By JULMUNIR I. JANNARAL | Managing Editor
There is a saying “it is cheaper by the dozen.” But in the minds of a group of young doctors of Tawi-Tawi who are 12 of them they believe combining their 12 brilliant minds in effect can easily uproot even big trees.
This is how these young physicians want to achieve especially they are aggrieved how they are being treated by Dr. Sangkula Laja, the Chief of the Integrated Provincial Health Office (IPHO) in Tawi-Tawi and concurrently the Chief of Datu Halun Sakilan Memorial Hospital (DHSMH). This hospital is a 50 bed capacity Primary Hospital which serves as the Provincial Hospital of Tawi-Tawi.
In short, Tawi-Tawi doctors demand immediate investigation on their IPHO head for gross negligence after 9 doctors tested positive of COVID-19.
Dra. Shadrina Tahil-Sarapuddin, who serves as the spokesperson of the 12 aggrieved physicians told the Philippine Muslim Today that Dr. Laja being the head of IPHO Tawi-Tawi had compromised the lives of many.
This is after 72 health care workers (HCWs) (approximately 25% of its workforce) have been tested positive for COVID-19 in the past 3 weeks.
Dra. Shad Tahil who is called by her shortened name for brevity said “no other hospital in the Philippines has had 25% of its HCWs testing positive, especially not in a short amount of time.”
She also said that through the initiative of MOH-BARMM officer in charge (OIC) Dr. Amirel Usman, the DHSMH is on lockdown but with minimal function so as to cater for emergency cases.
She said it cannot be completely placed under lockdown as there is no other functional government hospital here Bongao, Tawi-Tawi.
When asked if there are any among the young doctors who were tested Positive of COVID-19, Dra. Shad Tahil admitted there are 9 doctors who have been tested and positive to have the Coronavirus. She said that 8 of them as of this writing are currently under isolation and quarantine, while the 1st one, has fully recovered.
Hence, the Datu Halun Sakilan Memorial Hospital was immediately placed under lockdown since September 25, when the 8 doctors were confirmed to be tested positive of the dreaded Coronavirus.
Problems besetting the Frontliners
Asked on what are the problems now besetting the Frontliners, Dra. Shad Tahil categorically told the Philippine Muslim Today that the biggest problem of their hospital is the lack of Infection Control Protocols.
She said it was made apparent by the rapid surge of cases among hospital HCWs.
“When we had our first 2 HCWs testing positive, no proper contact tracing was done, close contacts were not isolated and quarantine, no quarantine facility for HCWs, these problems to name a few contributed to the surge of cases.
The hospital was simply complacent and unprepared. There was no contingency plan. We were poorly prepared to deal with COVID-19 and it bit us – it bit us hard,” Dra. Shad Tahil lamented.
Do you have enough PPEs that can protect you from the dreaded Virus?
When this Managing Editor asked for the availability of the Personal Protective Equipment (PPE), her curt reply is this, “No, we do not, in fact most of us have not been given disposable PPEs since COVID-19 came about. In terms of basic protective equipment, we were given only the the basic like surgical face mask, face shield, alcohol and non-disposable PPE.”
Dra. Shad Tahil added, “We still had to spend for N95s face mask and replenish our supplies with our own money. The situation was worst when we had the surge of cases. Without proper contract tracing or isolation and quarantine of close contacts done, we were unnecessarily exposing our colleagues and patients to COVID-19.
How many COVID-19 patients who are Active, Asymptomatic, Mild, Severe, and Deaths?
It was good enough though in the Pandemic situation, Dra. Shad Tahil was kind and polite to answer even to the smallest details.
“Unfortunately, due to the lack of COVID-19 testing in the province, we are unable to determine the true burden of the disease. Testing is limited only to those diagnosed as COVID-Suspect. In the latest update, we have a total of 109 cases, 73 are HCWs, 9 are doctors. 36 are either admitted or from the community. We have a total of 9 deaths.
