News on AMOSUP Hospital

（1）【SPECIAL ISSUE】DAILY JAPAN SHIPPING NEWS

DAILY JAPAN SHIPPING NEWS

SPECIAL ISSUEAMOSUP SEAMEN’S HOSPITAL

For further development of Philippine seamen’s community

Enhancing medical care and promotingthe health of Philippine seamen

Give indirect supports for safe operation of Japanese merchant shipping fleets

AMOSUP Manila/Cebu/Iloilo/DavaoOperating seamen’s hospitals in 4 areas across Philippine

Kaiun Keizai Shimbunshaco.,ltd.

【Japan shipping News】　 Kyobashi-Nagaoka Bldg,3-6-1,　 Hacchobori,Chuo-ku,Tokyo,　 104-0032 Japan　ＴＥＬ（81-3）-3552-7596　ＦＡＸ（81-3）-3552-7598

（2）【SPECIAL ISSUE】 DAILY JAPAN SHIPPING NEWS

70% of seamen onboard Japanese mer-chant fleets are a member of AMOSUP

Philippine seamen are becomingindispensible for Japanese maritime

transportation and economy

　“ASSOCIATED MARINE OFFICER’S AND SEAMEN’S UNION OF THE PHILIPPINES-PTG-WO-ITF” is Philippine’s largest seamen’s union.　Its current number of union members is 95,000, of which more than 40% (over 40,000 members) are working for Japanese merchant fleets. Among the 60,000 seamen working on board the 3,000 ships comprising Japanese merchant fleets, 70% are mem-bers of AMOSUP. Philippine seamen have become an important human infrastructure supporting Japanese merchant fleets and thus the Japanese economy. If, for some reason, a situation arises that Philippine seamen could not get on board ships, not only Japan but the whole world would fall into an economic turmoil. It has become an essential req-uisite for the sustainable development of Japanese maritime transportation, Japanese economy and the global economy to continue stably supplying healthy and high quality Philippine seamen to Japanese mer-chant fleets.

It started as a small clinic with only 5beds. After about 30 years, it has grown

into an organization over 50 times in size, with more than 240,000 outpa-tients a year and 500 medical staff

　AMOSUP opened its first healthcare facility in Phil-ippine for seamen and their family in June, 1978. “It was difficult for common people to get medical care on their own at that time, because social security systems were still underdeveloped in Philippine. People had to pay the entire cost for medical care, which was very expensive. Seamen were employed for fixed terms, and during periods that they could not get a job on board a ship, they did not have enough income to cov-er healthcare expenses. Deeply concerned about this situation, Captain Oca tried to improve the situation by creating a hospital in the port area for seamen and their family” said Dr. Conrad F. Oca, current President of AMOSUP and son of Captain Oca. To be healthy and fit for work is fundamental and a prerequisite to the lives of seamen. Captain Oca clearly recognized this point and embarked to build a hospital for sea-men. 　It started as a small clinic in South Harbor, Manila’s port area with only 5 to 6 beds and special-izing in outpatient care. The global maritime industry was not yet aware of the huge potential of Philippine seamen. In later years, however, the international maritime community started to introduce Philippines to the center of the global seamen labor market. The rapid growth of world economy and globalization since the late 1970s gave rise to a global increase in the demand for shipping capacity, which resulted in the tightening of the maritime labor market and increased maritime labor costs. Costs for seamen surged not only in traditional maritime powers such as England and U.S., but also in newer and advanced maritime countries such as Norway, Greece and Japan, fueled by the rapid economic growth. Moreover, the 1985 Plaza Accord triggered accelerated flagging out of ships in Japan. Against this backdrop, Philippine sea-men started to be spotlighted as the central player of the international maritime labor market, with their low cost labor and almost-native English speaking abil-ity as their selling points. Along with this trend, the number of members of AMOSUP expanded rapidly. 　The AMOSUP Seamen’s Hospital, which began with only one doctor and five beds, continued to expand

as the number of members grew. Today, it has expanded to operate four general hospi-tals across the Philippines: one each in Manila (opened in June 1978/ February 1987), Cebu (opened in April 1997), Iloilo (June 2005) and Davao (August 2008). The total number of beds across the four hospitals have reached 255 (Manila 100/Cebu 60/Iloilo 45/Davao 50), approximately 50 times more than when the first clinic was opened. Likewise, the total number of medical staff now exceeds 500, with 230 doctors (Manila 150/Cebu 34/Iloilo 24/Davao 22) and 308 nurses (Manila 174/Cebu 55/Iloilo 35/Davao 44). The total number of outpatients a year was ap-proximately 240 thousand (Manila 120/Cebu 60/Iloilo 30/Davao 30 thousand, as of De-cember 2013). AMOSUP Sea-men’s Hospital supports the

health of Philippine seamen working on the seas of the world by responding to their ever-growing healthcare demand and thereby underpins the safety of the daily operations of international maritime transport by Japa-nese and other merchant fleets.

Captain Oca’s vision lives onAll medical services provided to seamen

and their family free of charge

　The biggest feature of AMOSUP Seamen’sHospital is that it provides all medical services to member seamen and their family free of charge. This policy has not changed since the hospital was first founded, according to the vision of Captain Oca who always placed seamen’s welfare first before anything else. This free-of-charge medical service covers the member seaman himself, his parents and brothers/sisters aged 18 or below in the case when the member seaman is not married, and the sea-man himself, his spouse and his children aged 18 or below in the case when the member seaman is mar-ried. All the four hospitals including Manila, Cebu, Iloilo and Davao adopt the same policy. This pro-vides an important incentive for choosing seaman as a career in the Philippines where healthcare cost is expensive and the social security system is still not sufficient. However, AMOSUP’s healthcare service goes even further.

Launch of new pilot projectsto aggressively expand service

Insurance coverage for healthcare provided outside of Seamen’s Hospital

/ Satellite clinic system

　With the number of member seamen continuously expanding driven by the ever-increasing demand in world shipping capacity, AMOSUP has launched new projects to aggressively meet the expanding healthcare needs of seamen. Among the four Sea-men’s Hospitals, especially the one in Manila is facing the problem of not being able to catch up with the increase in healthcare demand of member seamen and their family. AMOSUP is currently working on two projects to address this problem and provide healthcare service better tailored to member needs. One is “collaboration with insurance companies for healthcare provided outside of the Seamen’s Hos-pital” and the other is “building a satellite clinic

system.” The former is a mechanism to cover the expenses of healthcare provided to member seamen and their family outside of the Seamen’s Hospital through collaboration with insurance companies. AMOSUP pays the insurance fees to the insurance company on behalf of its members. This project aims to have other hospitals cover the part of the healthcare that AMOSUP Seamen’s Hospital cannot provide by itself and to assure the costs for such treatment/healthcare up to a certain amount (20,000 peso), while also contributing to mitigate the conges-tion at the AMOSUP Seamen’s Hospital. 　The latter project aims to provide healthcare to seamen and their family who have difficulty in visit-ing the Seamen’s Hospital because they live in areas far away from Manila such as the northern part of Luzon Island, where there is potential demand for healthcare services to seamen. AMOSUP and existing general hospitals in these areas will form partnerships to provide healthcare for free to sea-men and their family who live in these areas. “At present, the patients must travel over (to distant AMOSUP Seamen’s Hospitals), but this project brings healthcare closer (to where the patients live)” explains President Oca. These two projects have already started. Specifically, a satellite clinic pilot project has already been launched in Dagupan City (northwest part of Luzon Island) since February 2013. After one year of pilot operation, in February 2014, AMOSUP will consider expanding this project to other areas of the Philippines based on the out-comes of the pilot project.

Promoting the health ofPhilippine seamen is a precondition for

the safe operation of Japanesemerchant fleets

The trust and cooperation fostered between Japanese management and Philippine seamen in the international

maritime labor market form thefoundation for everything.

　Many tankers and bulk carriers comprising Japa-nese merchant fleets are flag-of-convenience ships, on which Philippine seamen work. The Japanese shipping industry and Philippine seamen have be-come so inseparably connected with each other, like an organic system, that if they are disconnected by any chance, the impact would cause economic tur-moil not only in Japan but across the world. There-fore, it is indispensible that the relation between Japanese shipping industry and Philippine seamen is maintained to ensure safe and stable operation of Japanese merchant fleets. The trust and cooperation fostered between Japanese management and Phil-ippine seamen in the international maritime labor market form the foundation for ensuring continuous and stable supply of high quality and healthy Philip-pine seamen at appropriate costs. 　While the AMOSUP Seamen’s Hospital is basi-cally a facility developed and operated by AMOSUP alone, numerous footprints of Japan-Philippine co-operation can be found in these hospitals. The fol-lowing is a report on the four AMOSUP Seamen’s Hospitals respectively located in Manila, Cebu, Iloilo and Davao.

Symbol of AMOSUP

Manila

Cebu

Davao

Iloilo

Aparri

Cabanatuan

Angeles

Legazpi

Calbayog

Tacloban

Santa

BaguioDagupan

Tarlac

Olongapo

San Pablo

Batangas

Calapan

Puerto Princesa

Cadiz

Bacolod

Zamboanga

Iligan

General Santos

Cagayan de Oro

Butuan

Roxas

Map of Philippines


　Manila is the capital of the Philippines. The Metro Manila (metropolitan area including Manila and 17 nearby cities and towns) has a population of 12 mil-lion and an area of 638 km2, both of roughly the same size as the 23 wards of Tokyo. Moreover, 21 million people inhabit the wider metropolitan area including parts of the adjacent states of Bulacan, Rizal, Laguna and Cavite, forming one of the largest cities in the world. 3,000 km south of Tokyo, Manila can be reached by a four-and-a-half hour flight from Tokyo. 　It was in June 1978 that AMOSUP, the largest seamen’s union in the Philippines, established the first AMOSUP Seamen’s Hospital in Manila. At first, it started off as Roberto S. Oca Workers’ Clinic (RSOWC), a small outpatient clinic with 5 to 6 beds located in South Harbor, Manila’s port area. Roberto S. Oca was an elder brother of Gregorio S. Oca who was the former president and founder of AMOSUP (late Captain Oca, father of current President, Con-rad F. Oca). AMOSUP later expanded the clinic into a three-storied hospital with 50 beds and surgery, internal medicine, obstetrics and gynecology, pediat-rics and dentistry departments as well as operating rooms and an intensive care unit (ICU). The hospital was certified as a Tertiary Level (rank of general hospital with specialized departments) general hospi-tal in February 1980 by the Philippine government. This was when the former clinic set sail in earnest as AMOSUP Seamen’s Hospital. 　AMOSUP later relocated the Seamen’s Hospi-tal from the port area to Intramuros in the First District at the center of Manila in February 1987 (construction started in June 1985), in order to meet the expanding healthcare needs of the rapidly in-creasing seamen population. The new AMOSUP Seamen’s Hospital was located at only a few min-utes’ walk from the AMOSUP headquarters. It had over 100 beds and ample facilities to further en-

hance the healthcare services provided to member seamen. Intramuros, meaning “within the walls,” is the oldest district and historic core of Manila where Miguel López de Legazpi, the first Governor General of the Spanish Colony, set up a base for conquering the Philippines in the late 16th century. AMOSUP Seamen’s Hospital Manila provides medical care to member seamen in a historic environment sur-rounded by Manila Cathedral and San Agustin Church which are representative Roman Catholic architectures of the early modern age. 　AMOSUP Seamen’s Hospital Manila provides healthcare to AMOSUP members and family, who live on Luzon Island or temporarily called at a port in the island, which accounts for approximately 40% of the 95,000 AMOSUP members. We visited AMOSUP Seamen’s Hospital Manila supporting the health and lives of member seamen and their family in the megacity Manila.

