What a poor country like the Philippines suffers most from is a lack of good hospitals. Sick persons sometimes have to travel very long distances to get medical help in hospitals. And sometimes the patients do not reach the hospital alive.

The Philippine Charity Sweepstakes Office has a program of giving ambulances to local government units. But where would these ambulances take the patients when there are no well-equipped hospitals nearby? They have to take emergency cases two or three provinces away or to faraway Manila. And needless to say, some patients are dead by the time they get there.

So the ambulances are used by the mayor, or his wife or children or house help, to go joyriding or to go marketing or shopping, or to go to Metro Manila.

That is why we see so many ambulances from the provinces running around the metropolis. Sometimes the ambulance is used by the mayor to smuggle drugs.

Many Filipinos are in poor health, or die before their time because there are not enough hospitals to take care of its citizens.

Do you know that patients from the provinces who are suffering from end-stage kidney failure have to travel all the way to Metro Manila to be dialyzed to ensure their survival? Kidney patients will die within weeks or months if they are not hemodialyzed (a process of cleaning the blood of toxins via a machine, a cleansing that the failing kidneys can no longer do). A patient with end-stage kidney failure has to be dialyzed three times a week (at fees ranging from P3,000 to P15,000 per session), so that patients from the provinces have to rent rooms in Metro Manila to stay alive.

So I cannot understand why Gov. Michael Keon and the Ilocos Norte Provincial Board are blocking Laoag Mayor Michael F. Fariñas from upgrading the Laoag City General Hospital (LCGH).

The upgrading of the LCGH has been ongoing since 2002. It is part of Laoag?s Comprehensive Land Use Plan (CLUP), approved by the City Council, reviewed and approved by the provincial board, and approved by the Department of Health. Health Secretary Francisco Duque commended Fariñas for wanting to upgrade the city hospital and provide quality and affordable health services to his constituents.

Laoag had set aside P24 million for the upgrading of the hospital and has secured a P350-million loan from two government banks and an international aid agency. That was during the governorship of Ferdinand Marcos Jr. The governor is now Michael Keon, a cousin of Marcos Jr., and he and the provincial board are blocking the improvement of the LCGH.

?Both hospitals will offer the same medical services and facilities,? Keon said in a letter to the Department of Health. ?It is important to note that the proposed LCGH is only 10 minutes away by car from the provincial hospital. The proximity of the two hospitals to one another plus the same service and facilities will result in what can only be described as ?cut-throat? competition as both compete for the same market share of patients-clientele.?

The provincial board disapproved a resolution of the Laoag City Council giving Fariñas authority to secure loans from government banks. Duque changed his mind about his endorsement of the upgrading of the LCGH and even wrote the Development Bank of the Philippines to discourage it from giving the LCGH a loan.

Why are they doing this? Any other local government official would be happy to have more than one hospital in his territory. In the case of Laoag and Ilocos Norte, patients cannot be accommodated in the present hospitals.

In a letter to Duque in 2008, Fariñas reported: ?At present, the Laoag City General Hospital sometimes cannot accommodate patients seeking medical intervention due to lack of space. The situation also holds true with the Governor Roque Ablan Sr. Medical Hospital (GRASMH) where some patients stay in alleys and corridors, and the Mariano Marcos Memorial Hospital (MMMH).?

Duque replied that the LCGH should remain a level 2 general 50-bed hospital (not a tertiary hospital) subject to review by the DoH. Again, why are they doing this to Fariñas and the people of Laoag?

The answer can only be petty politics, a case of one-upmanship. Keon doesn?t want Laoag to have a better hospital than the province because of his rivalry with Fariñas. Keon waged a bitter political battle against a close relative of the mayor, former Gov. Rudy Fariñas.

As for the two hospitals being close to each other, Metro Manila has more than a dozen hospitals, public and private, within minutes of one another, and there is still crowding in all of them. In Houston, Texas, there are many hospitals beside one another and the city is famous all over the world for its outstanding feats in medicine, especially in the field of cardiology. It is the home of the Texas Heart Institute and the Baylor Hospital, among the pioneers in heart transplants (my doctor-daughter studied there before getting a fellowship at the Yale Medical Center in Connecticut).

As for the disapproval by the provincial board, the Department of Interior and Local Government said the act ?went beyond the perimeters of review set by the Supreme Court.?

?The authority of the Sangguniang Panlalawigan (Provincial Board) to review the acts of its component municipalities (cities) is limited to reviewing only (1) ordinances or (2) resolutions approving local development plans and public investment programs, per provisions of Sec. 56(a) of the Local Government Code of 1991 (RA 7160).?

Clearly, the governor and the Sangguniang Panlalawigan had no legal authority to disapprove the project.