Community health nurses | Taking care of the poor and underserved

“For me, when a child says that she has not seen a nurse nor a doctor, that means that is where my services are needed.”


MANILA – Many nurses are forced to leave the country to work abroad due to their dismal working condition. But there are also nurses who dedicate their life to serve the underserved in the countryside.

Among them are Ruth Ello and Carmen Bolinto.

Ello is with the Health Empowerment and Action in Leyte and Samar (Heals), while Bolinto works in the Cordillera region. They chose to work in the communities where people die without seeing doctors, there are no health facilities, and mortality rate is high even for preventable illnesses.

Bolinto said she chose to serve in the community because health services do not reach people in the interior villages unlike in the city where services are concentrated.

“Nurses who chose to work in the country are in the city. But even then, social services are still lacking in the urban poor areas. That is why there is a need to serve in communities where people are mostly neglected,” she added.

Carmen Bolinto, 20 years working as community health nurse in Cordillera region. She joined the recently held National Conference of Nurses in Manila last March 19 and 20. (Photo by A. Umil/
Carmen Bolinto, 20 years working as community health nurse in Cordillera region. She joined the recently held National Conference of Nurses in Manila last March 19 and 20. (Photo by A. Umil/
According to the Council for Health and Development, a national organization of community-based health programs in the Philippines, of the country’s total 41,000 villages, only 17,000 villages have government-established health stations that are often ill-equipped with facilities, medicine, as well as staff.

There is only one nurse in every 40 villages, says Nars ng Bayan, an association of community health workers.

Positive gains

Bolinto said there is fulfillment in serving in the community especially when their efforts have positive results. For one, Bolinto said, in her 20 years of community work, she had seen people’s ability to become self-reliant.

“People in the far-flung areas, although lacking in health services, are actually self-reliant once they are empowered with knowledge,” Bolinto said in an interview with

She recalled that in one village, they initially thought that the only problem was the people’s failing health. But later on, through workshops and trainings, the people themselves found out that poor health is rooted in their poor economic condition. Without income, there will be not enough food on the table that will lead to the worsening health condition of the people.

Bolinto said there was only one midwife in a hinterland village in a Benguet who goes to different sitios (sub-villages) that are located far apart. Most of the illnesses were diarrhea and acute respiratory infection; there were also those who died from stroke and hypertension.

Bolinto said the village people built a cooperative store with a starting fund of P10,000 ($223). They were able to increase the fund, which they then used to buy supplies for the health facility. They could eventually afford to give honorarium to community health workers.


Being a community health worker even makes them vulnerable to harassment and attacks.
“Because we work in the interior villages, the state forces claim that we help the rebel groups,” said Bolinto. Since the late 1990s, the military has been tagging Bolinto as a supporter of the New People’s Army (NPA).

“Our intentions are very clear in helping the community attain the health services that they need. But the state forces got it all wrong and even tag us of being an NPA. That is unfair,” Bolinto said.

Several times, a soldier asked her what she was doing in the far-flung villages. In one instance, soldiers interrupted a training to “invite” her to the camp for questioning. She said she fears that one day soldiers might just take her. But she never hesitated to continue her work up to now. Aside from being a community health nurse, she is also a faculty of the Saint Louis University.

“It never crossed my mind to stop this kind of work, and I still continue to serve.”

Human right

In Eastern Samar where Ello is based as community health nurse, community health workers as well as patients are experiencing harassment by the military.

“In Magsaysay village, Gen. Macarthur town, the soldiers ransacked the records of the patients because they claimed we were taking care of rebels and not the residents of the village,” Ello said. She said the military insisted that they were giving medical support and treating wounded rebels.

Ello said that to make sure that the community health workers are not discouraged by such an experience, they discussed with them their basic human rights and how the law does not allow soldiers to enter public premises such as health facilities.

It gained positive result because the health workers themselves told the soldiers that they cannot enter not only their clinic but also their community. She said the soldiers left the village, but transferred to sitio Burabod, Mabini village, Basey, where soldiers arrested a civilian on false allegations of being a member of the NPA. Since then, the area has been militarized.

Ello said people in upland areas in Eastern Visayas are in need of social services as they continue to recover from the damage, not only from typhoon Yolanda in 2013, but also from typhoons Ruby and Seniang in 2014. But if militarization continues, their recovery will be even more delayed, poverty will worsen and so will the people’s health.

No stopping in serving the communities

Ello said although there are health centers in the communities in Eastern Visayas, there is no doctor, proper facilities and equipment. This is the main reason why she sees no reason to leave the work to which she had dedicated her life. If she leaves and lets herself be cowed by the challenges faced by community health workers, who else will help the poor?

She said the Eastern Visayas Regional Medical Center (EVRMC), the only regional hospital unit in the whole region that is complete with equipment and facilities, is to be privatized. Thus, community health nurses are even more needed to serve those who cannot afford expensive services.

Ello said EVRMC is the go-to hospital of the people of Eastern Visayas, as district hospitals also lack equipments and medicine.

The EVRMC is among the 72 government hospitals that the Aquino administration targets to be modernized under the Public-Private Partnership program. Ello said in the country’s history of “modernizing” public hospitals, services has become expensive.

Bolinto said nurses took an oath to serve the poor. She said in times of doubt, just always think of the Department of Health’s mission, “To guarantee equitable, sustainable and quality health for all Filipinos, especially the poor, and to lead the quest for excellence in health.”

“Let’s think about the actual condition of our country and consider that that is where we are needed the most. For me, when a child says that she has not seen a nurse nor a doctor, that means that is where my services are needed,” Bolinto said. (

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  1. The commitment and dedication is very admirable. I wish we have more health professionals like you Ruth and Carmen.

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