In the Philippines EMTs Are Instructed to Not Revive You

The following is a true story. I wrote it as it happened so it is a very hot take. It has been edited for spelling and to keep the identities anonymous.

Around 3pm I was shouted for and I ran downstairs. I was asked if I knew how to revive someone and I had no idea what was meant but I ran out the door. The man was sitting up so it looked like he needed water but one guy was holding him up in the chair. I asked if he had a pulse.  I could not feel one. I had them put him on the ground and then I started compressing his chest. I did not breathe into his mouth. I asked for a flashlight to look at his pupils. They did not seem to dilate. I asked for a stethoscope but they did not have one. I kept compressing his chest and it seemed like he might be breathing. There was a huge vein on his neck that seemed engorged and standing out. Probably his jugular. I then tried to keep his mouth open and esophagus unobstructed by having them hold his head up. Then the ambulance showed up.

They came in there with no sense of urgency, no equipment, lazily walked over and put the digital meter on his finger and said well he's dead that's it. In no way shape or form did they attempt to revive him or to acscertain his condition except for obtaining his pulse via his finger.  They did not check his breath or eyes (maybe they did).  Then they walked away calmly and returned but this time with a stethoscope and a blood pressure gauge which they did not use. Then they walked back to the ambulance and left. They said the hospital will not take a dead man. I pleaded with them to take him to the hospital to attempt to revive him. I asked if they had a breath machine pump.  I asked if they had heart paddles.  The nurse (?) told me they have no equipment. 

The EMERGENCY AMBULANCE HAS NO EQUIPMENT!!!  Well I looked and that's not really true they had alcohol and a few other things but nothing that would save a man's life. So we waited for the funeral home to come snatch him.

It appears he was standing on a gas container to weld the ceiling. It also appears that the cord he was using to power the welding machine snapped and was broken. He could have been electrocuted. Likewise he could have passed out from not eating as I was told he did not eat at all that day. The day was not very hot due to it being overcast but still not eating can catch up with you in a bad way. He was fallen face first into the corner of the room onto an old fridge and some other stuff.

At first it appeared he might have fallen from the ladder since the ladder was on the ground but I do not think that is the case.  I do not know how long he was there. His helper found him lying on the ground. He came running after he heard him scream. He was on the other side of the wall in the street.

His welding instrument was lying next to the gas container which lends credibility to the idea that he was standing on it and fell. There are no brusies or blood on his body. Nothing from the ears or the eyes. It is as if he died all of a sudden. That he fell face first and did not try to get up would seem to mean he was electrocuted. One of his slippers was missing but I do not know how it came off. 

That the ambulance personnel did not try to revive him in any way is most upsetting.  Most upsetting indeed.

In the end, to be honest, he was not a safe worker and that negligence is likely what killed him. But, my god, the EMT's in the Philippines sure aren't worth a shit. Now he is lying in the area he was working with a pillow to support his head and a fan blowing on him and they are keeping vigil until the funeral home comes to retrieve him.

They rubbed alcohol all over his body.

The family arrived and one woman wailed and screamed shouting in Jesus name while smacking him and trying to revive him. They also anointed him with oil in an attempt to wake him up.  They did way more than the EMTs.

The police finally arrived and with them the EMTs returned. The family wanted the man, who had been dead for 90 minutes now, to be taken to the hospital. At first they brought out the stretcher but then the EMTs spoke with the police and they did not take him. I talked to the police and they said that the first time around they had called the doctor at the provincial hospital and she said do not bring him because he had no vitals and because of COVID.

It was a harrowing and grief stricken scene. I think the family was very angry that they had not transported him to the hospital. The man was 36.

The EMTs called the doctor and the doctor yelled at the PNP when the phone was handed to him. The EMTs were told by the doc at 3pm when they first called to not revive if there were no vitals.

Around 5pm more relatives came over and tried to revive the man by praying in Jesus name and shaking his limbs. I stepped outside the gate to ask the PNP officer if he was CPR trained. He said no. I asked if they teach you that at the academy. He scrunched up his face, shook his head, and took a puff from his vape machine.  He did say the EMTs were CPR trained and that he did know what CPR is. But the PNP are not trained in that technique.

