Devolution of Healthcare

Conversing with some of the Barangay Health Workers

Today, I was able to visit a few Barangay Health Stations and Rural Health Unit. I was able to interact and engage in discussion with many of the interns who were working at these BHSs. At the first station, it appeared that community members were not really aware of the existence of the health center and as such, there are no patients. It was made clear that this partnership between the medical school and the community’s was supposed to be collaborative. It was not prescriptive or up to the school to impose or implement their own systems. Rather, the students who were placed there were to respond to the local needs and wants of the community and utilize their technical skills to provide such services. The BHWs are incredibly important to the survival of these stations. Often times, they are senior citizens who are well past the age of retirement that are volunteering to be there. They get paid variably, ranging from 500 to 1,000 pesos per month (roughly 10 to 20 US dollars) but they do so because it gives them a sense of purpose and self fulfillment being able to give back to the community. The BHS provide very basic primary level care. Any high risk cases are referred out, first to the RHU which is equipped with TB DOTS, a basic laboratory, and a stock room of medications. The nearest secondary hospital is 10 minutes away from the RHU and the nearest tertiary hospital is 25 minutes. Since these stations are funded for by the provincial and municipal governments, it really depends whether or not these areas have health conscious advocates who are willing to go out and raise awareness about the needs for such clinics. The devolution of the healthcare system was intended to better the system because it was the assumption that the local government would know the local needs best and therefore be able to best respond to the diseases and conditions at hand. However, because they are reliant on the local government for money, if the health clinics are not properly funded, it will seriously suffer.