Reply to questions by Kavel Alpaslan of Gazete Duvar on the revolutionary health system and response to the Covid-19 pandemic
1- First of all, could you tell us about your moral and ideological background about healthcare system for people? How CPP describes it?
The CPP believes that people’s health is paramount to their welfare. It is stated in the Party’s program that “The people’s economic and political rights, the right to social services, health, education and others shall be guaranteed.” Public health care should therefore be provided by the state.
The Party thus supports the people’s demand for higher budgetary allocation for public health from the reactionary government. It supports the people’s struggles for more hospitals and medical professionals, cheaper medicine, free basic medical services, as well as better pay and job security for doctors, nurses and other health workers. It denounces health budget cuts to favor military spending and bureaucratic corruption.
For its part, the revolutionary movement maintains departments, bureaus, committees, and even mass organizations, dedicated to public health. In revolutionary villages, health committees are formed to administer services to the community.
2- We know that CPP has doctors helping the people. So how does your system work in normal conditions?
The CPP maintains health bureaus from the national to the regional level to monitor the people’s health needs, draft health policies, train medical workers, and render free health services. Health care is one of the main tasks of the NPA. At all levels and units, the people’s army maintains a medical staff with medics and combat doctors. Revolutionary mass organizations in barrios and communities have their own barrio medical groups or health committees who work hand-in-hand with NPA medics and doctors, and where they exist, with the reactionary government’s barrio clinics.
I’m not sure how you would define “normal.” When conditions permit, that is when there are no enemy troops in the area, NPA units and local Party branches can conduct mass clinics for medical consultations (diagnosis and treatment of common diseases and ailments), dental services (tooth extraction and installation of dentures) and minor operations (pilonidal cyst incision and drainage, circumcision).
Though limited, they strive to provide basic medication for high blood pressure, diabetes, cough and common colds, bacterial and fungal infection and other basic medical problems. Most of these are bought by the revolutionary committees using funds from taxes and contributions from allies and friends. The NPA medics also provide alternative medical treatments using acupuncture and traditional practices. To augment their limited pharmaceutical supply, they use herbal remedies found in communities and forests. They manufacture tablets and capsules using herbal plants. An example of this is the blend of cough remedies (capsules and syrup) that NPA medics make from lagundi (Vitex Negundo) leaves.
Some NPA medics are capable of delivering babies and conducting well baby consultations. Most are schooled in prenatal care. They are also trained to detect mental health problems and are capable of conducting pyschological first-aid and care.
Together with BMGs, NPA medics launch sanitation drives, build latrines and grow herbal gardens. During crises and calamities, health workers in the barrios take care not only of the sickly but also of the elderly and pregnant women.
3- Now let’s talk about Covid-19. Today, a lot of places in the world, have a lot of difficulties to fight this virus, because of private healthcare and working conditions of the masses. How party sees the links with global capitalist economic system and public healthcare system?
Public health care in the Philippines is very limited in the cities and non-existent in most rural areas. The people are left to fend for themselves, and health care professionals are expected to step into the breach with very little funds and minimal government support. The Covid-19 health crisis has demonstrated this very clearly. The Duterte government has failed to protect the general population. It has refused to conduct mass testing because it didn’t want to realign intelligence and military funds. Hospitals and medical workers are overstretched with so few hospitals ready to admit Covid-positive patients. They are forced to rely on private and individual donations for ventilators, protective personal equipment and other basic needs.
The Philippine public health system is severely inadequate and unresponsive to the people’s needs as it has long been neglected by the government. This was made even worse by neoliberal policies of privatization and various austerity measures that imperialist institutions like the World Bank and the International Monetary Fund imposed on the country over the past three decades. Since the 1990s, there has never been a time when budget for public health reached the GDP percentage recommended by the World Health Organization. Budget cuts and privatization of public hospitalis, in the guise of “corporatization” has become the norm. Provincial hospitals are turned over to private capitalists to generate profit to continue operations. The Covid-19 pandemic has put a spotlight on how the Duterte government cut by half the budget this year for the the state’s infectious diseases program. Medical tourism to attract rich foreign patients (and thus, foreign capital) is encouraged. Doctors and nurses leave the country in droves to earn decent wages.
The government’s boast of providing universal health coverage, through the Philippine Health Insurance Corporation (Philhealth), is empty as public subsidy is very low per patient and patient enrollment is very limited. (Note: Millions of peasants who have no access to hospitals do not carry Philhealth cards as they have nowhere to use it.) Worse, Philhealth funds are siphoned by unscrupulous private clinics, in cahoots with public officials. The Department of Health is riddled with corruption and has been known to enter into anomalous deals with big Pharma. An example of this is the tragedy caused by Dengvaxia, an experimental anti-dengue vaccine manufactured by Sanofi Pasteur.
4- In context of the Philippines, what you can say about state measures against Covid-19? How workers and peasants are dealing with this disease?
