Eubios Journal of Asian andInternational Bioethics
EJAIB Vol. 30 (6) August 2020
www.eubios.info
ISSN 1173-2571 (Print) ISSN 2350-3106 (Online)
Official Journal of the Asian Bioethics Association (ABA)

Copyright ©2020 Eubios Ethics Institute(All rights reserved, for commercial reproductions).

Contents

pageStatement on individual autonomy and social responsibility
within a public health emergency – WeCope Committee 273
A call to cease the use of war metaphors in the COVID-19
pandemic – WeCope Committee
277Statement on state and governance in COVID-19 pandemic– WeCope Committee
279
Moral leadership during the pandemic- Christopher Ryan Maboloc
284
Morality and politics: strengthening pandemic preparedness
for public health emergencies in the Philippines- Aldrin F. Quintero
288
Are the measures for COVID-19 realistic, justified, oroverblown? Preparing the path to the new normal-Randy A. Tudy
292
A historical evaluation from quarantine to compartmental
model: from Ottoman Empire in 1830 to the Turkish Republic
in 2020 and from cholera to COVID-19- Sukran Sevimli295
The possibility of a renewed discourse on peace: expositionof realities amid COVID-19 pandemic- Al Flores Quillope, 302
A new social work approach for Sri Lanka: Buddhist social
work - Rev. Omalpe Somananda
307
The impacts of social distancing during COVID-19 pandemic onhuman health - evidence from Bangladesh- Md Masud Parves Rana
312
The role of nursing with respect to disability and COVID-19
crisis -Dhastagir Sultan Sheriff318
People’s personal ethics and responsibilities during the
pandemic: stories and experiences of recipients of social
amelioration program (SAP) of Digos City -Rogelio P. Bayod,
Erikka June D.Forosuelo, Marianne Eve S. Sanchez
320
Ecological health: key to economic health and humanwell-being - Rogelio P. Bayod
323
Deaths without goodbyes: deprivation of dignified death andobjectification of dead bodies during COVID-19 pandemic in
the Philippines -Albert C. Albina
330
Fears and Hopes of Indigenous Students in Southern Mindanao
During Covid-19 Pandemic-Rogelio P. Bayod and Jenny P. Morante
334
Couple educators’ mission during COVID-19 pandemic:
ensuring a meaningful and relevant learning for students whilestaying at home
-Christine May D. Bayod and Rogelio P. Bayod
338
Challenges, difficulties, and opportunities of nurses during
COVID-19 pandemic: an assessment of disaster nursing careexperience - Angeline Anastacio
344
Ordering information

Editorial address, and all correspondence to:Prof. Darryl Macer
Email: darryl@eubios.info

Editorial: Learn together to Cope
As we continue to live in the time and space of the
COVID-19 pandemic, a number of questions continue toface us as individuals and as nations. There are obvious
differences between countries in their success in dealing
with the crisis. While China seems to be back to normal,
in the USA and Brazil there are tens of thousands of newcases every day. Even the home country of Eubios Ethics
Institute has seen several new cases after a hundreddays of no cases. Three recent Statements from theWorld Emergency COVID19 Pandemic Ethics (WeCope)
Committee start this issue of the journal., exploring therelationships between individuals and communities,
states and governance, autonomy and responsibility, andthe use of the War Metaphor. Readers who would like tocontribute to the ongoing subcommittees areencouraged to do so.
All but one of the other 15 papers in this issue stemfrom the series of International Public Health andBioethics Ambassadors (IPHA) Conferences that havebeen regularly held over the past few months. They
provide a chance for discourse and dialogue between
disciplines and cultures that open windows into different
localities and nations as they attempt to respond
ethically to the COVID-19 pandemic.
Some of the papers touch on broader aspects,
whether it be social work in Sri Lanka, indigenous
studies, nursing or others. In her paper from Turkey
Sukran Sevimli provides some interesting comparisons
between the current pandemic and how the Ottoman
empire dealt with cholera in 1830. Pandemics are notsomething especially new, but we still have a long way to
go to find the optimal way to deal with them.
The Ninth International Public Health and Bioethics
Ambassadors (IPHA9) Conference will be held 3-4
September 2020. I invite many more readers to join.
Given the number of papers that are being produced
and published, already by August this year we haveexceeded the number of regular pages for the whole
year, and issued six copies of the journal usually double
the regular length. We still have many more papers in
Press, and we hope that this open dialogue on bioethics
can save lives. For those who subscribe to the hard copy,
we hope soon printing and mail services will be resumed
to enable us to send hard copies to readers. Please keepon submitting your papers, and joining the virtual
conferences.
- DarrylMacer

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

Statement on individual autonomy andsocial responsibility within a public healthemergency- World Emergency COVID19 Pandemic Ethics (WeCope)
Committee (18 July 2020)

As an independent, multidisciplinary and cross-culturalcommittee, comprised of experts from cultures andnations across the world, we offer the following
recommendations on the concepts of individualautonomy and social responsibility in the context of the
COVID-19 pandemic.1
Introduction
Since the advent of modern Western bioethics,‘autonomy’, generally defined as capacity to makeinformed decisions in relation to oneself, has developed
as an axial ethical principle. Autonomy implies anobligation to respect. Autonomy soon became hegemonicin some contexts and thus underestimates other relevant
ethical principles in our shared human existence, withgreat loss to our common morality.
One of the neglected ethical principles was
responsibility, which is generally defined as theobligation to answer for one’s own actions andomissions. Specifically, social responsibility is theobligation to contribute to the welfare of a pluralist
society. However, ‘responsibility’ has often been viewed
from a narrow legal perspective, as ‘accountability’, asbeing the direct cause of an effect, acknowledging
authorship, and being subject to the penalty stipulated
by law. ‘Responsibility’ has a broader, moral meaning as
the capacity to answer for what has been done, and also
for what, while having the power to do it, was not done
and what ought to be. For the purpose of this statement,“responsibility’ is a function of moral agency and not alegal or political construct.
Individual ‘autonomy’ and social ‘responsibility’ havebeen too frequently perceived as opposed concepts andrealities, as if being responsible would somehow restrain
the exercise of autonomy, or as if autonomous
individuals would somehow dismiss their social
responsibility. This is what is still happening today, inthe context of the pandemic in some parts of the UnitedStates of America, for example, regarding the use ofmasks, with a current strong movement against their use
in the name of individual autonomy, totally discarding
the whole notion of responsibility.
However, this has not been the common
understanding of ‘autonomy’ and ‘responsibility’ outside
1 The

chair of this WeCope Subcommittee is Maria do CéuPatrão Neves, PhD, Universidade dos Açores, Portugal (Email:m.patrao.neves@gmail.com). The following made written
contributions to this Statement: Aldrin Quintero, Darryl Macer,
Dhastagir Sultan Sheriff, Fabrino Atanásio, Hasan Erbay, Kala
Perkins, Lakshmi Vyas, Manuel Lozano, Marlon Lofredo, Mireille
D'Astous, Raffaele Mantegazza, Rogelio P. Bayod, Şükran Sevimli,
Suma Jayachandran and Nader Ghotbi. This Statement draws on
ideas and literature from many sources, and benefited fromother persons’ comments as well. Selected academic references
are provided in background papers.
https://www.eubios.info/world_emergency_covid19_pandemi
c_ethics_committee

modern Anglo-American bioethics. At the turn of the 20th
century to the 21st century, as bioethics asserted itself
globally, there was a broader reconceptualization ofautonomy and a parallel strengthening of its relationshipwith other ethical principles, namely that ofresponsibility, such as is already stated in article 5 of the
Universal Declaration of Bioethics and Human Rights(2005):“Autonomy and individual responsibility: The
autonomy of persons to make decisions, while
taking responsibility for those decisions andrespecting the autonomy of others, is to berespected.”
The awareness that autonomy requires a
proportional assumption of responsibility was thus
globally recognized by all countries.
The current COVID-19 pandemic has confronted eachindividual with their own autonomous behavior andtheir own obligations towards society, aware that each
person can affect the well-being of the community.
Indeed, this pandemic, to which there is no proveneffective treatment and where the control of theinfection depends on individual behavior, has dictatedthe valorization of the community’s interest to thedetriment of the individual’s, voluntarily or legally, also
encouraging to reframe the concepts of ‘autonomy’ and‘responsibility’ and their relationship, within a global
context of public health emergency.
1. The concepts: from a classic definition to a global
understanding
Broadly, ‘autonomy’ is the capacity and the right to makechoices by yourself towards yourself; and ‘responsibility’is the duty and the obligation to acknowledge agency or
to be accountable for the consequences. The individual isthe direct cause of something (effect), by their own
decisions or actions, and thus becomes accountable forthe consequences. However, this is a legal, narrow,definition; the moral, broader definition is that therecognition that the exercise of autonomy is always
contextualized (and not abstract) and that responsibility
also falls on what was not done but what could andshould have been done.
Beyond the more general and formal definition of'autonomy' and ‘responsibility', developed by different
professionals and scholars, it is important to recognizethat the notions these concepts convey can also be
expressed by other words in different cultures. In
communities where these concepts are not common, thesame idea may be present in other terms, and it isimportant to have this sensitivity to recognize thoseterms and how when they are culturally embedded also
express the notions of 'autonomy' and ‘responsibility'.
The concepts of ‘autonomy’ and ‘responsibility’ can andshould also be recognized in daily practice.
Recalling the example of facial masks, it is known thatthey have long been common in several Asian countries
but were less used outside Asia. Today, it is recognizedthat the widespread use of masks creates two barriers to
the risk of infection and therefore their use is highlyEubios Journal of Asian and International Bioethics 30(6) (August 2020)
recommended from a public health point of view.2 In
many countries where masks were not available, people
started to produced them, with cultural meaningful
colors and drawings, using their own resources andcreativity for a common purpose.
A broad view on autonomy and responsibility allows, inthe current pandemic situation and in the diversity ofgeo-cultural contexts in which it spreads, to engage
people towards a greater awareness, both of what they
can freely do and what they need responsibly to do.
Recommendation 1: The concepts of autonomy
and of responsibility should be considered in theirbroad moral meaning (and not in a narrow legal
meaning), and in the cultural context tounderstand the different ways they can be
expressed and the specific meaning they canacquire. In the current pandemic individualautonomy must be balanced with social
responsibility to control the spread of theinfection.
2. The context: from theoretical requirements toeveryday practice
The definition of ‘autonomy’ and ‘responsibility’ as moral
obligations to be acknowledged by the self and respectedby others is not enough for their true and effective
compliance. Formal principles require material
conditions to be fulfilled. These material conditions can
include political (e.g. a dictatorship weakens both, theautonomy and responsibility of citizens who are
expected to obey given rules), economic (e.g. low income
people have to be totally focused in their survival andare not really free to make choices beyond their mostbasic needs), social (e.g. within some cultural andreligious environments, people are constraint to follow
what is traditionally established for them), educational(low level of education and/or lack of a critical mind
narrow the range of choices and the awareness of
responsibility) requirements. These different contexts
influence the exercise of autonomy and responsibility.
Also, urban, rural, or tribal communities have different
internal dynamics.
‘Autonomy’ is not only about making decisions freely
about oneself, feeling empowered, and being selfconfident; but also being free from fears that limit one’s
decision, such as violence or hunger. ‘Responsibility’ is
not just responding from one’s own decisions andactions; but also being cooperative with others,
supportive at least among those close to you (a smile,
listening, a prayer, are gestures of kindness available toall). Both attitudes admit different levels of performance.
In the context of a pandemic, it is important to adopt
behaviors that are expected from each person as acontribution to the common good, and, above all, tourgently provide the adequate and necessary means forthe exercise of both autonomy and responsibility. SARCoV-2 can infect everyone, but not everyone is equally
exposed, nor does everyone have the same conditions toprotect themselves. The pandemic has worsened
2 Statement of the World Emergency COVID19 Pandemic Ethics(WeCope) Committee, Wearing Masks and Face Covers as Social
Responsibility during COVID-19 pandemic (23 April 2020)

275

inequalities, further compromising the autonomy andresponsibility of the most disadvantaged, in this crisis asin the future.
Recommendation 2: The exercise of autonomy
and of responsibility require some basic political,
economic, social, and educational conditions to betruly and effectively developed. Otherwise, people
can neither be recognized as autonomous, nor canthey be held morally responsible. In the current
pandemic, basic conditions for the exercise of
autonomy and responsibility should be assured.
3. The balances: from a single pattern to a diversityof dynamics
The current pandemic has revealed what was already a(underground) reality, hidden by the banner ofhegemonic
individualistic
autonomy:individualautonomy is only ethically legitimate when exercised
responsibly; likewise, responsibility can only be
assumed if grounded in autonomy. Individual autonomy
without responsibility lacks awareness and converts
freedom into libertinism; social responsibility withoutautonomy can lead to violence and tyranny. Therefore,‘autonomy’ and ‘responsibility’ are complimentary,
insofar as they reinforce each other, and alsointerdependent, insofar as they need each other to bothdevelop fully.
Indeed, communities are not built by a summation of
single individuals. Communities are straightened nets ofrelationships where each part, each person evolves anddefines itself by the relationships it keeps with different
people and institutions. The whole is greater than theparts, the community is greater than the individuals.
The recognition of the other is the premise for selfrecognition, and it is by participating in different
collective works for the common good that individuals
fulfill themselves. Relationships redefine the persons.
Therefore, the responsible exercise of autonomy does
not diminish personal autonomy, but recognizes thateach human being is constituted in his interaction withhis community. There are many gratifying examples suchas volunteering, blood donations, food banks, animal
shelter, helping old aged people, and supporting publiccauses like environmental protection, reducing childlabor, recycling of wastes, and so on. In the context of thepandemic, there has been many moving examples of
persons who sacrifice themselves to help others: healthprofessionals working far beyond their hours to takecare of the patients; young people who satisfy some of
the basic needs of elderly and others who are confined;or ordinary citizens who distribute food for those whohave lost their jobs.
Recommendation 3: Autonomy and responsibility
should not be viewed separately. They arecomplementary concepts, and interdependent
realities, so their respective exercise isreciprocally enhanced. The current pandemic has
confirmed that true autonomy is always
responsible and responsibility is only effectivewith consideration of autonomy.
4. The interdependencies: a responsible autonomy
The recognition that both individual autonomy andsocial responsibility towards the community are276

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

inalienable
andmutually
reinforcing
ethicalrequirements, leads to the imperative of assuming
responsible autonomy in all circumstances, including themost demanding as in exceptional pandemic situations.
In the context of the SARS-CoV-2 pandemic, thebalance between autonomy and responsibility was put tothe test from the beginning and at four main levels:
isolation of patients, quarantine for suspects, population
lockdown and social distancing. Each of these different
levels imposed some sort of limitation to the individual’s
freedom of movements, always according to the needs ofthe wellbeing of the community, thus viewed as apersonal contribution to the common good. The
pandemic will eventually contribute to a greaterawareness of the human condition of community andalso global interdependence and thus to the deepening of
our sense of belonging and duty towards society.
Recommendation 4: The exercise of responsible
autonomy requires that each and every one
recognizes the impact that one’s choices can havein the community to which one belongs and towhich one has duties. The current pandemic
stresses the importance of responsible autonomy
foreveryone’s
life
andwellbeing,asinterdependent beings.
5. The citizens’ obligations developing a socially
responsible individual autonomy
Each person is also a citizen benefiting from the goods
society provides and contributing to common good.
Therefore, each person before acting, should check if
his/her decision were to be adopted by all, would it
contribute to a peaceful coexistence. Indeed, morality of
individual decisions and actions depend on thepossibility to become universal. This requirement
applies directly to the current pandemic and addresses
each of the following question: if my autonomous
decisions and actions ought to be followed by all myfellow’s citizens would my community be safer,
healthier, and better than before? This is a question thateach and every person is able to answer; and if they do it
honestly, and act accordingly, then we would mostcertainly build a better world for humanity.
Different circumstances, such as the SARS-CoV-2
pandemic, require different contributions. In this context
there are key ethical principles and critical proceduresthat should be observed:- rejecting a narrow and limiting self-centeredattitude, acknowledging that no one lives alone;- embracing an integrated vision of oneself, as
belonging to a community and coexisting with otherpeople, as well as being inhabitants of a shared world
with other beings;- adopting a global view of the world in recognition of
the network of interdependencies in which we alllive;- requiring high-quality public consultation, with thecapacity to identify misinformation, and promoteinterdisciplinary approaches;- understanding that the current pandemic situation
requires a more altruistic, cooperative and solidarity
attitude;- recognizing that strengthening equality, that is,equal opportunities to all, is a moral challenge thatwill benefit each and every one.
Recommendation 5: Moral legitimacy of
individual autonomous decisions depends on their
universal potential to be adopted by all. Therefore,
they ought to be altruistic, cooperative, andhelping to strengthen solidarity and equality.
These general requirements for moral behavior
become even more important in exceptionallyvulnerable and demanding situations such as thecurrent pandemic.
6. The states’ obligations promoting a socially
responsible individual autonomy
States have the power and the duty to intervene in orderto promote citizens’ social responsibility, while
protecting their individual autonomy, namely throughthe establishment of norms to protect public health, thesupervision of their compliance and the penalty for noncompliance. Therefore, states should also balance thecitizens’ right to autonomy and the citizens’ capacity tosocial responsibility when adopting public healthmeasures, respecting individual human rights,
evaluating economic and social conditions of the
population to actively participate in public policies andalso to comply with public health rules, and enhancing
social justice. Each political decision should thus check,previously to become a rule, if there had been an
opportunity to listen to all citizens, would it bereasonable to expect their agreement.
In this context there are key ethical principles andcritical procedures that should be observed:- respect for human rights (for the three first
generations of Human Rights) as the common
morality worldwide;- accuracy, taking well-informed decisions, relying on
the best scientific knowledge and evidence;- proportionality when limiting, provisionally,
individual rights on behalf of the common good;- equity or fairness in distributing burdens andbenefits;- truthfulness on the presentation of facts and doubts,
probabilities and predictions;- transparency over the definition of criteria and theirimplementation;- open communication fostering a broad dialogue andenhancing a pluralistic debate;- accountability for the decisions taken and the actions
implemented.
Recommendation 6: The moral legitimacy ofpolitical decisions depends on their consensual
acceptance. Therefore, they ought to respecthuman rights, be accurate, proportionate, fair,truthful, transparent, inclusive, accountable.
These general requirements for an ethical public
policy become even more important in exceptionalsituations as the current pandemic, where somehuman rights can be provisionally limited onbehalf of the common good.
7. The international community’s obligations toenhance globally responsible cooperation

