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QUEZON CITY’S SUNDOWN CLINIC: Klinika Bernardo pioneers, innovates community health care for HIV patients

By Raymund B. Villanueva

“MM” became a commercial sex worker soon after he became sexually active. An only child of a single parent, he wanted to be able to support his mother and ageing grandmother after finishing college. But financial difficulties were getting in the way of his dreams and often had no fare money back to Rizal province after a day in school. “Natutulog ako noon sa Luneta, at pumayag ako sa mga offer na ganun,” he revealed. (I sometimes had to sleep at the park and started to agree to have sex with strangers.)

He was able to earn a college degree and was already working as a sale consultant when he learned he was HIV (human immunodeficiency virus) positive. Then active in LGBTQ (lesbian, gay, bisexual, transgender, and questioning) circles, he met and was befriended by an incognito Quezon City government health worker who convinced him to have himself HIV tested.

“I had myself tested in July 2011. I received the result on September 26 at exactly ten o’clock in the morning,” he recalled. “Iyon nga, positive.” (That was it, I was HIV positive from thereon.)

MM said he initially did not react much to the news. “Honestly, I did not know much about HIV. Very few knew about it in those days,” he said. It was only when learned more about it and its potentially life-threatening progression, AIDS (acquired immunodeficiency syndrome), did he decide to tell his mother. It was only then that he cried. “I was 22 just years old,” he said.

MM asked his friend for a meeting to ask her advice on what to do. It was then that Adelle Aldaz revealed to him she was a health worker of the Quezon City government. Aldaz told him that Quezon City’s “mega-clinics” have special services for those who find themselves in such a situation.

Undercover health workers

“Mama Adelle,” as MM eventually started calling her, was then a counselor for HIV patients at one of Quezon City’s mega-clinics, the Klinika Batasan (the others were Klinika Project 7 and Klinika Novaliches). The counselors were not licensed health professionals but had undergone intensive trainings in dealing with commercial sex workers and the LGBTQ community, specially MSM (men having sex with men), and in convincing and educating them on safe sex and HIV.

“We went to bars at night where our clients usually were and that was where I met MM,” Aldaz said. “We do not identify ourselves as health personnel of the LGU until we have earned their trust. It is easier to talk to gay men; the commercial sex workers in Cubao are more difficult to befriend. We have to convince them at first that we are not the police out to arrest them or convince them to stop doing what they are doing,” she added.

Aldaz said meeting MM came at a good time. She was applying for transfer to the old Klinika Bernardo. It was closer to her residence and was then being transformed from a regular barangay clinic to a social hygiene health institution for commercial sex workers and HIV patients.

Country’s first Sundown Clinic

Klinika Bernardo physician Leonel John Ruiz said there were only two places people could go to have themselves tested and treated for HIV a decade ago: the RITM (Research Institute for Tropical Medicine) in Muntinlupa and San Lazaro Hospital in Manila. Both were too far away for Quezon City residents, the lines were always too long, and the test results usually arrived weeks after. “We thought of putting one up in Quezon City for the MSM and commercial sex workers our counselors were able to convince,” Dr. Ruiz said.

A Quezon City social hygiene clinic counselor with an HIV patient at Klinika Bernardo. (Raymund Villanueva/Kodao)

Klinika Bernardo Park is strategically located between the streets of commercial Cubao and the bars of the Timog Avenue area. “But we have many non-QC residents who’ve walked in. This area has many bus terminals and passengers saw the signs we put up offering free and discreet HIV testing and treatment,” Dr. Ruiz said. Some of their clients hail from as far as Mindanao.

Then Vice Mayor Joy Belmonte was the local official who inaugurated Klinika Bernardo when it opened as a social hygiene and HIV treatment clinic in October 2012. Dr. Ruiz said Klinika Bernardo became a reality because Quezon City’s top two officials at the time had soft spots for the sectors the clinic primarily serves. “[Now] Mayor Belmonte is strong on HIV health care while Mayor Bautista pushed hard for Quezon City to be non-discriminatory of the LGBTQ community,” he said. Former mayor Bautista also granted their requests for new equipment and furnishing, such as air-conditioning sets and laboratory machines after the clinic won the coveted Galing Pook Award in 2014. The Galing Pook Award of the Department of Interior and Local Government-Local Government Academy recognizes innovative practices by local government units. “Because of such support, we now conduct in-house laboratory procedures that drastically cut the waiting time for test results if they were taken at either RITM or San Lazaro hospital from weeks to just two or three days,” Dr. Ruiz said.

A Klinika Bernardo medical technologist operating a testing machine. (R. Villanueva/Kodao)

He added that they received great assistance from the group Reaching Out for Most At-Risk Population, a project supported by the United States Agency for International Development, that helped Quezon City design Klinika Bernardo’s service delivery procedures and from the group Sexy When You Know It who trained its personnel on motivational counseling.

The product is a safe space for HIV patients and commercial sex workers. “We are open at three o’clock in the afternoon until 11 at night because of the nature of work and lifestyle of our clients, who go out mostly at night,” Dr. Ruiz explained. “Here, they do not have to be with many other patients of other illnesses who [used to] look down on them,” he added.

Klinika Bernardo has two sections on its two floors. The first floor is the social hygiene clinic that caters to commercial sex workers mostly for their sexually-transmitted infection screenings and check-ups while the upper floor is the HIV testing and treatment area. But the lively chatter and banter of the counselors, personnel and the clients is what defines it more as safe space. “Klinika Bernardo is not only discreet, it is very welcoming to all. Even our security guards are LGBTQ community members,” Dr. Ruiz said.

Dr. Ruiz clarified however that patients with other illnesses may still avail of its other health services. “We are an inoculation center during this (coronavirus-19) pandemic, of course,” he said.

Not just a clinic

Klinika Bernardo’s successes provided lessons that encouraged Quezon City’s other social hygiene clinics to become HIV-treatment centers as well. Its Galing Pook Award has also attracted other local governments to study it. The clinic has provided support for the creation of social hygiene clinics in the cities of Marikina, Manila and Valenzuela, as well as in the province of Cavite.