The family decided around 5:30pm to take him to the hospital because only the doctor can pronounce him dead. So they put him in a tricycle but his feet were sticking out and with rigor mortis setting in they could not make his knees stay bent. So I told them to put him in the back of the car and then they sped off to the hospital. 

Later I was told the doctor at this hospital said he could have been revived if he had been brought in within an hour of his accident. It sounds nice but I don't know. All I know is he is dead and the EMTs did nothing at the behest of the doctor they called.

The moral of this story is: STAY SAFE!  Because in the Philippines the EMTs WILL NOT REVIVE YOU!

Hospital Emergency Room

Hospitals in the Philippines are wretched places. Even the private hospitals are awful. I had to visit an emergency room recently at The Doctor's Hospital. It looked like this:

What you should keep in mind is that this is a brand new emergency room. An addition to an already existing hospital. This place is where the ambulances will be dropping off people in need. Now why would they construct this new wing and leave a telephone pole stump in the road!! Can you see it in the picture?  Here it is up close!!!

Here it is even up closer!

It looks like a carabao patty but is a lot more dangerous. I watched at least two vehicles run over this obstacle. Imagine an ambulance running over it!  Imagine an ambulance coming there at all. Now I did ask about this stump and was told it was PLDT's responsibility because they own the telephone poles. I did go to PLDT to ask about it but was greeted with a very long line and told come back tomorrow.

You know what? It's not my job and if no one else cares why should I?  This is the Philippines!

Look at the first picture again. See that white thing in the middle of the driveway where the ambulances are supposed to offload?  Here is what the other side looks like.

Is this COVID-19 related!? Is this part of social distancing? You have to be dropped off and signed in at this station!? While all the traffic is driving by? RIDICULOUS!! I went by two days later and they moved this sign-in station from the center of the ramp to the side.

It's not any less stupid but at least the doors aren't blocked off anymore.

But I am not finished.  Look at this. 

This poor man is being pushed in his wheelchair IN THE BUSY STREET IN THE RAIN around the corner from the emergency room to I don't know where probably to some evaluation place. Do I need to point out how dangerous this is? Why does The Doctor's Hospital allow their staff to do this? They could have pushed him through the building but they didn't!! Why not? A few days later I saw the same scenario being played out.

Why are they pushing wheelchair bound patients through the busy street!? The answer I received was basically, "Well they are just going over there." That is not an excuse because when I was there the guy I was with was wheeled through the building to the emergency room area. It almost makes you wish a car would smash right into these people just so they can learn a lesson about how stupid this all is.

Filthy Filipino Hospital Facility

Hospitals in the Philippines are nasty. Just plain nasty. I visited one recently again. Visited a sick man and had a chance to take a look at a hospital I had not yet visited.  Here are some pictures.

It's a truism that you can judge a place by its bathroom. The state of the CR says volumes about any establishment. This hospital's CR was as gross as any other CR in the Philippines. No toilet paper. A shower right next to the toilet so everything gets wet when you bathe. Typical really.

This sign on the wall is almost like a bad joke.

A detailed diagram on proper hand washing but on the sink there is only a tiny little bar of soap and there are no paper towels or hand cloths to dry your hands afterwards. What is the point then?

Despite the tiny bar of soap at least the sink is clean. No rust spots or water discolouration. 

Now let's look at the window.  Very grody.  See that stuff in the corner?  No?

Do you see it now? It's an ant pile! There are ants all over the floor and window in this bathroom.

Both corners of this window are covered in ants. They are crawling from the window to the trash can and back again. Did they janitor not see this? Did he not let his boss know they need to fumigate the CR?

Just as you enter the patient's room you are greeted with this sign:

It's basically a warning that everyone is a thief. That you cannot trust your nurse. And guess where you are supposed to store your stuff. In a cabinet? A closet? No.

You put your belongings in this open shelf where everyone can see your goods! Unless you hide your things under your pillow it will be impossible to not leave your belongings in sight!

Downstairs there is a rather weird cabinet which is a shrine to a surgeon who used to work at this hospital. Just one guy. Not the entire hospital. If the hospital has won any awards they weren't displayed as prominently as this man's many awards.

God's masterpiece? What does that even mean? Your guess is as good as mine.

Thankfully in the lobby there is a huge sign listing all the services the hospital offers.

