Central Region Physical Framework Plan 47

INFRASTRUCTURE AND UTILITIES In general, the road network in the region is adequate. On account of the 4,955.9 km. increase in road length, the road density Infrastructure forms the backbone of the improved from 0.71 km. of road per sq. km. of economy and society. They are the basic land area in 1990 to 1.04 in 2000. These road facilities, equipment and installations that produce densities were much better than the national the utility products and services crucial for figures of 0.54 and 0.67 during the same years. economic and social development. Infrastructure Among the provinces, boasts of the highest also provides the physical connection among the road density of 1.32 while Oriental Negros has production and settlement areas. the lowest at 0.79. The infrastructure sector covers the The quality of roads in the region, however, following subsectors: transportation, energy, remains poor. The paved road ratio in 2000 was communications, water supply / irrigation, and only 0.19. This is slightly lower than the national social infrastructure. figure of 0.21. This indicates that most of the

roads in the region need upgrading or Transportation improvement. Among the provinces, has

the highest paved road ratio of 0.36 while Bohol Transportation impacts every economic has the lowest at 0.14. (see Map 22) and social activity. The transportation subsector provides the physical link among people, Urban Roads. Throughout the 1990s, Metro products and services. The principal modes of had its road network improved and transportation in Central Visayas are roads, water upgraded through the Development and air. Project (MCDP), a foreign assisted project funded by the then Overseas Economic Cooperation Roads Fund (OECF). The main objective of MCDP was to assist local governments in Metro Cebu cope Due to its island configuration, the region's with rapid urban population growth and the road network almost invariably follows the pattern increased demand for travel on the arterial of the coastline, which is circumferential with roadway system. cross-country roads that usually end up at a A total of 71.35 kms of arterial roads were seaport. (see Map 21) constructed/improved in , City Between 1990 and 2000, the road network and Mactan Island under MCDP. All primary in Central Visayas increased by 4,955.9 km., arterial roads were expanded to four to six lanes bringing to 15,587 km. the total road length. Almost 90 percent of the total road length is classified as local roads, i.e., constructed and/or maintained by the local government units. Although Oriental Negros has the biggest land area (5,402.3 sq. km.) it ranked third only among the region's four provinces in terms of total road length in 2000. Cebu had the longest road network covering 5,461.32 kms. Almost half of the region‘s national road is accounted by Cebu. This indicates that a sizable chunk of the national government's investments on road in Central Visayas over the years went to Cebu. However, during the ten-year period, Oriental Negros showed the biggest increase in road length among the four provinces as more and more local roads were opened up in the province by the local government with very little assistance from the national government. The Cebu South Coastal Road project located in Cebu City is one of the components of MCDP III. (MCDP III PMO) 48 Physical Environment

