Dedicated, overworked personnel sustain gov’t hospital’s program for abused women and children

Arianne Christian Tapao, VERA Files

Posted at Dec 17 2017 08:37 PM

(Second of two parts)

The Child Protection Unit at the Philippine General Hospital. Photo by Arianne Christian Tapao

Across from the Philippine General Hospital (PGH)’s emergency room, a large, green building leads to two special units designed to protect women and children.

The bigger one is the Child Protection Unit (CPU), a two-story office complete with equipment, facilities and staff. Beside it, the smaller, cramped room called the Women’s Desk has only tables strewn with paperwork. 

Both serve as the Women and Children Protection Units (WCPUs) of the PGH, created under the 1997 Administrative Order 1-B, later repealed by the Women and Children Protection Program in 2013 to reinforce implementation.

While they offer the best services in the country, the crown jewels of the government’s protection program continue to face a string of challenges – overworked personnel, lack of staff, funds, equipment and facilities, all of which speak volumes about the quality of assistance children and women victims of abuse in Metro Manila are getting.

The units operate separately, but both lament an overwhelming number of patients, most of them referred by other state-run hospitals. Nine hospitals visited for this report confirmed they would refer many cases, especially of sexual abuse, to the PGH.

Quite a number of women and children come on their own, but most are referred by several government hospitals from around Manila and Quezon City, and as far as Cavite and Rizal, which are actually required to have their own units.

“Something as basic as giving medico-legal forms, why can’t they handle the case,” Rizza Pamintuan, women’s desk officer, said. “Is it really just an issue of competence or is it really a problem of willingness to actually do it?”

The result is unsurprising: The protection units of PGH continue to operate with limited resources, long struggling to cater to the needs of the most vulnerable sectors of society.

It is the life 35-year-old Pamintuan has become accustomed to in the Women’s Desk, where she hears harrowing tales of women raped or hit by husbands or strangers. She would receive 20 to 30 cases a month. Sometimes the number reaches 80.

The Women’s Desk was created to comply with the Rape Victims Assistance and Protection Act of 1998, which states government agencies should “establish in every province and city a rape crisis center located in a government hospital or health clinic.”

Funding and staffing depend on the hospital. “We’re mainstreamed to the hospital, so you are looking at the whole hospital in itself as the center,” Pamintuan said.

Should she retire or resign, the post may be absorbed by other departments that need it, leaving the Women’s Desk with no personnel. “The possibility of losing the one staff they have is very real,” she said.

Marilyn Julia, a social worker at the medical services unit, is the only other Women’s Desk staff. But she said in an interview she would be replaced by January. As per protocol, social workers take rounds in special units for three years, including the Women’s Desk.

The Child Protection Unit is luckier, as it enjoys a roster of seven child protection specialists, a nurse, three psychologists and eight social workers. It also has three legal consultants, a developmental pediatrician for children with special needs and a police officer. 

It has an interview room, filled with toys to put children at ease, where doctors talk while psychiatrists observe in another room through a one-way mirror and two closed-circuit television cameras set up on the ceiling.

Yet due to high demand, its workers are stressed as they sometimes work way past office hours on the streets of Metro Manila to find temporary homes for abused children. 

Maria Perpetua Sadio, social worker at the PGH-CPU, says the office receives a daily average of six to eight children. Photo by Arianne Christian Tapao

Social worker Maria Perpetua Sadio estimates six to seven children visit the CPU every day.

“The stories are depressing, it’s hard to listen. You’re already tired with three or four. What more if it’s six,” Sadio said in an interview. 

Some days, they reach 11 and the office, which opens at 9 a.m., would close at 8 p.m.

“If there are children that need to be taken to shelters, the process lengthens,” she said.

Most shelters are run by churches and Sadio recalled a time she pleaded till late evening with nuns to take in an “emergency case.” 

Had there been none, she would have stayed with the child in the CPU as taking a child home is forbidden.

