191. Dagupan Day 5

Today I am the primary surgeon for vaginal hysterectomies, again assisted by the residents. About this time my German-born, Canadian-trained Go-Med partner (her first mission) asks, why are we here? She sees the many skilled residents, a well-equipped operative suite, and the common histories of patients who so far seem to have been experiencing their problems for just a few months. It's not like we are seeing patients who have been on waiting lists for years. The impression being that in out absence, the residents would be providing surgical management.

preop clinic: plastic table and chairs in a hallway

But who knows? Perhaps it's just been in the past few months that clinics have been picking up patients for us; similar patients who presented at clinics six months ago may have just been told to save up money for private surgeons, with only emergencies making it into the system.

The Philippines has an impressive medical system (witness the thousands of the Philippine nurses trained in the Philippines and now working in U.S. Hospitals). But the director of ob-gyn resident training informs me that Philippine health officials figure that the nation is a million doctors short of what is needed, and I assume like everywhere, shortages are greater in rural areas.

The operative suite bears out this suggestion of physician shortage. There are just four operating rooms in the largest (and only?) public hospital in the province. My U.S. hospital, one of the two largest hospitals in the county, has 17 operating rooms. All told, I would guess the county has at least 50 operating rooms.