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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.

Protesta ng LGBT sa Mendiola, marahas na binuwag

Umabot sa 20 na lumahok sa taunang Pride March ng Lesbian Gay Bisexual at Transgender group na Bahaghari ang hinuli matapos na marahas na buwagin ang kanilang protesta sa Mendiola, Hunyo 26, 2020.

Pahayag ng Bahaghari spokesperson Rey Valmones-Salinas na mapayapa ang kanilang aktibidad at sinusunod ang social distancing dahil sa pandemya subalit hindi nagtagal ay sinugod sila ng mga pulis at hinuli kabilang na ang mga driver ng kanilang sasakyan.

Nakadetine ngayon sa Manila Police District ang mga nahuli. (Bidyo ni Joseph Cuevas/Kodao)

IFI apologizes to sexual minorities, rejoices in the presence of LGBTIQ+ among members and clergy

Iglesia Filipina Independiente (IFI) urged its members to embrace lesbians, gays and people of all other sexual orientations in an edict issued by its Supreme Council of Bishops (SCB) earlier this year and currently being circulated on social media.

Hoping to end “hurtful hate and suspicion,” the Church said it is challenged to stand with lesbian, gay, bisexual, transgender, intersex, queer/questioning and those who identify with the other sexual minorities (LGBTIQ+) as it did when it “affirmed the gift of women priesthood” in the 1990s.

“We believe that the Church must openly embrace God’s people of all sexes, sexual orientations, gender identities and expressions (SSOGIE) as we embark on a journey toward a just and peaceful world,” the SCB statement “Our Common Humanity, Our Shared Dignity” said.

Founded in 1902 as a revolutionary national church, IFI continues its reform-oriented doctrine and practice, including tolerance of freemasonry, optional celibacy for its clergy, women priesthood, and special missions for oppressed sectors such as the Lumad of Mindanao.

The Bishops apologized to the sexual minorities for the failures in the past.

“We humbly ask for forgiveness for the many times we have shown indifference, and have made the LGBTIQ+ people feel less human, discriminated against and stigmatized. We apologize for instances they felt that, through our thoughts, words and deeds, God’s love is selective,” the statement said.

IFI said the presence of the sexual minority among its members and clergy must be recognized and rejoiced.

“We applaud their persistent belief in God’s embracing love. The judgment, intolerance and non-acceptance have not stopped many from serving the Church, even through the priestly order. They have enriched the life, work and witness of the Iglesia Filipina Independiente,” it said.

The SCB also said it hopes its move can effect change among other Churches and church people.

“Through this declaration, we implore agenda-setters to discuss laws and initiatives challenging LGBTIQ+ discrimination. Only through this can we truly protect our brothers and sisters in the community, against issues such as abuse and the rise in HIV and AIDS cases in the sector; against avoidable fear, suffering and caution,” it said.

Need to propagate

IFI priest and human rights advocate Dionito Cabillas said their Church must strive to propagate the statement as it is an official declaration from its supreme council.

Cabillas said not all IFI members are ready to accept the edict, but its clergy must explain and teach it in their respective congregations.

“To be true to our revolutionary tradition, we must be a Church that truly loves God, serves the people and struggles to eliminate all forms of discrimination,” Cabillas said. # (Raymund B. Villanueva/Featured image from IFI-Negros Occidental FB page)

LGBTs make voices heard at SONA protest

By Mark Kevin Reginio

Rainbow-colored flags enlivened the streets as members of the lesbian, gay, bisexual and transsexual (LGBT) community joined the massive protest during Monday’s second state of the nation address (SONA) by President Rodrigo Duterte.

Naniniwala kami na andaming ipinangako ni Duterte – na po-protektahan at irerespeto ang karapatan ng LGBT, ang karapatan ng kababaihan at isusulong ang anti-discrimination bill at ordinances. Hindi niya natupad kaya naririto kami para singilin siya,” BAHAGHARI-Metro Manila spokesperson Bernadette Neri said.

More than demanding the president of their representation, the LGBT community also called on Duterte to recognize their basic rights.

A working class LGBT, Alena Lauriua, 19, joined the protest to call on the abolishment of contractualization policies on workers.

