Earlier this week one of our midwives gave me news that I hate hearing. Another maternal death. One of our clients, whose name I am withholding for privacy reasons, passed away last week. She was 24 years old, and pregnant with her second baby. She was due to give birth at the end of this month.
She was from Dumaran but worked as a household helper in an urban community. She had her first check up with us when she was already 6-months pregnant. We don’t know why she waited so long before having a check up but she may not have realized she was pregnant, or may not have been able to take the time off. As part of our standard operating procedure, we gave her a referral to have lab tests done at the City Health Office. She never gave us her results, so it is likely she never went.
During her prenatal check ups, her blood pressure was normal and she showed no signs of the symptoms to come. But on December 3, we’re told she started experiencing pain and her blood pressure was elevated. She started having convulsions. Her employer brought her to a private hospital in Puerto Princesa, where she was told that she could not be helped unless she first paid P100,000 to be admitted.
This blows my mind. Of course, I was not there when this happened, so I cannot verify all the facts. But the Barangay Health Workers who liaise with our organization told us that she was told to gather the money needed before they would admit her. I’m shocked that she would have been asked for P100,000, because at that point, no one had checked her out, so how would they even know whether she would need a Cesarean or another type of operation? Also, President Duterte recently signed a law preventing medical facilities from requiring a deposit.[1]
The patient and her employer knew they would not be able to find that kind of money, so they proceeded to Ospital ng Palawan. Our client was admitted into the hospital, but we do not know what interventions followed. We only know that news came on December 4 that she had died. Her baby also did not survive.
This is a tragic event that highlights the problems that together often lead to women needlessly dying as they are trying to give life. The model is called the “Three Delays”, and it states that most maternal deaths are due to (1) delays in the patient seeking medical care, (2) delays in reaching an appropriate facility, and (3) delays in receiving adequate care when a facility is reached.
While all kinds of women die from pregnancy- and delivery-related deaths, it is poorer women who suffer most. If our client wasn’t a house helper, she might have had more time to access care earlier in her pregnancy, and find the time to go to City Health for her labs. Of course we will never know, but those labs might have been able to predict that she would have complications. If she was wealthy, she might not have been turned away from the hospital with the instructions of finding P100,000. If our client had money, she would likely have been admitted to one of the city’s private hospitals and been given the care needed to save her life.
Everybody loves to blame the government for the country’s failings. And while this is often well-founded, the problem also lies with us, the citizens of the Philippines. Too often it is ordinary Filipinos who don’t enroll kasamabahays for benefits, or give them or other employees time off to seek medical care. It is ordinary Filipinos who allow inhumane policies, and who are comfortable looking the other way. We can’t change the fact that a great majority of Filipinos live in poverty. We can change how we treat those in need.
[1] https://pcoo.gov.ph/news_releases/duterte-signs-anti-hospital-deposit-law/