World

Meet the health-care workers spearheading the Philippines’s fight against coronavirus

As the world grapples with the coronavirus pandemic, the Philippines — home to tens of thousands of the world’s health workers — is under lockdown. At home, these workers are overworked, underpaid and at great risk. At least 150 doctors have been infected, and 20 have died — making up around 10 percent of covid-19-related deaths in the Philippines as of the first week of April.

Martin San Diego/For The Washington Post

At the front line is Philippine General Hospital. Since its designation as a covid-19 referral center, its halls have cleared to make way for coronavirus patients and suspects. With many of the senior consultants sent off duty for being high risk, it is the hospital’s young doctors who are the backbone of the fight against covid-19. Photographer Martin San Diego followed a team of anesthesiologists.

Martin San Diego/For The Washington Post

The empty halls of Philippine General Hospital. On a normal day, it usually feels like a battlefield hospital with its hallways swelling with patients.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

The anesthesiology department works in teams of four in 24-hour shifts every other day.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Gibson Ibale, 29, a third-year anesthesiology resident, heads to the covid-19 wards for his daily rounds.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

The anesthesiology staff tunes in for the department's daily video conference update.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Ibale, right, rests with other hospital staffers.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Issa Guerrero, middle, also a third-year anesthesia resident like Ibale, leads the four-person “airway” team for her shift.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

An airway team prepares for an intubation simulation.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Even during simulations, the team follows all personal protection procedures.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

At the anesthesiology department, a four-person “airway” team takes care of intubations — a crucial procedure for containing the respiratory disease. Georgia Tiu, 31, recounted the moment she felt the gravity of the pandemic: A mechanical ventilator hooked to a patient stopped working. “We were not allowed to proceed with manual bagging … as it supposedly would aerosolize the virus and put the other patients in the ward at risk for infection,” Tiu said. “For the first time in my life, I watched a patient not breathing and stood there and could do absolutely nothing to help her.”

Martin San Diego/For The Washington Post

The team gets ready for an intubation simulation.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Each member of the airway team takes turns simulating intubation on infants.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Even though most covid-19 patients are adults, the hospital is preparing for the worst.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

In between intubation calls, the airway team refines their safety procedures to minimize risk of contamination.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

The team also makes sure that all equipment is protected to avoid cross-contamination.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

A team member catches her breath in between simulations.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

John Jefferson Besa, 27, is an internal medicine resident who monitors more than 20 patients. A day before he spoke to The Post, he experienced his first covid-19 death. “I spoke to the relatives over the phone. … They really wanted to see the patient,” he said. “One of the biggest things the pandemic removes is the privilege to allow the family to see the patient in their last moments. … [It] strips off that part of humanity that’s very essential.”

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

John Jefferson Besa makes his way to the hospital via a shuttle service provided by a private company.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Besa starts another 24-hour shift.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Besa puts tape on his face to protect from the pressure of the face mask he has to wear most of the day.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Health workers meticulously don personal protective equipment (PPE) as they prepare to enter a ward of covid-19 patients.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

Besa, who goes by JV, dons his PPE, while a co-worker pens his initials on his chest to make identification easier once inside the covid-19 ward.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post

The Philippines has more than 4,000 coronavirus cases and counting. Mass testing efforts, set to begin Tuesday, are expected to yield more.

Martin San Diego/For The Washington Post

For now, around 50 out of 130 beds in Philippine General Hospital are still free — while private hospitals have declared full capacity. If the admissions here fill up, a hospital spokesperson said, it will mean the disease has spread among the urban poor. If that happens, it will be much harder to contain.

Martin San Diego/For The Washington Post

Besa enters the covid-19 ward, where he'll be stationed from 6 a.m. to 2 p.m.

Martin San Diego/For The Washington Post

Martin San Diego/For The Washington Post