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
States have the responsibility to work together, tocooperate and act solitarily, mostly when facing global
problems, as a pandemic. This pandemic affects all
human beings in the world. Although every person canbe infected, the living conditions of any person may
make others susceptible to infection, severe harms, andless likely to receive medical care, and to benefit from
economic assistance, and less resourceful to overcome
the crisis, etc. Therefore, international solidarity, at the
medical, economic and social levels can contribute to theaccess of all people to a basic package of emergency help.
Moreover, the huge endeavor to create a vaccine against
the coronavirus and a safe and efficient treatment for
COVID-19 can only be accomplished in a reasonable timeframe through international cooperation, at the scientificlevel.
Recommendation 7: Sovereign states have theobligation to cooperate with one another, at all
possible levels, to contribute to global justice. In
the current pandemic, all states should cooperate
to the extent of their capabilities, in finding a drugor vaccine against COVID-19, and these therapies,
once discovered, should be accessible to all who
need them.
https://www.eubios.info/world_emergency_covid19_pandemi
c_ethics_committee
Members, World Emergency COVID19 Pandemic Ethics(WeCope) Committee:
Dr. Thalia Arawi (Lebanon)
Dr. Mouna Ben Azaiz (Tunisia)
Dr. Lian Bighorse (San Carlos Apache Nation, USA)
Dr. Andrew Bosworth (Canada)
Dr. Rhyddhi Chakraborty (India, UK)
Mr. Anthony Mark Cutter (U.K.)
Dr. Mireille D'Astous (Canada)
Dr. Ayoub Abu Dayyeh (Jordan)
Dr. Nilza Maria Diniz (Brazil)
Dr. Hasan Erbay (Turkey)
Prof. Nader Ghotbi (Japan)
Prof. Abhik Gupta (India)
Prof. Soraj Hongladarom (Thailand)Prof. Miwako Hosoda (Japan)
Prof. Dena Hsin-Chen Hsin (Taiwan)
Dr. Anower Hussain (Bangladesh)
Prof. Bang-Ook Jun (Republic of Korea)
Prof. Hassan Kaya (South Africa)
Dr. Sumaira Khowaja-Punjwani (Pakistan)
Prof. Julian Kinderlerer (South Africa)
Dr. Lana Al-Shareeda Le Blanc (Iraq)
Prof. Marlon Lofredo (the Philippines)
Dr. Manuel Lozano Rodríguez (Spain)
Prof. Darryl Macer (New Zealand)Prof. Raffaele Mantegazza (Italy)
Dr. Aziza Menouni (Morocco)
Dr. Endreya Marie McCabe (Delaware Nation, USA)
Prof. Erick Valdés Meza (Chile, USA)
Dr. Ravichandran Moorthy (Malaysia)
Prof. Firuza Nasyrova (Tajikistan)
Dr. Suma Parahakaran (Malaysia)
Prof. Maria do Céu Patrão Neves (Portugal)
Prof. Deborah Kala Perkins (USA)Prof. Osama Rajkhan (Saudi Arabia)
Ms. Carmela Roybal (Tewa Nation, USA)
Prof. Mariodoss Selvanayagam (India)
Prof. Mihaela Serbulea (Romania)
Dr. Jasdev Rai Singh (England)

277

Dr. Raquel R. Smith (USA)Prof. Takao Takahashi (Japan)
Dr. Ananya Tritipthumrongchok (Thailand)
Dr. Lakshmi Vyas (UK)Prof. Yanguang Wang (China)
Prof. John Weckert (Australia)
Dr. Anke Weisheit (Uganda)
Inquiries to: Prof. Darryl Macer, Chair, WeCope Committee;
Email: darryl@eubios.info Tel. +1-949-439-9307

A call to cease the use of war metaphors in
the COVID-19 pandemic- World Emergency COVID19 Pandemic Ethics (WeCope)
Committee (14 June 2020)

Preamble
As an independent, multidisciplinary and cross-culturalcommittee, comprised of experts from cultures andnations across the world, we urge all to reconsider theirlanguage, stating:
Recommendation 1: In communications relating
to COVID-19 and coronavirus, any reference ormetaphor belonging to the semantic context of
war must be avoided.
War is sweet for the inexperienced, said Erasmus ofRotterdam. Using the metaphor of war to describe apandemic means underestimating war, taking it as achallenge or a fight, almost normal, and quite natural.
What we are facing is not an enemy who has a clear will
to destroy us; it is a virus, a natural organism with nopersonal will, and if anything has enhanced its
destructive action, it is years of unfortunate ecologicalmanagement by the humans. There is no invasion fromanother planet to this world. Everywhere, and especiallythose with less resources, are paying the price of a
globalization without a soul, without respect for natural
resources and unfortunate ecological mismanagementby human beings.
The use of the war metaphor is extremely dangerous
because it risks transforming preventive public healthprocedures into instruments of social control. The
emergency of war requires total mobilization against thehuman enemy, and not taking responsibility for thedamage that can be caused to other people, as in the caseof the pandemic. There is no one to kill in a pandemic,
but there are many to defend against the possibility of an
infection. It is not a question of acting aggressively
against another person or even defending yourself fromanother person, but of defending others from ourselves.
In warfare, gas masks are used to defend us from aweapon used by other people, but masks in a pandemic
are mainly used to protect others from our potential
breathing out of infectious droplets. The situation isexactly the opposite of war: the use of face masks is an
act of love towards others, not an act of defense against
an enemy. We are asked to keep our distance not fromour enemies but from our friends aiming to isolate thevirus. We are not building physical trenches but social
barriers that allow the well-being of others and limit thedamage that we could do.

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

Recommendation 2: Particularly with regard tocommunications aimed at children andadolescents, it is necessary to differentiate thesituation caused by the virus from that of war,with detailed examples.
The use of the war metaphor is especially dangerous
in education. Telling the kids that we are at war means
presenting war as a natural response to an emergency,with an aggression that is not appropriate. Children havethe right to grow in a safe and healthy planet where
there are sensible ways of uplifting one another’s morale
for managing a pandemic that do not terrorize theirlives. The language of the government and leaders must
give inspiration to the youth and the next generation
without using the pandemic to instill fear in people.
Words affect people psychologically and emotively andhave psychological consequences. The virus has not
attacked us out of an evil deed; it is taking advantage ofthe mistakes in human approach to the nature with rapid
globalization on a fragile base. But war is nothing
natural; it is the worst of the choices that human beings
can make and must never be used as a metaphor todefine what is instead a strategy of resistance against avirus that must find us united as brothers and sisters,
without ever using the word enemy.
Recommendation 3: It is necessary to avoid any
form of stigmatization towards those who do notrespect the health rules, inviting them to change
their behavior but without pointing to them as
enemies.
Any form of stigma distracts public opinion from thereal goal of fighting the novel coronavirus but not groupsof humans whatever their behavior. Furthermore,
stigmatization produces an effect of infantilization: oneis led to believe that the population as a whole is unable
to comply with the rules and that there are particulargroups that do not have this ability. This can lead todiscriminatory behavior, including ableism, ageism,
classism up to actual racism. Stigmatization can cause ashift in the way one thinks and there are behavioral
consequences.
Recommendation 4: Safety and preventive
measures must always be presented as emergency
measures against the virus and their durationmust be limited to the period of time necessary forthe safety of the community.
Michel Foucault’s analysis of the politicalmanagement of plague and leprosy are pertinent. Thesediseases, spread throughout Europe, were used for social
control purposes; it was the territory, in its physicalsubdivision and the regulation of spaces, that constituted
an instrument of control and became more and morepervasive. When in the 17th century a sphere of intimacy
took form, almost immediately the political tactics forviolating it were created. In the current situation, it isnecessary to be cautious in the analysis; credibility
should not be given to the conspiracy readings. It isnecessary to understand that every standard and every
control device, put in place exclusively for healthreasons, may lend themselves to be used for otherreasons, unless citizens become democratically aware of

the situation and pay close attention to what may
happen in the future. For instance, the automatic
download and installation of tracking software forcontact-tracing without an active opt-in option should becritically evaluated.
Using a safety device such as a face mask, ormaintaining a safe physical distance, when implemented
through understanding and awareness, is different frombeing subject to an imposed standard. Wearing a facemask so as not to harm someone else is a profoundly
moral act; it is not a question or paranoia of others as
possible danger, but on the contrary, of attenting to ourown behavior in respect to the wellbeing of others. Thisshould constitute the transition from passively accepted
norms to internalized norms with the fulcrum on therelationship between the self and the other, during the
pandemic.
Recommendation 5: Research should be
conducted to find the most suitable language todefine the attitude of human beings towards the
pandemic. One possible choice could be the term
resistance.
In an emergency, each person should put in placepersonal and collective resistance strategies, so it is amatter of resisting the virus from a medical point of view
but also of behaving in such a way as not to harm otherpersons.
Very often when we speak of individual responsibility
we consider ourselves as isolated individuals, a kind of
abstraction, owner of rights and duties. The link between
responsibility and autonomy is sometimes so close thatthe fulfillment of one’s duties seems to be indifferent
from the relationship with others, as in “I do my duty to
be able to enjoy my rights”, the focus is on ‘me’ and ‘my’duties and rights.
The coronavirus emergency has reversed thesituation; I wear a face mask so as not to harm otherpeople, and I keep social distances first of all because I
could hurt others. The ethics of the self, to be defended at
all costs, as if it were a city besieged by the enemy, hasbeen turned upside down in the ethics of the other. We
ask children to stay at home not because they areparticularly at risk, but especially to protect their
grandparents; all this could be a reversal of therelationship between individual and community. It is not
the community that imposes rules on the individual, who
perceives them as limitations, but it is the individuals
who limit themselves because this is the only way tobelong to a community. I don't come first, and strictly
speaking, nor does the other, but the relationshipbetween the self and the other is the foundation of
everything.
It is the relational aspect of COVID-19 and its
preventive measures, which must be at the center of
ethical reflection. The community is not made up of
wandering atoms, of people who fear the other, but ofrelationships that redefine the subjects within them, intheir micro- and macro- relationships which then build
the social totality, in which the recognition of the other isthe premise for self-recognition of the ego.
Inter-connective
metaphorsshouldbring
cohesiveness and encouragement during a pandemic.
One should not experience loss of control or feel

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
disempowered, nor should they feel that there is apossibility of non-compliancy from their perspective.
The pandemic can be a turning point for many citizens todevelop new ways of thinking, to encourage cooperation
to contribute positively to everyone’s well-being insteadof reinforcing the possibility of others being victimized
while dealing with preventive measures. Social measures
should foster a sense of encouragement and a greater
sense of responsibility. The operational models anddynamics from a social consciousness perspective should
be fostering and nurturing especially for preventive
measures for health and well-being.
Inquiries to:Prof. Darryl Macer, Chair, WeCope Committee;
Email: darryl@eubios.info Tel. +1-949-439-9307
Prof. Raffaelle Mantegazza (Italy), Chair, sub-committee
WeCope; Email: raffaele.mantegazza@unimib.it
Members, World Emergency COVID19 Pandemic Ethics(WeCope) Committee: https://www.eubios.info/
world_emergency_covid19_pandemic_ethics_committee
Dr. Thalia Arawi (Lebanon)
Dr. Mouna Ben Azaiz (Tunisia)
Dr. Lian Bighorse (San Carlos Apache Nation, USA)
Dr. Andrew Bosworth (Canada)
Dr. Rhyddhi Chakraborty (India, UK)
Mr. Anthony Mark Cutter (U.K.)
Dr. Mireille D'Astous (Canada)
Dr. Ayoub Abu Dayyeh (Jordan)
Dr. Nilza Maria Diniz (Brazil)
Dr. Hasan Erbay (Turkey)
Prof. Nader Ghotbi (Japan)
Prof. Abhik Gupta (India)
Prof. Soraj Hongladarom (Thailand)Prof. Miwako Hosoda (Japan)
Prof. Dena Hsin-Chen Hsin (Taiwan)
Dr. Anower Hussain (Bangladesh)
Prof. Bang-Ook Jun (Republic of Korea)
Prof. Hassan Kaya (South Africa)
Dr. Sumaira Khowaja-Punjwani (Pakistan)
Prof. Julian Kinderlerer (South Africa)
Dr. Lana Al-Shareeda Le Blanc (Iraq)
Prof. Marlon Lofredo (the Philippines)
Dr. Manuel Lozano Rodríguez (Spain)
Prof. Darryl Macer (New Zealand)Prof. Raffaele Mantegazza (Italy)
Dr. Aziza Menouni (Morocco)
Dr. Endreya Marie McCabe (Delaware Nation, USA)
Prof. Erick Valdés Meza (Chile, USA)
Dr. Ravichandran Moorthy (Malaysia)
Prof. Firuza Nasyrova (Tajikistan)
Dr. Suma Parahakaran (Malaysia)
Prof. Maria do Céu Patrão Neves (Portugal)
Prof. Deborah Kala Perkins (USA)Prof. Osama Rajkhan (Saudi Arabia)
Ms. Carmela Roybal (Tewa Nation, USA)
Prof. Mariodoss Selvanayagam (India)
Prof. Mihaela Serbulea (Romania)
Dr. Jasdev Rai Singh (England)
Dr. Raquel R. Smith (USA)Prof. Takao Takahashi (Japan)
Dr. Ananya Tritipthumrongchok (Thailand)
Dr. Lakshmi Vyas (UK)Prof. Yanguang Wang (China)
Prof. John Weckert (Australia)
Dr. Anke Weisheit (Uganda)

References279

Lawn, S., Delany, T., Pulvirenti, M., Smith, A., & McMillan, J.
(2016). Examining the use of metaphors to understand theexperience of community treatment orders for patients andmental health workers. BMC psychiatry, 16, 82.
https://doi.org/10.1186/s12888-016-0791-z
World Emergency COVID19 Pandemic Ethics (WeCope)
Committee (23 April 2020), Wearing masks and face covers
as social responsibility during the COVID-19 pandemic,
Eubios Journal of Asian and International Bioethics (EJAIB)
30(5) (June 2020), 197-198. https://ww.eubios.info
World Emergency COVID19 Pandemic Ethics (WeCope)
Committee (31 May 2020), Statement on ethical triage
guidelines for COVID-19, Eubios Journal of Asian andInternational
Bioethics(EJAIB)30(5),
198-201.
https://ww.eubios.info

Statement on state andgovernance in COVID-19
pandemic- World Emergency COVID19 Pandemic Ethics (WeCope)
Committee (18 August 2020)
As an independent, multidisciplinary, and cross-culturalcommittee, comprised of ethicists from cultures andnations across the world, in the context of our previous
statements, we offer the following recommendations on
the concepts of State and Governance in COVID-19
pandemic.3
1. Introduction
The pivotal role of government in global healthemergencies like the COVID-19 pandemic cannot be
downplayed. In fact, the government is the primary
responder, strategic planner, policy maker, peace andorder keeper, financier, provider, program implementer,among others. Failure in government response to any
pandemic can result to uncontrolled infection spread,deaths, economic collapse, social unrest, hunger,
violence, and other crises that may lead to the collapse of
the same government that has sworn to protect anddefend its people from harm.
Looking back at the history of pandemics we can see
government that were resilient, sharp, decisive, humane,caring and concerned, crisis prepared, excellent crisis
manager, quick responder, with foresight, very good inmanaging people and public order and peace, cohesive,
systematic, reasonable, and respected as it was able tocommand educated obedience and calm.
However, the COVID-19 pandemic has revealed someproblems on resiliency, crisis preparedness, leadership,and management of governments around the world. In
3 The chair of this WeCope Subcommittee is Marlon Lofredo,

