MERS-CoV and OFWs, Part 3

Four months after she died in Riyadh, my sister in law, a former nurse in a Saudi government hospital, is finally home in our province in Negros Occ. Welcome home, Gemma. Lois, their only child, 13 yo, with her in this photo which I took from Gemma's fb wall.

She should have been brought home last August 17 via Cathay Pacific (Riyadh-HK-Manila). But about one or two days before she would be transported, Cathay demanded a new requirement before they would transport Gemma. First they demanded an "import permit" from Manila. When I wrote to  them  what  is that “import permit” and what agency in Manila it should come from, they corrected it to "embalmer's certificate" from Saudi, etc. My brother wrote to the travel agency arranged by the Saudi hospital, to look for another airline that would not be too bureaucratic.

So the travel agency arranged for a new airline. Saudia Air took her from Riyadh to Manila direct, arrived mid-day today, then PAL for Manila-Bacolod. The plane landed in Silay-Bacolod airport before 6pm, the body was brought to Rolling Hills funeral park in Bacolod, short mass, then she was buried. Now she is back in  the  province where  she was born  and  grew up.

Her arrival  at Manila  airport today was reported in TV Patrol of ABS-CBN, and was reported online.

 Body of Pinay MERS-CoV victim arrives in PH

Report from Atom Araullo, ABS-CBNnews.com

Posted at 09/04/2014 2:51 PM | Updated as of 09/04/2014 2:51 PM

MANILA – The remains of a Filipina nurse who died from the Middle East Respiratory Syndrome-Corona Virus in Saudi Arabia arrived in Manila on Thursday morning.

The body of Gemma Barrilea Oplas arrived at the cargo section of Ninoy Aquino International Airport Terminal 1 past 10 a.m. It was immediately brought to Bacolod….

Special thanks again to the DFA. Riyadh PH Embassy coordinated with Saudi MOH and the hospital to finally bring her back.

Problem 1, bringing home the remains, is solved.

Problem 2, sending the benefits that the hospital would give to Gemma's family (her siblings included, based on Saudi laws and culture). This will take several weeks more...

I checked the ABS-CBN facebook page for this report, there were many comments. Mostly positive and notes of condolence, but there are some idiots who wrote negatively about Gemma, or about health OFWs in Saudi in general. Ignoring the idiots, here are some comments, mainly from Gemma’s friends:

Jan Jefri: FYI po, colleague ko po ung nsa news.. she died here in Riyadh kaso need to keep for 2-3 months freezed para macontain ung virus.. SOP po yan ng Ministry of Health dto s KSA. Pinoy nurses are highly competitive when it comes to giving nursing care to patients regardless of the disease that a patient have. Direct contact na kulang nlng mahalikan at mayakap ang mga pasyente. We took care our patients as our own family.. Yan ang risk sa profession na pinile nmin.. All we need is your prayers to all nurses all over the world.

Ang work po nmin as nurse dto is from the dirtiest to clean work..meaning all in one po.. package ika nga!!! At dyan competent mga pinoy nurses.. a million salute to you Ate Gemma, may your soul rest in peace. Youre a HERO!!!

..and another thing, if you're working as ER nurse in any facility hndi mo alam kung anong meron ang bawat pasyente na pumapasok sa unit..Likewise, madaming ntatamaan ng MERScOV na asymptomatic pero positive pala s test.. so hindi mo rin tlaga masabi.. need tlga to boost immunity para sa mga virus na yan and effective handwashing.. especially now that ebola is around. MERS and EBOLA will go hand and hand!!! Fight fight fight fellow nurses!!!

Oo nga, instead na magsalita ng hndi maganda..better to pray for everyone..wala nman may gusto na madapuhan ng deadly virus na yan..

Rest in peace ate gemma.. ur memories will remain in our hearts.. a million salute to you!!!

Richel Amante Tayros: Rest in peace Gemma kapitbahay ko yan.at yung mga bad comments ng iba na kung ano anung speculation pwede kung wala kayong alam hwag na lng magsalita ng masama.hindi nyo kilala yung tao pra husgahan.

Yoj Arnaldo: Sa mga may negative comment jan, gemma took care of her colleague na may mers.nahawa sya and namatay ahead.d pa nga alam ng nkahawa sa kanya na patay na sya.gemma is a friend of my friend.imbes magcomment ng pangit,kesyo ganito o ganyan, why cant u just pray for her soul...

Danilyn Pinote: tama na,hwg naman kau masyado putak ng putak.saludo ako sa kanya. nagbuwis sya ng buhay nya para sa ibang tao.ginampanan lang nya ang trabaho nya. condolence po

Roxane Septimo Romias: She a Person withbeautiful heart kahit nung nakalatay sya pneumonia pa lang findings in ask pa nxa ako i doble check ung namatay ng mers cove kasi kaibigan nya meron

Myrz Flores: Totoo na mers cov yun..nag alalaga siya ng kaibigan na may mers then siya pa yung namtay..yung inalagaan niya buhay at stabke na sa ngaun.kakalungkot naman talaga at ngaun lang siya nakauwi.

