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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.

A Call to the Philippine Army: Respect for Press Freedom in Word and Deed

STATEMENT: September 27, 2021

The Freedom for Media Freedom for All (FMFA) a coalition of press freedom advocates, condemns the Philippine Army’s Distributed Denial of Service (DDOS) cyberattacks on the websites of two alternative media organizations, Bulatlat and AlterMidya, as assaults on press freedom and free expression.  

We call on the press and the media community as well as free expression groups to join their voices in the collective resistance of these violations of Constitutionally-protected rights.

Philippine Army spokespersons have denied responsibility for the attacks. But the government’s own Department of Information and Communication Technology (DICT), through its Computer Emergency Response Team has traced these actions to the Internet Protocol (IP) address assigned to the PA.

DDOS attacks overwhelm websites with fake traffic and makes them inaccessible. It is no more than a form of censorship repugnant to any society that claims to be a democracy. 

Information has always been crucial to the exercise of a people’s sovereign will that is the core of a democracy. A free press must provide a diversity of views so that society can engage in the decision-making process, debate and argumentation that is crucial to good governance.  

It is specially vital today when, besieged by a pandemic and in preparation of national elections in 2022, Filipinos must be able to decide who will lead them for the next six years after the end of this administration. The Filipino people are called to make one of the most important decisions in the country’s political history. 

The Philippine Army is sworn to defend the country and protect the people. Its service does not operate in the political sphere. In contrast, the press in providing news is necessarily engaged in political affairs. The Army’s interference in the conduct of news organizations over reaches the military mandate. Even as it claims to respect press freedom, these recent actions have directly attacked the press, an institution protected by nothing less than the Constitution. 

Since the military by its function is not a repository of democratic values, we call on our soldiers to cease forthwith this insidious campaign to silence media and its members; to limit citizen access to views and perspectives that may differ from those held by the government in power. 

The Philippine Army should demonstrate the respect for press freedom in deeds as well as in words. 

Signed,

National Union of Journalists of the Philippines (NUJP)

Center for Media Freedom and Responsibility (CMFR)

Philippine Center for Investigative Journalism (PCIJ)

Mindanews

Philippine Press Institute (PPI)

CHR: Democracy needs a free press

The Commission on Human Rights (CHR) underscored the role of a free press in a democracy, even as it noted the Philippines’ steady decline in the World Press Freedom Index in the last four years.

In her keynote message for a journalists and human rights defenders’ project Friday, May 28, CHR executive director Jacqueline Ann de Guia said democracy needs a free press to thrive and survive.

“It is the power of a free and independent media—to be a watchdog, to promote transparency and accountability, and to amplify the voices of the weak, disadvantaged, and marginalized—that put pressure on government to be responsive to the needs of the people,” de Guia said.

De Guia however expressed alarm at the state of press freedom in the country, adding that international group Reporters Without Borders has noted continuing attacks against mass media, journalists and other human rights defenders in the past four years.

“The state of press freedom in the country is a cause for concern for CHR. In the past four years, data from the World Press Freedom Index shows a continuous decline of the Philippines from 133rd out of 180 countries in 2018; to 134th in 2019; 136th in 2020; and 138th in 2021,” de Guia said.

De Guia spoke at the project launch of Safeguarding Journalists and Human Rights Defenders in the Philippines by various media groups led by the Asian Institute of Journalism and Communication and the International Media Service.

Other attendees included members of the Journalists Safety Advisory Group (JSAG) that crafted the Philippine Plan of Action for the Safety of Journalists (PPASJ) last November 2019 on the occasion of the 10th anniversary of the Ampatuan Massacre.

The JSAG included the National Union of Journalists of the Philippines, Center for Media Freedom and Responsibility, Center for Community Journalism and Development, and the Philippine Press Institute.

Commission on Human Rights executive director and spokesperson Atty. Jacqueline Ann de Guia. (AIJC photo)

In her address, de Guia said the press must maintain its ability to expose corruption, demand redress of grievances, and call out lies and propaganda in favor of truth.

