On Delays and Healthcare Access

 “Nganong karon ra man ninyo gidala si tatay nga grabe na man?”

Sometimes we ask this question mindlessly, without malice. Not because we’ve grown callous, but because we care.

Just recently, I learned that this simple question can actually break some families’ hearts. As I sat by the bedside of my dying patient, talking with his family, I was reminded again of the painful realities of our healthcare system and that nobody really wants delayed medical care. It’s just that access is not the same for everyone.

My patient came from a mountainous community in Malungon, Sarangani Province, near the borders of Malita, Davao Occidental. Their place can only be reached by motorcycle or horse, crossing four hours of rough terrain and several rivers.

When he first felt the symptoms of his illness, his instinct was to wait it out. Endure until it passes. The virtue of “pagtitiis” is often the poor Filipino’s first line of defense against illness.

But the pain did not pass. It worsened. The next instinct was to ask for help. Their nearest neighbor lived almost a kilometer away. His neighbors carried him like a child for more than four hours, traveling by motorcycle on rocky roads to reach the nearest district hospital.

But before they could even decide to leave, they needed to find money, so they sold their horse and a few pigs. And now that they are in the city, with mounting hospital expenses, they have sold so much more than their animals. They have also sold their land.

As doctors, I know that we don’t mean harm when we ask that question. But maybe there’s a better way to ask.

Perhaps instead of “Nganong karon ra man ninyo gidala si Tatay nga grabe na man?” we can ask, softly, “Giunsa ninyo pagdala si Tatay diri?” or “Asa pa diay gikan si Tatay?” These questions are not accusations of neglect, but open doors to stories, not wounds.

Because more often than not, for the ordinary Filipino, behind every delay is not neglect. It is sacrifice. And while a single medical consult is ordinary for many, for some, it costs them their entire livelihood. Any accusation of neglect, even if unintended, robs them of their dignity and pride. And sometimes, that’s all they have left.