Klinika Bernardo’s ageing structure that may soon be replaced by a bigger building. (Raymund Villanueva/Kodao)

The clinic played a leading role in the creation and operation of the HIV inter-referral system and service delivery network with not just health institutions but with persons with disability (PWD) groups, the Department of Social Welfare and Development (DSWD) and churches. Klinika Bernardo’s experiences also helped in the creation of policies supporting HIV patients, such as financial assistance packages from the DSWD and the granting of PWD identification cards to persons with HIV and AIDS. “Klinika Bernardo is not just a clinic, it is now a network,” Dr. Ruiz said.

Klinika Bernardo’s latest innovation is the use of the motorcycle delivery services to send medicines to clients who could not to take public transport due to their co-morbidity or simply do not have fare money.

“HIV and AIDS are no longer life-threatening illnesses with proper management and innovations in health care delivery.”

-Dr. Leonel John Ruiz, Klinika Bernardo

Usual problems

Despite the special support it receives from the local government, Klinika Bernardo is not without problems usual to the health care delivery sectorin thePhilippines. The clinic has its share of shortages of anti-retro viral drugs that only the Department of Health (DOH) can buy from abroad. The clinic also experiences low supply of testing kits for viral loads of HIV/ AIDS patients as well as pre-exposure prophylaxis tablets for their sexual partners.

Although it has never ran out of medical supplies, these are always in low supply at Klinika Bernardo. (Raymund Villanueva/Kodao)

Klinika Bernardo said it has yet to experience running out of medicines and kits despite conducting 30 to 40 tests every day, but is always concerned when supplies are getting low. It has informed Mayor Belmonte of the situation, who in turn told them she is looking into the possibility of the local government procuring the special supplies for its hygiene clinics across the city.

“It could not come sooner as HIV cases have gone back up to pre-pandemic levels. There were not many walk-ins and there were less visits by our clients during the lockdowns, but we are now back to 1,000 cases under our care,” Dr. Ruiz said.

Dr. Ruiz said that Klinika Bernardo also suffers from staffing problems. It has requested for two more encoders, a pharmacist, a utility aide and a nurse. Its two nurses are already taking up other tasks, such as encoding. He added the clinic wishes its contractual counselors and case managers to be given permanent employment status by the LGU. “Our counselors are very vital to the kind of service we provide here. They are the first contacts; they are the support system; they even conduct tracing of patients who suddenly do not visit the clinic anymore. They are family to our patients,” Dr. Ruiz said.

The doctor revealed however that the Quezon City Council has already approved of the building of a new three-storey structure to replace the current ageing one. All they need is another building to temporary house the clinic while a new is being built at the same location.

Former mayor Bautista for his part said he hopes that plans to build a home for HIV patients abandoned by family or partners would be approved. He revealed that this was his Stage 2 of the Klinika Bernardo plan when he was mayor.

“I hope that they approve it soon, for a more holistic approach in addressing HIV-AIDS in the city and set another example for the rest of the country.”

-FORMER QUEZON CITY MAYOR HERBERT M. BAUTISTA

Klinika Bernardo counselor “Jaja” also has a radical dream of their own: Clinics for transgenders like them. “HIV information for MSM is already getting adequate. But HIV cases among transgenders are also rising. We need dedicated clinics for us because we need to study if treatment for HIV or any other illness is safe to administer if a transgender patient is undergoing hormonal therapy,” they said.

Life–saving

MM said Klinika Bernardo saved his life, the reason why he left his sales consultancy job and applied to become a full-time health counselor. He is now both a Klinika Bernardo worker as well as client. With Aldaz’ guidance and support, he has religiously followed all health protocols and religiously took his medicines.  “It’s been 10 years and I have never suffered an opportunistic infection,” he said.

He said his being a Klinika Bernardo counselor now gives meaning to his life. “Akala ko wala nang silbi ang buhay ko. Pero narito ako ngayon, tumutulong sa iba para madugtungan ang buhay,” he said.

(I thought my life had become meaningless. But here I am, helping others live on.)

He said he is always grateful to and contanstly inspired by her “Mama Adelle.” MM said he still periodically sends her text messages: “I owe you my life.”

Asked what messages he receives from his own clients and fellow patients, MM said: “Pareho din lagi. Utang nila ang buhay nila sa akin.

(The same, always: They owe their lives to me.) #

(CONTACT KLINIKA BERNARDO HERE)

This story was made possible through a grant by the Philippine Press Institute under the auspices of the Hanns Seidel Foundation.

Rights group hails Doc Naty’s release

Court said her arrest was ‘offensive’ and ‘repugnant’ to due process

Human rights group Karapatan welcomed the release of Dr. Natividad “Naty” Castro after an Agusan del Sur Regional Trial Court (RTC) junked the kidnapping charge against the red-tagged community doctor.

The doctor’s family announced she walked out of detention on Wednesday and has reunited with her siblings.

“We in Karapatan welcome the release of Dr. Natividad Castro based on the court’s decision on her motion to dismiss,” Karapatan secretary general Cristina Palabay said in a statement.

Castro was arrested at their home in San Juan City last February 18 in a commando-style raid by the Criminal Investigation and Detection Group of the Philippine National Police.

Karapatan said Castro was denied due process and her arrest and imprisonment were arbitrary.

Branch 7 of the Bayugan City RTC in a March 25 resolution said it found no probable cause against Castro and ordered her release from the Agusan del Sur provincial jail.

“Without probable cause, the court did not acquire jurisdiction over the accused, which warrants the dismissal of this case,” Presiding Judge Fernando Fudalan Jr. said.

Judge Fudalan ruled that Castro was not properly identified in the warrant the police presented to her family during the raid, which only listed a certain “Dra. Maria Natividad.”

 “A preliminary investigation without a subpoena being issued to the respondent is offensive to due process. Either intentional or a product of omission, the same produces a serious effect repugnant to respondent’s right to liberty,” Judge Fudalan said.

Karapatan said the National Task Force to End Local Communist Armed Conflict’s (NTF-ELCAC) “malicious and baseless statements” against the red-tagged community doctor are all lies.

“We extend our hugs of solidarity to Doc Naty and her family, as we enjoin her to continue doing her work as a community health and human rights worker and to exact justice and accountability from those who violated her rights,” Karapatan said.