It sure is a good thing this hospital offers medicine. I was kind of scared that it didn't! Imagine going to a hospital that did not offer medicine! One service not listed is CT Scan and that is just too bad because the doctor told the man I was visiting that is the very service he needs!

Now let me give you a very brief history of this hospital.  Last year it was known as Bacolod Our Lady of Mercy Specialty Hospital and it shut down on August 1st which is exactly one year ago today!

https://www.philhealth.gov.ph/news/2018/own_closure.html

The closure of BOLMSH is a decision that was made by its own Management and not by PhilHealth nor of the Government.

It can continue to exist and operate to serve its local constituencies and for the welfare of its employees if it wants to, even without its accreditation with PhilHealth. 

The denial of their application for continuous accreditation filed on January 30, 2018 stemmed from the fact that the hospital has been convicted twice for committing fraudulent acts which involve padding of claims, misrepresentation by furnishing false or incorrect information, and breach of warranties of accreditation/performance commitment as provided for in Sections 154, 158 and 164, respectively, in the Revised Implementing Rules and Regulations (RIRR) of Republic Act 7875, as amended.

This hospital was convicted of fraud twice! TWICE! But who cares!? Because jobs will be lost which is why the Mayor tried his best to intervene.

https://www.pna.gov.ph/articles/1039246

“This issue is a matter of public interest and we must explore all avenues to prevent a disruption of health care services and even loss of jobs,” the mayor said during the meeting, which lasted for almost three hours on Friday night at the Bacolod City Government Center. 

Pending resolution of the issues, both parties agreed that the hospital will continue to operate until July 30, 2018, instead of closing down this week.
In a press statement, Lourdes Diocson, PhilHealth regional vice president for Western 

Visayas, thanked Leonardia for “bringing BOLMSH and PhilHealth together to clear up the issue on the closure” of the hospital, whose accreditation for 2018 has not been approved yet. 

“Together, we worked out the options to continue the services of BOLMSH and to ensure the availability of services of the hospital to its clientele,” she said. 

Diocson said the decision on the closure was made primarily by the hospital. 

“The denial of the (PhilHealth) accreditation was because of the conviction of fraudulent activities which were committed in previous years under the previous management, Tiong Bi Inc.,” she said. 

Diocson stressed that the impending closure is not because of the PhilHealth’s failure to pay the PHP25 million dues as claimed by the hospital. 

It was not paid because the accreditation of BOLMSH for 2018 was not approved yet, she added. 

“Everybody was happy after the meeting. It was a win-win solution,” Amante said in a separate statement.

This hospital was convicted of fraud, the Mayor wants it to remain open, he apparently does not bring up the issue of fraud, and somehow it's a win-win situation despite the fact that it still shut down???  But no worries.  With some fancy-schmancy restructuring and rebranding the hospital reopened in January 2019.

https://www.sunstar.com.ph/article/1783277

THE Bacolod Queen of Mercy Hospital Inc. is set to open on Thursday, January 17, said its chief operating officer Dr. Wilson Tulmo. 

Tulmo said while the new hospital will use the building of Bacolod Our Lady Of Mercy Specialty Hospital that closed down in July 2018, the Bacolod Queen of Mercy Hospital (BOLMSH) is now under the new management and a new corporation, new personnel, facilities, business permit and registration from the Securities and Exchange Commission.  

He said the new management was able to get the License to Operate (LTO) from the Department of Health (DOH) on January 15. 

"We will now be applying for an accreditation from the Philippine Health Insurance Corporation (PhilHealth). This is a different name and a different corporation entirely new," he said. 

“We started from zero. We already have LTO from the DOH and that we will now be applying for an accreditation from the PhilHealth and the accreditation will be retroactive from the date that the DOH LTO was issued,” he added. 

The BOLMSH shut down its operations due to the non-issuance of the hospital accreditation from PhilHealth following lapses of the previous hospital administration. 

Lapses?  Is that what they call being convicted TWICE of fraud? But let's get the perspective of the hospital itself.

The Bacolod Queen of Mercy Hospital, located at the site of the Bacolod Our Lady of Mercy Specialty Hospital that closed down last year, will be operated by an entirely new company, Dr. Evangeline Johnson, its consultant and spokesperson, said yesterday.  

Her son, Lucho Giron, is the president and chief executive officer of the Bacolod Queen of Mercy Hospital Inc., the company that will operate it.

