07.04.2020

Philippines: COVID-19 as a public health crisis

The COVID-19 pandemic exacerbates the long-standing symptoms of a weak and inequitable public health system in the Philippines. A densely populated capital, widespread socioeconomic disparities, and inept infrastructure have made the country an epidemiological disaster waiting to happen.

Photo: istock / junpinzon

Like any other country whose health system is put to the test, the Philippines with its relatively ill-equipped health system, is expected to be overwhelmed with the surge of cases. A shortage of hospital beds in regular as well intensive care, mechanical ventilators and masks are among the most pressing issues in a country of 100 million people and over 7,600 islands.

Days after the announcement of a lockdown, it became evident that action plans and centralized power alone will not be enough to ensure social protection for all. For members of the civil society, it was a call to take a more active role in addressing the pandemic.

Without intending to romanticize the concept of resilience, Filipinos have always been known to pull through environmental hazards and humanitarian crises that regularly plague the country. This pandemic is no exception. To help mitigate the impact, decentralized arrangements between corporations and workers have been made. Some are providing continuous payment and are moving to flexible work schemes, while others are directly offering cash assistance to employees. Less optimal short-terms fixes, which provide immediate relief but are not certain to benefit workers in the long run, range from releasing the workers’ 13th month pay to utilization of leave credits during the period of quarantine.

 

Innovation and resourcefulness

In the face of the rapidly unfolding COVID-19 crisis, improvisation, local initiatives and creative innovations are the call of the hour. They are key to address the lack of personal protective equipment (PPE), testing kits, and critical infrastructure. Scientists from the National Institute for Health developed a local antigen-based screening test kit that lowered the cost and reduced turnaround time for the results. Students from the University of the Philippines released models for sanitation tents, which were adopted by local government units. Due to the shortage in supply of PPE, workers in the garment industry developed a design for masks together with infectious disease specialists and temporarily converted their workspace into a makeshift mask factory. Local communities in villages started assembling face shields made from everyday materials.

 

Social rearrangements as windows of solidarity

Equally important than technological innovations, it is truly inspiring to see how many innovations in terms of social solidarity emerge. Schools, hotels, and event places have opened up their spaces to cater to patients with mild symptoms of COVID-19. Cafés and dormitories were opened to accommodate frontliners and the homeless. Furthermore, various individuals started their own fundraising programs for relief of marginalized groups, developed databases to match donors and those who need assistance, and volunteered in government relief efforts. Professionals of different fields are also offering free online consultations via social media platforms.

 

Stigma and discrimination against underpaid, overworked frontliners

While most respond to the pandemic with a strong sense of solidarity, public anxiety over the spread of the virus led to the emergence of discriminating acts vis-à-vis frontliners. Being susceptible to the virus, some have been evicted from boarding houses, refused to be sold food, and, at times, subject to violence.

A nurse in the southern Philippines was splashed with a corrosive disinfectant by five men while in Quezonan ambulance driver was shot in his hand after being accused of transporting COVID-19 positive patients. Despite the risk to their personal or family’s health and poor compensation, health care workers continue going to work bravely.

 

Any public health crisis is essentially about social justice

Comprehensive health care, even at normal times, is prohibitively expensive and factually out of reach for many people in the Philippines. Filipinos shoulder more than half of their total health expenses out of pocket. It is estimated that one million people are driven into poverty every year because of health-related expenses. 6 out of 10 patients in the Philippines die without seeing a doctor.

Social justice, at the end of the day, is at the bottom of any public health crisis. Civil society in the Philippines took on much of the burden, performing tasks that urgently need to be addressed by governments, such as fundraising for more protective equipment and testing, securing frontliners’ welfare, and ensuring food supply and distribution. The big gap in this crisis is yet to be filled with the state’s response. Hands-on civil society initiatives grounded in solidarity and justice continue to be an important source of hope at this decisive point in time.

 

 

Dr. RJ Naguit is a consultant for public health at the Institute of Politics and Governance (IPG) in Quezon City, Philippines. He is also chairperson of Akbayan Youth, the youth organization of the Akbayan Citizens' Action Party, and the Youth for Mental Health Coalition (Y4MH).


The views expressed in this blog series are not necessarily those of FES.

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