Castro’s arrest drew widespread condemnation from the medical community that demanded her immediate release.

Castro spent 40 days in jail. # (Raymund B. Villanueva)

[EXPLAINER] Who is Doc Naty and why is her arrest unjust?

She may well be the poster girl of service and selflessness. But the State thinks she is a top criminal deserving of the heavy-handed arrest she was subjected to by the police last Friday.

Dr. Ma. Natividad Marian Castro was arrested commando style in their San Juan City home in the heart of the metropolis, the police disregarding her Constitutionally-guaranteed rights to apprehend who they allege is a top Communist Party of the Philippines leader.

But as her arrest quickly spread on social media, institutions she was associated with described her and her life’s work with nothing but acclaim and immediately condemned what she is being made to endure.

Who is Doc Naty? What made her a target of State heavy-handedness? Why do many people demand her freedom?

Honor student

One of the first institutions that immediately condemned Doc Naty’s arrest was her alma mater St. Scholastica’s College-Manila (SSC-M) where she graduated High School Batch ’84 valedictorian. The community doctor, the school said, was one of the 100 outstanding alumnae who was awarded the St. Scholastica’s Alumnae Foundation Inc. Centennial Award in 2006 because of her outstanding humanitarian work setting up community-based health programs and services in Mindanao.

“She exemplifies the Scholastican and Benedictine spirit, in her life of ora et labora (prayer and work) and service especially to the poor and the marginalized sectors of our society. She embraced the lives of the most impoverished of farmers, fisher folk and indigenous people on the mountains and plains in the Caraga Region of Mindanao. Dr. Naty even brought to Geneva some of the Lumad people to seek help as victims of militarization,” SSC-M said in a statement a day after her arrest.

In their own statement of support, Doc Naty’s fellow Isko/Iska (people’s scholars) said she was outstanding in academics “[i]n UP Diliman where she graduated cum laude in BS Zoology, and onto UP College of Medicine where she graduated with [them] in 1995.”

“Naty is not an ordinary doctor. She is a servant leader actively involved in health and human rights and working towards providing health care for all by serving in rural and geographically isolated areas,” members of the UP College of Medicine (UPCM) Class of 1995 said.

UPCM’s Department of Family and Community Medicine said Doc Naty did nothing but live up to the ideals of a doctor that the country invested in. “Her 26-year career is not of wrongdoing but that of selfless service to the poor and the marginalized,” it said.

Many other health and human rights organizations immediately came out with their acclamation of Doc Naty’s life’s work and condemnation of the brutish manner in which she was arrested, including the Health Action for Human Rights, Karapatan, the Commission on Human Rights (CHR), the Free Legal Assistance Group (FLAG), Gabriela, Pangkalusugang Lingkod Bayan-UP Manila, Community Medicine Development Foundation (COMMED), Community-Based Health Program (CBHP)-Butuan, and even former United Nations Special Rapporteur on Human Rights Defenders Michel Forst who twitted said he was “more than worried” over her arrest. Even senatorial candidates Dr. Minguita Padilla and Dr. Carl Balita condemned the arrest.

SSC-M said it is ridiculous to accuse its alumna of kidnapping and illegal detention of those she is helping and whose human rights she is defending.

“It is unjust that one who has chosen to live in places that are not reached by the services that every human being is entitled to receive; one who has committed her life to give life to others, is now deprived of her right to life, a life that she has lived witnessing to Christ’s love and compassion,” the school said.

In her own words

What was Doc Naty, a top graduate of the country’s top schools, doing in the hinterlands, dispensing health care to people who obviously could not afford to pay for even the most basic of health care?

In her own words, Doc Naty said she had been working as a community doctor, public health practitioner and human rights activist in the Agusan Provinces since she started practicing medicine professionally in 1996.  

“I worked with marginalized sectors in rural and urban communities, mainly with families of farmers, agricultural and mining workers, informal sectors in the urban poor and national minorities, helping peoples’ organizations build their capacity to respond to their immediate and long term health needs within the context of mutual cooperation and empowerment,” she wrote in September 11, 2021, explaining what she does to her batch mates in the UPCM Class of 1995.

She listed the organizations that she worked in all these years, including CBHP-Butuan, COMMED, Karapatan, the Missionary Sisters of Mary, the Religious of the Good Shepherd, SSC-M’s ENFIDE Institute, and even the government’s own Department of Health-Region 10 in its European Union-sponsored Women’s Health and Safe Motherhood Project.

“I started in Agusan at a time when epidemics of cholera and measles were yearly cycles and malaria, schistosomiasis and tuberculosis were so rampant that our health services were vital in remote Lumad and peasant communities or else people died for lack of medical care,” she revealed.

Dr. Ma. Natividad Marian Castro being comforted by her sister when she was surfaced at Bayugan City Jail last Saturday. (Photo from Dr. Darby Santiago’s FB wall.)

Like most other community doctors, Doc Naty was witness to the other injustices their patients suffer. These include the killings of farmers, workers and Lumad for the sake of mining in the region she chose to serve. She described the violence as a widespread displacement of Lumad communities to clear the path for the foreign exploitation of non-renewable resources such as metals and coal, the declaration of large tracts of land with peasant and Lumad communities as special economic zones, rendering the people powerless to assert their right to land, livelihood and resources.

“[T]hese issues have become central to my work in the past 10 years, I find myself working more and more with church people, people in the academe, media, the educated youth and other professionals to explain issues of environment justice and human rights, how the basic sectors of farmers and workers should have a voice in the path to sustainable and just development, how the rights of the Lumad as historical and cultural stewards of their ancestral domain must take precedence over its destruction in the name of development,” she explained.

It was with this conviction that Doc Naty traveled to Geneva, Switzerland in 2016 to plead the case of the Lumad before the international community. This may be one of the reasons why posters were put all over Caraga on November 20, 2020 by suspected state agents alleging Doc Naty and other known human rights defenders of the region are “communist NPAs (New People’s Army).”