She added that the press must equally allow the people to decide better and demand more from the government that bears the obligation to uphold and protect the human rights of all.

The last four years have seen journalists, media workers, and media organisations being repeatedly confronted by a dangerous and hostile climate marked by episodes of harassment, silencing, and even death.

“And with the closure of ABS-CBN, we have greatly felt the gap in delivering critical information in hard-to-reach communities to help them cope and survive disasters, calamities, and this current Covid-19 pandemic,” she said.

De Guia said that the CHR’s Task Force on Media-Related EJKs (extrajudicial killings), with regional desks in its Bicol, Cotabato and Cebu regional offices, is ready to investigate attacks against the press.

“Thus far, 21 media killings have been docketed for investigation in different CHR regional offices covering July 2016 to May 2021. We are also investigating 7 cases involving 20 victims of other alleged human rights violations, including unlawful/arbitrary arrest/detention, frustrated killings, and red-tagging,” she said. # (Raymund B. Villanueva)

Groups condemn red-tagging of 2 CDO journalists

Media groups condemned the worsening attacks against the press in the Philippines following the death threat against Mindanao Gold Star Daily associate editor Leonardo Vicente Corrales, who is also alleged to have a P1 million bounty on his head.

In a press conference, the National Union of Journalists of the Philippines (NUJP) raised concerns over the red-tagging of Corrales, along with veteran journalist Froilan Gallardo of MindaNews.

On August 27, Corrales received flyers sent via courier service alleging that both him and Gallardo are members of the Communist Party of the Philippines and New People’s Army.

The courier packet, sent on August 24, identified the sender as Danilo Tirso Mantangan of Sitio Camansi, Lagonglong, Misamis Oriental with mobile phone number 09091020123.

“It’s an attempt to brand journalists as combatant parties of the conflict, instead of journalists and civilians,” NUJP Western Mindanao safety officer JB Deveza said.

Deveza pointed out that the flyers also attacked the credibility of the journalists by describing them as “biased” and “supporters of terrorist organizations.”

“We expect that this is not going away soon,” Deveza said, explaining the need “to express our outrage and for the state to do something about it.”

“It does not only endanger the life of our colleagues but also depriving the community of fair and unbiased reporting,” he added.

Conflict journalists

Gallardo, who has covered the various conflicts of Mindanao for since the 1980s, said he was included in the ongoing red-tagging of journalists, lawyers, church workers and activists for having recently interviewed the New People’s Army about a raid they carried out in August.

“We cannot just write the government’s side, but also the rebels’,” Gallardo said.

“If they think that by doing this they would kill the idea of journalism, they thought wrong”

Gallardo said journalists are duty-bound to get the side of rebels in the many conflicts in Mindanao as they are expected to interview government armed forces as well.

“We fail to get both sides of the story, then we are no good as journalists,” Gallardo explained.

Predicate to ‘terrorism’

Former NUJP chair Inday Espina-Varona said journalists do not work in a vacuum and called the attacks part of a national government policy stemming from President Rodrigo Duterte’s vow to “crush Asia’s longest running communist insurgency.”

“Actually, he (Duterte) had given himself his own deadline of June 2019, so there is a sense of urgency now,” she said, adding that the red-tagging on Gallardo and Corrales are connected and appeared to be in line with government’s efforts to amend the Human Security Act.

Among others, this could lead to the classification of journalists’ interviews of persons or groups tagged as terrorist as “an accessory to crime and to terrorism.”

“There is a strong attempt from government officials to not allow this (interviews with rebels) anymore because it is deemed to be giving succor to their enemies,” Varona said.

“The government’s view is: if you don’t want to be red-tagged then you need to condemn certain parties, which is not what a journalist does,” she added.

Making journalists vulnerable

Varona said the sedition charges filed against opposition figures, which stemmed from a bogus ouster matrix Malacañan Palace itself released, makes journalists vulnerable as it opens the possibility of their inclusion in the case.