150 doctors; 174 nurses Largest among AMOSUP Seamen’s

Hospitals Total floor area 7,054 ㎡ (main building

and annex combined) Number of beds 100

　AMOSUP Seamen’s Hospital Manila is located 10 km north of Ninoy Aquino International Airport, in the Intramuros district of Manila, at Cabildo Corner, San Jose Street. It’s about a 20 minutes’ drive from the airport if the roads are not jammed, but since traffic jam is normal in Manila, it usually takes about twice as much time to get to the hospital. It is only a few minutes’walk from the AMOSUP Seamen’sCenter (the headquarters), a perfectly convenient

location for member seamen. Intramuros district is where Miguel López de Legazpi, the first Governor General of the Spanish Colony, set up a base/fort for conquering the Philippines in the late 16th cen-tury. The district is still surrounded with the fort walls built in those days. Many European Baroque style buildings including Manila Cathedral and San Agustin Church can be found in Intramuros, which was the first site in Luzon Island to be baptized by the Roman Catholic Church. Remains of batteries can still be observed at Fort Santiago, reminiscent of the colonial era. The district is the most popular tourists’ spot in Manila with its unique, attractive atmosphere fusing European and Southeast Asian cultures. 　AMOSUP Seamen’s Hospital was relocated from the port area to Intramuros in February 1987 (con-struction was started in June 1985). The main build-ing and an annex stand next to each other on a

premise of 1,200 m2. A Spanish architectural style was adopted to make the appearance of the hospi-tal harmonize with the surrounding environment. The main building has a floor area of 4,564㎡ with one floor below ground and three more above. The annex has four floors above ground level and floor area of 2490㎡ , which makes the total floor area ofthe two buildings 7,054㎡ . The total number of beds is 100. The annex used to be a training center for seamen since it first opened in 1987 until 2000, but when the Maritime Academy of Asia and the Pacific (MAAP) was established in Kamaya Point in Mariv-eles, Bataan, in August 1999, the annex building was renovated as hospital space to respond to the in-crease in healthcare demand. [MAAP is a merchant maritime academy privately run by AMOSUP and a board of governors including organizations repre-senting maritime employers and workers of Japan and Philippine, and the International Maritime Em-ployers Committee Limited (IMEC) from Europe.] 　150 doctors (including 52 residents and 98 consul-tants) and 174 nurses work in this hospital. Besides these medical staff, there are 467 non-medical staff

such as radiology technologists, medical technolo-gists, physical therapists, pharmacists, administra-tive personnel and staff in charge of maintenance work. Working days and number of doctors vary by each department. During the daytime hours (8:00-17:00) , 1 surgeon, 1 physician, 5 family physicians (initial consultation/general practice), 8 obstetricians and gynecologists, 9 pediatricians see the outpa-tients, and during nighttime, 1 surgeon, 1 physician, 3 family physicians, 3 obstetricians and gynecolo-gists, and 2 pediatricians work on a 24 hour shift, in rotation. Those who took a 24 hour shift take 2 to 3 days off after that. Medical examination and research related departments work during the day-time (8:00-17:00). Nurses work in 3 shifts around the clock (7:00-15:00-23:00-7:00) and rotate every 15 days. Outpatient reception is open from 8:00 to 17:00 on weekdays and 8:00 to 12:00 on Saturdays.

AMOSUP Seamen's Hospital Manila・Annex

Lots of People wait for their turn in the courtyard Medical inteview for outpatient

Psychological test before boarding

Blood test・centrifugal machine

Overview of the facility

AMOSUP SEAMEN’S HOSPITAL MANILA Established in June 1978　Started out from a small clinic run by Roberto Oca, Captain Oca’s elder brother.

Grew into a Government-certified general hospital in February 1980Relocated in February 1987 to current location in Intramuros

In a graceful environment surrounded by historic Roman Catholic buildings of the early modern period


Annual outpatients 120,000, inpatients 5,000, pre-boarding medical

checkups 5,400The only Seamen’s Hospital with a MRI

facility, 160 slice CT scannerCertified for Tertiary Level (highest

rank) general hospital by the Philippine government

Accepts internship students

　Medical departments of AMOSUP Seamen’sHospital Manila include internal medicine, general/clinical surgery, pediatrics, obstetrics and gynecol-ogy, outpatient, anesthesia, ophthalmology, otorhino-laryngology, pathology, radiology, family medicine, emergency medicine, rehabilitation, nuclear medi-cine, dentistry, nursing, pharmacy, dietetics/nutriol-ogy, and pre- and post-boarding medical examina-tion. One of the characteristics of Seamen’s Hospital Manila is that it has a rehabilitation department which is a criterion for being certified as a Tertiary Level hospital by the Department of Health (DOH)

of the Philippine government. Among the fourSeamen’s Hospitals located across the Philippines, Manila Hospital is the only one that has a MRI scan-ner (since February 2010) as well as 2D ultrasound scanner and extracorporeal shock wave lithotripsy equipment (breaks gallstones using electric waves). 　Usage data of Seamen’s Hospital Manila for 2012 was: number of inpatients 4,965 (average number of inpatients admitted per day 13.6); total patient days of inpatients 21,945 (average stay of inpatients 4.4 days); bed occupancy rate 62.7%; number of outpa-tients 120,730 (average of 410.6 patients/day); disem-barkation of sick seamen during voyage 98 (average of 0.3 patients/day); number of dentist’s patients 54,664 (average of 224 patients/day); patients tak-ing ultrasound scanning examination 8,794; patients taking x-ray examination 15,653 (average of 53.2 pa-tients/day); patients admitted for examination 25,739 (average of 237.4 patients/day); patients visiting the hospital for examination 338,291; seamen taking pre-boarding medical examination 5,404 (average of 18.4 patients/day); seamen taking post-boarding medical examination 23 (average of 0.1 patients/day); num-ber of surgical operations 4,675; number of childbirth 618; patients receiving rehabilitation 7,417 (average of 25.2 patients/day); seamen taking pre-boarding psychological examinations 4,592 (average of 18.8 pa-tients/day); number of deaths 51. The average num-ber of outpatients visiting the hospital per day was 410 and those visiting the dentist were 220. Surgical operations were conducted on 8 to 9 patients per day on average. Seamen’s Hospital Manila treats the largest number of patients among the four AMO-SUP Seamen’s Hospitals in the Philippines. 　Seamen’s Hospital Manila can also be character-ized by the number of internship students (clini-cal trainees) it accepts. Since it is a Tertiary Level hospital certified by DOH, it accepts more intern-ship students compared to Seamen’s Hospital Cebu (Secondary Level) and other hospitals. According to the medical education system in the Philippines, students must first graduate a high school, a gen-eral university (4-year science course) and a medical graduate school (4-year course specializing in medi-

cine) and then experience a 1-year “post graduate internship (PGI)” before they are qualified to take a national exam for medical practitioners. Students will become a general practitioner when they pass the national exam, but they will still need to under-go a 3 to 4 year residency (depending on the special-izing department) and take the Board Certification Examination to become a specialist doctor. When they pass this exam, they finally become a specialist doctor such as a general physician, general surgeon, general podiatrist, etc. Furthermore, if they wish to further advance their specialist skills, they will undergo fellowship training for another 1 to 2 years and take the Sub-specialty Board Certification Ex-amination. When they pass this exam, they will be-come a specialist such as a cardiovascular physician who can conduct highly specialized medical practice. 　AMOSUP Seamen’s Hospital Manila has been ac-cepting an average of 6 to 7 residency trainees in family medicine, obstetrics and gynecology and 1 to 2 fellowship trainees in endoscopic surgery every year since 2009. The residency period is for 4 years and fellowship is 2 years. In 2012, a total of 24 resi-dency trainees in family medicine, obstetrics and gynecology (2 in 1st year, 6 in 2nd year, 8 in 3rd year, and 8 in 4th year) and 2 fellowship trainees in endoscopic surgery (1 each in 1st and 2nd year) were trained at Seamen’s Hospital Manila. Seamen’s Hospital Cebu, which is a Secondary Level DOH certified hospital, only accepts 4-year residency trainees in family medicine. 　The main building and annex of the hospital stand next to each other and are connected with a passageway. The main building has an open ceiling space at the center of the building (same as Sea-men’s Hospital Cebu). The inner courtyard is used as the patients’ waiting lounge. When you walk in through the entrance on the first floor of the an-

nex, you will see the nuclear medicine department and examination room on the left and the depart-ment of ophthalmology further beyond. The nuclear medicine department’s computerized tomography room is equipped with electrocardiographic test-ing machines, mammographic scanner, ultrasonic devices, nerve testing apparatus and a state-of-art 160 slice CT scanner that has just been delivered in June 2013. In addition, some of the equipment can only be found here at Manila Hospital among the AMOSUP Seamen’s Hospitals such as the magnetic

resonance imaging (MRI) scanner which was intro-duced in February 2010, a 2D ultrasound scanner, and a gamma camera donated by the International Transport Workers' Federation (ITF). The CT scan-ner has been renewed to a latest model with a pro-cessing speed three times faster than the previous one, contributing to reducing waiting time for the patients. The 64 slice CT scanner that used to be used at Seamen’s Hospital Manila was transferred to Seamen’s Hospital Cebu in October 2013. On the second floor of the annex are the internal medicine, general surgery and dentistry departments as well as the medical psychology and psychiatry room and chemotherapy room. The 6 dental chair units at the dentist’s are in full operation from morning to eve-ning every day. We saw many patients waiting in the passageway on the day we visited the hospital,

too. The administration office, information manage-ment room and conference rooms are located on the third floor. The fourth floor houses doctors’ and nurses’ offices, the library and a work out gym. 　On the other hand, on the first floor of the main building, various departments are arranged in a way to surround the waiting lounge at the center. The medical records room, pharmacy, radiology, pathology/histology laboratory, pediatrics, obstetrics and gynecology departments and the emergency room are located around the waiting lounge. On the second floor are the female surgical ward, newborn intensive care unit (NICU), operation room, labor and delivery room, sterilizing room, and stone treat-ment center where extracorporeal shock wave litho-tripsy is conducted. Approximately 3-4 patients per day visit the hospital to receive this treatment for breaking gallstones, and many of them are seamen who want their gallstones treated before getting on board. On the third floor are the male surgical ward, isolation room, orthopedic ward, pediatric ward, intensive care unit (ICU) and the rehabilitation de-partment. There is also a chapel on this floor. Most of the wards have around 10 beds in one room but there are special rooms with only 1 or 2 beds (each for 1 room) on third floor for senior officers such as captains and chief engineers. On the basement floor are a staff cafeteria with 60 seats, pre-boarding med-ical examination room, dietary consultation room, engineering maintenance room, etc.