The Bacolod Queen of Mercy Hospital’s vision and mission is to serve patients, especially the underprivileged, with loving care at compassionate and affordable rates, Johnson said.  

“You can entrust us with your lives because we take them seriously,” she said, pointing out that the hospital has a very strong management team and brand new equipment. 

Giron is the majority shareholder of the firm running the hospital that has four other members of the board. There are two women who do not wish to be identified and engineer Edgardo Bayog and lawyer Robert Camarista, Johnson said.  

“It’s still a closely held family corporation, we don’t have partners here,”Johnson said. 

http://www.visayandailystar.com/2019/January/16/topstory2.htm

I don't even want to investigate anymore.  It should be clear by now that Philippine hospitals are all about milking that money from PhilHealth which is a corrupt agency anyway. And this hospital, despite the closure and reopening, is still filthy!

Rabies Pamphlet

On Good Friday I rescued two kittens. A few days ago one of the dogs attacked the kitten and I was bit by the feline while I prying them apart. Even though I am quite certain this cat does not have rabies I did not think the risk was worth taking so I went to the hospital to get a rabies vaccination shot. What follows is not the story of getting a rabies shot. That is whole other convoluted and ridiculous story for another post. This post is about an interesting rabies pamphlet the hospital had on display.

Right off we are greeted with this awesome cover. There's a cute little puppy and his owner is petting him all the while oblivious to the lurking fear within. One bite and the devil dog is loosed into the boy's blood and it's "game over, man" for him.

The inside of the pamphlet is a series dreary and dismal Q and A's.

Q: What is rabies?

A: Rabies continues to be a public health problem in the Philippines, which is one of the top 10 countries with rabies problem. It is responsible for the deaths of 200 to 300 Filipinos per year.

Q: How is rabies transmitted?

A: Dogs are responsible for 96% of human rabies cases in South-East Asia, but there are also reports of human rabies due to bites of cats, horses, cattle, and other carnivorous animals.

Bites from cattle, horses, and other carnivores animals? All of these Q and A's are ripped from the WHO's website and the fuller answer reads:

Dogs are responsible for 96% of human rabies cases in South-East Asia, but there are also reports of human rabies due to bites of cats, mongooses, jackals, foxes, wolves and other carnivorous animals. Rabies due to monkey and rat bites are rare. Horses and donkeys get aggressive and bite ferociously when they are rabid. Cattle and buffaloes do not bite when they are rabid, but precautions should be taken while examining sick animals that are salivating.

https://www.who.int/rabies/resources/SEA_CD_278_FAQs_Rabies.pdf

The final three questions are excessively depressing and fatalistic.

Q: Is there any specific treatment for a rabies patient?

A: There is no specific treatment once symptoms of rabies have developed. There is almost nothing that can be done apart from keeping the patient comfortable, and avoiding physical pain and emotional stress. 

Q: Is rabies always fatal?

A: Human rabies is almost always 100% fatal, with no specific treatment available anywhere in the world.

Q: What should I do when I get bitten or scratched by an animal?

A: Please treat any potential exposure to rabies seriously. Once clinical symptoms appear, death is almost inevitable.

The final picture is quite a gem. A very tender and realistic depiction of a child infected with rabies and lying on his death bed.

Actually he is almost hovering rather than lying. This picture is straight out of The Exorcist. I think that is supposed to be the boy from the cover but here is wearing a regular t-shirt while on the cover he is wearing a sleeveless shirt. Has he learned his lesson about the lurking fear? I think so.

Over all this pamphlet is a little scary. There is no hope offered. There is no mention of the vaccine. The only advice a patient receives is to wash the wound and consult the nearest Animal Bite Centre. And if you don't you will die. You will die a painful death gnashing your teeth and salivating as you  violently seize and thrash about while tied spread-eagled to a bed.

The back of the pamphlet isn't very remarkable. Except for one thing. One teeny tiny thing.

Dum-dum-DUUUUMM! Sanofi Pasteur!?  Are you kidding? The French pharmaceutical company that manufactured Dengevaxia which the Philippines government indiscriminately administered to 800,000 kids? The French pharmaceutical company that conspired with President Aquino to use Filipino children as guinea pigs?  The French pharmaceutical company that sold President Aquino a vaccine for the express purpose of killing Filipino children??

