Empowerment in the Philippines: there's no medicine to cure fatalism

"Advocates for Community Health", a partner of TWHA in the Philippines was confronted with a very difficult situation in a region where the army and armed forces were inflicting terror. Advocates managed to mobilize the people through a program on health. Not through a regular medical program, but through a program on mental health. Doctor Marites, president of Advocates, was recently in Brussels. She tells us all about her experience.
No medicine can cure fatalism in a community

Dr Marites: “Advocates for Community Health is an NGO (non governmental organization). We set up health campaigns in the Filipino countryside, where we usually focus on widespread diseases like malaria. We have a multi-disciplinary approach. We carry out medical missions, we train local health workers, we have prevention-programs and we help the population to organize their own health education and prevention. We mobilize people to take action for their right to health.
In the area of Nueva Ecija, in central Luzon, we were confronted with very specific issues. Often, people welcome us with open arms, but here they were very closed. They were afraid to talk about themselves or their problems. By investigating the situation, we were able to observe some serious problems in the mental health of the locals. Many people were depressed and suffered from panic attacks. Kids and youngsters had nightmares and were not able to dream of a better life. Life in the villages seemed one dark burden to carry, without any perspective. The villagers were complacent about their fate. We discovered that traditional community life had vanished. The bayan nihan' - farmer families working on the fields and helping each other out - did not exist anymore. The 'frog hunt', a traditional village festival where they chased frogs at night and ate them, was not organized anymore. Contact between people was limited and there was a lot of distrust. Each family lived in isolation."

How did they end up in this situation?

Dr Marites: “We knew the region suffered from a 'counter-insurgency campaign'. This is a campaign led by the infamous general Palparan, in which the Filipino army brutally reacts against insurgents. Farmer-activists in the region were arrested, tortured or even killed. The campaign allegedly ended. But the army still maintains checkpoints on access roads and they still monitor every movement in the region. Even Advocates continuously had to justify their activities. 
We soon discovered what else was going wrong in this village. Multinational mining companies are active in the region, financing local police officers and even armed groups. They had established a network of spies in the villages. If somewhere there was protest or unrest, the spies had to inform the companies. All existing farmer organizations fell apart because of this.

The local government didn't take any action against this systematic terror. Every attempt of the people to fight for their rights was nipped in the bud. Fear and distrust was everywhere in the villages. No one knew whether or not their neighbor was a spy."

As a health worker, how do you deal with these issues?

Dr Marites: "Within Advocates, we had to reflect on how to handle this extremely difficult situation. It seemed as if the entire community was hit by depression and anxiety. We decided that a purely medical approach was not enough. The background of the symptoms was the repressive climate and feelings of powerlessness within the population.
We decided to focus on stress and to set up a community program on it. Our activists approached people one by one. They worked together on the field so they could talk and gain their trust. It took a lot of patience and time. But still, this way we were able to identify a small group of women who wanted to follow a course on how to become a health worker.
Our course was based on ‘experience-driven learning’. Women had to start by voicing their own fears and problems so they could start to process them. They learned how to deal with their problems and they broke through the stigma attached to someone with mental health problems. They learned to differentiate between stress in repressive and anti-social living circumstances and real cases of mental illness, which require special treatment. They learned the basic skills to deal with stress and received a broader education so they could give health information to the community. They were thought to use herbs to relieve stress and slowly started to approach people with similar problems.
From this small group, new potential candidates were identified to form a network of small groups of 5 to 7 people. This way, the advocates were able to foster mutual trust in the community. When heavy storms and floods hit the region, people even took the initiative to react to their fragile environment. Advocates helped them set up a tree-planting initiative to create a natural protection against floods and soil erosion. Some committees planted herb gardens full of plants with healing properties against stress and anxiety."

But in the mean time, the repression continued?

Dr Marites: "Well yes, but this was another issue that needed to be addressed step by step. Within the groups we were discussing the true cause of the problems: the lawlessness of the miners, terrorizing the region. They had to be stopped. The challenging task of forming a broader organization became even more important.
But since the people were now able to collaborate again and were more aware of their situation, it was easier to find allies to plead their cause and force change. These allies were local church communities and youth organizations. In this network, they adressed the local authorities. The mayor and the councilors were put under pressure to end violations of human rights. With success. After ample pressure, the government  sanctioned the miners and instituted a temporary activity ban (“temporary restraining order”). 
As a consequence, the army became less aggressive and the armed groups disappeared from the foreground. The silent complicity between miners, army and politicians was broken and the road to recovery of assertive farmers’ organizations was wide open again."

I presume this is an experience you will repeat ?

Dr Marites: “The evaluation of our work in Nueva Ecija was positive. An important lesson is that as a health worker you first need to analyze the context before you can have a positive impact on health issues in a community. The ultimate goal was to revitalize and heal the community from fatalism. But no medicine can cure fatalism!
Our approach was one of empowerment: making people speak up again and exchange problems, together taking positive action for the community, educating people and teaching them to take responsibility for the wellbeing of the community and take political action as a community. 
We believe that the problems we have seen in Nueva Ecija are more widespread than what you might expect. In the Philippines, there is not only a climate of terror against activists, but also against big groups of the population. This is certainly the case in regions where miners are active. The actions in Neuve Ecija can certainly be repeated in other regions.”

In Belgium, what can we do to help?

Dr Marites: "We notice that our government and politicians are eager to protect multinationals and the rich. For them, profits are more important than human rights. What we notice is that this policy is being promoted in Europe, so also in Belgium. In dealing with the Philippines, everything is about free markets and trade, which supposedly creates wealth. In practice, we see that for farmers, free markets become the “law of the jungle” where multinationals can terrorize the population without repercussions. Human rights and the right to health are less valued than the profits for big mining companies.

If Europe is really serious about the importance of human rights, then it needs punish European multinationals who infringe on human rights. It is the duty of the Belgian and European population to bring this issue to their attention.”