The "New Poor": LGBTs as a Vulnerable Sector

In April 2012, the Policy Development and Planning Bureau initiated a timely and ground-breaking policy forum-workshop  entitled “The NEW POOR: Sexual Minorities as a Vulnerable Sector”  tackling for the first time the Lesbian, Gay, Bisexual and Transgender (LGBT) Community as a marginalized sector in need of social protection. This was closely followed by a Policy Study Session in May 2012 where sexual orientation and gender identity (SOGI) and its impact on child rights protection was discussed in the light of increasing incidence of LGBT youth bullying. Eventually during the 2012 Mid-Year National Management and Development Conference (NMDC) of the Department of Social Welfare and Development (DSWD) leadership, the Gender and Development (GAD) Focal in the person of then Assistant Secretary Florita R. Villar shared with the DSWD officials their desire to begin expanding GAD to cover SOGIE issues in response to emerging trends and concerns in gender and development, especially in terms of sexual and reproductive health and rights. Since then, there has been a draft comprehensive policy paper on LGBT rights and SOGIE issues that was submitted to the Secretary through then Undersecretary for Policy and Plans Alicia R. Bala. While the policy recommendations  and action points were categorized into institutional/organizational plans, employees’ welfare, and DSWD mandate/sectoral concerns, said policy recommendations  focusing on the latter category would is the most substantive and would have most impact to the Department’s social development work. 

Also in June 2012, after providing feedback to Undersecretary Alicia R. Bala on the proceedings of the April Policy Forum and May Policy Study Sessions, the PDPB was directed to formally transmit it to the Office of the Secretary for due consideration. That same year, the DLLO commented for the first time on the anti-discrimination against LGBTs bills in Congress, with the PDPB providing additional inputs for incorporation into the Department’s final position paper. Then, in February 2013 that the DSWD Central Office GAD finally held it’s first orientation/briefing on SOGIE for its Focal Persons. On the other hand, DSWD-NCR through the initiative of Dir. Alice Bonoan and GAD Focal person Froilan Maglaya maximized their March 2013 Women’s Month celebrations by conducting  a series of Gender-Sensitivity Trainings (GSTs) for NCR staff and the Haven for Women’s staff and clientele. 

In June 2013, UNDP and USAID co-sponsored the “Being LGBT in Asia” event for the Philippines, a national dialogue between various LGBT organizations nationwide and where key government agencies were invited to share their efforts on SOGI issues and LGBT human rights. DSWD had a lot to boast of in terms of internal education and capacity-building as well as external support and advocacy for SOGIE-related issues,  Forwarding the proceedings of the said UNDP/USAID activity to the DSWD Secretary afterwards, she acknowledged and welcomed all policy recommendations relevant to the DSWD mandates and sectoral concerns. Thus, it is but proper that DSWD continues along this policy track.

SEXUALITY AND HUMAN RIGHTS

Sexual orientation, like gender and race, relates to the fundamental aspects of human identity. While formally defined as the pattern or direction of sexual and emotional attraction and conduct, sexual orientation relates to the “deepest affairs of the heart, the innermost desires of the mind, and the most intimate expressions of the body”. In other words, it goes into the very core of what it means to be human. Meanwhile, Human Rights are founded on the concept of respect for the inherent dignity and worth of a human being. The right to freely determine one’s sexual orientation and the right to express it without fear are human rights in the fullest sense. Therefore, gay and lesbian issues and problems as part of the human rights agenda crosses into both categories of human rights; those that are “liberty-oriented” and those which are “security-oriented”. They seek to ensure the Civil and Political Rights or “liberty rights” such as the right to life, liberty and security, freedom of expression, and freedom of association and assembly. They also ensure Social and Economic Rights or “security rights“ such as the right to work, education, food, shelter, and a decent standard of living.

 

EMPLOYMENT DISCRIMINATION

Employment and decent work is part of the basic human rights involving social and economic concerns. No less than the Philippines Constitution provision on Social Justice and Human Rights mandates this.