Kaya sumama ako rito dahil ramdam ko ang hirap ng mga mamamayang Pilipino. Maraming pangako ang rehimeng Duterte, sa mga mangggawa na ititigil ang kontraktuwalisasyonat endo (end-of-contract) kung saan ito’y hindi pa naipapatupad sa mga kompanya,” Lauriua said.

Labor secretary Silvestre Bello III last year said the Duterte administration will not allow contractualization among workers. Latest data by the Philippine Statistics Authority however reveals there are about 4.5 million non-regular workers in the country a year into the Duterte presidency.

Lauriua is working at a handicraft company where she receives sub-minimum wages.

Free education

Yan Puno, 15, a youth LGBT, attended the rally to call for free education.

[Nanawagan po ako para sa] libre at pang-masang edukasyon,” Puno said.

He is also part of Kalipunan ng Damayang Mahihirap who recently occupied around 5,000 idled houses in Pandi, Bulacan. But while they were successful in achieving free housing, youth members of KADAMAY still demands free education as a matter of right and state obligation.

Duterte promised the youth of free education for all starting this school year but later retracted saying he first wants to prioritize ‘financially disadvantaged but academically able students.”

Neri hopes the president would fulfill promises he made last year in first SONA, including the continuation of the peace talks with the National Democratic Front as well as ending martial law in Mindanao.

“Kinakailangan na itong mga kagyat na usapin ay makatugon siya ng positibo para sa mamamayan. Kung tumitindig siya para sa mamamayan ay tumitindig din siya para sa mga LGBT,” she said.#

Bayan: Send Pemberton to Bilibid

Bagong Alyansang Makabayan and other patriotic organisations held a protest rally in front of Camp Aguinaldo last December 4 to condemn what they believe is preferential treatment to convicted killer US Marine Lance Corporal Joseph Scott Pemberton.

According to Aaron Bonette, chairperson of the LGBTQ organisation Bahaghari, Philippine President Benigno Aquino killed Filipino transgender Jennifer Laude for agreeing to a special facility for the US soldier instead of a national Filipino prison as originally ordered by the trial court that convicted him.

The US refused to turn over to Philippine authorities after his conviction last December 1 and instead insisted that Pemberton be brought back to the military camp where it has its own facilities.

Both Philippine and US governments are reported to be jointly building a new jail for Pemberton in accordance with Visiting Forces Agreement provisions.

Patriotic organisations however say that the move is not only unjust to the victim but is in fact another violation of Philippine sovereignty by the US government.

The protest rally also called on the abrogation of the Visiting Forces Agreementbetween the US and Philippine governments. #

US Marine found guilty of killing Filipino transgender

Militant organizations cheered as the Olongapo Regional Trial Court found US Marine Lance Corporal Joseph Scott guilty of homicide for killing Filipino transgender Jennifer Laude.

Led by the Bagong Alyansang Makabayan, they held a vigil rally last December 1 as the promulgation of the judgement was ongoing.

Bayan secretary general Renato Reyes Jr said that the Filipino people should remain vigilant on where the convict would be jailed.

Their fears were proven correct soon after as the Philippine government agreed to returning Pemberton to the US-controlled facility Joint US Military Advisory Group compound inside Camp Aguinaldo.

This move violated the court’s order that Pemberton should first be committed to a Philippine jail facility such as the National Bilibid Prisons pending formal agreements on where the convict should serve the rest of his jail term.

Pemberton should be committed to a Philippine jail, militants insist

Militant organizations held a protest rally while the promulgation of the judgement on US Marine Lance Corporal Joseph Scott Pemberton was being read at the Olongapo Regional Trial Court last December 1.

Pemberton was found guilty of committing homicide in connection with the death of Filipino transgender Jennifer Laude last year.

He was sentenced to a minimum of six year and a maximum of 12 years for the crime.

While declaring partial victory over the conviction of the US soldier, the militants said that he should be jailed in a Philippine correctional facility.

They warned that the US government may initiate moves to take custody of the convict and that the Philippine government may agree to such machinations.

They were proven correct when the US and Philippine government immediately agreed to transport Pemberton to a US facility inside Camp Aquinaldo last night.

The move is contrary to the explicit instructions of the court to bring Pemberton to a national jail such as the National Bilibid Prisons.