Risking their Lives to Bring Health Services to the Poor in Remote Areas

Even as they provide much-needed health services in far-flung areas, community health workers (CHWs) are not spared from being targets of the military’s counter-insurgency campaign. In Guihulngan, Negros Oriental, two CHWs shared how they risk their lives just to be able to continue serving the poor. Their stories reveal how soldiers from the Armed Forces of the Philippines (AFP) hamper their work and harass them in violation of provisions of international humanitarian law protecting medical personnel.

Volume VIII, Number 28, August 17-23, 2008

Guihulngan is a fourth class municipality in the province of Negros Oriental. Mountainous, the city is 120 kilometers away from Dumaguete City.

With a population of 91,358 based on a 2007 government census, there is only one government hospital in the city, the William Villegas Memorial Hospital. The hospital has 50 beds and four doctors. Medicines are also limited.

Patients who go to the hospital are sometimes referred to the Dumaguete Provincial Hospital. Most of them would not go due to financial constraints. They have to pay at least P1,000 ($22.07 at the Aug. 15 exchange rate of $1:P45.31) for the ambulance that would take them to Dumaguete.

Farming and fishing are the main sources of livelihood. Majority of the residents do not have money for hospitalization. They solicit financial support from politicians, when they have to seek hospitalization.

The municipal health officer is also assigned to two more rural health units. She is burdened with triple tasks without additional pay.

Mountain clinic

Given the deplorable health situation, alternative health care is important.

The Order of Franciscan Missionaries (OFM) established two mountain clinics in the 1970s, one in Sitio Kalabaklabakan, Bgy. Trinidad and another in Sitio Kansalakan in B Banwrangay (village) Banwage.

Bulatlat visited the mountain clinic in Brgy. Trinidad. The village is 33 kilometers away from the city proper. From the city, one would have to take a tricycle and a 45-minute ride on a motorcycle used as public transport (called habal-habal) before reaching the place.

The initial approach was clinic-based and curative. They started with the barrio medical aides (BARMA) who are capable of basic health skills.

It was in 1983 that the approach was changed to community-based health program (CBHP). Nuns from the Rural Missionaries of the Philippines trained CHWs to serve in the communities.

Hampering services to the poor

Bgy. Trinidad has 13 active CHWs, 35 family health workers and 50 newly-trained CHWs.

CHW Amy Tapales who has been working as a staff of the mountain clinic since 1978 said that the military presence has hampered the health care delivery of CHWs.

She said that the mountain clinic has five satellite clinics but only one remains functional, the one in Sitio (sub-village) Malabanahaw.

Josephine Saguran, another staff who has worked there since 1991, cited an incident when patients from Sitio Kambairan went to the mountain clinic. “To avoid a military checkpoint, the patients had to pass through the river,” she said.

Tapales related, “People cannot come here anymore. We are also cautious of going to the communities.”

Before, the clinic has at least 50 patients per month. These days, very few patients would risk going to the clinic. “Some of our medicines have already expired,” said Tapales.


Saguran related that on Oct 1, 2005, the soldiers strafed their house. She said that they were lucky that nobody got hurt. Her daughter could have been hit if she had not been able to move fast enough. That day, four other CHWs were staying at her house.

They recovered 19 bullets after the shooting. The perpetrators were men in uniform with no nameplates.

Three days later, on October 4, 2005, about 40 soldiers from the 11th Infantry Battalion of the Philippine Army went to the mountain clinic. They occupied the multi-purpose hall, kitchen, cottages and clinic area. The staff members then were at the city, attending the Foundation day of the St. Francis of Assisi Seminary.

Tapales’ husband, whose house is beside the mountain clinic, saw the soldiers. The soldiers pointed a gun at him.

On July 28 this year, Saguran and Tapales attended a forum organized by Kaugmaon at the second floor of the public market in Guihulngan City.

A man approached Saguran and introduced himself as an employee of the provincial office. Saguran suspected that the man is an intelligence agent of the military.

The next day, the same man sent her a text message. “You have to clear your name.”

Saguran replied, “My name is Josephine, that’s very clear.”

A couple, both of whom are CHWs, was visited by the military who took their kits from the health training. The soldiers just said they would return the papers.

Another CHW was visited by soldiers but she refused to give her training kits.

Tapales related one incident when they were cooking medicinal plants. The soldiers told them, “That’s for the NPA.”

Feleciana Sta. Ana, another CHW, was unjustly accused as a member of the “medical team” of the NPA. The soldiers stayed in their house for weeks.

“We are in the order of battle,” said Tapares.

Other CHWs who experienced harassment are the Quirante sisters Emilia and Marycris. Tapares said both of them provide acupuncture services to the residents. Emilia, former chair of peasant group Kaugmaon also acted as the health committee chair of the group.

In Bgy. Linantuyan, Lourdes Baloy, also a Kaugmaon leader and CHW, has been slapped with charges of grave coercion by the military.

Violations of international humanitarian law

According to the Health Alliance for Human Rights (HAHR), the military’s actions constitute violations to international humanitarian law stated in the Geneva Conventions Protocol II.

Article 9 of the Geneva Convention provides for the protection of medical and religious personnel. “Medical and religious personnel shall be respected and protected and shall be granted all available help for the performance of their duties.”

Furthermore, Article 10 provides that, “Under no circumstances shall any person be punished for having carried out medical activities compatible with medical ethics…”

In Bgy. Mani-ak, soldiers occupied the barangay hall and the chapel, said Tapares. “They even stayed in houses.”


Tapales called for the immediate pull out of military troops in Guihulngan. “Sila ang nagdadala ng gulo. Wala naman silang ibinibigay na social services.” (They are the ones disrupting the lives of the people in the communities. They do not provide social services.)

Saguran said, “When they give you a can of sardines, they ask for a live chicken.”

Asked what keeps them going, Saguran replied, “Guihulngan is my home…I feel satisfaction when I am with the people.”

Tapales said she has learned a lot from the people and she longs for the day when the people would be free from inequities. (POSTED BY Bulatlat.com)

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