J.R. Borja General Hospital

Cagayan De Oro City (30 June) — City Mayor Constantino G. Jaraula debunked criticisms that medical and hospital services are not getting fair attention from City Hall, saying that the city government is spending this year over P200 million for the J.R. Borja Memorial City Hospital and the City Health Office.

“All in all in health, more than P200 million ang atong allocation. Wala nato abandonaha ang serbisyo sa panglawas sa katawhan because that is part of the services that we would want to be for Cagayan de Oro City,” Mayor Jaraula told a group of local mediamen during a press conference held yesterday afternoon at the City Mayor’s Office reception hall.

Jaraula called for a media conference to shed light on criticisms against City Hall for reportedly allocating a ‘measly’ amount from the P97 million supplemental budget which was approved lately by the City Council.

“Either ignorance or malicious, kadtong P97 million nga gipagawas was a supplemental budget ug ang gihatag sa city hospital was just an addition to the basic (annual budget allocation). But no matter how you explain this, kung malicious ang ila, dili gyud nila masabot,” Mayor Jaraula hurled back to his critics, adding that the criticisms… “only come ignorance on local governance”.

For the ‘respectable’ operation of the J.R. Borja Memorial City Hospital, Mayor Jaraula explained that the city has allocated this year an amount of P91.347 million for the city-run hospital.

This amount is broken down as follows: P50.647 million for personal services which is basically intended for salaries, wages and allowances for doctors, dentists, nurses and other health personnel; P32.9 million for maintenance and other operating expenses (MOOE); P27.8 million for drugs and medicines and P5 million for other expenses.

Like the city-run hospital that caters to the basic health needs of the poor people, Mayor Tinnex said the city government has set aside some P109.1 million for the City Health Office operations.

This covers P60 million for personal services, P24.5 million for MOOE, P17.5 million for drugs and medicines and P7 million for other expenses.

In addition from local funds, Mayor Jaraula said the local government got a P62 million subsidy from the national government through the Department of Health (DOH) as part of the pledge of commitment by President Gloria Macapagal-Arroyo in August 2007.

Of the said amount, according to Mayor Jaraula, some P22 million is intended for the completion of the construction of the J.R. Borja Memorial City Hospital Annex Building Project, while the remaining P40 million will be used for upgrading and expansion of the 22 barangay health centers all over the city.

Aside from this, Jaraula said the city government is deploying two units of mobile clinics in an efforts to address the health needs of the ‘poorest of the poor’ and underprivileged residents in the hinterland areas under the so-called “Forwarding Delivery of Basic Health Services Program”.

A three-man team composed of a doctor, a dentist and a nurse will be assigned to each mobile clinic while extending medical and dental services to the residents in upland barangays, he added.

With barangay Lumbia serving as its base point, the first unit, which was delivered lately, will serve barangays Bayanga, Mambuaya, Dansolihon, Tignapoloan and Besigan while the other mobile clinic will cover barangays Pagalungan, Tagpangi, Taglimao, Tuburan, Pigsag-an and Tumpagon.

Mayor Jaraula hopes that the deployment of the two mobile clinics will help reduce the patient population at the overcrowded city-run J.R. Borja Memorial City Hospital, especially those coming from far-flung barangays.

With the mobile clinic doing regular stopover at every covered barangay, poor patients will no longer have to travel to the City Hospital to avail of medical check-up and other health services, the Mayor said.

The mobile clinic could also serve as an emergency ambulance if a patient needs an immediate transport to a nearest hospital during emergency cases, he concluded. (CIO)

The facilities and services of the city government-run J.R. Borja General Hospital could have been improved if the equipment, drugs and medicines donated by other sources were accepted.

Former City Hospital Chief Dr. Vincent Tero disclosed that too much politics played at the city hall-run hospital pushes it into a “pitiful” state.

“The order of the day is not to accept any donation coming from the opposition bloc especially from Senator Aquilino Pimentel, Reps. Rolando Uy and Rufus Rodriguez,” he said.

Tero who also served as City Health Officer during the incumbency of Mayor Vicente Emano and then was later detailed to the Philippine National Red Cross –Mindanao Blood Bank when he accommodated some P2 million worth of medicines from Pimentel sometime in 1997.