To date, many Filipino LGBTs still do not get equal opportunity in employment and are deprived of the right to earn a decent living. Even with the proper education, training and experience, some LGBTs are not hired, promoted or given the opportunity for professional advancement in the workplace. In many job applications or interviews, one’s sexual orientation becomes the focus instead of the relevant qualifications/credentials needed for the job. If one is lucky enough to be employed, an LGBT has to contend with “Dress Code” issues because their outward appearances are viewed as a limitation. Vague “immorality clauses” in employment contracts also subject them to a seeming “higher” standard of conduct or behavior. And because of the notion that LGBTs are “sexual predators”, they are more prone to allegations of sexual harassment.  Less obvious forms of discrimination involve LGBTs sometimes being deprived of the opportunity for trainings and seminars, or of being promoted. Always seen as “single” individuals with no children or families to support, they do not enjoy the usual social security benefits/insurance privileges that can be extended by employers and the government. In the most extreme cases, LGBT workers risk dismissal from their jobs because of their sexual orientation and gender identity. The difficulty here is that no employer will actually state that as the reason for termination, but will use some other bases to justify firing an LGBT employee or not renewing a contract.

Of particular concern also, is the fact that since some LGBTs are deprived of equal employment opportunities, they are forced to resort to illegal or “unsavoury” sources of livelihood. This is the reason some transgenders engage in “sex work” or prostitution.  Such instances of marginalization fall squarely into the social protection mandate of the DSWD and bears looking into.

Note that education really plays an important role in getting the appropriate employment later on. Some LGBT youth miss out on completing their formal education. Either their parents pull them out of school for being LGBT and the family “black sheep”, or schools and colleges actually expel them or subject them to disciplinary sanctions which prevents them from graduating. With little or no educational attainment, few skills or inadequate training, LGBTs are again relegated to jobs that further marginalize them.

CHILD RIGHTS PROTECTION AND LGBT YOUTH

Child rights advocates and human rights activists love to talk about protecting children and promoting their welfare, but they have never really seen how this impacts on lesbian, gay, bisexual and transgender (LGBT) youth. Nowhere else is child abuse more evident or prevalent than in sexual orientation and gender identity- related cases. LGBT youth are more vulnerable to abuse and violence because of how their sexuality and gender is viewed by society.

Numerous documentations on violence against LGBTs show that early experiences of discrimination begin from childhood. Instances of child abuse are perpetrated by family members who are embarrassed about the homosexual tendencies of children and they try to make these kids conform to heterosexual gender stereotypes. Most parents are prepared to employ whatever means possible to force kids to exhibit more heterosexual traits and spare the whole family the humiliation and stigma of having a gay relative. All this under the “right” of parents to discipline and ensure obedience from own their children.

 

From researches done by LGBT groups like IWAG Dabao, Link-Davao, and LEAP, Inc., the common findings show that a great majority of Filipino LGBTs who suffered discrimination and violence say it started from their childhood, and respondents in these studies cite their own parents or family members as the primary perpetrators who abused them under the guise of “disciplining” them to become “normal” because they were already exhibiting signs or tendencies of being LGBT. It is under this context that this type of child abuse must be looked into. Is there ever an acceptable ground for committing child abuse, and where does the right to discipline of parents end? It appears that even with the Child and Youth Welfare Code (PD 603)  and Republic Act No. 7610, corporal punishment or child abuse must be viewed with the added dimension of a child’s sexual orientation and/or gender identity.

The family is not the only social institution that children move in during their young lives. LGBT youth spend at least 15 years of their lives in the educational system where they suffer discrimination and abuse from adults exercising substitute parental authority. Teachers, guidance counsellors, and other school officials impose disciplinary sanctions that involve verbal, emotional, psychological and sometimes, physical abuse for students’ actual or perceived homosexual orientation. In the Philippines, where the good schools are mostly Catholic-run private schools, the treatment of effeminate boys and masculine girls range from being chastised in the principal’s or guidance counselor’s office, to public humiliation in front of classmates, or even suspension or outright expulsion. It bears emphasizing that LGBT youth are also deprived of their basic right to education when their schools expel them or subject them disciplinary sanctions because of their  actual, or perceived, homosexual tendencies.

As true child rights advocates, these are just some issues which must be looked into. Sexual orientation and gender identity is a part of children’s personhood, and cannot be ignored. If this aspect of their humanity is denied, young LGBTs are deprived of their right to security and well-being, and most of all, their right to development.

