Why We Need Scientists and Public Health Leaders
With a global pandemic in our midst, now is the best time that we lend our ears to scientists and public health leaders to guide us towards what is best for the country. However, the government seems to have been doing the opposite. Ever since the beginning of the pandemic, a time when we need their support the most, scientists and workers in the healthcare sector have, instead, taken multiple jabs against them from the government.
Public health is not prioritized in the Philippines, as seen clearly on how our government is handling this pandemic and how they allocate the budget for the health sector, said Shaila Bautista, MD, in an interview with UNDERSCORE. “Our scientists and health workers are still underpaid, overworked, and on top of these, are being stopped from working abroad,” she added in reference to the policy decision of the Inter-Agency Task Force (IATF) to ban the overseas deployment of nurses in order to ensure that the country’s health care requirements are fully met (Patinio, 2020).
“[Scientists and health workers] are still being shamed by our own government officials. These acts from our government officials push the health workers to be eager to pursue greener pastures abroad,” she continues.
Here is a closer look at how the Philippine government is treating our public health leaders and experts, and how this negligence is evidently backfiring.
On Lockdowns
According to Pitlo (2020), Manila’s lockdown surpassed the 78-day quarantine of Wuhan, the first epicenter of the COVID-19 outbreak. Pitlo also writes that while President Rodrigo Duterte leans more in relying on the military and police forces — as they are organized forces that could easily carry out orders — health experts must also play a role in crafting and adjusting the overall plan.
The same article by Pitlo also mentioned that the government appointed a new czar to head the country’s contact tracing — and this new czar was a police official turned mayor who had apparently excelled in conducting contact tracing in his city.
To date, the Philippines is one of the countries with the longest and most strict lockdowns. And yet, is also one of the top 20 countries with the most COVID cases.
On the “White Sands” of Manila Bay
Not only scientists in the public health sector are being pushed aside — but also those in the marine sciences sector. The Department of Environment and Natural Resources (DENR)’s recent rehabilitation project of the Manila Bay, which involved dumping 500 tons of crushed dolomite to mimic white sands has received myriad criticisms and suggestions alike.
The University of the Philippines’ Marine Sciences Institute (UP-MSI) had suggested the planting of mangroves instead of dumping crushed dolomite whilst offering to help in its rehabilitation — to which DENR’s Undersecretary Benny Antiporda had angrily replied: “Kalahating bilyon ang binayaran sa kanila simula 2016 hanggang taong ito. Kalahating bilyon na puro lang konsultasyon, walang infrastructure. Kalahating bilyon ang binayaran natin sa UP na ‘yan, Hindi niyo karapatan batikusin ito dahil bayaran kayo. ‘Yun lang po ang masasabi ko sa UP. Uulit-ulitin ko: Bayaran kayo,” (Rita, 2020).
(“The government has paid UP for half a billion pesos since 2016. Half a billion worth of consultation and no concrete infrastructures. We are paying you; therefore you have no rights to criticize. Again, I’ll reemphasize, we are just paying you.”)
The bay’s rehabilitation project has its flaws according to experts: Jerwin Baure, AGHAM spokesperson and fisheries expert of fishers group Pambansang Lakas ng Kilusang Mamamalakaya ng Pilipinas (PAMALAKAYA) said that the bay’s new “white sands” is susceptible to coastal erosion, considering the number of typhoons in the country (Perez-Rubio, 2020); Dolomite contains high amount of heavy metals such as aluminum, lead and mercury, which would contribute to the pollution and acidity of Manila Bay, according to Fernando Hicap of the fisherfolk group Pambansang Lakas ng Kilusang Mamamalakaya ng Pilipinas (Pamalakaya) (Chaves, 2020); and the Department of Health Undersecretary Maria Rosario Vergeire herself had said that crushed dolomite can cause respiratory issues when inhaled (Galvez, 2020).
On Appointing a non-health personnel to handle a Health Crisis
In times of pandemic, health insurances such as PhilHealth is greatly needed. However, with a new and inexperienced leader after PhilHealth’s corruption and mismanagement allegations — negative effects are more likely to occur.
