Pawa Hospital Is Sick: Let’s Do Something And Help

My email and open letter to the president of the Philippine Hospital Association (PHA).

May 27, 2009

Bulan, Sorsogon


To the incumbent president of the Philippine Hospital Association (PHA):

Dear Sir:

I am fascinated by your motto Take That Big Leap to the issue of strengthening the hospitals of the Philippines which I copied from the PHA website and reproduced hereunder :



I come from Bulan, Sorsogon, Region 5 and also would like that our Pawa Hospital not be forever forgotten and left behind but be part of that Big Leap. I am not for strengthening our hospitals of the future but of the hospitals that exist today. Pawa is a member of PHA and has been around for many years already but it hasn’t improved since its establishment but deteriorated. It is very weak and very sick and requires strengthening now!

It is in a very desolate situation in all its aspects:

-the building has never been repaired as it looks dilapidated, dirty façade and moldy walls both outside and inside, dark corridors and broken floors, very poor illumination, dirty toilets and generally very poor sanitary hygiene. Indeed, by modern standard, it is a ruin but still continue to admit patients.

-the medical facilities and instruments  are practically missing, even the most basic ones like stethoscopes, blood pressure gadgets are very limited and partly defective, etc.

Yet, the medical personnel of Pawa are willing to work and continue helping their patients. But as we know, the lack of the right instruments and medicines and the very poor facilities limit also the capacities of medical workers no matter how good and willing they are.

Our local government has done something to increase the number of medical doctors in Pawa and help where it can. But technically, Pawa Hospital falls on the provincial responsibility, hence the LGU Bulan does not receive or does not possess the allocated budget for the maintenance of Pawa Hospital.

The photos I posted will speak louder than words. And should you come for a visit to Pawa Hospital you would- as a healthy person- hesitate to get inside in the interest of your health and hygiene. This would be understandable. You in turn would understand then what a sick patient has in mind being delivered in Pawa Hospital for “treatment and recovery”.

I ask you in your capacity as PHA president to do something for Pawa Hospital that would bring Pawa  to public consciousness and to governmment authorities directly responsible for this hospital and, last but not least, to any activities that would bring in financial resources for its repair or renovation and for the upgrade of its medical facilities.

I thank you for your attention and for all the efforts you will be undertaking for Pawa Hospital.

Sincerely yours,

Jun Asuncion

Bulan Observer











At first glance, you might think this is a deserted military camp.























 But this is a hospital, the Pawa Hospital in Bulan.











Young and friendly nurses at work. They deserve a cleaner and modern hospital to work to.










 Admission room? No computers, not even a type writer.











 Oxygen tanks, perhaps empty, beside trash bins and broom.











Sterile materials?












The very minimal medical materials, lacking medicines.












Yet, a newly born Pawa baby.


Pawa Hospital should be improved and upgraded so that it can serve our people better.

Let’s create a forum to discuss ways how we can help and eventually create an aide scheme.

I have created under Categories on the right the Pawa Hospital Forum for this purpose.

Please help Pawa Hospital.

(View all photos.)


jun asuncion


13 thoughts on “Pawa Hospital Is Sick: Let’s Do Something And Help

  1. Hello jun,

    Thank you for calling the attention of the PHA president. It is a high time that Pawa Hospital get the necessary attention from the PHA.

    Bulan is a big town and has a population of 82,688 according to 2000 census and that was nine years ago. It must be around 100,000 now.

    It is so pathetic that a town like this big does not have a decent hospital for her people.

    Gotladera Mem. Hospital ( popularly called Pawa hospital) is in dire need of infrastracture repairs, medicine, medical supplies and medical equipments as shown in the pictures. I hope, this time, PHA will focus its attention on the miserable poor state of Pawa Hospital.

    I am curioius what will be the respond of PHA.


  2. Hello Dora,

    Thanks for your concern. I haven’t got any reply from the PHA president. This is Philippines, everything is not taken seriously. I hope Bulan is not like the Philippines.

    We just hope that there are private persons who can help us.
    Or we’ll try other alternatives. The same way with the St. Remedios Charity Clinic, we should try other alternatives of saving it.

    jun asuncion

  3. Mr. Jun A,

    I’m back, Kumusta po!

    Pawa Hospital is sick! Doctor is sick. Patient is sick and dying maybe! Bulan local leadership is sick. Hopefully, politicians are not indisposed.