“HATE” CRIMES and PROFILING

According to research conducted by the Philippine LGBT Hate Crime Watch, of the 141 documented cases of hate crimes from 1996 to 2011, ninety five (95) cases involved gay men, twenty six (26) involved transgenders, sixteen (16) involved lesbians and four (4) involved bisexuals. From an average of ten (10) LGBT people murdered between 1996-2008, the number has risen to twelve in 2009, 26 in 2010, and 27 from January to May 2011. Unfortunately, majority of these cases get labelled as “robberies gone wrong”  or get merely dismissed because “there was a disagreement about the fee”. These criminal cases get “sweeped under  the rug” and don’t get pursued because authorities don’t think they’re a priority as if the LGBT victims are dispensable people, or because the families themselves wish to keep everything quiet for fear of being embarrassed about their kin’s sexuality. Until now, there is no proper appreciation for such crimes which are clearly motivated by “hate” because of the way the victims seem to be “targetted” for their seeming vulnerability, and the manner or cruelty by which they were killed to become almost unrecognizable corpses.   

In a period between 2007 and 2010, the police repeatedly conducted raids of gay saunas, old cinemas, and parks in Metro Manila on different charges of vagrancy, indecency, pornography, prostitution, sex trafficking, operating without license and other flimsy reasons. Clients, bar staff, bystanders were arrested by groups and detained for more than 12 hours. The arrested persons are usually threatened by the arresting officers with exposure to media or to their families. And once again, the particular weakness or vulnerability of LGBTs because of sexuality issues are used against them.

GENDER-BASED VIOLENCE

Meanwhile, R-Rights’ 2012-2013 gender-based violence research was conducted in a wide range of languages and included people from all parts of society. The findings show that while violence and exclusion takes place in every sphere of LBT women’s life and covers a whole range of physical, emotional, and sexual violence, including family violence, state violence, forced marriage, and marital rape, LBT women experience violence more frequently when their sexual orientation and gender identity are visible. This important study mention the presence of laws that “target” LGBT people, and the absence of specific laws that protect LGBT. Because direct state violence is not reported as much as family violence, this reflects how the messages from the State about sexual orientation and gender identity play out in the private sphere of the home and in families. Once more, family violence really dominate the findings and the stories where are often quite extreme, including subjecting lesbian daughters to “corrective rapes”.

RECOMMENDATIONS:

· Expand basic Gender-Sensitivity or Gender and Development (GAD) trainings to include SOGI issues and LGBT rights

· Review laws, policies, and programs for specific sectors under DSWD mandates with an added dimension of SOGI/LGBT concerns

.

 

Proposed UN Convention on Elderly Rights

The elderly sector has been recognized as a vulnerable community in need of special protection since the early 1990s.   But twenty five (25) years hence, still no United Nations convention or treaty has been drafted in their favor. Compared to the other marginalized sectors such as women, children, Persons with Disabilities (PWDs), and even migrant workers, older people have seemingly been left behind and they still don’t have an international human rights basis to call their own and rely on. Thus, it can be said that older people’s rights are largely “Invisible” in international law. The explicit recognition of older people’s rights is still absent in most international human rights instruments. Except for the International Convention on the Protection of the Rights of Migrant Workers and their Families, nowhere is age discrimination specifically mentioned.

Existing International Human Rights Law

Indeed, the Universal Declaration on Human Rights (UDHR), the International Covenant on Civil and Political Rights (ICCPR), and the International Covenant on Social, Economic, and Cultural Rights (ICSECR) are the basic international human rights documents meant to promote and protect the rights of all persons, young or old, regardless of status. But as in the case of women, children, PWDs, etc. senior citizens or older persons are also a vulnerable  sector in need of special, if not additional, protection.

While it cannot be said that existing human rights instruments do not protect the rights of the elderly, these international law bases are deemed as not sufficient to address the unique concerns of senior citizens because these documents do not capture all the nuances and features of ageing. There must be an understanding of why the ageing population becomes a marginalized sector by virtue of a combination of factors and influences. These require an insight into ageing vis-à-vis gender issues, economic status, socio-cultural beliefs and traditions, as well as politics and social welfare services. What is critical to this framework is the need to find a “universality” to these concerns that the international community will finally take notice. Governments and States around the world must acknowledge that ageing  and an elderly population is a commonality that all countries share, and any genuine effort to address older people’s needs may entail some international standard of elderly care and legal protection that must be based on social justice and human rights. While concrete measures by each State may vary depending on their resources,  thru a binding international instrument such as this, there may at least be a benchmark for a progressive achievement of a level of care and protection for our senior citizens worldwide. It is this scenario that  will hopefully give proper context  to approaching ageing and elderly issues, and guide our own interventions.