But Doc Naty said that all the medical missions she was part of, all the trainings she conducted to tutor thousands of new community health workers from among the peasant and the Lumad, all the workshops she held to produce effective herbal medicines, all the encouragements she dispensed to encourage “walking blood banks”, all the minor surgery and dental extractions she performed, and all the births she assisted, were worth it.  As a result of their work in communities and through cooperation and collaboration with government and non-government programs and projects, disease control programs for malaria, schistosomiasis and tuberculosis have effectively reached the grassroots level while epidemics of cholera and measles have become scarce in the past 10 years.

“I have seen death sown and life being rebuilt. I take comfort in the sure knowledge that the struggle for people’s development will continue as surely as I helped develop leaders and workers with integrity and fire in their hearts for the poor and marginalized,” she wrote.

Doc Naty was aware of how her work is viewed by the government. “In my field of work, the money is scarce, job/personal security is poor (hahaha) but the rewards are immeasurable when I see the babies that I have delivered thrive and become leaders themselves, dedicating their lives to continuing the development work that I helped start in their communities,” she wrote.

It is in the midst of a global pandemic and while Doc Naty was taking care of family members that she was repaid by a contemptuous State in ways it is most accustomed to.

Raid on an ancestral home

Doc Naty’s younger sister Menchi graphically described in a Rappler interview how Friday’s arrest went. Menchi said that she just came from hearing Mass and was opening their gate when plains-clothed men approached, pushed her aside and caused her bruises. They did not identify themselves and forced their way in. Menchi said that other men in civilian clothes scaled their walls. The raiders destroyed their front door and arrested Doc Naty.

Menchi added that it was only when the raiders were already inside the house that they were able to talk to them. They were showed a photocopy of an arrest warrant issued by the Bayugan City Regional Trial Court that contained hundreds of names that did not include Doc Naty’s. The doctor was then whisked away without being allowed to put on shoes.

The FLAG, retained as counsels by Doc Naty’s relatives after the raid, immediately sought access to her at the Intelligence Group, Camp Crame, where she was reportedly brought and detained. Before this, her sister, who was also at Crame, was denied access, as was another lawyer-friend.

“Upon inquiry, police officers from the Intelligence Group informed FLAG that Dr. Castro was no longer at Camp Crame as she was supposedly ‘brought to the airport’ to be ‘delivered to the court’ in Butuan City. Family members proceeded to the airport but were not able to see her there. The scheduled flight to Butuan took off without any confirmation of Dr. Castro being on board. Requests for copies of the warrant of arrest, reports and documents relative to Dr. Castro’s arrests and transportation likewise went unheeded,” FLAG revealed.

Throughout the whole afternoon and continuing to the present, none of her relatives or lawyers has been able to gain access to Doc Naty and no official confirmation from her captors, the PNP, has been made as to her whereabouts,” the group of human rights lawyers narrated.

“Dr. Castro has been denied access to her counsel and to her family, in violation of her rights under the Constitution and the law. She was also denied her medication for her hypertension and diabetes because the police refused to allow her sister who wanted to bring her medicines and test kits to have access to Dr. Castro,” it continued.

Dr. Ma. Natividad Marian Castro at Bayugan City last Saturday. (Photo from Dr. Darby Santiago’s FB page)

On Saturday, Doc Naty was surfaced at the Bayugan City Jail where her family was finally allowed to see and talk to her. The CHR, who was also present, was informed that the doctor would be presented to the public prosecutor’s office when it opens tomorrow, Monday.

As the charges against Doc Naty are non-bailable, chances of her immediately regaining freedom are slim. But her lawyers are sure to question the manner of her arrest as well as her name’s absence in the photocopied arrest warrant shown her family. It will surely take months or years before the community doctor would again be free to dispense health care to the peasant and Lumad communities dear to her. But as in the case of vice principal and ACT Teachers Union secretary general Rosanilla “Lai” Consad in Butuan who was released after less than a year in jail, Doc Naty’s family and friends hope it shall be sooner than later. # (Raymund B. Villanueva)

‘Do not blame health workers going abroad’

Image by Carlo Francisco/Kodao

On the deployment ban of health workers abroad:

“We cannot blame our nurses and other healthcare workers who want to seek better paying jobs abroad despite the risks to their own health and anxieties of leaving their own families behind…[O]ur government leaders have clearly proven that their labor, remarkable contributions, sacrifices and voices are not valued.”–Joanna Concepcion, Chairperson, Migrante International

FIRST PERSON: Kung magka-COVID at sa pampublikong ospital nagpapagamot

Ni Mona Nieva

Ang may akda ay naging pasyente ng COVID sa isang pampublikong ospital sa bandang hilaga ng Kalakhang Maynila. Mahigit isang linggo rin siyang nanatili roon hanggang payagang makauwi para ituloy ang pagpapagaling.

Kung magka COVID ka at malala at sa public hospital magpapagamot, ito ang payo ko sa iyo base sa aking karanasan noong Abril:

1. Masks – magdala at everyday magpalit ka. Sa ward, iba-iba ang makakasama mo, iba iba rin ang level ng COVID. Bukod sa iyo at sa ibang pasyente, para rin ito sa kapakanan ng mga health worker na gagamot sa iyo.

2. Loperamide – kasi baka magka-diarrhea ka at hindi ka na mabalikan ng nurse, lalo kapag full capacity ang ospital. May oras lang ang pagbisita nila at sa dami ng pasyente may chance na makalimutan nila. Hind iyon sadya.

3. Vitamin C – para maka-double dose kahit nasa ospital. Tulungan mo rin sarili ang mo.

4. Biscuit/crackers – pero individually-wrapped. Huwag iyong maramihan, kasi isang bukas lang ay contaminated na lahat iyon. Sana iyong may palaman na rin. In case late ang rasyon ng pagkain. Pwede mo pa i-share sa ibang pasyente.

5. Table napkin o kitchen towel – huwag tissue kasi napakanipis nito. Madali masira ang tisyu. Pero kung kitchen towel or table napkin, sapo ang lahat ng ubo, dahak at more ubo. Maayos pang maitatapon. Mahihikayat din ang iba na hindi na dumahak at dumura sa basurahan kasi kawawa iyong maglilimas nito.