According to ABS-CBN News (2020), the freshly anointed head is a former National Bureau of Investigation (NBI) director and a certified public accountant. Dante Gierran, the new head of state medical insurer, admits that he has no knowledge about PhilHealth’s operations nor about public health. His knowledge only encompasses the fields of financial management, law, insurance, and investigation.
“Scientists have a key role not only in avoiding inappropriate and risky decisions, but also advising policymakers about the wiser moves to make towards a human-centered society, thereby fomenting scientific knowledge and enhancing cross-cultural connections and joint research.”
The Role of Scientists and Public Health Leaders in Decision-Making and Society-Shaping
Scientists have a key role not only in avoiding inappropriate and risky decisions, but also advising policymakers about the wiser moves to make towards a human-centered society, thereby fomenting scientific knowledge and enhancing cross-cultural connections and joint research.
Evidence-based Decision Making
In these trying times, the betterment of the whole is more important than personal gain. According to Escoboza et al. (2015), leaders of health organizations, including public health are characterized by the concept of “servant leader” — putting collective wellbeing as a priority. Their values include a willingness to change, to collaborate, and to be a central player in the health system of the future. With scientists and public health leaders, what is best for the collective would be kept in mind when making decisions — backed up by science, facts, and research. These decisions include policy-making.
According to King (2016), evidence-based decision making has become synonymous to good governance. Scientific advice is immensely important in dealing with emergencies such as virus outbreaks — like the COVID-19 pandemic. Multitudes of challenges need input from experts, and for this reason, governments have a scientific angle such as departments in fisheries, agriculture, etc.
Frank Gannon, director of the QIMR Berghofer Medical Research Institute in Brisbane, Australia, and former Director of EMBO and Science Foundation Ireland, believes governments need formal structures that provide expert advice. Otherwise, he says, self-interest might be picked up.
Provision of clear and consistent statements
One of the pivotal roles of scientists and public health leaders is being the source of general statements that are meant to guide the public in terms of technicalities with health, science, and environment. In a research journal authored by Escoboza, et al. (2015), it was highlighted that public health leaders and scientists must have a well-built understanding of public policy, strategic planning, information management, social media, managed care, cultural competence, and human resource management. With this, there is a strong notion that the statements coming from public health leaders and scientists are factors that can either save or endanger one’s life.
It was also mentioned by Escoboza, et al. (2015) that skills include communication with multiple audiences employing new technologies, inter-organizational collaboration, networking abilities, advocacy, and change management. However, in the present situation in the Philippines, it is highly rampant that even the public health leaders are delivering inconsistent and vague statements that led the public to speculate and be misguided by such information. Aside from the issue of inconsistent statements — the Department of Health (DOH) case reporting and classification became subjective (e.g. considering the asymptomatic and mild patients as recovered even without undergoing swab test to confirm their health status) which made it challenging for the public to concretely grasp the trend of COVID-19 in the Philippines. The statements declared on dolomite’s dangers and shield usage in the motorbikes — all these misguided the citizens.
The leaders’ stable and clear statements have the power to improve the health of the nation and to combat misinformation which became dominant in this time of the pandemic. Collection of more information to strategize better public health planning and to determine the role of community chief health strategists needs help from the government, public health workers in state and local health agencies.
Role in the allocation of the sector’s budget
The funding process needs attention due to the limited resources available for public health. Limited funding support impacts training and workforce development programs. Attempts to solve this issue are often met with resistance by funding agencies and policymakers concerned about diluting the true intent of the investments or diverting the funds for other purposes.
“On the issue of the hazard pay, it angers me that PhilHealth officials dared to corrupt 15 billion of its fund (1) while our health workers are being deprived of 500 pesos/day as their hazard pay (2). Some of them even died without proper compensation. The Philippines is being led by people who are not prioritizing public health, even amidst a pandemic crisis,” Shaila Bautista, M.D. expressed her disappointment with regards to the methods on how the government is viewing and spending the public health and science budget.
