My mom, who hails from Bicol, has experienced being forced to stay home or evacuate during Mayon Volcano's eruptions. However, she tells me that in facing today's public health crisis, she's "unaccustomed." She constantly goes to me and asks me to explain to her what "enhanced community quarantine" means. If the resolution isn’t obeyed, what are the repercussions? And the list just grows longer and longer, day by day while we are locked in our own home to wait ‘til the quarantine protocol is lifted.
Aside from the ongoing efforts to lessen COVID-19 cases from affecting a greater population and putting Filipinos at risk, the bigger picture that our public servants should take into consideration is the impact this pandemic is creating on the communities being left behind. They must look at the urban and rural poor, Filipinos who rely on their informal sector jobs, and people living below minimum wage who, like my mother, have absolutely no idea about the "how to's" in dealing with this novel virus socially, mentally, and economically. The coronavirus' taking their livelihood away is for them the only downside to this pandemic .
In the past week of the quarantine, I've noticed that the marginalized sector often relies on what their neighbors see on TV about COVID-19. Most of the time, they fall prey to fake news surrounding their sitios, or unverified videos and chain messages circulating on Facebook. Unfamiliarity with the imposed circumstances and constant misinformation can lead to serious problems we might overlook.
Remember, laborers and workers have resisted staying at home, and despite the agony the virus can bring, continue to work “normally.” A lot of people have criticized them, calling them selfish, illiterate, and “pasaway/matigas ang ulo,” as if they really wanted to risk their necks outside. Either way, these workers could die: work outside and get the virus, or stay inside and die from hunger. (READ: [OPINION] Let’s not forget the poor during the coronavirus pandemic)
Moreover, in my barangay, patrols roam around, announcing, “Huhulihin po ang mga aso para hindi na kumalat ang virus," and “Wala na pong pupunta ng computer shop, bawal po mag-inuman sa kalsada, manatili lamang po sa inyong mga bahay.”
Yes, the messaging is straightforward but do we really think that what we do routinely, and on a normal basis, can just be halted by reprimanding announcements and weak communication measures? It could have been more productive if on-the-ground announcements were about how to prevent catching the virus, what the infection pathways are, who to contact locally, what the specific domestic precautions are, etc.
What are the most important questions relevant to the underrepresented? What are the practical questions they have in mind which are not being addressed?
What can help? A “community-centered” response
Beyond securing effective communication tools, and producing rapid change in managing this pandemic – the ongoing enhanced community quarantine should look into understanding the protocol's keyword itself: "community.” A concrete and definitive community-centered response can be one of the most effective interventions in our context. This enables us to look beyond developing mobile applications and analyzing statistical projections of COVID-19 cases, which are, more often than not, not immediately relevant or important to the communities/marginalized sector.
Community-centered response aims to prioritize the vulnerable, the poor, and women to successfully mobilize local, and in our context, barangay-level security and active involvement.
In Liberia, community-centered response was one of their key tickets out of the Ebola crisis. The response highlights effective “risk communication.” Their strategy is very simple. They organized the key actors in the community and let them do informal surveys, identifying key issues highlighting people’s in-depth fear and the roots of the stigma, soliciting behavior patterns, and understanding community-based culture, values, and collective motivation.
The strategy also aimed to achieve community self-reliance and to build a bottom-to-top approach by cultivating a culture of caregiving. This response prioritizes prevention of further cases and protecting the current community situation outside the confirmed cases.
However, we have to take into account that Ebola and COVID-19 have keen differences in terms of severity and transmission.
How do we replicate this in PH?
In the Philippines, the Department of Health has heavily relied on social media to produce and reproduce information materials for the public. While Viber, Facebook, and Twitter have enormous reach, we can’t deny the fact that we are still preaching to the same crowd over and over again. Social distancing has restricted our mobility, but it isn’t an accepted excuse to further the class divide and to prevent decent and accurate information from reaching others with no access to social media.
We've seen how groups, institutions, and individuals have mobilized donation drives, offered free online psychosocial support, and filled in the financial gaps that have kept our fellow Filipinos from getting their most basic necessities. And while our collective effort has reached thousands of our kababayans, these efforts alone aren’t enough.
How do we visualize a community-centered response in the Philippines? We first have to understand how we respond and communicate the risks.
1. Each unit of the society should have a clear role. Provincial and municipal health officers are our frontliners in this response. One of the key objectives is to standardize response through the directive of provincial health offices. Barangay health workers (BHWs) shall be at the forefront as well. My experience with BHWs is that they are technically volunteers with minimum pay. We have to deploy them and pay them full time because they have full knowledge of their communities, sitios, and compounds. Subdivision housing association members can also be second in line. In rural cases, chieftains, chief leaders, IP leaders can also lead and coordinate with the barangay. In Libon, Albay a Barangay Health Emergency Response Team was formed even before the quarantine in NCR was enacted.
2. The mass number of donation drives is an opportunity to interact with beneficiaries and at the same time provide relevant info dissemination/pamphlets that’s easy to understand. Translating the materials to one’s own mother tongue is preferable but we need to ensure that these materials reflect massively on the perceptions, identities, fear, stigma, and information needs of our communities.
3. Protocols that are community-centric mean they are clearly adjusted to the local demands. For one, we need to adjust to the local ways of mobility. The use of tricycles and pedicabs are practical and can pass through small eskinitas and hard-to-reach parts of the localities. Many have also rallied that tricycles are effective in observing social distancing measures.
4. Inclusion of detailed contingency planning and thorough community-care. This includes localizing mass testing, and building testing centers per city/municipality. Community-care shall include the roles of family members with or without a COVID case in the family. Filipinos' close familial ties shall be recognized and should be used to the community’s advantage by making family members first responders as well. Upfront participation of social protection workers are also essential in monitoring community quarantine measures.
In a community-centered response, total lockdown isn’t advisable. As what we are currently experiencing, it only perpetuates human rights violations. Lockdown masked as enhanced quarantine also produces stigma and violence at home. Conflicting individuals also tend to hide the disease because a lockdown only generates an image of “kahihiyan” (shame). A lockdown only adds to the wider class divide and privilege of access.
What we propose under this response is collective and centralized community effort to mass produce awareness raising, prevention, and response measures.
Our current version of the enhanced community quarantine has no sense of "community" at all. What we hope for is an institutionalized “bayanihan” – involving the most affected and basic units of our society in communicating, mobilizing, and decision-making.
To end this pandemic, we must first eliminate communicative inequality: a symptom that has contributed to the cause of wider health disparities rooted in our health system.
My Lolo, despite already in his late 70s, is still an active farmer. He’s also leading their town’s senior citizen coalition in Bicol. Will he ever have enough resources at hand for him to fully understand that this awful pandemic is harmful their age group?
He and so many other Filipinos are why we should shift to a community-centered response in order to combat COVID-19. – Rappler.com
Jona Turalde is an anthropology student and reproductive health advocate. She is the youngest board member and champion of the SheDecides movement. Public health policies and women’s human rights are her favorite conversation starters. She tweets at @jonaturalde.