Ross-ana Hulleza Toroy: I would like to express my sincere condolence to the family of my friend gemma oplas.rest in peace my dear friend.

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See also:
MERS CoV and OFWs  May 08, 2014
MERS-CoV and OFWs, Part 2, August 26, 2014

MERS-CoV and OFWs, Part 2

As I posted On MERS CoV and OFWs last May 08, 2014, my sister in law, Gemma B. Oplas, died last May 6, 2014 of the disease. She was an ER nurse at King Fahad Medical City (KFMC) in Riyadh, the biggest Saudi government hospital in that city. She was attending to a MERS patient, and within days, she herself was infected. Death was fast, only 6 1/2 days after she was confined.

It is now 3 months and 3 weeks since she died and her body is not flown home yet, it is still in a freezer in Riyadh. That is one of the hard travails of OFWs who died of infectious diseases abroad.

I am not aware of the science of containing viruses, but refrigeration for more than 3 months is supposed to be enough to kill any virus in the body. If cremation is only allowed in Saudi Arabia, but it's not.

Two weeks ago, KFMC and the Saudi government have decided to send home Gemma's body via Cathay Pacific cargo (Riyadh-HK-Manila) and Gemma was supposed to arrive in Manila last August 17, Sunday afternoon.

But a belated correspondence from Cathay Pacific the day before said that HK government and Cathay would require an "import permit" from my brother (in Negros Occ.) before the airline will transport the remains.

Import permit for the dead???? Cathay said this permit should come from the DOH, that it is safe to bring home the body of a deceased person who died of that infectious disease. It's weird. I asked my friend, DFA ASec Eddie about it and it is also his first time to hear a case of requiring an import permit for the dead.

People have high stigma against this disease. Like (1) the managers of the funeral park in Cadiz City, Neg. Occ. who adviced that Gemma be cremated in Bacolod instead of being buried in Cadiz (64 kms. north of Bacolod), (2) DOH Bacolod which will not allow opening the casket and wants the body to be buried quick, (3) various airlines including Cathay, and (4) the HK government.

I went to DOH Bureau of Quarantine (BoQ) last week, August 20. I was able to talk to its Director, Dr. Mavic Vasquez. She said it is not their duty or responsibility to give a permit for incoming deceased people. They can give for outgoing ones. She thought that it should be DFA Riyadh, with Saudi Ministry of Health (MOH), that should issue such permit. A dead person here (Filipino or foreigner) that must be transported abroad for burial or autopsy or whatever purpose, the BoQ issues the permit to transport.

I called up again the DFA Office of the UnderSecretary for Migrant Workers Affairs (OUMWA). The person I spoke there wanted to call Cathay Pacific as DFA guys themselves are surprised with this new requirement. He called the Riyadh Philippine Embassy (PE) instead to inquire what the problems are. He was informed that there may be some problem with the Saudi MOH, but the PE is doing something to hasten the repatriation of Gemma's body.

Last week, I wrote to a Cathay officer and asked what exactly is the "import permit" that they require and from what agency or Department it should come from. They replied,

"...If not cremated, death Certificate + Undertakers Certificate. If death caused by communicable disease, admittance allowed only when the remains is cremated or properly embalmed and enclosed in hermetically sealed coffin."

So their earlier requirement of an "import permit" was irrelevant as the HK government wants an Undertaker's Certificate + proper enclosure in a sealed coffin. 

In one yahoo report  last May 26, 2014, the Saudi government expressed high alarm, even desperation, in attracting health professionals who will risk their lives attending to MERS patients.

Gemma's death benefit package from the hospital is not released until now. There are some bureaucracies in the Saudi government and my brother is asking the assistance of the Riyadh PE.

All the papers for OWWA benefits, SSS, etc. cannot start unless there is a death certificate or at least Report of Death from DFA Riyadh embassy. The Report must come with the body, so the longer that the body is not repatriated, the longer will be the non-processing of said papers.

There must have been several OFW health workers who died of MERS-CoV in Saudi alone this year. Some must be there until now. It is really hard for the immediate family, like my younger brother and their only child, 13 yo Lois. to endure these uncertainties. Lots of stigma attached to this disease, but it is not the victims's fault. Gemma died in the course of her work, she was an ER nurse there. I think media alarmism and sensationalism has fanned this public stigma.

Next problem would be OFWs who died of ebola, if any, in Africa. The same public stigma, or even worse, would be attached to the victims. One reason why many Filipino relatives and family members of OFWs who died of MERS are silent. They seldom, if any, admit publicly that their kin died of that disease.