He said during his stay with the city hospital, he accepted a donation of CT Scan from Pimentel, but he was allegedly ordered to reject the same and later transferred to the Northern Mindanao Medical Center (NMMC).

“Naa unta’y CT scan ang city hospital. Dili na unta mobayad ug tag-tres mil ang mga pasyente sa dakbayan kung magpa-CT scan pero wala dawata,” he stressed.

Another CT scan coming from Rep. Uy was about to be delivered to the city hospital last year, but was again rejected by the present administration without any justifiable reason.

Tero said the present administration has made the city hospital into a “pitiful” state including it’s services to the public.

“Bisan gapas ug alcohol wala diha. Tambal pa kaha hinoon,” he added.

A reliable source said that according to the Dr. Tero operating equipment lamps and other equipment are no longer serviceable.

The hospital use fluorescent lamps as incubator for premature babies.

“Ang suga kahulogon. Gihiktan na lang. Mahadlok ang gi-operahan,” he said.

He said that turning-over the entire responsibility of the city hospital to the Department of Health (DOH) is the only solution to uplift the status of the city hospital.

Members of the opposition bloc is set to conduct an investigation on Tero’s disclosures.

Earlier, Dra. Fe Tagayuna, who was appointed by City Mayor Constantino Jaraula to head the city hospital but later resigned from office after she was reportedly detailed to one of the urban barangays.

Assistant Minority Floor Leader Roger Abaday said Tero’s pronouncement is a clear indication that the city hospital has been manage badly.

“Maulaw kita sa katawhan nga instead of improving it’s services to the public it has become an awkward health service provider. This should be corrected,” he said. by LITO RULONA Gold Star Daily News Mindanao

CAGAYAN de Oro City Mayor Constantino Jaraula said that the national government can always give financial assistance to JR Borja Memorial City Hospital even if it doesn’t acquire its ownership.

Jaraula said this at Bombo Radyo over the weekend in reaction to the bill of Rep. Rufus Rodriguez seeking to make the city hospital an annex of the national government-owned Northern Mindanao Medical Center (NMMC).

Both hospitals are located in Cagayan de Oro City; the city hospital in Carmen, the NMMC along Corrales avenue.

Jaraula added that he is not opposed to the city hospital becoming an annex to NMMC provided that there will be no change in ownership.

“If it’s only for operational purpose, then yes, I will not oppose for the city hospital to become an annex of NMMC. But if there is a change of ownership, no,” the mayor bluntly said over the radio.

In justifying his stance, Jaraula said that the efforts of Cagayan de Oro in keeping ownership of the hospital since 40 years ago when it was established would all go in vain once it transfers ownership to the national government.

House Bill 239 provides “for the upgrade and modernization of the J.R. Borja City Memorial Hospital as an extension hospital of the Northern Mindanao Medical Center in Cagayan de Oro and appropriating funds therefore.”

Once passed into law, the city hospital would be placed under the direct supervision of the Department of Health (Doh) and thus automatically qualify for yearly funding from the national government’s General Appropriations Act.

JR Borja Memorial City Hospital was named after former Mayor Justiniano R. Borja who also has a street and a statue named after him. By MARK D. FRANCISCO Gold Star Daily News Mindanao

A CITY official Monday brushed aside allegations that “politics” was behind the troubles besetting JR Borja General Hospital, even as he denied claims that City Hall has blocked donations made by political rivals to the city-run medical facility.

Pro-administration Councilor Dante Pajo said City Hall was eager to receive the 10 dialysis machines earlier pledged by 1st district Rep. Rolando Uy, who belongs to the local political opposition. Councilor Pajo said the donation includes a building that will house the equipment.

“I’ve talked to the Mayor [Constantino Jaraula] and he said he’s okay with the donation,” said Pajo, chairman of the health committee.

Last year, Rep. Uy’s office lamented that City Hall had spurned a similar effort by the lawmaker, who chose to donate the hospital equipment instead to the nationally-run Northern Mindanao Medical Center. The donation was funded from the congressman’s pork barrel.