Map 21. Major Road Network Central Visayas Region Physical Framework Plan 49

Map 22. Paved and Unpaved National Roads 50 Physical Environment complete with curb, gutter and sidewalks. New length of 265.80 meters and an operational area road openings were paved with asphalt concrete of 29,252 sq.m. PMO has four while old alignments were paved with Portland terminal (or secondary) ports, namely: Port of cement concrete. Traffic signals were also , Port of Ubay, Port of and Port of procured and installed in 15 intersections in the . All these ports have RORO facilities. All cities of Cebu, Mandaue and Lapu-Lapu. in all, PMO Tagbilaran has 17 government and Ongoing road projects in Metro Cebu aim private ports under its jurisdiction. to upgrade the road link leading into and out of PMO 's base port is the Port of Metro Cebu. Dumaguete in Oriental Negros. This port has a total berth length of 579 meters and an Ports operational area of 26,409 sq.m. PMO Dumaguete has three (3) Terminal Management Being a region composed of island Offices (TMO) located in the Port of , provinces, sea transport is one of the primary Siquijor; Port of Tandayag (), Oriental modes of transportation in the region. It is the Negros; and Port of , Oriental Negros. cheapest means of reaching other provinces in All these ports have RORO facilities. All in all, and outside the region. As of 2002, there were there are 23 government and private ports under about 139 ports in the region, both public and the jurisdiction of PMO Dumaguete. private. More than one fourth of the country's The Cebu Base port, which occupies an ports are thus located in Region VII. area of 40 hectares in Cebu City's waterfront, is The ports in the region operate under two the largest port in Cebu province and the second port systems. Ports located in Bohol, Oriental largest in the country, next to the Port of . It Negros and Siquijor are under the Philippine includes the Cebu International Port. The Cebu Ports Authority (PPA) port system. Ports in Cebu Base port handles about 87 percent of the total are under the jurisdiction of the Cebu Port Cebu passenger traffic. Authority (CPA) which was created in 1991 Under the Cebu Base port are five through Republic Act No. 7621. Management Offices, namely: Danao There are two Port Management Offices Management Office, Sta. Fe Management Office, (PMO) under the PPA Port System: PMO Toledo Management Office, Management Tagbilaran and PMO Dumaguete. Office and Mandaue Management Office. These five Management Offices have jurisdiction over PMO Tagbilaran's base port is the Port of 16 major ports throughout the province. Overall, Tagbilaran in Bohol. This port has a total berth Cebu has 44 government ports and 55 private ports. (see Map 23) The 2002 Study on the Cebu Integrated Figure 2. Passenger and Cargo Traffic in Major Port Development Plan funded by the Japan Ports in Central Visayas, 1994-2003 International Cooperation Agency (JICA) enumerated the following conditions that limit the 25 capacity and efficiency of the Cebu Base port: 1) limitation of maximum draft; 2) lack of space for 20 land area expansion; 3) limitation of waterfront expansion; 4) limitation of offshore expansion; 5) 15 deterioration of facilities; 6) low productivity of cargo handling; and 7) lack of passenger 10 facilities. The Study pointed out the need to 5 establish another port outside of the Cebu Base Port. This new port would serve as international 0 '94 '95 '96 '97 '98 '99 '00 '01 '02 '03 container terminal and foreign cargo terminal and would also handle feeder domestic container Passenger Traffic Cargo Traffic vessels. The existing Cebu Base port in Cebu City would then be primarily used for the Source: PPA and CPA Central Visayas Region Physical Framework Plan 51

Map 23. Major Seaports 52 Physical Environment transportation of passengers by RORO ferries, general aviation), 3.914 million passengers and passenger/cargo vessels, and fast crafts. 91,277 tons of cargo. In 2003, a total of 117,275 ships called on The installation of two additional passenger the region's major ports. Ninety-nine percent boarding bridges (PBB) for two aircraft parking (99%) of these emanated from other regions in bays that are not yet PBB-equipped is an the . More than 19.68 million immediate plan of the Mactan Cebu International passengers, 20.76 million metric tons of cargo, Airport Authority. The development of a second and 508,396 TEUs of cargo containers also remote parking ramp that will be primarily passed through the region's major ports, growing designated as cargo aircraft parking bay is also at an average annual rate of 7.58 percent, 3.65 considered as an immediate project. Meanwhile, percent, and 4.83 percent, respectively, for the the construction of a second terminal building is a last nine years. short-range plan. This will be used primarily for international operations with mixed PBB Airports capability of handling small jets geared for low- cost operations. The Mactan Cebu International Airport The region has also two (2) secondary (MCIA) is the major hub of air travel in the country airports. These are located in Tagbilaran City, outside of . It is located Bohol, and Dumaguete City, Oriental Negros. A approximately 600 km south of the Ninoy Aquino secondary airport is one that serves principal International Airport. It is strategically situated, as towns and cities with regular traffic densities that travel time to and from 14 Asian Pacific cities warrant the operation of jet-prop aircraft. These takes only three to four hours. two airports cater to flights to and from Metro The MCIA occupies an area of 1,018 Manila only. Plans are afoot to transfer the hectares in Mactan Island, off mainland Cebu. Tagbilaran airport to , off The airfield properties include a 3,300 x 45 m Tagbilaran City. Land acquisition and runway, full parallel and rapid exits x 23 m width consolidation is currently underway. taxiway and an apron that can accommodate 12 There are three feeder airports in the wide-bodied aircrafts. The airport is managed by region, but these are not used for commercial the Mactan-Cebu International Airport Authority operations although some chartered flights are (MCIAA). accommodated. These are located in Siquijor, The MCIA currently serves 11 airline Siquijor; Sta. Fe, Cebu; and Ubay, Bohol. A companies with flights to and from 16 domestic feeder airport is one that serves towns with and 14 international destinations. In 2003, MCIA limited passenger traffic. (see Map 24) served 74,522 flights (domestic, international, and Central Visayas Region Physical Framework Plan 53