I think there are other weird stories in bringing home OFWs who died of infectious diseases, but since many of the kins here are not too open to reveal it publicly, the stories are kept in the dark. I don't think they should be ashamed to admit that their kin died of an infectious disease, especially while performing their profession. If their kin stole abroad and was shot and killed, then there is a reason to be ashamed.

On MERS CoV and OFWs

This is my sister in law, Gemma Barilea-Oplas, holding my elder daughter Elle Marie, and beside her lone child, Lois, sometime in late 2010 in our province in Neg. Occ. Elle is now 7+ years old while Lois is 13 years old. Gemma is an OFW, a nurse in King Fahd Medical City (KFMC) in Riyadh, Kingdom of Saudi Arabia (KSA) for more than a decade. It's a big Saudi government hospital. 

Gemma died the other day. It was a fast death. Confined in the same hospital where she was working last Wednesday night (KSA time), she was able to call my younger brother, Bobong, to inform him of her situation. A tube was put in her mouth by Thursday, she accepted Bobong's call, their last conversation.  ICU by Friday, renal failure and plummeting BP by Monday, dead by Tuesday, this week.

Bobong and Lois stay in Cadiz City, Negros Occidental, my hometown. He wanted to fly to Saudi, he went to Bacolod City last Monday for his passport application, was told that his passport will be released May 26. Too long, he contacted me, so I contacted a good friend way back in UP Diliman in the 80s, now DFA Assistant. Secretary Eddie de Vega for help. DFA responded with speed and efficiency, I am very thankful of them. But bad luck has taken over.

Yesterday, I got my brother's passport at DFA even though he will not fly to Saudi anymore. DFA Asst. Sec. Fred Santos personally attended to me. Thanks again ASec.

Gemma's death is suspected to be caused by the Middle East Respiratory Syndrome - Corona Virus (MERS-CoV): ASec Santos brought me to DFA Under Secretary Jesus Yabes' office, to ask how the DFA can help bring back the body. PH embassy in Riyadh has no knowledge about her death. The hospital has imposed a news bllack out about her case, and most likely similar cases involving their sick staff. ASec Eddie and I are of course disappointed. How can the PH government, DFA in particular, deal with this, how grave is the problem, if some Saudi government hospitals have this poicy?

Maybe the hospital wants to further study the body whether it is indeed MERS-Cov or any other disease which caused the death. But they should have informed the PH embassy.  The news black out policy by the Saudi government hospital, even if done temporarily, strengthens suspicion that the MERS CoV problem there could be worse that what the Saudi government would reveal to media and the public. Similar to China government's news sanitation policy when SARS spread there and killed several people. The actual death toll was higher than what was reported.

A lawyer friend working at the DOJ, Jojo, commented,

That is a problem Noy. But this Merscov is taking its toll on our OFW health workers in Saudi. The government should act with the same urgency as it did when it published the names of a plane load of OFWs and asked them to come in for tests. By now the Philippine Embassy in Riyadh should already have an action plan on how to respond to our OFWs who fall to the Merscov. Maalarma na sila para sa mga kababayan natin na na-expose na sa Saudi, hindi lang sa pag naglanding na sila dito sa Pinas at madadamay tayo at saka pa lamang aaksyon ng lubos. The highest diplomatic measures should already be undertaken as we speak to protect our OFWs in Saudi from the Merscov.

Jojo is right. My brother asked for a copy of Gemma's medical abstract through her close friend, also a Pinay nurse in the same hospiital. I hope they can give the abstract. It is not official yet if it was MERS CoV or other disease that killed Gemma. But when she was confined last Wed, all the symptoms of the disease were with her.

I discovered last night that the Inquirer has reported it the other day.

 A related news from interaksyon last week. 

"Public concern over the spread of MERS mounted earlier this month after the resignation of at least four doctors at Jeddah's King Fahd Hospital who refused to treat patients for fear of infection...."

I think the PH Embassy in Riyadh will contact KFMC to get the official report, even if the latter will insist on its news blackout policy, implicit or explicit. 

I do not know if the hospital will take it against my brother that I write this story as this may put them in a bad light somehow. But it is for the benefit of both KSA and PH governments and the public in general in both countries, if there is more transparency how grave or non-grave the situation of MERS incidence is in KSA.

To Gemma's siblings, parents, relatives and friends, in Cadiz and elsewhere, this is a sad reality that we have to accept, including the delayed repatriation of her body back home. 

Thanks to many friends who expressed sympathy when I posted this note in my fb account last night, 

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See also:
Drug Innovation 9: Treating Lympho Leukemia and HIV/AIDS, January 10, 2013 
Drug Innovation 10: Cancer, H7N9 and Government, April 26, 2013 
Drug Innovation 12: H7N9, SARS, Bird Flu and Vaccines, May 14, 2013
Drug Innovation 13: Why Expensive Cancer Drugs Are Cost-Saving After All, June 10, 2013