The city-run hospital is no stranger to being deprived with much-needed diagnostic apparatus and other life-saving equipment simply because these are offered by politicians who don’t play footsies with the incumbents.

Dr. Vincent Tiro, a retired chief of hospital at JR Borja, said the practice became common during the Emano administration.

The physician recalled that at one point during the first term of then Mayor Vicente Emano — now a vice mayor — the latter castigated him for receiving the P2 million worth of medicines from Sen. Aquilino Pimentel, a native of Cagayan de Oro. Starting out as allies, Sen. Pimentel has been Emano’s political nemesis for years now.

“I received it with all gratefulness as then the chief of the hospital as it would mean more service for the sick and needy. I never thought I would be chided for doing what is right,” Dr. Tiro said.

“Politics is very well entrenched at the hospital, from the appointment and removal of personnel, up to the distribution of medicines to barangays,” he said.

Not once did Emano castigate him for handing out medicines to barangay officials deemed outcast to the former mayor’s political circle.

“He [Emano] once told me to ‘Ikaw na lang mag-mayor’ when I reasoned with him on the equitable distribution of medicines,” Tiro said.

During his watch, Tiro said Pimentel also donated a CT scan, which he said was “very much needed” in any hospital to help diagnose various medical conditions. Poor patients, he added, need not go to private hospitals and spend P3,000 for a CT scan.

Tiro said the equipment went to the NMCC instead because Emano would not want it in the city-run hospital.

Weeks later, Tiro said he was fired as chief of the hospital and detailed to another department until he retired in early 2000.

The former JR Borja chief said the P10 million hospital building donated by Pimentel in late 90s suffered the same fate, as the Emano administration had refused to shell out money as counterpart. The building, he said, was left to deteriorate for over a decade now.

However, Pajo said the three-storey building may finally be completed within this year. The after Department of Health (DOH), he said, has offered to finish the project.

“DOH-10 (Northern Mindanao) has already started the bidding phase of the project last June 8. Of the six bidders who signified interest in undertaking the project, five bidders qualified,” the councilor said.

The city-run hospital has lately been rocked with controversies, heightened by resignations of several doctors late last month. The physicians–numbering 18 out of the hospital’s 35 doctors–complained of low pay and poor working conditions.

They also lamented the hospital’s inability to give adequate health services to poor patients because the facility lacks even the basic medical equipment.

The hospital management had earlier suspended its weekend consultations.

Pajo said the Saturday and Sunday consultations have been resumed since last week. He said City Hall is already hiring doctors to replace those who resigned. He also denied the resignations had crippling effect on the hospital’s services, describing the doctors’ exodus as a “minor setback.” By Cong B. Corrales Sun.Star Cagayan de Oro

THE city-run JR Borja General Hospital hasn’t had a stable budget in recent years, its appropriations rising and falling to resemble that of an erratic curve.

In 2006, the city hospital enjoyed its biggest budget in six years — P123 million — but this amount would dramatically be reduced to around P60 million the following year, or a cut of over P62 million.

On its face, the hospital’s general budget cycle — not counting the exceptional downward spiral in 2007 — has seen a steady growth, rising from over P56 million in 2004 to around P70 million in 2005. From 2007, the funding climbed to over P78 million in 2008, increasing to P83 million this year.

But these increases have largely been driven by inflation and the local government’s administrative obligations to the hospital personnel.

Funds allocated for medicines and life-saving apparatus — lumped under the maintenance, overhead, and operating expense (MOEE) — have remained disproportionate to Cagayan de Oro’s population over the years, and followed the erratic pattern in the general budget.

For example, the MOOE in 2005 saw an increase of over half the amount compared to the previous year — at around P24 million. This amount would only grow by P2 million in 2006, and dropping by a whooping P6.9 million in the succeeding year.

In 2008, the MOEE would again rise to P13 million, or an appropriation of over P32 million.

The additional money for MOEE this year? A meager P215,353.

Specifically, a budget of P4.6 million out of the P32.9 million MOOE for 2009 is allocated for medicines, patient’s subsistence, and medical supplies such as X-ray films, medical oxygen, and nitrogen oxide.

