Community Health Workers: Unsung Heroes of a Failed Health System

In a poor country where one out of two people dies without receiving any medical attention, where more than half of the population do not have access to basic health care, community-based health workers who provide needed services to fill this health-care gap should be heralded as heroes, not thrown to jail and tortured.

By ARNOLD PADILLA
Bulatlat.com

MANILA — In a poor country where one out of every two people dies without receiving any medical attention, 50 percent of the population do not have access to health care, 40 percent do not have access to essential medicine, 10 mothers die daily due to pregnancy and childbirth-related causes, and 100 municipalities are doctorless and nurseless ¹ while more than 7,700 nurses, 83 doctors, and 196 professional midwives leave the country yearly ² to work abroad, trainings to equip ordinary citizens attend to the basic health needs of poor and neglected communities should be welcomed.

And a government that is sensitive to the needs of its people should support such initiative, or at least be thankful to medical professionals and volunteers who give their skills, knowledge, time, and resources in order to help bridge the widening gap in the need and availability of health services in the country.

Dr. Alex Montes ministering the sick during a medical mission in Montalban, Rizal. (Photo courtesy of CHD)

So when 43 health workers — including two medical doctors, a registered nurse, a registered midwife, and 39 community health workers — while conducting a training-seminar, were arrested and later tortured by the police and military on claims that they were making bombs, you know at once that something is seriously wrong.

Community-Based Health Programs

The Council for Health and Development (CHD), which together with the Community Medicine Foundation Inc. (CMFI) organized the training-seminar attended by the 43 health workers, is the national organization of nongovernment community-based health programs (CBHPs) in the Philippines. It raises resources for the CBHPs including reading, education, and training materials as well as financial support. The group, which is registered in the Securities and Exchange Commission (SEC) as non-stock and non-profit, also conducts trainings and consultations with CBHPs.³

Since 1973, nongovernment CBHPs has formed part of the Philippine health care system. From simply providing training for paramedics in far-flung and neglected rural communities, CBHPs have overtime become part of the common people’s aspirations and struggles.⁴

Programs considered as CBHPs aim to respond to the basic health needs of the people through education, training, and services. Unlike episodic health campaigns such as breastfeeding or immunization programs, for example, CBHPs deal with the health issue in a holistic approach, i.e. health problems of the community are recognized to be inter-related with the economic, political, and cultural problems of the society.

Dr. Ma. Teresa Quinawayan in action. (Photo courtesy of CHD)

Thus, they do not provide solution to health problems but assists and facilitates in laying the foundation of a health system that is governed by the people at the community level. ⁵ Maybe this concept of CBHPs is too “communist” for the Armed Forces of the Philippines (AFP) and the Philippine National Police (PNP)?

But the CBHPs have long been recognized even by the United Nations (UN). In the late 1970s, CBHPs were institutionalized globally following an international conference on primary health care organized by the World Health Organization (WHO) and the UN International Children’s Emergency Fund (UNICEF). That conference officially recognized the role of paraprofessionals or auxiliary health workers in lieu of physicians in the rapid extension of health services in the Third World. They were to play a key role in achieving universal access to health services. ⁶ In fact, CBHPs in the Philippines were recognized by the UN Development Programme (UNDP) as among the most “innovative social organization and practices of the South.”