Ganma camera, donated by ITF

MRI placed only in Manila Hospital

Latest model of CT Scan 160 Slice

Ultrasonic crush machine for magallstone destruction.Seafarers tend to have magallstones.

Surgery schedules. 11 surgeries from 7AM to 5PM

Only rehabilitation institution in 4 Hospitals. Rehabilitators

Double occupancy room for senior officers

6 Units in dentistry. Full operation


Hospital staff interview

　AMOSUP Seamen’s Hospital Manila has a much larger capacity and more sophisticated facility com-pared to the other seamen’s hospitals in other areas of Philippine, but the number of both outpatients and inpatients is also exceptionally large compared to other seamen’s hospitals, as it is situated in the capital and largest city of the country. The 95,000 AMOSUP members and their family living in this area, accounting for 40% of the total number of the population covered by AMOSUP’s medical service, come flooding into the hospital every day, causing continuous congestion. 　Ms. Bridget K. Flordeliza started her career as a nurse at the AMOSUP Seamen’s Hospital in May 1981, when the hospital used to be called by the name Roberto S. Oca Workers Clinic (RSOWC). In May 1984, she was appointed as chief nurse, the youngest (at the age of 27) chief nurse ever in the history of Philippine nurses, and for nearly 30 years since then she has been working as chief nurse at AMOSUP Seamen’s Hospital Manila. She is a living witness of the history of the hospital. She suggests that for mitigating the congestion, “…it is important to maintain the system going. At AMOSUP Sea-men’s Hospital we have a system in place to divert people from other sections whenever a section runs short of staff. Not only the doctors but nurses too, must continue to develop their skills, knowledge and experience without getting satisfied with their pres-ent status.” 　Doctor Karen Kristine San Juan will complete her residency and become a specialist doctor in family medicine next year. She comments “It is necessary to enhance training for both doctors and nurses so that medical procedures can be carried out more quickly, which will help (mitigate the congestion).” She emphasizes that the skills improvement of each staff member is essential in enhancing medical services. Below are our interviews with three staff members of the hospital, including administrative di-rector, Elena Gysrell V. Jiloca, regarding the future and issues of the AMOSUP Seamen’s Hospital.

What are the characteristics of AMOSUP Seamen’s Hospital?

Bridget K. Flordeliza, R.N. / Chief

　“One clear characteristic is that President Conrad Oca wants to make sure everyone gets a chance to develop their skills. All members of the medical staff, including nurses, are allowed to take a leave for participating in programs to advance their skills. Nurses can make use of scholarships, too. We also provide training via the Internet and remote educa-tion through collaboration with a partner institution (The Lyceum of the Philippines University)” 　“In addition, the hospital provides a scholarship program covering 100% of the cost for attending a medical university and 50% for a medical gradu-ate school, for the daughter or son of hospital staff entering a medical school. This program is available

for one high-performing student per year. I, too, was granted a chance by our boss (Captain Gregorio Oca) to work for one year in Japan (received train-ing at Tokai University and Musashino Red Cross Hospital in 1991-92).” 　“Another thing about this hospital is that the whole hospital and its staff have a feeling that we are all a member of a family. You can say the same for our patients, the seamen and their family, too. Once they visit us as a patient, they will come back again when they get sick. Although it’s a personal episode, I remember about a patient, a baby I de-livered who grew up and visited us (when he got sick). This patient remembered me. The staff, the patients, we are all a big family.”

Karen Kristine San Juan − Chi, MD/ Senior Resident PhysicianDepartment of Family and

Emergency Medicine

　“This hospital can be characterized by the high level of medical care it provides. While, there are many public hospitals in Manila, most of them do not have advanced medical equipment. Another characteristic about this hospital is that its service is limited to seamen and their family. I don’t think there are many examples like this, even for big companies.” 　“(AMOSUP members) often spend a long period at sea. When they get off the ship and return home, they usually get a health checkup, but many of these seamen are concerned about their family’s health, too. So we provide counseling and care (to the seaman himself) and his family members altogether. Another distinct point is that we have sophisticated equipment that allows for advanced surgical operations. We also conduct seamen’spre-boarding medical checkups. Seamen take this checkup about one month in advance of the voyage. If the checkup shows any signs of concern, then the seaman will be instructed to improve his condition through a diet program or other means, (so that he will be qualified to board the ship).” 　“In Philippine, all members of the family usually gather whenever someone in the family undergoes an operation or gives birth to a child. But here, since we are a seamen’s hospital, in many cases the hus-band cannot be there to witness (the childbirth or operation). Therefore we must take very good care of the family’ (mental side). That’s another aspect that is different from other hospitals.”

Ma. Elena Gysrell V. Jiloca, MBA /Executive Secretary・Administrative Director

　“We are continuously improving this hospital, based on the needs of member seamen. We par-ticularly place importance on pre-boarding medical checkups. Recently, there are many seamen with high cholesterol values and blood pressure. We pro-vide care and counseling in advance of the board-ing day so that the patient can improve his health status in time (and be qualified to board the ship). We always place highest priority on responding to AMOSUP members’ requests and providing ser-vices to meet their needs.”

What do you think is necessaryto further improve this hospital?

Flordeliza / Chief Nurse

　“From the standpoint of a nurse, it is important to maintain the system going. There are many sick patients in Philippine and there are not enough nurses to take care of these people. In some hospi-tals, even though there are sufficient nurses, they go home right away when their duty is over. But here, at AMOSUP Seamen’s Hospital, we have a system in place to divert (people) from other sections when a section runs short of staff. I think it is very impor-tant to maintain this kind of system (for facilitating the operation of the hospital).” 　“I also hope that this hospital would become big-ger in size. It wasn’t this crowded before, but re-cently the number of member seamen has increased so much, the hospital is always full of patients. The

staff doesn’t even have time to take a rest. More and more operations are being conducted and (the operation room’s) schedule is always full. Some of our patients had to be transferred to other hospitals because there were too many people on the wait-ing list. These patients are sent back (to AMOSUP Seamen’s Hospital) when anything goes wrong with them. Our outpatients also have to wait for a long time. When I think about the member seamen, who don’t have much time to spare because of their tight boarding and training schedules, I truly wish that we could expand our capacity. We want more beds, too. We even have patients waiting to be treated in the ICU. Patients are kept waiting for their opera-tion and admission into the hospital because there are not enough beds. I can’t help but to hope for a larger capacity.” 　“In addition, doctors attend various conferences and academic meetings to learn about the latest therapies. I think nurses, too, need to do the same. If nurses had the ability to explain to patients (about their pathological conditions and ways to address those conditions,) like doctors do, then the patients could be relieved from their concerns sooner. Not only the doctors but nurses and administrative staff, too, must continue to develop their skills, knowledge and experience without getting satisfied with their present status. For example, we collect the latest knowledge on HIV and other issues every day. It is important to accumulate and convey such knowl-edge (including information such as where they can get a HIV testing etc.) to the seamen to help them hedge health risks in advance. We hope to regularly hold lectures for seamen perhaps once or twice a month.”

San Juan / Senior Resident Physician

　“The most frequent surgical operation done on seamen is the surgery for gallstone removal. Cur-rently the procedure can be performed using an endoscope, so it is of smaller burden on the patient’sbody, and they can leave the hospital in 24 hours after the operation. Unsurprisingly, the seamen’sdiet is not well balanced on board a ship, with lim-ited intake of fresh vegetables and increased in-take of meat, beer and salt, which are factors that can induce the formation of gallstones and kidney stones. (Seamen are) in need of counseling on vari-ous aspects of health including self management of physical conditions and dietary habits. We hope to increase that kind of opportunities.” 　“We always need to continuously update our fa-cilities. The ultrasonic scanners to start with, but facilities need to be updated and upgraded in all our departments. Right now, (we don’t have enough ultrasonic scanners and expecting mothers) are waiting to get a checkup. Some people can’t evenget treated because they have to wait for sonogra-phy. People have to make an appointment one week in advance to get an ultrasonic examination.”

Not only the AMOSUP Seamen’s Hospi-tal but many other public hospitals are also suffering from insufficient capacity and facilities. Are there any measures that could be taken to mitigate the sit-uation?

Flordeliza / Chief Nurse

　“Many inpatients are here for surgical operations. We have introduced endoscopic operations 4 years ago, which has greatly contributed to reducing patients’ stay at the hospital. If (surgical operation techniques could be improved) in all departments, I think that would help a lot (in mitigating patient congestion).”

San Juan / Senior Resident Physician

　“The best thing we could do is to enhance train-ing for both doctors and nurses so that medical procedures can be carried out more quickly, which will help (mitigate the congestion). Patients come from Cebu Island (to AMOSUP Seamen’s Hospital Manila), due to various reasons including the lack of medical facilities in Cebu. It’s always crowded dur-ing the evening hours. Some of the facilities that we have, like the MRI, is only available here (at the Ma-nila hospital), which is another reason that we are attracting so many patients. So, it’s really important that we speed up the procedures by upgrading our skills through training.” San Juan/Doctor, Flordeliza/Chief Nurse, Jiloca/

Executive Secretary

interview−

“To mitigate the continuous congestionBoth the doctors and nurses are working to develop their skills, knowledge and experience to be able to mitigate the situation”


　“If healthcare and welfare were enhanced to pro-tect seamen’s and their family’s health, the seamen could commit themselves to work with peace of mind, which in turn would contribute to the devel-opment of Philippine economy.” 　Dr. Conrad F. Oca, President of AMOSUP, ex-plained the purpose of why AMOSUP, a seamen’s labor union, should operate hospitals for seamen and their family. Moreover, Dr. Oca doesn’t forget to pay respect to retired seamen who have contributed to Philippine and seamen society over many years.

“We also operate an action slip system to support retired seamen. We issue a treatment slip for indi-vidual retired seamen upon application, so that they can receive care at the Seamen’s Hospital. Those seamen who have worked over 20 or 30 years are eligible for this service. This is part of our efforts to enhance seamen’s welfare.”　President Oca’s perspective goes even further. He aims to launch additional projects to aggressively diversify services and enhance the healthcare and welfare of seamen.

Specifically speaking: ⑴ AMOSUP plans to provideinsurance coverage up to 20,000 peso per year for healthcare provided to member seamen and their family outside of the Seamen’s Hospitalthrough collaboration with insurance companies. AMOSUP will pay the insurance fees to the insur-ance company on behalf of its members; ⑵ The “sat-ellite clinic project” aims to provide healthcare to seamen and their family who have difficulty in vis-iting the Seamen’s Hospital because they live in areas far away from Manila such as the northern part of Luzon Island. AMOSUP and existing general hospitals in these areas will form partnerships to provide healthcare to seamen and their family who live in these areas. These two projects have already started. Specifically, a satellite clinic pilot project has already been launched in Dagupan City since February 2013. After one year of pilot operation, in February 2014, AMOSUP will consider expanding this project to other areas of the Philippines based on the outcomes of the pilot project. 　The following is an interview with AMOSUP

President, Dr. Conrad F. Oca, who is committed to improving the working environment and welfare of Philippine seamen, following his father’s will to “en-hance healthcare for seamen, regarding the future prospects of the Seamen’s Hospital.”

