ILOILO City – A team from the City Health Office’s Sanitary Division was combing one of the city’s “shantytowns” for traces of a fatality due to acute gastroenteritis (AGE) when they established: there’s inaccessibility to basic sanitation and hygiene.
“Sa palibot, kadamo gid higko. Indi naton ma-identify kon iya sang sapat or sang tawo,” said Dr. Roland Jay Fortuna, medical officer at CHO.
In this city, as of Aug. 30, 2022, only 21 out of 181 barangays have a zero open defecation (ZOD) status, or a measly 11.60 percent.
Open defecation refers to the practice where people go out to open spaces, periphery of water bodies, or other public spaces rather than using the toilet.
Data showed this city is also beset by AGE cases and cholera, affecting more than half of the 180 barangays, as of Sept. 14. Since July 26 this year, the CHO has logged 556 cases of AGE, including 11 deaths and 12 confirmed cases of cholera. The city has been placed under a state of calamity.
Fecal contamination of the environment, particularly in deep wells, water refilling stations, among other water resources, and poor hygiene practices were tagged as culprits.
Over 50 deep wells and 25 water refilling stations in the city have so far been tested for coliform and E. coli bacteria. The city government is currently conducting disinfection of the deep wells through chlorination.
According to Fortuna, the city wants to build public restrooms, particularly in the barangays where many homes lack sanitary toilets.
“Kay kon indi naton ma-control ang source sang contamination, kon indi naton ma-secure nga safe ang aton water sources ma-sige-sige lang gid ni sia ang aton AGE cases,” said Fortuna.
The ZOD campaign was presented to the city by the Department of Health (DOH) in Region 6 in November 2019, just two months after the coronavirus disease 2019 (COVID-19) hit the region, according to CHO’s officer-in-charge Dr. Annabelle Tang.
She said the city was not able to take off until this second quarter of 2022.
“The efforts at that time were focused on the COVID response. All hands were on deck and several lockdowns were imposed. Hence, it was not a good time to conduct the said activity,” Tang added.
The CHO has completed the initial round of verification and certification so far, she said, and they anticipate certifying and verifying more barangays.
WV’s struggle
Majority of the provinces and highly urbanized cities (HUCs) in Western Visayas are still struggling to eliminate “open toilet” or open defecation practices in their respective communities.
Western Visayas has a total of 4,502 barangays, of which 65.23 percent, or 2,643, have been designated as ZOD.
According to DOH-6 data, four provinces and two highly urbanized cities, namely Aklan, Antique, Guimaras, Negros Occidental, Iloilo City, and Bacolod City, have yet to achieve ZOD status for 60 percent of their respective total barangays.
Engineer III Jomer Fayo of the DOH-6 Environmental and Occupational Health Sector Section said the local government units have to achieve a 60 percent target by the end of 2022.
The provinces and HUCs in the region with low accomplishment in terms of eradicating “open toilets” are Aklan, Antique, Negros Occidental, Iloilo City, and Bacolod City.
According to the data, Negros Occidental has the lowest achievement rate of 8.49 percent, with only 51 of 601 barangays having ZOD status.
Bacolod City also showed low accomplishment in open defecation eradication wherein 14.79 percent or only nine barangays got ZOD status out of 60 total barangays.
Fayo said the regional health office is now focused on these areas, especially in Negros Occidental, where geography is a challenge.
Meanwhile, only the province of Iloilo has achieved 100 percent ZOD status as of August 30, 2022, after all of its 1,721 barangays have been certified as ZOD villages.
The achievement of the province also made it the third province in the country to eradicate the unhealthy practice. The first two provinces are Sarangani and Leyte.
Iloilo province, a first-class province composed of 42 municipalities and one component city, has a projected population of 2,088,233 by 2022.
Among the strategies and interventions Iloilo province has carried out to achieve its ZOD status include the institutionalization of the ZOD program through the passage of the Provincial Ordinance No. 2018-179 entitled “Zero Open Defecation Ordinance of the Province of Iloilo.”
The province has implemented the adoption of the ZOD program at the municipality and barangay levels through the implementation of the Philippine Approach to Sustainable Sanitation.
Moreover, the provincial government has allocated P5-million as augmentation support to the provision of toilet bowls to identified households in the province.