Map 24. Airports 54 Physical Environment

Energy facilities of these four IPPs is 155.35 MW. The three NPC power plants in Naga, Cebu are now The energy sector covers energy resource managed by IPP Salcon Power Corporation. development, installation of power generating These power plants have a combined installed facilities, and electrification. capacity of 125 MW. (see Map 25) Meanwhile, the small island grids in the region have a Power Generation and Transmission combined installed capacity of 27.22 MW. Power distribution in the region is done The power industry is divided into three through 138 kV overhead lines, except in Bohol major sectors: generation, transmission, and where the transmission network is 69 kV. distribution. Under the present set-up, the Electricity distribution is carried out by ten electric National Power Corporation (NPC) generates its cooperatives and three private investor-owned own electricity and buys electricity from utilities. independent power producers (IPPs). The Department of Energy (DOE) projects Generation was a monopoly of NPC until a 6.9 percent annual growth in demand for the issuance of Executive Order No. 215, electricity in the region from 2005 to 2014. In “Amending Presidential Decree No. 40 and order to meet the expected increase in demand, Allowing Private Sector Participation to Generate 425 MW of additional power will be added. In the Electricity.” The private sector was invited to small island grids, the demand for electricity is invest in power generation to accelerate capacity forecasted to grow at an average annual rate of expansion. This policy reform was instituted to 14 percent. Additional capacity of some 28 MW is address the crippling power crisis that hit the expected to be installed by 2014 to meet the country in the early 1990's. demand. Central Visayas is host to 16 power plants Unlike the and grids, the with aggregate installed capacity of 632.15 MW. Visayas grid is formed by interconnecting the Figure 3 shows the break down of the region’s island grids of Cebu, Negros, Panay, , energy sources: 323.35 MW oil-based (51.2%), and Bohol. During the 1990-2005 period, 192.5 MW geothermal (30.4%), 109.3 MW coal transmission development focused on attaining a (17.3%), and 7 MW hydropower (1.1%). There unified grid for the Visayas through are four IPPs in Central Visayas that generate interconnection via 230 kV and 138 kV and sell electricity to NPC and other customers, submarine cables that serve as backbone bringing stability in power supply to the region. transmission system for the region. The These IPPs are Toledo Power Corporation, East interconnection projects carried out during the Asia Utilities Corporation, Cebu Private Power period were the Leyte-Cebu Interconnection Corporation, all located in Cebu, and the Janopol Project, Leyte-Samar Reinforcement Project, Hydroelectric Power Plant in Bohol. The Leyte-Bohol Interconnection Project Stage 1, combined installed capacity of the generating Negros-Cebu Interconnection Project, Negros- Panay Interconnection Project, Leyte-Cebu Uprating Project and the Cebu-Mactan Interconnection Project. (see Map 26) Figure 3. Energy Sources in Central Visayas, 2003 Electrification

Hydropower Coal 1% Cognizant of the need to accelerate the 17% Geothermal development of the rural areas, the energization 30% of barangays was given priority in recent years. This was carried out by electric cooperatives and privately owned utilities. As of August 2004, 97 percent or 2,918 out 52% of the 3,003 barangays throughout Central Oil-based Visayas have been energized. This accomplishment was better than the national Source: NPC Central Visayas Region Physical Framework Plan 55