First, could you tell us about thehistory of AMOSUP Seamen’s Hospital?

　“At first, AMOSUP established a clinic, the Rober-to S. Oca Workers Clinic (RSOWC) in South Harbor, Manila’s port area, in June 1978. In honor of RobertoS. Oca, (Philippine trade union leader and elder brother of the late Captain Oca (Gregorio S. Oca, founder and former President of AMOSUP) and uncle of current AMOSUP President, Dr. Conrad F). Oca. That was the start of our Seamen’s Hospital. At that time, RSOWC was a small outpatient clinic with only 5 to 6 beds. In February 1980, the clinic expanded into a general hospital with 50 beds. In addition to the existing internal medicine, dentistry and laboratory (for research and examination) de-

Conrad F. Oca,President of AMOSUP

“Insurance coverage for healthcare provided outside of Seamen’s Hospitalthrough collaboration with insurance companies”

“Partnering with existing hospitals in Dagupan City,launch of local satellite clinic pilot project” Aggressive activities

to diversify and enhance services for seamen and their family

Key Person Interview


partments, the hospital newly established surgery, obstetrics and gynecology departments and an in-tensive care unit (ICU). It was certified as a Tertiary Level (highest rank) general hospital by the Philip-pine government.　With the increase of AMOSUP member sea-men, however, the number of patients eventually increased to a point that the existing capacity became insufficient to accommodate the patients. AMOSUP constructed a new hospital with over 100 beds at Cabildo Corner, San Jose Street in Intramu-ros (construction was started in June 1985) and the Seamen’s Hospital was relocated to its current loca-tion in February 1987. However, only the AMOSUP members living near Manila (on Luzon Island) can come to the hospital. Therefore we decided that sea-men’s hospitals need to be built on Visayan and Mindanao Islands, too, where many seamen’s homes are. Thus additional Seamen’s Hospitals were es-tablished in Cebu (April 1997), Iloilo (June 2005) and Davao (August 2008).

As a labor union, why did AMOSUP de-cide to build and operate a hospital by itself? What was the momentum behind the decision?

　“At the time (our hospital was first established 1978), the Philippines did not have an adequate social security system, although I must say it still doesn’t. It was difficult for common people to get medical care on their own (since that time,) because people had to pay the entire cost for the care, which was very expensive. Seamen (were employed for fixed terms, and) during periods that they could not get a job on board a ship, any money they earned was used up for living expenses and could not afford to pay for healthcare expenses. Deeply concerned about this situation, Captain Oca (Former President of AMOSUP) tried to improve the situation by cre-ating a hospital in the port area for seamen and their family. So that was the starting point of our hospitals.”

What is the significance or purpose for AMOSUP to build and operate the Sea-men’s Hospital by itself?

　“One key point is that medical cost is very expen-sive in the Philippines. To give an example, if a per-son is employed by a company and that company has a health insurance policy, then the employee will be covered to a certain extent by health insur-ance, but if he is employed by a company without any health insurance, then he must pay for all the medical expenses by himself. While this is not a problem limited to seamen, if seamen and their fam-ily’s health are protected with decent healthcare and welfare systems, Philippine seamen could commit themselves to work in peace of mind, which in turn would contribute to the development of Philippine economy.”　“We also have a special action slip system to provide service to retired seamen. In principle, AMOSUP Seamen’s Hospital only provides (free) healthcare to incumbent members. However, there are cases where retired seamen are not paying for social security fees and cannot get medical care. These retired seamen may be in need of care be-cause they have hypertension or perhaps because their family member needs operation. In such cases, we issue a treatment slip, a pink-colored slip card, upon application (and review,) to allow these people to receive treatment at AMOSUP Seamen’s Hos-pital. I’ll accept and review the applications. Those retired seamen who have contributed as AMOSUP members over extended years are eligible for this system. If it is really necessary, not only incumbent AMOSUP members but also other people including AMOSUP employees and their family can receive treatment by making applications. People who make use of this pink slip are increasing in recently. Those seamen who have worked over 20 or 30 years are eligible for this service. This is part of our efforts to enhance seamen’s welfare.”

AMOSUP Seamen’s Hospital is a won-derful endeavor and an extremely im-portant facility for promoting the health and welfare of seamen. However, what do you think is necessary to make it an even better hospital than it is now?

　“The (four) AMOSUP Seamen’s Hospitals are all general hospitals but not all areas of health treat-ment are covered in all four hospitals. For example, one of our hospitals has a gastric camera, but it doesn’t have endoscopy equipment to remove gall stones. In such cases, that hospital has to refer its

patients to another hospital (for endoscopic opera-tion). In such cases, the seaman used to be required to pay by himself (for the endoscopic operation), but we now have introduced a new insurance system. AMOSUP has entered collaboration with an exter-nal insurance company to provide supplemental coverage for healthcare cost of up to 20,000 peso (approximately 46,000 yen) per seafarer and his fam-ily per year. AMOSUP has now built a nation wide network with insurance companies to cover (the expenses of healthcare provided to member seamen and their family outside of the Seamen’s Hospitals). AMOSUP pays the insurance fees to the insurance company on behalf of its members.”　“Another new project is being implemented right now. There are currently four AMOSUP Seamen’s Hospitals (Manila, Cebu, Iloilo, Davao) in the Philip-pines. Among these four areas, Luzon Island, partic-ularly the area around Manila, supplies the largest number of seamen. Approximately 40% of the 95,000 AMOSUP members live in the area around Manila and other places of Luzon Island. Hospitals at Iloilo and Cebu cover the seamen in the Visayan Islands and the hospital at Davao covers those in Mindanao. While there are many member seamen who live in the northern parts of Luzon Island (as well as the area around Manila), it is difficult for them to visit the hospital in Manila because it’s too distant. Therefore we have launched a pilot project for es-tablishing a satellite clinic in Dagupan City. This is a project to form a partnership with an existing large hospital (in Dagupan City) so that seamen and their family who live in these areas can receive health-care for free at this partner hospital. Member sea-men and their family can receive surgical operations and be admitted to this hospital if they wish. De-pending on the outcomes of this pilot project, which has started in February 2013, we may expand it across the Philippines. After one year of pilot opera-tion, AMOSUP will decide whether to expand it or

not, based on (members’) needs and benefits. Dagu-pan City is the first site for trying out this satellite clinic system. It will make it easier for us to spread the system to other cities if it turns out to be suc-cessful in Dagupan. At present, the patients must travel over (to distant AMOSUP Seamen’s Hospi-tals), but this project aims to bring healthcare closer (to where the patients live). At this point, we do not have a clear image or target as to how many (satellite clinics) will be established in the future. All I can say right now is that the target will be just as much as is necessary for AMOSUP members. Right now, we have the four AMOSUP Seamen’s Hospitals lo-cated in Manila, Cebu, Iloilo and Davao, as well as a new satellite clinic in Dagupan City. There are many more remote areas, for example Bohol Island, where a number of member seamen live. We will es-tablish satellite clinics in areas (where many seamen live but) without sufficient access to healthcare.”

Assumed the position of Hospital director of Manilabefore assuming the position of the president of AMOSUP

≪ Spotlight ≫　Among the 150 doctors that work at AMOSUP Seamen’　s Hospital Manila night and day, there is one Japanese doctor. His name is Shoei Yoshida, a 37 year-old, quarter Japanese-Filipino born in August 1976. He is a true multi-lingual who speaks native Japanese, English and Tagalog because he “spent 5 years in Japan during elementary school and went to a junior high for Japanese students in Manila.” 　He is undergoing specialization training (specialized clinical training course) at AMOSUP Seamen’s Hospital Manila to become a specialist doctor in family medicine (comparable to a “general physician” in Japan) with an aspiration to “become a doctor who supports community healthcare.” He will complete his 4-year family medicine training in April 2014 and make it as a specialist doctor. “I visit the Japanese Association Manila Medical Clinic (operated by the Japan Overseas Medical Fund) in Makati 2 to 3 times a week to see Japanese patients” said Dr. Yoshida. He takes care of not only Philippine seamen but Japanese residents in the area, too. Dr.Yoshida/Family Doctor

Dr. Conrad F. Oca　Born in June 1963 and aged 50 years old. He assumed the role of AMOSUP President in November 2010, upon the death of his father, Gregorio S. Oca (Captain Oca), who was the founder and former president of AMOSUP. He himself is a licensed medical doctor who studied in the University of the East Ramon Magsaysay Memorial Medical Center (UERMMMC). He used to serve as the hospital director of AMOSUP Seamen’s Hospital Manila prior to becoming the AMOSUP President. While he was a medical student at UERMMMC he used to be fellow students with Dr. Teodosio F. Alcantara and Dr. Richard John C. Pecson, the directors of AMOSUP Seamen’s Hospital Cebu and Davao, respectively.


　Cebu is the second largest city in the Philippines, located 600 km south of Manila, the capital. It can be reached by a one-hour flight from Ninoy Aquino International Airport. The Mactan-Cebu Internation-al Airport is located in Lapu-Lapu City on Mactan Island, off the coast of Cebu Island. Lapu-Lapu City and Cebu City are connected with two bridges, so it’s only a 30 minutes’ drive from the airport to the center of Cebu City. In the Southern Visayan region of central Philippines, Cebu City and Lapu-Lapu City, together with 6 other neighboring cities includ-ing Mandaue, Toledo and Talisay form the Metro Cebu megacity area with a population of about 2.5 million, second largest to Manila. It is a beach resort area and a popular destination for Japanese honey-mooners, so the name Cebu is familiar to Japanese people, too. 　The area was conquered in 1565 by Miguel López de Legazpi, the first Governor General of the Span-ish Colony. Cebu was the first Spanish colonial city established in the Philippines, even older than Ma-nila. Cebu was the capital of the Spanish colony for the 6 years until Manila was colonized in 1571. Per-haps it is the legacy of the long colonial history that the people of Cebu are particularly devout Roman Catholics among the people of the Philippines where Christians account for 90% of the population. You will find numerous Roman Catholic churches on the streets of Cebu, which is not only the hub of com-merce, trade and industries but also the center of culture and religion in central Philippines from the Visayan to Southern Mindanao region.　AMOSUP established the Seamen’s Hospital Cebu in April 1997 (construction commenced in July 1994). It was the first seamen’s hospital to be built outside of Manila (Seamen’s Hospital Manila was first built in 1978). The central Philippines including Cebu is a massive labor pool of seamen supplying approximately 15,000 AMOSUP mem-ber seamen and an area with extremely high de-mand for the welfare and healthcare of seamen and their family. We visited AMOSUP Seamen’sHospital Cebu which treats over 200 outpatients ev-ery day.