Ph.D., St. Paul’s University Quezon City, the Philippines (Email:mpplofredo@spuqc.edu.ph) The members of the drafting
subcommittee include Marlon Lofredo, Thalia Arawi, Andrew
Bosworth, Rhyddhi Chakraborty, Mireille D’Astous, Nilza Maria
Diniz, Manuel Lozano Rodríguez, Darryl R.J. Macer, Maria do
Céu Patrão Neves, Suma Parahakaran, Osama Rajhkan, Anke
Weisheit,. This Statement draws on ideas and literature frommany sources and benefited through comments from otherpersons
aswell.
https://www.eubios.info/world_emergency_covid19_pandemic_ethics_committee

280

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

particular, it exposed the growing disparity between
state and the people as seen in mass defiance of statepolicies and protocols in response to the pandemic
around the world. The pandemic did not only reveal
some striking failures of leadership and policymaking insome states resulting in more deaths and high infection
rates, but also excellence in management by some state
leaders.
We have seen in the news how governments around theworld are responding to the challenges of Covid-19,
some desperately, others steadily.
Efforts ofgovernments to control the spread of the disease andprevent more deaths and harm to society and people
come in variety of ways and effects: from imposition of
lockdowns and community quarantines to the use of
military and police forces in imposing discipline, peaceand order, and delivery of essential services; from
granting emergency powers to chief executives tocreating abruptly prepared laws, policies, and protocols;from shutting down economic powerhouses torestricting some people’s rights; from efforts to leave noone behind to eventual marginalization of the socially,physically, ethnically, and economically vulnerable, etc.
Some governments are showing success, others are indire need of guidance, order, and even oversight.

b)

c)

d)

2. State as an Institution of Effective Leadership andUnified Action
There is a great difference between power andleadership: the mere possession of power or being in aposition of authority does not make one a leader. At thecore of leadership is the ability to enable a group ofpeople to achieve a goal that none of them could
accomplish on their own, while political power is simply
related to control, authority, and influence. State leaders
are expected to be effective and unitive, especially intime of national emergencies, so is the system ofgovernance in a State. Governance is the management ofpublic affairs by State and non-state associations. State
government is state leadership or management of publiclife. Government’s effectiveness and unity are shown in
different responsive, relevant, operative, efficient, andethical ways and means of responding to the pandemic
and its effects.
Any government, national, state,provincial, community and/or tribal, and its leaders are
expected to lead the people, and gain their collaboration,
to a unified action against COVID-19. It is in this lightthat we present the following principles andrecommendations.
Recommendation 1: State policies and regulations
promulgated for the prevention and control of COVID19 need to be just, compassionate and humane,science-based,
and
truly
responsive,
nondiscriminatory and equitable. This time of global
health emergency is an opportunity, as well as achallenge, for governments around the world to prove
themselves as resilient, cohesive, trustworthy,
credible, and legitimate institutions capable ofcreating and implementing laws and policies thatbuilds resilient, cohesive, and trusting communities.
a) Policymakers should give credence to findings andrecommendations of science and frontliners who are
directly involved in actions to control the virus ande)f)provide healthcare to the infected. In this way,policies and regulations will be more responsive,
effective, and efficient as they are enlightened byresearch and sound reasoning and judgment.
Policies should be unifying and inclusive rather thandivisive and exclusive, and guarantee reasonable,
acceptable, and temporary limitations to somerights, privileges, and freedoms of the citizens.
Policies should also take account of the lessadvantaged members of the population, thedisplaced and refugees who cannot follow pandemic
control requirements for lack of available resources.
This will guarantee social obedience and trust thatno one will be left behind.
Policymaking should involve not only the politicians,
military and police officials, economic players, andkey government officials, but also experts andcommunity representatives in a collaborative effort
to craft more responsive protocols that are proactive
ad not reactive, caring and loving, rather thanpunitive and militarized.
Policies should strike a balance between conflicting
goods, if possible. In a pandemic, it should never bea choice between economy and public health, nor
between public order and peace and public health. If
reasonable balance cannot be achieved, publichealth should be the priority. A sick populace is asick economy, and an ailing country. While ensuringcommunity security and order is important, greaterattention and priority should be given toguaranteeing public safety and public health.
Governments are also reminded to avoid too
punitive and vindictive enforcement of pandemic
policies and laws. It is beneficial to governments toalways remember that laws and policies are meant
to promote the general welfare of the people and not
make their situation even worse.
Government policies need to ensure that no one isleft behind. Essential services should reach all,especially the most vulnerable members of society,and that all frontliners are properly equipped,
protected, and supported.

Recommendation 2: An organized and collaborative
management system where line of command is clear
working as a hub of credible, contrastable and formal
information from which directives should be wellestablished. Such sources of information should bewell-advised by scientists and healthcare experts. The
role of these experts should never be taken for
granted by state leaders and policy-makers since they
are the ones who have an understanding, albeit
evolving, of the nature and dynamics of SARS-CoV-2
and its resulting COVID-19.
a) It is recommended that State COVID-19 management
teams should adopt the collaborative whole-ofsociety approach that inclusively engages all sectorsof society to respond and find solutions to the
problems posed by the pandemic, especially whenresources are scarce. Governments need to listen to
its people and the private sector since no one has amonopoly of solutions.
b) Regular updates and progress reports fromgovernment and COVID-19 Management teamEubios Journal of Asian and International Bioethics 30(6) (August 2020)
officials should be done to assure the public ofgovernment support and concern, as well as topacify public panic and resolve confusions. To
ensure that State updates and reports are based on
independent science it is highly recommended thatexpert members of the COVID-19 Management teamdeliver the information to the public, unlessotherwise, it is demanded by situation that the State
Chief Executive addresses the nation.
c) Government should exploit all forms ofcommunication, including the social media, todisseminate information and guidelines, andfeedback on them, to ensure the public is welleducated on the nature, transmission, and morbidity
of COVID-19, and guarantees public knowledge of
disciplinary protocols to be followed. A well-known
and recognized official source of information canquell the proliferation of fake news anddisinformation. At the same time, creation of avariety of independent fact-checking organizations
can enhance the veracity of information to ensurethat different perspectives on inescapable ethicalquestions are considered. Where there are politicaldifferences in the use of scientific information, andchoice of experts, this should be transparently
acknowledged.
Recommendation 3: Establishment of effective andefficient COVID-19 control systems aimed at zero
infection and death, and total containment or evenelimination of the virus.
a) States are encouraged to establish a system ofeffective control of COVID-19 which includes, but is
not limited to, mass testing, establishment of safe
quarantine and isolation facilities, wearing ofclinically recommended face masks, and/or facecoverings, 4 and physical distancing, localized
community quarantines, and continuous informationand education campaigns in mass media and all
medium of communications on proper hygiene,
regular hand-washing, and other safety and healthpractices and protocols.
b) Social control policies should not ignore otheraspects of general welfare or wellbeing such as
livelihood,sustenance,
education,
economy,employment, and protection from domestic abuse
and sexual offense. Effectively balancing thedemands of these social goods vis-à-vis thechallenges of the pandemic can contribute largely tocontrolling or preventing the spread of the virus andits corresponding social, psychological, andeconomic effects.
c) Governments are encouraged to establish welldesigned
andoperational
publichealthinfrastructures and institutions that are resilient,inclusive, non-discriminatory, and effective (i.e., canrespond quickly) in handling pandemics and other
health crisis; and, ensures that more than enoughsupply of necessary equipment and gadgets are

4 Although some states still have a shortage of face masks, ortheir price precludes universal access, face coverings arealmost universally available.

281

available by stockpiling, in advance, essential
emergency resources.
d) Governments are called to support research anddevelopment of vaccines and treatment, and suchactivity should be a part and parcel of its pandemic
management system.
e) Scientists need to address the fundamental questionof whether zero infection and death is actuallypossible, even in economically capable states, as has
been illustrated by the reemergence of cases inquarantined island states, such as New Zealand. We
recommend that a global assessment of the evidence
should be transparently made in 2021, as the world
has gained a year of epidemiological data from theattempts of all states in the world to face thepandemic.
f) Governments need to fund independent research toassess all aspects of their attempts at control andmitigation of the COVID-19 pandemic, to establish
workable good practices for each state andcommunity.
Recommendation 4: Government should ensure that
allocated funds for COVID-19 response are efficiently
and ethically spent.
a) A just, transparent and non-discriminatory macroand micro allocation and distribution of available
resources and funds is needed to ensure everyone
equitably benefits.
b) Governments should assure the public that noresources, money or in kind, are lost in graft andcorruption, by making regular public transparency
reports as well as independent audits on
government spending, borrowing and allocation. In
this way, public trust and confidence is guaranteed,and people become more obedient and cooperativein government programs and policies.
c) The pandemic should not be used as an excuse orpretext for wanton exploitation of the easement ofallocation and release of funds policies to preventthe flow of valuable and scarce funds toinappropriate programs, overpriced facilities andsupplies, improper spending, and insatiable pockets.
d) Mechanisms for accountability need to bestrengthened.
3. Adherence to Principles of Human Rights and
Democracy
Respect and promotion of fundamental freedoms andhuman rights are the foundations of a free and caring
nation. The protection of these human and social goods
is essential to the State’s legitimacy and continued
existence. It’s inherent to a socially responsible State toensure that in all circumstances and situations, these are
well safeguarded and advanced.
Recommendation 5: Human rights and fundamental
freedoms are not be unwittingly and unnecessary
compromised by the State in its COVID-19
management.
a) Governments ought to ensure that while strictmeasures to avert the further spread of COVID-19
are enforced, human rights and fundamental
freedoms are carefully upheld. The enforcement ofexcessively harsh and severe measures to control

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b)

c)

d)

e)

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
movement of people has caused blatant violation ofbasic human rights, like imposing immediate
physical punishment for violators, destruction ofproperty, warrantless arrest, illegal detention,
curtailment of freedom of expression, etc., whose
victims are the poor and underprivileged while therich and powerful are dealt with mercy andcompassion and are excused of any liability. Whilecertain concessions as to limitations of some
freedom may be justified through quarantine andlockdowns to prevent further infection and death,the requirements of justice, fairness, equity,
humanity, and dignity are not overlooked or
altogether sidelined.
Governments need to ensure that the practice ofpolice power does not infringe on constitutionalrights to life, liberty, due process of law, and privacy.
Ethical management of COVID-19 requires areasonable and justifiable balance between police
power and protection and promotion of general
welfare, a crucial principle that every government
should remember.
Constructive dialogue and open communication
between the government and the people can beestablished to discuss policies and protocols on
COVID-19
responseandmanagement
so
understanding and agreement on reasonable
limitations of certain rights and freedoms can bepeaceably reached.
Governments are obliged to guarantee that law
enforcement agencies and deputized peace andorder personnel are well informed of the limitations
set by human rights and fundamental freedoms to
avoid abuses of power resulting to unnecessary
violations and lawsuits.
While contact tracing is very important in averting
further spread of the virus, this should not be used
as a pretext to unwanted monitoring andsurveillance with the intention of illegitimately andcovertly gathering intelligence data that can be usedagainst opposition, government critics, activist, andadvocacy groups. Amidst the global emergency,
States are under obligation to ensure that thefundamental freedom and right to privacy besafeguarded and respected, unless otherwise, theexercise of such right becomes an active threat to
public health and safety. In relation to this,governments should be very careful not to violate
informed consent and privacy in the use of wearable
technologies or tracking devices. It is well forgovernments to keep in mind that the central
objective of all efforts against COVID-19 is to stop its
spread and potency, and any policy or law that
disrespects human rights and fundamental freedoms
are unreasonable, unethical, and a blatant violationof human dignity.

Recommendation 6: The principle of checks andbalances is not to be sacrificed.
a) While cooperation and solidarity among thebranches of government is extremely necessary to
end the COVID-19 pandemic, checks and balances
should not be sacrificed. The Executive department
should not be handed grand and limitless powers by

Parliament or Congress in order to avoid
authoritarianism and implementation of draconianmeasures that may not necessarily be for theprevention of COVID-19 pandemic, but are aimed tofurther their grip of power and personal or party
agenda.
b) The separation of powers should be safeguarded forthe benefit of the state, such as ensuring theindependence of the judiciary and mechanisms foroversight and accountability.
Recommendation
7:
Vigilance
authoritarianism and legislative excess.

againsta) Since public demonstration against what isperceived to be unjust and unfair, excess anddeficiency, are limited or impossible during
pandemics because of lockdowns and strict
quarantine rules (physical distancing), there arereports of governments sneakily passing legislations
that further the authoritarian and dictatorial powersof abusive and power-hungry regimes. Besides, insome cases, Congressmen and Ministers of
Parliament cannot even meet face to face to engage
in debates, so it is easier to pass legislation in a timeof pandemic where legislators merely watch anddebate via videoconferencing.
b) Moreover, the pandemic has become a justification
for the legislation of draconian laws that further
limit the freedom and rights of people. Special or
emergency powers given to the Chief Executive arefurther extended, sometimes giving the President orPrime Minister unlimited power to implement
whatever measures they want to impose beyond thelimits set in the country’s fundamental law.
c) National emergencies are a good opportunity fortyrants and authoritarians to further their grip of
power, so an independent and strong-willed
legislative and judicial department are necessary tocheck and balance the executive department toprevent excesses and abuses.
d) Legitimate protests against what is perceived to be
an excess and deficiency in the State’s COVID-19
management should not be perceived as a threat tothe government’s legitimacy and power, muchworse, like in some countries, seen as a terrorist act
jeopardizing government efforts to stop the
pandemic. Rather they are to be recognized as
constructive criticism and essential contributions to
the improvement of government programs andplans against COVID-19.
4. Preparedness
The experiences and lessons learned from the COVID-19
pandemic should encourage and inspire governments toestablish and institutionalize more responsive, effective,and efficient emergency and crisis preparedness andmanagement guidelines and infrastructures.
Suchemergency and crisis preparedness and management
blueprint should be inspired by sound science, credible
information, and ethics principles.
Recommendation 8: While we can never be perfectly
prepared to respond to pandemics since they are ofdifferent natures and dynamics, governments canlearn from previous cases more adequately, to theEubios Journal of Asian and International Bioethics 30(6) (August 2020)
utmost of their capacity and ability, to prepare for the
next case by establishing a national framework foraction in times of global health emergencies, that canbe activated anytime a new one occurs.
a) Governments are now obliged to institutionalize anational health care emergency framework if they
have none, or if they have, to revisit and revise it
based on the lessons learned from the COVID-19
pandemic.
b) The whole-of-society approach to preparedness andresponse is highly recommended, where first
response and management begins in the community
level, with trained crisis managers and relevant
resources.
c) Governments should invest in pandemic response
infrastructures and equipment since crises like thisare not uncommon anymore, including advanced
vulnerability and risk assessments, and research anddevelopment support.
d) Health care emergency lessons should be integrated
in the education system to educate young people ofthe nature and consequences of pandemics like
COVID-19, but also to condition them of thenecessary discipline and protocols.
e) Over and above all these, all state and government
efforts to put in place effective heath emergency
frameworks and guidelines must lead to resilienceand social cohesion.
f) With regard to all these recommendations,international bodies, other States, and civil society
organizations can play an important role where
national systems lack financial resources andexpertise.
5. Continuity and Reinforcement of Economic andSocial Support Systems
Balancing the demands of the economy with thedemands of public safety and health is not an easy task.
Ethical and sustainable socio-economic development is
critical to enhancement of the health of all. Governments
need to be able to manage effectively and ethically thetension between health and economy, with protection of
the people as the primary motivation.
Recommendation 9: States need to promote evidencebased policies to attempt to find an acceptablebalance between enhanced sustainable economic
activity and long-term gains in health, and thepotential risks of economic activity when physicaldistancing cannot be maintained.
a) Opening spaces where people cannot adequately
physically distance when infection is still very high is
not only risky but also irresponsible and unethical.
While people need income to survive, the State cancreate a mechanism of support to those whose
employment was severely affected. Governments
can solicit the assistance of private institutions toprovide ancillary support to their employees,
especially the no-work-no-pay ones.5b) In countries or areas where infection is low andbusinesses can safely open, suitable stimulus
5 The WeCope subcommittee on Ethical Values and Principles

for a New World Order is reviewing detailed options.