The government is the one who determines the budget to be given in the health sector. With this budget, essential medicines, and health facilities can be made accessible and available to the public. DOH is in charge of a health information system that ideally would help us have a better system of reporting cases and contact tracing. Government is also the one responsible for providing the health workforce with proper compensation and a safe working environment. Lastly, all of these would lead to health service delivery. Overall, government leaders have a great responsibility in providing healthcare that is accessible, available, and affordable to the people because health is a right.
Adapting Scientocracy
The COVID-19 pandemic is reminding us of the significance of accurate and research-based knowledge as the backbone of political decisions and policies. Countries like Spain, the United States of America, Italy, and the United Kingdom who initially ignored scientific advice concerning the public health were once pushed through the edge of the disaster. However, countries that embraced health professionals and scientists’ statements and guidance were able to mitigate the virus spread and reward their citizens’ relief from the threat of the pandemic.
Dr. Ashley Bloomfield, a public health official of the Government of New Zealand said that as a country, they were able to respond with the pandemic as they were directed by public health advice and evolving shreds of evidence. The International Health Regulations provided a framework for sharing information about the virus, strategies on disease surveillance and response, laboratory capacity, infection prevention, and control, and risk communication. In the case of South Korea, the country utilized and implemented advanced implications of science and technology that was prepared and contextualized by South Korean scientists to systematically disseminate information through the embodiment of cellular phone notifications about recent district updates regarding new cases and comprehensively tracing the close contact of the confirmed patients through utilizing security camera footage, credit card records, even GPS data from their cars and cellphones.
New Zealand and South Korea, as countries that leaned towards the experts, were able to save their country’s public health sector from collapsing; to protect the country’s economy; and to shield every family from the virus contamination. These cautious measures were intelligent steps taken by a society that values scientific implications in the middle of a pandemic. These two countries are just among the other handful of countries that were able to handle the virus impressively, and are gradually shifting back to their normal routines but with the continuous observation of minimum health standards. The threat of the virus is always present, but a country that respects and values scientific research and public health officials’ opinions would always know the appropriate buttons to press.
According to the World Health Organization’s Building Blocks of Health System, for a country to have a health system that has improved health outcomes, as seen in its people, is responsive; has social and financial risk protection; and is efficient. The Philippine’s health system must be built with leadership/governance, financing, access to essential medicine, health information systems, health workforce, and service delivery as the foundations.
In an interview with UNDERSCORE, Shaila Bautista, M.D. mentioned that among the six building blocks, the leadership/governance block is the most important block for it can affect the remaining blocks.
“I think it’s placed in the bottom part to signify that it should be the first one to be built before building the other blocks,” she concluded.
A society that is structured from the guidance and leadership of scientists and public health practitioners is a society that is capable to promote multidisciplinary approaches to research, encourage cooperation between the social and natural sciences, stimulate a holistic approach to problem-solving that takes into account a realistic range of socioeconomic conditions and effects, explain carefully the implications and the inherent limitations of their research findings to the public, and invigorate the creation of science-coordination mechanisms, fully involving the governments of all countries, as a way to promote integrated responses to global problems.
REFERENCES:
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Chaves, L. (2020, September 14) Manila’s new white sand coast is a threat to marine life, groups say. Retrieved October 16, 2020, from https://news.mongabay.com/2020/09/manilas-new-white-sand-coast-is-a-threat-to-marine-life-groups-say/
Escoboza, S., Yphantides, N., & Macchione, N. (2015, February 26). Leadership in Public Health: New Competencies for the Future. Retrieved October 15, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341427/
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Galvez, D. (2020, September 07) Take it from DOH: Dolomite dust can cause respiratory issues, other health hazards. Retrieved October 16, 2020, from https://newsinfo.inquirer.net/1332196/take-it-from-doh-dolomite-dust-can-cause-respiratory-issues-other-health-hazards#ixzz6b1vdZDcL
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Rita, J. (2020, October 14). Manila Bay ‘white sands’ not washed out but black sands ‘washed in’ -DENR exec. Retrieved October 16, 2020, from https://www.gmanetwork.com/news/news/nation/759820/manila-bay-white-sands-not-washed-out-but-black-sands-washed-in-denr-exec/story/
