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From the air bases to Greenhills: Ex-military doctor heads San Juan public hospital

MANILA, Philippines – San Juan Medical Center (SJMC) Director Joseph Acosta’s office is bare. On his table rest 4 stacks of documents, some of the papers awaiting his signature. Behind him are shelves with barely anything, just a few books, some binders, a telephone set, his laptop.  

He’d just started as the director of San Juan’s public hospital on the last week of September. On his second week as director, he’d even had to argue with the previous director about funds from the Philippine Health Insurance Corporation (Philhealth).

He had not planned on staying for long. He said the office of Mayor Francis Zamora sent him an invitation to be the hospital chief in August. Initially, he wanted to refuse. He wanted some challenge, he said.

At first he did not think it would test his brain at all. He had served as as commander of the Armed Forces of the Philippines Medical Center (AFPMC), which had a 1,200-bed capacity. SJMC has only 150 beds. 

Baka hindi na po ako ma-challenge (I’m worried I won’t be challenged),” he recalled telling the mayor. But his first impression was wrong. 

In his State of the City Address on the first week of October, Zamora lamented the state in which the previous administration had left the public hospital. He said healthcare delivery through the hospital is hampered because of the unfinished P500-million renovation started by the previous government.

He also revealed that medical equipment worth P137 million had been delivered but were still in crates, untouched.

Acosta confirmed all of this. “Noong pinuntahan ko itong new hospital, pagpasok ko pa lang, challenge na (Upon entering the new hospital, I knew it was already a challenge),” he said.

To get to his office alone, Acosta has to pass through the new building’s lobby, go through an empty hall where construction workers have installed new and unused elevators, then through the emergency room, then through another hall, before reaching the elevators or staircase that would take him to his office. 

This, including lack of medicines and fatigued employees have made SJMC the object of citizens’ discontent. On San Juan’s public hotline, Acosta says about 90% of the complaints are about SJMC. 

The prospect of changing the quality of San Juaneños experience with public health would prove to be a challenge for Acosta. He eventually said yes to Zamora, and sees himself as hospital director for the next 3 years. 

Military service

Acosta recounts his time in the military not by year, but by which hospital he was working in at the time.

In 2001, after Acosta had just finished his residency at the Philippine General Hospital (PGH), he was assigned to Sangley Hospital in Cavite City. That was how it worked in the military, he recalled. You would be told to go anywhere. 

It was not so far from his Muntinlupa, which he’d called home since he was born. The hospital at the airbase was small, Acosta said. When he was assigned there, it did not even have an operating room. Having studied hospital design in PGH, he wanted not just an operating room but an accreditation with Philhealth, so the hospital would have a steady source of income. 

He recalled how one of the people working with him on the redesign was connected to a 3-star general, Lieutenant Jose Reyes, who he said was impressed with his plans and gave him a P4-million budget to fix the hospital at Sangley. 

Reyes was so satisfied that he sent Acosta to Cesar Basa Airbase in Pampanga after. He spent two years working on the hospital there, from design to Philhealth accreditation. The finished hospital had not even been blessed when Acosta was asked to go to Clark Airbase for the same project.

On weekdays he would oversee work on hospital design and management. On weekends he would see patients at his Muntinlupa clinic. Every week, for 5 days, he would be a public servant. For the remaining 2, he would be a private practice plastic surgeon. He said he never left private practice because one only earns so much in the military. 

Hindi ka naman yayaman in public service kung hindi ka corrupt (You wouldn’t get rich in public service unless you’re corrupt),” he said. 

After Clark, he studied to be a flight surgeon in San Antonio, Texas. Flight surgeons are physicians who are trained to maintain their patients’ health to be in keeping with military standards. Their patients are pilots and crew members, officers and enlisted members. They need to know how the body reacts under extreme pressure, thousands of feet from the ground. 

After returning from Texas, he was then assigned to go to the Edwin Andrews Air Base in Zamboanga City. While working at the hospital there, Reyes – the man who gave him his break – told him to also retrofit the hospitals in Mactan Air Base and Villamor Air Base at the same time. He recalled he would have to fly back and forth, from Zamboanga to Mactan to Villamor, for 2 years. 

In 2004, he was named one of the 10 most outstanding Philippine soldiers. By 2007, he had the reputation of being a hospital planner in the Air Force. 

“The first thing you have to do, when you build or retrofit a hospital building, you have to talk to the end user – the patients – first,” Acosta said. His years in this particular line of work have taught him to always know the place where the facility is being built. 

Outsider in San Juan

Acosta would be assigned to more hospitals in his career. After two years of fixing 3 hospitals in Luzon, Visayas, and Mindanao, he was then told to design a hospital at Camp Teodulfo Bautista in Jolo, Sulu. 

While Acosta recalled all the hospital plans he helped make, he would point out the most important things to consider when designing hospitals. Patients have to get in easily. There should be very little noise. There should be enough beds. It should be close to the camp’s gate. It should be on flat ground.  

With Acosta’s help, a trauma center was established at the military camp in 2007. It provided immediate management of combat casualties in the Air Force in that part of Mindanao. It was inaugurated as a 65-bed capacity hospital in 2016 and could finally accommodate not only sick military personnel but also their dependents, and even civilians.  

By 2017, at 56, he retired from service. He decided to be a private practice doctor full-time, doing trips to the Visayas and Mindanao for his cleft lip surgery missions.  

These are the years of experience in his portfolio as he takes on his role as SJMC hospital director.

As an outsider to San Juan and its politics, he laments that not enough funds go to hospitals and public health. He said he has observed that, perhaps, local officials do this to keep their constituents dependent on them. Instead of everything being provided in the hospital, citizens would have to go to City Hall, knock on politicians’ doors, be indebted to them for help.  

Acosta said he does not know how to fix this culture, but he sees hope in San Juan’s new mayor. 

Ayokong mag-serve sa trapo. After nag-usap kami [Zamora], nakita ko sa kanya, noong nagsasalita siya, ang ganda ng puso, bata pa, marami pa siyang magagawa,” Acosta said of their first meeting. 

(I didn’t want to work for a traditional politician. After we first spoke, when he started talking, I saw he had a good heart, he was young, he still has so much to do.) 

He does not want to let him down. “I’ll need at least 1 year just to oversee the move to the new hospital. Maybe [I’ll be here] 3 years,” Acosta said. 

I will not leave until maganda na siya (I will not leave until this hospital works for the constituents).” – Rappler.com