“I was home by 9 or 10 p.m,” she said. The next day, she set out to look for another shelter.

The CPU operates like a nongovernment organization, with funding from different sources like the British Embassy, Sadio said. 

In October, the hospital administration finally took the CPU under it, which means more institutional support, Pamintuan added in a recent interview.

The CPU follows an ideal protocol devised by the Department of Justice’s Committee for Special Protection of Children, of which the CPU is a member and plays a crucial role in case management.

As the first step of administering medical and legal services, officers at the CPU will assess if a case falls under child abuse laws. An “in-take” social worker would then interview the victim before he or she is made to undergo a medico-legal exam.

The Women’s Desk also strives to follow a protocol for victims, who are given medico-legal forms and scheduled psychiatric evaluations.

Problems arise if help is not given early to those who might decide to file a case in court. “They would clean themselves because they’re grossed out over what happened,” she said. 

As abused women move around or wash their bodies, the chances of collecting evidence, such as the perpetrator’s semen, shrink.

In addition to other challenges, there has not been much source of funding for the Women’s Desk since the pork barrel scandal erupted in 2013, cutting millions of pesos the office could have gotten. 

They were only able to get around P200,000 before the issue broke out, Pamintuan said. “Everything is frozen, so are our accounts.”

“There are instances that I spend on supplies,” she added, referring to rape kits, a box containing swabs, urine containers or blood collection device, among others, which a sexually abused victim may use to form a case in court.

That can be tough as Pamintuan receives salary grade 6, which means she receives only P13,000 a month. “At least there’s hazard pay.”

Rape kits at the PGH lie idle. Photo by Arianne Christian Tapao

Yet, these rape kits would often be useless, as it takes years before a case is heard in court. Instead of being taken to Camp Crame for analysis, the kits are left in a storage room to rot. 

Under the 2009 Magna Carta of Women, all government bodies should create programs that would allocate five percent of their budget that would enhance development and mainstreaming of gender in an agency.

In the meantime, doctors are willing to help on-call, but request they be given a room, since the hospital is always crowded. Their room is so tiny to begin with. 

While the situation at the CPU seems better, Dr. Marissa Resulta, who also works at the WCPU of the Rizal Medical Center, admits her job entails a heavy burden.

Like Pamintuan, Resulta said listening to patients is hard. “Every now and then, they relive the trauma, stare off into space. The person they love the most abuse them.”

Lisa (not her real name), an adolescent, came with her elder brother to the CPU. In tears, she recalled how she was molested by her own father, and how their mother did not believe her, even telling her: “You asked for it, so it happened.” 

Lisa’s brother also cried, knowing he would have to send his father to jail. Listening, Resulta could not hold back her tears.

“As a physician, you should not show any emotions, you should show no partiality. You should stay neutral. But at that moment, I cried with them,” she said.

It is nowhere near the most pleasant job in the world, but knowing they’re not at the losing end is enough, she said. “The only consolation is at least I was able to defend them.”

This is also the very reason Pamintuan has stayed at her job for almost two decades now. Yet even she can only do so much, and may leave the unit in two years. There’s a limit to what one can endure, she said, before the stories of abuse take a toll on you.

With Julia out next year, Pamintuan is also looking for her replacement, but it’s hard to entice someone to take over a “depressing” job.

But Pamintuan, determined to keep the Women’s Desk alive, said she cannot leave it unmanned.

All these efforts are to ensure the sustainability of the only office at PGH that provides care for abused women at the hospital. “Just to make sure it lives on,” she said. 

This is the conclusion of a two-part story taken from the author's undergraduate thesis, “For the Children of Eve: An Investigative Study on the Implementation of Women and Children Protection Program in Selected Metro Manila Government Hospitals" done under the supervision of University of the Philippines journalism professor Yvonne T. Chua from January to May 2017.

VERA Files is put out by veteran journalists taking a deeper look at current issues. Vera is Latin for “true.”