09 June 2005

Poor, Pregnant, and Verbally Abused

With the Sandra Cam and the Lion King issues hugging the news limelight lately, I am picking up on a story that I fear will be forgotten and ignored. It is one story which has been going on for years, one in which I have been witness to, but sadly no one bothered to address.

Filipinos are too patient a people to have let this happen for so long.
2 Gov't Doctors Confirm
Dark Stories in Delivery Rooms

THE TONGUE-LASHINGS turned out to be true.

Two officials of Dr. Jose Fabella Memorial Hospital in Manila yesterday admitted they were aware that some of their doctors and nurses had verbally abused pregnant mothers, as told to the Inquirer by two health workers and a former nursing trainee.

But Doctors Jeffrey Leonardo and Sylvia de la Paz said the cases were "isolated" and involved either misguided or overworked staff members of the government hospital.

In spite of an insufficient budget, Fabella handles as many as 80 obstetric cases daily, according to De la Paz, a member of the obstetrics-gynecology staff.

One of the sources said the hospital dealt with as many as 15 pregnant mothers in labor at any given time during the "peak season," which is usually in September.

"Still, we never use this as a justification," De la Paz said. "We never allow our people to mistreat patients even if sometimes it is [no longer] humanly impossible to accommodate so many patients at a given time."

The sources said they had witnessed mothers in labor being berated by some doctors and nurses, allegedly insisting that these "perennially pregnant" women should resort to artificial birth control methods.


The same story was picked up that week by BloggingBaby.com. That blog has a more harrowing title than this post and will scare any pregnant mother for sure.

When I was an intern, I personally witnessed pregnant mothers verbally (and physically) abused by obstetric residents. I served most of my medical clerkship and internship years in government hospitals. I've seen some obstetric residents (mostly first-years) berate and scold poor, pregnant mothers who come to give birth naturally or by caesarean method. As interns, my classmates and I will usually talk about these sad incidents during short breaks. But that was it. No mother complained and we didn't as well knowing that the residents had a say in our grades.

There are two perspectives here: those of the obstetric residents' and those of the poor, pregnant mothers.

Government hospitals where the obstetric residents work are usually ill-equipped and undermanned. In any given year, there will most likely be 5 OB Residents on-duty per day, and if the average daily delivery load is about 80 babies, just do the math, and see how much work (doctors term that "toxicity" here) an OB resident gets daily. Daily is defined as a solid 24 hours, ok? Even doctors get tired and hungry. And if you are tired, hungry, and you keep seeing that ER door swinging because pregnant mothers who are fully-dilated keep arriving, you might probably snap out, too.

Most poor, pregnant mothers choose to give birth at government hospitals like Jose Fabella Hospital because it is less expensive. Many of them probably get hurt because of the verbal abuses, but will also probably tolerate it because they know they would be back there again to give birth to another child.

Being tired, hungry, and overworked are not reasons to yell at other people, most especially if they are pregnant, and are about to give birth. Yes, we all know that. But it should also be remembered that doctors are not saints. They get tired too and snap. If you were to ask me for solutions, I will propose to add a neuro-psychiatric stress exam to the battery of tests prior to an obstetric residency. I will also ask for a better working schedule for the residents, and improved hospital facilities.

This has been going on for years. No one has bothered to raise a howl, not even a whisper. I still think that if there was contest in patience (pagtitiis is the Tagalog word), poor Filipino pregnant mothers are clear hands-down winners.

1 reactions:

Anonymous said...

hi doc. i just happened to be blog hopping and found yours. it's very nice and informative.
i'm currently a medical clerk. i've just finished my rotation in Fabella 2 weeks ago. We just stayed there for 2 weeks. But that was enough to give me a culture-shock. I agree with your comments. I know who the doctor in the inquirer article is...I have bumped into him once or twice during my rotation (I belonged to a different team). I got to hear some "feedbacks" from this doctor...most were bad. What's worse is he's an alumni of my school! I hope doctor's would remember that patients are people with feelings. They should be treated with respect, their welfare should be their topmost priorities. Isn't that what's being a doctor is all about?