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FEATURES
January 22, 1998
home Rx: Diagnosing the Infirmary
Misha D. Pallorina
Stepping into a hospital makes one feel so sterile.

Stepping into the University Health Service (UHS), however, is another story altogether. There seems to be no difference between the street's polluted air and the Infirmary's general milieu. Worn furniture, murky fluorescents, stained walls.

Medical History

Founded by the Board of Regents (BOR) way back in 1929, the UHS was first housed on Florida Street. It eventually transferred to Padre Faura in 1933. After surviving the World War II, the UHS was relocated to Diliman, Quezon City in 1949. The building we now frequently pass sitting just across the UP Chapel and beside the Shopping Center was erected in 1957. The Virginia Llamas Romula Pavilion, an annex for more rooms, was then added in 1971.

In 1973, President Lopez believed that "the University community is entitled to the best health care available," and envisioned the UHS as the fulfillment of this demand. Whether or not the Infirmary has answered the UP community's call for the "best health care," what is certain is that the Infirmary has met the need for the most economical medical service.

Although the UHS has evolved from a 12-bed to a 50-bed hospital, it was stripped down to 25 lately. Still, UHS Director Dr. Marcia Macalinao maintained that "compared to other hospitals, we are very low [priced]." The Infirmary offers the free blood tests, urinalyses, picalyses, and physical examinations to UP students and employees. Aside from these services, the Infirmary's rooms are also in demand. Prices, which are based on the 1983 rates, are almost ludicrously low. The airconditioned single room costs P100/day, with a 35% discount for UP employees and 60% discount for UP students. Outsiders, meanwhile, have to pay P350/day. Considering that these rooms will easily cost P800-900/day in other hospitals, the slight difference isn't anything to whine about. But that isn't the only goodie in the bag: UP students also get a two-week freebie upon admission to the wards.

Classified by the Department of Health (DOH) as a primary hospital, the Infirmary's beds cradle patients with "simple, uncomplicated, and medical conditions to a limited extent." Illnesses such as chickenpox, measles, mumps, and the like are under this category. Cancer, stroke, and hypertension clearly belong to another category. Still, according to Dr. Macalinao, the Infirmary houses patients with these illnesses because they cannot turn down the family members of UP employees who prefer the Infirmary's low rates. "[Because of this] we are classified as secondary, minsan tertiary pa," she claimed.

Flipping Through the Medical Records

This primary hospital is where College of Human Kinetics Administrative employee Mrs. Carmelita Martinez was brought last December 26. Her illness was rather uncomplicated compared to others in the UHS -- it was diarrhea, which she attributed to the Noche Buena she had just eaten.

According to Mrs. Martinez, the attending physician Dr. Yutoco and the nurses left her unmonitored since she arrived at the Emergency Room (ER) between 11 pm and 12 midnight. Dr. Yutoco, meanwhile, retaliated this.

UHS records testified that Mrs. Martinez was admitted in the ER at 2:50 am. Dr. Yutoco then gave the patient Diatabs, hydration fluids (hydrite), and a Buscopan tablet. Afterwards, when the patient complained of cramps at 4 am, "wala nang ginawa si Imee [nurse at that time]...kung hindi i-massage 'yung binti niya...si Alet [nurse who relieved Imee] ganoon din." Former Director Dr. Edrosa added that "the nurses' center...is centrally located...hindi maaaring hindi siya namo-monitor."

Mrs. Martinez claimed that she lost so much fluids due to loose bowel movement and vomitting that she was infused with approximately four dextrose bags a day for three days at the New Era Hospital. Dr. Yutoco countered that Mrs. Martinez had been given a total of three to four hydrites. "That's enough for four hours of [fluid] losses," Dr. Yutoco added. She further stated that Mrs. Martinez had not been given intravenous (IV) fluids because the patient adamantly refused the dextrose and instead asked for oral hydration.

