Maasin has already converted its gym into an annex of the RHU to accommodate the growing number of dengue patients.

The hospital nearest to the town is the 75-bed Ramon Tabiana Memorial District Hospital in Cabatuan but it is also overcrowded with dengue patients.

The gym in Maasin, which has been operating 24/7 for two weeks now, accommodates 34 dengue patients amid limited medicines and overworked personnel.

“Gasululod ang mga cases sa gihapon and maskin ang mga admitted case. Amon challenges kay medyo gamay personnel gid naton, indi naton ma-predict kun sano sila ma-give up although ga shifting sila. Ang aton mga bulong, maskin ma-emergency purchase kami, amon bulong gakulang-kulang,” Albacete lamented.

To counter the increasing dengue patients admitted in hospitals, Convocar said that they already issued an advisory that all Rural Health Units can be used as hydration units for patients who do not exhibit warning signs (i.e. abdominal pain, persistent vomiting, signs of fluid accumulation, mucosal bleeding, lethargy, restlessness, liver enlargement, increase in hematocrit and/or decreasing platelet count) and are able to tolerate adequate volumes of oral fluids.

“Ginabuligan naton ang mga pasyente sa ospital by the hydration units nga ginaubra naton. Ang effect sang mga hydration units, nabuhinan naton ang mga admitted cases sa hospitals para ang hospitals ma-focus na gid sila sa mga patients nga ga-exhibit warning signs,” she said.

From January 1 to July 13, 2019, the health department has recorded 18,834 dengue cases with 94 deaths in the region.

The provinces of Aklan, Antique, Guimaras, Iloilo, Capiz and the highly-urbanized Iloilo City have declared dengue outbreaks.

On Tuesday, the Sangguniang Panlalawigan placed the province of Iloilo under a state of calamity due to dengue with 23 deaths and cases surging to 6,806 as of July 13, 2019.