Flight, Fight, And Fakes
A review of last year's top health stories
By Michelle Ciriacruz
 Like the horse, 2002 was highly spirited. It was the year for explosions, suicide bombings, and military activity.
This spirit of the times went after the health sector as well.
The events within it might not be as violent as elsewhere, but certainly, they were far from dull.
Several important health bills were debated on. The malpractice bill generated the loudest uproar, the reproductive health care act roused hostile words and actions from conservative religious groups, while the nursing act was passed to keep nursing graduates home.
Fake drugs,
bangungot, a virus scare, and dissension within the Lung Center of the Philippines were major items within the local health front as well. Last year, well-known dermatologist Dr. Vicki Belo and the Osaka Iridology Clinic suddenly had something in common. They had a brush-in with the Philippine Medical Association (PMA).
Meanwhile, AIDS and human cloning featured heavily in international health news.
ICE ON THE HOUSE
Before the Perez-Jimenez joust of credibility ousted other headlines to the bottom of the page, the medical malpractice bill was the subject on everyone's minds and debates.
House Bill No. 4955 or the malpractice bill is now in cold storage, however. The opposition against it, especially from the medical community, proved too overwhelming for it to gain enough votes to even merit discussion beyond
committee level.
Authored by Rep. Oscar Rodriguez of Pampanga, the bill seeks to protect and strengthen patient rights by penalizing the negligence of medical and dental professionals with cancellation of their license, imposition of a fine of PhP500,000 up to PhP1 million, and imprisonment.
Unfortunately, the bill was riddled with flaws. Chief among them was that its provisions and clauses would make quality and affordable health care for the masses more difficult to obtain.
The leading medical societies argued that the bill would only succeed in promoting defensive medicine and undermine patient-doctor relationships. To protect themselves against the threat of litigation, doctors would order a battery of sophisticated, expensive but unnecessary tests before they would treat their patients. This means increased expenses for the patients.
The penalties imposed, the medical societies also argued, are too harsh-comparable to those imposed on hardened criminals with clear intent to inflict harm or death.
BAIT FOR NURSES
The exodus of our best nurses and doctors to other countries has reached alarming levels. Their search for greener pastures could bring about a massive shortage of qualified health care personnel in the country.
The Nursing Act of 2002, authored by House minority leader Carlos Padilla and Rep. Eduardo Nachura, might set back the tide somewhat, the government thinks. It was signed into law last October, serving to repeal RA 7164.
The Act upgrades the wages of public nurses from Salary Grade 8 or 9 to 15, which means an increased take home pay of PhP 15,810 monthly. Private hospitals are also encouraged to calibrate their salary schedule with the law's prescribed rate.
To upgrade the level of skill and competence of government nurses to world-class standards, the Nursing Act mandates their regular retraining under the Comprehensive Nursing Specialty Program.
Government nurses, who opt to work in the country, will receive incentives and a benefit package that include free medical care for nurses and their families, scholarship grants, and other noncash benefits.
A Professional Regulatory Board of Nursing will oversee and implement the provisions of and standards set by the Nursing Act.
This law seeks to make local employment opportunities for nurses more internationally competitive. The question is, will our nurses bite? Especially as the 2003 National Budget cannot even accommodate the pay hike of government nurses.
TO MOTHER OR TO SMOTHER
It was dubbed as the pro-abortion bill.
A text message saying "Let us unite and fight against HB 4110 that will allow even a 13-year-old to have an abortion without her parents' permission!" started to circulate.
Catholic Church groups denounced it. They protested that the passage of such a bill would bring about "the culture of death," in which law sanctions the murder of unborn children. They also maintained that the bill would encourage promiscuity among the youth as it legalizes all forms of contraceptives.
HB 4110 or the Reproductive Health Care Act became another moral arena for those that could countenance only the natural family planning method to limit and space the number of children of a couple and those that desire to open up more choices for a woman's reproductive health needs.
The authors and supporters of the bill pointed out that nowhere in the bill does it say it allows abortion. However, since about half a million abortions do take place every year, the bill makes sure that women have access to quality medical care for the management of complications arising from abortion.
