‘ONLY 3 OBs IN OUR GOV'T HOSPITALS!’ KPH doctor bares staffing shortage

TABUK CITY, Kalinga — A shortage of obstetricians at the Kalinga Provincial Hospital (KPH) emerged as one of the key concerns during a joint committee hearing of the Sangguniang Panlalawigan (SP) on Thursday, September 10, as health personnel explained the circumstances surrounding a complaint involving the treatment of a woman in labor.

Obstetricians, or OBs, specialize in pregnancy, childbirth and conditions affecting women’s reproductive health. At KPH, they are responsible for managing deliveries and performing procedures such as cesarean section operations.

During the hearing, Dr. Marriane Baggay, an OB-Gynecologist at KPH, said the hospital had only one OB available to attend to patients for several periods between late June and August, placing a heavy workload on her amid the hospital’s high number of deliveries and operative cases.

The staffing problem began after one of KPH’s obstetricians, Dr. Basco, went on leave on June 28 to care for her seriously ill mother, who later died in August.

Baggay said she was left as the only OB handling patients at the hospital for a period, requiring her to attend to cases in both the delivery room and operating room.

“Ibagak ti situation ti KPH, since July up to now, dalawa kaming doctor nga nabati. Edi July, Doctora Basco went into leave kasi nga nagsakit ni mother na and eventually natay ni mother na,” Baggay said.

Although Basco returned to duty on July 21, Baggay said she continued reporting for duty because the hospital still needed additional OB support amid its workload.

“Siyak lang ti OB from July, uray kitan tayo diay record, from June 28 to July 21, and July 21 sinublat dak ni doktora Basco pero still nagduduty parin ako,” she added.

Heavy workload, few OBs

Baggay said the staffing shortage was compounded by the number of operative cases handled by KPH.

The hospital recorded around 70 to 80 operative cases in July, making it difficult for one doctor to manage several operations in a single day, especially since cesarean sections can involve complications requiring additional attention.

“Ang census namin for July is mga 70-80 nga operatives… Kasi nu ag-CS ka, wenno agopera ka to more than four in a day, ket nagrigat nga aramiden ngay didjay. Although kunayo CS lang dayta. So CS comes with complications. So nu adu ti ma-CS, ada nga ada ti complications,” Baggay said.

Because of the workload, Baggay said there were instances when patients had to be referred to hospitals in Tuguegarao when their cases could no longer be safely handled by one exhausted doctor at KPH.

She said referrals were made when necessary because doctors also had to consider their capacity to safely manage patients already under their care.

“I can only do so much. Ada man mairefer sagsagaysa diay Tuguegarao nu haan kon nga kaya ta aggigidanen,” she said.

Baggay said that from August 1 to 16, she again became the only OB attending to patients in both the delivery room and operating room.

“In August, nagleave latta ni doctor Basco kasi critical ni mother na. So from August 1 to August 16, siyak metlang ti maymaysa nga OB nga agmaman diay delivery room ken OR,” she said.

She added that patients whom she could no longer safely accommodate at KPH were referred to hospitals in Tuguegarao.

“Ada man mairefer ko nga sagsagaysa diay Tuguegarao ket nu talaga na nabbanog nek metten. I can only do so much,” Baggay said.

‘We need more OBs’

Baggay said the shortage of obstetricians affects not only patients but also the doctors who remain at the hospital and carry the additional workload.

She said there are only three obstetricians serving Kalinga and that efforts are being made to recruit additional specialists.

“It’s not only about the patient. We need more OBs,” she appealed.

Baggay also appealed for understanding between health workers and patients, saying both sides should treat each other courteously even when difficult situations arise.

She acknowledged that patients or their companions may sometimes become upset or speak harshly to hospital personnel, but said health workers also understand that patients are under stress.

“Nu kuna tayo nga, very courteous kayo koma dapat nga empleyado, same with the patients koma met,” she appealed.

She said the hospital is trying to recruit another OB, but retaining specialists remains a challenge because of employment arrangements and compensation.

“Adu maysa nga OB, ada nagivite tayo, hopefully maala tayo. Iti problema gamin kanyatayo ket kasla nga contract of service lang ti kasla nga sweldo da,” Baggay said.

Baggay asked those who question the work of doctors to also consider the pressure faced by the few OBs handling patients.

She said that with only two doctors available at times, it can be difficult to manage the number of patients and procedures coming into the hospital.

“Imaginen yo duwduwa kami, so nasakit metlang ti loob mi nga makangeg na ikatten yo dagitan. You come to our shoes. Itry yo man ti agopera,” she said.

She emphasized that doctors are doing what they can while dealing with situations involving the lives of both mothers and babies.

“Ima lang met ti gamgamiten mi, with prayers kasi we dealing with lives,” Baggay said.

