Clinic detention is illegal!! Not yet 2yrs old and held in clinical detention!!!!
REPUBLIC ACT NO. 9439 April 27, 2007
AN ACT PROHIBITING THE DETENTION OF PATIENTS IN HOSPITALS AND MEDICAL CLINICS ON GROUNDS OF NONPAYMENT OF HOSPITAL BILLS OR MEDICAL EXPENSES
On Sept 7th at approx. 9:30am baby J (2yrs in December 2016) sustained a hot coffee burn to his chest. His mum was so shocked and took him to the hospital nearest to her house. Here, at around 10am Mum was told that the baby was critical and might die and must have surgery. She asked how much it would be and was told around ten thousand pesos. She consulted with her partner, a Govt driver in Bataan, and they decided they should go ahead since they had been told it was critical. Baby J went to the operating room at 6:30pm and was out at 6:35pm, having had a debridement – a medical term for cleaning a wound. Mum was instructed to use a ‘burns cream’ daily after a bath and cover with a single layer of gauze, which was taped to baby J’s delicate skin. On the 8th Sept at 10am they were discharged. They got a big shock when they received the bill of 57,852.00 pesos!! For 12 hours!! The parents queried the bill and were told that it was correct. The surgeons fee was twenty five thousand pesos, essentially 5000 pesos per minute!! More than DU30 recieves for sure!! They cannot pay this indulgent amount and are now not permitted to leave, being under ‘hospital arrest’. They have received ten thousand pesos from the PCSO towards the bill, and have offered to try and pay a monthly amount till its paid but the billing section won’t allow that. In addition, they are being charged 800pesos daily for the privilege of being held against their will; for the bed, one of 6 in a cramped room PLUS 350pesos daily for ‘nursing station’ fees – even though they are not receiving any treatment as they are discharged!!
Baby J was seen by a clinical nurse specialist in burns from Triple B Care Projects (a sec registered NGO, non – stock ,not -for -profit organisation www.TripleBCare projects.org) on Sep 11th and discovered the awful truth about baby J’s detention. The burn to Baby J’s chest is in fact partial thickness and would normally heal within a few days without the need for surgery, if international standard treatment had been applied at the outset, including correct 1st aid.*
FIRST AID FOR ALL BURNS: REMOVE CLOTHING AND JEWELLERY,COOL BURN UNDER RUNNING WATER FOR 20MINS, COVER WITH A CLEAN LINT FREE TOWEL OR PLASTIC FOOD WRAP. GET GOOD MEDICAL HELP
Our 25th Telemedical link in Nepal was set up today to a health post in Tangting, Kaski. This is a community health post with just 2 nurses, 1 birthing bed, offering a very basic service with no diagnostic equipment and basic drugs supplied by the Nepali government.
Tangting is a Gurung village that is in a very remote part of Nepal, located 21 miles North of Pokhara. There are 200 houses with a population of approx 1350. The village is surrounded by hills and forests so to get to the main hospital in Pokhara it is an hour walk to meet up with jeeps then a two and a half hour drive!
We will do all we can to help improve the health and lives of the village people through our Swinfen Telemedical link.
We were contacted today by a referring doctor that moved from a clinic in Banjul to the MRC unit in Fajara. Having set up a Swinfen Telemedical link to the Banjul clinic she was so impressed with our service that she wanted to set up a Swinfen link to the unit in Fajara which we have gladly put in place for her.
The MRC is a public hospital specialising in Adult and Paediatric medicine, Cardiology, TB and Liver disease. they have a range of diagnostic equipment and excellent availability of drugs, although they may not be the very latest. They have 42 beds, 6 Doctors, 30 nursesand many other research doctors contributing to the clinic service. For those patients that cannot afford to pay the hospital will waiver the fees, most will manage to pay as they are only charged a contribution towards the service.
Although there are many doctors at the unit, there are big gaps in their knowledge. At present there are only 2 adult physicians – the other doctors have either no specialty or are Paediatricians. They see a lot of dermatology and have no one with expertise in this field. They are however in a privileged position of being able to do investigations, but do not always know what to make of the results.