Over 100 medical staff includingdoctors, nurses andmedical employees

Total floor area 3,500 ㎡　Number of beds 60　

Round-the-clock operation

　AMOSUP Seamen’s Hospital Cebu is located on Camino Vicinal Street, Umapad in Mandaue City which is north-east to Cebu City in Southern Vi-sayan Region of central Philippines. It is 4 km, a 10 minutes drive from Mactan-Cebu Airport. It was opened in April 1997 (construction commenced in July 1994), second oldest to AMOSUP Seamen’s Hospital Manila, and the first seamen’s hospital built outside of Manila. The total floor area is 9,051㎡ when combined with AMOSUP Sailor’s Home Cebu, AMOSUP’s accommodation facility for the welfare

o f seamen , which stands adjacent to the hospital. The hospital stands on a premise of 2,517㎡ and has a floor area of 3,534㎡ (1st floor 1,504㎡, 2nd floor 1,015 ㎡, and 3rd floor 1,015㎡), a standard size among the four AMOSUP Seamen’s Hospitals. 　The to ta l num-ber of staff is 166, of which 106 are medi-cal staff and 60 are non-medica l staf f . Break down of the medical staff is: 19 consultant doctors, 2 resident doctors, 9 family medicine physicians, 4 dentists, 5 radiation technolo-gists, 12 pathology researchers and tech-nicians and 55 full t ime nurses . Non-medical staff include 15 staff members in

the administrative, accounting and human resource sections, 3 pharmacists, 5 staff members for medi-cal records management, 9 dietary (health manage-ment) managers, and 1 dental assistant. There are also employees in charge of the adjacent AMOSUP Sailor’s Home Cebu/Sports Complex, engineers and staff members who do maintenance works, AMO-SUP employees managing the pension fund, etc. and store staff of “Slop Chest,” a mini supermarket located within the facility. 　Outpatients are accepted from 8:00 to 17:00 on Monday through Friday and just during the morn-ing on Saturdays. The work hours for the adminis-trative section are the same. However, doctors are on call around the clock and so are the nurses on three shifts (7:00-15:00, 15:00-23:00, 23:00-7:00). The hospital has 60 beds for inpatients.

Over 200 outpatients a day and 900 operations a year

(including child delivery) 64-slice CT scanner transferred from

Seamen’s Hospital Manila

　Medical departments of AMOSUP Seamen’sHospital Cebu include general internal medicine, general surgery, obstetrics and gynecology, ophthal-mology and otorhinolaryngology, pediatrics, pathol-ogy/medical examination, anesthesia, radiology, out-patients and emergency medicine, general dentistry, pharmacy, and family medicine (first visit/general practice). In addition, it also offers dietary (health management) counseling, emergency services as a general hospital. The average number of outpatients visiting the hospital per day is approximately 200 with 30/day at the dentist and 150-180/day for the rest of the departments. The average number of in-patients is about 20/week and average stay of inpa-tients is 4.6 days/patient. Operations are in principle conducted twice a day and 3-4 cases per day. 613 surgical operations were conducted in 2012 and 250 child deliveries take place annually, totaling around 900 operations a year.　Characteristic with regard to equipment and fa-cility is that it is equipped with a CT scanner and

a mammography device that are not introduced at the Seamen’s Hospitals in Davao and Iloilo. The single slice CT scanner that was introduced in 2005 was replaced in October 2013 with a Japanese- made 64-slice scanner that had been used at AMO-SUP Seamen’s Hospital Manila. However, Seamen’s Hospital Cebu does not have a magnetic resonance imaging (MRI) scanner, (which can only be found at Seamen’s Hospital Manila). 　AMOSUP Seamen’s Hospital Cebu has been certi-fied as the Secondary Level general hospital (as it includes all departments except rehabilitation) by (the Department of Health (DOH) of) the Philippine government, and therefore is qualified to accept internship students. Graduates of medical gradu-ate schools (4-year graduate course specializing in medicine after finishing a regular four-year college) must undergo a “post graduate internship (PGI)” before they can take the national exam for medi-cal practitioners. Since three years ago, Seamen’sHospital Cebu has been accepting 3 to 4 trainees a year (mainly in family medicine), including PGI train-ees as well as specialist residency trainees who are being trained to become a specialist doctor through a 3 to 4 year residency after acquiring a medical license (the period depends on the specializing de-partment). 　Like the other AMOSUP Seamen’s Hospitals, Seamen’s Hospital Cebu, in principle, offers care to only AMOSUP members and their family mem-bers. Emergency patients, however, are accepted 24 hours 365 days. Care provided to emergency pa-tients that are not an AMOSUP member is limited to emergency treatment, and they will be trans-ferred to a nearby private or public hospital when their conditions become stable. All AMOSUP mem-bers and their family members can receive all treat-ment for free including the prescribed drugs. This free-of-charge healthcare service covers the member seaman himself, his parents and brothers/sisters aged 18 or below and unmarried in the case when the member seaman is not married, and the sea-man himself, his spouse and his children aged 18 or below in the case when the member seaman is mar-ried. Patients are required to show their AMOSUP

ID card and seamen’s booklet for member seamen himself, and a dependent’s ID and latest payment slip for family members, in order to receive health-care for free. 　The hospital is a three-story building with an open ceiling space at the center of the building. The outpatient departments are arranged on the first floor. Upon entering the entrance, you see in anti-clockwise order from the right, the pharmacy, pay desk, pediatrics, surgery, internal medicine, emergency room, laboratory, ophthalmology and otorhinolaryngology, radiology, obstetrics and gy-necology, dietary (physical condition) counseling room, and then the staff cafeteria and administration office. The radiology department is equipped with a Japanese-made 64-slice CT scanner, which was transferred from the Seamen’s Hospital Manila in October 2013, X-ray scanner, portable X-ray scan-ner, mammography scanner and ultrasonic devices. On the second floor are the operation room, labor and delivery rooms, recovery room (for post-oper-ation recovery) and a nurse station as well as the female ward. The family medicine (general practice) department, pediatrics ward, male ward, isolation rooms, a conference room, intensive care unit (ICU) and a chapel are arranged on the third floor. The el-evator used within the hospital has been donated by a Dutch maritime transport operator, Stolt-Nielsen Limited.

AMOSUP Seamen's Hospital Cebu

Opened in April, 1997

Cebu

AMOSUP SEAMEN’S HOSPITAL CEBUThe first seamen’s hospital to be built outside of Manila (opened in April 1997)

Responding to high healthcare demand in an area supplying a vast number of seamen



　Dr. Alcantra was born in Manila in January 1966 and aged 47. He also serves as the manager of the AMOSUP Sailor’s Home Cebu, an accommodation facility for the welfare of seamen, adjacent to the hospital. He studied in the University of the East Ramon M　agsaysay Memorial Medical Center (UERMMMC) during 1987 to 1992, where he was a fellow student and a good friend of the current AMOSUP President, Dr, Conrad F. Oca. In 2002, he came to Cebu as a pediatric doctor. He became a doctor because he “wanted to save the lives of small children.” Not only Dr. Alcantra but Dr. Richard C. Pecson, Director of AMOSUP Seamen’s Hospital Davao, was also President Oca’s fellow student at UERMMMC. 　Mr. Gonzales, Hospital Administrator, was born in March 1972 and aged 41. He was born and raised in Cebu, and he has been working as administrative staff at AMOSUP Seamen’s Hospital Cebu since the preparation stage before it opened. He is also the administrator of AMOSUP Sports Complex and Co-Administrator of the Sailor’s Home. 　Dr. Alcantra pointed out as one of the character-istics of AMOSUP Seamen’s Hospital Cebu, that “it maintains an advanced management system that has been accredited by the Philippine government

(PhilHealth) and Det Norske Veritas (a Norwegian classification society).” Meanwhile, Mr. Gonzales commented that “we want to enhance health pro-grams for member seamen and their family through collaboration between the hospital and its adjacent Sports Complex, because after all, our ultimate goal is to reduce the number of our patients by making everyone healthy.” 　Below are our interviews with these two men

who watch over of the health of Philippine seamen supporting the safe operation of Japanese merchant fleets, through the operation of the hospital in cen-tral Philippine Cebu.

What are the characteristics ofAMOSUP Seamen’s Hospital Cebu?

Dr. Alcantra / Hospital Director


　Ms. Lingaro, the ward supervisor at AMOSUP Seamen’s Hospital Cebu, who manages the nurses

and other hospital staff, pointed out that, in addition to upgrading the medical facilities of the hospital,

“each member (of the hospital staff) from the top management to ordinary workers should think what needs to be done to make (the hospital) better.” She thinks that it is important that everyone working at the medical front maintains their motivation to con-tinue to improve in their own area of assignment. Below are our interviews with two nurse leaders of AMOSUP Seamen’s Hospital Cebu.

Jubeth Palmas S. Lingaro, RN, MAN /ICU − Ward Supervisor

　“I joined this hospital in November 1999, ever since, I have worked here for over 14 years. (The biggest characteristic of this hospital is that) all the doctors and staff are such nice people, not to men-tion that many of them are specialists with sophisti-cated expertise in their own field. Among the many hospitals in the Philippines, Seamen’s Hospital Cebu is equipped with a variety of good facilities. The nurses are committed to training and improving skills. (I’m in a position) to manage (nurses), and I think that the nurses and other staff are all capable

of taking good communication with the patients. Whenever a problem arises, we discuss it among the staff to find a solution. That’s one of the main roles (as a ward supervisor.)”　“(In order to make this hospital even better) in addition to upgrading the medical facilities of the hospital, each member (of the hospital staff) from top to bottom should think what needs to be done for improvement.”

Jussary C. Agustin /OPD-ER Head Nurse

　“(My responsibilities are) to ensure that the nurs-es and the equipment that they use are all in good condition. It includes both desk work and (on-site) supervision. I prepare documents at the administra-tive office and also go round all the sections of the hospital to make sure that everything is operating smoothly.” 　“(The good thing about this hospital is) that it provides such valuable benefit to seamen and their family. I think it’s a really good thing that seamen and their family members can receive healthcare free of charge.” 　“(To make this hospital even better…,) we already have quite a solid lineup of facilities, but I think we could do better, for example, (if we had) a MRI scan-ner (like the one they have in Manila).”

Placed Maria on hospital property

AMOSUP Seamen’s Hospital CebuMedical Director / Administrator InterviewTEODOSIO F. ALCANTRA MD, MBA, FPPS

“Maintains an advanced management system that has been certifiedby the Philippine government and ISO by Det Norske Veritas

(a Norwegian classification society)” LEE JOSEPH Y. GONZALES　MAHAd　

“Our ultimate goal is to reduce the number of our patientsby making everyone healthy”

Lingaro/Supervisor, Agustin/Head Nurse

interview−

Gonzales/Executive Secretary, Alcantra/Hospital Director

“The important thing is that each member of the hospital staff from top to bottom thinks what needs to be done”


　“We have been certified as a Secondary Level hospital by the Philippine government (Depart-ment of Health). In addition, we have also been certified to ISO’s management system standards (ISO9001: 2008) by Det Norske Veritas AS (a Nor-wegian classification society). These can be pointed out as our characteristics. We obtained certification from DNV in July 2010, not just for Seamen’s Hos-pital Cebu, but for the whole AMOSUP Seamen’sHospital organization including Manila, Iloilo and

Cebu. This means that if there is one hospital that does not meet the standards, all the rest of the hos-pitals could not be qualified for the certification. So we’re always (managing the hospital) with a sense of tension. All the four AMOSUP Seamen’s Hospi-tals (including Manila, Cebu, Iloilo and Davao) use the same management system. DNV certified us based on the recognition that the Seamen’s Hospital is a maritime organization, too.” 　“Needless to say, we are subject to PhilHealth (national health insurance system of the Philippines). But PhilHealth only covers 25-30% of the medical costs and the remaining 70% or more must be borne by the patients. At the Seamen’s Hospital, however, all member seamen and their family members can receive healthcare for free. That’s another distinct characteristic. (The costs) covered by PhilHealth can be appropriated to doctor fees, so we can enhance hospital operations.” 　“Government certification for PhilHealth is re-newed every year, so we must undergo screening

and review each year (to check whether we meet certain standards as a facil-ity subject to PhilHealth). Seamen’s Hospital Cebu is classified as a Secondary Level hospital (among the three-tiered government classification system). (One of the key criteria to be-come a Secondary Level) hospital is whether there is an intensive Care Unit (or not). (And Cebu has it.) To become a Tertiary Level (highest rank) hospital, you must have a rehabilitation department, but at pres-ent, only Manila has this department among the four AMOSUP Seamen’sHospitals, and that’s why Manila is the only one clas-sified as Tertiary Level. While DNV certifies all (the affiliated AMOSUP Seamen’s Hospitals) as one organization, (government certification for) PhilHealth

is obtained on an individual hospital basis.”