Patient had earlier KPH consultation

Another health worker also clarified the circumstances surrounding the patient whose treatment became the subject of the complaint.

She said the patient had initially been brought to KPH earlier that day because of elevated blood pressure and was assessed at the hospital’s outpatient department.

According to the health personnel, the patient had been taking one tablet of her prescribed medication three times a day. After checking her blood pressure, which was recorded at 140/90, the health worker said she adjusted the dosage to two tablets three times a day.

“Kas kuna ni ma’am nga inbaon da ti KPH kasi mataas ang BP, haan da nga mainage idiay (Pinukpuk District Hospital), incheck ko diay OPD po. Ti nakakuwa gamin idiay, one tablet three times a day, pero inkuwak nga two tablet three times a day kasi 140/90 (BP),” she said.

The health workers said the patient was seen at around 1 p.m. and was advised not to immediately return to Pinukpuk because her labor could progress and she might need to return to the hospital quickly.

Instead, the patient was advised to stay near Bulanao so she could immediately return to the emergency room if her labor pains worsened or she developed other symptoms.

“Agpayso diay kuna ni ma’am nga 1:00 p.m. pailang ma’am ngem haan kayon agawid diay Pinukpuk kunak kasi ada ti tendency na nga agprogress dayta so agyan kayo pailang toy Bulanao tapno anytime nga agsakitsakit agsubli kayo latta diay ER,” she added.

However, the patient and her mother-in-law eventually went home and later returned to KPH at around 6 p.m. She was then admitted for labor watch after health workers determined that she was already in labor.

“So nagawid da latta sir. Tapos diay ER, napan suna ti around 6:00 p.m., idiayen nga aglabor isunan isunga inadmit mi po for labor watch isuna,” Baggay said.

Another health worker said the patient later insisted on leaving the hospital and going to Taclobao despite being admitted for monitoring.

“Naginsist ni ma’am nga rumwar,” she said.

KPH doctor performs CS in Taclobao

Baggay also explained that she was not initially aware that the patient who was eventually operated on in Taclobao was the same patient who had previously been seen at KPH.

She said she had planned to take a day off after several weeks of continuous duty at the hospital.

Although she was officially off duty that day, Baggay said she could not leave for Tuguegarao because she still had to remain within the vicinity of the hospital in case her services were needed.

She eventually went to Taclobao after learning that no OB was available there to attend to the patient.

Baggay reiterated that Kalinga has only three OBs, making it difficult to immediately provide another specialist whenever one is unavailable.

She said she had to make a decision after learning about the situation because sending the patient back to KPH could have further delayed the needed procedure.

Baggay eventually performed the cesarean section. According to the patient’s mother-in-law, the baby was born in good condition.

“Now daytoy patient nga daytoy nga nairefer, kunak gamin idiay nga aldaw, agoff nak tata nga Saturday kasi for the past few weeks en. Kunak agkuwa ak man ti off. Am I entitled to an off? I’m at the hospital 24/7. So hanak makapan diay Tuguegarao kasi if you are a doctor you are within the vicinity of the hospital.

“Dayta nga patient nga napan idiay (Taclobao), I was not aware nga isu metlang gayam from the provincial hospital. I went kasi awan matawagan da nga OB at that time because nakaout garud ni doktora Basco. We are only three OBs in Kalinga. So di mapanak diay, nakibtot nak, alangan ipasublik idiay KPH. So I operated the patient,” Baggay narrated.

Another health worker urged patients and their companions to seek clarification directly from health professionals when they do not understand hospital instructions instead of immediately bringing their concerns to social media.

Both sides heard

The explanations were presented during the joint hearing of the SP Committees on Health and Sanitation and Appropriations, chaired by Board Members Alfredo K. Dangani and Jerome Chester Alunday, respectively.

The hearing gave both the complainant and KPH personnel an opportunity to present their respective accounts of what happened.

Board Members Alfredo Dangani, Jerome Chester Alunday, Emilio Kitongan and Camilo Lammawin Jr. stressed that hearing both sides was necessary before reaching any conclusion.

“Isu garud nga adatoy tayo ta masapol maawam ti bawat sides bago ti judgement. Kasi nu maymaysa ti denggen tayo ket unfair,” the local legislators emphasized.

The board members said the complaint should not only be viewed as an issue of determining who was right or wrong, but also as an opportunity to identify gaps in hospital services and determine how these can be addressed.

The hearing consequently brought attention not only to the circumstances surrounding the complaint but also to the staffing and operational challenges faced by KPH.

While the accounts helped clarify the circumstances presented before the committees, the discussion also highlighted the need to address the shortage of obstetricians and strengthen the hospital’s capacity to manage deliveries, emergency cases and other patients requiring specialized care.