They explain that HB 4110 stands for a woman's freedom to choose the family planning method most suited for her value system and needs. The bill would pave the way for programs that guaranty her "access to information and education, and universal access to safe, affordable, and quality reproductive health care services."
THE FAKERS
An epidemic hit the Philippines in 2002-an epidemic of fake and substandard medicines.
Every year, the Bureau of Food and Drugs (BFAD) confiscates about PhP150 to 300 million worth of counterfeit drugs. These drugs are either smuggled in from neighboring countries like China and Thailand or manufactured locally.
They could be genuine but unregistered, substandard, adulterated, or underdosed.
The flood of such drugs in the country only succeeds in adversely affecting the economy and does nothing for public health. Genuine but smuggled drugs may be cheaper but if the consumer chanced upon a fake posed as genuine, he will be putting his health and his life in jeopardy.
Last year, the BFAD closed down eight pharmacies for selling unregistered fake medicines.
WHILE HE WAS SLEEPING
For several weeks after the death of popular matinee idol Rico Yan, apparently from
bangungot, the public became intensely curious about this rare condition that could snatch a young man in the prime of health as he lay sleeping.
It was Good Friday morning when he died. The night before, Rico Yan and friends were partying at a resort in Palawan, where they had a few drinks and a lot to eat. Later, Rico was heard groaning in his sleep but his friends attributed it to snoring. When they woke up, they found Rico lifeless on his bed.
Findings revealed death from cardiac arrest following a rupture of the pancreas, in other words, from
bangungot.
Bangungot is actually an enigma in medical science. It seems to target young males aged 20 to 30 and seems to be common among people in Southeast Asia but not in Western countries.
OUT OF AFRICA
The Department of Health denied that the West Nile virus was ever in the Philippines. The University of Florida says otherwise, if antibody tests to the virus were to be relied on.
When 12 members of the Larrazabal family in Ormoc City were downed by symptoms suspiciously like those caused by the West Nile virus, the public became alarmed that the disease wreaking havoc in the United States might have jumped ship somewhere and was making its presence known in the Philippines.
Almost 4,000 people in the US have been infected with this virus. As many as 100 cases turn up each day. As of December 3, the death toll for 2002 according to the US Centers for Disease Control and Prevention is 216.
Most of those infected do not develop symptoms; those that do complain of flu-like symptoms. However, in about one case in 150, the virus can cause encephalitis, which could be deadly.
Epidemiologists and doctors in the Philippines refused to label the cases in Ormoc as caused by the West Nile virus. They say that, very likely, the Larrazabal family became sick from the Japanese encephalitis virus, a close relation of the West Nile virus and more common in the region.
Mosquitoes that sting infected birds and mammals and then humans spread the virus. US health authorities have confirmed that the virus could spread human-to-human through organ transplantation and blood transfusion.
FIGHT CLUB
Dr. Fernando Melendres, executive director of the Lung Center of The Philippines (LCP), was accused of graft and plunder by some of the LCP's medical and nonmedical staff, led by Dr. Jose Pepito Amores, deputy director for hospital support services.
Allegedly, Dr. Melendres falsified documents in hiring an architectural consultant, violated auditing rules on the drawing of petty cash to circumvent the law on public bidding, and implemented a reorganization plan without board approval. He was also charged with illegally depositing Php150 million of LCP funds in five investment management accounts with the Philippine Veterans Bank.
The supporters of Dr. Melendres contended that the charges were trumped up to besmirch the doctor's reputation and integrity. His stern management style, they said, have disgruntled some doctors and employees.
Dr. Melendres disputed the charges, describing them as petty. He claimed that his detractors might be more interested in getting their way with the 12 billion-peso prime lot in Quezon City owned by the LCP, which they wish developed into a "mixed-use" medical, commercial, and residential center.
Dr. Melendres opposed this. His plans involved instead converting the LCP property into a multispecialty center catering to heart, brain, blood, and cancer patients.
