JOLO, Sulu (MindaNews / 28 March) — Due to its physical topography as archipelagic and its geographical location as having dispersed island municipalities, much of Sulu has never been accessed and is virtually unknown, therefore remaining to be boggling the imagination of the worlds. On the other hand, because Sulu is an old polity, inherited attributes and roles in history and politics borne by the present, continue haunting new juridical entities such as the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) and the Philippine nation that have never really come to terms and moved on from anxiety over threats that old Sulu empire represented.
Socio-psychological and political burdens at times become debilitating to Sulu’s current inhabitants and disadvantageous to its government as these are partly consequences of expectations and frustrations of the revival and restoration of a glorious past that might have already receded to the mists of forgetfulness to be realistic and sustainable aspirations.
But Vice Mayor of Jolo, Ezzeddin Soud L. Tan says with confidence that as in times past, when faced with threats of great consequences to public security and well-being, the current administration of Provincial Government of Sulu has consistently faced up challenges and fought squarely on its own, relying on self- will and determination – and, weathering along with all stakeholders, especially the elders, traditional leaders, the local government units, and constituents in the municipalities and the barangays. In the end, Sulu triumphed and has always risen up on its own wings.
The municipal local governments adopt and acquire guidance on laws and policies in security, public order, and threats to public health from the Province. And in calamitous times, the provincial administration has not been lax and never amiss in doing its level best in shielding its constituents from any form of harm and danger and in providing sound lead for the municipal local governments, the presiding officer of Sangguniang Bayan ng Jolo observes.
Dr. Farah Tan-Omar, head of Sulu Integrated Provincial Health Office (IPHO), reiterates this in the compendious assessment of Sulu’s handling of the COVID-19 pandemic. Sulu provincial government did good in its management and implementation of all that was best and possible that could be and have been done in fighting COVID-19 outbreak, she says, adding that the provincial government even used its own resources and never did it take to complacency, nor found idly sitting until assistance from outside could arrive.
In the early days of the pandemic, the Governor shelled out from his own pocket to make sure that Sulu frontliners got the minimum basic supplies and equipment even as the world was groping and grabbing for scarce supplies. A one-time procurement of Personnel Protective Equipment (PPEs) worth P800,000 and additional costs for surgical facemasks that was running to as high as P1,700.00 per box, prohibitive alcohol, vitamins, etcetera, were immediately planed in from Manila and distributed in Sulu in those times of acute panic and scarcity when the rest of the BARMM was awaiting the release of the Bayanihan Grant to provinces, cities and municipalities (the grants were released in April 2020).
‘One big unknown’
Dr. Omar rated the efforts and management of Sulu vaccination program as satisfactory mainly for the level of efforts and the good management of the program and of the handling of the COVID-19 pandemic as one and integrated provincial concerted effort.
Herself a member of top management team of Sulu Inter-agency Task Force (IATF), Omar was hands-on from the procurement of vaccines down to management of COVID-19 suspects, including attending to the details of the conduct of burial for COVID casualties in accordance with Muslim culture.
The COVID-19 pandemic was a one big unknown, she explained, and the uncertainty it brought was the root of much anxiety and fear. Everyone was caught unprepared. No one could claim expertise, let alone the Sulu IATF when even the World Health Organization (WHO) could commit mistake. Much of the strategies adopted were experimental if not trial-and-error. One could mention for instance the use of physical shields and barriers to fend off the virus.
In the Jolo port, she recalled frowning at the mandatory antigen testing of inbound travelers. “It was a waste of money and efforts because antigen testing was weak basis for COVID detection.” She remembered being at odds in opinion with the province, but somehow the provincial government wanted people to see something was being done to demonstrate the urgency of the situation for everyone to pay serious efforts to follow protocols.
Being in the frontline mechanism, the IPHO in particular had to be closely attuned to the national guidelines by making sure that protocols implemented on the ground were based on the national understanding of the pandemic. On the other hand, the Sulu IATF was also faced with the realities of scarcity of resources. “You might have the money, but there was nothing you could buy. And even if some windows for procurement of supplies become available, you are an island province in this very far location, you might be last in priority. So you have to have the right connections.
“Minsan wrong na in pang hati ‘ta, basta sibu-sibu da.” (We may err in comprehending the situation, it was not what mattered at that moment. What was important was that we were all one and the same in that comprehension). This was one of the most important guiding principles for Dr. Farah. To her, the most important task on hand was to establish uniformity of understanding and that this goal was effectively achieved and communicated down the line of command by the Sulu IATF. This spelled success for the campaign to fight COVID-19 and for the vaccination program.