Map 25. Power Plants and Substations 56 Physical Environment

Map 26. Completed Power Interconnection Projects Involving the Visayas Grid Central Visayas Region Physical Framework Plan 57 energization level of 91.4 percent during the authorized public telecommunications carriers to same period. The remaining 85 unenergized effect a universally accessible nationwide barangays are scheduled for energization in the telecommunications network. Executive Order remaining months of 2004 and during No. 109 for its part compelled operators of the the 2005-2006 period under the Expanded Rural lucrative cellular mobile telephone system Electrification Program, thus, attaining 100 (CMTS) and international gateway facility (IGF) percent energization level by 2006. services to cross subsidize and carry out a local exchange carrier service program in service Communications areas assigned to them. Specifically, CMTS and IGF operators were required to install 400,000 Effective and efficient communications and 300,000 telephone lines, respectively, in the integrates settlements and production areas, no areas assigned to them. Central Visayas Region, matter how physically far apart they may be. along with and , Communications can transcend geographical was assigned to Islacom (now Innove). boundaries and provide limitless economic and Towards the latter part of the 1990's, the social opportunities to everyone. use of cellular mobile telephone service became The communications sector includes the very popular throughout the regions. This subsectors of telecommunications and postal phenomenon could be attributed to the short services. messaging service feature of CMTS. The use of CMTS also compensated for the absence of land Telecommunications lines in certain areas of the region. Meanwhile, areas still unserved and Government's policy aimed at market underserved by telephone service rely on the reform ushered in a significant improvement in services being provided by the government's the telecommunications industry during the Telecommunications Office (Telof). Telof 1990's. As a result of liberalization, more players operates wired telegraph or radio stations that gained access to the telecommunications industry provide telegram service, among others. especially in the area of local exchange carrier While the installed telephone density in the service, which is fundamental to the government's region increased considerably, the actual use goal of universal access to basic of basic telephone service remains poor, as telecommunications service. there is a broad gap between the installed The region's telecommunications industry telephone density and the subscribed telephone is comprised of 28 providers offering the following density. A more important indicator of greater services: basic telephone or local exchange basic telephone penetration is the subscribed carrier, cellular mobile telephone, domestic and international record carrier, Very Small Apperture Terminal, paging, satellite, public trunk repeater, and international gateway facility. Figure 4. Telephone lines by province, 1995-2000 As of end of 1995, there were only 86,704 550 telephone lines in Central Visayas. The region's 500 450 telephone density of 1.73 land lines per 100 400 population was much lower than the country's 350 density of 2.01 during the same year. 300 By 2000, there were already 529,576 250 200 telephone lines throughout the region. This lifted 150 the telephone density to 9.28, overtaking the 100 country's 9.05 during the same year. (see Fig. 4) 50 The upsurge in the number of installed 0 Region 7 Bohol Cebu Neg. Or. Siquijor telephone lines was an offshoot of two critical Executive Orders signed by President Fidel V. 1995 2000 Ramos in 1993. Executive Order No. 59 mandated the compulsory interconnection of Data Source: Telof 7 58 Physical Environment telephone density. In 2000, the subscribed post offices and postal stations in the region. telephone density in the region was placed at less In recent years, the government-owned than half of the installed telephone density. Philippine Postal Corporation (PPC) has focused Increasing the subscribed telephone density, its activities on two areas: improving access of which requires making the service more far-flung barangays to postal services, and affordable, should be a more important area for enhancing service delivery. While no additional attention in the immediate future than merely post office was opened during the last few years, expanding the number of telephone lines. barangay post offices were established in remote Another aspect of local exchange carrier barangays that have sufficient demand for postal service that needs to be addressed is the wide service. Barangay officials manage the barangay disparity among provinces in terms of access to post offices. To further serve outlying areas, PPC basic telephone service. Among the provinces, maintains the services of mail contractors. In Cebu accounted for a hefty 85 percent of total 2004 there were 13 mail contractors throughout telephone lines in the region in 2000. This the region. explains why Cebu has also the highest Despite the intensified efforts to promote telephone density among the region's provinces, the various postal products and improve postal placed at 13.44 in 2000. Cebu's telephone delivery, transactions at the post offices have density was also higher than the region's 9.28 slowed as a result of the stiff competition and the country's 9.05 during the same year. In provided by electronic mail and private mail contrast, Bohol, Oriental Negros and Siquijor had couriers. Private mail couriers are widely telephone densities of only 2.75, 3.75 and 6.00, perceived by the public to be more efficient, respectively. reliable, fast and safe compared to the public post Moreover, despite the rapid expansion in offices. The volumes of domestic and the coverage of basic telephone service, some international mails posted and delivered have municipalities in the region still do not have also been decreasing during the last five years. access to basic telephone service. These are , , and Sevilla in Bohol; Tudela Water in Cebu; Basay and in Oriental Negros; and E. Villanueva and Maria in Siquijor. The infrastructure aspect of water resource development includes facilities for water supply Postal Communications and irrigation.