    In this trying time, amidst financial and economic crisis, we played the roles of both the doctor and patient. As Jesus Christ said in quoting the proverb: “Physician, heal thyself”.

    I would surmise that the plight of pawa hospital is the effect or product of devolution under the local government code. Kaya tuloy nabubulok na ang ating mga hospital sa kanayunan, ultimong health centers walang gamot dahil sa kakulangan ng pondo, kakaramput na pondo, pinag-iinteresan pang-ibulsa ng mga ganid sa kapangyarihan.

    sabi nga ng mga kontratista sa gobierno, “kunting semento, kunting espalto, milyun-milyong proyekto”.

    This is probably the price of devolution, as opined by a writer in Bulatlat website referring to the sad plight of hospitals in the poor municipalities and provinces.

    “Many municipalities and provinces have suffered financing shortfalls causing the diversion of health funds to other priorities. There was also no prior development of health staff including those retained by the DoH, or local government executives and officials for their new roles in a devolved environment.”

    Tuberculosis (TB) is the most common major infectious disease today. Based on the Health Alliance for Democracy (HEAD) data, around 36 percent of 82 million Filipinos are affected by the disease. Of these, 75 die of TB while around 100,000 contract the disease every year.

    Aside from this, TB is also a sensitive index of a nation’s poverty,

    These unattended health problems have been made worse by the devolution, sometimes referred to as decentralization, of health services from the Department of Health (DoH) to local government units (LGUs).

    Under the Local Government Code of 1991, DEVOLUTION “refers to the act by which the national government confers power and authority upon the various LGUs to perform specific functions and responsibilities.”

    It includes the transfer to the LGUs ─ such as health, education, agriculture and social service ─ of the records, equipment, and other assets and personnel of national agencies and offices corresponding to the devolved powers, functions and responsibilities.

    To implement the decentralization plan, health planning and control was transferred to LGUs in 1992. The power of the Department of Health (DoH) diminished significantly with the transfer of responsibility for primary health care to about 1,600 LGUs.

    Supposedly the lead agency in health, the DoH maintains specialty hospitals, regional hospitals and medical centers. Many of these hospitals have been or are in the process of corporatization. Regional field health offices or Centers for Health Development are located in 16 regions. These offices manage provincial health teams and retained personnel. With the devolution of health services to LGUs, the provincial governments oversee provincial and district hospitals, while the municipal governments manage rural health units (RHUs) and barangay (village) health stations.

    Aside from the 600 hospitals, the devolution also included the transfer of administrative authority of about 46,000 health sector personnel to the local level, based on the April 2002 “Decentralization and Health in the Philippines and Indonesia: An Interim Report” by Samuel Lieberman of the East Asia Rebounds of the World Bank.

    The devolution has been beset with economic and administrative problems. LGUs lack the necessary resources to effectively deliver basic health services and expand the coverage of these services due to the mismatch between the costs of devolved functions and the corresponding internal revenue allocation (IRA).

    Based on the Local Government Code, provincial and municipal governments with higher fiscal capacity (using per capita income as a measure of financial base) tend to get higher per capita IRA allocations than those with lower fiscal capacity.

    Many municipalities and provinces have experienced financing shortfalls causing the diversion of health funds to other priorities. There was also no prior development of health staff including those retained by the DoH, or local government executives and officials for their new roles in a devolved environment. Even if the DoH created the Local Government Assistance and Monitoring Service (LGAMS) to assist and support DoH representatives located at the provincial level, this was only an ad hoc body with limited resources and adequately prepared staff.

    let’s hope and pray na laging may pag-asa ang bukas, sa bawat paglubog ng araw sa kanluran, ay muli itong sisikat sa silangan na punong puno ng pag-asa, na tayo’y muling babangong muli sa kahirapan at makakamtang ang kaginhawaan sa mga darating na panahon.

    Sana, wala ng sakit si Pawa Hospital! Sana’y mabigyan na ng lunas ang kaniyang karamdaman, dahil alam ko matagal na itong tinitiis ni Pawa Hospital at matagal-tagal itong nakaratay sa banig ng karamdaman.

    Pawa Hospital get well soon!