She also said, “we have no data that would determine if they are asymptomatic, mild or severe. Doctors are often unaware of testing results and often rely on the official FB Page of Dr. Laja (Kasehatan ng Pamaranan Tawi-Tawi).
The BARMM has just released recently P5 million through MSSD to Tawi-Tawi IPHO. Are you not happy with the release of this amount?
Dra. Shad Tahil happily answered, “We are happy. We are welcoming any help we can get in our fight against COVID-19.”
Tawi-Tawi being the last Province to the South, do you think the MOH-BARMM is fair to IPHO Tawi-Tawi in giving supplies and equipment? You know from the Press Releases sent to us by the Bureau of Public Information, the MOH-BARMM has concentrated much on the hospitals in Mainland Mindanao like the Cotabato Regional Medical Center in Cotabato City and the Amai Pakpak Medical Center in Marawi City, and those in the island provinces of Sulu, Basilan, and Tawi-Tawi seems to be left behind . What is your comment on this observation?
“As we have no data to support our claims, we cannot make an objective comment,” she said.
Are you satisfied with the leadership of MOH-BARMM under Minister Saffrullah Dipatuan? And the IPHO Tawi-Tawi under Dr.Sangkula Laja?
“With regards to the leadership of MOH-BARMM it is very difficult to comment because we do not see first-hand what is happening in BARMM.”
“But what we can comment on is what happening here in Tawi-Tawi. We strongly believe that we are in this predicament because of our Provincial Health Officer (PHO) II, Dr. Laja.”
Dra. Shad Tahil said given with the prevailing situation now going on in Tawi-Tawi in time of this pandemic, they went to the extent of submitting their position paper to BARMM Interim Chief Minister Ahod “Al Haj Murad” Ebrahim last September 17, 2020.
As an excerpt to the letter today Chief Minister Ebrahim, the aggrieved physicians of Tawi-Tawi said as quoted here:
“When we wrote the first time, we were motivated by our collective convictions in your sincere care and affection for BARMM as you manifested them in various public pronouncements in the past. The emergency situation in our hospital exactly fits your stature and authority to resolve the problem as we believe no one is in a better position to intervene than the father of BARMM. Our health situation requires immediate action if we are to contain the spread of the virus and protect our community from the malaise of the pandemic. It is the safety of the HCWs of DHSMH like us, the residents of the Municipality of Bongao in particular and the people of Tawi-Tawi in general that are at stake here.”
Dra. Shad Tahil further lamented “by all accounts, our letter of 17 September 2020 was not acted in spite of its urgency since no information whatsoever was relayed to our hospital or any emissary sent to pacify the fear and uncertainty engulfing every one of us. To the very least, an investigation must be initiated from the upper health echelon of BARMM to give us hope that a solution is forthcoming. The Covid-19 pandemic is deadly and therefore should be contained at all cost.
Following the protocol of the Inter-agency Task Force (IATF) on Emerging Infectious Diseases, our dear hospital must be in lockdown mode in the first instance considering the magnitude of those infected with Covid-19. But sad to say, our hospital remains operational as it is the only functioning hospital in Bongao, Tawi-Tawi. Even in our moment of despair after we were exposed to Covid-19, Dr. Laja required us to report for work unmindful of the indiscriminate contamination we might spread to our patients and those that work with us. But our sworn duty to protect and save lives was our conscience in our collective decision to isolate and quarantine ourselves using our own resources and medical wisdom as our best effort in helping contain the spread.
Our situation is so dire and pathetic with no proper Personal Protective Equipment (PPE) being provided and no Covid-19 dedicated isolation facilities to count on. Hopefully we remain asymptomatic because if we get ill due to Covid-19 complications, God forbids we end up in unnecessary death.
The situation had worsened from that of 17 September 2020. Update of the situation is herein provided in the matrix below:
We had been polite and tempered when we wrote to you on 17 September 2020 hoping not to antagonize anybody particularly our Hospital Head Dr. Sangkula Laja believing that as a Medical Doctor he is with us in our sworn duty to protect and save lives.