International Instruments on Ageing

As early as 1982, there was the UN General Assembly Resolution that led to the Vienna International Plan of Action on Ageing adopted during the 1st World Assembly on Ageing. It was the first time a consensus was reached that ageing was indeed a “Life-long” process which must be given attention early on for preparation in social, economic, and health aspects. It was only in 1991 that the UN General Assembly adopted the 18 UN Principles for Older Persons which focused on independence, participation, care, self-fulfillment, and dignity. Several other UN GA Resolutions followed, ranging from a Proclamation on Ageing to a Declaration on the International Year of. Older Persons  It was only in 1998 that the Macau Regional Plan of Action on Ageing for Asia and Pacific was developed. This document focused on seven (7) major areas of concern which included health and nutrition, income security, maintenance and employment, housing and transportation, social services and community, as well as social position of OPs. This was followed in 2002 by the Madrid Plan of Action on Ageing which was adopted by the 2nd World Assembly on Ageing. And while this document gave priority to security, dignity, full participation and human rights, it set policy directions in three (3) major areas of concern, namely: ageing and development, health and well-being, and enabling and supportive environments. It also called for a change in attitudes, policies and practices to put an end to age discrimination and to include ageing in global development agendas. By the time the Shanghai Implementation Strategy came out as a follow-up by the Asia-Pacific region to the 1999 Macau and 2002 Madrid Plan of Actions, the three (3) Areas of Concerns also included a portion on implementation and follow-up. The strategy provided guidelines on the implementation of commitments on ageing made under the two previous Plans of Action.

But while these international instruments on ageing are recognized bases for promoting elderly issues, they are not of the same status as international  human rights law. They are not like a treaty or convention signed and ratified by different member States that can officially compel compliance with international commitments and obligations. The above-mentioned documents merely provide guidelines for the implementation of plans, programs and services for older persons They are merely “recommendatory” at best, and governments may or may not act upon them. These documents are also very general in scope; they do not provide specific guidance or outline State obligations in detail. What more, because they are not legally binding, they provide no additional incentive for implementation or accountability. 

Yet a convention would provide governments with a clear, conceptual and legal framework, one that will mainstream human rights issues, ensure greater visibility of older people, and provide more exposure for senior citizens’ concerns. It can clarify States’ responsibilities, including the minimum standards and action necessary.

Translating Rights into National Laws and Policies

The Philippines is one of those countries whose fundamental law specifically mandates caring for our elderly. In the 1987 Constitution, every Filipino was assured of a rising standard of living and an improved quality of life. But along with other underprivileged sectors like the sick, disabled, women and children, the elderly were promised priority in health and social services. And while it is still the primary duty  of families to care for their elderly, the Philippine government is obliged to design social security programs for seniors. On the other hand, not all countries expressly mention their senior citizens in their Constitution.

Our Filipino elderly also enjoy an assortment of benefits and privileges under several national laws like the Republic Act No. 344 or the Accessibility Law, RA 7876 providing for the establishment of Senior Citizens Centers in every city and municipality, RA 8425 or the Social Reform Act allowing sectoral representation for seniors in the National Anti-Poverty Commission (NAPC). In fact, RA 9994 is actually the third version of the Senior Citizens Act which grants discount privileges, free services, and additional government financial  assistance for indigent senior citizens. But the beauty of RA 9994 is that it sought to provide for the needs of Filipino seniors under a social protection framework, integrating a life cycle approach - a variety of “from womb to tomb” interventions that maximizes educational  and employment opportunities to the elderly and providing for a social security and healthcare system that will allow them greater financial independence and self-sufficiency in the future. Other countries do not provide this and only have “piece-meal” legislations for their senior citizens, such as healthcare services, social security schemes, retirement or pension benefits, and universal social pension.

We also have the Philippine Plan of Action for Senior Citizens (PPASC). Of late, we already have a third 5-year successor plan spanning 2012-2016, which first started as a Philippine Plan of Action for Older Persons (PPAOP) 2000-2005, and then was followed by the Philippine Plan of Action for Senior Citizens (PPASC) 2006-2010. These national sectoral plans were all anchored on the Macau and Madrid Plan of Actions, and the Shanghai Implementation Strategy. But since these are not legally binding commitments, not every country formulated a national plan for their elderly.

