Physicians working in the Doctors to the Barrios (DTTB) program on Sunday denounced a Department of Health (DOH) plan to transfer them from their assigned rural municipalities in Central and Western Visayas to private hospitals in Cebu City, where the COVID-19 pandemic is raging.
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Rural health physicians in those regions were told on June 26 they would be pulled out of their respective municipalities to report for duty in unspecified private hospitals in Cebu City as part of the government's COVID-19 response. Those from Western Visayas were to report for work in Cebu from June 30 to Sept. 5, while those from Central Visayas were expected to report from June 26 to July 30.
This order was only supported by a request letter addressed to the Undersecretary of Health for Field Implementation and Coordination Team (FICT) for Visayas and Mindanao and an unsigned advanced copy of an Office Order, respectively.
“We, the Doctors to the Barrios Batches 36-ALAB and 37-MANDALA strongly condemn this directive because: 1) the involved doctors have not been suitably informed through writing, 2) no proper consultation with the stakeholders was done prior to this directive, 3) detailed guidelines and protocols to protect the doctors in this temporary reassignment are not provided, and 4) it contradicts the thrust of the DTTB Program,” said the group in a statement posted on Facebook.
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The absence of proper communication to justify the temporary reassignment of rural health physicians serving in geographically isolated and disadvantaged areas to serve in private hospitals in Cebu City is a clear violation of the Magna Carta of Public Health Workers, they said.
As the reassignment also involves the Doctors to the Barrios and the local government units that they serve, it is only appropriate to conduct proper consultation with all stakeholders before the directive was issued, they said.
“The DTTBs and the local chief executives should have been represented in decision-making involving this temporary reassignment. Failing to do so makes such directives exploitative for doctors and inconsiderate for the communities that they serve. There is complete disregard [of] the concerns of the doctors and the local chief executives,” the group said.
“And in the absence of such consultation, the Department of Health fails to provide clear protocols to safeguard and protect the Doctors to the Barrios who will temporarily render service in private hospitals. No clear information regarding the DTTB’s safety, protection, lodging, insurance, and specific duties have been provided. The likelihood that the services rendered by public servants will be abused by private institutions increases because of the lack of clear guidelines for their protection. No proof of agreement between private institutions and the DOH were made available for discussion among all parties involved,” they said.
“Lastly, lest we forget, the Doctors to the Barrios Program of the Department of Health was created in 1993, primarily, to address the need for doctors in rural communities, especially in geographically isolated and disadvantaged areas. Removing a DTTB from a municipality, albeit temporarily, will deprive health care to thousands of Filipinos in already marginalized communities. If we further clip the already short human resources for health in GIDAs, we perpetuate the existing inequities in access to health care that the DTTB program wishes to address,” the group said.
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On Sunday, Health Undersecretary Maria Rosario Vergeire announced that Health Secretary Francisco Duque III had ordered the deployment of doctors, including DTTBs, to Cebu City to address the continued rise in COVID-19 cases in the area.
“The assigned doctors are rural health physicians and not municipal health officers. Meaning the municipality they serve already has a municipal-hired doctor ensuring that the municipalities they serve will not be left doctor-less during their assignment,” she said in a statement.
Cebu City has the highest number of COVID-19 infections nationwide with 4,962 cases including 2,596 recoveries and 156 deaths as of Sunday.
The DOH earlier identified cluster of infection in 13 barangays in Cebu City.
Cebu City is also the only area nationwide that is under the stringent enhanced community quarantine (ECQ), which was reimposed by Malacañang on June 15.
In a TV interview, Vergeire said the redeployment of doctors who volunteered to serve in rural areas to Cebu City would definitely push through because of the public health emergency there.
She said the temporary assignment is not new as DTTBs have been temporarily redeployed in the past under similar emergency situations such as the Marawi siege and the Super Typhoon Yolanda response.
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She said a pre-deployment orientation will be conducted and the DTTBs will be provided roundtrip transportation, statutory allowances, actual hazard duty pay, accommodations, and other incidental expenses during their deployment period in Cebu City, including post-deployment quarantine.
But the Kabataan Party-list threw its support behind the Doctors to the Barrios, calling the DOH order exploitative.”
"Instead of ordering the transfer of DTTBs, DOH must step up its massive emergency hiring of health personnel with proper compensation, protection, and security of tenure to encourage our health workers to apply, and to effectively combat COVID-19 and ensure health for all," Kabataan Party-list Rep. Sarah Elago said in a statement.
A multi-sector group on the COVID-19 response also criticized the DOH, saying the redeployment was “highly irregular and contentious.”
“We need to hire more doctors, not just re-assign those already serving underserved areas,” the Citizens' Urgent Response to End COVID-19 said.
“Pulling out doctors from these areas will disenfranchise patients who equally need care. As one doctor puts it, they are also facing an important battle in our own front, looking after non-COVID and COVID patients alike including those who are going home because of the untimely Balik Probinsya Program,” the group said.
Cebu City on Sunday reported an increase of 131 new cases of COVID-19, bringing total infections there to 4,962.
The Cebu City Health Department (CHD) said total recoveries rose to 2,596, with 157 more patients recovering from the disease.
Meanwhile, the death toll climbed to 156 with six new fatalities.
The CHD said there are also 2,210 active cases undergoing treatment or quarantine.
Cebu City still has the highest number of infections nationwide, followed by Quezon City with 3,255 cases as of Sunday.
The Filipino Nurses United – Cebu chapter on Monday appealed to government officials to urgently address the severe problem of overworked nurses in the city’s hospitals which are struggling with the overflow of COVID-19 patients.
The FNU called for the mass hiring of nurses with minimum entry salary of P32,000, just benefits including hazard pay, adequate personal protective equipment (PPEs), and safe nurse to patient ratio as necessary solutions to solve the severe understaffing of nurses in the hospitals.
The Cebu Medical Society, in a statement early last week, raised concerns over the city’s “exhausted and overwhelmed health system.” It said hospitals were undermanned, essential medical equipment were scarce, while doctors and nurses were getting sick or exhausted. Since hospital beds for COVID-19 patients in Cebu City were full, many patients were waiting in the emergency room while others were refused admission.
There were also doctors, nurses and other hospital staff who were on quarantine, compounding the shortage of medical personnel.
In related developments:
* Interior Secretary Eduardo Año said violators of the enhanced community quarantine (ECQ) in Cebu City will be immediately arrested as the area is emerging as the new epicenter of COVID-19 in the country as new infections surpass those in the National Capital Region. He also said he would issue a show cause order against barangay officials who were involved in a Sinulog street dance and procession that drew a crowd in one of the city's hotspots. “We will not tolerate any violation of our quarantine protocols. Those responsible will be made to account,” Año said.
* Data from the DOH showed the positivity rate for COVID-19 tests in Central Visayas almost doubled last week, from 18.2 percent on June 18 to 33 percent on June 27. The rate measures the percentage of those tested who are found to be positive for COVID-19.