CBHPs (Community Based Health Programs): Celebrating 40 Years of Serving the People. - If good governance starts local, then meaningful public health service must be communal.
I have been in the health profession for about 17 years now, a short period of time compared to my professors in the university and colleagues who’ve been in community medicine for ages, but throughout that short period of time, I saw how the Philippine health situation ironically deteriorated through the years despite the breakthroughs in medical science and technology.
One defective health policy after another (e.g. privatization, deregulation, decentralization) negated whatever gains we harvested from all-out efforts of concerned community doctors and public health professionals. This resulted in health care becoming more inaccessible to the majority as one administration after another (post-Marcos era) failed to address the health needs of the population.
Although the future may seem bleak, there is a silver lining to all these. Unknown to many of us who live in the fast-paced life of the cities, there exist ordinary people, health professionals, nurses, midwives, hospital workers, and doctors who continue to band together and work for the change that we all desire for our children. They don’t need awards or recognition for doing what they do. They just do their work with only the people’s welfare in mind. They are the unsung heroes.
Flash back to 1973
The gravity of the health situation correlated with the economic, political, and cultural panorama in the country. The raging economic crisis and political turmoil resulted in an all-time high poverty index and widespread neglect of basic social services.
Taking inspiration from the concept and practice of the “barefoot doctors of China,” nuns Sr. Xavier Marie Bual SPC (+), Sr. Eva Varon MSM (+), and Sr. Mary Grenough, MM turned the tables when they pioneered community-based approach to health care or what came to be known as Community Based Health Program.
In its core, CBHPs view that health problems should be seen in context of Philippine society. CBHP is not the answer to all the problems but serve as a means to initiate social transformation.
CBHPs also believe that organizing is the key and the backbone to its continuing existence and growth. For CBHPs to succeed there must be recognition that health problems need to be solved through people’s participation and organization.
Through their organizations, the people can articulate their problems and needs; collectively analyze them, and jointly work towards their resolution. Solid organizing, on the other hand, ensures the active participation of community members in the economic, political, and social aspects of development.
Rooted in communities, CBHPs aspire for a health care that is nationalist, relevant, accessible, and responsive to the needs of the people.
Countryside revolution: Empowering the people.
From a handful of community health workers who initially trained in the different Diocese in Ilagan (Isabela), Palo (Tacloban), and Iligan (Lanao del Norte), there are now more than 10,000 CHWs serving their communities in most of the major provinces. CHWs have become an integral part of their communities, providing basic health services with emphasis on self-reliance and disease prevention.
One such volunteer is Virginia Serendo of Barangay Bug-ang, Toboso, Negros Occidental. Around six to 10 patients visit her house every day.
The funny thing is that she is not a barangay leader or a fortune-teller. Neighbors and other folks coming from the far sitios of their village frequent her home for health advice and treatment.
Serendo is one of the CHWs trained by a CBHP in Negros in 2009. After finishing the three-level Basic Health Skills Training course, she has learned to diagnose simple diseases, prepare herbal medicines, and administer acupuncture and acupressure. She was able to apply what she learned by providing health care services to community members.
Her health knowledge and skills have earned her the trust and confidence of the community members. They seek her for health advice and for various health treatments, but say she and her fellow CHWs never hesitate to refer patients to the hospital or clinic if the medical condition of a patient is beyond their capacity.
“Our skills will never compensate for a doctor’s, but in places where most of our villagers have died without seeing a doctor, the diagnostic skills we have learned through various trainings have helped decrease the feeling of helplessness during times of crisis,” Serendo said.
Community members are so confident of her skills in preparing herbal medicine, particularly lagundi that they pool some amount and request Serendo to produce herbal medicines in bulk for the need of the community.
Health mass movement
In the face of a disorganized Philippine health system that urban-centered and focused in tertiary care, the practice of community-managed health programs made significant contributions not only in terms of improving the community’s health but in awakening and mobilizing the people to deal with the root causes of poverty-related sickness.
The CBHP helped transform thousands of trained and dedicated community health workers into organized community health committees and teams that take care not only of the community members’ health, but also lead a continuing campaign to uphold the people’s right to health.
They continue to lobby the government to address the health needs of the people – on whom sovereignty resides and from whom all government authority emanates as stated in our Constitution.
This specific duty is covered in the so-called “general welfare clause” of the basic law of the land,. Aside from guaranteeing the people’s the right to life, liberty, and the pursuit of happiness, the Charter calls on the State to “promote the general welfare” of all.
Thus, today, in the midst of a raging controversy involving the pocketing of more than P10 billion of taxpayers’ money, it is only right that we demand from President Aquino that these funds be allotted to social services that would directly benefit the people.
The President must try his very best to emulate these CHWs or at the very least reciprocate their heroism with an act of selflessness and nationalism on his part.
Celebrating 40 years of serving the people
On November 12-14, we will be celebrating the 40th anniversary of CBHP in the Philippines with the theme “Apatnapung Taon ng Puspusang Pakikibaka at Paglilingkod sa Sambayanan”.
A fair would be held on November 12 to 14 at the UP Manila College of Medicine grounds, coordinated by the national secretariat, the Council for Health and Development and the office of Dean Agnes Mejia.
Other commemorative activities and attractions include exhibits, interactive booths, acupuncture demonstration, herbal preparation, and sharing of experiences with CHWs from different CBHPs in Luzon, Visayas, and Mindanao.
Meanwhile, the 4th National Colloquium of Community Health Practitioners and Advocates titled “KKK: Kalusugan, Kabuluhan, Kabayanihan” would be held simultaneously on November 13-14 at the Buenafe Hall, UP College of Medicine, Manila.
- Dr. Darby Santiago
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