Philippine Hospitals
During the last ten years I stayed several times in hospitals here in Davao City. I learned always that patients acquired infections. Nowadays Philippine health experts started warning again “that one out of twenty patients confinded in a hospital or health care unit acquires infection during admission”!
The former president of the Philippine Hospital Infection Control Society, Dr. Mario Panaligan said, that the infections are secondary or not related to the patient’s original condition. Of course, many patients are susceptible to micro organisms, which can cause infection because of a very weak immune system.
It makes really thoughtful and nervous to learn from Dr. Victor Rosenthal, a World Health Organization’s Infection Control Guidelines External Reviewer, that in most developing countries “15 out of 100 patients confined in the intensive care unit are at risk of acquiring hospital-related infection”… .
The two experts published a five-point-strategy to prevent such hospital infections, for example washing hands, which is a simple procedure but it lessens the chance of transmitting pathogens.
Can we be sure about proper sterilization and disposal, which should be observed always? Are contaminated items still being left with a patient? How to avoid contact with food or common waste receptacles?
I would strongly agree with Dr. Panaligan, who cited the importance of re-education doctors and health workers as the aggressiveness of intervention in healthcare facilities, which will determine their success in infection control.
How safe are Philippine hospitals? What do you think?
Hi Klaus - Do you have information on the difference in infection rates between Philippine hospitals and hospitals in other countries? Is the infection rate higher here in the Philippines? Lower?
In my opinion the rate in infection is not much higher in the Philippines in major hospitals than any other country. as far as provinicial small clinics I’m not familiar with that.
The matron is very much missed in western hospitals. Used to be one time that hospital cleanliness was carried out with military precision.
Now cleanliness is managed by Dad’s army types in suits.
Hi Klaus, it is not different in other countries. When I went home to Vancouver, I heard that hospital wings were being closed due to contamination. Now we see antiseptic gels in elevators and hallways for the public to use. This was the same in Norway. In New Zealand, my husband got a serious infection from a minor surgery. His thigh got so swollen and red and it took 6 weeks (instead of just overnight) to heal. The doctor was so nervous about it and was scheduling his appointments either very late or very early in the day so that no other patients were around to see what he has done.
I had surgery here last year and it went well. I would think that the hospital staff in the tropics are more wary of infections and would take extra precautions. However, I do worry that it is very easy to get antibiotics here, without prescriptions. This is just the right formula for developing the Super Bug.
Hi Klaus,Here in the Uk we have had problems with hospital infections for a few years now.The problem appears to have arisen since hospitals contracted the cleaning to outside contractors,getting rid of in house cleaners.Some wards have even been closed, but there is now a big shake up to improve.Over use of antibiotics has also been blamed as this temporarily reduces the effect of the immune system to protect the body from infection,regards Chas.
Hi Klaus. I agree with Ellen and Chas above. Nosocomial (hospital-acquired) infection is indeed a big problem all over the world.
In developed countries it’s a problem of indiscriminite use of very broad spectrum antibiotics. The bacteria are therefore more virulent and very resistant to a lot of antibiotics. Also there are a lot of people who are institutionalized (nursing homes, etc) that are recycled through the hospital sysytems carrying with them resistant bacteria back and forth.
In developing countries the opposite is true. Nosocomial infections are usually less virulent and most bacteria are ’still’ sensitive to most antibiotics. The use of broad spectrum antibiotics are still not too widespread because of costs. But as the costs of these antibiotics become affordable, the infection pattern common to developed countries will be duplicated there too.
One should acquaint with terms like the rates of Pseudomonas, MRSA (methicillin-resistant Staphylococcus aureus), VRE (Vancomycin-resistant enterococcus) and C. diff (Clostridium dificile) infections. These are usually available in most Microbiology sections in hospital laboratories even in small hospitals in the Philippines…and avoid those ones with high rates.
There are surgeons who are carriers of MRSA. These doctors have a high rate of surgical wounds infected with MRSA. It will not be rude to ask your surgeon when was the last time his nostrils (the most common sites where MRSA is carried) were cultured for MRSA.
The most prudent action of course is prevention. Avoid hospitals. Also make sure your outpatient surgical centers have a very low infection rates. Talk to your local friendly microbiologist or lab tech.
Shalom.
Hi Bob, I don’t have those information yet, but I am sure there are some of our LiP readers, who might be able to know about such figures. I would also go with Dan’s opinion, EVEN I also learned from some incidents in Philippine major cities…
Hi Dan, thanks for your comment. If possible, I would never like to stay in a provincial hospital. the problem might come up, if travelling somewhere and ’something happened’… .
