On top of being classified as geographically isolated and disadvantaged areas (GIDA), eight new partner-municipalities of the Zuellig Family Foundation have weak health systems that have been making it difficult for residents to access health services and programs. According to the Department of Health, GIDAs “refer to communities with marginalized population physically and socio-economically separated from the mainstream society.”
They are “isolated due to distance, weather conditions and transportation difficulties (island, upland, lowland, landlocked, hard to reach and unserved or underserved communities).” There is also high poverty incidence and presence of vulnerable sectors and communities that are either in or are recovering from crisis situation or armed conflict.

Years of neglect for health made residents passive participants in healthcare while local leaders, though willing to make reforms, lacked the capacity to respond to the enormous challenges affecting health conditions. The eight mayors of these towns are all in their first term and all have expressed commitment to improve their local health systems to achieve better health outcomes.

Given the characteristics and challenges faced by GIDA municipalities, the Foundation developed a model of intervention based on its experience with its other GIDA partner-municipalities. This model revolves around strengthening health systems at the barangay level; capacitating stakeholders to manage self-sufficient health systems; mobilizing the health workforce to provide services in areas where people cannot access health facilities; and addressing various social determinants of health that will provide a favorable context for sectoral interventions to work through partnerships with non-government organizations and other members of civil society.

The Foundation has built partnerships with the governors of Samar and Northern Samar who have expressed support for ZFF’s initiatives. In addition, regional and provincial institutions including the DOH-Centers for Health Development, University of Manila School of Health Sciences, Palo (Leyte), Provincial Health Offices, Department of Social Welfare and Development, and PhilHealth have been tapped for a more purposive engagement with partner-municipalities under the Health Leadership and Management for the Poor (HLMP) Program.

The new set of partner-municipalities, Cohort 5, are Matuguinao, Talalora and Zumarraga (Samar), Mapanas, Catubig and Las Navas (Northern Samar), and Agutaya and Magsaysay (Palawan).

At the crack of dawn one Monday, nine business executives found themselves trading their power suits for a more casual getup and trooping to the country’s Southern Luzon provinces. They are Zuellig Family Foundation’s trustees who all cleared their calendars for an entire day so that for the very first time, they get to visit one of ZFF’s partner-municipality.

Rather than the regular formal meetings to hear about progress reports, the trustees agreed that a site visit would be a better way of knowing and appreciating how the Foundation’s programs and grants have been affecting rural communities.

The trip also involved a visit to the main office in San Pablo City, Laguna, of its program partner, CARD MRI (CARD) which is a microfinance institution serving seven million Filipino clients across the country.

Dr. Aristotle Alip, Managing Director of CARD welcomed the trustees and walked them through their office and their recently-opened business unit, the BotiCARD. This pharmacy is an offshoot of its partnership with ZFF which aims to make affordable medicines readily available to CARD members in different rural villages. Also in the pipeline for implementation is the granting of business loans to health workers from ZFF’s partner-municipalities across the country.

Since attending their health leadership training program in February 2009, three leaders from Dao in the province of Capiz have been actively implementing health programs to make sure every resident in their town receives proper healthcare.

The efforts of the three—Mayor Joselito Escutin, Municipal Health Officer Humbelyn Horneja and Vice Mayor Loreto Eslaban—have borne fruit and have not gone unnoticed.

No death among mothers or infants has been recorded since 2009. Cases of malnutrition and infectious diseases have been dropping. In 2011, they were among the finalists in the Galing Pook Awards for Outstanding Local Governance Programs.

The municipality was cited by the Galing Pook Foundation for “leading and managing health innovations.”
During the recently-concluded awarding ceremony held at the Malacanang Palace, Philippine President Benigno Aquino III personally handed out awards to winners and finalists.

Dao is one of the first set of Zuellig Family Foundation’s partner-municipalities. Since their first training module, the three leaders participated in three more leadership programs of the Foundation while simultaneously carrying out health programs targeted at pressing health concerns in their town.

San Pablo in Zamboanga del Sur is another partner-municipality of ZFF that has been consistently implementing noteworthy health programs.

For three straight years, a village from this town received recognition from the Department of Health for efforts in helping the country attain its Millennium Development Goals on water supply and sanitation.

Barangay (village) Kapamanok recently received a plaque of recognition and P150,000 from the DOH for being one of 32 finalists in the 2011 National Search for Barangay with Best Sanitation Practices.