“There’s a lot of institutional repression, but it’s not just enough to say ‘let’s wait for a law or a campaign’ because these attacks are not a joke and should be taken very seriously. They should be laid at the feet of a government that consistently failed to recognize these threats,” she said.

Jonathan de Santos, NUJP National Capital Region chair stressed that journalists are civilians and should not be labelled as belonging to any side in the conflict for simply doing their jobs. He added that if this can happen to journalists, it could happen to anyone.

Ms. Azenath Formoso of the Commission on Human Rights (CHR) read spokesperson, Atty. Jacqueline Ann C. de Guia, CHR spokesperson, calling attacks on journalists attacks on people’s right to the truth and to be fully informed.

The CHR It also echoed calls for security forces in Cagayan de Oro and Northern Mindanao to investigate the red-tagging and ensure the safety of targeted individuals.

The College Editors’ Guild of the Philippines (CEGP), meanwhile, said the attacks against Corrales and Gallardo extend to the ranks of the campus press.

“Military intelligence agents infiltrate campuses all over the country and take pictures of student publication offices,” CEGP national secretariat member Trixia Amboy said during the press conference.

In a statement, the Philippine Press Institute (PPI) for its part called the red-tagging of Corrales and Gallardo “baseless and irresponsible.”
This does not only endanger the profession and render chilling effect but also put the lives of those red-tagged and their families at risk,” PPI said.

“We urge the government to hold accountable the perpetrators of such false, malicious and dangerous propaganda,” PPI added. # (Raymund B. Villanueva)

Media groups reject media regulation

Media groups reject a proposal to regulate mass media through a so-called Magna Carta for journalists, as announced by a Malacañan official Friday.

The National Union of Journalists of the Philippines (NUJP), the College Editors’ Guild of the Philippines (CEGP) and the Philippine Press Institute (PPI) rejected outright the proposal of the Presidential Task Force on Media Security (PTFoMS) to regulate the profession “in the guise of a “Magna Carta.”

In reaction to a speech by PTFoMS executive director Joel Egco in Baguio City Friday, the groups said it was not the first time that such a measure is being proposed, which they have consistently opposed.

SunStar-Baguio reported Egco as saying the proposed measure would seek to professionalize journalism through qualifying and classifying exams.

“If you want to become a media personality, you will have to take an exam every six months to assess your qualification which would set either a managerial position or a corresponding salary level or grade equivalent to that of government,” Egco was quoted as saying.

Egco was addressing Northern Luzon journalists who attended a seminar on media safety protocols developed by the PTFoMS in light of the continuing threats against media workers.

He said that professionalizing the ranks of journalists by classifying them into three levels would lessen threats against them.

“With the qualifying exam, journalists can now be qualified as a level 1, 2 or 3, and depending on the vacant position to be applied, they can now for example apply for a reportorial position which is level 2 while obtaining a level 1 qualification,” Egco said.

Saying that while it does not question Egco’s intent, the NUJP, however, said the proposed “Magna Carta,” which goes so far as to set salary grades depending on “competency,” is fraught with danger.

The group added that the proposal would allow the government to determine who can or cannot be a journalist, which is totally anathema to a profession that can thrive only in independence.

The CEGP for its part said the proposed Magna Carta is a misguided attempt by President Rodrigo Duterte’s “politically erratic regime, known for its pseudo-journalists, trolls, fake news and manipulation of public opinion.”

The student journalists said that the Duterte government is in no position to dictate on the media since its own “biases and sensibilities are geared towards the creation of state-sponsored fake news that dumb down the toiling masses.”

A Philippine Press Institute officer, meanwhile, said on a social media post that their group has already rejected the so-called Magna Carta a long time ago.

“’Levelling’ has nothing to do with quality of journalism. We should [instead] care for the following: welfare and protection, ethical practice, and truth-telling,” PPI executive director Ariel Sabellino said.

The NUJP added it cannot allow government the opportunity to meddle in any way in the profession and urged journalists as well as media owners to unite in opposing what it called a clear threat to freedom of the press and of expression. # (Raymund B. Villanueva)