This hospital is playing an important role in enhancing the welfare and healthcare of seamen. What do you think is neces-sary to further improve this hospital?

Mr. Gonzales / Administrative Director　“Medical technologies are constantly advancing. A 64 slice CT scanner arrived at this hospital in Oc-tober (2013). Before this scanner arrived, which had been used at Seamen’s Hospital Manila since 2007, we have been using a rather conventional single slice scanner since 2005. It is essential to continue upgrading our medical facilities in order to provide high quality care. For example, the video scope that we currently use for surgical operations is a digital device with good resolution. There are 3D equip-ments available for surgical operations now. Tech-nology is constantly evolving and we would like to keep up with that progress, but obviously, we have (budgetary) constraints.” 　“We are running family health programs in col-laboration with the Sailors’ Home Cebu and Sports Complex, including programs for children, wives and the seamen himself. We provide basketball classes (capacity of 80 participants) and swimming classes (capacity of 180 participants) (at the Sports Com-plex). We also have cooking classes for housewives and seminars for healthy cooking instructed by the hospital’s dietician. These programs are designed to

promote health communication within the family. If the whole family including the children can attend our programs together, (family members) would be-come more aware of each other’s health conditions, which would be most effective in promoting health. We are advantageous in that we have the Seamen’sHospital, the Sports Complex, kids’ room, and ac-commodation facility (Sailors’ Home) all together on one premise, as well as a variety of health building facilities and equipment. We want to further en-hance health programs so that everyone in the fam-ily can become healthy. After all, our ultimate goal is to reduce the number of our patients by making everyone healthy.”

Newborn Intensive Care Unit

Pediatric ward

DNV Business Assurance ManagementSystem Certificate

PhilHealth Certificate for Philippines health insurance

Wait for their initial consultation

CT Scan 64 Slice, transferred from Hospital Manila

Built in open ceiling structure

3 Units in dentistry

Nurse station


　500 km south, about an hour’s flight from the cap-ital Manila, Iloilo is located on the southern coast of Panay Island in the West Visayan region of central Philippines. Its state capital, Iloilo City has a popu-lation of approximately 420 thousand (as of 2007), the 9th largest city in the Philippines. More of the lush green is left unspoiled in this city compared to larger cities like Manila, Cebu and Davao. The lo-cal government unit for providing public services is based in Metro Iloilo encompassing five surround-ing towns (Leganes, Oton, Pavia, Santa Barbara, and San Miguel as well as Iloilo City,) which together has a population of 650 thousand. The state of Iloilo has a population of 1,560 thousand. Metro Iloilo is positioned as the political and economic center of the Western Visayan region of central Philippines. It is also known as a center of education and cul-ture, with a branch campus of University of the Philippines (UP), the top ranking University in the Philippines, and five other prestige universities. The people in this area are said to be well educated and have a relevantly higher command of English compared to other areas of the Philippines. This may be one of the reasons why this area provides abundant seamen who are qualified to work in the international arena. This area has achieved signifi-cant economic growth in recent years driven by the rapidly growing construction demand in the Philip-pines. High-rise buildings are gradually increasing in this area, too. 　Iloilo is an important supply base of international seamen and home to the second largest number of AMOSUP members next to Manila. AMOSUP Sea-men’s Hospital Iloilo is located on the site of an old private residence on Onate Street, Mandurriao, Iloilo City, a 20 minutes drive (14 km) from Iloilo Airport. It was opened in June 2005 (construction began in

February, 2004) to support the health and health-care of seamen and their family in the West Visayan region of central Philippines, covering from Iloilo, Antique, Capiz and Aklan states on Panay Island to Bacolod City on Negros Island and Guimaras Island. The hospital has an annual consultation of more than 27,600, which means an average of more than 100 consultations a day. We visited AMOSUP Sea-men’s Hospital Iloilo striving to respond to a sharp increase in healthcare demand.

Purchased and rebuilt an old private residence into a hospitalTotal site area 2,750 ㎡

Compact in size compared to otherAMOSUP Seamen’s Hospitals24 doctors; 35 nurses; 45 beds

　AMOSUP Seamen’s Hospital Iloilo is located on Onate Street, Mandurriao, Iloilo City, the state capi-tal of Iloilo on the southern coast of Panay Island in the Western Visayan region of central Philippines. It is about a 20 minutes drive from Iloilo Airport, which is 450km south, an hour’s flight from Manila Airport. AMOSUP purchased a property that used to be a private residence and rebuilt the existing building into a hospital. The site area is 2,750㎡ rela-tively compact in size compared to other AMOSUP Seamen’s Hospitals. The building is three stories high and has a floor area of 2,655㎡ . 　There are 9 full time doctors, 13 consultants, and 2 dentists, a total of 24 medical doctors working at the hospital. Other medical staff includes 35 nurses, 2 surgical assistants, 1 dental assistant, 8 pathologi-cal laboratory staff, 2 radiological technologists, 2 health examiners and 4 pharmacists. In addition, there are 10 administrative staff and 9 staff mem-bers in charge of maintenance of the building. Out-patients visit the hospital during 8:00-17:00 on Mon-days to Fridays and 8:00-12:00 on Saturdays. The total number of beds in the wards is 45, with 8 to 10 beds on each floor and some other in the intensive care unit (ICU), isolation room and operation waiting room.

General hospital with 28,000annual patients

Surgical operations on Mondays and Thursdays, over 600 operations a yearDental treatment equipment, X-ray ma-chine, blood testing equipment, etc. do-nated from All Japan Seamen's Union

　Medical departments of AMOSUP Seamen’s

Hospital Iloilo include general surgery, general pedi-atrics, anesthesia, internal medicine, cardiac surgery, dermatology, obstetrics and gynecology, ophthalmol-ogy and otorhinolaryngology, pathology/medical ex-amination, general dentistry, radiology, psychological counseling, dietary (health management), pharmacy, and emergency medicine. It is the largest general hospital in the area, but it does not have a family medicine department (comparable to a “first visit department” or “general physician” in Japan). An array of medical equipment, including the treatment equipment in the general dentistry department, the X-ray machine in the radiology department, and the blood testing equipment in the pathology/medical examination department, have been donated from All Japan Seamen's Union, as with the Seamen’s Hospital Davao. 　Usage data of Seamen’s Hospital Iloilo for 2012 was: number of total annual outpatients 27,632 (daily average 103.63 patients/day); number of admitted inpatients 1,322 (daily average of 3.63 patients/day); number of discharged inpatients 1,289; number of annual patients at the dentist’s (including checkups) 5,498 (daily average 17.45 patients/day); number of annual patients at the radiologist’s 3,782 (daily aver-age 10.36 patients/day); number of annual patients at the pathological examination department 13,141 (daily average 31.57 patients/day); number of an-nual surgical operations 606 (surgical operations are conducted on Mondays and Thursdays); number of child delivery 236. Usage rate of the Seamen’s Hos-pital is very high relative to the population of Iloilo City, suggesting that the healthcare demand is par-ticularly high among seamen and their family. 　As with the other Seamen’s Hospitals, Seamen’sHospital Iloilo offers care exclusively to AMOSUP members and their family members. Emergency

Hospital with abundant nature Genaral hospital in neighboring hospitals


AMOSUP SEAMEN’S HOSPITAL ILOILOAMOSUP Seamen's Hospital Iloilo

Opened in June 2005, to support the health and healthcare of seamenand their family in the Western Visayan region of central Philippines,

the second largest supply area of Philippine seamen


　All the nurses of AMOSUP Seamen’s Hospital Iloilo uniformly noted insufficient capacity and the need to enhance the medical facilities of the hos-pital. Although the medical facilities of AMOSUP Seamen’s Hospital Iloilo is much better than nearby public and private hospitals, further enhancement of the facilities is a pressing issue, given the surging demand for healthcare and the numerous patients that come flocking to the hospital every day. While the AMOSUP Seamen’s Hospitals in the other ar-eas have welfare facilities for accommodation andsports activities established on the same premise,Seamen’s Hospital Iloilo does not have any of those adjunct facilities due to space constraints. We inter-viewed three nurses, the chief nursing officer, the assistant chief nurse, and the supervisor. All three of them said they were familiar with how seamen feel and think, because they have a father, husband or a brother, who is a sailor.

Romelyn P. Matutina, RN. MAN/OIC, Chief Nursing Officer

　“(I) have two elder brothers and they are both seamen. As a matter of fact, my eldest brother is an AMOSUP member. So I know a little about seamen.(I am positioned) above the supervisor to manage all the nurses. For example, I pay attention to where they are working or whether they are insufficiently allocated. It has been four and a half years since I joined this hospital. I used to work in a private hospital (as a nurse), but now I am on the manage-

ment side and my responsibilities have changed from when I was an ordinary nurse. It is hard to say which is better, but one thing I can say is that (AMOSUP Seamen’s Hospital) provides better ser-vice to the patients, which (I am) very proud of. We sometimes ran out of medicine and other stock at the hospital I used to work for before, but that never happens here.” 　“Ten years from now? … (I)’d like to study about management and set up a research department (in the hospital). I’d also like to see a training center for nurses. That would help us provide better healthcare.”

Precious Anne Sencida /OIC, Assistant Chief Nursing

Officer

　“I’ve been working in this hos-pital since 2007. (My) father is a seaman, so I think I know how to communicate with seamen. This kind of a system (where members and their family members can re-ceive healthcare free of charge) is something that cannot be found in other hospitals, and I think it is of a huge benefit to seamen.” “(Ten years from now) I wish there was a facility for training nurses in the hospital. (I) wish I could become a

trainer there.”