283

packages should be offered to small and medium
enterprises severely affected by the pandemic. Suchpackages could include low interest rates andflexible payment schemes, for example, so as not toburden the establishments even more. On the other
hand, businesses shouldn’t be rescued regardless of
their relaunch chances.
c) Social support to the poor and underprivileged,
refugees, senior citizens in need, the differently
abled, and displaced workers and unemployed, areseen in some government’s pandemic response andrecovery programs, in order that those living in the
peripheries of society are not left even further
behind.
d) Financial support to social entrepreneurs should be
encouraged to assist displaced workers in starting
their personal business enterprises.
Recommendation 10. Governments need to ensure
adequate food security.
a) Agriculture is an indispensable and integral part ofthe economy and social development. In times ofpandemic and other similar disasters, especiallywhen international trade is difficult, sufficient foodsecurity is essential to keep people alive. Agriculture
is a strong and reliable support system for the
economy and the society.
b) Financial and material support to the agricultural
sector is needed to increase production of foodsupply,includingsafe
andunhinderedtransportation of products, supply of seeds andsustainable fertilizers, financial support such asloans with low interest rate and manageable
payment schemes, farming equipment andmachineries, and so on. Farmers and fisherfolk need
to be provided protection and health services toensure continuous supply of food.
c) Agricultural support systems in times of pandemic
should be included in the national or local actionplans against pandemics. Structures and operation
systems that facilitate sustainable food production
during pandemics or any national healthemergencies or disasters should become part andparcel of the national or local disaster response andmanagement framework.
Recommendation
11:
Governments
shouldtransparently evaluate the impacts of all policies,
both positive and negative consequences on different
persons, institutions and the environment, so lessons
learned can be shared internationally, to work for all
the planet.
Citizens should not expect perfect
governments, but governments need to be able toadmit mistakes and learn lessons, so that the people
that they represent can make choices about the type ofsociety that they live in.
Members, World Emergency COVID19 Pandemic Ethics(WeCope) Committee
https://www.eubios.info/world_emergency_covid19_pandemi
c_ethics_committee
Dr. Thalia Arawi (Lebanon)
Dr. Mouna Ben Azaiz (Tunisia)
Dr. Lian Bighorse (San Carlos Apache Nation, USA)

284

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

Dr. Andrew Bosworth (Canada)
Dr. Rhyddhi Chakraborty (India, UK)
Mr. Anthony Mark Cutter (U.K.)
Dr. Mireille D'Astous (Canada)
Dr. Ayoub Abu Dayyeh (Jordan)
Dr. Nilza Maria Diniz (Brazil)
Dr. Hasan Erbay (Turkey)
Prof. Nader Ghotbi (Japan)
Prof. Abhik Gupta (India)
Prof. Soraj Hongladarom (Thailand)Prof. Miwako Hosoda (Japan)
Prof. Dena Hsin-Chen Hsin (Taiwan)
Dr. Anower Hussain (Bangladesh)
Prof. Bang-Ook Jun (Republic of Korea)
Prof. Hassan Kaya (South Africa)
Dr. Sumaira Khowaja-Punjwani (Pakistan)
Prof. Julian Kinderlerer (South Africa)
Dr. Lana Al-Shareeda Le Blanc (Iraq)
Prof. Marlon Lofredo (the Philippines)
Dr. Manuel Lozano Rodríguez (Spain)
Prof. Darryl Macer (New Zealand)Prof. Raffaele Mantegazza (Italy)
Dr. Aziza Menouni (Morocco)
Dr. Endreya Marie McCabe (Delaware Nation, USA)
Prof. Erick Valdés Meza (Chile, USA)
Dr. Ravichandran Moorthy (Malaysia)
Prof. Firuza Nasyrova (Tajikistan)
Dr. Suma Parahakaran (Malaysia)
Prof. Maria do Céu Patrão Neves (Portugal)
Prof. Deborah Kala Perkins (USA)Prof. Osama Rajkhan (Saudi Arabia)
Ms. Carmela Roybal (Tewa Nation, USA)
Prof. Mariodoss Selvanayagam (India)
Prof. Mihaela Serbulea (Romania)
Dr. Jasdev Rai Singh (England)
Dr. Raquel R. Smith (USA)Prof. Takao Takahashi (Japan)
Dr. Ananya Tritipthumrongchok (Thailand)
Dr. Lakshmi Vyas (UK)Prof. Yanguang Wang (China)
Prof. John Weckert (Australia)
Dr. Anke Weisheit (Uganda)
Inquiries to: Prof. Darryl Macer, Chair, WeCope Committee;
Email: darryl@eubios.info Tel. +1-949-439-9307

Moral leadership during the pandemic- Christopher Ryan Maboloc, PhD
Ateneo de Davao University, the Philippines
Email: ryanmaboloc75@yahoo.com
Abstract
The Covid-19 Pandemic manifests the important role ofmoral leadership in managing a crisis. In the light of thebig disruptions to both public life and private enterprise,
the need for an ethics of virtue becomes apparent. Most
governments usually look into the consequences to theeconomy but disregard the meaningful role of moral
character in making sound judgment. This article is anattempt to look into local experiences and values incontrast to institutional approaches in the West when it
comes to the response to the Covid-19 public healthemergency in the Philippines and elsewhere.

Introduction
Commitment to justice is paramount in all aspects ofsocial and private life. This means that the greatest
challenge in the midst of a pandemic is the ethicalchallenge. Moral approaches to planning, policy making
and implementation, are necessary to improve access tohealth care and guarantee public order and safety. The
problem is that there appears to be a disproportionate
burden on the poorest sector of society when it comes toemergencies. In the Philippines, this is a cause ofconcern. Critics say that some officials lack thecompetence in handling issues, especially those related
to the socio-economic aspect of the pandemic. It is
without argument that a scientific approach to impact
mitigation is needed to make any response to a publichealth emergency effective.
Ethical theories and their relevance
Ethics is a guide to right decision making. Human action
cannot address important issues when it is not alignedwith the right moral principle. Brillantes and Fernandez(2008, 7) think that it is not correct to see people ascustomers instead of citizens when it comes to public
administration. Public officials are key actors and theirdecisions affect the lives of people in many ways. Thereis a professional obligation on the part of health careexperts and public officials (Institute of Medicine, 2007).
However, we must also understand that there are ethicalapproaches to the issue of Covid-19 that governments
around the world must pay attention to (Macer, 2020,
65).
Duty ethics emphasizes the idea of a moral mandate.
Public officials often refer to the law as basis for theiractions. In the Philippines, the legislature gave thePresident enormous powers by way of the Bayanihan Act(RA, 11469) that allowed the chief executive to re-alignfunds in the national budget to Covid-relief efforts. Thisauthority meant almost a trillion pesos was madeavailable for social amelioration, purchase of personal
protective equipment (PPE), support to affectedindustries and companies, and other pandemic response
related expenses. More importantly, the President has
made a pronouncement that there will be no room forcorruption in the government’s disbursement of funds.
This is consistent with the idea of public trust.
Recent business practices are aware of egalitarianand justice issues (Boatright, 2005). For instance, large
corporations in the Philippines announced billions ofpesos of donations for relief efforts, the biggest of whichcomes from San Miguel Corporation, a company whose
annual revenue of almost a trillion pesos constitutes 5%of the country’s annual Gross Domestic Product (GDP).
Such an act is more than what the notion of corporatesocial responsibility (CSR) is all about. The private sector
has a moral role to play in pursuing the social good. In
the Philippines, such moral role is not apparent in themind of the public. People see corporations as profitmaking enterprises. Indeed, the idea of a CSR does notresonate with the general public or in poor communities
who still rely on the programs initiated by barangay
officials in the area of basic services, which is actually
mandated by law.
Elsewhere in the world, specifically in Western
societies, the emphasis has been on the impact to theEubios Journal of Asian and International Bioethics 30(6) (August 2020)
economy. This consequentialist approach has enabled
their governments to act swiftly in order to mitigate theill effects of closed businesses and a receding economy.
Early estimates put the loss to Western economies at
sixteen (16) trillion dollars. It appears too that affluent
societies have every means to provide money tohouseholds and to pay for unemployment claims. But inorder to avoid further damage to the economy, the US
federal government allowed states to draw their own
guidelines in terms of easing restrictions and permitting
select businesses to open.
The Social Amelioration Program (SAP) is the mostimportant government relief in the Philippines. The
government has targeted eighteen (18) million people asbeneficiaries. The Department of Social Welfare andDevelopment was tasked by the Bayanihan Act to be theimplementing agency. The Local Government Unit at thebarangay or community level was expected to assist in
the validation and disbursement. Barangay Daliao is aprime example. At first, there was a lot of confusion at
the community level. Some sectors complained to local
officials of being left out. But in the end, leadership at thegrassroots level prevailed. The important thing was theconcern and compassion for the poor. One reflection isthat political differences among leaders, in this respect,must be set aside in order to serve the public better.

Figure 1: Barangay Daliao, Davao City, Philippines
during community quarantine
The ethics of virtue: some thoughts
Virtue is the perfection of the human person. For
Aristotle, virtue is about self-realization. The basic idea isthat human beings possess potentials that must be
realized. Aristotle was clear in terms of making
distinctions between intellectual and moral virtue. He
says that “virtue, being of two kinds, the intellectual andmoral: man’s intellectual virtue owes its birth andgrowth to teaching while moral virtue comes about as aresult of habit.” (Nichomachean Ethics 2:1) The practiceof the good is called phronesis. For Aristotle, moral virtue
is about the capacity to be excellent in doing things. In
explaining the above concept, it is important to know theimportance of ethical judgment. The Institute ofMedicine in the US (2007) says; “In their analyses of themoral reasons for formulating a policy or taking an action,285

ethicists are not limited to looking at the ethical principles
that were included explicitly in the process; they can also
point out values that were included implicitly in whatmight otherwise seem to be purely technical decisions.”
During the distribution of SAP assistance in thePhilippines, there were many instances of people being
denied of the relief. During interviews, people mention
as reason the fact that they have not been included in thelist. While it is of no use to blame people for the fiasco, abasic sense of the good could have helped local officials
at the barangay level. This means exerting extra effort toinvestigate the situation of a constituent to determine if
the same is qualified. An important aspect to this claim is
the need not only for the knowledge of guidelines but
moral competence as well. If and when local officials saythat people have to refer to the guidelines, the value ofcaring for people is lost along the way.
Ryan Urbano (2014) thinks that “a monistic approachto ethical decision making is not very helpful.” Thereason he cites is that public administration is acomplicated matter. For instance, Ghotbi (2019, 28)
refutes Rawls since the latter only explained social
justice in terms of institutional relations between people.
In fact, justice in terms of public administration is “quite
complex and difficult.” (Urbano, 2014). The matter ofsocial justice is not only about determining the costs andbenefits of any public funded program. As such, Ghotbi(2019, 29) thinks that there is a need to define themeaning of the virtue of justice. For this reason,
democratic processes also require honesty and thetrustworthiness of public officials.
The basic point is that if public officials are truly
committed to the moral good, then their job does notstop in identifying beneficiaries. The idea of virtue in
Aristotle points to the importance of the institutional
good. Justice cannot be limited to institutional
mechanisms or procedures. It is important thatguidelines “coincide with people’s general sense about
the way their lives should be lived, that guarantee people
an opportunity to participate, and that affirm to people
that they will be treated fairly and with respect.”(Institute of Medicine 2007). Any decision on the part of
the government should be linked to the ability toflourish, one that is consistent with the individual’s
desire to achieve the highest goal of human life.
Human empowerment is needed in the time of apandemic. People must have the relevant capabilities
that will enable them to make the right choices. Martha
Nussbaum says that we have good reasons to think that
universal values “are not just acceptable, but badly
needed, if people really are to show respect for all
citizens in a pluralistic society.” (Nussbaum 2000, 60).
The idea of human flourishing is anchored in the conceptof what “being human” is about. Societies must respect
the substantive way in which human life is lived. In thissense, the desire to achieve a life in which one is able toexpress most fully what it means to be human should beguaranteed by the state at all times.
Moral leadership in the public realm
In examining the role of moral leadership, theories point
to the moral development of the human person. In thisregard, ethicists consider the character of the person andhow the same is able to influence the decision-making

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processes. But the basic question remains – can virtue betaught? It seems that there are important competencies
that can be given in school – the ability to evaluate,
analyze or make judgments on issues. However, theperspective of value appears to be outside the realm offormal learning. Indeed, persons are formed by their
upbringing at home, which develop them to become
individuals who act ethically. In the realm of public life,
however, the challenges are different.
The word crisis (Gr. Krisis) originally means“decision.’ This is important. It has been said that thecharacter of people is formed during crisis moments. We
are troubled by actions that undermine our humanity.
Strict laws may deter an individual from doing anything
wrong or in doing something excessive. Yet, it is without
argument that a good person always acts with a sense ofsincerity because it is the highest principle when it
comes to public life. This is all linked to the notion of
moral integrity. In the context of the Philippines, such aperson is one who is not tempted or influenced bymoney or power. A man of moral integrity is like thefoundation of an edifice. The strength of the structure
depends on its foundation. A man of virtue does noteasily collapse in the midst of adversity.
But how should a public servant act? What should
guide his or her actions to be able to serve the public
well? According to James Svara (2007, 109) the virtuebased approach would consider the question, “whatwould a person of character do in this situation?” Moralleadership is important in the bureaucracy, especially inthe area of health care. Rogelio Bayod (2019) laments
about the health care problems in the Philippines. Still,
people have found ways to survive. While draconianmeasures are preferred by strong leaders, the idea ofsocial cohesion has been most helpful in containing the
local transmission of the virus (Arambala, 2020, 193).
The basic point here is that transparency is important, aprinciple that is based on the moral virtues of truth andhonesty.
A society that does not embrace moral virtue will
collapse. Public accountability cannot rely on a “stick andcarrot” approach. It is necessary that people are formedon the basis of the moral good. Schools, in this respect,
are crucial in training young people. Yet, if schools do not
act as centers of freedom then they would preclude
rather than expand human freedom. In fact, guidelines
are actually restrictive. The fact of the matter is thatthese are drawn from discussions of people in positionsof authority. Given this, real democratic dialogue isabsent. The pandemic reveals the many inadequacies ofsocietal structures. The problem is systemic. The poor,
for instance, do not have access to online learning. It is
important, in this sense, that the voices of those in themargins are heard. An official who holds himself
accountable will listen rather than insist.
People have been suffering too from the stigma ofsocial discrimination. The moral role of any public
official for that matter is to ensure that the poor andother marginalized sectors are protected from the harmcaused by unjust structures and policies that favor the
few. In this way, the preferential option for the poor thatis taught by the Catholic Social Teaching can be helpful. It
is rooted not only in the desire to realize justice insociety but also in the character of the Christian faith aswell. This faith is grounded in the idea of charity for theneighbor. The love for the neighbor as an alternative tothe short-sighted approach of strict rules is cognizant of
the value of human freedom and the respect for human
life. Instances of police abuse in India, for instance, inorder to impose a lockdown, is morally unacceptable.
Western models of morality
Public attitude is vital in determining the future of any
society. Real change cannot be done overnight. It entails
a lot of sacrifices. To end violence in society, it isimportant that individuals recognize what is morally
wrong. If a leader in the modern world embraces theidea of political domination, then he disrespects the
freedoms of people. The use of physical force on
individuals or the act of spraying disinfectants on humanbeings is a grave violation of justice. From all angles,
such are demeaning acts. Both are a form of disrespect ofour humanity. In fact, Mahatma Gandhi’s Satyagrahaemphasized the power of truth. A country cannot befounded on force or violence. The freedom of a nation
can only be rooted in the respect for humanity.
How does one create a society? In the Kantian sense,
this can only be grounded in the idea of autonomy.
People come into an agreement and determine forthemselves the kind of society they want. Hegel,however, was more circumspect in terms of the nature of
the state. Hegel saw the value of the community as adeterminant in terms of building a nation. Communal
values like solidarity expresses the identities of people.
This means that our public lives cannot rest solely on
Western-bred principles. But while this is the case,something universal cannot be dismissed. It isremarkable to think that the concept of human dignity
remains intact in terms of institutional value andinfluence.
But the power of sovereignty appears to be in control
at the start of the pandemic. Nations are acting likefather figures in controlling their populations. Borders
have been closed to protect public safety. Border control
as a measure is not wrong. However, it would be helpful
if right now countries will come up with a united
response to the pandemic. Affluent nations should also
help poor countries. While racism is seen as anotherpathology that American society has to deal with atpresent, the problem of poverty appears to be thegreatest malady that has bedeviled many countries in theSouth. Right now, rich nations can provide a common
fund that will not only fight the coronavirus but alsoenhance and sustain the lives of the poor to make theirsocieties resilient to any public health emergency.
The basic point here is to call for the moral leadershipof nations. Countries such as South Korea, New Zealand,
and Japan, which have been successful in their approachto the Covid-19 pandemic, should take that greater
moral role of convincing the global north to hold itself
truly responsible in helping the people in the global
south. The poor have suffered for decades and yet theaffluent societies in the world have only given 0.7% of
the equivalent of their annual GDPs to address global
poverty (Singer, 2001). This must change. Thomas Pogge(2007) has indicated that global poverty is due to unjust
structures. Still, the development paradigms in the ThirdEubios Journal of Asian and International Bioethics 30(6) (August 2020)
World, including the Philippines, remain to be
Eurocentric (Mansueto, 2020).
We cannot be overly optimistic. Unjust global
structures are difficult if not impossible to change given
the sense of superiority of some nations and the realityof cultural hegemony. Yet, in this cultural war, Filipinos
are also known for their resilient spirit. Millions of poor
Filipinos have survived by embracing indigenous values
and ways of life. The term “Bayanihan” in RA 11469 incontrast to the “CARES” Act passed by US Congress is notjust a matter of nomenclature. The communal spirit ofsolidarity is all about people realizing that beyond moral
individualism, we must act morally for the greater goodof society.
“Bayani-cracy” and group solidarity
The Bayanihan Act passed by the Philippine Congress
would not have any real impact if LGUs did not act withurgency. Barangay officials have provided the humanresources to reach out to the poorest sectors of society.
Dramatic moments happen at the local community level.
From the perspective of the Philippine national
government, there are not enough funds to pay foruniversal testing. The Department of Health has not beenquite helpful, some reports say, in insuring that Overseas
Filipinos get their swab test results immediately. In viewof this lapse, many have been unnecessarily overstaying
in hotels sans their health certificates and travel permits.
Is there a way out of this predicament? Perhaps, thenotion of solidarity can be used in terms of fighting the
pandemic. Bautista (2020), citing Jocano (1999) writes:“The spirit of pakikipagkapwa (being one with the other)pakikisama (being along with) and bayanihan(community spirit) binds them together to rise again.
Pakikipagkapwa, and bayanihan are sacred values thatdefine who the Filipinos are. Pakikipagkapwa is treating
another person as a fellow human being.”
Western values point to autonomy and creating
opportunities for the people. Equality is a question ofentitlement. Human individuals should be able to enjoy
the goods in society and must not be prevented fromtheir fair share of its wealth. Justice is a matter of giving
jobs to people and equal pay, for instance. In thePhilippines, it is about the family and community. The
father is expected to be responsible for the future of hischildren while the mother cares for their well-being.
Children, in return, are expected help their parents. At
the end of the day, it is not a question of opportunity or
debating about entitlements, rights, skills or talent.
Rather, it is about helping each other (bayanihan). The
word “bayanihan” is derived from the term local term
“bayani” which means “hero.” Helping another is being ahero to that person. During this pandemic, frontline
health care workers emerged as the real heroes by
putting their lives on the line in order to save human
lives. This is apparent in the response of medical
personnel to the pandemic locally and elsewhere in theworld (Maboloc and Ferrer, 2020).
Bautista (2012) has attempted to merge this concept
with the idea of Western democracy by calling it “bayanicracy.” Against moral individualism, he says that moral
strength can only be founded in the bond of solidarity.
Indeed, this is an aspect of moral leadership that is
authentically Filipino in terms of context. It is about that287