Despite being a rural community, every household in the village has access to level-2 potable water. All households also have functioning sanitary toilets. Headed by its Barangay Captain Faustino Elcarte, households practice waste segregation and also have individual compost pits for biodegradable trash.

Other San Pablo villages that previously made it to the finals were Barangay Kondum in 2009 and Barangay Pantad in 2010.

The municipality of San Pablo is headed by Mayor Belman Mantos while its Municipal Health Officer is Dr. Hermeraldo M. Catubig, Jr.

By Eileen Leus

Thousands of families in the town of Apalit in Pampanga found their homes still submerged in floodwaters days after back-to-back typhoons hit the Philippines. In efforts to help these victims, the Zuellig Family Foundation, through its Community Disaster Relief Program, gave 1,000 families relief packs consisting of food, milk and water.

Assisting the Foundation in the storing, packing and distribution of the relief goods were the Rotary Clubs of Manila Sta. Ana, Abad Santos, Downtown Manila, Rotary Club of Southern Pampanga, Rotary International (RI) District 3810, RI District 3790, the Iglesia Filipina Independiente Church and the 703th Infantry Battalion of the Philippine Army. The Coca-Cola Foundation (Philippines) gave 1,000 six-liter water jugs.

Apalit was just one among several towns in Pampanga and Bulacan that suffered from deep floods as typhoons Pedring and Quiel battered Northern and Central Luzon in late September and early October.

Waters dumped by the two typhoons caused Pampanga River, where 30 river systems in Central Luzon converge, to swell and flood several towns. The two typhoons left 120 dead and P15.1 billion worth of damages in agriculture and infrastructure.

By Schenley Belmonte

Strong health systems and equal access to quality healthcare are crucial to the achievement of the Millennium Development Goals (MDGs), and information and communication technology (ICT) has the potential to enhance both of these areas.

This fact surfaced during the Third Philippine Health Outlook Forum held last December 13.

During the said Forum, government officials and private group representatives alike shared how technology is currently being harnessed to improve government services and how it can further enhance health systems.

In his Forum presentation entitled “Pursuing Kalusugan Pangkalahatan (Universal Health Care) and Health MDGs through Public-Private Partnerships (PPPs),” Health Secretary Enrique Ona reported on the health gains that have been made since the start of the Aquino administration. These include the enrollment of 5.2 million poorest families to the Philippine Health Insurance Corp. (Philhealth), the improvement of facilities across the country’s rural areas and the hiring of 21,500 new nurses to serve in these facilities.

However, according to Ona, greater funding is necessary to sustain these gains. He said they need P80 billion in 2012 alone but their expected allotment next year is only half of this amount. Moreover, P200 billion additional funds will be needed between 2013 and 2016 to achieve Universal Health Care. This urgent need opens the opportunity for PPPs, as expressed by Ona when he said, “Thankfully, to overcome these concerns, we have thus far been able to utilize and rely upon a great tool: Public-Private Partnerships.”

The same was reiterated by Zuellig Family Foundation (ZFF) Chairman Roberto Romulo who said that through PPPs, the MDGs “can be achieved in less time, at lower cost and with greater sustainability.”

One specific opportunity for PPP is the booming field of ICT. “We must scale up and learn to maximize the use of modern information and communication technology towards the goal of improving the sharing, analysis and validation of data and health information,” Ona said.

Philhealth CEO Eduardo Banzon echoed the need for ICT in Philhealth. They need ICT for information management, database management and data capture.

Ona cited PhilHealth’s new services made possible through partnerships with the private sector. PhilHealth, through partnerships with the SM chain of malls and the CIS Bayad centers, was able to build convenient registration sites for their enrollees. In addition, telecommunication companies, like Globe and Smart, have provided marketing and communications support to promote PhilHealth benefits to the public. And with the help of IT solutions company E-soluzione, Filipinos are able to transact with PhilHealth using their mobile phones.

The need for private sector participation in ICT for health has actually gotten the attention of a group of private firms and individuals who formed a technical working group (TWG) following the Second Philippine HOF that was held last year.

Esther Go, president of the technology solutions firm Medilink and member of the said TWG presented their group’s specific recommendations.

Her group said information should be standardized so errors in the information and management systems can be minimized. They also recommended that all providers, facilities, pharmacies and approved medicines be given “identifiers” so these can easily be identified and accounted for.