Nerissa T. Celiz, RN/ Supervisor (Critical Area)

　“My husband is a seaman. I’ve been working here since 2007. (My responsibility is) to monitor the nurses and their working conditions. Other than that, I also manage consumables and inventory of medical supplies. I think the working environment is much better here compared to the hospital I used to work for before.” “(Ten years from now) I hope the facilities and medical equipment of this hospital will be enhanced. I truly feel it’s neces-sary to provide better healthcare. Particularly, I wish there’s a mammography scanner because it is very important (for women’s healthcare).”

patients, however, are accepted 24 hours, 365 days. Care provided to emergency patients that are not an AMOSUP member is limited to emergency treatment, and they will be transferred to a nearby private or public hospital when their conditions become stable. All AMOSUP members and their family members can receive all treatment for free including the prescribed drugs. This free-of-charge healthcare service covers the member seaman him-self, his parents and brothers/sisters aged 18 or below and unmarried in the case when the member seaman is not married, and the seaman himself, his spouse and his children aged 18 or below in the case when the member seaman is married. 　When you walk through the entrance of the hos-pital on the first floor, you will see a large waiting room and a reception desk on the right and a phar-macy on the left. Further left is the general outpa-tient section where patients are asked to measure their temperature, etc. The emergency room, pathol-ogy and blood testing laboratory, dentists’, X-ray room and the staff dining room are allocated on the first floor. On the second floor are the female ward, obstetrics and gynecology ward, two operation rooms, labor and delivery room, recovery room, ICU, doctors’ waiting room and the nurse station. On the third floor are the pediatrics department, isolation room, male ward, nurse station and the administra-tion office. The internal structure of the hospital is very much similar to that of the Seamen’s Hospital Davao. In addition, opinions of Dr. Ryan Ed S. Com-uelo, the hospital director, have been reflected upon building the hospital. 　We happened to visit the hospital on Saturday morning, when the waiting lounge was very crowd-ed with many outpatients. There were particularly many children from babies and infants to elementa-ry school children waiting for their turn, which left a strong impression on my mind. Waiting room

Blood and pathological examination machine. Donated by JSU

3 Units in dentistry, donated by JSU X-ray tomography machine, donated by JSU

Matutina/Chief Nurse, Sencida/Chief Nurse, Celiz/Supervisor


interview−


　Dr. Comuelo and Dr. Liwag were both born in 1967and are aged 46. Dr. Comuelo is a surgeon and Dr. Liwag an obstetrician-gynecologist. Dr. Com-uelo came to know Dr. Conrad F. Oca, AMOSUP President, when he was an intern at the Cardinals Santos Medical Center (in Metro Manila, San Juan City). Dr. Comuelo became to be so deeply trusted by Dr. Oca that he was asked to become director of Seamen’s Hospital Iloilo. Both Dr. Comuelo and Dr. Liwag, the medical and administrative directors of the hospital, pointed out “lack of capacity” as the most important issue concerning the hospital. Sea-men’s Hospital Iloilo cannot build additional welfare facilities for accommodation or sports activities, like the other AMOSUP Seamen’s Hospitals do, due to its limited space. The Western Visayan region is the second largest supplier of seamen next to Manila, with accordingly high healthcare demand by sea-men and their family members. We interviewed the two directors seeking a solution to solve the conflict between surging seamen’s needs and spatial con-straints.

What are the characteristics of AMOSUP Seamen’s Hospital Iloilo?

Dr. Comuelo / Hospital director　“This hospital is responsible for taking care of the seamen and their family who live in the entire West-ern Visayan region, covering not only Iloilo but also Capiz, Antique, and Aklan states (on Panay Island) as well as Bacolod City on Negros and Guimaras Is-land across the strait. Moreover, (the Visayan region is) home to the second largest number of AMOSUP members next to Manila. The fact that there are five famous maritime schools in this region is one of the reasons why this area is a major supplier of (seamen). Over 27,000 consultations in the hospital in a year. There used to be more than 5,000 AMO-SUP members in this area as of 2005, but I suspect the number has grown to exceed 15,000 by now.” 　“Cebu is also an area with many (AMOSUP members). Seamen living in Mindanao go to ei-ther Seamen’s Hospital Davao or Cebu. (Members and their family) living in Cebu don’t come here.

Dr. Liwag / Administrative director 　“This area, Iloilo, used to be a quiet countryside, with no particular economic activity except agricul-

ture and fishery, but now, the number of seamen is growing rapidly. These sea-men send money from overseas to their family in Iloilo, which is driving the area’s economic growth. Even high-rise build-ings are starting to be built in Iloilo City. I guess this region may be the second fastest growing region next to Manila. The foreign money sent from seamen working on the seas of the world is sig-nificantly contributing to the area’s eco-nomic growth. (The main characteristic) of this hospital is that it is a hospital (sit-uated in such a socio-economic setting.)”

How do the member seamen and their family think about the hos-pital?

Dr. Comuelo / Hospital director“There are two public hospitals and four private hospitals in the area, but the cost of healthcare at these hospitals is very expensive. Al-though we have a national medical insurance system (Philhealth) in the Philippines, it only covers 20% of (the healthcare costs) so the remaining 80% must be paid (out of the pockets of the patients). In addition, drug costs are not even covered by insurance. Sea-men get a relatively higher salary (than people in other occupations in the Philippines,) nevertheless, (healthcare cost would still be a heavy burden) on them if they had to go to a private hospital. That’s why (most seamen and their family members) come here whenever they get sick, because (they can re-ceive healthcare here free of charge).” 　Dr. Liwag / Administrative director 　“Regardless of whether the hospital is public or private, only 20% of the healthcare cost is covered by the Philippine health insurance. However, we provide healthcare to all AMOSUP members free of charge, including hospital admission fees and drug costs.” 　“AMOSUP Seamen’s Hospital is very highly recognized for its service quality. For example, a captain of a ship gets good salary. He should have enough money to go to any private hospital if he wishes. But they all come here, because they trust us for our (medical quality). We are particularly highly regarded for our surgical operation facili-ties. Sometimes, non-members who heard about our reputation come here and ask us to perform opera-tion on them. Of course, we have to decline these requests.” 　“AMOSUP Seamen’s Hospital is (highly respected) because everyone concerned, including Captain Oca and Dr. Conrad Oca (current President of AMO-SUP), has always been committed to improving the welfare of seamen.”

Yes, I can see that this is a very nice hos-pital. What do you think is necessary to further improve this hospital?

Dr. Comuelo / Hospital director　“We lack space in our OPD(relative to the number of patients). Daily outpatients exceed 100, but we do not have sufficient capacity to meet this demand.” That’s why our outpatient department sometimes becomes so crowded

Dr. Liwag / Administrative director 　“(The premises adjacent to the hospital) are pri-vate properties and there is no way that we can (expand) the hospital. We really need to expand (our facilities) in order to provide sufficient healthcare service to member seamen. It may be possible to transfer (part of the functions of the hospital) to an-other location, but operation of separate facilities in distant sites would impose too much burden on the management side. Considering this, it is best to ex-pand our facilities to premises adjacent to our pres-ent location, but (these premises are private proper-ties) and there is little chance (that we may be able to acquire them). However, we have not given up the idea of expanding (the facilities). In addition, we

don’t have MRI or CT scanners here. There are many AMOSUP seamen and their families living in this region and accordingly we take care of many patients. Enhancement of the facilities is a pressing issue. We have already proposed about it to Presi-dent Oca. The proposal is under consideration, but the problem is that we can not find an (appropriate) site.”

“First of all, we need land to expand, for the sake of the member seamen. We would also like to build recreation facilities such as a swimming pool and basketball courts (like other Seamen’s Hospitals). Member seamen in this area are longing for that kind of facilities. (Recreation facilities) will help pro-mote exchange and communication with (employers and shipping companies) by holding tournaments and other events.” 　“It would also be nice to have a “Slop Chest*” like they do in Cebu and Manila. They have a Slop Chest within the hospital at Cebu, and one within the same premise at Manila. We wish we had one (at Iloilo, too,) to further enhance the welfare of sea-men. At Slop Chests, you can buy the same goods at much more reasonable price than at ordinary su-permarkets. Seamen are away from their homes for extended periods from 6 to 9 months. During their voyage, there are times when they can’t transfer money to their family in a timely manner. If there is a Slop Chest, it would be of great help at such times, because AMOSUP member seamen’s family will be able to buy daily goods on deferred terms. There is a particularly strong demand for a Slop Chest from seamen’s family (,but we don’t have the space to build one).”

Female surgery ward

Maternity room

Liwag/Execcutive Secretary, Comuelo/Hospital Director

Diagnosis by Dr.Comuelo

AMOSUP SEAMEN’S HOSPITAL ILOILOInterview with the hospital director and the administrative director

(also subspecialty obstetrician-gynecologist) “Lacking capacity to meet the surging healthcare demands”

Ryan Ed S. Comuelo, MD, FPALES, FPSGS / Hospital director 　　　　　　　　 Arnold P. Liwag, FPOGS, FSGOP /　　　　　　　　　　　　　Obstetrician-gynecologist and administrative director

* Slop Chest: A small supermarket or convenience store for AMOSUP members that mainly sells groceries. The primary purpose is not profit but to enhance the welfare of seamen and their fam-ily, therefore, the goods are sold at nearly whole-sale prices, much cheaper than retail market price. In addition, AMOSUP members can pur-chase goods on deferred payment terms, which is a very well-received service among seamen families. There is a Slop Chest attached to the two seamen’s hospitals in Manila and Cebu.


　Davao is the central city of Mindanao region in southern Philippines, located 1,000 km south, about one and a half hours’ flight from the capital Manila. It is the third largest city in the Philippines and an economic and cultural hub of southern Philippines, as well as an important supply base of seamen. Sea-men’s Hospital Davao was opened in August 2008 (construction commenced in November 2007), the latest among the four AMOSUP Seamen’s Hospitals in the Philippines: Manila (opened in 1978, renewed in 1987); Cebu (1997); Iloilo (2005); Davao (2008). It supports the health of seamen and their family in southern Philippines. After building the second sea-men’s hospital in Cebu, AMOSUP was initially plan-ning to build the next seamen’s hospital in Davao, the central city of Mindanao region, in the early 2000’s. However, it decided to defer the plan for a while as terrorist bombings took place sequentially in March 2003 at Davao International Airport and in April the same year at a ferry station in Davao City. Therefore, a seamen’s hospital was built in Iloilo in 2005 before Davao. 　We visited the AMOSUP Seamen’s Hospital Davao, where approximately 100 patients visit a day.

Total site area 10,000 ㎡22 doctors; 44 nurses; 50 beds Dental treatment equipment,

X-ray machine, etc. donated fromAll Japan Seamen’s Union

　“AMOSUP (Gig Oca Robles) Seamen’s Hospital Davao is located on R. Castillo St., Agdao Davao City, which is only a ten minutes’ drive from the Davao International Airport on Mindanao Island, Philippines. Construction of the hospital was com-menced in November 2007, with the support of All Japan Seamen's Union (JSU) and International Mari-ners Management Association of Japan (IMMAJ). It was opened the next year, in August 2008. The dental treatment equipment, the X-ray machine and some other equipment were donated by JSU. 　The total site area is approximately 10,000 ㎡ , al-most the same size as the inner field of Tokyo Dome Baseball Field. The Seamen’s Hospital and AMOSUP-JSU Multi Purpose Center (welfare and accommodation facility for seamen) share the site, using 5000 ㎡ each. The building is a three-storied structure with floor area of 1,650 ㎡ for each story and a total floor area of about 5,000 m2. There are 6 full-time doctors and 16 part-time doctors, a to-tal of 22 medical doctors working at the hospital. Other medical staff includes 27 full-time regular nurses, 4 assistant nurses, and 13 backup nurses (called “relievers”), a total of 44 nurses. The total number of staff including administrative staff is 122, of which 83 are full-time workers, 10 are part-time and 29 are backup staff. The hospital is operated 24 hours, 365 days and the staff members work on three shifts from 7:00-15:00, 15:00-23:00, and 23:00-7:00 (the next morning). Outpatients are accepted from 8:00 to 17:00 on Monday through Friday and just during the morning on Saturdays, similar to most hospitals in Japan. There are 50 beds with 25 each in the male and female wards. Inpatients are admit-ted up to 7 days in principle, but admission may be extended to 30 or perhaps 45 days upon a written

permission from the hospital director, depending on the condition of the patient.