sense of belongingness in which people fight for thecommon good. The common good is not about individual
achievement. There is that traditional understanding inwhich people realize the value of others in making things
happen. In the concept of “bayanihan,” the image is thatof a community carrying the house of a neighbor. This is
symbolic of the fact that as individuals, there is a limit towhat we can do. However, if we act as one, things can bedone to overcome our problems. In addressing the
pandemic, the idea of “bayanihan” means that politicaldifferences must be put aside to realize the common
good.

Figure 2: Frontline Health workers performing swab
testing in the community
In what way can Western democracy be blended with
Oriental or even the Filipino way of life? History might
be of help. After the Second World War, the Americans
led by Gen. Douglas MacArthur occupied Japan with theintent of changing Japanese society. The general had noknowledge about Japanese culture, but he informed the
US government in Washington of the great respect of theJapanese people for their Emperor. While some sectors
wanted Emperor Hirohito to be brought to Court
Marshall, MacArthur insisted that there will be blood in
the streets if that happened. Instead, the general allowed
Hirohito to rally the Japanese people to help rebuild thedevastated nation. He asked the people to share what
they have and make the necessary sacrifice for thecountry. Hirohito was a symbol for Japanese nationalism
during the war, but MacArthur used this influence to get
public support in reforming Japanese society, including
the overhaul of its elitist economic and political system.
The above experience of solidarity was a merger ofWestern technocracy and Japanese ingenuity. Japanpossesses an industrial might so that it was able totransform its war economy for peaceful purposes.
MacArthur commissioned the Government Section of theoccupation to write a new constitution that also gavebasic freedoms to the Japanese people, including thefreedom of speech. What came next were massive
industrial and labor union protests that also helped
shape labor and economic policies in the country. Groupsolidarity is crucial in this regard. At present, when it
comes to this pandemic, Macer (2020, 130) observes
that people in the East went ahead with the need to wear
masks whereas people in the West were previously
advised that it wasn’t necessary. But the basic point here
remains, group solidarity empowers the community toconfront whatever threatens their well-being.

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Conclusion
This paper has provided a normative approach to the
problem of ethics in the time of a pandemic. But while it
firstly analyses the Western approaches to ethicalleadership, it also gave emphasis to local experiencesand group solidarity that are crucial to human survival.
Progress and recovery for Western societies depend on
the numbers we find in the economic data. For a society
such as the Philippines, people must rely on thecommunal spirit in order to survive. Still, people areaware that moral integrity is crucial. This explains whytrust is an important element when it comes toaddressing public issues. The unjust global structures in
the world demand that changes should take place, but
for now, societies such as what Filipinos have must rely
on local values, i.e., the “bayanihan” spirit, which
requires putting the interests of others above self in the
pursuit of the common good.
The point of the paper is that moral leadership does
not solely belong to the top. It is also not only formed byprinciples or universal concepts and values. It is also
informed by local history and personal sacrifices. The
available literature on leadership often supports the ideathat crisis situations bring the best out of a person’s
character. This paper intends to show that communal
values from the grassroots level also form leaders amongpeople so that they will act with a sense of urgency.
Group solidarity and the concern for others areimportant considerations that help determine how
justice for everyone can be realized in society. The
present coronavirus pandemic, in this regard, is one ofthose great challenges that should bring the best out of
every community as people strive to overcome thisdifficult problem.

Maboloc, C.R. & Ferrer, C.A. 2020. “The Covid-19 Pandemic andSocial Inequality.” Eubios Journal of Asian and International
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Macer, D. 2020. “Covid-19 must push Bioethics Journals toOpen Access.” “Ethics of Care and Philippine Politics during
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Macer, D. 2020. “Wearing Masks in the Covid-19 Pandemic, thePrecautionary Principle and the Relationships Individual
Responsibility and Group Solidarity.” In Eubios Journal of
Asian and International Bioethics 30 (4): 129-132.
Mansueto, M. 2020. “Enrique Dussel’s Philosophy of Liberation:
Philosophical Reflections at the time of the COVID-19 Global
Pandemic.” In Social Ethics Society Journal of Applied
Philosophy 6, Special Issue on Covid-19.
Nussbaum, M. 2000. Women and Human Development.
Edinburg, Cambridge: Cambridge University Press.
Pogge, T. 2007. “Severe poverty as a human rights violation.” In
Freedom from Poverty as a Human Right, edited by Pogge, T.
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Singer, P. 2001. One World: The Ethics of Globalization. New
Haven: Yale University Press.
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References

Abstract
Infectious diseases such as Ebola, severe acuterespiratory syndrome (SARS), avian influenza and themost recent COVID-19 continue to emerge, evolve, andkill significant numbers of people and frighten andthreaten many more. Infectious diseases entail someunique ethical features that are often encountered bypublic health officials. Public health measures used tocontrol them sometimes involve infringement of widely
accepted individual rights and liberties, infectious
diseases raise difficult philosophical questions about
how to strike and balance between the goal of protecting
the greater good of public health and the goal ofprotecting individual rights and liberties.
This paper should like to advance three theses: first,
that political thought depends on ethics; second, that thekind of ethics that provides its firmest basis is an ethics
that emphasis is laid on importance of the society rather
than centrality of the individual; and third, that
conformity to this ethics would make a large impact inorder to strengthen the pandemic preparedness for
Public Health Emergencies in the Philippines. This paper
asserts the importance of strengthening mechanisms
and policies to healthcare in the Philippines which
addresses the burden of combating infectious diseases
such as COVID-19. The primary focus of this paper is noton the existence of injustice on a national scale but on its
implications for those who have power to act within the

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Boatright, J. 2005. Business Ethics. 4th edition. Singapore:
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Brillantes, A. and Fernandez, M. 2008. “Is there a Philippine
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Public Administration?” In Journal of Philippine Public
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Ghotbi, N. 2019. “Justice as a Moral Issue.” In Philosophy andPractice of Bioethics, edited by Macer, D., Takahashi, T., andGhotbi, N. Kumamoto, Japan: Eubios Ethics Institute.
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Morality
andpolitics:
strengthening
pandemic preparedness for public healthemergencies in the Philippines- Aldrin F. Quintero
Notre Dame of Marbel University, Philippines
Email: mengzi.khun@gmail.com

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
legislative body, including governments
councils, private companies and researchers.

research

Introduction
The Philippines has little experience with modern
pandemic preparedness. Even without a pandemic, theshelters can be troubled by overcrowding, inadequate
sanitation, and poor medical services. According to AsianDevelopment Bank report in 2018, six out ten patientsdie without ever seeing a doctor. When Filipinos get sick,they shoulder fifty six percent of total health expenses,
out-of-pocket. As a result, every year, one million
patients are driven to poverty because of catastrophic
health expenses. Although COVID-19 can infect anyone
regardless of race, social class, or beliefs the public must
realize that specific segments of the population will be
more vulnerable to the social and economic impact of thecurrent pandemic. If the Philippine health care system
had been more robust and had safeguards in place, thecitizens would not be having so much burden to facenow.
A “public health emergency” is defined as an
occurrence or imminent threat of an illness or healthcondition, caused by bio terrorism, epidemic or
pandemic disease, or a novel and highly fatal infectious
agent or biological toxin, that poses a substantial risk of asignificant number of human facilities or incidents orpermanent long-term disability (WHO/DCD, 2001). In
2013, at the height of the Middle East Respiratory
Syndrome (MERS-COV) outbreak, the Senate Bill No.
1573 or the ‘Pandemic and All-Hazards Preparedness
Act’ was filed. The bill called for the creation of a national
health strategy in cases of pandemics and national
emergencies. It seeks to “strengthen national response
and preparedness for public health emergencies”, suchas those which result from natural disasters and severe
weather, recent outbreaks and pandemics, bioterrorism,
mass casualties, chemical emergencies and radiation
emergencies. Sadly, the bill was largely ignored at the
senate due to divisiveness, factions of different parties
and the elite conceptualization and the policy making.
Furthermore, Brillo (2010) analyzing political elite
controls the government and its policy making apparatus
largely comes from those who can afford to be patron,
that is those who have the wealth and the position to dofavors for large numbers of ordinary people. These haveprofound consequences on policies, as the heavy relianceon vertical and horizontal dyadic relationships steers
policy making towards the pursuit of providing rewards(e.g., special privileges, monopolies, or unwarranted
exemptions), while offering little incentives to pursue
categorical programs. The legislative program becomes
more of a personal rather than ideological or partybased program. As the overarching intention is to satisfy
clientele demands, policy making becomes continuallymarred by accommodations and concessions which leadto inconsistent or aimless policies.
Preparedness refers to activities and measures taken
in advance to ensure effective response to the impact ofhazards, including the issuance of timely and effective
warnings and the temporary evacuation of people andproperty from threatened locations. It also refers to predisaster activities, including an overall strategy, andinstitutional and management structures, that are geared289

to helping at-risk communities safeguard their lives andassets by being alert to hazards and taking appropriate
action in the face of an imminent threat or the actual
onset of disaster (Senate Bill 1573). The bill was filed
considering that the MERS-COV, a coronavirus strain thatwas deadlier than the 2002 SARS outbreak, could cause
unimaginable chaos if it were to spread in thePhilippines. It is proposed that its capacity to respond toa pandemic can be gauged based on how it handled
SARS, particularly in terms of containing human-tohuman transmission. Border control is particularly
challenging given porous borders, and the lack ofdiagnostic resources and border control personnel. With
only minimal economic growth over the past decade, theeconomy is particularly vulnerable to economic disasters
such as the collapse of the agricultural, industrial andtourism industry. The government does not have thecapacity to adequately compensate for such vast lossesof livelihood.
Fr. Nono Alfonso, SJ (PDI, 2018) in his commentary
entitled “morality in politics”, aptly describes the politics
in the Philippines as best illustrated in Rudyard Kipling’s“The Ballad of East and West”. He writes, “Oh, East is
East, and West is West, and never the twain shall meet!”.
In analysis, on one side, Filipino politics have thegovernment and its ‘diehard supporters,’ and on theother, the so called ‘destabilizers,’ made up the
opposition party and sectors of the church, media andcivil society. And it appears that a wedge has been placed
between the camps, and this divide has gotten worse by
the day. Indeed, with so much toxicity in the air, can thetwain ever meet? Almonte (2007: 119) stressed that “thePhilippine society most urgent need is to raise thepolitical capacity of the Philippine State, to set it freefrom the dominance of vested interest groups and enable
it to act, unequivocally, on behalf of the common good
and the national interest.” Here, political capacity refers
to the legitimacy and effectiveness of state institutions,and insuring the autonomy of these administrative elite,that is insulating it from the importuning ofparticularistic groups.
Morality and politics
Morality is always complex. It encompasses humanrights, but is also cognizant of cultural norms andstandards. Americans, for example, are very sensitive
about autonomy and freedom, and will fight for these.
But other cultures, like in the East, also value communityand spirituality. According to Jonathan Haidt (2013),
specialist in moral and political psychology, “therighteous mind, is like a tongue with six taste receptors.”
In reality, however, humans deal with political and moral
issues simplistically when there is always a lot toconsider. The drug problem in the Philippines, forinstance, is not so much a peace and order issue as ahealth and economic problem. Again, there is a need to
be open to the other and to his worldview if men are tosolve their moral and political problems as a nation.
Morality binds and blinds. Men are genetically“groupish,” according to Haidt (2013). Darwin proposedthat the fittest survived, but in human evolutionary
history, man needed to belong to a group in order tosurvive and thrive. That has been the function of humans
group identities; but the downside is that this can blind