The region's postal network is composed of Water Supply 136 regular post offices, 16 extension post offices, 20 barangay post offices and 26 postal In general, the number of the regional stations. Cebu accounts for almost half of the population served with safe drinking water

Table 8. Water Supply Service Coverage by Province, 2003

Population Served by Population Underserved/ Safe Sources Unserved Total Area Population % to Total % to Total No. Population No. Population

Bohol 1,239,829 732,219 59.0 507,610 41.0 Cebu * 2,921,305 1,225,933 42.0 1,695,372 58.0

Oriental Negros 1,200,315 691,757 58.0 508,558 42.0 Siquijor 87,079 55,883 64.0 31,196 36.0

Central Visayas 5,448,528 2,705,792 50.0 2,742,736 50.0

Source: Provincial Water Supply, Sewerage and Sanitation Sector Plans, 2003

Note: * Excluding Cebu City Central Visayas Region Physical Framework Plan 59 increased in the last decade. Still, there remain a Half of the households dependent on this water large number of people without access to safe system were in Oriental Negros. water. Level III (individual household connection) Based on the latest Provincial Water systems are usually established by LWUA- Supply, Sewerage and Sanitation Sector Plans, assisted water districts and local government only about half or 50 percent (2.7 million) of the units. Presently, there are 227 service providers total regional population (excluding Cebu City) of Level III water systems in the region. In 2003, had access to potable water supply in 2003. This about 45 percent (1.2 million) of the population implies that approximately an equivalent number with access to safe water got their water from (50%) had no access to adequate and safe water Level III facilities. supply services. The regional coverage rate was There are 16 water districts in the region: way below the national figure of 79 percent. (see two in Bohol, seven in Cebu, six in Oriental Table 8) Negros and one in Siquijor. (see Map 27) Among By province, Siquijor had the highest these water districts, the Metro Cebu Water percentage of population served by safe water District (MCWD) is the largest. sources (64%) while Cebu had the lowest (42%). In the franchise area of MCWD, supply of Cebu's low coverage might be due to the large water is low as the water district is only able to number of people in Cebu that had to be provided meet less than half of the demand. Demand for with water. Also the rate at which the population water for domestic and industrial/commercial use in Cebu is growing (Cebu has the highest is expected to increase at an average annual population growth rate in the region) is hindering rate of 3.30 and 2.50 percent, respectively, from efforts at attaining a higher coverage rate for 2004 to 2020. Meanwhile, with the implemen- water. tation of a number of water projects, water supply There are three types of water supply is expected to increase at an average annual rate systems in the region: Level I or point source of 6.80 percent during the same period. facility, Level II or communal faucet system, and Level III or individual house connection. Irrigation Level I water sources are deep wells, shallow wells, covered/improved dug wells, open As of 1999, 26,889 hectares in the region dug wells, rainwater collectors and developed representing 39 percent of potential irrigable area springs. Level I facilities are common in rural have been irrigated. This accomplishment is barangays, majority of which are publicly-owned. lower than the national accomplishment of 43 In 2003, about 46 percent of the served percent during the same period. However, the population (1.2 million people or 248 thousand region's performance was a big improvement households) depended on Level I water supply from the 1990 level of 22.30 percent. This could facilities regionwide. Of the household total, 54 percent were in Cebu. Most of the Level II Irrigation project in , Cebu (communal faucet) water system sources in the region are springs and dug wells. The water supply facilities themselves were put up by DPWH, LWUA, DILG or the local government units. Regionwide, there are 270 operating bodies providing Level II water systems. Only about 5 percent of the served population (136,783 people or 26,808 households) though were dependent on Level II facilities for their water needs in 2003. 60 Physical Environment

Map 27. Cities/Municipalities with Water Districts Central Visayas Region Physical Framework Plan 61

be attributed to the implementation of a number Table 9. Potential Irrigable and Irrigated Areas, 1990 and 1999 of projects during the 1990's, among which were:

Bohol Irrigation Project Stage 1, Visayas 1990 1999 Potential Communal Irrigation and Participatory Project, Irrigable Area Second Communal Irrigation Project, Agrarian Area Irrigated Percent Irrigated Percent (hectares) (ha.) Irrigate (ha.) Irrigate Reform Infrastructure Support Project, and various government-funded communal irrigation, Bohol 40,800 7,780 19.07 14,959 36.66 small reservoir impounding and pump irrigation Cebu 10,064 2,590 25.74 3,896 38.71 projects. Oriental Negros 17,028 5,162 30.31 7,605 44.66 Among the four provinces, Bohol has the largest area of agricultural land under irrigation Siquijor 699 211 30.19 429 61.37 (14,959 hectares). (see Table 9) In terms of the Central Visayas 68,591 15,743 22.30 26,889 39.20 proportion of irrigated area to total potential irrigable area, however, Siquijor ranks first with Philippines 3,169,594 1,566,008 49.40 1,350,368 43.19 61 percent of its potential irrigable area irrigated. Source: NIA 7