These realities were evident during the 1st Regional Meeting on Ageing and Health for the Western Pacific organized by the World Health Organization (WHO) in July 2013. While the more affluent countries like Australia, New Zealand, and Japan clearly have an advantage because of their resources, the Pacific island nations admitted they were still a long way off. Their governments had no laws to fall back on, so there are no clear national plans or programs for their elderly. With their governments not providing concrete interventions, families serve as primary caregivers and healthcare is mostly out-of-pocket.

Having a United Nations Convention on the Rights of the Elderly will certainly compel different countries to have this more comprehensive and integrated approach to caring for their older persons  - from national laws and policies, to sectoral plans to actual programs and services. It will no longer be “optional” as what the current international documents  on ageing only manage to do.

The Way to Go: Five  Basic Reasons for a UN Elderly Rights Instrument

Simply put, the following are the basic reasons why pushing for a UN convention on the rights of the elderly is a good idea and a cause worth supporting:

1. Ageing is inevitable and good portion of any country’s population will be composed of older people. They are already a growing demographic given the  many ageing societies around the world, so there must be deeper understanding of their needs and issues, and these must be articulated in the language of human rights and contained in a single universal text..

2.  Vulnerability is not only experienced by children by virtue of their minority; elderly folk are marginalized and discriminated against by virtue of their seniority and ageism is so prevalent, if tolerated any further it already borders on abuse and violence.

3. Present international human rights mechanisms neglect the rights of older people. Besides being absent in many treaties and conventions, there are clear gaps in protections available to older people in existing human rights standards.

4. While general provisions in the two international covenants do apply to everyone, the lack of specific standards around what these rights mean for older people and in the context of old age means there is little understanding or attention to older people’s rights.

5. There are no specific human rights standards on issues like elderly abuse, long-term, and palliative care. A growing body of evidence shows that many older people face abuse and violence in their own homes, and in institutional and long-term care facilities.

As such, the DSWD must support this effort to come up with a UN convention for older persons to protect their rights and welfare.

The Phenomenon of Elderly Abuse

For many years, Elder Abuse was a hidden, unspoken issue in society. Similar to wife-beating, incest, and child abuse, it was a private problem kept within the confines of the domestic realm. But as a form of family violence, it has remained under or mis-diagnosed, under-reported, and poorly addressed by public policy even if it is not uncommon that if one type of abuse is occurring within a home, other forms of abuse may be (or will soon be) taking place. Meanwhile, elderly abuse is still often ignored by health professionals, and sadly, most perpetrators of the abuse are usually one’s own family members.
As the elderly population multiplies, so will the incidence of elder abuse. One out of every 20 elderly people will be a victim of neglect or physical, psychological or financial abuse this year.
Extreme cases of elder abuse have obvious manifestations, like pressure marks on the body, broken bones, depression, unexplained withdrawal from normal activities, unattended medical needs, or strained, tense relationships. But most elder abuse is subtle. It is difficult to tell the difference between normal interpersonal stress and abuse. Thus, it seems, elder abuse and neglect are often “hidden”.
But the phenomenon of elder abuse is becoming increasingly recognized by both medical facilities and social agencies. More and more studies have highlighted the seriousness and magnitude of elder abuse as an issue concerning the health and welfare of older persons. As such, Elder Abuse is now considered a major public health and human rights issue.

DEFINING ELDERLY ABUSE
The World Health Organization’s (WHO) Toronto Declaration on Elder Abuse defines elder abuse as “a single or repeated act, a lack of appropriate action, occurring within any relationship where there is an expectation of trust that causes harm or distress to an older person.” It is not just an intentional negligent act that causes harm to a vulnerable adult, but may actually consist of neglect, abuse, and actual violence against an older person. It may take the form of physical, psychological and emotional abuse, financial or material exploitation, medical maltreatment, even sexual exploitation and abandonment.
FACTS AND FIGURES AT A GLANCE
Statistics uncover a frightening picture of elderly abuse around the world. The problem may get worse as the number of senior citizens increase. In the United States, it is estimated that people over the age of 65 will number about 52 million in the year 2020. With those aged 85 years or older as the fastest growing group, they will comprise a big part of America’s population-almost 1/6 of the tota
he Philippines elderly population has been steadily increasing in both size and proportion. By 2010, Filipino senior citizens are estimated to be 7M.
Initially thought to be a problem of the developed world, elder abuse is now recognized as universal, although evidence from less-developed countries is primarily anectodal. In the Philippines, elderly abuse is still not as prevalent as in the West. But of late, elderly abuse is no longer unheard of in modern Filipino culture. Despite our strong tradition of filial piety, it is not as unknown as people perceive it to be. It may be quite disturbing, but we have to admit that it may be a sign of the changing times.