Duterte opted to implement a lockdown and enforced an “extreme enhanced community quarantine” using military and police forces, instead of carrying out mass testing and enjoining the people to self-quarantine. He is relying on these draconian measures to contain the spread of the virus, instead of coming up with a coherent and comprehensive response in dealing the health crisis. Instead of realigning his own discretionary funds (currently at P2.5 billion), he asked for emergency powers to take over private enterprises and reallocate public funds (up to P275 billion) then promptly disappeared in public view as he “self-quarantined.” A week later, no steps has been taken to undertake mass testing, medical frontliners continue to suffer from lack of facilities and equipment, and the Covid deaths and infections continue to rise.
Duterte’s military lockdown banned all public transportation, effectively stopping workers from going to work. He established checkpoints to stop people from entering or leaving the national capital. Jobs hung in the balance, as most enterprises took a few more days before closing or stopping operations. Medical workers, those who work in the groceries and the other basic services, were forced to walk miles and hitch rides to get to hospitals and their places of work. Bearing the brunt of the lockdown are the semiproletariats like the oddjobbers, jeepney and tricycle drivers, small store operators and others who rely on their daily wages and incomes to survive. Thousands are growing desperate to leave the capital and go back to their home provinces, even if they have to travel hundreds of kilometers on foot.
In the countryside, peasants face further bankcruptcy as the lockdowns in Luzon and other provinces in the Visayas and Mindanao prevent them from delivering their produce to markets and buyers. Some of them, like the vegetable producers from the North Luzon, have resorted to dumping their products along roads even as shortages and hunger rise in the cities. They are barred from the cities where they procure basic necessities and agricultural supplies.
The people are seething with anger at the failure of Duterte’s government to address the crisis. They have called for free mass testing, emergency food and financial aid and compensation for their losses. Workers and health professionals have called for PPEs and adequate facilities. They demand just wages, job security and better working conditions.
The Duterte government has so far failed to provide a comprehensive set of medical, public health, social-economic measures. Without these measures, the government’s military lockdown is simply a repressive measure that restricts people’s rights. The Duterte regime is exposing itself as a power-hungry, callous, self-serving fascist cabal of militarists and bureaucrats. There have been calls for Duterte’s resignation and even ouster of his government.
5- How is the situation for CPP on the field? What are the measures that you take against Covid-19 in the parts that you control?
So far, we have not yet received any report of Covid transmission in the guerrilla fronts. Most areas are insulated, as most peasants do not venture outside their cluster of barrios as they are too busy working in the fields. When they do, they only travel to nearby cities and town centers to sell their produce or visit relatives or replenish basic supplies. There have been no reports so far of Covid transmission among their children who go to school in the cities.
However, the Party has directed all units of the NPA and people’s health committees to help in containing the spread of the virus in their respective areas of responsibility. It has come up with educational materials to be used in information drives, and called on the people to unite and collectively fight the virus through sanitation drives and by implementing measures recommended by the World Health Organization.
The CPP has also declared a ceasefire in response to the UN call for a global ceasefire and is focusing its time and energy to the fight against Covid-19. Today, it has directed NPA units units to step up emergency food production and intensify economic work in revolutionary territories to mitigate the misery and hunger Duterte’s lockdown has inflicted on the people. As with health care, production work is one of the key tasks of the NPA.
The Party also directed its members in the cities to carry out education and sanitation campaigns, as well as food drives, while raising demands for mass testing and other public health measures. At the same time, the Party must lead in taking action to resist the militarist restrictions imposed by the Duterte regime, and raise their call for the ouster of Duterte to make him answer for his criminal sabotage of the public health care system.
6- Last question, how CPP sees possible future after this global crisis?
The CPP is positive that the Filipino people can and will pull through this health crisis despite the Duterte regime’s inutility and callousness to their plight. Hundreds of health workers are working round the clock even without adequate facilities and personal protective equipment. The people are united and are taking recommended measures to stop the contagion.
Without doubt, the Covid-19 pandemic will a have a severe impact on the economy and drag it deeper into crisis. Even now, government officials have already announced that the local economy will contract, with the GDP lower by as much as 4 points. Hundreds of billions of pesos will be lost in production, transportation and tourism; as well as in overseas remittances. As always, it will be the toiling massess-—the workers and peasants— who will bear the brunt of this contraction. Thousands of jobs will be lost, both in the cities and in the provinces. Agriculture will further drop as the Duterte regime is already moving to open the economy further to imported rice and other agricultural products.
The Party foresees greater battles and struggles being made after the crisis. The people has once again witnessed and experienced the banckruptcy of the current social system. Even in lockdown, they are restive and are bound to erupt in protests. They are already holding Duterte accountable for his failures and calling out insensitive government officials (who prioritized themselves and their families over their constituents). At the same time, the Party sees the people intensifying their struggles for jobs, housing, higher wages, better water and sanitation facilities, and other social services and benefits lacking in the current crisis.