Social Infrastructure Cebu province is home to 64 percent of HEIs in the region. Eighteen percent (18%) of the Higher Education Institutions total HEIs are located in Oriental Negros, while the remaining 15 percent and 3 percent are in Because of its strategic location and Bohol and Siquijor, respectively. accessibility, Central Visayas is considered the Majority of the said institutions are located center for education in the Visayas and in the urban centers. Cebu City alone accounts Mindanao. It is home to seven state colleges and for 31 percent or 37 of the total HEIs. Two of the universities and their satellite campuses as well most prestigious universities, the University of as several private colleges and universities. The San Carlos and the University of the Philippines, satellite campuses of U.P. Visayas and the are in Cebu City. Mandaue City, which is part of College of Aeronautics are located in the region. Metro Cebu, is host to nine institutions, eight of The region boasts of a number of which are privately owned/managed. Dumaguete institutions offering quality programs in specific City has seven HEIs, six of which are private. fields. Three (3) universities are identified as Tagbilaran City has six HEIs, five of which are Centers of Excellence in Teacher Education. private. These are Silliman University in Dumaguete City The presence of a good number of and the Universities of San Carlos and San Jose reputable HEIs in the region has attracted many Recoletos in Cebu City. Silliman University is also students from Eastern and Western Visayas and a Center of Excellence in Nursing. In addition, the as far as Mindanao for their tertiary education, region has four higher education institutions resulting in a continued upward trend in tertiary identified as Centers of Development for various education enrollment. In school year 2002-2003, disciplines. there were 191,975 enrollees in HEIs, with more From 1999 to 2003, the number of higher females pursuing tertiary education than males. education institutions in the region increased with Cebu City in particular had an inflow of students the privately owned and managed institutions not only from outside of Central Visayas but also outnumbering the public or government from the other provinces and municipalities in the institutions. As of 2003, the region has a total of region. Because of the city's strategic location, it 119 higher education institutions (HEIs) providing is easier for students from other regions in the tertiary education. About 80 percent of the HEIs Visayas and even in Mindanao to pursue their are privately owned while the other 20 percent studies in Cebu than in Manila. are state universities and colleges and their Tertiary schools are faced with the satellite campuses. Of the private HEIs, 71 challenge of improving their quality of education percent are non-sectarian while 28 percent are and upgrading and modernizing their respective sectarian, i.e. run by religious organizations. (see facilities in order to remain competitive. Map 28) 62 Physical Environment

Map 28. Universities and Colleges Central Visayas Region Physical Framework Plan 63

Tertiary Health Facilities However, the region's hospitals have not matched the excellent reputation of the best hospitals in Central Visayas has a total of 105 Metro Manila. Affluent and critically ill patients are hospitals. Half or 54 of the total number of still brought to Manila or abroad for heart bypass, hospitals in the region are found in Cebu. As of organ transplant, diagnosis and treatment of 2003, the region has a total of 5,686 hospital cancer diseases and others. beds, up from 5,421 in 2000. This has resulted in The two government-run tertiary hospitals a slight improvement in the hospital bed to in Cebu City, the Vicente Sotto Memorial Medical population ratio (1:1,047) though still very much Center and the , have below the standard of 1:500. experienced marked increases in admissions of There are 19 hospitals providing tertiary all types and cases. Although intended primarily services not only to patients from the region but to provide tertiary level of medical services, these also from other provinces in Visayas and hospitals are forced to accommodate all types of Mindanao. Of the 19 tertiary hospitals, 15 are patients, many with relatively minor health private and 4 are government. Cebu City is home problems, from nearby municipalities, provinces to 11 or 58 percent of the total number of tertiary and even from other regions due to lack of hospitals in the region. (see Map 29) facilities in the community hospitals in the municipalities. Consequently, these two hospitals Among the privately owned hospitals, are plagued with problems of congestion, most, if not all, have upgraded their equipment shortage of medicines and medical supplies and and facilities to be able to offer the latest medical shortage of medical staff. Despite the technology and services to the general public. inconvenience, people in the lower and middle- Modern diagnostic services, delicate surgery and income brackets continue to seek medical other non-invasive alternatives to surgery are attention from these hospitals than from private now being provided in these facilities. At least medical facilities because of the relatively lower three major hospitals in Cebu City have acquired cost of public health care services. the reputation for excellent health service, attracting patients from as far as Mindanao. 64 Physical Environment

Map 29. Tertiary Hospitals