It has been months since explosive revelations of large-scale corruption dominated our headlines, and weeks since thousands took to the streets in protest, demanding accountability. Yet, tellingly, we are still waiting for anyone to be truly held accountable. This has happened too many times: each scandal ignites a surge of outrage, only for momentum to fade and our collective will worn down by silence and inaction. We find ourselves losing energy to care and eventually growing numb. The cycle is frightening.
None of this is new, and those who remember Napoles and PDAF can attest that while the shapes and players may change, the story rarely does. But just because we’re familiar with the scandal does not make the pain less acute. Repeated failures of accountability have only paved the way for more egregious forms of plunder. If the estimate of P1 trillion siphoned from flood control projects alone is true, we could have fed millions of hungry Filipino children or delivered life-saving medicines and services to countless communities.
As medical doctors and public health practitioners, we are doubly outraged, given how limited the health care budget already is. The money wasted in corruption is the very lifeblood needed to keep patients alive, to staff our hospitals and clinics, to ensure every Filipino receives the care they deserve. As powerfully proclaimed at the Trillion-Peso March, ‘Libo-libong pasyente [ko] sa barrio na sana ang nagamot ng mga luxury cars niyo!’
But indignation is only the beginning. The real challenge is transforming outrage into action, and the health sector cannot afford to be a passive observer. What then can we do?
First, we must call attention to the ways in which corruption directly harms health and well-being. The failure to control floods due to siphoned-off funds, for instance, can lead to leptospirosis outbreaks and mosquito-borne diseases like dengue. Substandard roads are occupation hazards that also set back walkability, bikeability and their health-promoting effects. Less visible but no less damaging are medical assistance funds that, when funneled through politicians, become tools of patronage rather than mechanisms for strengthening health institutions. This perpetuates dependency and undermines universal healthcare.
Second, we must also confront how the health sector itself is involved in corruption. Like flood control, disease control has always been used to justify huge expenditures, and there are also allegations of ghost projects for health, not to mention ghost patients and ghost procedures. Demanding accountability for issues closer to home is the most difficult of all to do, because it will require confronting our peers, mentors and even friends to the same standard we demand of politicians and those in power. But if we wish to speak with moral authority, we must stop tolerating unethical practices in our own ranks, including the Department of Health and throughout medical leadership.
Third, we need to recenter communities in our practice. Both corruption and catastrophic health expenditures thrive when the health system is top-down, hospital-based and specialization-driven. By rightfully focusing our attention to actual community needs – including preventive and primary health care as well as the social and political determinants of health at the local level – we not only lower costs for everyone, but reduce opportunities for corrupt practices. Beyond token inclusion, true reform also means opening ourselves to other forms of expertise, such as patient advocates, barangay health workers and allied professionals. By doing so, we prevent power from becoming unchecked and ensure better outcomes for all.
Finally, as health professionals, we should stand with the rest of the country in protesting and resisting corruption. Some of us might be insulated from the worst effects of misgovernance because of our relative privilege, and the pressures of work can be an excuse for social disengagement. But thinking that medicine and politics do not mix is not only naïve but also dangerous. Silence makes us complicit. Our Hippocratic oath – to do no harm – rings hollow if we continue to allow our corrupt political system to harm our people’s health and well-being.
Thankfully, we are not alone in this struggle. As exemplified by Drs. Bobby dela Paz and Johnny Escandor, there is a long and proud history of courage within the health sector – of doctors, nurses and community health workers, both in and out of government – who understood that caring for the sick also means confronting our social ills. This is the kind of health care our people have long been denied – and the kind we must now fight for, together.