COLLEGE of ARCHITECTURE
COLUMBAN COLLEGE
OLONGAPO CITY
Chapter 1
THE PROBLEM AND ITS SETTING
1.1 Introduction
“If access to health care is considered a human right, who is
considered human enough to have that right?” – Paul Farmer
What do we really know about the predicament of
healthcare in the Philippines? What do we—the ordinary people—
truly understand about the condition of our country’s medical
system? Is it fair? Is it just? Or has it quietly become a privilege
reserved for the few?
For years prior, the state of the Philippines' healthcare
system has long been marred by chronic underfunding,
inefficiencies, and glaring inequalities—from overcrowded public
hospitals to the financial devastation wrought by a single
diagnosis, the cracks in our health system run deep. Though these
flaws have persisted for decades, the COVID-19 pandemic was a
brutal wake-up call. The worldwide crisis stripped bare the
chronic weaknesses—the shortcomings of our medical system:
overwhelmed hospitals, underpaid and overworked medical
professionals, lack of critical care infrastructure, and a health
system struggling to support even its most basic functions during
a time of national catastrophe. In numerous places, healthcare
became a privilege rather than a right, and countless Filipinos
COLLEGE of ARCHITECTURE
COLUMBAN COLLEGE
OLONGAPO CITY
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bore the brunt of a system that was simply not built to withstand
such pressure. It was more than just a health crisis—it was a
brutal reminder of how far behind we’ve fallen.
Despite global advancements in medicine and healthcare
technology, Predicting the long-term course of the Philippines'
national healthcare systems has grown increasingly challenging.
Yet amid this uncertainty, one truth is undeniable: the Philippine
healthcare system remains critically underprepared for both
present and future demands.
Tertiary care hospitals in the Philippines are few and
disproportionately centralized in Metro Manila, leaving provincial
regions critically underserved. With a population exceeding 116.8
million, the country continues to struggle with a deficient doctor-
to-patient ratio, a shortage of intensive care unit (ICU) beds, and
inadequate diagnostic and research capabilities— factors that
place it significantly behind its Southeast Asian neighbors.
Although the COVID-19 pandemic prompted healthcare reform
across many nations, the Philippines has largely remained in a
reactive and fragmented state, —relying heavily on foreign aid,
outdated facilities, and short-term solutions. This cyclical pattern
of minimal response underscores the urgent need for a
transformative approach—our health system is stuck in a
perpetual cycle of "bare minimum," when what we need is a
radical leap toward international standards. It is about time we
broke the cycle.
COLLEGE of ARCHITECTURE
COLUMBAN COLLEGE
OLONGAPO CITY
3
characterized by dependence on foreign assistance, obsolete
infrastructure, and short-term mitigation efforts. the Philippines
remain in a reactive, patchwork state—relying heavily on foreign
aid, outdated facilities, and short-term solutions. Our health
system is stuck in a perpetual cycle of "bare minimum," when
what we need is a radical leap toward international standards. It
is about time we broke the cycle.
This thesis proposes the establishment of a World Health
Organization (WHO) Level Tertiary Healthcare Facility—a large-
scale, multidisciplinary medical complex designed to deliver
cutting-edge, integrated care that adheres to or exceeds globally
best practices. Such a facility would not only handle the nation's
overwhelming backlog of specialized healthcare demands but
would also serve as an administrative center for medical
innovation, pandemic preparedness, and future healthcare
professional training.
Beyond pandemics, the rising prevalence of non-
communicable diseases globally, many of which are influenced by
the built environment, underscores the urgent need for
architectural intervention in healthcare design—the quiet killers
are heart conditions, cancer, diabetes, and stroke—now the
leading causes of death in the country. According to the Philippine
Statistics Authority (PSA), the leading causes of death in 2024
were ischemic heart diseases with 60,253 deaths, neoplasms
(cancer) with 33,910 deaths, and cerebrovascular diseases
(stroke) with 30,552 deaths. In response to these failures, this
project aims to reimagine what a Philippine hospital can be: not
just a place of healing, but a resilient, future-ready institution that
COLLEGE of ARCHITECTURE
COLUMBAN COLLEGE
OLONGAPO CITY
4
represents dignity, equality, and hope for a healthier nation. This
thesis envisions a facility that merges architectural innovation
with healthcare excellence—designed with adaptability,
sustainability, and community empowerment at its core.
Emphasizing these architectural solutions ensures that healthcare
facilities remain resilient and capable of adapting to emerging
demands while fostering healing, inspires hope, and enhances
overall well-being. As design and technology continue to advance,
the future of healthcare architecture will support healthier, more
resilient communities, achieving the goals of flexibility and
sustainability
