THERE ARE some no-brainer observations that I want to share: many island barangays in the Philippines do not even have their own health centers, and when medical emergencies occur, there are no ambulances that can take patients to a hospital.
But wait — let us assume for a moment that ambulances are available. How would they cross the sea? Would they not need a roll-on/roll-off (Ro-Ro) vessel? Yes, but not all island barangays have access to such vessels. This means that thousands of our fellow Filipinos living on islands are virtually stranded when life-and-death situations arise.
The Philippines is made up of 7,641 islands. Of the country’s 42,046 barangays, experts estimate that at least 5,000 to 7,000 are located on islands. Provinces such as Palawan, Sulu, Tawi-Tawi, Masbate, Romblon, and Camiguin are practically defined by their island barangays. Yet despite this reality, most of these communities have no sea ambulances. Instead, residents rely on fishing boats or motorized bancas to transport patients to hospitals — often in the dead of night, in rough seas, and without any medical equipment on board.
This is not merely a health issue — it is also a governance issue. The Local Government Code clearly states that local government units (LGUs) are responsible for providing basic health services. Yet many LGUs have never prioritized sea ambulances in their budgets. They wait for donations or, worse, simply leave their constituents to fend for themselves.
There should be a law requiring LGUs to provide sea ambulances for island barangays under their jurisdiction. They should not wait for handouts or foreign aid; they should use their own Internal Revenue Allotments. If LGUs can afford to fund fiestas, basketball courts, and welcome arches, why not invest in sea ambulances that can save lives?
Let us also be clear: sea ambulances should not be improvised motorboats with a red cross painted on them. They must be fully equipped, just like land-based ambulances, and staffed with trained emergency medical technicians (EMTs). They should carry oxygen tanks, stretchers, first-aid kits, and other life-saving equipment. They should also have marine-grade radios — not just cell phones that lose signal in the middle of the sea.
But the solution does not stop there. A proper system must be in place. Sea ambulances should be linked to a 911-type dispatch system that covers the municipality or city. Land-based ambulances should also be stationed at the port to receive patients and complete the emergency transfer. Otherwise, the effort of saving a life at sea may be wasted once the patient reaches land and must wait again for transport.
Take Jomalig Island in Quezon Province as an example. A 2019 health assessment found that only the main health center had relatively complete services, while residents of remote barangays struggled to access care due to the lack of transportation. This situation is not unique to Jomalig. It is the reality in hundreds, if not thousands, of island barangays across the country.
The truth is that more than 5,000 coastal barangays likely lack reliable land connectivity to hospitals. Less than 10 percent of coastal LGUs have dedicated maritime emergency units. The consequences are serious: poor maternal and child health outcomes, preventable deaths from accidents, and a glaring lack of disaster resilience.
So what can be done?
First, Congress should pass legislation mandating LGUs with island barangays to procure and operate sea ambulances. Second, the Department of Health should integrate sea ambulance programs into its Health Facilities Enhancement Program. Third, LGUs should explore cooperative or cluster-based arrangements, where two or three municipalities can share one or two sea ambulances for greater efficiency.
Finally, accountability must be enforced. Too often, sea ambulance services fall between bureaucratic cracks — health agencies see them as a transport issue, while transport agencies view them as a health concern. In the meantime, lives are lost.
I believe this is one of those situations where the solution is not rocket science. It is simply common sense. Our people need sea ambulances. Island barangays deserve the same emergency services as those on the mainland. The only question is whether our leaders will choose to act.
Because in a country with thousands of islands like the Philippines, sea ambulances are not a luxury. They are a necessity — and the time to provide them is now. /PN