Currently there are 70 healthworkers of Datu Halun Sakilan Hospital who have been tested positive in the past 3 weeks, including a total of 9 doctors. No other hospital in the Philippines has had this many cases in such short amount of time.
“We, the doctors of Datu Halun Sakilan Memorial Hospital put into question the leadership of our agency, Dr. Sangkula G. Laja, on how he handled this crisis and how his actions or lack thereof has compromised the lives of many.”
“Throughout this ordeal, Dr. Laja has failed to perform his duties. He refused to acknowledge the advice of our Internal Medicine Consultants, who due to the lack of Infectious Disease Specialists in Tawi-Tawi, are the local experts on this disease.
He made decisions without proper consultation with doctors in both the government and private sectors and he repeatedly ignored protocols and guidelines set by the Department of Health (DOH).
Despite our plea to put the hospital on lockdown, he insisted to continue hospital operations despite the risks without providing proper personal protective equipment to the HCWs.
Despite being the only hospital in operation in Bongao, Tawi-Tawi, he failed to prepare a contingency plan should an outbreak occur in the hospital. Through his actions or lack thereof, he has betrayed our trust and failed to safeguard the health of the people he has sworn to protect.
We are requesting your government to send a medical team to take over hospital duties to allow the hospital to recover.
We are also requesting a group of experts, ideally Infection Disease Specialist, to evaluate existing protocols and identify breeches in infection control and prevent this tragedy from happening again.
Lastly, we request that an investigation be conducted on our institution’s head, Dr. Laja, for gross negligence.
As doctors, we must protect the unsuspecting patients of DHSMH who believe in the promise that they get healed by our institution. To infect them with the deadly Covid-19 virus is a crime unforgivable by any standard measure of decency.
Rest assured that we are motivated by no less than our love for our beloved hospital and the people we served, the citizens of the Province of Tawi-Tawi. Let us be united in protecting and saving lives!”
The Group of 12 Tawi-Tawi Physicians in their position paper also submitted their laudable recommendations to the Ministry of Health of the Bangsamoro Autonomous Region in Muslim Mindanao (MOH-BARMM).
• Being an isolated island province, there is an urgent need to establish a testing center in Tawi-Tawi. Once established, enhanced community testing would ensure we are able to detect and curb transmission in the community.
Currently we are still fulfilling our duties as medical frontliners, not knowing if we have COVID- 19 or not. We mourn, as one by one, we see our colleagues test positive. We fear not only for families but for our patients as well. We do not want to resign but how can we continue serving if our safety is compromised.
Again, we are not here to criticize or disregard what the Provincial Government, Local Government Units (LGUs), Inter-Agency Task Force (IATF) and other line organization has done. Instead, we would like to thank them for everything that they have accomplished. We write this letter as a cry for help, for now more than ever, we need your help. For it is only together that we may have a chance against it.
Hoping for an immediate response. Thank you and More Power! Wassalam.
Dra. Shadrina Tahil-Sarapuddin
Provincial Health Officer I
Datu Halun Sakilan Memorial Hospital (IPHO Tawi-Tawi)
Note: She has been in service for more than a decade in IPHO Tawi-Tawi (13 years)
Dr. Jamar Sarapuddin
Medical Specialist IV Pediatrics
Dr. Cynthia Ferrer
Rural Health Physician
Dr. Muhjali Theodore Aliaza
Rural Health Physician
Dr. Rwidz Shan Laurente
Medical Officer III
Dr. Edward Jay Azman
Medical Officer III
Dr. Rene John Febro
HRH-Medical Officer IV Internal Medicine
Dr. Lissa Belle Pombuena Rural Health Physician OBGYN
Dr. Shayr Amarillo Hamad HRH-Medical Officer IV
Dr. Al-Rasheed Matolo HRH Medical Officer IV
Dr. Abdel Majeed Mohammad Isa Medical Officer III
Dr. Zhoyida Jaji
HRH-Medical Officer III