FACTORS INFLUENCING ELDERLY ABUSE
Caregiver stress. This commonly-stated theory holds that well-intentioned caregivers are so overwhelmed by the burden of caring for dependent elders that they end up losing it and striking out, neglecting, or otherwise harming the elder. Much of the small amount of research that has been done has shown that few cases fit this model.
Personal characteristics of the elder. Theories that fall under this umbrella hold that dementia, disruptive behaviors, problematic personality traits, and significant needs for assistance may all raise an elder’s risk of being abused. Research on these possibilities has produced contradictory or unclear conclusions.Cycle of violence. Some theorists hold that domestic violence is a learned problem-solving behavior transmitted from one generation to the next. This theory seems well established in cases of domestic violence and child abuse, but no research to date has shown that it is a cause of elder abuse.

POLICY RECOMMENDATIONS
a) Establish information programs and increase public awareness to minimize risks of neglect, abuse and violence to older persons;
b) Include training on the prevention, detection and management of social problems of senior citizens among  healthcare professionals and law enforcement officers, specifically on the handling of elder abuse;
c) Encourage the development and utilization of supportive community resources that provide in-home services, respite care, and stress reduction with high-risk families; In addition, explore the possibilities of subsidies and outreach support for family and caregivers to promote quality homecare for senior citizens; and
d) Ensure high priority to the enactment of measures that would provide social protection to the elderly and reduce their socio-economic and political disparities.

Addressing Health Issues of Senior Citizens under RA 9994

It cannot be helped that when one talks about ageing and the elderly, matters involving health are always included. Republic Act No. 9994 otherwise known as the Expanded Senior Citizens Act of 2010 is the third version of the senior citizens law. Since the first senior citizens act, RA 7432 and its successor RA 9257, the Philippine government has continuously sought to expand elderly benefits and privileges, and address various ageing issues especially those related to health concerns. 

Guided by the national sectoral plan, the 5-year Philippine Plan of Action for Senior Citizens (PPASC) which in turn was anchored on international instruments such as the Madrid Plan of Action, the Macau Programme of Action as well as the Shanghai Implementation Strategy, a major area of concern focuses on advancing the health and well-being of Filipino seniors.       

As such, one of the most expanded provisions of the RA9994 refers to medical benefits and health privileges of Pinoy senior citizens. While previously the most availed of discounted purchase pertained to drugs and medicines, under RA9994, the 20% senior citizens discount now applies to the discounted purchases of influenza and pneumonia vaccines for seniors. More importantly, the 20% SC discount likewise applies to essential medical supplies, devices, accessories and equipment used by seniors such as geriatric diapers, glucometers, blood pressure apparatus, wheelchairs, and walkers. Thus, it has been emphasized that commonly used assistive devices such as eyeglasses, hearing aids, and even dentures are also covered by the SC discount. 

These major additions were brought about by relevant researches and studies from partners in the academe which looked into issues of health and economics affecting Filipino elderly. As such, many details were also clarified through active policy-making and coordination by the National Coordinating and Monitoring Board (NCMB). Chaired by the Department of Social Welfare and Development, the NCMB Secretariat regularly communicated and coordinated with the proper government agencies like the Department of Health (DOH), the Philippine Health Insurance Corporation (PhilHealth), and the Food and Drug Administration (FDA) formerly known as the Bureau of Food and Drugs (BFAD). Now, it has been declared that some doctor-prescribed vitamins and minerals used to treat deteriorating health conditions of the elderly must be discounted just like many maintenance drugs. 

Another area which was greatly improved is on hospitalization benefits of seniors. Previously, this aspect was governed by the DOH through various issuances detailing computed discounts for room rates, laboratory and diagnostic tests, drugs and medicines, and even the professional fees of attending physicians. The new DOH guidelines, namely DOH Administrative Order No. 2012-0007, Series of 2012 now applies the 20% discount and the applicable 12%VAT exemption to the TOTAL hospitalization billing. Moreover, the separate availment of PhilHealth coverage has been institutionalized under the new rules. Seniors can get both their 20% SC discount and PhilHealth benefits during hospitalization.

