Hatid Probinsya and Balik Probinsya, more harm than good?

The national government’s program of sending people back to
their hometown recently came under fire for spreading COVID-19 in the
provinces. For example, Tanauan town and Baybay City in Leyte each recorded
their first respective confirmed COVID-19 cases last May 28. Both confirmed
cases were among the first and so far only batch of beneficiaries of the Balik
Probinsya, Bagong Pag-asa
Program (BP2). Meanwhile, in the war-torn city of
Marawi, nine confirmed cases are beneficiaries of the Hatid Probinsya
program.

BP2 and Hatid
Probinsya

BP2 is a pet project of President Duterte’s long-time
trusted aide and now Senator Bong Go. Executive Order 114, which enabled the
said program, came two days after the Senate adopted Go’s resolution urging the
executive department to formulate and implement a Balik Probinsya program.

BP2 is a “long-term program of the government intended for
Metro Manila residents who want to go home to their provinces for good”. It
reportedly aims to decongest the National Capital Region (NCR) and is mostly
targeted at people from urban poor areas. It is also packaged as
“redistributing wealth” by bringing development to the countryside.

According to BP2’s website, the first batch was composed of
112 individuals from the province of Leyte. Leyte Governor Dominic Petilla said
that most of them are workers who lost their jobs due to the Luzon-wide
lockdown. BP2 has three phases of intervention, namely short-, medium-, and
long-term.

The short-term intervention provides beneficiaries
transport, cash assistance of Php15,000, and livelihood opportunities. All
government programs, activities or projects with funding will be adapted for
the program.

The medium-term intervention involves projects or programs
for implementation after the lockdown and lifting of travel restrictions. This
includes establishing new special economic zones in Visayas and Mindanao, among
others. The long-term plan includes passing of laws deemed important for rural
development.

The program’s goals look good on paper but its pretentious
character is exposed by the absence of concrete plans for strengthening rural
production. Beyond the program’s promises, what work will people going back to
their hometowns really have?

Likely not much, because the program’s vision of developing
the countryside is still under the framework of neoliberalism which continues
to destroy the country’s agricultural sector. The special economic zones the
program envisions to build will, if anything, just cater to the needs of
foreign capital but with scant domestic linkages and contributions to national
development.

The long-term plan includes the passage of the Duterte
administration’s priority bills like the National Land Use Act and giving tax
incentives to tourism industries – both have the potential to hasten land
conversions. Even legislation supposedly giving incentives for agriculture is
more inclined to push for more destructive corporate plantations. There is also
the self-serving political logic and push for shifting to a federal system through
Charter change.

On the other hand, Hatid Probinsya is intended to help
individuals stranded in Metro Manila by quarantine travel restrictions go back
to their home provinces. This includes overseas Filipino workers (OFWs). The
program arose after reports of thousands of OFWs stranded for more than a month
in quarantine facilities. BP2 trips have been temporarily suspended to
prioritize the Hatid Probinsya program.

Infecting the
provinces

In the absence of a mass testing program, BP2 and Hatid
Probinsya are turning out to be additional sources of COVID-19 transmission in
some provinces. It is a disaster slowly unfolding especially with the
healthcare capacity in rural areas much lower than in NCR.

Mass testing means testing all suspected cases whether symptomatic
or asymptomatic, testing all close contacts of positive cases, regular testing
of all frontline healthcare workers, and testing for surveillance of high-risk
communities or vulnerable populations. Testing is crucial to detect cases,
isolate carriers, and trace contacts to contain the spread of the virus.

The Department of Health (DOH) claims that its expanded
risk-based testing broadens the coverage of persons to be tested. However,
according to the Department Memorandum No. 2020-0285, RT-PCR testing is still
based on a prioritization scheme.

RT-PCR is the gold standard for COVID-19 testing. In the
Hatid Probinsya program, locally stranded individuals (LSIs) are tested only
using the rapid test method. Scientists and medical groups do not recommend relying
solely on rapid tests to check if individuals are positive for COVID-19. Their
results are not that reliable and hence of very limited use in infection
control.

The country’s current healthcare capacity is also still not
suited to respond to pandemics like COVID-19. It is very much privatized and
uneven between regions; thus access is an issue.