Kikori is a settlement in Papua New Guinea; it lies in the delta of the Kikori River at the head of the Gulf of Papua. As the crow flies it is 245miles from the Capital, Port Moresby. The hospital has 100 beds and serves a wide area around the gulf, given that the next nearest hospital is in the Capital. The medical staff consist of six nurses, about 20 community health workers, occasional visiting medics on short term stints and a British Doctor, Beth Lewis, who has been there for four years.
In addition to looking after all the in-patients this amazing medical team run clinics at the hospital and do outreach visits to villages up-river, where they seeks out possible TB cases, a disease that is endemic there and very common. Facilities are minimal; there is ‘bedside’ ultrasound, AFB staining, and microscopy for TB, very limited bedside blood testing (Glucose, Hb, HIV, Malaria, hep B). Microscopes are available but stains and expertise are limited. It would do some current doctors good to have to manage without X-rays or any other scans, let alone the limited selection of blood tests!
If a patient really does need to have scans of any description, specialist services, or even anything more than basic blood tests, the only option is to consider transfer to Port Moresby. Getting there is 12-16 hours by dinghy through the rivers then across open sea to Kerema the provincial capital. It’s a very dangerous journey where the currents meet at the mouth of the big rivers. In the wet season lives are lost every year by people making the journey. But it is the only real way out… then from Kerema to Moresby it’s another 12+ hours by truck on the road. The vast majority of the population they serve are subsistence farmers who may just get a little income from marketing, but the journey to Moresby costs more than most make in a year.
Another challenge for medics visiting anywhere overseas is language. In this area of PNG there are eight main languages that they are confronted with. English, Pidgin and Moto are the three common ‘trade’ languages plus five widely spoken local tribal languages, but they have patients from at least another 10 language areas who use the hospital. Thankfully, most people speak one of the three main languages, but when they’re from further afield they may not. With some patients the clinical history can get a bit muddled as its been translated from their language via another language into Pidgin, a vague and imprecise language for trying to convey concise observations!
At the end of April this year I had an email from Beth to say that their ‘dinghy had died’. It had been repaired many times but had been working so hard that the motor ‘gave up the ghost’. Without it all of the TB outreach work came to a complete standstill as, living in the delta, without a boat she and her team could not get to any of the villages to do TB clinics/ follow ups/ awareness or to bring patients to hospital for treatment. Kikori has one of the highest TB rates in the world, and 70% of the 100 hospital beds were filled with TB patients. Hence the importance of the outreach clinics to try and stem the spread of TB in the area.
Beth Lewis is a very self-effacing young lady, but deeply committed to her work with the locals. The demise of their dinghy came as a cruel blow to her, her team and the work they all do.
So, one of Beth’s friends set up a ‘crowd funding’ page to raise the money for a new outboard engine. The funding target was £7,000. After just 10 days that target had been exceeded; the exercise produced £7,025 on ‘Gogetfunding’ plus £2,500 from other sources including Beth’s Church back in the UK.
Shortly after, she wrote to say “the most huge THANK YOU for making our dream of a dinghy to continue Kikori’s TB work a reality”.
She felt that the response to the appeal had been incredible, and the team were very excited to be able to plan the purchase of their new motor. “What is most incredible is that you and others like you- people that I’ve never actually met personally – believe in this enough to support us in this way”.
Given that the funds had exceeded the amount required for the engine they were also able to replace the fibreglass dinghy with a bigger one and set aside funds to pay their operators/ drivers for their work on TB outreach patrols as nationwide budget cuts for health facilities meant that their workmen, who also function as drivers, had had their hours halved so only employed 18 hours/ week, but the TB trips are often 2-3 days. What’s left over has been allocated for upkeep and maintenance, and some for the TB programme which may include extra “ambulance” trips.
In early August the 23ft fibreglass dinghy and a 40HP Yamaha outboard arrived on a cargo boat from Port Moresby. “Hugest big thanks from all of us in Kikori for helping us to continue to see people live well and healthy in this little corner of the swamp here!”
The remarkable team at Kikori work for a wide community with the barest of resources; they truly deserve our highest regards.
The Swinfen Charitable Trust is honoured to have been able to help in 57 cases referred from Kikori by Beth Lewis in just over 18 months.