Still, Mrs. Martinez maintained that she was denied admission to the Infirmary because, the nurse on duty allegedly told her a memo from the Chancellor ordered that only UP students would be admitted in the Infirmary. "Wala akong sinabing hindi ko siya a-admittin," Dr. Yutoco explained. "I think I have an inkling na sinabi ni Alet na ward lang 'yung available, and usually pag ward nalang ang available at ganoon lang [kakonti] 'yung beds...students are priority," she elaborated. This was at 6 am. Four hours before this, Mrs. Martinez, according to Dr. Yutoco, refused to be admitted because "she was looking for a single room...[but] ward lang ang available noong time na 'yon." When Mrs. Martinez decided to go to the ward, she asked the surprised doctor if she could go home via a taxi. After this, the disgruntled patient boarded a taxi and went on her way even as her neighbor, who accompanied her to the hospital, was being sought by the nurses.

"Hinahabol ko nga 'yung reseta niya, kasi I thought she was going home," Dr. Yutoco explained. Mrs. Martinez, however, headed to the New Era Hospital after only a short stop at her house.

To most, this incident proves that there is indeed reason to tag the UHS as "Infirmatay."

A Terminal Case?

Chancellor Claro Llaguno chuckled at the term, saying "matagal na 'yan." Even Dr. Macalinao could only smile in resignation when she heard the term, although she said that "it's unfair." To some, however, the term "Infirmatay" really hits home. "Gumagawa kami ng paraan para maging satisfied sila [patients], still wala pa ring satisfaction," nurse Lina Encarnacion professed.

But even as some may view the label "Infirmatay" as connected with the retold first-hand experiences of alleged negligence by the doctors, others think that the answer to the whole "Infirmatay" is appearances.

"I think the only way [to erase the nickname] is to upgrade it [Infirmary] to a higher level hospital," Llaguno explained. This means upgrading facilities and equipment, bringing in more consultants for complex illnesses, and the like. Thus, Llaguno had major building repairs and a clean-up done last year. Additional manpower was hauled to tidy up the UHS's surroundings which, to Llaguno, is very dirty...I should not say 'very dirty,' but by my standards, it's not quite clean for a health service."

Although he deems physical appearances important in discouraging the monicker "Infirmatay," Llaguno also admitted that "the reality is all of us have budgetary constraints." UHS Administrative Officer Ms. Zeny Anzures reported that the total Monthly Operating Expenses (MOE) received by the Infirmary is P2.1 M. There is no equipment outlay, thus, the UHS asks for donations and proposes the purchase of certain equipment to the Chancellor.

This has worked so far for the Infirmary. Last December, the Llamas Annex was renovated, with each of the rooms repainted. In the same year, a new X-ray machine has also been acquired, upgrading the second-hand machine that was being used since the 1940s. Philippine Amusement and Gaming Corporation's donation of an ambulance also helped the Infirmary's needs. Aside from this, the UHS is pushing for the acquisition of an ultrasound machine for the lying-in clinic.

All in all, "our general plan is to upgrade [the Infirmary] to secondary," Llaguno expressed. This means the UHS will be able to dispense with more services. "We want to look into the services given to our students...and improve it," he further explained.

Stepping out of the Infirmary and back onto the street, one will recall the massive, broken metal equipment lying on the aisle. Or maybe the dusty corners and ceilings, or even the pungent bathrooms. Mrs. Martinez's story may also come to mind, coupled with rumors and other tales of inefficient service. If the odor of the "Infirmatay" is left to linger like this, one cannot expect petty changes to mask the redolent smell.

Ration
DOH Standards
Infirmary
Doctor : Bed 1 : 5 1 : 1.47
(17 doctors, 13 full-time)
Nurse : Bed 1 : 3 1 : 1.47
(17 nurses, 1 in public health)
Admin : Bed >1: 4 1 : 1.32
(19 admin. employees including 4 ambulance drivers)

What these nice-looking figures failed to note, however, is that nobody should be foolish enough to believe that these standards ensure efficient service.


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