She also cited transformational applications, like telemedicine and mhealth, as necessary tools to eliminate distance barriers and improve equity in access to medical services. Through this technology, both patient and doctor need not be at the same place at the time to make proper diagnostics. They will just need a mobile application to communicate.

Her group also called for the establishment of a National ICT4H Stakeholder Council and the appointment of a DOH Chief of Information. Other recommendations of her group include the establishment of compliance bodies to test and certify, and prevent abuse of the standards and the capacity-building of health workers. The group suggested that all public health workers be ICT literate by 2016, which means ICT training programs must be incorporated in the continuing education of all health workers.

Union of Local Authorities of the Philippines (ULAP) President Governor Alfonso Umali also called for the need for ICT. He also underscored the critical roles played by local and provincial governments in the health systems and cited innovations that have improved health services. Among these is the transformation of the provincial government’s pharmacy into an economic enterprise to address the perennial problem of lack of medicines. These days, the pharmacy has become self-sustaining and able to provide the medical supply needs of rural health units and village pharmacies.

After the Forum, the recommendations of the Forum participants were gathered and analyzed. Based on these, the ZFF will form new technical working groups to work on the achievement of the MDGs, similar to that of the TWG on ICT.

Natural hazards – storms, floods, earthquakes, volcanic eruptions, drought and landslides – occur regularly in the Philippines but disasters have increased in frequency and magnitude in recent years. The latest was Typhoon Yolanda (Haiyan) on November 8, 2013.

The World Risk Report published by the United Nations University’s Institute for Environment and Human Security (UNU-EHS), the German Alliance for Development Works (Alliance), and The Nature Conservancy, ranked the Philippines as the third most disaster prone country among 173 countries in the world, behind Vanuatu and Tonga.

Compounding its vulnerability to extreme natural events, the Philippines has seen three times the global average in sea level rise. According to the World Meteorological Organization (WMO), the Philippines recorded the highest average increase in sea levels in 2013, at 60 centimeters against the global average of 19 centimeters since 1901. Rising sea levels is a “major force of nature” against which countries like the Philippines can do little. Disaster risk reduction, early warning systems and disaster preparedness can help but sea level rise poses a major additional risk.

Jean-Pascal van Ypersele, Vice-Chairman of the UN Intergovernmental Panel on Climate Change (IPCC), noted that the Philippines is greatly affected by rising sea levels around the world, and because of this, even stronger storms in the future could wreak more severe damage to the country. He stressed the need for the Philippines to take climate adaptation seriously in order to prepare itself for what are expected to be continuing major risks from climate change.

“The Philippines can brace itself for the worst, but there’s no other way than to drastically change the way structures are built in the coastal areas. It’s to build a more resilient society, a more resilient infrastructure, an infrastructure made of housing, of buildings that resist better in extreme events with very high winds, very strong rain events. That is what is called adaptation to climate change and increasing the resilience,” van Ypersele said.

The Philippine Risk Reduction and Management Act (PRRMA) of 2010 defines resilience as “the ability of a system, community or society exposed to hazards to resist, absorb, accommodate and recover from the effects of a hazard in a timely and efficient manner, including through the preservation and restoration of its essential basic structures and functions.” More than preservation and restoration, resilience involves three elements: preparedness, adaptation and transformation. While effective disaster preparedness and climate change adaptation are essential to containing and coping with the adverse consequences of natural disasters, resilience requires a transformative change in the way society approaches natural hazards and climate change. It calls for a fundamental transformation in business models and mindsets regarding vulnerability in order to create a truly disaster and climate-resilient society.

Building a Resilient Society: Program Objectives

The proliferation of public and private sector initiatives and activities – shows that there is increased attention being given to building disaster and climate resilience in the Philippines. The private sector, in particular, has become increasingly involved in initiatives to make businesses more resilient to disasters and climate change and to contribute to national efforts at building a resilient society. While work is already underway in this regard, much more needs to be done.

It is in this context that the Carlos P. Romulo Foundation for Peace and Development, in cooperation with the Zuellig Family Foundation and the Manila Observatory, will launch a series of events over the next three years, beginning with a conference on July 9-10, 2014, to initiate and stimulate a continuing exchange of ideas and information on how best to build a resilient Philippine society. Beyond better disaster preparedness, risk reduction and climate change adaptation, the conference will give particular attention to the innovative and transformative changes needed to build resilience. The conference is expected to conclude with a statement highlighting the urgency of building a resilient society and proposing a set of concrete follow up measures to help achieve it.