It is also quite fortunate that the PhilHealth has been quite proactive and has been updating their rules and issuing relevant guidelines to facilitate availment of benefits especially for senior citizens. Among its improved programs and services are the “discounted” vaccines for seniors at selected Philhealth-accredited government hospitals to avoid affliction with influenza and pneumonia. Meanwhile, their “Lifetime Membership” program allows retirees and seniors to complete payment of a minimum number of months for automatic PhilHealth coverage which shall remain valid and in-effect until the senior eventually gets deceased. On the other hand, the “sponsored” program for indigent senior citizens is specifically mandated under the Mandatory Philhealth Coverage provisions of RA9994 and is being implemented in coordination with the Department of Social Welfare and Development’s National Household Targeting System (DSWD-NHTS). This same database of identified indigent senior citizens has also been utilized by the DOH as the basis for their FREE influenza and pneumonia vaccines program.

And speaking of particular benefits targeting indigent senior citizens, the Social Pension Program providing a monthly stipend of P500 has been found to make such an impact in improving the quality of life of poor elderly folk. Families report that they no longer feel so burdened caring for ageing parents or relatives because of this small allowance which helps with the family’s finances. The seniors themselves say they use the money they receive to buy their maintenance drugs, go for medical check-ups, or buy some food items like milk or rice. Evidently, this ultimately redounds to improved health and well-being of senior citizens.

Other significant health or medical-related provisions under RA9994 is the establishment of a geriatric ward in every government hospital, or at the very least a special unit reserved for sick senior citizens in all medical facilities. Already there is the Eva Macapagal National Center for Geriatric Health (NCGH) located near Malacanang which specializes in geriatric care and is equipped with state-of-the art facilities and equipment. Meanwhile, a comprehensive and integrated national health program for senior citizens must also be developed by the DOH as expressly provided for under RA 9994.  Hence, their current program for “active ageing” includes the conduct of regular “fitness camps” for elderly government employees and soon-to-be retirees. 

Admittedly, there is still much to be desired for a uniform and effective implementation of RA9994. Even with greater efforts from the concerned government agencies, the cooperation of the private sector is still essential. Thus, dialogues with the business establishments and appropriate orientations/trainings to familiarize them with relevant guidelines must also be encouraged.

The same goes for the senior citizens themselves; they must be given special lectures and capability-building sessions to inform them of their rights and privileges under RA9994, and how they can avail of these benefits and privileges properly and reasonably. 

Lastly, existing mechanisms and institutional arrangements like the establishment of Office of Senior Citizens Affairs (OSCA) in every city or municipality, the active engagements and participation of Regional Coordinating and Monitoring Boards (RCMBs) and Regional Inter-Agency Committee for Senior Citizens (RIASC) must be strengthened and/or improved on to ensure proper monitoring and implementation.

Footnote to the WHO Western Pacific Regional Meeting in July 2013

On July 9 to 11, 2013, the World Health Organization (WHO) Meeting on Ageing and Health for the Western Pacific Region was held in Manila. Together with representatives from the Department of Health (DOH), the Department of Social Welfare and Development (DSWD) was tasked to present a Country Report on government policies and programs promoting elderly care and welfare in the Philippines. Other representatives from the DOH included Dr. Irma Asuncion, and DSWD’s regular partners, Dra. Elizabeth “Bambi” Caluag, and Ms. Remedies “Jing” Guerrero. Besides Atty. Germaine Trittle P. Leonin of the National Coordinating and Monitoring Board (NCMB) Secretariat, DSWD was also represented by Director Patricia Luna, Asst. Bureau Director Paz Sarino, Ms. Marlyn Moral of Social Technology Bureau and Ms. Fritzie Barrameda of Standards Bureau.   

It has been a particular advantage for the Philippines to have clear mandates in our 1987 Constitution, identifying the senior citizens as a vulnerable and marginalized sector. Moreover, provisions on Social Justice and Human Rights clearly mandates raising the quality of life for all. Other national laws like the Magna Carta of Persons with Disabilities (PWDs) as well as the Accessibility Law are PWD-related legislation which may be taken advantage of by our senior citizens.  