6. Disposable na pangkain – May pagkain sa ospital at maayos at masarap naman ito. May plastic na kubyertos na kasama. Pero kung may nagpadala ng pagkain, mainam ito para hindi masira ang pagkain. Itapon sa basurahan pagkatapos, lahat ng ginamit. Kahit generous ka, no sharing, para sa kapakanan ng lahat.

Rasyon na pagkain sa pampublikong ospital. (Larawang kuha ni M. Nieva)

7. Extra bottled water – may bottled water sa ospital pero minsan mauubos mo kaagad or late darating ang rasyon.

8. Toiletries – sabon para sa iyong hand washing at kung ano-ano pa. Posible naman ang maligo pero mabilisan kasi nakakahiya sa ibang pasyente.

9. Alcohol spray at alcohol pang refill – bring your own alcohol. Importante ito lalo’t marami kayo sa kwarto, iisa lang ng banyo at mixed ang ward. Maaari din itong hiramin ng mga med tech kapag i-xray ka.

10. Charger – because

11. Electric fan – kasi mainit. Kung may extra fan doon, huwag mahiyang manghiram. If magdadala ka, iyong maganda na. Iwan mo na rin doon para sa mga susunod na pasyente.

12. Kumot – walang kumot o unan sa public hospital.

13. Damit – yung presko at madaling isuot, kasi mainit sa ospital. Ang pamalit ay dapat pang-dalawang linggo, lalo ang underwear. Hindi kasi makakapaglaba dahil sa swero o IV. Wala ring pagsasampayan.

Do’s and don’ts

Magpahinga at magpalakas. Mahirap matulog sa ospital pero possible. Gawin iyong lung exercises para lumakas agad ang baga.

Huwag magpanic. Sa loob ng iyong ward, maaari kang makakita ng mga pasyenteng mai-intubate o mamamatay, lalo kung walang separator na tela ang mga hospital bed o mixed ang kaso sa ward. Meron ding tatalon sa bintana.  Anuman ang dahilan nila, kalmahin mo ang sarili mo at isipin mong gagaling ka.

Selfie ng may-aksa sa loob ng ospital.

Makipag kapwa-tao. Makipagkumustahan. Hindi ka man sanay, makakabuti ito sa mental health mo at ng kapwa pasyente.

Unawain ang mga health worker. Kulang kulang pa rin mga PPE nila. Iyong iba, sisinghap-singhap na habang kinukuhaan ka ng BP. Yung iba naman, basang basa na ng pawis to a point na tutulo na parang bukas na gripo yung pawis nila kapag tumungo lang sila. Pero tuloy lang ang pag asikaso sa may sakit.

Huwag mong tiisin ang hindi dapat. Sakaling may mamatay sa iyong ward, paalalahanan ang mga health worker na takpan kung hindi agad makukuha ang labi ng isang pasyente. Kung lumipas na ang isang oras at wala pa rin takip o hindi pa rin kinukuha, ipaalala muli. Huwag mong sundin iyong kasabihan na “Pagtiisan mo na lang dahil naka public hospital ka.” Deserved ng buhay ang respeto, ganoon din ang mga patay.

Magpasalamat ka. Hind mo man nakikita yung doktor mo, ipaabot mo ang iyong pasasalamat. Pasalamatan mo rin ang lahat ng health worker na makakasalubong mo sa iyong paglabas.

Cheers to life! #

Putting Back the “Community” in Community Pantry

By L. S. Mendizabal

On the seventh day since the first community pantry on Maginhawa St., Quezon City was erected, one of its initiators, Ana Patricia Non, took a break but did not rest. The 26-year-old small entrepreneur, “Patreng” to many, gave a press conference via Facebook Live, explaining why she and her fellow organizers ceased operations temporarily: They did not feel safe after the National Task Force to End Local Communist Armed Conflict accused her of being a “communist,” a brand the Duterte administration has proclaimed to be synonymous with “criminal,” “terrorist,” “a menace to society.”

“People are grateful because the community pantry revived their spirits to help one another in times of crisis . . . But even that had to stop. It hurts that we were forced to close even for just a day. Think of how many families, how many meals the community pantry would have provided,” Patreng said in Filipino, her voice cracking, barely able to hold back tears. “We had to stop for the time being to ensure our safety and to clear the allegations.”

On the same day, Metro Manila Eastern Police District set up its own community pantry with rice, canned goods, face masks and face shields. Also stacked are copies of the Gideon Bible and the police journal magazine replete with red-tagging propaganda because, y’know, “Communism is bad.” Throughout the Duterte regime alone, PNP is notorious for tens of thousands of extrajudicial killings in the war against drugs and anti-terror campaign. From accessorizing dead bodies with pieces of cardboard that said, “Pusher ako, huwag tularan (I am a drug pusher, do not emulate)” to giving away food and bibles under cardboard signs stating a rather interesting iteration of the Maginhawa Community Pantry slogan,

“Magbigay nang naaayon sa kakayahan, dumampot ayon sa inyong pangangailangan (Give what you can, seize what you need)”—their altruism is of the violent kind.

Ana Patricia Non (Photo from Altermidya)

Death, hunger, gloom and doom

Since the novel coronavirus claimed its first victim in the Philippines when the government failed to promptly close our borders, there’s been no mass testing or contact tracing. Hospitals are full. Frontliners are grossly underpaid, overworked and dying. COVID funds amounting to a trillion pesos have yet to be felt by 18 million beneficiaries still waiting for a second cash dole-out.

Unemployment is at an all-time record high. According to IBON Foundation, the total number of unemployed and underemployed soared to a staggering 12 million in February 2021. With the absence of food subsidy and the disruption of food systems, the poor are the hardest hit by draconian lockdowns, or this administration’s single palpable response to the pandemic. Minimum wage earners must go out to work or find work every day, risking COVID exposure. Staying home is a luxury the poor simply can’t afford. To them, dying from hunger is a more immediate concern than dying from the virus.

Academics of the Philippine Sociological Society in a study on the community pantry initiative claim that Filipinos have also been experiencing feelings of “gloom and doom.” WHO says that isolation, bereavement, fear and loss of income during the pandemic have been detrimental to individual mental health. Constant news of human rights violations may cause gloom and doom as well, for how can you sleep soundly at night knowing a 12-year-old boy just died after barangay tanods chased him when he was “caught playing outside?”