Well that is what some idiots believe. Do they also know that the rabies vaccine used in the Philippines, Verorab, is manufactured by this same company? I bet they do not. 

https://www.who.int/immunization_standards/vaccine_quality/PQ_112_rabies_1_dose_sanofi_pasteur/en/

Probably better to keep this information secret lest any more panic breaks out. 

At the Veterinary Clinic

Recently the UN released a report stating that 3 out of 10 hospitals in the Philippines lack basic toilet facilities. That is only people hospitals. What about animal hospitals? I can testify they are horrendously unsanitary.

For instance here are two clinics that do not have proper disposal containers for used needles. Instead they use plastic bottles.

If you don't know, this is what a proper needle disposal container looks like:

It is not true that just any plastic container is appropriate to be used for needle disposal and for a veterinary clinic to use a bootleg bottle which can be easily punctured shows that they are not interested in investing in proper medical sanitation devices.  Why not use a cardboard box? Or a yellow shopping bag from SM Supermarket? It would be just as unsanitary, unsafe, and wrong.

Each clinic does reuse those bottles rather than dispose of the whole bottle which is even more unsanitary because that means they are keeping a bottle which has accumulated goodness knows how much bio-waste. It also means someone has to shake out all the needles through the tiny hole which is wasteful and dangerous work if they get pricked. Where they dispose of the needles at the end of each day I have no idea.

At one clinic where I took my dog I asked to use the CR and was directed to a room in the back which contained this horrendous sight:

Absolutely disgusting. There is no reason this place is lacking a proper toilet and sink along with soap to wash up afterwards. Not to mention the walk back to this room was dangerous because the floor was slippery with dog piss and faeces. Dogs are kept in large cages with no bottom and they are allowed to mess all over the floor. The whole area stunk awfully. 

This is only two clinics. How many other veterinary clinics in the Philippines are as disgusting as this? Likely quite a few. 3 in 10 perhaps? 

Scenes From the Hospital

At a recent visit to the hospital I saw some crazy stuff.  

The guy I was waiting on either had appendicitis or a UTI or just a cramp. The doctors weren't sure. So they ran a few tests.  Blood work and urinalysis. All this had to be prepaid in cash of course so we paid but they forgot to give us a urine cup when we paid so that messed everything up. He had already peed without collecting a sample. So we had to get a cup and wait.  Here is the cup:

Looks familiar doesn't it?

I asked the doctor why they did not provide a sterile urine cup sealed shut and he said that is just what the hospital provides. What an answer! Maybe the hospital and Shakey's both get their plastic cups from the same supplier. I did not ask him why we had to provide the cup and why it was not the nurses' responsibility to provide it instead.

The doctor asked how my friend felt and he said the pain had subsided. The doctor said that when the appendix bursts the pain will subside so that means his appendix has likely burst but they have to wait for the urinalysis results to be sure. I wonder where he got his medical degree.

I saw a bathroom with no toilet paper, no soap to wash your hands, and no paper towels to dry your wet hands.

Very sanitary.  Not even a bucket of water and a ladle. How many nurses and doctors and visitors are walking around the hospital spreading faecal matter and crotch germs?


I saw one of the Stations of the Cross.

Every Friday during Lent the Catholics parade around the city from station to station praying and singing very loudly. Do they do the same in the hospital? Do they have a procession of prayers and music so loud it could wake the dead?

Outside the hospital I saw a rotted wooden electric pole.

Why not just get rid of the wooden pole?  Why leave it attached to the concrete pole? The whole area smelled like urine because it also functions as a toilet. So after doing your business in the hospital toilet you walk out with your unwashed, filthy hands to catch a tricycle in an area that is basically a urinal. Disgusting.

I did not get a picture of the most interesting thing I saw. I hope you can imagine it well enough.

A cop truck pulled up, one of the cops jumped out, and with his machine gun dangling at his side, finger on the trigger, he waddled over to the information desk and, I think, he asked if the guard on duty and seen someone matching a description. I didn't hear the conversation but I'd imagine they were looking for a perp who had been shot and come to the hospital for help.

Really wish I'd been able to get a picture of that little scene.

And if you are wondering about my friend, well it seems he only had a cramp.