Waiting, hoping: a day on the ward
Angel, 13, steps inside a smaller room with a yellow door. It is Friday, a school day, but this is not a classroom, where children learn maths or science or the Chocolate Hills and the three islands of the Philippines.
In the room, there is a woman in a crisp white laboratory coat waiting for Angel, ready with a syringe. Angel has been in the same room the week before and the week before that and many other weeks since September last year.
Today, she is wearing a purple floral sleeveless top so she doesn’t have to roll up the sleeves. She stands nonchalantly and takes the shot; she doesn’t cringe or cower. By now, she is used to the jab on her right arm. When she is done, she goes back to her seat, in a row of red plastic chairs in the waiting room with the pastel green door. She opens her borrowed tablet, with its dusty violet leatherette cover, and attempts once again to prevent an army of zombies from eating the brains of her plants. It is her favourite game; she plays it nonstop while waiting here. She will wait for another doctor to call her name. There will be another procedure to check her blood.
Angel has leukaemia, diagnosed in September last year. It was an ordinary night with fever, says her father. But it was no ordinary fever; the thermometer stayed at 40 degrees Celsius. She is bald now. Her thick black hair, which once cascaded down her shoulders, is gone because of chemotherapy.
Welcome to the Cancer and Hematology Center of the government-owned Philippine Children’s Medical Center (PCMC) in Quezon City in Metro Manila, Philippines. It is a decrepit building, built decades ago with the help of Elizabeth Taylor. It has faded walls of red, blue and yellow, and is adorned with the names of the children of ex-President Marcos.
‘Every day, 200 to 300 outpatients come here,’ says Jara Corazon Ejera, the centre’s deputy director of PCMC. A hundred of these are cancer patients, like Angel.
Angel’s father Armando is a tricycle driver, but he has stopped driving to take care of his daughter. If he could, he would still ply the roads of Bulacan. But he needs to bring Angel to the hospital almost every week. Bulacan, in the northern part of the country, is two hours away from the PCMC.
In the mornings, they leave their borrowed house before the roosters wake, because the queue at the hospital can be long. Armando says he and his wife chose to bring Angel here because the cost of treatment is half that of private hospitals. And the doctors are good and kind, he says.
Angel’s Cytarabine infusion, a chemotherapy agent, for example, costs 200 pesos ($4.61) at the PCMC. In a private hospital it could cost 1,000 pesos ($23).
Miriam, mother to 11-year-old Johnell, leaves home at 5am to beat the queues. Although she lives in Caloocan, two hours away from Metro Manila, there is no choice.
‘I asked around in my neighbourhood,’ Miriam explains. ‘They told me the PCMC is good. And it is. I’ve seen the doctors here. They are really good.’
Miriam used to work in Dubai as a domestic helper but went home to the Philippines when she learned of Johnell’s leukaemia.
Parents like Miriam and Armando usually have to stop working so they can take care of their children full-time. The children have to stop schooling until they get better.
At the medical centre, there is no fixed schedule for treatments. Sometimes, the children turn pale in the dead of night, in the stillest of hours, between dreams and nightmares. When that happens, the parents have to rush them to the hospital. The costs keep on spiralling because leukaemia patients are so fragile that they cannot cope with public transportation. It is too dirty. It is too tiring. So the parents have to pay for a taxi.
During treatment, the children go through several procedures, which can sometimes take the whole day. To save on costs, the family brings lunch and snacks.
The doctors are warm and gentle, all smiles in their white laboratory coats. They know the children by the name.
Generations of children have sought treatment in this government institution. The health service is free at this hospital, although patients have to pay for their medicines. Still, this is a big help for the poor in a country where healthcare is generally not covered by the state.
Yet the 3.7 hectares of land on which the PCMC stands have drawn the interest of property developers, putting the institution’s future at risk. The hospital management is fighting the plan through campaigns, slogans and protests, as well as dances and songs. In the meantime, the children and their parents are keeping their fingers crossed that the centre will stay where it is.
Johnell is getting better, but he wears a mask so his health does not deteriorate, Miriam says.
In a corner by the window, nine-year-old Shyli sits patiently, waiting for her turn with another doctor. She just had a shot of chemotherapy; another doctor will check her. She asks her mother to massage her arm. It is hurting, she says.
In the waiting room, there are children everywhere. Some are sleeping, some are playing, some are lying about; some are in wheelchairs, injected with dextrose, while some are covered with masks or pink headwear. Some are writing and drawing shapes or hugging brown teddy bears donated by strangers.
The fetid smell of medicines wafts in the air. It is unbearable to most visitors, but the children and their parents are used to the dizzying stench.
The mothers and fathers know each other, not by their names, but the stories they share. They see each other every week, every two weeks or every month, depending on their children’s platelet counts or haemoglobin level or body temperature.
Sometimes, somebody stops coming and there is an empty seat in the waiting room.
But every day, another child, a new patient arrives. Here in the waiting room, the one with the pastel green door and walls with hot air balloons.