Heartless triage and cruel algorithms

By this time, many Filipinos should be familiar with the story of the short, unhappy life of Katherine Bulatao, 26, who gave birth at home last April but died after five frustrating, excruciating hours as her husband sought help for her postpartum bleeding.

From their home, Katherine’s husband Jan Christian transported her to six hospitals, only to be rejected by them because the facilities were already full, lacked a blood supply, or had no personnel to attend to her. An investigation has been promised, but so far there has been no word of sanctions or reparations.

But it turns out that Katherine’s death has been replicated elsewhere in the world. In India, reports The New York Times, Neelam Kumari Gautam, who had gone into labor, was rejected by eight hospitals 15 hours after she and her husband left their home. As one hospital after another refused to accept the writhing Neelam, her husband observed that “it wasn’t simply that the doctors couldn’t help her, it was as if they didn’t want to help her.”

But Neelam isn’t the only such victim. Two young mothers in labor died in Hyderabad and in Kashmir, with the family of the latter reporting that “hospital staff were so uncaring that they didn’t even help with an ambulance to take the body home.” The family was forced “to wheel her body down the road, in a stretcher, for several miles.”

Deciding who lives and who dies plays out like a painful lottery everywhere COVID-19 has struck. In the US, hospitals have jointly been reviewing their triage plans originally prepared for post-disaster scenarios but tested cruelly in the face of the coronavirus crisis. “The plans struggle to address a range of ethical issues, and also matters of social equality,” said the NYT in an earlier report. “People with underlying medical problems may get ranked lower, yet low-income people and people of color often have more health problems because they cannot afford top-notch care.” And the numbers of deaths, as well as their lopsided distribution across race and class, are a testament to how this logarithm works out.

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There has been no word if the Duterte administration or even the Department of Health has embarked on scenario-building. But the way things are playing out here, as with most everything else like quarantine rules and their enforcement, the distribution of relief aid, and ushering society back to the “new normal,” it’s the poor who are shouldering much of the onus.

Indeed, Interior and Local Government Secretary Eduardo Año has laid the blame squarely on the shoulders of the teeming masses, who, he says, are to blame for being “uncooperative” with the increasingly draconian measures employed by the government.

The same “blame the people” rule book applies as well to other government officials. A former soldier suffering from PTSD was gunned down on the streets of Quezon City after he supposedly ignored police warnings. Hundreds have been arrested and detained, many in inhuman conditions, for supposed violations of quarantine. In the wake of the chaos that followed the loosening of harsh controls of community quarantine, both Transportation Secretary Arthur Tugade and the Metropolitan Manila Development Authority blamed commuters for not being ready for the abysmal lack of public transportation. Even if they were the ones who should have anticipated and prepared for the flood of commuters.

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Meanwhile, the biggest violators of the strict quarantine guidelines have been people in authority. NCRPO chief Maj. Gen. Debold Sinas stands out with his “mañanita,” while Año has ordered the relief of Senior Supt. Roderick Aguto of the Bureau of Fire Protection after allowing an outing in Boracay, with one personnel later testing positive for COVID-19, delaying the reopening of the resort island.

Near the airport, hundreds of repatriated OFWs and locally stranded OFWs-to-be wait out their turn to come home while camped out in sidewalks or makeshift shelters even as local authorities dither about taking them in. Labor Secretary Silvestre Bello III, meanwhile, could only ask for prayers as he pleaded with Saudi leaders to help this government repatriate the remains of about 300 Filipino workers there. Pray that “we can get their remains, that they help us and send home these people,” he said. “These people,” you must remember, are our own compatriots, caught in the heartless algorithm of an indifferent, incompetent government.

rdavid@inquirer.com.ph