Meanwhile, the prime legal basis, Republic Act No. 9994 as the 3^rd version of the senior citizens law tries to be a comprehensive, integrated piece of legislation for addressing the needs of the senior citizens. Besides healthcare provisions, it tackles educational opportunities, continuing employment, availment of livelihood skills training, as well as social pension benefits. And, besides the relevant legislations for senior citizens like the Expanded Senior Citizens Act of 2010, our national sectoral plan - the Philippine Plan of Action for Senior Citizens (PPASC) 2012-2016, especially the area of concern “Advancing Health and Well-being” was highlighted in the Country Report. 

The DOH’s thrust of promoting “healthy living and active ageing” was also something to be proud of. A key to well-being is healthy eating and proper nutrition. Food choices and basic cooking preparations were just as important as the amount of food intake. Nutrition and proper eating is also a strategy which can be used effectively to address health issues and other diseases. Besides genetic tendencies and ageing consequences, lifestyle practices also contribute to health risks. Avoidance of vices such as smoking and alcohol drinking, and most of all drugs, was also emphasized. Being prone to certain injuries because of weakness and frailty, especially for those slowly ageing already, assistive devices and safe, age-friendly environments such as facilities and transport are important. 

As such, with the healthcare needs being a major part of the ageing policies and programs, there is a need to focus on improving the health human resources component as well - be it institutionalizing geriatrics and gerontology as part of the curricula of various disciplines and not just the medical field, or giving specialized trainings for the “non-formal” medical practitioners, such as TESDA-trained caregivers and community-based, homecare caregivers. 

It is also important that there should be a proper institutional arrangement or mechanisms in place to implement the policies and programs for senior citizens. Thus, the National Coordinating and Monitoring Board (NCMB) and its regional counterparts, the RCMBs, as well as the Office of Senior Citizens Affairs (OSCA) are quite significant. It was also interesting to cite that the active participation of our senior citizens groups, as organized and established federations and associations ensured the sector’s direct involvement in all matters pertaining to them. However, even as the DSWD and the DOH are able to work together and are currently coordinating well, it is still highly advisable that there be established a primary government agency which shall focus on the elderly population and all its related concerns, much like the other sectors of children, women and PWDs, for the purposed of having clear and unified policy directions, a specific budget allocation, including a dedicated workforce contingent.

Although the WHO meeting seemed mainly focused on healthcare for the elderly, most of the recommendations recognized the need for an integrated, comprehensive approach to elderly care. This includes an improved financial capability that meant continuing education, employment or livelihood opportunities, assured pension benefits, accessible and affordable health programs and services, etc. Based on the sharings of “Best Practices”, the Philippines should be proud of its government efforts and measures promoting and protecting the rights of our senior citizens. With all the recommendations about having an “integrated and comprehensive” approach to elderly care, our RA 9994 alone exactly seeks to accomplish that already.

Given the current discussions at the United Nations-level in New York, particularly the Open-ended Working Group on the proposed UN Convention on the Rights of the Elderly, a specific treaty or convention as an international human rights instrument which demands compliance is always a strong compelling basis for national governments to give attention to the needs of a particular sector. The DSWD provided essential comments and inputs to the country position the DFA hoped to advance in August 2013 in New York. The WHO, as a UN body, was requested to make a similar positive representation in New York to support this stance.

Remember Your Dreams, Young Man (For Marben)

We remember you as a curly-haired boy in pajamas
picking me up after night classes at UP Law
and within those hallowed halls you decided
what your future would be...
Remember those dreams, young man

In grade school, your teacher asked all of you
what do you want to be when you grow up,
listening to all professions named you never settled;
as sure and unblinking you replied
- to be the President of the Philippines

You always knew what you wanted
and was willing to work hard for it;
for a generation blessed with wikipedia and google,
I saw you do diligent research on the internet
as you tried to finish a paper for school

the youngest ever to learn how to drive,
you were driving around San Carlos by fifteen;
you single-handedly arranged a day-trip to Sipaway Island,
negotiating with the boatman, arranging for our packed food,
and planning the whole island itinerary

even then we knew, we had faith in you
because you made us believers in your abilities
So know that even when we make bad decisions for ourselves
it is always our choice if they remain mistakes or Life's lessons learned
Remember your dreams, young man...

GPL 7/12/2014