As of June 27, the NCR recorded 17,450 total confirmed
COVID-19 cases surpassing scientists’ projection of 16,500 cases by the end of
June. As of June 26, the region has 2,487 isolation beds, 1,071 ward beds, 569
ICU beds and 879 ventilators dedicated to COVID-19. The 10 doctors per 10,000
population and 12 nurses per 10,000 population in the region generally meets
World Health Organization standards (10:10,000 for doctors and nurses).
However, there are much fewer physicians and nurses in regions outside Metro
Manila.

According to DOH Region 8, there are 499 total confirmed
cases of COVID-19 in Eastern Visayas, of which 68% or 341 cases are returning
residents, as of June 27. Of these returning residents, 293 are LSIs, 45 are
OFWs, and three are BP2 beneficiaries. Leyte, which accounts for 40% of the
cases in Region 8, is the destination of most of the returning residents who
tested positive with COVID-19.

Meanwhile, in the Bangsamoro Autonomous Region in Muslim
Mindanao (BARMM), there are 58 confirmed cases, with the province of Lanao del
Sur having the highest number of cases at 35. This includes the nine returning
residents confirmed to be COVID-19 positive in Marawi City.

Eastern Visayas has only two COVID-19 testing centers, both
are located in Tacloban City. Of the two, one is a private testing center and
the other one, the Eastern Visayas Regional COVID-19 Testing Center, is a public facility. BARMM, on the other hand, has
only one testing center, the Cotabato Regional and Medical Center, located in
Cotabato City, Maguindanao.

The majority of licensed COVID-19 testing centers in the
country are in the NCR, accounting for 29 of the 67 total centers. This could
be a factor why Metro Manila is the top region with total number of
cases—higher testing capacity results in more cases detected.

In terms of facilities, the province of Leyte only has nine
ICU beds, 203 isolation beds, 50 ward beds, and 10 mechanical ventilators
dedicated to COVID-19 cases, as of June 26. Data from the 2018 Field Health
Service Information System (FHSIS) shows that there are only 57 medical doctors
in Leyte, including 7 doctors in Ormoc City, 4 doctors in Tacloban City, and
117 public health nurses.

Quarantine facilities in Region 8 are currently running on
full capacity prompting the Regional Task Force 8 and local government units to
request for a 14-day moratorium on the national government’s Hatid Probinsya
program.

Lanao del Sur meanwhile reported 3 ICU beds, 30 isolation
beds, one ward bed, and four mechanical ventilators exclusive for COVID-19
cases. There are only 31 medical doctors and 16 public health nurses. In the
city of Marawi there are only 2 doctors and 2 nurses.

In the whole region of BARMM, the doctor and nurse ratio per
10,000 population are 0.8 and 3.8 respectively. For Region 8 the ratios are 2.5
doctors per 10,000 population and 6.6 nurses per 10,000 population.

The increase of confirmed cases in Leyte is disproportionately
affecting healthcare workers. On June 16, of the 59 new cases reported in
Region 8, 22 are hospital workers. Of the 59 new cases, 52 are from Leyte. As
of June 27, there are already 94 healthcare workers infected with COVID-19 in
the region.

Ill-conceived plan
and self-serving agenda

The Hatid Probinsya and Balik Probinsya programs are proof
of government’s ill-conceived COVID-19 response. The less able rural areas are
now bearing the brunt of the lack of a cohesive response plan that addresses
the gross socioeconomic and healthcare incapacity of the country.

The government failed to maximize the three months of
lockdown to start the mass testing, tracing of all contacts of positive cases,
and isolation and quarantine needed to contain the spread of the virus. It also
did not increase the health system’s capacity to treat all COVID-19 cases.

Instead of focusing on boosting the country’s healthcare
capacity, the government apparently even used the pandemic to boost the
political career of Palace favorites and to push for more neoliberal and
authoritarian policies. Injecting a self-serving political agenda undermines
the competent health response so needed by the people.

The administration’s prescriptions and practice to deal with the health crisis are not working. This only makes the call for an alternative approach that contains the virus and cures patients, instead of compromising them, even more urgent.

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