Meantime, Dr. Amores also got into hot water. For something as irrational, he said, as not possessing a career executive service officer rank (CESO), he was ordered terminated by the LCP board.
Dr. Amores pointed out that all senior officials of the LCP and other government hospital directors did not have CESO rank.
BEAUTY AND THE EYE ON THE BEHOLDERS
Identified as she is with celebrities, in effect, making her a celebrity herself, when Dr. Vicky Belo had a brush in with the PMA, it was immediately in the public eye. She was asked to explain about her self-advertisement, which is contrary to the code of medical ethics.
There were rumors that she was in danger of losing her license. However, it was probably just showbiz exaggeration as, after a dialogue with PMA, she was simply requested to keep her practice more in tune with the guidelines of the PMA.
The PMA also had issues to clarify with the Osaka Iridology Clinic-again centering on commercial advertising. Osaka had been claiming in television commercials that their services have medical value.
The Philippine Academy of Ophthalmology has also taken the practice of iridology to task. It has officially stated that iridology is a sham science.
COVER STORY
Weeping mothers are forced to give up their children for adoption. The death of their husbands from AIDS, contracted from selling blood to collectors who used unsanitary methods, have left them with no means of support. Soon, the women themselves will succumb to the virus.
This is the scenario now confronting China. The government-backed blood-selling schemes in central China's Henan province have given birth to a catastrophic AIDS problem.
About 1 million in Henan are already infected. UN officials say those with HIV in China could go as high as 10 million to 20 million by 2010.
The Chinese government, instead of mobilizing a medical and financial support program for the victims, would rather try to cover up this scandal of their own making. Foreign and Chinese journalists are barred from interviewing the affected peasants in Henan. The government is even blocking the efforts of humanitarian organizations to help the victims, reports say.
ATTACK OF THE CLONES
If the claims of the Raelians were to be believed, the world would soon see the birth of the next generation of cloned human beings.
The Swiss-based Raelian movement is a "flying saucer religion". Its members are convinced that life was created by extraterrestrials 25,000 years ago through cloning. Through its gene technology company, Clonaid, they have been trying to recreate their mythology by cloning a 10-month-old child who died February last year.
Using a cloning machine developed by Korean scientists, dubbed the RMX 2010, Clonaid fuses cells taken from the donor to an egg cell minus its genetic material. If the combined cells develop into an embryo, it is implanted into a surrogate womb.
Over 50 Raelian women have volunteered to be surrogate mothers.
However controversial, the Raelian movement is just one among the many groups worldwide that are into human cloning experiments.
Italian gynecologist Dr. Severino Antinori, who in 1994 helped a woman of 62 to have a baby, claimed that he has also succeeded with cloned pregnancies. Three women patients are carrying eggs that have been subjected to nuclear transfer, the same technique used to create Dolly, the world's first cloned sheep.
Reports said another fertility expert, Kentucky-based Dr. Panayiotis Zavos, conducts his human cloning experiments in an unnamed developing country.
Not all of the human cloning proponents approve of the creation of human embryos for implantation, however. Cloning specialists warn that, at this stage, the technology is bugged with physical deformities, immune system deficiencies, and premature ageing among its aborted or live birth cloned animal fetuses.
Most specialists would rather study therapeutic cloning instead of reproductive cloning. Dr. Ian Wilmut, the creator of Dolly, plans to create early human embryos, genetically identical to one another, for stem cell research.
The embryos could be harvested for their stem cells, which would be grown into different organs for transplantation. He explained that the use of human embryos for stem cell research could help in the understanding and treatment of cardiac problems, Parkinson's disease, and diabetes. This is still not ethically acceptable to many, as the embryos would die in the process of removal. They say this is forcible removal of organs from a living human being.
Since there is still no consensus on the beginning of life, some governments find it difficult to come up with clear regulations on human cloning. The US situation clearly portrays a division regarding cloning issues.
In the US Senate, two cloning bills have run aground of each other-one that bans both reproductive and therapeutic cloning and another that allows the latter.
The United Nations is already deliberating on an international treaty that would ban the creation of human clones.
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