Salute to women community health workers

March is recognized in many countries as Women’s Month. During this month, we often celebrate the achievements of high-profile women who have made significant contributions to society. Without trying to diminish the inspiring stories of famous women leaders, we need to recognize, too, the unnamed women who literally risk life and limb to carry out their duties during this pandemic.

These women are our community health workers. Whether barangay health workers or barangay nutrition scholars, they are mostly women. They are categorized as “volunteers” because their position is not permanent, which makes them more vulnerable to the demands of the barangay captain or other influential leaders who hold the power to appoint them. They usually get an allowance and a smattering of benefits in the form of trainings, medicine, and groceries on special occasions.

Being a volunteer does not lessen their importance in the community. Their role is critical as they are the first point of contact between the formal health care system and the rest of the community. As members of the Barangay Health Emergency Response Teams, they are tasked to help manage all COVID-19-related health care needs, particularly the task of visiting houses to proactively find cases in the barangays.

Unlike their counterparts in hospitals, these women often earn much less, with benefits and support that are just a pittance compared to what the medical frontliners in hospitals get. They wiggle through narrow and dirty alleys, visit crowded shanties, talk to half-naked men drinking in street corners, and beg mothers to agree to inoculate their kids with anti-polio or anti-measle vaccines. With the hysteria over the unproven allegations against the Dengvaxia vaccine, many mothers are afraid of any vaccine. The task of educating mothers is an added burden, since community health workers are also required to help reach the target number of vaccinations against polio or measles in the barangay.

But their greatest challenge during this pandemic is to find a balance between their work in the community and their responsibilities as wives, mothers, or grandmothers. Add to that the burden of limited income for the family and the risk of contaminating their family every time they return home from work. Says Aida (not her real name), 40 years old: “At the end of my grueling day, I run to the nearby market to buy whatever I can quickly cook for dinner. I am famished by this time because I cannot even afford to buy food while I work. Sometimes, the families I visit are gracious to share a snack or a glass of cold water. After dinner, I help my children with the modules they have to complete for their online class. I sleep late because I do part-time work as a laundry woman for my neighbor. As a single parent, I cannot rely on my allowance as a health worker.” On some occasions, Aida’s income has to be stretched to accommodate the requests of her aging parents who rely on her for medical support.

What can be done in practical ways to honor these women? First, they should be given a sense of stability in their appointments by basing their position on clear and transparent guidelines. Second, with the movement restrictions resulting from the pandemic, we may need to hire more community health workers; many ad hoc responsibilities fall on their shoulders, since they are perceived to be able to absorb all health-related tasks in the community. Third, they should be provided hazard pay to compensate for the risks they face every day. Some LGUs are better than others in providing support and compensation to their community health workers.

Finally, we all need to be aware of the situation of women beyond the boardrooms and executive offices. The inequality is not only across gender, but also across economic status within the same community of women.

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Leonora Aquino-Gonzales used to work at the World Bank as a communications specialist. She is currently teaching at the College of Mass Communications, University of the Philippines.