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him to other groups. This can be observed for instance,
how the Philippine politics has reduced them to warring
tribes once again. Haidt (2013) writes: “Morality binds
and blinds. It binds us into ideological teams that fighteach other as though the fate of the world depended on
our side winning each battle. It blinds us to the fact thateach team is composed of good people who havesomething important to say.” The way out is rather
obvious: to recognize that men belong to one big groupthat is humanity. Men are groupish, but why notrecognize everyone, each group, as part of that bigger
group to which they all belong? Haidt (2013) writes:“Men may spend most of their waking hours advancing
their interests, but they all have the capacity totranscend self-interest and become simply part of awhole. It’s not just a capacity; it’s the portal to many oflife’s most cherished experiences.”
Politics depend on ethics
Does politics depend on ethics? Indeed, this paper
asserts that all political problems are in the end ethicalproblems. The political problems refer to both the day to
day problems faced by the legislator, and the problemsof political theory, of how government itself is to beorganized or justified. Politics in both sense depends on
ethics. According to Blanshard (1966): “any question
about what a government should do is a politicalquestion. All such questions, are nearly all, are ethical.”
For instance, in healthcare, should old people who,
through improvidence or ill fortune, lack the means totake care of their health, be supplied with this means bysociety? Surely, it is a moral question. Any question is a
moral question whose decision depends on a choice
between values. A non-moral question becomes moral
the moment the instant values are introduced.
Political theory as well as political practice ends inethics. Edmund Burke says, “the principles of true
politics are those of morality enlarged; and I neither now
do, nor will ever admit of any other.” If what is Burkesays is true, it is important to the person working inpolitics that his ethics should be sound. Sir David Ross
has accustomed the person to thinking that the greatquestions of ethics are two, “What is right? And What isgood?”. However, Ross is a notable legalist who holds
that there are certain rules of promise-keeping, truth
telling, and so on, which lay obligations on a person
which at times are even stronger than the claim of thegreatest good.
The task of politics is to study, as its subject matter,masses of individuals wrought into social organizations,masses through and through moved by value-judgments.
The subject matter of politics is then, a society of ethicalbeings. Hence it may be argued, politics must consider
the ethical nature of man. Morals must be taken into
account by statesman. The task however of statesman, it
may be objected, is not to fit human beings together likepieces of wood in a jig-saw puzzle, so that each, despite
his personal preferences, ideals and prejudices,
accommodates himself under law to each. The politicallife involves action and movement. The statesman has todeal not with wooden blocks, but with human beings
with purposes and policies. He must decide on suchpolicies himself. The whole political arena is one action,and of choice between alternative plans that promotes

the common good.
When governments start adopting strict measures,
this leads to curtailment of rights and they are always
questioned, irrespective of their political wisdom.
Communitarianism works on the premises that one’s
place in the economy, standing in the political order,
reputation among fellows and holdings: all of these comefrom other men and women (Walzer, 1983). The
emphasis is laid on importance of the society rather thancentrality of the individual. It strives to weighparticularism against universalism and argues that the
search for a common point of unity for everyone leads tomisunderstanding and misleading distributive justice.
Michael Sandel expressed “the common good is about
how we live together in the community. It’s about the
ethical ideals we strive together, the benefits andburdens we share, the sacrifices we make for one
another. It’s about the lessons we learn from one anotherabout how to live a good and decent life”.
Promoting the common good of the people is thegreatest good
Communitarians argue that freedom of choice, evenunder fair conditions can be a basis for a just society andrights cannot be prioritized over the common good. Any
institutionalized body engaged in the war against COVID
19 with a broad representation of the stakeholders(doctors, nurses, practitioners, administrators, patientsand people in general) when functions well, like South
Korea, it provides a typical as well as a beautiful example
of communitarian democracy (Raghuvanshi, 2020). They
work together to constitute an optimum society (safeenvironment, proper functioning hospitals, maintained
supply of essential services, etc.) envisioned by themembers of the particular community. When viewed
through a communitarian lens, any conflict resolution
with respect to solutions for any infectious disease canbe best arrived by envisaging the betterment of thecommunity.
The communitarian approach is based on the notionthat everyone derives their identity from the broader
community. Individual rights count, but not more thancommunity norms (Authers, 2020). These notions goback to the Greeks, but in modern times, the philosophy
is widely connected to the sociologist Amitai Etzioni andphilosopher Michael Sandel. Sandel argues that justicecannot be determined in a vacuum or behind a veil of
ignorance, but must be rooted in society. He sets out atheory of justice based on the common good.
China practiced another kind of communitarianism
after the COVID 19 first appeared in Wuhan. The peopleof that city were told to lock themselves in, and often
forcibly quarantined, for the good of the community andthe state, largely identified with the long-justified
obedience to a hierarchical and authoritarian but
benevolent state. The notion of social solidarity remains
strong showed in the spectacular discipline with which
China and other Asian nations dealt with the problem(Authers, 2020). The coronavirus makes it all too clearthat pursuing one’s own self-interest is not enough.
While everyone has the legal right to purchase as much
hand sanitizer as they can find, if that is all they think
about, the welfare of others and society itself are at risk.
Everyone need to challenge the idea that people is justEubios Journal of Asian and International Bioethics 30(6) (August 2020)
pursuing their own happiness as individuals. Whenpeople live in society, they depend on each other.
Therefore, they have obligations to each other.
The Philippine Healthcare System has been very sickfor decades. And it has not been receiving enough funds
and attention to make it well. The Department of Healthtasked to serve a population of over a hundred million,
has not received sufficient budget increase to be at parwith the good health care systems in the world. Whenthe first local transmission of the virus was confirmed in
the first week of March 2020, the government’s responsein the beginning was chaotic-there was no identifiablecommand center to specifically deal the crisis. Vague
orders and pronouncements were given by the palace,
only to be interpreted in different ways by different
officials. All these exposed their empty pronouncementsof readiness and their complacency. While all thesethings are taking the spotlight, along with the daily
updates of COVID-19 victims, the root cause of all thischaos and unorganized response, which is government
complacency, is being erased from the picture.
In dealing with coronavirus crisis, compounded bystrict rules on social mobility, the ways to organize,
assert and extend solidarity may be done through theuse of technology. Using communications technology,
people can exchange knowledge and wisdom on
boosting immune systems and health care methods toensure the health of the elderly, the pregnant and all thatare at risk. The Indigenous Peoples, as well as thecommunity people, are rich with knowledge and wisdomin this field.
At the community level, people can initiate controlled
exchanges and sharing of resources such as sanitationmaterials, food, medicine, water and even shelter for thehomeless. Organized communities are also much morecapable of surviving the current pandemic.
Strengthening the pandemic preparedness for publichealth emergencies in the Philippines
The Philippines, like many developing countries, is being
dealt a particularly brutal blow bow by the coronavirus.
Social distancing is impossible in cramped urban areas.
For Filipinos living paycheck to paycheck, the abrupt lossof work is devastating families. The real work of thegovernment must be done pre, during and postpandemic, to strengthen constitutional procedures, rules
and norms to address this current pandemic. The real
work of the government must to be done pre, during andpost-pandemic, to strengthen constitutional procedures,
rules and norms to address this current pandemic. This
paper asserts the importance of strengthening
mechanisms and policies to healthcare in the Philippines
which addresses the burden of combating infectious
diseases such as COVID-19. This led for the proposal torevisit, amend and ratify the pending Senate Bill No.
1573 also known as ‘Pandemic and All-Hazards
Preparedness Act’ that was ignored by the legislative
body way back 2013. The chief aim of the government
must be focused on general welfare and overall
improvement in standards of living of the people.
In the first two weeks since the declaration of a
lockdown on March 15, 2000, confusion and lack of
coordination among various government agencies andlocal government units resulted in contradicting

291

statements, orders, and advisories (Limos,2020). Under
Senate Bill No. 153, the Department of Health will createa pandemic strategy, mandate to undergo evaluation,organizing and training to improve the country’s
preparedness prior to a health emergency’s existence
and will be the lead agency that will issue directives tothe Department of the Interior and Local Government or
DILG, the Philippine Red Cross, and the National Disaster
Risk Reduction and Management Council or NDRRMC.
The Secretary of Health will be able to “spearhead thecreation of a national health strategy to address publichealth emergencies,” which includes “plans for
optimizing a coordinated and flexible approach to the
medical surge capacity of hospitals, other health carefacilities, critical care and trauma care, and emergency
medical systems.” If necessary, health professionals
would also volunteer to fight the current problem. Thisbill would have made such a big difference had it been
approved, especially to the DOH, which is having getting
attacked on social media for trying to recruit volunteers.
The bill also calls for the creation of an emergency fundevery fiscal year for pandemics and other emergencies. If
this were in effect today, the president would not haveneeded to realign and reallocate budgets or unspentmoney that has already been earmarked for various
government agencies.
The role of political parties in making democracy
work is well-discoursed and, at least in theory, is also
well-accepted. Worldwide, however, there is growing
dissatisfaction towards parties and party politics. This is
more apparent in countries where democracy is weak
and parties serve other un-democratic purposes. Parties
are supposed to serve the purpose of interest
aggregation, leadership formation and candidateselection.
However, in some countries like the Philippines,
parties have largely been a mechanism to facilitate
patronage and personality-oriented politics. In thePhilippines, much of the studies on political parties
discuss how the lack of functioning political parties andunderdeveloped or mal-developed party system
weakens democratic practice. Studies on political parties
have established the negative impact of wronglydeveloped and underperforming political parties on
democratization (Aceron, 2011).
In another study, Brillo (2012), examining thelegislation of the foreign investment law, analyzed thebureaucrat-politician’s dynamics in its policy making. He
argued that contrary to the weak state thesis a different
set of dynamics exist between the bureaucrats andpoliticians. He noted that the bureaucrats were active,
autonomous, and dominant in policy making, as theybasically determined the inputs of the discussions, thecritical content of the proposal, and most importantly,
the policy outcome. On the other hand, the politicians
were passive and reactive in the lawmaking process, as
they deferred to the wisdom of bureaucrats and their
participation was largely confined to fine tuning—
adjustments or refinements in the form of stipulations or
exceptions to suit and placate supporters, constituents,
allies or favored interests.
A small voice among scholars has questioned thesoundness and adequacy of the weak state-elitist
framework. They have pointed out that its clichéd

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

explanation is out of sync with the contemporary policy
making experiences. By implication, the weak stateelitist view is deemed overuse and, by taking a broad
perspective, is too general to be of much analytical use inpolicy making analysis (Atkinson and Coleman, 1989;
Howlett and Ramesh, 1995; Mikamo, 1997). Thesescholars suggested that pluralism better characterizes
present-day Philippine policy making since there isincreasing fragmentation among political actors inlegislating policies. Here, the actors are seen as
autonomous with distinct interests, resources, andpower which give rise to divergent positions acrosspolicy issues over time. Thus, in the light of the changing
nature of policy making in the Philippines, these studies
imply the need to reassess the dominant weak stateelitist framework.
Aceron (2001) would observe that "because of its
weaknesses, the party system has failed to offer
meaningful policy choices—and so to provide for orderlychange." In the same vein, Hutchcroft and Rocamora(2003) note that "Philippine-style democracy provides aconvenient system by which power can be rotated at the
top without effective participation of those below.” Other
Philippine literature on political parties focus on
explaining mal-development and under-performance ofpolitical parties (Timberman, 1991; Lande, 1965; Aceron
et al., 2009) and point to several reasons for the lack ofdevelopment or mal-development of political parties,
namely: (1) the legal-institutional environment which is
not conducive to the development of democratic and fullfledged political parties; (2) the weak linkage of politicalparties to citizens; (3) the failure to pass legislative
measures to reform political parties; and (4) theprevailing political culture of patronage and personalitybased.
There is indeed, a need to reinvigorate the call for
scrapping of Laws which contributed to the sufferings ofthe mass populace in the midst of the pandemic, such as
the Pandemic and All-Hazards Preparedness Act. It calls
for continued and wider social protection and relief to all
health workers, of any categorization, as well as all
economically vulnerable sectors of the society.
Conclusion
As the world is holding its breath over the spread of the
new coronavirus, COVID-19, and governments are taking
or preparing drastic measures that will necessarily
sacrifice individual rights and freedoms for the general
good. It’s a test of medical capacity and political will. The
need to amend and ratify the pending Senate Bill No. 153
will benefit the greatest number of people as aconsequence, produce the greatest good. The continuingchallenge over the years has been implementation ofreforms. All reforms should move in consonance with acommon vision of serving the welfare of the people andrestoring trust in government. Power is supposed toemanate from the people. The People elect leaders who
in turn govern representatives of the people. Public
office is considered a public trust; hence, there are ways
through which public officials are made accountable for
their decisions and actions.
The virus is a shared challenge. So too is the comingof global slump. Practicality and the demand forsolidarity for the welfare of the people justify generous

help. It is a practical challenge that must be met withwell-informed decisions. But it is also a political and an
ethical challenge. That the notion of social solidarity
remains strong showed in the spectacular discipline withwhich China and other Asian nations dealt with the
problem. Without visible solidarity in a crisis for which
nobody bears blame, the Philippine society will bemorally, maybe consequentially, dead.
References

Aceron, Joy. (2011). Stability and Performance of Political
Parties in Southeast Asia Philippines, Party-Less No More?
(Emerging Practices of Party Politics in thePhilippines). At:
http://www.researchgate.net/publication/31538803
Alfonso, N. SJ. (2018). Morality in Politics. Philipine Daily
Inquirer. January 4. At: http://www.opinion.inquirer.net
Asian Development Bank. (2018). Governance: Promoting
Sound Development Management. Manila, Philippines: ADB.
Atkinson, Michael and William Coleman. 1989. Strong Statesand Weak States: Sectoral Policy Networks in Advanced
Capitalist Economies. British Journal of Political
Science,19(1) 47-67.
Authers, J. (2020). How Coronavirus is shaking up the moral
universe. The Economic Times.
At:
https://economictimes.indiatimes.com/news/international/
world-news/how-coronavirus-is-shaking-up-themoruniverse/articleshow/74888344.cms
Blanshard, B. (1966). Morality and Politics. De George, R. (Ed.)
Ethics and Society: Original Essays on Contemporary Moral
Problems (pp. 1-23). Anchor Books Doubleday & Company.
Brillo, Bing Baltazar. 2010. The Politics of the Anti-Dumping
Law of the Philippines. UPLB Journal, 8(1) 17-29.
Catlin, G. F. G. (1927). The Monist 37(3). Oxford University
Press Cornell University https://jstor.org/terms
Haidt, J. (2013). The Righteous Mind: Why Good People Are
Divided by Politics and Religion. Paperback.
Hutchroft, P.D. & Rocamora, J. (2003). Strong Demands andWeak Institutions: The Origins and Evolution of the
Democratic Deficit in the Philippines. Journal of East AsianStudies 3, 259-292. http://citeseerx.ist.psu.edu.
Lande, Carl. 1965. Leaders, Factions and Parties: The Structureof Philippine Politics. New Haven, CT: Yale University
Southeast Asian Studies.
Limos, M. A. (2020, March 30). Santiogao Filed a Pandemic
Preparedness Bill. It Was Ignored.
At:https://www.esquiremag.ph/politics/news/miriamsantiago-pandemic-bill-a000293-20200330.
Walzer, M.1983. Spheres of Justice, 3-4 (1st Ed.).
Wright, W. K. (1916). ‘Review of Hastings Rashdall, Is
Conscience an Emotion?’, Philosophical Review, 25, 81.

Are the measures for COVID-19 realistic,
justified, or overblown? Preparing the pathto the new normal-Randy A. Tudy, Ph.D.
Cor Jesu College, Philippines
Email: randytudy@cjc.edu.phAbstract
Different countries have different measures against the
COVID-19 pandemic. Consequently, reactions fromcountry to country also vary. After more than twomonths, people are getting impatient and agitated for
personal reasons, including physical, psychological, andeconomic reasons. In this paper, I will argue on theEubios Journal of Asian and International Bioethics 30(6) (August 2020)
merits and demerits of the measures implemented bydifferent countries, whether these are realistic, justified,or overblown. First, I discuss the similarities andcontradictions of how different countries implemented
mitigating measures. Second, I focus on the responses
and reactions of people on the government's policies andguidelines. Third, I will argue if the measures undertaken
by each government addresses the needs of people andsociety in general. The implication for immediate andfuture actions is also discussed as a roadmap to the newnormal.
Introduction
Countries around the world reacted as to how to deal
with the COVID-19 pandemic. In the Philippines, forinstance, President Roa Duterte imposed community
quarantine, instead of calling it a lockdown, on March 15,
2020. Within each country, provinces and cities also
responded accordingly, depending on their situation.
Particularly in Digos City, which is located in thesouthern part of the Philippines, declared a community
quarantine last March 16, 2020. On March 28, the first
positive case for the city was recorded. On April 8, 2020,
the city elevated the quarantine level to enhanced
community quarantine (ECQ), which included thesuspension of all public transport services and theclosure of establishments, except those related to food,medicines, communication, and communication andother vital services. But, on May 29, the Digos City Health
Office reported seven new cases. They were all
employees of a provincial hospital located in the cityproper. The following day the city mayor held a press
conference. While many expected the mayor to return to
ECQ, it did not happen. According to the mayor, noquarantine can prevent the spread of the virus. He
explained that the city could not be crippled for long. It is
not good economically. He, however, asked the people toaccept the new normal. It is living with COVID-19
without necessarily getting infected by disciplining
themselves and following the minimum health standards
such as wearing masks, washing of hand, and social
distancing. Three days after, the city relaxed thequarantine protocols from General Community
Quarantine (GCQ) to Modified General Community
Quarantine (MGCQ).
The response of the mayor elicited questions about
the implementation of the ECQ in the city. Was it
appropriate? The same question was raised in other
cities and countries around the world. Some people
regarded the government's measures as anti-poor or
anti-business. For the past months, businesses wereclosed. Losses piled up. People lost livelihood andincome. Was the response to COVID-19 realistic,
justified, or overblown? Counties differ in their responseto the pandemic. The US, for example, was a bitcomplacent at the beginning. Europe was hesitant at
first. In Asia, Japan did not impose a lockdown. However,Vietnam was a different case. In this paper, I argue on the
merits and demerits of the measures implemented bydifferent countries, whether these are realistic, justified,or overblown. This paper contributes to the debate on
the proper or appropriate response to a pandemic.