Omega Avenue community pantry. (Photo by Roberto de Castro)

A social phenomenon bred by state abandonment

On April 14, Patreng and her little bamboo trolley of free vegetables with a signboard bearing the words, “Magbigay ayon sa kakayahan, kumuha batay sa pangangailangan (Give what you can, take what you need),” first stood on a street corner in the city with the most COVID cases and deaths in the country. Small vendors and tricycle drivers nearby have since helped Patreng repack and distribute goods as well as facilitate the daily queue of neighbors they’ve invited themselves. And just like that, a movement was born.

Within three days, PSS identified 44 community pantries nationwide with majority in NCR. As of this writing, there are 500 from as far up north as Cagayan all the way south to “DDS Country,” Davao City. PSS in its initial analysis of the community pantry calls it an “emergent agency”—an independent initiative taken by stakeholders to effect changes on their situation. Emergent collective behaviors rise when preexisting structures fail to meet people’s demands. Notably, a good chunk of the community pantries that swiftly followed Maginhawa’s example are of organized masses from marginalized sectors who initiated community kitchens and collective gardening since the first enhanced community quarantine. PSS notes that these earlier emergent agencies didn’t quite capture the people’s imagination the way community pantries have.

Although they’re not the cure to end food insecurity, the viral spread of community pantries is but a symptom of the true state of the nation: Like Patreng, Filipinos are “tired of complaining and fed up with government inaction.”

Fish on their way from Laguna de Bai to community pantries in Quezon City. (Pamalakaya photo)

Half a piece of ginger, cups of taho and a tale of two oranges

Community pantries have been practiced in the US and other parts of the world. When COVID hit Thailand, locals installed cupboards filled with food, medicines and other necessities in public spaces in Bangkok to help one another. Called “happiness-sharing pantries,” they spread all over the country, reaching a total of 1 400 by the end of 2020. As lockdown restrictions were lifted in Thailand and stores reopened, the pantries were later abandoned.

In the Philippines, community pantries show no signs of slowing down as Duterte stays in power, hoarding public funds for his election war chest. (The original Maginhawa Community Pantry announced Monday night it will cease to be a distribution center starting today, Tuesday, April 27. It will instead be a donation center from which nearby community pantries shall be replesnished.—Ed. ) A viral element of the phenomenon is its slogan which people have adopted and translated into many different languages and dialects, my favorite being LGBTQ+ organization Bahaghari’s “Gumib luv offering ayern sa kerichinabels, gumeching vatai sa needine lustre.” More than just a catchphrase, Filipinos from all walks of life have been unified by the idea and practice of a mutual aid grounded on giving what they can and taking only what they need.

In contrast to donation drives where the same prepacked goods are given to households without taking into account household size, you have the freedom to get what your family specifically needs from a community pantry regardless of what you donate. How much one takes / gives is a non-issue. In a Bulatlat article, University of the Philippines Professor Sarah Raymundo says that community pantries defy the capitalist market because they highlight products’ utility (use value) over their monetary worth (exchange value).

This encourages people to prioritize the needs of others over their own. For instance, a resident in a resettlement area in San Jose Del Monte, Bulacan only needed a small slice of ginger, so she broke one into two pieces “para makakuha rin ang iba (so others may have as well).” In Kawit, Cavite, a taho vendor gave out free cups of his own product by a small roadside table. Inspiring passersby, they bought more cups of taho for his little pantry. Patreng also shared in the press conference how an old beggar picked up two oranges. When he was told to get more, he said two were enough to get him by for the day.

The community pantry is a utopian space where the destitute and benevolent converge, often one and the same. More than bayanihan and volunteerism, it advocates collectivism. This boggles the minds of the rich because they only understand an individualist way of life, not unlike that of a barangay captain in Los Baños, Laguna who threw a fit, accusing organizers of profiting off their pantry. His angry constituents later exposed him on social media for using personal connections to get vaccinated ahead of frontliners.

The Maginhawa Community Pantry. (Photo by Roberto de Castro)

“Communist Pantry,” “just bayanihan” and other anti-people takes

Once the community pantry became a phenomenon, anyone who knows this administration damn well would’ve seen red-tagging from a mile away. Historically, emergent agencies or relief efforts that expose government incompetence are met with hostility. Last year alone, cops destroyed Sitio San Roque’s community kitchen and apprehended youth volunteers distributing food packs to impoverished communities in QC, Malate, Marikina, Bulacan, etc. Armed men killed activist Jory Porquia while conducting relief operations in Iloilo City.

According to UP Prof. Danilo Arao in an online forum on journalism ethics and community pantries, red-baiting is the “highest form of fake news” because it endangers lives. It is the state’s go-to tactic in discrediting and demonizing personalities and organizations so that hurting them is justified. Another objective of red-tagging, Arao explained, is to challenge its target/s to denounce Communist links. Sounds familiar? Mainstream media, GMA Network being the biggest offender of late, has become nothing more than a mouthpiece of a regime that persecutes people like Patreng whose only fault is facilitating change.

Neoliberalism has so deprived us of basic social services and turned everything into a capitalist commodity that Filipinos sharing goods among themselves has become quite the spectacle. That said, what really frightens the state is not its “phenomenal” or “bayanihan” aspect, or Patreng’s political affiliations. The community pantry is not just a place of sharing and caring but sharing and caring between the middle and lower social classes with similar traumas caused by the pandemic and exacerbated by state inutility and terrorism. Some might’ve lost jobs, others loved ones, most of them hope. Now, they find solace and strength in being able to not only take but give, whether it’s 50 kilos of fish from small fisherfolk alliance PAMALAKAYA; sacks of sweet potatoes from a farmer in Paniqui, Tarlac; or three packs of noodles from the kind balut vendor at Maginhawa. The community pantry feeds people for a day but empowers them for much longer as they continue to struggle in a society that takes jobs, loved ones and children’s lives, and thrives on widespread hunger, doom and gloom.