Iloilo Governor Arthur Defensor Sr. attributed this ZOD achievement to the dedication of the local government units (LGUs), specifically their respective municipal health offices and local chief executives.
This, he added, has been realized through the collaboration of the provincial government through the Provincial Health Office (PHO) and the LGUs.
“Ang kinanglan sina maayo ang trabaho naton kaupod ang mga municipalities so kon ano man ang nagahalin diri sa provincial capitol, gamit man ina sia ukon programa, maayo ang implementasyon naton pag-abot sa municipal level. I think that is the formula there,” said Defensor.
Aside from Iloilo, the province of Capiz also hit the target after 87.32 percent or 413 out of its total of 473 barangays, got the ZOD status.
Guimaras, meantime, is nearing the target after posting 59.18 percent, or 58 of the 98 barangays in the province-island achieving the ZOD status.
The provinces of Aklan and Antique also posted 37.92 percent (124 out of 327 barangays) and 41.69 percent (246 out of 519 barangays) of accomplishment, respectively.
Fayo cited the COVID-19 and the delay in the creation of the ZOD verification and certification teams for the provinces and cities as among the factors that affected their low accomplishments.
He added that though this problem is also one of their priorities to be addressed, unfortunately it was not given much attention.
The ZOD verification and certification team should be composed of the city/municipal health officer, sanitation inspector, City/Provincial Social Welfare and Development Office, rural health personnel (as assigned), City/Municipal Engineering Office, City/Municipal Agriculture Office, and City/Municipal Disaster Risk Reduction and Management Office.
Fayo noted that the guidelines for the ZOD program of the government through DOH Memorandum No. 2015-0021, Guidelines on Verification and Certification of Barangays for ZOD Status, were issued in 2015.
For now, he noted that the regional health office is lobbying the LGUs to give focus on addressing this health issue.
On the part of the health department, Fayo said they are extending technical assistance to the LGUs to fast-track their efforts to eliminate open defecation.
AGE in the city, short and long-term solutions
Rochelle Gray, 35, of Barangay Tanza Timawa Zone 2 couldn’t believe that her 4-month baby Amara had been infected despite all of her care and protection. Sharing with this writer a few photos of the baby girl, the father, Tyron, also could not help but shed tears at the thought that he could no longer cuddle his bubbly daughter.
Baby Amara was the youngest AGE death here. She was one of the eight pediatric fatalities reported.
The baby was brought to the hospital at 4 a.m. after experiencing a fever but died a few hours later on the same day.
Rochelle emphasized that they take extra precautions, including using mineral water to prepare the baby’s milk and sterilizing the feeding bottle.
Following her daughter’s death, she now fears for the safety of her two other kids. However, she expressed that all they have to do is to be careful and ensure that no other family members get sick.
Though the baby was already laid to rest on Sept. 10, the family is still struggling financially because they still have debt to pay for the funeral service. Their call for help continues, as of this writing.
Iloilo City Mayor Jerry Treñas said the city government is taking steps to provide short and long-term solutions to the city’s rising concerns over AGE.
He acknowledged that there is an “urgency” as the situation has already taken a toll on the lives of the residents.
The city mayor called for a meeting with the city’s major water distributor, Metro Pacific Iloilo Water (MPIW), to fast-track its water distribution pipes or pipe laying for safe water supply in areas that do not have water connections from them yet.
He also echoed the establishment of communal toilets. Treñas said the city is identifying the barangays where communal toilets are needed.
He explained that these communal toilets can be dislodged regularly to avoid overflowing and contamination of water sources.
The city government is also considering erecting overhead water tankers that will be supplied with safe drinking water by MPIW.
“You know there are certain areas nga indi gid pwede ang mga shallow wells like ang mga areas nga lapit sa patyo kag mga septic tanks,” the city mayor explained.
Initially, the city government has distributed bottled drinking water to the affected barangays, established static tanks for safe and clean water from MPIW, which is for free for a month, and procured vaccines, medicines, and other needs using the city government’s P12.5 million quick response fund.
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(This story is part of the journalism fellowship of the Philippine Press Institute under the auspices of the Hanns Seidel Foundation.)/PN