Average of 100 outpatients/day (over 3,000/month), of which 30%

are dentist’s patientsEmergency patients are also accepted (about 7 patients a month on average)

　Medical departments of AMOSUP Seamen’s Hospital Davao include anesthesia, ophthalmolo-gy and otorhinolaryngology, family medicine (first consultation), internal medicine, surgery, obstet-rics and gynecology, and pediatrics. Other de-partments include pathological laboratory, phar-macy, radiology, and dietary counseling (health management) and dentistry. The anesthesia de-partment is capable of performing not only gen-eral anesthesia but spinal anesthesia and epidu-ral anesthesia as well. The surgery department includes orthopedic surgery, pediatrics surgery, and urology sections. It also conducts laparo-scopic surgeries. The obstetrics and gynecology department boasts the latest medical facilities including ultrasonic scanners. The pathological laboratory performs clinical microscopy, blood

General HospitalNew patient consulted by doctor

AMOSUP Seamen's Hospital Davao

Opened in August 2008; the latest among the existing AMOSUP Seamen’s HospitalsLocated in Davao, the third largest city in the Philippines to support

the health of seamen and their family in southern Philippines


AMOSUP SEAMEN’S HOSPITAL DAVAOGIG OCA ROBLES SEAMEN’S

HOSPITAL DAVAO（　　　　　　　　　）


and serum testing, and immunological testing. The dentist offers pharynx and mouth examina-tion. The number of daily outpatients is approxi-mately 100 on average, meaning more than 3,000 a month, of which 70% are general outpatients and 30% are dentist’s patients. In addition, the hospital accepts about 7 emergency patients a month on average. 　In principle, Seamen’s Hospital Davao offers care exclusively to AMOSUP members and their family members. Emergency patients, however, are accepted 24 hours, 365 days. Care provided to non AMOSUP members is limited to emer-

gency treatment, and they will be transferred to other hospital. All AMOSUP members and their family members can receive all treatment for free. This free-of-charge healthcare service cov-ers the member seaman himself, his parents and brothers/sisters aged 18 or below and unmar-ried in the case when the member seaman is not married, and the seaman himself, his spouse and his children aged 18 or below in the case when the member seaman is married. This means that uncles, aunts, and cousins are not covered. AMO-SUP members are deemed as “members” for 6 months after return from a voyage. If more than 6 months pass without getting on a boat as a sea-man, (in other words, without becoming an AMO-SUP member again,) he and his family members will not be subject to the healthcare service any-more, meaning that service will be terminated, in principle, even if the treatment is not completed. 　The structure of the hospital building is very similar to that of Seamen’s Hospital Iloilo. Dr. Comuelo, Director of Seamen’s Hospital Iloilo, provided some advices in designing the building. When you enter the hospital on the first floor, you will see a large waiting room (entrance room) and a reception desk on the right and a dispens-ing pharmacy on the left. Further inside are the general outpatient section (a consulting room and a space where the body temperature, weight, height and vital signs of the patient etc. are mea-sured), radiology department (X-ray room), oph-

thalmology and otorhinolaryngology department, the (staff) cafeteria, administration office, and the dietary counseling room. The nurse station, obstetrics and gynecology department, operation room, labor and delivery room, intensive care unit (ICU), infant and maternal care unit (IMCU) and the female ward are arranged on the second floor. On the third floor are the surgical depart-ment, internal medicine department, male ward, pediatrics, and the dentistry department. There were many patients waiting in the lounge, maybe seamen and their family members, on the day we visited the hospital.

3 Units in dentistry, donated by JSU X-ray tomography machine, donated by JSU. Bonifacio/Radiological Technologists

Emergency Room Operation Room

Male surgery ward

Hospital staff interviewLisette Wendelyn K. Panlilio /

Human Resource Manager

　“I am responsible for human resource manage-ment. I am working on a project to enhance col-laboration between doctors and nurses. I think it is important to build closer collaboration and promote information sharing.”

Maria Corazon V. Tan, RN, MAN /Chief Nurse

　“Nursing is a very tough job and many nurses quit their job. But this hospital offers a nice working environment and good working conditions, so there are few people who quit their job. We have a good boss and good staff, too. I think this is an excellent place to work in for my own personal development and career progress.”

Bianca Mae R. Montojo, MAN, RN /Nurse Supervisor

　“(I) used to work in a public hospital before. I get the impression that all the staff members here in-cluding doctors and nurses are very professional. At a public hospital, one nurse must take care of 20 to 30 patients in most (wards), but here, you take care of just 2 to 3 patients. This environment enables us to provide sufficient care to each and all our pa-tients. I think that’s the greatest characteristic. I wish to continue working here as a nurse even after (I) get married.”

Pia Marie O. Biliran, RN /Head Nurse

　“(I) used to be an English teacher. I studied hard to become a nurse and was lucky enough to get a job here. This is (my) first place to work as a nurse. This hospital has adequate medical facilities and staff to provide good care for the patients. AMOSUP Seamen’s Hospital offers various opportunities and experiences to further develop and improve (my) skills.” Panlilio/Human Resource Manager, Tan/Chief Nurse, Montojo/Supervisor, Biliran/Head Nurse

“Strengthening collaboration between doctors and nurses; 　　　　　　　　delivering better care through information sharing”

“Excellent work environment and medical staff　　　　　　　　　　　　　　　　　　　　　　with professional attitude”

“Experience opportunities to improve skills”

interview−


　Dr. Pecson is the hospital director of Seamen’sHospital Davao and also serves as the manager of the AMOSUP-JSU Multi Purpose Center adjacent to the hospital. He came from Manila in August 2008 when the hospital first opened and has been direct-ing the hospital to date. He was a fellow student of Dr. Conrad F. Oca, current AMOSUP President, at the University of the East Ramon Magsaysay Me-morial Medical Center (UERMMMC) (graduated in 1991). Dr. Pecson and his wife, who is a pediatrician, are devoted to supporting this hospital. Below is our interview with Dr. Pecson who indirectly supports the safe operation of Japanese merchant fleets by taking care of the health of Philippine seamen.

What is the greatest characteristic of AMOSUP Seamen’s Hospital Davao?

　“We did not have an AMOSUP Seamen’s Hospital in the Mindanao region before. So the seamen and their family living in this area had to go all the way to either Manila or Cebu to get healthcare. This hospital was born in response to the strong requests from the seamen of Mindanao to Captain Oca (late Gregorio S. Oca, former president of AMOSUP). Sea-men, who spend long periods out in the sea, are al-ways concerned about their family back home. The health and safety of their family are of utmost im-portance to them. They won’t need to worry about their family so much if there is a hospital nearby that they can rely on. Our hospital was born to respond to such needs, to support the seamen and their family living in Mindanao region. That’s one of the greatest characteristics that define the hospital.” 　“There are four AMOSUP Seamen’s Hospital in the Philippines: Manila (opened in 1978, renewed in 1987); Cebu (1997); Iloilo (2005) and Davao (2008). The Davao hospital was supposed to be built right after Cebu and before Iloilo in the early 2000’s. But be-cause of the serial terrorist attacks in 2003 at Davao Airport and elsewhere, we changed the plan and decided to build the hospital in Iloilo before Davao.” 　“Above all, the most important characteristic is that we provide healthcare service to AMOSUP seamen and their family members free of charge. Family members who are subject to this free-of-charge service are the member seaman himself, his parents and brothers/sisters aged 18 or below and unmarried in the case when the member seaman is not married, and the seaman himself, his spouse and his children aged 18 or below and unmarried in the case when the member seaman is married. So uncles and cousins are not included. Patients are required to show their AMOSUP ID card and seamen’s booklet for member seamen himself, or for example, a marriage certificate for the member’s spouse, in order to receive healthcare for free. AMOSUP members are deemed as “members” for 6 months after return from a voyage. However, we deal with individual cases in a flexible manner. For example, let’s say, a seaman has been an AMOSUP

member for over 20 years, and he has never visited an AMOSUP hospital through these years. One day he happens to fall sick for the first time in 20 years and came to our hospital, but it has been more than 6 months since he got off his last boat. In such a case, we will see the patient for free, so it’s case by case.” 　“In principle, we do not see non AMOSUP mem-bers, but we provide first aid treatment for emer-gency patients. The Philippine law does not allow hospitals to refuse the acceptance of emergency pa-tients. Once the emergency stage is over, however, non-member patients are transferred to other hos-pitals. Some patients say that they don’t want to be transferred to other hospitals because the facilities and staff are much better at the AMOSUP Seam-en’s Hospital. They offer extra money and ask us to keep them here, but we cannot accept this because we are a hospital operated to serve AMOSUP mem-bers.”

How do the member seamen andtheir family think about the hospital?

　“Our patients are very much satisfied with the hospital. They say that the facilities are very clean, both doctors and nurses are good, too. We are high-ly recognized for doctors with advanced expertise, kind and beautiful nurses, and friendly hospital staff. If a seaman visits the hospital, he will be prioritized in the waiting list. We see the seaman first, then other family members. We don’t want to keep the seamen waiting (because they have a tight on-board-ing/off-boarding schedule). That’s another reason why we receive high reputation from busy seamen.” 　“Healthcare costs are generally expensive in the Philippines. We have high quality facility and equip-ment in this hospital, as a matter of fact better qual-ity than other private hospitals, and seamen and their family members can receive that high-quality healthcare free of charge. I think that gives an in-valuable advantage for them.”

I can see that the facilities, the doctors and nurses are all outstanding. What do you think is necessary to further improve this hospital?

　“It would be perfect if we could get a little more medical equipment. Specifically speaking, we want a CT scanner and some space to install it. If we could use a CT scanner, the care we provide at the intensive care unit (ICU) can be improved. Among (the four AMOSUP Seamen’s Hospitals in the Phil-ippines), only Manila and Cebu has a CT scanner. At Manila, they also have an MRI scanner because they have much more patients than we do. I think (we can do with the existing facilities) here, since we also have to take into account the budgetary constraints.”

Dr.Pecson/Hospital Director

Diagnosis by Dr.Pecson

AMOSUP (Gig Oca Robles) SEAMEN’S HOSPITAL DAVAOInterview with the hospital director

“AMOSUP member seamen and their family members can receive healthcarefree of charge …an invaluable advantage”

“Highly recognized for doctors with advanced expertise” “Seamen are prioritized before family members …don’t want to keep

the seamen waiting because they have a tight boarding schedule.”

Dr. Richard John C. Pecson, MD FPOA / Hospital Director

News on AMOSUP Hospital

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