Humaneness

It was a small webinar sponsored by CURE Covid, a consortium of progressive organizations concerned about how best to respond to COVID-19 in the country. They asked four people to assess the government’s response so far in terms of effectiveness (Dr. Joshua San Pedro, a community physician), participation of stakeholders (Dr. Marion Jimenez-Tan, formerly with the Department of Social Welfare and Development, and now UP College of Social Work), comprehensiveness (Dr. Edelina de la Paz of UP Manila). The humane aspect of the pandemic response was assigned to me—humaneness in English, makatao in Filipino.

Preparing for the webinar, I realized that while there are all kinds of international guidelines on the three other dimensions we were evaluating, I could not find any on humaneness, which tells us something about how the world looks at public health. Solutions are usually framed by a technocratic perspective, using medicines, quarantine, or even tanks as in the Philippines.

So, I read up on other countries’ responses and did find many countries’ consciousness of humane aspects. I came up with three broad criteria for evaluating humaneness, all derived from a human rights framework as it should apply to public health.

First and foremost would be protection of groups at special risk. I was not just thinking of people with underlying medical conditions (hypertension, diabetes, respiratory ailments) that would increase risks for complications, but also those who are socially disadvantaged. Poverty would be the single leading risk variable. Then we have socially disadvantaged groups, mainly senior citizens, women and children, people with physical and mental disabilities. There are our frontliners and those providing essential services involving contact with many people and therefore increased risks. That includes the police and military.

Not only was there a neglect of the groups at risk, but there were situations where they were put at greater risk—for example, health workers not given adequate protection and hazard pay.

The drastic lock-ins were inhuman in the way the elderly and minors were sequestered without providing relief, for example a public space within barangays so they could go out for sunlight, fresh air, and exercise. We also saw an increase in violence against women and minors, not surprising because homes became pressure cookers.

Second, humaneness should be measured by social safety nets. Pre-lockdown, we were already at a disadvantage with the absence of unemployment insurance and weak PhilHealth coverage. After the lockdown, instead of building the safety nets, we only saw a further deterioration of PhilHealth, reliance on dole-outs such as “ayuda” (help) packages of food, and a measly one-time social amelioration program payment with so many reports of “kupit-COVID” (corruption) that the national government decided future payments would no longer go through local governments.

It was not surprising that Social Weather Stations found that involuntary hunger increased from 16.7 percent in May to 20.9 percent in July.

My final criterion was rule of law, meaning laws used not so much to punish than to help protect the common good. Two aspects were especially disturbing. First was the arbitrariness of the application of laws. Just take masks for example, with local ordinances prescribing fines varying from P250 to P1,000 for the first offense, and some local governments breaking down the offenses to “no mask,” “mask not covering nose,” “mask not covering mouth and nose.” That arbitrariness has led to a second problem around the rule of law: the use of draconian, cruel measures like arresting people who were sitting in front of their homes rather than staying inside.

And the tanks, oh, the tanks brought into Tondo and Navotas. I checked the internet wondering what other country used tanks, but the only tanks used in other countries were those for disinfection.

A military man told me we needed the tanks to scare people so they would behave, which is really “rule by law,” not rule of law. I said, yes, people were intimidated, but the result was to hide relatives who had symptoms, and to avoid testing because the tanks and armed men had now become associated with mass testing.

I’ve always argued that a human rights perspective is still the best for public health if you want effectiveness, comprehensiveness, and people developing their stakes in the endeavor.

No doubt, there are humane and effective examples of COVID-19 management among some local governments, and those should be documented as best practices to be emulated. But for now, overall, I’m afraid I have to give the overall program an F or Fail or, as I quipped, F for Falfak.

mtan@inquirer.com.ph