On hospitals: System of cost and compromise

By Erich Marie A. Mendoza

As a student of biological sciences, I thought of hospitals as spaces for innovations, as a manifestation of scientifically established frameworks capable of saving lives. But when my brother got hospitalized last April, it felt like reality slapped me every time I entered the very institution I used to put on a pedestal.

Access to health care is one of the fundamental rights of every human being, at least in theory. But in third-world countries like the Philippines, health care always reveals itself as a system of compromise, an excruciating mechanism that strips underprivileged people of their rights and dignity. When my 18-year-old brother was rushed to the emergency room, there was a race between his life and the queue of patients outside the hallway. As his lungs gradually collapsed and his chest subjected him to agonizing pain, my mother could only close her eyes and crane her neck to see if the line had already moved for her son’s life. For a family that does not have a safety net or financial means for hospitalization, everything is an out-of-pocket cost. It was excruciating to see my brother endure not only the pain, but also the guilt of being in an emergency situation. He was troubled not only by the blebs in his lungs, but also by the expenses our family had to shoulder with each tormenting day that passed inside the hospital.

Every time I stayed in the hospital, I had to swallow the pain and grip whatever faith I had left to keep my composure intact. I saw my mother’s strength in the moments when my brother would hold her hand tight until he fell asleep because he was scared of the onslaught of pain and of being alone, as the drugs worked antagonistically with his organs. After two weeks in a public hospital, my brother’s condition was still unstable. It was frustrating to wait for the pending results of various tests while my brother was writhing in pain. That moment propelled me to convince my mother to transfer him to a private institution, regardless of the cost. Nanay was hesitant because of the money, or the lack thereof, but we were already compromised.

Everything moved fast in the private hospital. My brother was well taken care of, there was no sweat dripping off his body because the room was air-conditioned, and the results of his scans took only hours to be released. However, every service, from the tests down to the equipment used, had a cost. With the nature of his condition, we were left with no choice but to transfer again to a public hospital but with a private service, “as pay,” just to have his operation immediately. Despite being delirious from the reinforced pain and medications, the primary worries that still corrupted my brother’s mind were the expenses and his education. He generously offered his card, where he receives his stipend from his scholarship, and told Nanay to use the remaining money. I also had to let go of my savings from my own scholarship and online jobs to help pay the bills.

There was this bench situated at the farthest back of the covered area where I used to sit one morning after I slept in the hospital. From that position, I could see many people from different walks of life who were patiently waiting for their names to be called. There were senior citizens, a pregnant woman, a mother trying to lull her toddler to sleep, and other individuals whose faces were bound by the same exhaustion I was going through. I recognized the worry in their eyes and the stillness of their bodies, as if they were one weight of burden away from collapsing. They were spent, but they still had to wait for the system to entertain them.

If bureaucratic processes in health care painstakingly dehumanize people, where does the care in health go? If the system itself creates more vulnerabilities for the underprivileged, then what are we left with?

People with insufficient means, especially money, have to beg and plead for their case in different government institutions for reimbursement and insurance. You have to stoop below your dignity and swallow your pride at the expense of giving a loved one another chance at life. You have to endure pain and patience first before you become a patient. And more often than not, after leaving the hospital, people may not have buried a body six feet under the ground, but they are still buried in debt all the same.

Perhaps this system of compromise also leaves individuals with no choice but to refuse hospitalization and accept their fate instead. Poverty will cost a life, which is the ultimate, devastating manifestation of compromise. And as the cost of health care becomes more inaccessible, our fundamental human right will remain an illusion.

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Erich Marie A. Mendoza is an aspiring writer from Barotac Viejo, Iloilo. She is deeply interested in the complexities involved in life — in living organisms. Erich first became a volunteer in the Marka Merkado project of Kikik Kollektive in 2019. She was also one of the facilitators in the Mata sang Bata, Mata sang Bagyo project of KK in 2023, which focused on the children of Nueva Sevilla, Barotac Viejo.

She is passionate about the way words and thoughts entangle to create a coherent piece, and such works are always motivated whenever she is involved with KK. Her love of nature and biological life in general is sustained while she continues her education as a BS Biology student in Miagao, Iloilo.

KIKIK KOLLEKTIVE is an Iloilo-based independent artists’ collective that creates interventions, collaborations, and community-engaged art projects, with an aspiration to uphold local distinction amid global homogeneity. Known for public artworks and relational programs that narrate stories of traditional public markets, children in the aftermath of calamities, land-based Visayan wisdom, and lesser-known Ilonggo freedom fighters, the collective was among the highlighted artist collectives at the 11th Asia Pacific Triennial of Contemporary Art at the Queensland Gallery of Modern Art in 2024.