Today I woke in fear of death and the president of my country tells me I would be so lucky to die. It is not far-fetched to think I might. To date, 17 doctors have already succumbed to the pandemic. One was the father of a close friend. Another, a specialist who taught my batch of doctors in med school. The first physician casualty was just a few years my senior. Other physicians, meanwhile, lie on the brink of death in intensive care units as hundreds of healthcare workers are quarantined. Those of us who remain at the frontlines confront the gaunt spectre of our mortality everyday. A friend has already tested positive for COVID-19. It is a terrible thing to look askance at patients thinking they might be your doom. Or to meet your end in the act of healing. But the president of my country thinks that the death we confront is a beautiful thing: dulce et decorum est pro patria mori so the saying goes, and the president would have us believe there is no tragedy here, only the sweet and fitting death of martyrs.
But there is no fortune to be found in the deaths of my colleagues, only tragedy, for they need not have died. As early as January this year, various countries have already enacted measures of containment against the spread of COVID-19; instead of following suit, our officials chose to ignore the alarm in favor of their expedient political relationship with China. The Secretary of Health explicitly mentions this when he justified his refusal to call for a travel ban against the PRC. And even now, with 2,084 confirmed cases of COVID-19 in the country, when 96 people have died, 17 of which are doctors from the frontlines, the government’s response is still glacial, inutile, and callous. The government remains opaque as regards its public health strategy. Testing remains a privilege reserved for the rich and powerful. Public hospitals remain ill-equipped for the pandemic. Protective equipment for healthcare workers remain scarce.
Dr. Oscar Tinio of the Philippine Medical Association tells us that the deaths of our colleagues were perfectly preventable: they were killed by the inadequate supply of PPEs. One thing is therefore clear: the government has betrayed the medical community. The blood of our fallen colleagues stains this administrations’ hands. It is the state’s responsibility to craft a credible response to public health crises. However, either through gross incompetence or sheer evil, the Duterte administration continues to mobilize health workers against a pandemic with neither ample protection nor the guidance of a coherent public health strategy. Make no mistake — more physicians will be killed by this government in the days to come. It is neither sweet nor fitting to die betrayed by the country you serve.
When the clinic I work for closed during the first few days of the lockdown, I could not wait to volunteer at the frontlines. How guilty I felt then to remain sequestered in the relative safety of home. I could see myself in full protective gear, rushing up and down hospital corridors, a soldier in an army of health workers serving the afflicted against a cacophony of ventilators. These are dark days and they require much sacrifice: why not myself and my learning? There will always be a fell romanticism in danger: when you offer a life for another’s next breath. The horror of the COVID-19 pandemic loomed so large in my mind it took a friend’s question to help me remember lessons I learned from serving in PGH: that patriotism is often a mask of exploitation.
I saw the call for volunteers as soon as it came out. Could there have been a more insulting and murderous proposition? There is no better proof of how little this government values its citizens — the government has weighed the lives of health workers at the forefront of the battle against this pandemic and found them dirt cheap: P500 a day, minus tax. The minimum wage in the national capital region is P537 per day. The Magna Carta for Health Workers and the Bayanihan Law both entitle volunteer health workers to hazard pay on top of a special risk allowance. If the government cannot be bothered to ascribe value to the people saving the lives of the citizenry, even when it is codified, I wonder just how much more expendable it views the common man. And even beyond the measly allowance, there is no assurance to be had from the DOH. The glaring lack of PPEs. Healthcare workers unable to access test kits for COVID. The uncertainty of the protocol regarding health workers who will contract the dreaded disease. The president’s silence regarding a national medical strategy even as he praises China. Through its negligence and incompetence, the government will clearly send more physicians to their deaths. Suddenly, I had no desire to die so soon for so little.
The DOH has since retracted its original terms and conditions for the volunteers but is yet to come up with an alternative program. I had heard that same rhetoric before. Exploitation in the guise of self-sacrifice and nationalism. The government deceives health workers believing that it is their moral obligation to accept exploitative work conditions para sa bayan. Nevermind that it is the government’s obligation to ensure that Filipinos, including health workers, receive a living wage, pandemic or no. Nevermind that it is the government’s responsibility that health workers are adequately protected in this crisis that they may continue serving their fellow Filipinos. Nevermind that P275 billion has been made available for this crisis and we are still kept in the dark as to its spending. To accept the government’s initial proposition would have been to consent to their disregard for the value and dignity of health workers.
I see pictures of my med school batchmates clad in protective medical gear, and I am awed and jealous and proud in equal measure. How they persist in spite of our leaders. I hope for their safety. The system that allowed the DOH to even contemplate the terms it initially proposed has long been in place. I remember the sleepless nights we spent monitoring patients with cavitary tuberculosis hour upon hour as clerks and interns with barely any hospital-provided PPEs. I remember the river of blood seeping into my pants as I compressed a dying woman’s chest. I remember the days I stayed awake for 36 hours straight. I think of the outrage online, how the public now finds it unacceptable that health workers are treated so poorly, then I remember that we have long been exploited in our country. Residents work for at least 120 hours a month for a salary barely above minimum wage. Nurses and medical technologists suffering worse treatment. Interns tasked to perform essential hospital work as free labour in the guise of training. If we find all this outrageous now, why did we ever think it was acceptable for the hospitals we worked for to treat us as expendable tools?
And yet this exploitation has always been insidiously framed as sacrifice for the country. How many times have we been put in harm’s way by this rhetoric? Healthcare workers have died, are dying, and will die in the face of this pandemic because of the current system that disregards their lives and exploits their bodies. To protect our ranks, we must clamor to dismantle a system that allows for our exploitation in the first place. And the clamor must persist beyond this pandemic to ensure that we are never slaughtered en masse again. To do otherwise is to allow for systematic murder to persist.
But for now, we toil against the virus and allow for the possibility of death. For now we raise our voices for our dignity and our lives. We do not need your empty platitudes. We need concrete responses. There is no sweeter nor more fitting end to this battle than to honor the memories of our fallen colleagues by ensuring that no one else needlessly dies.
It is exhausting to face two enemies at the same time: in this case, COVID-19 and our own government. So let us raise our voices to clamor for our dignity and our lives: adequate PPEs, COVID testing for PUI frontliners, a sound protocol for COVID-infected health workers, a transparent and coherent public health plan. What is sweet and fitting is to live a life of service to your countrymen, not to die as an expendable pawn.
If nothing changes, it will be our corpses we count in the next pandemic. Assuming we’re unlucky enough to survive this one.