The conference is expected to bring together officials of the Philippine government, experts and scholars, members of the diplomatic community, international organizations, business leaders, local and international NGOs, the media, and bilateral and multilateral aid agencies to explore more effective ways of building resilience in cities and communities throughout the country.

Following the July 2014 conference, the Carlos P. Romulo Foundation for Peace and Development, in cooperation with the Zuellig Family Foundation and the Manila Observatory, will undertake a series of follow-up activities over the next three years, including the convening of specialized workshops/roundtables, to review and assess progress, identify roadblocks and find ways to move forward on resilience across sectors and geographic areas.

It should be emphasized that the Carlos P. Romulo Foundation for Peace and Development as well as the Zuellig Family Foundation and the Manila Observatory see their role as conveners for multi-stakeholder dialogue and for bringing partners and parties together to act in concert on the basis of a shared approach to building a resilient society. Their aim is not to duplicate or take over the work being done by others in this field but to reinforce and add value to their efforts.

Over a period of three years, the follow-up activities will aim at:

– Promoting and supporting multi-stakeholder dialogue on building a resilient Philippine society in the face of the country’s increased exposure and vulnerability to extreme natural events and climate change.
– Generating heightened awareness on the urgency of building resilience and contributing to concerted and continuing advocacy for this purpose.
– Promoting innovative approaches and solutions to resilience.
– Supporting and reinforcing ongoing national and local initiatives and activities to build a resilient society.
– Fostering the continuing exchange of experiences, lessons learned and best practices on resilience
– Supporting the mainstreaming of resilience into the country’s development plans, policies and programs.

Conference objectives

The conference itself will seek to:

– Develop a common understanding of “resilience”.
– Review progress made by various stakeholders — the government, the private sector and business associations, foundations and other aid-giving organizations, the media, the academic community and technical and scientific institutions as well as international/regional organizations – on building resilience.
– Identify new and innovative approaches and solutions to building resilience in various sectors – resources (water, food and energy), social services (health care, education and livelihood), and infrastructure (shelter, buildings, roads/bridges, information and communications) – and in cities and local communities with a view to developing a roadmap to resilience.
– Enlist the support of the media, including social media, to highlight the importance of building resilience.
– Promote multi-stakeholder collaboration on the basis of a shared approach to resilience.
– Agree on the follow-up events and activities over the next three years.

*******
The meeting will be from July 9 to 10, 2014. For more information: email Mel Reyes at reyes@pfgc.ph

This article also appears in the General Carlos P. Romulo website, http://carlospromulo.org/.

Mother Nature’s fury may be unstoppable but its destruction can be minimized.

A recently concluded forum held in Washington, D.C. focused on the need for preparedness and resiliency, especially in the Philippines, which U.S. State Department managing director for Overseas Citizens Services Michelle Bernier-Toth, described as “prone to natural disasters.”

As mentioned by Zuellig Family Foundation (ZFF) chairman Roberto Romulo during his presentation, the United Nations’ World Risk Report for 2014 ranked the Philippines second to Vanuatu due to the country’s exposure to natural phenomena, particularly cyclones.

Forum organizers, US-Philippines Society (US-PS), Center for Strategic and International Studies and US Embassy of the Philippines also held a forum around the same time in 2013. It focused on the Philippine health system, but since it was held a few days after super typhoon Haiyan struck, it also became a venue to seek assistance for typhoon victims. This year, the forum was titled “Readiness and Resilience: Lessons Learned One Year after Typhoon Haiyan.”

Like this year, ZFF also took part in the 2013 forum. It then became a recipient of part of the funds received by US-PS from donors.

ZFF used the donation for a recovery program targeted at pregnant and lactating women of 12 municipalities in Eastern Samar and Samar. The program also helped frontline health workers who were also victims of the typhoon. As Public Works and Highways Secretary Rogelio Singson said during the 2014 forum, resiliency does not only involve having physically sound structures but also back-up staffing to make sure services are delivered during and after disasters.

Recovery assistance for mothers and frontline health workers

According to ZFF president Ernesto Garilao, the foundation’s limited-time assistance program led to a “surge of mothers” seeking health services, an unusual event for most of the municipalities because oftentimes mothers will only go for checkups if they are gravely ill. Lack of money also discourages mothers from heading to the hospital even if they know theirs may be a complicated delivery.