Management, Machinery, Network
“The planning in all levels is meticulous so that all members of the vaccination team are aware of who is in charge of what.” On hindsight, she feels proud and fulfilled that the management of vaccination program in Sulu went through thorough planning with full participation from the provincial health office down to the barangay health workers.
The unity in action succeeded chiefly for three components, according to the assessment of the members of the health sector: management, machinery (mechanism), and the network and complementarity with beneficiaries and stakeholders.
Julkipli T. Ahijon, Jr., Focal Person of Sulu IATF and currently the Provincial Disaster Risk Reduction and Management Officer (PDRRMO) of Sulu, credited the satisfactory rating to the good line of coordination. To which John S. Schuck III, Sangguniang Bayan (SB) councilor and chair of the SB Committee on Health also echoed and agreed that it was primarily the hard work and dedication of the COVID-19 shield frontliners from the province, municipal down to the barangay levels. These were tangibly inspired and sustained in seeing affirmation through the complementarity of cooperation manifested by all other stakeholders among the community, the security sectors, the academe, and – excusing a few municipalities that did not find time to attend the meetings – the Local Government Units especially the barangay officials who were quick to respond. Thus, the outcome of the vaccination program was “satisfactory” because there was coordination and meetings at all levels of the sectors and of the organizational hierarchy.
Perhaps the long years of conflict and war that battered the province finally paid off by turning in some blessings to Sulu, too. The situations of restiveness had not only built psychological and economic endurance and grown grace in the hearts of communities making the Suluans resilient, patient, and self-reliant in trying times. But providently by their long dealing and day-to-day encounters (of the cordial kind) and getting used to each other’s presence have built rapport between the province and the military establishment that one of the valuable social capitals of Sulu now is its link with the military and security sectors.
Help from WestMinCom
Sulu will be forever grateful for the valuable assistance of Lt. Gen. Corleto ‘Corly’ Vinluan, Jr., a former commander of the military in Sulu, later promoted to lead the Western Mindanao Command (WestMinCom), who helped facilitate the acquisition of vaccines and the airlifting of patients to seek care in the better-equipped health facilities in Zamboanga City in Region 9 or the Zamboanga region.
The urgent on-spot training of health workers in the proper way of swabbing is credited to the generosity of the General for providing all the transportation needs to fly in experts from the Regional Epidemiology center in Zamboanga City to train the IPHO and the RHUs in swabbing.
The long red tape of getting vaccine supplies from the BARMM regional health office was shortened to only 20 minutes flying time since BARMM previously arranged to ferry the vaccines on cold trucks from Cotabato to Zamboanga City en route to Jolo and was risking a long 20-hour trip by land trip and by sea, not to mention the possibility of vehicle malfunction on the road.
One phone call of Dr. Omar to Vinluan was well rewarded by the good general’s immediately linking his subordinate to directly coordinate with the IPHO. Through this initiative of Jolo, WestMinCom eventually planed in as well the vaccine supplies for Basilan and Tawi-Tawi province. Six flights were conducted to convey the vaccines to Sulu until the national Department of Health (DOH) could figure out the way to reach the islands.
As of February 2023, the IPHO released a report indicating the vaccination statistics of every municipality for Sulu. For the province as a whole, of the targeted 632,383 eligible population for vaccination, only 254,854 or less than 50% were fully vaccinated and only 60,136 had their first booster which further dwindled to 8,596 for the second booster.
The capital town of Jolo, with a population of 137,266 as of the May 2020 census of the Philippine Statistics Authority, garnered the most number of vaccinated based on target, completing 78.4 % or 75,510 of 96,280 targeted as fully immunized. This was followed by municipality of Siasi and Tongkil, both island municipalities of Sulu.
As for the total allocation and distribution of vaccines, the municipalities allotted big shares of vaccines are the municipalities of Jolo, Siasi, Indanan, Maimbung, and Parang.
Overall, numbers may be low and dwindling but what needs appreciation is the effort and the process that went through to achieve the statistics, Omar said.
Among the challenges that deterred operation had been mostly natural factors and objective realities of Sulu province, such as geography and the distance and dispersion of island municipalities. The unavailability of transportation and lack of storage facilities that would have lengthened the shelf-life of vaccines came next. Transport and storage facilities could have eased the accessibility of far-flung island villages.