Community pantries as a collective refusal to not starve are a protest whether you like it or not. And it’s disturbing how Malacañang, NTF-ELCAC, some journalists and centrist liberals all sound the same: “It’s just bayanihan and should be free of any politics.” Keep calm and share gulay, they say. A bishop went as far as declaring that these pantries with their signboards will “forever erase the shame” of cardboard justice in the drug war. Great. When they’re not red-baiting whole movements, they’re whitewashing or romanticizing them. Why do we celebrate bayanihan yet balk at the idea of hopeful, empowered masses who feed one another and understand why they starve in the first place?

“Everything is political,” says PAMALAKAYA – Southern Tagalog Spokesperson Ronnel Arambulo. “Widespread hunger is a result of government inadequacy in responding to the health crisis. The national situation should not be seen as a separate picture from community pantries.”

Meanwhile, mayors have expressed support and assured organizers of their safety. A resignation was tendered. Gag orders were issued. These are little victories, indeed, but we must not be complacent. Patreng is right: She may be safe for now but entire communities are not. Believing that community pantries are red-tagged because some have given political meaning to them is only blaming the victim. It says outright, “They deserve to be red-tagged for not submitting to the status quo.” This fascist thinking is harmful to the people.

The Iloilo City mobile community pantry by a local LGBTQIA+ group. (Photo by Irish Granada)

From the masses, to the masses

An organizer posted on FB about buying vegetables from a peasant in Nueva Ecija. Upon knowing they were for a community pantry, she said, “Napanood ko sa TV kanina. Nagugutom ang tao, pinapasara pa nila! Komunista raw. E ano naman? Namimigay lang naman! (I learned about it on TV. People are starving yet the government wants to close them! They call them communists. What about it? They’re only giving out food!)” After donating 200 pesos, she added, “Maganda ‘yang ginagawa ninyo. Pipila kami mamaya pero hindi na gulay ‘yung kukunin namin. Bigas sana (What you’re doing is noble. We’re going to line up at the pantry later but we won’t be getting vegetables. I hope there’s rice).”

It isn’t hard for the poor to understand and embrace the community pantry as their own because they struggle the most and have been quite vocal about their grievances. Instead of calling them “komunista,” “reklamador” or “pasaway,” Patreng listened. If the masses are not afraid to voice out their demands and work towards social change, why should we be? Let’s stop telling them what to do and as them instead what must be done. Let communities lead the way for community pantries. #

References:

Altermidya (2021, April 23). To ask or not to ask: Lessons on red-tagging & community pantry [Video]. Facebook. https://fb.watch/56UyZvIOhF/

Bolledo, J. (2021). “12-year-old boy chased by Pasay tanods loses consciousness, dies”. Rappler. Retrieved from https://www.rappler.com/nation/minor-chased-by-pasay-tanods-loses-consciousness-dies-april-2021

Chatinakrob. T. (2020). “Happiness-sharing Pantries: an effective weapon to ease hunger for the needy during the pandemic in Thailand”. Retrieved from https://blogs.lse.ac.uk/seac/2020/09/16/happiness-sharing-pantries/

Dionisio, J. et al (2021). “Contagion of Mutual Aid in the Philippines: An Initial Analysis of the Viral Community Pantry Initiative as Emergent Agency in Times of Covid-19”. Retrieved from https://philippinesociology.com/contagion-of-mutual-aid-in-the-philippines/

IBON Foundation (2021). “Joblessness worsens in February and will get worse with ECQ”. Retrieved from https://www.ibon.org/joblessness-worsens-in-february-and-will-get-worse-with-ecq-ibon/

Raymundo, S. (2021). “Community Pantry Ph: Hugpungan ng ginhawa at pag-iral ng use value”. Bulatlat. Retrieved from https://www.bulatlat.com/2021/04/22/community-pantry-ph-hugpungan-ng-ginhawa-at-pag-iral-ng-use-value/

A million Covid cases

Cartoon by Crisby Delgado, PUP/Kodao

Despite having one of the longest and harshest lock downs in the world, the Philippines breached one million Covid cases on Monday, April 26. This means the most number of new cases per and the most number of new deaths per million people in South East Asia. The Philippines also has the second worst number of fully vaccinated people by share of the population in the region. #

Start inoculating prisoners, rights group presses gov’t

A support group for political detainees pressed the government to start inoculating prisoners, citing the higher possibility of coronavirus outbreaks inside the country’s overcrowded and poorly-ventilated jail facilities.

“Kapatid presses the national government to release a clear schedule for the vaccination of all prisoners, including the 704 political prisoners, in the national deployment plan for COVID-19 vaccines because the congested prison system places them at significant higher risk for the disease,” Kapatid spokesperson Fides Lim said.

The group Kapatid made the call after justice secretary Menardo Guevarra said that ordinary prisoners are not yet part of the priority list for the government’s vaccination activities against the increasingly contagious and deadly COVID-19.

Guevarra said that only elderly prisoners are eligible for early vaccination.

“[W]hile waiting for their turn to get vaccinated like the rest of the population, these [non-elderly] PDLs (persons deprived of liberty) will just have to follow minimum health protocols to reduce the risk of viral transmission,” Guevarra, Inter-Agency Task Force (IATF) Against COVID-19 member, said.

‘Mixed messaging’

Lim said Guevarra’s statement however contradicts an earlier assurance by the Department of Health (DOH) that “all persons deprived of liberty as determined by Bureau of Jail Management and Penology (BJMP) and the Bureau of Corrections (BuCor) are included under the Priority Eligible Group B-9.”

Kapatid asked DOH secretary and IATF Against COVID-19 chairperson Francisco Duque last March 2 to included all prisoners among the first to be vaccinated as part of the most “at-risk populations.”

DOH undersecretary and National Vaccine Operations Center chairperson Dr. Myrna Cabotaje told the rights group that prisoners are already identified for inclusion in the priority eligible population on the basis of stratifying the risks for contracting COVID-19 infection.

“So we quote to Secretary Guevarra the very words of the DOH in their reply to us: ‘Health is an absolute human right. No Filipino will be denied their right to get vaccinated with COVID-19 vaccine. The national government assures you that every consenting Filipino will receive the appropriate COVID-19 vaccine, to protect the life and health of every citizen, including all Political Prisoners,’” she added

“Shouldn’t the DOJ and the whole national government be saying the same thing to everyone?” Lim asked.