From 3,000 initially identified mother-beneficiaries, more than 4,200 actually availed of the program’s incentives program by the time it ended last July. No official death among the mothers was recorded during the period, though one mother who delivered in a private lying-in clinic but decided to immediately go home after delivery died the next day when she developed a severe infection and reached a Tacloban City hospital too late.

Garilao said the foundation’s learning from its assistance program underscored the need for a “more resilient health system, wherein the local government units, the health workers and the communities are prepared to ensure that risks and impacts are zero to minimal before, during, and after a disaster.”

He added that resiliency is “the ability of the governance structure and health systems to anticipate, prepare, adapt and transform to any systemic shocks, and bounce back better.”

Resiliency must be part of state-building

Manila Observatory executive director Antonia Yulo-Loyzaga emphasized the need to begin the work for resiliency as “part of state-building and not just a part of response for severe disasters.” According to her, scientists are in the agreement that what happened in Eastern Visayas due to Haiyan can happen in Metro Manila especially since most areas are below sea level.

Loyzaga said that of greater concern is earthquake. According to her, based on the finding of the “Risk Analysis Project,” a Japan International Cooperation Agency study that has been updated through an Australian grant, a 7.2-magnitude quake could separate Metro Manila into four sections. Based on the study, a post-disaster scenario will show that the Armed Forces of the Philippines will be greatly outnumbered and have little or no control should even just 10-percent of the four million informal settlers start looking for food for sustenance, similar to what the victims of Haiyan did.

According to Garilao, ZFF has begun piloting the development of a resilient health system in its partner-municipalities in the Samar island provinces. This is being done in partnership with the United Nations Children’s Fund and Manila Observatory.

Governance and leadership enhancement for resiliency

Garilao said that its work on improving leadership and governance is ZFF’s contribution to enhancing capabilities and making health systems resilient.

“To be resilient is to ensure that local governments will be able to reduce vulnerabilities of groups like mothers and their children. By reducing vulnerabilities, the local government will be able to reduce vulnerabilities, the local government will be able to reduce inequities in any post-disaster situation, by putting in place resilient and responsive development programs that would not only address health concerns, but also social protection, education, livelihood and incomes.”

Thanks to Panasonic, health centers in the towns of Basilan, Lanao del Sur, Sulu and Tawi-Tawi will have light even during times when electricity is not available.

In the run-up to its 100th anniversary in 2018, Panasonic launched the “100 Thousand Solar Lanterns Project” to help solve the challenges faced by emerging and developing countries facing unstable electrical supply. Last February, it donated 2,376 solar lanterns to the Philippines, bringing its total donations to over 32,300 units since it started in 2012.

On behalf of its partner local government units, the Zuellig Family Foundation submitted a proposal to Panasonic, which then agreed to donate 48 solar lamps that will be used in the health facilities of selected off-grid municipalities in the provinces.

In these municipalities, power outages are regular occurrences; hence, the solar lamps can go a long way, especially for a woman in labor at night.

Governors are focused on making sure their very poor constituents are given quality healthcare services at little or no cost.

During the “Governors’ Learning Forum” organized by the Zuellig Family Foundation (ZFF) in cooperation with the Department of Health, nine (9) governors told an audience composed of national and local health leaders about the strategies they, along with their core teams, implemented after realizing the gravity of health issues faced by their very poor constituents. Among their immediate reforms is ensuring their hospitals practice no-balance billing for indigent patients. They also talked to their mayors so their rural health units get accredited by PhilHealth. The core teams they created have members representing various sectors so every program and plans encompass larger social and economic issues, and likely more sustainable.

The forum is under ZFF’s Provincial Leadership and Governance Program. It was held last March 10 at the Astoria Plaza.  

Governors present were (from left) Jayvee Uy of Compostela Valley, Emmanuel Ortega III of La Union, Daisy Fuentes of South Cotabato, Jose Ong Jr. of Northern Samar, Ryan Singson of Ilocos Sur, Adolf Plaza of Agusan del Sur, Zaldy Villa of Siquijor, Albert Garcia of Bataan, and Hilario Davide of Cebu.

Also at the event were health assistant secretaries Enrique Tayag and Leonita Gorgolon, Department of the Interior and Local Government Undersecretary Austere Panadero, regional director (RD) for Region 9 Emilia Monicimpo, assistant RD for Region 11 Anabelle Yumang, and assistant RD for Region 12 Francisco Mateo.

See related photos here.