Nena rises at 4 a.m. to cook a pack of instant noodles for her four children. Her live-in partner, Jojo, has gone to ply his tricycle route. He makes only about P300 a day and is still paying for the loan he took out (at 5-6 rates) to buy the tricycle.
While cooking, Nena worries about her youngest, 5-year-old Jamjam. He has been losing weight, having recurring fever, and coughing incessantly for the past two months. Lagundi syrup is of no help. She took him to the health center, where he was given carbocisteine. Still, he continued to cough and lose weight. She also took him to the hilot, thinking of kulam. Nothing happened.
Three days ago, she noticed that Jamjam was having difficulty breathing and was relieved only by nebulizations at the center. She and Jojo decided to consult a physician, but they worried about how to get to a hospital. The nearest is privately owned, and the consultation fee is at least P500, aside from the costs of the lab tests. On the other hand, the nearest government hospital is in Manila. The fare from Cavite to Manila costs P100. They calculated that they needed P200 just for the fare. (Jamjam will sit on Nena’s lap so he can ride for free.)
At 6 a.m., mother and son are on their way to the government hospital in Manila. At 8 a.m., they are in a queue at the pediatrics clinic counter. But the nurses tell Nena that the quota of 60 new patients per day has been filled. Nena begs the nurses to include Jamjam in the quota. We’re sorry, say the nurses. Our patients also came from far places. Come back tomorrow.
Nena sobs. She has only P400 left. If she takes Jamjam home, she will have only P300 for tomorrow, unless she borrows money again. They can stay overnight at the hospital, but where will they get food? And her family will worry if they don’t come home. She can try the nurses again, but then again…
In the waiting area, Nena notices an unguarded backpack. Patawarin sana ako ng Diyos(May God forgive me), she tells herself. But she decides against taking it.
A news report is blasted from the TV set in the waiting area: Senate President Juan Ponce Enrile, nagbigay ng pera sa mga senador nung Pasko! The report says all senators, except four, got P1.6 million each for Christmas.
A doctor walks through the hallway of the clinic and surveys the row of patients in the waiting area. Her gaze falls upon Nena and Jamjam. She raises her eyebrows and quickly approaches them.
The dialogue, in Filipino, is quick:
“Ma’am, how many days has your son been having difficulty breathing?”
“Doktora, three days already.”
“No other symptoms like a cough?”
“It’s been two months since he began coughing and losing weight. He’s lost almost half of his weight. And there’s fever.”
The doctor examines Jamjam, then calls a nurse and asks for oxygen. She tells Nena that her son’s condition is worrisome and he has to be taken to the emergency room.
Nena asks the doktora what will happen to Jamjam, and begins to cry.
Jamjam is hooked to oxygen support and put on a wheelchair. Another doctor takes mother and son to the emergency room, where several other doctors attend to the boy. One attaches an IV drip on Jamjam’s arm. His blood pressure is taken—several times. The mother senses that something’s wrong.
“Doktora, what’s happening?”
“Nanay, we can’t find your son’s blood pressure. His breathing is bad. We need to put a tube in his lungs so he can breathe. Do you have money for the respirator? If none, you will serve as the machine that will help him breathe. Magbobomba kayo.”
To rent the machine, Nena needs at least P2,000. Jamjam also needs antibiotics. Some of the lab tests are free of charge, but the others are not. Nena thinks of the P400 she has left. She can’t call Jojo, she has no cell phone.
The doctors lead Nena to a social worker, who assists her. She manages to contact Jojo, who promises to bring the needed money before the day ends.
In Cavite, Jojo turns to his brother for help. But his brother, who has three children and another on the way, can lend him only P500. Jojo understands, and thanks his brother profusely. He looks at his watch, thinking that his prized possession will probably fetch another P500 from the loan shark. But the loan shark gives him P2,000: “Here. For your son. Pay me when he gets well.”
The father takes the money, knowing that this “generosity” comes with a stiff price. With P2,500 in his pocket, he heads to the hospital.
The doctors have inserted a tube in Jamjam’s mouth and down his trachea; one is helping him breathe with a bag. Blood extractions, as well as x-rays, have been done. Nena brings the blood samples to the lab and pays for the lab work with her P400. She still has to buy antibiotics and medication to raise Jamjam’s blood pressure, but her money has run out. She has to wait for Jojo to come. Unknown to her, the doctors have given Jamjam medication from donors.
The doctors tell Nena that Jamjam has tuberculosis complicated with severe pneumonia; the infection has spread through his blood. They ask her if anyone else in the family has TB. Nena has no idea. They tell her to have all the family members tested.
They also tell Nena that despite the medication, Jamjam still has very low blood pressure. They urge her to seek the help of local politicians. It’s the election period, after all.
But all these are a blur to Nena. Her mind is as chaotic as the emergency room. She is waiting for Jojo to come. Jojo will tell her what to do. Where is Jojo, anyway?
A doctor approaches Jamjam and listens to his chest and heart.
CODE! Doctors and nurses instantly surround Jamjam. A doctor pounds the child’s chest with a fist.
Another doctor tells Nena what is going on. Her son’s heart has stopped beating and they are trying to revive him. If his heart does not start beating again after 30 minutes, they will stop all efforts of resuscitation.
Nena suddenly feels that the weight of the world is upon her. She cries. She prays. Diyos ko! Ang anak ko! For the first time in her life, she shouts her prayers, hoping that from earth, her screams will be heard by God in heaven.
Thirty minutes pass. We’re sorry, the doctors say.
The nurses remove all the devices attached to Jamjam’s body. Nena embraces her child and shakes him, hoping he is just sleeping.
Just then Jojo runs into the emergency room, looking for Nena. He sees her crying. He sees a lifeless Jamjam. He breaks down and weeps.
A week later, Nena and Jojo bury Jamjam in the public cemetery. Along with their son, they bury all their hopes and dreams for him. And then they face the future buried in debt.
Korina Ada D. Tanyu, MD, 27, is a pediatrics resident at the Philippine General Hospital where, she says, she and her colleagues encounter similar stories every day. She wishes that such situations will not happen to anyone, but realizes that with the way things are, these will only disappear in her dreams.