As of August 1, 2007, the National Statistical Coordination Board (NSCB) placed the city’s total population at 553,966.

What that means is that at any one time, the local government only sets aside a miniscule P8.30 on medicines and other life-saving apparatus for any patient admitted to the city-run hospital.

To compare, the P123 million budget in 2006 allocated around P23.4 million for medicines and medical supplies.

Noticeably, however, bulk of that budget went to the construction of an additional building amounting to P50 million. The rest was appropriated to hospital equipment such as one unit of operating room table that cost P1.3 million, five units of fire extinguisher that cost P79,550, a unit of ultrasound machine at P4 million, two computer sets at P120,000, a unit of anesthesia machine at P2.3 million, and two ECG machines at P300,000.

Sun.Star Cagayan de Oro’s analysis of the budget is based on the approved appropriations in the last six years obtained by this paper.

The hospital’s budget has come under scrutiny after several doctors resigned lately, complaining of low pay and poor working conditions. They also lamented the lack of crucial life-saving devices at the hospital, which they said has contributed to its deteriorating services.

Corruption has also tainted the management of the hospital.

In 2007, several employees accused the then hospital chief, Dr. Jerie Calingasan, of graft and corruption. A graft case against Dr. Calingasan is pending at the Ombudsman.

Calingasan, who was stripped of his position at the hospital and reassigned back to the City Health Office, has denied the allegation.

Aided by their lawyer, Manuel Ravanera, the employees alleged that Calingasan made “emergency purchases” that were not actually “emergency” in character. Among the hospital “purchases” was a repair of a Toyota Tamaraw FX and a Kia Besta Ambulance, which amounted to P131,200. Calingasan reimbursed the amount because it supposedly came from his pocket.

There were also purchases of hospital supplies, among others, eight kilos of detergent powder at a price of P11,500.00 or an amount of P1,437.50 per kilo.

In 2006 and 2007, Calingasan was reimbursed the amount P855,939 purportedly due to the “advances” he made to the hospital.

During that period, the complainants alleged that the hospital purchased an overpriced X-ray machine, which cost P6.5 million but supposedly had an actual market price of P3 million. A surgical table that is unbranded and costing P400,000 allegedly purchased at P1.2 million.

These and other irregular transactions were approved by then mayor Vicente Emano, the complaint said.

Last year, a state auditor said in a report that P15 million worth of drugs and medicines at the city-run hospital cannot be accounted.

WE are on the last day of a three-day training we are conducting for personnel of the Department of health, Center for Health Development of Northern Mindanao. This is the 3rd batch of similar trainings the Valleser Communications Consultancy is doing for that agency.

It is unavoidable, therefore, that during breaks between lectures and workshops we indulge in some idle talks. At one point, I opened the topic on the possibility of having our beleaguered city hospital to be “cooperative-ized.” This after news that majority of doctors  un the said hospital have left and gone to other hospitals, set up private practice or have immigrated to other countries.

The lack of physicians has forced the city hospital to stop taking care of outpatients on weekends. Trying to put reason to this insane situation, the city officials through the hospital administration, is practically telling city residents not to get sick on weekends or else thsy could not be served - as if we have control as to when to get sick.

Well, it is normal for doctors to move around and seek greener pasture. The critical lack of physicians at the city hospital, however, is a phenomenon unique to itself. What keeps doctors away from the city hospital is not the low pay; neither is it the very demanding character of being in a public health system.

Ask those who have been there and they will tell you the real reason. They are tired and nauseated by the way dirty politics has seeped into what should have been an apolitical system. Doctors are forced to play politics by trying to reason out to patients why their services degenerated so much.

Even if doctors are gods and can cure even with just cotton and Q-tips, this would not be possible at city hospital. One of the doctors who have left the hospital told “Table talk” that he left because he wanted to keep the dignity of the medical profession.

having a cooperative hospital is not a novel idea. Other smaller and bigger cities in the country have done it. Our city officials should not be ashamed to accept their inability to run and manage a hospital. it’s time they should seriously think of turning it over to a cooperative.

It’s gutter politics that’s flushing our city hospital down the gutters!