For medical frontliners like Dr. Omar, their eagerness and dedication to reach out to remote areas is often hindered by the challenges of natural barriers primarily the vast oceans and the mountainous topography of Sulu province as archipelago comprised of dispersed island municipalities.
“The transport (of vaccines) to different municipalities has been laborious and costly especially to the islands. We have to consider there is no regular electricity in majority of the areas so we cannot store vaccines more than we can dispense for a limited number of days. Hence the personnel have to come to IPHO several times,” Omar shared. In many instances, the health personnel had to sacrifice their lives and dared the dangers at sea by ferrying in small bancas heavy blue boxes containing vaccines.
In the case of some municipalities with low turn-out of vaccination, the lackluster cooperation of some LGU leaders were to blame. Some LGU leaders were themselves even against vaccination. The wrong messages proliferating in social media that circulated around was also culprit.
Indigenous Peoples, Women
Den-Rasher Salim, Indigenous People Mandatory Representative (IPMR) to the Sangguniang Bayan ng Jolo, is one with the traditional leaders of indigenous Sama population of Jolo in not agreeing that the low turn-out of vaccination is to be blamed on culture or traditional belief system. It is wrong to point fingers at the tradition-bound communities such as the indigenous Sama and Sama Bajau population, says Morison A. Nursali, a leader of Sama Laminusa in Jolo and treasurer of Sulu IP Tribal Council. Proof of the matter is the fact that households of Sama in Barangay Takut-Takut in Jolo Town have mostly fully vaccinated family members, according to youth leader and Sama young religious, Jerry M. Jaji, a Sangguniang Kabataan representative and education head of the organization. IP’s simply follow what their leaders in the community tell them, Nursali said.
The acceptance of vaccination is due to trust and confidence among Indigenous Peoples not only in their leaders but in their recognition and acceptance of the bearers of vaccines, or the health workers who come to the communities to introduce the vaccines and explain the need for mass immunization, according to Bapah Gais E. Angeles, an IP leader of Takut-Takut. It is important to involve the indigenous and traditional tribal leaders to guide the health workers in communities. The leaders can also help to disseminate proper information and properly educate their lot. This was seconded by Maimona M. Muan, woman leader and community organizer of Muslimah Resource for Integrated Development (MURID), an NGO.
“Women leaders as mothers and householders are better at explaining and convincing men and children in proper health care. We can be tapped to assist in the information and education campaigns as well as helping with menial activities during the health rounds of RHU. The presence of women and mothers dispel the atmosphere of fear and coercion that often comes with the idea of getting vaccinated, ” Maimona volunteered.
Poor health-seeking behavior
Professor Sitti Lukaiya H. Usih, faculty and clinical instructor of the Health Sciences Department of Notre Dame of Jolo College Department of Midwifery, attributed the low vaccination acceptance to the over-all poor health-seeking behavior not only of the indigenous population but all vulnerable sectors such as the poor women and marginalized fishermen and itinerant households of ambulant vendor households as those residing in the stilt communities in Takut-Takut, Bus-Bus, and Chinese Pier in Jolo town.
When there is low quality of life due to poverty, health and well-being are often also neglected and last in householders’ spending priorities. So good health and well-being comes with good lifestyle, sufficient food and nutrition and high income and buying capability of the community, she explained. She agreed that Indigenous Peoples put much value on trust and confidence on leaders and health professionals. But she suggests that it is still important to link the status of vaccination program to the overall social and economic difficulties obtaining in the communities especially among IP households. Many of those who chose not to heed the LGU’s call for vaccination were more concerned of their day-to-day labor to eke out a living.
In conclusion, leaders of the health sectors interviewed were one in saying that horizontal lines connecting networks and linking coordination from the outside with the right office and agency have rightly complemented the consistency and self-sufficiency of vertical lines sustained by the good management and machineries of local actors.
In local Tausug parlance, the concept of linking and cooperation is silaturrahim or bridge of compassion. The success in fighting Covid-19 campaign and the recent vaccination programs were due to full coordination and cooperation of the various offices and agencies in the Covid shield and IATF, namely, the Bureau of Fire Protection, the Philippine National Police, the Armed Forces of the Philippines, the International Committee on the Red Cross, Philippine Red Cross, the Sulu IPHO, the RHUs in the municipalities, the local government units and barangays and Barangay Health Workers, the academe and even the religious sectors. (Mucha-Shim Lahaman Quiling for MindaNews)