Hi Jim, yeah, I have heard about it… Thanks for leaving your comment here…
Hi Ellen, thanks for dropping by. Your experiences are indeed interesting. Your examples from Vancouver and Norway also happened in other parts of the world. I actually posted this write up, because many times it really looks like we can’t trust some hospitals here in the Philippines - no matter, if in major cities or in the province. One of my in-laws also experienced a bad hepatitis infection here - but, of course, I would never like to mention the hospital’s name. As other readers said; it can happen anywhere. AND, Ellen, you are very right: it’s very easy here to get any kind of medicine WITHOUT prescription, if you know the pharmacy or/and the pharmacist. Super Bug? yeah, we mentioned that already, while still living in Germany and because many doctors have been very fast in issuing prescriptions…
Hi Chas, thanks for your interesting comment. Such things also happened in some other European countries, as far as I know. Cleaning by outside contractors in hospitals? Good topic. How this is being handled here in the Philippines?
Hi Dr. Sponk Long, thank you very much indeed for your interesting comment. Honestly, I am very much afraid to need a surgeon one day. I hope and wish, this will never become true. You advice to avoid hospitals. But if, we don;t have another choice? And is there really a difference being operated in a hospital or being an outpatient? I really try to find a lab tech now, just to be prepared for the future…
Hi Klaus! That’s the reason why I hate to go to the hospital.
.. Washing hands is the basic thing to do… 
Hi Klaus,Another, that i have issues with is hospital visitors.A few years ago visiting my mother many times after she suffered a stroke i was astounded by visitors ignoring the rules.Here now in the Uk all visitors are requested to rub anti bacterial gel on their hands before visiting wards, which is freely available,as we all carry some bacteria.Many times i saw people ignore this procedure,even when seen and requested by nurses to do so.I said to one nurse “If it was my hospital i would throw out visitors who did not follow the rules” she replied “we have no real authority to do that” amazing.These ignorant visitors do not realise they are putting their sick loved ones in danger,regards Chas.
Hi Cidy, I strongly agree with you…
Hi Chas, thanks again for your comment. I would say; unbelievable but true!!!
Hi Klaus,Whilst on the subject of Hospitals,i would like to mention,for those who may be interested:The Association of Bukidnons in America have recently shipped 9 Dialysis machines,donated by New York Hospitals, to various hospitals within Bukidnon Province,regards Chas.
Hi Chas, that’s really great. Thanks for your information. Maybe there are some more examples like this, which are really appreciated.
Hi Klaus. I don’t have any stastistics in infection rates of outpatient surgical centers. I will venture to say that it should be low as most cases of these centers are usually healthy and ergo have no or less infection exposures. One can argue though that most major hospitals have more rigorous infection control in placed than stand alone surgicenters.
On a different note…I think your topic about hospital infection is very apt with the present ‘civil’ war going on in Mindanao right now. There will be a lot of cases of open wounds in Mindanao hospitals in the next few months and it will worsen. It will be wise to postpone elective surgeries.
Off topic but a concern… expats should really be wary with the present Mindanao situation. The MILF knows now that the only way to pressure the Philippine government to the negotiating table is pressure from outside. The U.S. got engaged only when U.S. citizens were kidanpped and some were killed by the Abu Sayyaf (which I believe is the terror arm of the MILF). There will be kidnappings of foreigners soon…that’s inevitable.
Salma ya Salama, Klaus.
Had an experience with a provincial hospital last month because of an ameba infection. When we arrived at 3 am a dog with 3 legs just walked by the ER . The next day we got a prescrition for 24 pills of Flagyl. We had to go to at least 5 different drugstores to buy all 24 pills. Most drugstore only had 2 or 3 pills max.
Hi Dr. Sponk Long, thanks again for leaving a comment here. Regarding the ‘civil war’ in Mindanao, you might be very right. Postponing elective surgeries might be also a good advice for people living in affected areas like Lanao del Norte. I think we shouldn’t worry to much living in Davao City and its provincial surroundings. Regarding your “off topic”: I strongly agree with Bob Martin’s article. Btw, I have been travelling in Mindanao even during the early 1980s (and even to places like North Cotabato). I always came home save and sound. Sad to say only, that such negative headlines about Mindanao are really painful for people like me and many others, who love to live here…
Hi Fusion, thanks for your comment. Indeed: terrible experiences. You didn’t tell us, where this happened. Anyway, if you asked for Flagyl in some pharmacies, even here in Davao City, you might the answer NOT AVAILABLE (walai stock!). Experience of a Filipino friend of mine, also with ameba infection…
Just for the knowledge, Is the Health Service free for the poor? Do the poor have to pay if they go to the Government Hospitals in the PH?
Hi Fun, there are several provincial government hospitals. which provide ’such services’, but it mostly rules; no money - no help. The quality of ‘help’ is more then poor… and this makes me so very sad… .
If that is the case, It just unfortunate where the majority of the people are deprived of a basic health service because they are poor.
Hi FUN, you are so very right…