MANILA, Philippines — Heads of tertiary hospitals in several provinces in Luzon believe that rural health units (RHUs) in their respective areas must play bigger roles amid the "new normal" ushered in by the COVID-19 pandemic.
Doctors from medical centers in Batangas, Bataan, Ilocos Norte, and Baguio discussed this in an online forum hosted by the Institute for Solidarity in Asia and moderated by Dr. Maria Linda Buhat, president emeritus of the Association of Nursing Service Administrators of the Philippines last Thursday.
Dr. Glory Baltazar, Bataan General Hospital and Medical Center Chief II, said one of her main takeaways from her facility's experience with the pandemic was the need for district hospitals to cater to the brunt of primary and secondary care cases.
She shared this with the webinar's other guest speakers: Dr. Ramoncito Magnaye, Batangas Medical Center Chief II; Dr. Maria Lourdes Otayza, Marcos Memorial Hospital and Medical Center Chief II; and Drs. Ricardo Runez Jr. and Leamor Fangonilo who serve as the Medical Center Chief II and Public Health Unit Head of the Baguio General Hospital and Medical Center, respectively.
"[When] we were partially closed sometime April to May, the rural health units, the district hospitals, were quite helpless and they were overwhelmed taking care of the cases that they are really mandated to take care [of]," Baltazar said.
"Our new normal is that we have to establish and accept the fact that this is a prelude to the Universal Health Care [Law] wherein tertiary hospitals must only take care of tertiary cases," she added.
She further explained that, before the onset of the pandemic, the Bataan General Hospital and Medical Center, a tertiary level facility, was catering to primary care concerns in addition to its actual purview.
"So [RHUs] have to capacitate themselves, and accept they have to deliver babies that are not tertiary in nature, attend to simple cases like dog bites. Imagine we [were] catering to 100 dog bites and these are very primary cases so I think this is saying that we've been trying, all of us tertiary hospitals," Baltazar said.
The need for clear boundaries "We've been reaching out to our partners in the periphery, that [they] should take care of the preventative aspect, and we will take care of the curative aspect. Likewise, in the same vein, you have to take care of the primary cases and the secondary cases, and we'll take care of the tertiary cases," she added.
She added that her facility's designation as a coronavirus hospital necessitated a more effective implementation of boundaries between variying levels of healthcare facilities.
"Now [RHUs] already know already how to take care of simple [Normal Spontaneous Delivery] (NSD), simple cough and cold, simple maintenance of hypertension, and so on and so forth. I think this will be our new normal. They know where the boundary lies and the same direction, the competency and the capability of the hospitals will be maximized."
Dr. Leamor Fangonilo, Public Health Unit Head of the Baguio General Hospital and Medical Center, further advocated for capacitating facilities offering primary care.
"We need to empower our primary level of care, our partners in the communities, so that they will be able to cater to these primary cases."
She emphasized that the empowerment of these smaller facilities, in turn, would allow tertiary level hospitals to focus on offerring highly specialized medical care.