Letter From Philippines: Older People In Bulacan, Philippines Subject To Unofficial Village Curfews
By Joseph H. Batac
The Philippines had only one case when the World Health Organisation (WHO) declared COVID-19 a Public Health Emergency of International Concern (PHEIC). When the WHO declared COVID-19 a pandemic, the Philippines had forty-five cases of infection and two deaths. Most of these cases were in Metro Manila and the adjoining provinces of Luzon Island.
On 15 March 2020, the highest public health alert level was issued by the Philippine Department of Health, with social distancing as the main measure, and lockdown for Metro Manila and Luzon Island. Only public and private health services were allowed to continue operating while the rest of the economy was shut down.
Bulacan Province is located to the north of Metro Manila. In December 2019, the provincial government launched a program on ageing headed by Bulacan State University. This program focused on a number of strategies to enhance the wellbeing of older people: food, fitness, faculty (mental stimulation), friends, family, feelings, faith, financials, future and fear. For simplicity, F10 was the title of the program. F10 was conceptualized with the active involvement of the heads of the senior citizen organizations in each of the 24 towns and cities of Bulacan province.
In the F10 monthly meeting of March 2020, COVID-19 was discussed with reference to reports from the WHO and China. It was emphasized that older people are at high risk of contracting the virus and of dying. There was consensus about a need to take extra precaution, given the lack of immunity or a vaccine. The preferred action was for people to stay at home more often.
Like most local governments in low and middle-income countries, Bulacan Province had no pandemic preparedness plan in place. The initial information on managing the spread of COVID-19 focussed on personal hygiene. When the Luzon island lockdown was put in place by the national government, the idea of social and physical distancing became more prominent. In fact, some villages have imposed a 24/7 curfew on older people, even though there were no written, formal directives from any national or provincial government agencies. These 24/7 curfews for older people have been enforced by volunteer village security forces and community watch groups who, just like local public health personnel, the police and the military of the national government, do not have any education or training on COVID-19.
There have been no protocols or guidance about the care and support of older people during the pandemic from either the national nor provincial governments. This complete lack of timely and accurate information on the management of COVID-19 for older people has influenced the approach taken by village security forces and local public health personnel. Even basic information on nutritional support to strengthen the immune system and physiology was not available. This has resulted in older people being simply confined to their homes, relying on family and neighbours for access to their daily food needs, medical services and social outreach. The quality of life of these older people has deteriorated markedly in physiological, psychological and sociological dimensions during six weeks of lockdown to date.
This has resulted in older people being simply confined to their homes, relying on family and neighbours for access to their daily food needs, medical services and social outreach
While the lockdown was able to reduce the infection rate of COVID-19, nearly 70% of deaths are among older people. The national government has just extended the lockdown period for another two weeks, until 15 May 2020. Even so, there is no local government discussion or plan about how to provide older people in the community with support for testing, tracing or coping with the problems caused by social isolation and village curfews.
Once the lockdown is lifted, there will be a need for Bulacan Province’s Organization of Older People to organize and plan for life over the next two to three years by which time a vaccine will hopefully be administered and/or herd immunity has taken hold. The F10 program will have to be revised and updated to consider changes in the community-based public health system caused by the pandemic.