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Of inequitable allocations and accessibility

In the news recently were figures released supposedly by Philhealth showing the top hospitals receiving reimbursements from the agency for claims relating to COVID-19. Southern Philippines Medical Center, a hospital in Davao City received 326M pesos while UP-PGH got 263.3M pesos.  I was not surprised that my social media newsfeed included posts from both sides of the fence (The fence sitters among my friends on social media were not commenting about these anymore and seem content in just posting on food or whatever activity they were in.). Each were posting information divulged by the whistleblowers in the ongoing hearings on the issues pertaining to PhilHealth funds.

I will not go into the political aspect of this controversy but will just focus on the transportation aspects of the issue.  I will just compare the top two hospitals in the list to simplify the assessment while mentioning others in general.

The claim that the hospital in Davao was the equivalent of PGH in Mindanao doesn’t hold water as the hospital does not treat even 10% of the cases that PGH is handling and for a much smaller geographical area. While UP-PGH is accessible to a larger population and for less travel times, SPMC is not as accessible to say people coming from other major cities like Cagayan De Oro or Zamboanga City. Yes, there are other major cities on the same island that have sizable populations with ‘catchment’ or influence areas comparable to Davao City. They, too, probably need funds to be able to treat COVID-19 patients. It is true that there are many other hospitals in the National Capital Region (NCR) that have the facilities to treat COVID-19 patients. However, many of these are private hospitals that tend to incur more costs for the patient and are not generally accessible (read: affordable) to most people who are of middle and low incomes. Thus, UP-PGH can be regarded as the frontliner among frontline hospitals.

What? There are other public or government hospitals in Metro Manila and surrounding provinces? True, but many of those have very limited capacities in terms of facilities and Human Resources. The same applies to Davao’s case as well because there are also medical centers and hospitals in surrounding provinces. And to round-out the resources available to these hospitals, local government units have also (over) extended their resources to hospitals. Perhaps the allocations and proportions can be explained in another way that is not the “apologist” but based on actual numbers pertaining to cases handled by the hospitals?

Mobility for persons with disabilities

I saw these two people traveling along Marcos Highway just after the intersection with Imelda Avenue. I think they came from Tahanang Walang Hagdanan in Cainta. The tricycle is actually modified to allow for a person with disability to operate the motor vehicle. The side car is also customized to carry a person on wheelchair. Note that back of the sidecar? It is actually a ramp that is locked when traveling but can be lowered for wheelchairs to roll-on or roll-off. Since there are two persons on the vehicle, the driver’s wheelchair is seen folded and loaded in front of the lady on her wheelchair.

PWD vehicle

Such vehicles allow PWDs to be more mobile. Unfortunately, most public utility vehicles do not have features to allow wheelchair-bound people to ride on them. Such features may be seen in city buses in more progressive cities including those in Japan, Europe and the US. Trains can easily accommodate PWDs including those on wheelchairs as their floors are the same level as the station platforms and there is space inside the cars for PWDs. While access for PWDs is already contained in Philippine laws, there is still much to be done in terms of implementing provisions of such laws especially with respect to road-based public transportation.

Mobility for PWDs

Inclusive transport also covers persons with disabilities or PWDs as some people refer to them. Persons with disabilities include the blind, crippled, deaf, mute, and others who are physically challenged and therefore would have their movements limited or restricted. There are laws which provide for the needs of persons Republic Act 7277, which is the Magna Carta for Persons with Disabilities. Specifically, for accessibility, there is Batas Pambansa 344, “An Act that seeks to enhance the mobility of disabled persons” by requiring buildings, establishments and public utilities (e.g., transport) to install facilities or devices to enable use by PWDs. These include ramps at pedestrian sidewalks and at the entrance/exit of buildings. These should also include elevators and other devices to help “physically-challenged” or “differently-abled” persons up and down buildings including those elevated LRT/MRT stations. [Note: Quite frankly, I don’t really like all these supposedly politically correct terms but will nevertheless use them in this article.] 

IMG07690-20140212-0910A man on a wheelchair crosses the intersection at Katipunan-Aurora.

Unfortunately, most public transport vehicles are not PWD-friendly. Most buses and jeepneys do not have provisions for PWDs and, on most occasions, do not even bother to stop to accommodate PWDs, especially those on crutches or wheelchairs. The LRT and MRT are now just too crowded even for able bodied people to endure (especially on a daily basis) but access to the elevated stations have always been an issue as there are limited escalators and elevators either seem to be frequently out of commission or there are none at certain stations. A high profile public official even suggested at one point during his stint with Metro Manila that PWDs and the senior citizens should just stay home rather than travel; hinting that these people would just be a burden to others when they travel.

This is not the case in other countries. I have seen in Japan, for example, that city bus designs can readily accommodate PWDs and this includes low-floor buses for easy access between the vehicle and the sidewalk. Bus drivers fulfill their responsibilities of stopping and assisting persons on wheelchairs to board and alight from their buses even if it means they would have to compensate for their scheduled stops. Then there are those I’ve seen riding the BART in San Francisco wheeling themselves in and out of the trains and stations with ease.

Addressing the transport needs of PWDs is definitely an area that needs proper attention especially as groups advocate for inclusive transport. Persons with disabilities are an integral part of our communities and enabling them to travel is a big factor towards encouraging them to be productive despite their physical limitations. They are not asking us to pity them but instead empower them to be the best they could become given the opportunity to be productive, to contribute to society. As such, they deserve the facilities and services that will enable accessibility and mobility that is at the same time safe for them and everyone else.