293

Similarities and contradictions on COVID-19
response
COVID-19 pandemic caught many by surprise. However,
responses vary from country to country. For example,
Italy, France, and Spain implemented almost a complete
lockdown (Cohen & Kupferschmidt, 2020), althoughsome say it was quite late for Italy. While Germany
closed its schools, Sweden allowed children to be inschool. Generally, Europe started with hesitation until itbegan seriously implementing strategies like social
distancing, testing, and lockdowns as the COVID-19 cases
exploded (Bénassy-Quéré & di Mauro, 2020).
Other countries like China had a stricter
implementation by putting almost the entire population
at home (Cohen & Kupferschmidt, 2020). Vietnam
implemented an early lockdown using emergency
control measures (Ha et al., 2020). Singapore was also
lauded for its highly pro-active measures (Tay et al.,2020). Other countries also implemented lockdowns
such as India (Pulla, 2020) and in some European
countries. The Philippines placed the entire country into
general community quarantine as it received a risingnumber of positive cases.
The Philippines recorded its first COVID-19 positive
case on January 30, 2020. The following day, thepresident ordered a travel ban for those coming from
Hubei and other places in China where the spread of thevirus was recorded. However, as early as January 6, theDepartment of Health (DOH) required a strict screeningof incoming travelers from abroad. On January 20, theDOH created the NCov Task Force. It released thefollowing day the health advisories and guidelines on the
preparedness and response. On January 28, the membersof the Inter-Agency Task Force for the Management ofEmerging Infectious Disease (IATF-EID) was formalized.
A travel ban was imposed for those coming from Hubei,
China. As the cases increased, President Rodrigo Duterteordered the strict community quarantine in the National
Capital Region (NCR). All classes and work in this region
were suspended. On March 16, the president declared aState of Calamity through Proclamation number 929.
Then, he signed the Bayanihan to Heal as One Act on
March 24, 2020 (GOVPH, 2020). This Act allows thepresident to relocate, realign, and reprogram a budget ofaround US$ 5.35 billion from the national budget of 2020
to mitigate the effects of COVID-19 pandemic.
People’s responses and reactions
Governments take charge in addressing the threat of
COVID-19 pandemic. While fear of contracting the virus
emerged as the most significant predictors for people's
positive behavior change, such as social distancing andhand hygiene (Harper, Satchell, Fido, & Latzman, 2020),
a good number responded favorably to the government’s
protocols and guidelines. People stayed at home. The
busiest cities in the world like Tokyo and New Yorkappeared like a ghost town. However, other people
responded negatively to the government's emergency
measures. In the US, for example, there were protests bysome citizens against an imposed quarantine. Whilepeople in some parts of the world remained isolated intheir homes, others were on the beach like in California,
where thousands of people trooped to the beach. Many

294

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)are complaining about the curtailment of their freedom.
They needed to get out of home isolation.
Economists and business people complained about
the huge effect of quarantine or lockdown on theeconomy. In the Philippines, the secretary of the National
Economic Development Authority (NEDA) resignedsighting differences in principles with other cabinet
secretaries. The former was reported to have supported
a modified enhance community quarantine, which was
not favorable with other government officials (de Vera &Yap, 2020). Businessmen called for the relaxation of thequarantine, allowing the return of their businesses. The
same scenarios were happening around the globe. There
were already businesses that declared bankruptcy.
Tough times were happening, and the end was nowhere
to be predicted.
As the quarantine took longer, people started to feelthe inconveniences, including hunger. Those who reliedon rations from the Philippine government claimed tohave not received at all, or those fortunate to receive still
felt it was not enough. There were even complaints
against the corruption of the government's money andresources that did not reach the intended beneficiaries.
Even doctors were at odds with the government. There
were reports about Healthcare Professionals (HCP) who
vented their anger in the government because of a lack ofprotective equipment (Khan, 2020). Some doctors sued
their government like in Pakistan (Reuters, 2020),
France (Torres & Valentin, 2020), Zimbabwe (Chingono,2020), and other countries. Some were getting irritatedwhile others remained optimistic, but patience wasdwindling fast.
Governments’ Actions
As previously discussed, there were similarities andcontradictions on how people and governments acted
against the pandemic. Moreover, it would be interesting
to point out some of the responses deemed unique andworth appreciating. For example, Japan, which did not
impose lockdowns, ended its state emergency on May
25, 2020, with only 850 deaths (Normile, 2020). Japanurged its citizens to avoid the 3Cs- closed spaces, crowds,
and close-contact settings. Japanese people, known for
their discipline, were able to contain the spread of thevirus despite not fully following the lockdown measuresother countries did. South Korea, another Asian country,
was credited for its effective strategy against the
pandemic. One particular strategy South Korea
implemented was the provision of public phone booths
tests (Inn, 2020; Morales-Navaez & Dincer, 2020).
Singapore was one of the first countries that acted
swiftly by having an enhanced preparedness when it
immediately launched an aggressive contact tracing of its
first positive case. Quarantine measures were imposedon those with contact with positive cases, traveladvisories, and restrictions for those going and comingfrom China (Wong, Leo, & Tan, 2020).
All the governments in the world had been trying toslow down the spread of the virus and expecting toeventually eradicate it. Hence, social distancing, washingof hands, and making people healthy became necessities.
However, extreme measures such as lockdowns createda lot of inconveniences and affected people's livelihoodand crippled the economy. Since different countries havedifferent approaches, the questions remain regarding therightness, justification, and appropriateness of suchactions, particularly on imposing lockdowns orquarantine. The example is the case of Digos City that
imposed general and later enhanced community
quarantine. When the recorded cases suddenly
increased, the city did not remain in enhanced
community quarantine status but instead proceeded inrelaxing the protocols into modified community
quarantine. Establishments were finally allowed to open.
Public transportations and border restrictions werelifted. A mass gathering of people was allowed. However,
all these changes required the minimum healthstandards such as social distancing and wearing masks.
Roadmap to the new normal
Learning from the governments’ similar andcontradicting strategies, the next phase of addressing the
pandemic relies on how we apply the lessons from thepast three months. Does lockdown or community
quarantine remain the best strategy? The answer isnegative. People and governments realize that theprevious actions were necessary for the beginning, but
prolonging such measures is disadvantageous for both
health and economic reasons. The US government had
been pushed to the limits to balance people’s rights andpublic health in a national and global emergency (Gostin,
Hodge, & Wiley, 2020). It was also a struggle in otherparts of the world. The new normal is not just aboutrights. It is about what is right at the moment. People
and governments should realize that the new normal,
before the availability of the vaccine, demands disciplineand commitment.
For the following days and months, these are crucial
times. We will be living in the new normal. It is not thetime for criticisms of past mistakes. It is the time to apply
lessons of the past and to focus on the present and thefuture. Observance of the minimum health standards isthe key to keep going. It is the only way for all tocontinue living and surviving. Otherwise, the economy
will fall, and chaos will escalate. People will die notbecause of the virus but of hunger and psychologicalstress. The World Health Organization has publishedguidelines on how to protect oneself from the spread of
the virus. It also provides guidelines on the safe use ofalcohol-based sanitizer, suggests travel precautions, andpublishes other technical guidance.
Conclusion
Despite the lessons of the past pandemics, the COVID-19
caught individuals and governments by surprise. Its
magnitude and the speed of the contamination were
unprecedented.
There
were
similarities
andcontradictions on how the government responded. The
reactions of people vary from being supportive to being
antagonistic. However, we also see the best practices ofother countries, which can serve as models for others. At
first glance, the measure, specifically quarantine or
lockdown, is realistic and justifiable, especially whenpeople need to be disciplined and educated. It is not also
overblown because it was necessary for countries likethe Philippines. However, prolonging it causes more
harm to people's lives and the economy in general.
Lessons are learned. It is time to move. But, the challengeEubios Journal of Asian and International Bioethics 30(6) (August 2020)is to prepare and to live the new normal by following theminimum health standards. People should move withprecautions. The economy must be revitalized. The pathto the new normal is living with the pandemic without
necessarily getting infected.
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Inn, T. L. (2020). Smart city technologies take on COVID-19.
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Tay, K., Kamarul, T., Lok, W. Y., Mansor, M., Li, X., Wong, J., &Saw, A. (2020). COVID-19 in Singapore and Malaysia: rising
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295

A historical evaluation from quarantine tocompartmental model: from Ottoman
Empire in 1830 to the Turkish Republic in
2020 and from cholera to COVID-19- Sukran Sevimli, M.D.
Department of Medical History and Medical Ethics,
Dursun Odabas Research Hospital, Faculty of Medicine,
Van Yuzuncu Yıl University, Turkey
Email: sukransevimli@gmail.com
Abstract
The purpose of this study was to evaluate the Ottoman
Empire's first experienced quarantine and the Turkey
Republic's used compartmental models within
quarantine. This study was conducted as a review to
explore quarantine procedures applied from Ottoman
Empire to the present time in the Turkey Republic. For
this purpose, we collected pieces of evidence from
historical texts, articles, online reports, and books to
websites. The review findings were assessedchronologically. There were findings about the Ottoman
Empire and Turkish Republic. The first data wasincluded in the quarantine directives of the Sultan
Mahmud II (1808-1839) for cholera. Moreover, theOttoman Empire continued to fight epidemics such as
the plague, cholera, smallpox, malaria, and Spanish flu.
After being founded, the Turkish Republic state (1923)
has encountered some infectious diseases (cholera,
COVID-19) and used compartmental models within
quarantine with medical measures. However, while
quarantine applications were made more effective withtechnology, COVID-19 was held back with the oldquarantine application principles at short intervals. On
the other hand, "compartmental models within
quarantine" concepts and practices were carried out inmany countries instead of only quarantine and after awhile were implicitly followed by many countries,
including Turkey, for economic reasons; this systemafter being introduced caused controversy for economic
reasons. It is concluded that infectious diseases not only
threaten the health of people but also threaten socioeconomic life and even cultural and religious practices.
Their area of influence covers a wider area, the world,
more than other disasters. In spite of all scientific andtechnological developments, infectious diseases stillcannot be brought under control in a short time andmeasures have started to evolve from quarantine, social
distance practice, and herd immunity system. This study
offers the opportunity to reconsider and think ofquarantine practices from past to present.
Introduction
The aim of medical history research is to explore past
health issues and their solutions with treatment
methods, medical tools, medicinal plants or drugs,
medical equipment, patient transportation, quarantine,and so on. This kind of research has also contributed to
our understanding of the human journey from religions
to philosophy and science, being its cognitive evolution.
In this view, the journey of quarantine usage from past topresent give us information about its development andchanges in practice.

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

Quarantine use started as a solution to prevent
infectious diseases and prevent infectious diseases. The
word quarantine comes from the Italian word “quaranta(forty, 40)”, which refers to forty days of detention andisolation to control infectious diseases. In order toprotect against infectious diseases like leprosy, plauge,
syphilis and cholera (Eager, 1903) and to prevent/limit
transmission, suspicious or infected people and objects
used or touched by them were isolated (Ziskind &Halioua, 2008). This may include the isolation of theirvehicles (aircraft, ships, buses, train, etc.) or the housethey live in, and even the neighborhood may be included.
Furthermore, even the whole town, city, or a very large
area can be isolated. Historical quarantine varieties wereas follows:
Ancient quarantine: It included the rule that all vehicles
and people from the infected area were detained forforty days or less under certain supervision, and if they
were determined not to be infected during this period,
they would be released (O'Goman, 1895).
Limited or rational quarantine: It is a quarantine
applied to determine the cause or source of theinfectious disease. The purpose of this restriction is both
discovery and detection of resources of contamination.
This type of quarantine helps to realize research and islimited in time to research (O'Goman, 1895).
Medical research quarantine: In this form, all vehicles
that the suspect or sick people use or ride and theregions they come from are included; every item or
person included is quarantined (O'Goman, 1895).
These models were used by adding advancing
technology and medical facilities until the 21st century.
Moreover, high technology, biology, and medicine thathave developed over the last two centuries havemanaged to control the epidemics of the 18-19th
centuries significantly. However, virus-related infectious
diseases, pandemics such as HIV/AIDS, SARS, and MERS
have emerged (Barbisch, Koenig & Shih, 2015). However,an outbreak occurred that suddenly made existing
medical facilities inadequate, a stronger pandemic thanany of these pandemics: “Severe Acute Respiratory
Coronavirus 2 (SARS-CoV-2)” was reported in December
2019 in the Wuhan region of China, and COVID-19
turned into a pandemic in 2-3 months, and affected all
health systems. With the existing medical informationand medical facilities being insufficient, COVID-19 led tothe addition of new models to the existing quarantine
implementation. The current measures did not help totackle the fight against COVID-19 in a short period oftime; various countries managed to control it byapplying quarantine from time to time, but the
prolongation of the time led to other problems in the
countries. Therefore, new models of quarantine havebeen added.
These compartmental models have included
quarantine, lockdowns/curfews, and new social life
including social distancing and hygiene measures.
Another option was herd immunity, but the countries
trying to implement this model, Germany, Britain, andSweden, did not achieve the success they expected. All
countries, except Sweden, started to apply suchcompartmental models:

Quarantine: People or animals are kept undersurveillance in a certain place to protect them against
infectious diseases. Quarantine is a form of isolation ofpeople who are ill or may have been exposed to a disease
dangerous to society. People stay within a particularbuilding, in their home, in a specific part of a building, orwithin a geographical area during quarantine.
Lockdown/curfew: A lockdown/curfew is different
from quarantine as all people in an area are requested toremain in their own homes within the specified timeinterval without making any distinctions, such as apositive patient, suspected patient or not a patient. The
aim of this intervention is to determine COVID-19
positives and mitigate the transmission of disease.
Closure of borders and restrictions on public gathering,
the prohibition of travel in the country, or an area
corresponding to a few blocks, village, town, and city
lockdown are implemented for different durations (days,
weeks, or months). Finally, lockdown restrictions will beeased everywhere while it provides the possibility tofind the source and to identify any other cases of diseaseor transmission.
Controlled social life: Another model to consider issocial distancing by not leaving the house if it's notnecessary, and staying away from closed, stuffy, crowded
environments and using protective materials (face mask,
gloves, hand sanitizer, and cologne) and to realize social
and working life with these conditions.
Vaccination: Another method of protection is
vaccination; the concept of modern vaccination started
with the smallpox vaccine (1796) (Edwards, 1882) andhas become an integral part of public health practices inrecent centuries. The vaccine protects people from
disease and eliminates the disease. Although vaccination
is an effective way to prevent many diseases, it is not yet
possible to develop a vaccine for every viral disease. A
vaccine to protect against viruses may be hard to get due
to the mutation of the virus. However, at present, finding
vaccines for COVID-19 is really important for the world.
This study includes data from the Ottoman Empire
and the Republic of Turkey and its transition fromquarantine to compartmental model within 200 years.
This is an important pilot study because it includes both
historical perspectives from past quarantine applications
to the new compartmental model. Therefore, this study
provides a new perspective by comparing the data.
Methods
This study was conducted as a review to explore
quarantine practices from the Ottoman Empire 1830 to
the Turkish Republic 2020. For this purpose, wecollected pieces of evidence using keywords from
historical texts, articles, books and websites using thesearch engines including Google scholar, PubMed andWellcome Library, etc. After that, articles, books werecollected, separated, associated and qualified according
to their references. Finally, documents were arranged
and examined in chronological order compared with
developments from the Ottoman Empire to the Turkish
Republic.

