The fact that the Philippines is an archipelago subjects many places like Sitio Dyandang, at a significant disadvantage in terms of health service delivery and resource allocation, hence being called geographically isolated and disadvantaged areas (GIDAs). The Alma Ata definition of health is hard to grasp in areas where resources, government prioritization are scarce, hospitals and health professionals are non-existent, and whose people’s priority is mere survival instead of living to their fullest.
The documentary showed an issue on public health, which is in general, given less priority relative to curative, specialized interventions. Many people lack the awareness that health is a right, believing this is a luxury instead. They are placed under several misconceptions which may explain their belief that, for instance, TB is a “death sentence” and their provision of Spirulina for it, besides, of course, the fact that they are in a state of helplessness and resource scarcity.
The long journey to the “nearest” health facility severely limits access to healthcare. People then seek hospital care when symptoms are already at their worst. The ED is therefore the first and even last point of entry of the underprivileged. It does not help that prehospital care, which is an essential part of continuum of emergency healthcare is basically non-existent in GIDAs. Ideally (our favorite word), prehospital care provides fast evaluation and temporizing measures to resuscitate and stabilize patients needing immediate care so that these patients are transported to a hospital deemed appropriate for definitive care all under a “golden period.” However, for those in GIDAs the period is not golden, not even bronze. There are no proper vehicles, so people walk through muds, rivers, mountains for hours, with the risk of dying along the way, just to go to a destination that does not even guarantee definitive care due to lack of resources.
In accordance with WHO ECSA Framework, there should be a governance mechanism that will create policies to sustainable funding and partnerships, effective governance and universal access to safe high quality, needs-based emergency care for all, without regard to sociocultural factors. There should be multisectoral involvement to address infrastructures, livelihood, education, and other needs of people in GIDAs. It is my 4th time watching this documentary and heartbreak is all the same each time. Even after a decade has passed, nothing ever changed. The documentary should not be viewed as a glorification of resilience, kindness, nor bayanihan—roundabout things abused by higher ups. Instead, it is a demand for the attainment of people’s right to health.