  4. Mr. Attybenji,
    It’s nice to have you back for I know how busy you are!
    Yes, Pawa has long been sick – and dying I should say should it continue unattended by the public officials directly- and indirectly responsible for it.
    I’m planing to approach other government officials to let them know about Bulan’s sick and dying hospital.

    I also think that Mayor Helen De Castro should exhaust her capacity as town executive to find ways of reviving and putting into better shape the Pawa Hospital. Since she’s in good contact with Governor Sally Lee (who is supposedly directly responsible for Pawa Hospital) she should remind her of her responsibilty. I’ll be writing a letter soon to Governor Sally Lee and to all others higher in position.

    Thanks for explaining to us the Devolution Act under Local Government Code Of 1991. I think this concept has something to do with the striving of some people like Pimentel et al to introduce Federalism in our country. As you can see already in this decentralization of health services, how the revenues will flow during the transition period will be the biggest problem.

    Health is Wealth but for our local Government of Bulan this maxim seems not to apply for up to now they have done very little to the Pawa problem. They should help finance the Pawa Hospital from the taxes they collect from the Margaja Mining Industry in Bulan as well as from the revenues generated by this 4o million-project Bulan Integrated Bus Terminal.

    Sick people who go to Pawa hospital mostly cannot pay their bills. The local government of Bulan should therefore create a sort of social financing scheme/program for these people who cannot afford to pay. In this way there is also money coming in to Pawa hospital to finance its existence. I know that health is wealth but it also costs big wealth to maintain health- or a clinic or hospital for this matter.

    On our part, we will continue discussing this problem and soliciting the attention of the general public as well as the public officials.

    Since the Bulan Observer Online-Community is growing bigger with each year (we’re just on our second year) we hope to be able to get some responses from Bulan Observers everywhere and hopefully some suggestions. Let us be reminded however that Bulan Observer is launched primarily to observer political events in Bulan and not as a social institution aimed at solving such other problems like Pawa, general poverty, etc. This should not be confused with our definitions from the very beginning. These problems however touch us all and so we voice out our “Views and Concerns for a brighter Bulan”. But I believe it is the primary duty of our local public officials to offer solutions to these problems confronting Bulan and of involiving the private sector in ways it could help.

    Thanks again Attybenji.

    jun asuncion

  5. Makaluluoy po an hospital nato sa Pawa. I remember this was a project of my grandfather or grandmother and if I am not mistaken they donated the land where the hospital was built.

    What are the current elected officials doing?

    Just asking Manoy, no offense meant?

    Arvin Gotladera

  6. marhay na adlaw sa gabos. last week po mi dinalaw po ako na pasyente sa pawa bulan hospital, may itinatanong po kami sa doktora una po nagsabi sya sandali lang… pangalawang balik po nmin ay imbis po na sumagot ng maayos, ang ginawa po tinalikuran kami. kundi po nman bastos! mabuti pa ung tambay na walang aral ay kakausapin ka ng matino. kong gaano po kadumi ang loob ng hospital at lalong-lalo na mga kwarto ng ospital ganun din po kadumi ang ugali ng doktora sa pawa hospital.

    • Sad to hear this …and that should not be the reaction even if she were busy or whatever…

      Though a doctor has to protect the privacy of the patient from questioning guests (especially if not relatives- or even relatives if requested by the patient him/herself), that doesn’t mean that she should be rude to the guests. She still has the language to use to politely entertain the guests. Turning one’s back away is not being polite and professional.

      Not only in Pawa but even in decent hospitals everywhere can guests (and even patients themselves) encounter such “bad treatment”. But there is this little difference. Since Pawa is a deteriorated hospital, we can only imagine that not only the patients but also the employees are not really feeling well inside it, and even guests, the reason why receiving such a bad “treatment” automatically equates the character of that doctor with the hospital structure. Were Pawa a decent hospital with first class facilities and better paid personnel, that “erring” doctor would have been spared being compared to a dirty hospital room..

      This speaks for the need to renovate or upgrade Pawa hospita, an issue that has been there for a long time already.

      To sum up, we should treat others the way we want others treat us, be it inside or outside Pawa hospital.

      jun asuncion

  7. At Fe. Maybe the physician doesnt know the case of her patient that sh tried to avoid you. Just analysis hehehe…

  8. At Fe. Maybe the physician doesnt know the case of her patient that she tried to avoid you hehehe… I hope your patient got well.

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