Lim said it is ironic that the DOJ whose mandate includes the supervision of the BuCor should contradict the DOH statement and ignore the plight of over 215,000 prisoners compelled to live in subhuman conditions.

“This apparently may be yet another case of mismanagement from the top that results in mixed messaging,” Lim said.

 ‘Death traps’

Kapatid said extreme congestion inside the country’s prisons makes them “death traps” during the pandemic.

In November 2019, the BJMP reported that its 467 jails nationwide were at 534 percent of capacity as of March of that year while the BuCor said that the congestion rate in its 125 prisons was at 310 percent as of January 2019.

In October 2018, the Commission on Human Rights said “deplorable jail conditions” in the country are aggravated by the failure of the government, including police officers, to faithfully comply with even the minimum human rights standards and laws, such as the Anti-Torture Act (RA 9745). # (Raymund B. Villanueva)

Health workers say hospitals ‘on the brink of collapse’

By Joseph Cuevas

Health workers said hospitals are on the brink of collapse amid the spike in new number of coronavirus cases around the country.

In a press conference Tuesday, April 7, Alliance of Health Workers (AHW) members said hospitals are overwhelmed with new patients every day and employees themselves are falling ill from the virus.

A number of health workers also resigned or have taken early retirement options due to fear, fatigue, frustration and severe demoralization, AHW said.

Emergency rooms, intensive care units, wards, isolation facilities of private and public hospitals are overcrowded and overflowing, the group said, while tents or modular container vans are full of patients waiting admission.

“Even ordinary rooms are now being used as COVID wards. Outpatient departments are closed in most hospitals and many patients are being bumped off,” the group added.

AHW said understaffing schemes by hospitals force health workers to be on duty for at least 12 hours or even 24 hours while some hospitals only have skeletal forces.

Contractualization in some hospitals, such as job order and contract of services especially for nurses, has worsened during the pandemic, AHW revealed.

AHW officer Sean Velchez said 117 out of 180 Philippine Orthopedic Center employees are Covid-positive.

Screenshot of the AHW=led online press conference.

Delayed benefits and other issues

Union officers of the Jose Fabella Memorial Hospital and National Kidney and Transplant Institute said their hazard pay, performance bonus and health risk allowances have been delayed since 2019.

Meal and transportation allowances are also on hold after the Department of Health (DOH) recalled funds for said benefits, the unions said.

Cristy Donguines of the Jose Reyes Memorial Medical Hospital said medical equipment like personal protective gears and gloves as well as medical supplies like oxygen tanks and others are also on low supply.

Philippine General Hospital’s Karen Faurillo complained of failed contact tracing as well as lack of mass testing, isolation and treatment for health workers.

Kodao file photo of an AHW protest action. (Joseph Cuevas/Kodao)

Collapsing health care system

Solidarity of Health Advocates and Personnel for a Unified Plan to Defeat COVID-19 (SHAPE-UP) convenor Dr. Eleanor Jara revealed that primary and secondary health care systems are also failing to help the spread of the virus.

Jara said important community level Covid interventions such as mass testing, contact tracing, equipped quarantine and isolation facilities are inadequate.

Jara, whose husband was among the first medical workers lost to Covid in 2020, said the situation will only worsen as the Department of Health continues to deny government’s inept and failed Covid response.

“The government must also held accountable for the death of 97 health workers since the pandemic and the rising cases of Covid-19 among health workers and people,” she said.

The AHW demanded an overhaul of the inter-agency task force’s militaristic response to the pandemic as well as the resignation of health secretary Francisco Duque.

The group said the Rodrigo Duterte government must also be held accountable for its failed pandemic response. #

Measly ECQ aid an afterthought — IBON

by IBON Foundation

Research group IBON said that the Duterte administration’s financial assistance to families affected by the enhanced community quarantine (ECQ) is so little that it is plainly just an afterthought.

Giving assistance clearly only entered the government’s mind when it once again resorted to an ill-conceived ECQ to try and contain the uncontrollable spread of COVID-19, said the group.

The Duterte administration announced that it will distribute assistance to some 22.9 million low-income households affected by the renewed ECQ in the National Capital Region, Cavite, Laguna, Rizal and Bulacan (dubbed NCR+).

It promises Php1,000 per individual to be distributed by the local government units (LGUs) as cash or in kind.

The so-called supplementary Social Amelioration Program (SAP) is evidently hastily being put together just now, said IBON.

The group said that after a year, the government has noticeably forgotten about giving aid and has not even bothered to make any contingencies or guidelines for providing further emergency cash subsidies.

IBON also observed how the budget for this is not being determined by the needs of Filipino families being driven into deeper distress.

Instead, the allocation for aid is decided based merely on the amount of leftovers from COVID-19 response funds that should have already been spent.

The economic managers said financing would be sourced from Php23 billion in unspent Bayanihan to Recover as One Act (Bayanihan 2) funds.

As a result, said IBON, only a measly Php1,000 is being allotted per individual including for those who have already suffered joblessness, loss of incomes and livelihoods, and depleted savings after over a year of lockdowns.

This is even less than two days of the NCR minimum wage of Php537, said the group.

IBON added that the assistance looks even more meager compared to its estimated family living wage (FLW) of Php1,064 as of February 2021. The FLW is the amount needed by a family of five members each day to meet their basic needs.

As it is, even the very few families getting the full amount of emergency cash aid under Bayanihan 1, Bayanihan 2 and this supplementary SAP would only have gotten around Php15,607 to help tide them over the 54 weeks of lockdowns since March 15, 2020.

This is the sum of average assistance received under the SAP 1st tranche (Php5,637) and SAP 2nd tranche (Php5,970), and assuming a family gets the maximum Php4,000 supplementary SAP today.

IBON said that poor and low-income families in NCR+ deserve not just Php1,000 but at least Php10,000 in emergency cash subsidies to be distributed immediately, or ten times more than being offered after a year of lockdowns.

This should even be given for at least three months and then to at least the poorest 18 million or even 22.5 million families, stressed the group.

Substantial emergency cash subsidies will provide immediate relief to tens of millions of Filipinos as well as significantly spur aggregate demand to help the economy recover faster, said IBON. #

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Kodao publishes IBON articles as part of a content-sharing agreement.