Beyond lip service

This is one sector whose members feel, amid the coronavirus pandemic, as if “we are left on our own.”

No, they’re not people who have lost their livelihoods and are still waiting for the ayuda from the government, and whose communities might have been reverted to a strict lockdown – hard, hybrid or whatever term is used.

Instead they are, believe it or not, the heroes of the pandemic – the frontliners for which songs have been written, fine art and handicraft have been made, and even stamps have been issued as tribute to their courage and toil in this difficult battle.

They are the nurses – about 90,000 of them currently employed, with some 60,000 in government hospitals. This is according to Jocelyn Andamo, secretary-general of the Filipino Nurses United. FNU is the national organization of nurses.

Two decades before coronavirus disease 2019 upended our lives, Philippine nurses were already calling for higher pay and better working conditions. Last week, they issued yet another statement, lamenting that they remained “overworked, underpaid” and, worse in the time of COVID, not getting sufficient protection in the workplace.

At least one hospital, state-run San Lazaro, has denied or clarified several issues raised by its FNU chapter, whose members decried their “physical, emotional and mental” suffering as they battle the pandemic.

Like the other government hospitals designated by the Department of Health (DOH) as COVID referral facilities, San Lazaro Hospital has had one of the highest admissions of COVID-19 cases.

Those who are now grappling with the community transmission of the COVID-causing SARS-coronavirus-2 can only imagine what it must be like for the frontliners working in the constant presence of those infected, critically ill or dying of COVID.

Andamo told “The Chiefs” last week on One News / TV 5 that for every COVID patient that a nurse attends to while on duty, there must be a change of personal protective equipment. Apart from the disposable PPP, the face mask, which must be the surgical N95, is supposed to be discarded once it becomes damp from the user’s breath. (Some reports say it can be steamed for reuse.)

Due to limited resources, this isn’t happening in many hospitals, Andamo told us. She expressed fear that a reported plan of the government to procure N95 masks at half the regular price (the retail price is about P120 to P130) would mean lower quality items that fail to provide sufficient protection for the health frontliners.

Didn’t President Duterte say that in supply procurement, cheap doesn’t necessarily mean a better deal for the government?

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Our health workers can only dream of masks and PPEs made of the fabric developed by Israeli firm Sonovia. A colleague ordered from Amazon and gave me a washable, reusable Sonovia mask coated in zinc oxide nano-particles that lab tests have reportedly shown to be 99 percent effective in destroying viruses, bacteria and fungi. I nearly fell off my seat when I found out that the price for a set of just three masks was a whopping P7,000.

For some nurses, unfortunately, P7,000 is just P1,000 shy of their basic monthly pay in certain private hospitals. FNU says the salary rates range from P8,000 to P12,000. Those in government hospitals get a slightly better deal.

Compare this with the salaries paid overseas, which can be about P200,000 a month, and you will understand why there was a time when even some of our doctors were taking up nursing so they could work abroad.

In recent years, however, there has been a glut in nurses worldwide, as people in other developing countries also took up nursing. Filipino nurses have an edge because of English proficiency and natural tender loving care (it’s true), but there’s simply been an oversupply. Even in the Philippines, the glut pulled down nursing salaries.

At one point, there were reports that up to 300,000 nurses were either unemployed in our country, or else were working in non-nursing jobs that offered better pay, such as in call centers.

Today, Andamo estimates that at least 200,000 nurses are unemployed in the Philippines.

Amid the pandemic? That’s right – more so amid the pandemic, since fear of infection is also keeping them away from working in hospitals. The head of the National Kidney and Transplant Institute, Dr. Rose Marie Rosete-Liquete, told The Chiefs in another interview last week that the government had already approved the hiring of thousands of additional nurses for the NKTI, with funds available. But so far, she lamented, there had been no takers.

Among the first questions asked by the few who expressed interest, Liquete said, was whether they would be assigned to COVID wards.

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As early as March 19 this year, FNU had already taken note of a DOH projection that in three months, COVID cases could hit 75,000, with around 6,000 deaths. FNU was already calling at the time for better protection and working conditions for the frontline heroes, who even then weren’t getting heroes’ treatment: many were being shunned in the streets, with some even thrown out of their rented rooms or apartments.

Potential new nurses aren’t the only ones staying away from the NKTI, Liquete said; even non-COVID patients are putting off visits to hospitals, even for non-emergency surgery. In the past two years, for example, Liquete said the NKTI performed about 500 kidney transplants. But there has been not a single transplant so far this July, she told us.

Other hospitals have reported similar situations for their non-COVID patients. This is affecting their finances and consequently their ability to compensate and protect their personnel.

Last Friday, 18 years since the law was passed, it was announced that government nurses would finally get their mandated salary increase, retroactive to Jan. 1, 2020.

It took the Department of Budget and Management many months to release a circular implementing a Supreme Court ruling upholding the increase, as stipulated in Republic Act 9173 or the Philippine Nursing Act. RA 9173, passed way back in 2002, sets an entry-level pay of P32,053 to P34,801 for nurses in public hospitals – up from the current P22,316 to P24,391.

The nurses are still waiting to see the money. In the meantime, Andamo says they have to contend with some hospitals even leaving it up to their nurses to find facilities for COVID testing and pay for it. The price of the “gold standard” swab reverse transcription-polymerase chain reaction test ranges from P1,828.40 (with VAT) for local company Manila HealthTek’s GenAmplify, up to P6,500.

“Parang we are left on our own,” Andamo told us.

They can’t help feeling, she sighs, that all those tributes to the heroic frontliners are nothing but lip service.