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
Results and discussion
In this study, the Ottoman period and the Republic of
Turkey are compared in their different management
systems, since their different management forms haveimportance in quarantine implementation. Althoughreligion and culture are important, governance systemsof the states and the laws on which the system is based
are very important in the implementation of general orscientific practices.
Ottoman Empire epidemics and quarantine
Ottoman Empire was a Turkish and Islamic (sharia was
the legal code) state that existed from 1299 to 1923(İnalcık, 2016). This period involved kingdoms, conquestor religion-based wars, religion-based kingdoms andmale-dominated societies, formed according to thecharacteristics of its time period. Ottoman Empire had asultanate system, power was passed from the father tothe eldest son, and the life of the society was based onreligious rules/laws (Islam, Christianity, Jewish, etc.)(Anık, 2012). Science, education and medicinal studies
were conducted in accordance with the Islam religion.
Islam had a golden age with philosophic and scientificevidence and research between the 8th and 12th
centuries. However, unlike the ancient Greek period, in
this period science and philosophy was only for men.
This period changed with many reasons and the Islamic
world imitated what the church did in Europe between
the 12th and 18th centuries. Greek philosophy and science
were abandoned (Karaçay, 2011). Moreover, knowledge
was considered a way to reach Halik/Allah/God(Karaçay, 2011). As a result of this, the golden age ofIslam gradually turned into medieval Islam. Thisreligious approach in the Ottoman Empire had been
influenced by the adaptation of a religious
understanding after the 12th century (Karaçay, 2011;
Ofek, 2011). Religious people opposed the quarantine
implementation as detailed below, as this new Islamic
conception started in the 12th century. The contradictionof science and religion gradually led to the clergy
becoming more dominant in the state (Karaçay, 2011).
The Ottoman Empire took preventive healthmeasures in the emergence of outbreaks, just like otherstates. In this sense, the most important measures taken
was the initiation of the quarantine. The first quarantine
applications known in history were Dubrovnik in 1377
and 1473 in Venice due to plague (Vuković, 2020). The
plague epidemic was also seen in the Ottoman, but thequarantine was not made until cholera became apandemic. The first quarantine was started during Sultan
Mahmud II.
The Ottoman society was against quarantine due tothe Islam religion and trade. The thirtieth Ottoman
sultan, musician, poet, calligrapher, Sultan Mahmud II
and the Hekimbaşı (Minister of Health) Behçet Efendi
tried to persuade their society and their clergies. For thisreason Mahmud II (1808-1839) published an article at
Takvim-i Vekayi to convince the clergy and religion basedsociety (Yıldırım, 2006). This article also indicated thatquarantine had health benefits for society and it wasconvenient to sharia law. In addition, Algerian Hasan
Efendi wrote an "Ithafü'l-üdebô" epistle stating that thequarantine is not illicit. Considering that the quarantine
was not against the sharia law, it was decided to297

establish a quarantine organization across the country(Böke, 2009; Yıldırım, 2006). It was a wide-ranging
application that required extensive organization in thestate's highways, ports, and all settlements, including
foreign trade ships (Koloğlu, 2005; Yıldırım, 2006). The
Ottoman Empire started to apply the quarantine method,
however the term “usûl-i tahaffuz” was used instead of
the quarantine place, and “tahaffuz-hahane” was usedinstead of lazaretto (Sarıyıldız, 1996). The first tahaffuzhane in the Ottoman Empire was established inÇanakkale in 1835 (Kahya & Erdemir, 2000).
The first quarantine was implemented in Istanbul
due to a cholera case in 1831 with the suggestion of
Ministry of Health (Hekimbaşı) Mustafa Behçet Efendi(1774-1834), and ships coming from the Mediterranean
were quarantined in the Great Port, and those comingfrom the Black Sea in Istinye. Moreover, Mustafa Behçet
Efendi printed Kolera Risâlesi (4000 pieces) for the
public in Matbaa-i Âmire and distributed it to raiseawareness to state administrators and the public. After aserious religious obstacle was resolved, quarantineorganization was established in many provinces such as
Bursa, Samsun, Sinop, Malatya, Trabzon, İstanbul, İzmir
and Iznik and so on (Böke, 2009; Kumaş, 2011;Yaşayanlar, 2015; Yılmaz & Ersoy, 2017). After that, in
1837-1838, the 'Sanitary Department' was established inBab-ı Seraaskeri (Harbiye Ministry), and in 1838,'Meclis-i Umûr-ı Sıhhiye' (Quarantine Assembly) were
established. And, in 1840, 'Meclis-i Umûr-ı Tıbbiye'(council of medicine matter) was established in Mekteb-i
Tıbbiye (medical school) ”(Kahya & Erdemir, 2000; Tez,
2010)
Pilgrims belonging to the Ottoman Empire, before
arriving to the Holy Place were examined with a checkup
at the quarantine station. Pilgrims were subjected to a
35-day quarantine period (1831-1911) (Kuneralp,
1996). 22 pandemics occurred in Hijaz/Hicaz (western
Arabian province) during 1831-1911. Nine pandemic
records were collected: 1831 (20,000 dead); 1835-1846(15,000 dead); 1847, 1848, 1865 (15,000 dead);18711872 (130 dead); 1872-1873 (318 dead);1881 (5,000dead); 1882 (624 dead), 1891-1893 (30,336 dead);
1902, 1907, 1910 (329 dead) and 1911 (2,078 dead)(Kuneralp, 1996). Hijaz quarantine organization served
pilgrims between 1865-1914 (Sarıyıldız, 1996).
In the 19th century, the Ottoman Empire continued tofight epidemics (plague, cholera, smallpox, malaria, andSpanish flue), with many deaths and loss of property in
Anatolia (Ayar & Kılıç, 2017; Yıldız, 2014; Yılmaz &Ersoy, 2017). Quarantine practices were practiced byisolating areas with infectious diseases such as plagueand cholera, and those who were found to have noinfectious disease during isolation period were allowed
to enter the country. In addition, the items used werealso disinfected in the buildings. However, a problem
was serious protests over quarantine physicians
examining Muslim women. Furthermore, the quarantine
application was continued for medical reasons and in the
19th century, quarantine was applied to control and treat
leprosy, cholera, smallpox, typhoid, and syphilis(Çalışkan, 2020; Sarıköse, 2013; Şimşek, 2015).
In summary, this situation influenced all medical
applications and scientific studies during the Ottoman
period. Because the Ottoman Empire was a state of Islam298

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sharia-law system, all decisions taken including by the
Sultan had to be approved by the sheikh-Islam. Science
was therefore subject to texts that were read andmemorized only in madrasas (schools) (Güven, 2010).
Unfortunately, scientific research in labs was not done.
For this reason, the establishment of modern medical
faculty and laboratories required a very long time
(almost 10 years) and was a difficult struggle.
Passengers used to put their personal clothes in
special nets in rotating cabinets. The officers put
passengers’ clothes in cabinets that rotated 360 degrees,with hot air blowing, and conducted the disinfection
process with steam. Meanwhile, the passengers weretaken to private shower rooms with loincloth and clogs,
and then they were examined by a doctor. Passengers
who were thought to be healthy, were quarantined foran average of 8 to 10 days in the accommodation section.

Figure 1. The first written order in the history of quarantine:
Sultan II Mahmud's written law regarding the quarantine ofships coming to the Rumeli side of the Black Sea in 1831 due tocholera in the Indian, Acem and Russian lands, reported toIstanbul. (Ottoman Archive, HAT, 1129/47952, by Murat
Bardakçı)

Turkish Republic and compartmental models
quarantine, lockdown and controlled social life
After the Ottoman Empire collapsed, an independence
war was launched by Atatürk and the Turkish society.
After winning, the revolutionary leader Mustafa Kemal
Atatürk established the Turkish republic in 1923 as asecular system. It is necessary to briefly mention therevolutions that make up the Republic, to explain theadministrative, social and scientific change between thetwo states. Sculpting a human image in Islam wasconsidered a sin, therefore only two-dimensional humanpictures of the Ottoman Sultans were made. Iranianminiature art is an example of this (Mirrazavi, 2009).
Paintings from the Ottoman period belonged to paintersfrom western countries. Nevertheless, the republic
supported all branches of arts and this changed theban/sin understanding.
This change was important in determining thecurrent healthcare services and patient rights based onhuman rights. This secular system involved a democratic
regime based on law and scientific understanding;religion and state affairs were evaluated separately,
inequality between men and women was eliminated(such as the right to education, the right to be elected
and selected, the right to work, the removal of womenfrom chador, women expressing their right to enactmentof civil law over marriage arrangement, and women as
humans understood and accepted) (Avcı, 2013;
Demirtaş, 2008; Hermann, 2003). Atatürk said: "If you
want to measure the civilization of a nation, look at how
their women are treated" (Bilgin, 1990; Gökçimen,2008). Briefly, the constitutionally secular country
provided equal rights for every citizen; also, theseparation of religion and state affairs enabled thestudies of science to be carried out in accordance with
their own methods and findings.
However, some clergymen were not satisfied with thesecular system (women's rights, official law, and lack ofreligion clergy authority, education system, and scientificdevelopment, and so on) and the limitation of theirpowers, and they revolted under various names. Thisdissatisfaction is still ongoing for some reasons (e.g., theprohibition of the right of men to marry 4 women andalso marriage with underage girls, women's rights andespecially equal rights with men ), and they are trying toreturn to the sharia regime again (Hermann, 2003).
Islamist women, do not dwell on the issues mentioned
above by emphasizing justice (Özdural & UYSAL, 2005).
They criticize clerics who find the secular system
positive. Some clergymen support the secular system of
the republic and equal rights for people.
Wars and diseases: The Ottoman Empire, which
participated in the First World War, could not preventthe invasion of its territory immediately after the war
and was torn apart. After this situation, Turkish society
started a struggle for its independence under the
Presidency of Mustafa Kemal Atatürk. Of course, thesewars negatively affected the socio-economic and healthof the society. In 1920, there were three million
trachomatous in Anatolia, and half of the population had
malaria. On 2 May 1920, the Grand National Assembly ofTurkey was established after the opening of the firstcabinet where Dr. Adnan Adıvar was appointed as thefirst Minister of Health. The Ministry of Health madetwo-part planning of health services, namely prevention
and treatment. In addition, mandatory service and thefight against infectious diseases were brought tophysicians. Regarding infectious diseases, opening the
tuberculosis centers, fighting trachoma, malaria, syphilis,
and rabies, opening the Central Hygiene Institute and the
School of Hygiene, and organizing national medical
congresses were included. Also established for the fightagainst infectious diseases, Tahaffuzhan/Lazzaretto by
the Ottoman Empire actively served the Republic of
Turkey until the 1950s. As a result of the successes
against infectious diseases in the post-World War II
period, the functions of quarantine organizations

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
decreased worldwide. Infectious diseases isolation
method is now needed only after an evaluation of theclinical situation and technical possibilities. However,quarantine may be required under some clinicalsituation, with technical possibilities, legal basis, andpolitical will.
The most important legal arrangements in this period
were as follows:
Agricultural struggle and agricultural quarantine
law: Law Number: 6968 in 1957. Contagiousness as
determined by national and international legislation
requires precautions, quarantine services, principles,and policies in international ports of entry and exit, inthe straits, in territorial waters, airports, land bordergates. This law is particularly concerned with thequarantine of animals carrying infectious diseases.
International Health Regulation Official Turkish
Gazette Number 14517 in 1973; Quarantine diseases
included cholera, yellow fever, plague and smallpox.
Republic of Turkey, Ministry of Health, Borders andCoasts, General Directorate of Borders and Coasts helpedwith preventing the spread of infectious quarantine
diseases, with a total of 80 health inspection centers.
According to Article 195 of the TCK: "In infectious
diseases, it is necessary to comply with the mandatory
quarantine conditions. This is a crime if not observed,
those in this situation are punished." The isolation
program and then quarantine against infectious diseases
was previously mentioned. Standard isolation measures
were contact isolation, air isolation and droplet isolation
for illnesses such as tuberculosis, and chicken pox. The
Ministry of Health formed an “infectious diseases andfighting guide (Regulation 22/2018)” to prevent andreduce infectious diseases (Sağlık Bakanlığı, 2018).
Obstacles faced by the Ottoman Empire,
unfortunately, continues in the Republic of Turkey
especially with some religious speeches; some of themcontinue their hateful and discriminatory speech withunrealistic expressions. Unfortunately, some religious
based problems during the Ottoman Empire continue in
the Republic of Turkey in 21st century. Even though
there is a secular system and well developed science, aclergy may make a discriminatory speech (Desk, 2020,;Özkan, 2020) where they do not take medical facts into
account (BBC, 2020; Kirby, Taru, & Chimbidzikai, 2020;
Knipp, 2020). It is necessary to mention these becausesome people express their feelings of sexism,
discriminatory remarks and racism as a religious idea. It
is a public health duty to warn these people and to
explain their unhealthy/wrong discourse, and to startencouraging people to participate in preventive
measures. It must be a condition for all people to makestatements based on scientific data and facts. Should
people (religious or political leaders) have the right tomake false statements in a matter of public health? Itturns out that we should also talk about this as a publichealth problem in the 21st century.
There were humanistic religious leaders like Yunus
Emre, who said: “The world is my true ration, its people
are my nation”; “We love the created, for the Creator'ssake”; “I am not here on earth for strife, love is themission of my life”; “This world is a young bridge
dressed in bright red and green; look on and you can't

299

have enough of that"; “If you don't identify man as God,all your learning is of no use at all”; “The image of the
God is a mirror; the man who looks sees his own face inthere (Turkish Culture Portal, 2020).
The path followed in this process has developed asfollows: Since the first confirmed case of COVID-19 on
March 11, 2020, it has adopted many versatile and rapidtransmission routes. Unfortunately, the isolation
methods implemented so far have not been sufficient. In
a sense, they have tried to find the most effective method
through trial and error, as in many other states. The
number of deaths in Turkey is around 4,500 and thenumber of confirmed cases is around 160,000. The
implementation of quarantine to limit the epidemic
requires an adequate economic life and a strong strategy
because of its negative influence. Correspondingly, theWorld Health Organization (WHO) guidelines announced
that some policies will help to control the epidemic
outbreak such as isolation, quarantine, lockdown, andsocial distancing (World Health Organization, 2020).
In the first days of the epidemic, they tried todetermine whether the passengers in the airports were
infected with COVID-19 or not, using thermal cameras.
Then the 14-day quarantine was started for passengers
coming from abroad by air and road. The first confirmed
case was on 11 March 2020, but later it turned out that
this case was not the first. Turkey started quarantine forforeign passengers. After 11 March 2020, the 14-day
quarantine was started in addition to measuring thefever of all passengers. However, a significant number of
infected individuals in quarantine began entering homes
before the start of quarantine measures in Turkey. In
places where positive COVID-19 was found, entry andexit to apartments, villages or towns were banned andregional quarantine implementation was begun.
Meanwhile, travels abroad was limited, only Turksabroad came with private air travel and werequarantined for 14 days.
However, these measures did not prevent the
number of patients from rising too quickly, such thatcities began to be quarantined as a lockdown andintercity trips were prohibited. Meanwhile, positive
cases were found in workplaces, and those workplaces
were closed first, but this measure was not enough, so
shopping malls, cafeterias, restaurants and hairdressers
where people gathered were also closed. Meanwhile,
people aged 65-year and over were banned from goingout of the house followed by the lockdown for the sameage group. After a while, the same lockdown was
implemented for those who were 20-year and under. A
flexible working model (2-3 days a week) has been
implemented for employees working in government
offices; it has been decided to conduct training online,
while intercity travel was prohibited. Unfortunately,
workers and daily workers continued to work, including
minor workers. This process was realized as acompartmental model. Meanwhile, when faced with thethreat of limiting economic production and risingpoverty, it was decided to give up this lockdown or havea limited quarantine.
Briefly, this compartments model included
quarantine, a flexible working model, lockdown (e.g.,
regional, blocks or village) of the whole country, agerelated lockdown application (e.g., included 65-year and300

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

over and 20-year and under) and controlled social life.
The government announced that Turkey will switch to acontrolled social life model starting from 3 June 2020.
Furthermore, the Ministry of Health and COVID-19
scientific board are going to stress controlled social life
model’s rules such as hand washing, face mask use andsocial distance rules.
COVID-19 forced all of the world and its states toapply various models including quarantine, isolation,
lockdown, and controlled social life. However, economic
reasons have forced open closed workplaces and started
the intercity journeys with a controlled social life. Thismodel is not only for Turkey; most states have followed
the compartmental model such as the UK and Germany.

Figure 2. Checking the body temperature of passengers/
customers with a thermal camera.

Figure 3. One of the quarantine dormitories, on 14th day. (At:
http://m.bianet.org/bianet/yasam/223243-ingiltere-dengetirilen-333-kisiye-14-gun-karantina)

The Ministry of Health formed an “infectious diseases
and fighting guide (Regulation 22/2018)” to prevent andreduce infectious diseases. The field investigation team’s
first aim is to find the source and the effect after the
notification of the case and/or taking protection andcontrol measures including tracing of the contacts.

Figure 5. Lockdown/curfew

Controlled social life: Protect social distance; stay awayfrom closed, stuffy, crowded environments; don't leave
the house if it's not mandatory; use protective materials(face mask, gloves, hand sanitizer, and cologne).
Limitations
Historical qualitative data may involve more than foundin the data and also have various contexts orinterpretations.
Chronologicalevaluation
andcomparison are very important for reviewing historicalstudies. The present data were collected from academicsites (e.g., Academi.edu, Wellcome Institute/library,
Google Scholar, and PubMed) and also from websitesthat take official data into consideration and compared.
However, there was a possibility of some unreachable
resources.
Conclusion
This study evaluated quarantine data from the Ottoman
Empire to the Republic of Turkey, chronologically. The
data was collected in the context of epidemics andquarantine to explore the medical and scientific facilities
and the infectious diseases quarantine practices in those
periods. Infectious diseases that cause pandemics, havethreatened societies in every period of history.
Quarantine, which is one of the most important medical
applications in history, was not sufficient due to the factthat COVID-19 pandemic could not be controlled in ashort time and this negatively affects the economic life.
COVID-19 has continued to be a serious hazard for theworld due to wide transmission. The treatment model isstill not clear and vaccination studies have not beenconcluded yet. Moreover, the pandemic has brought
along many political, social, and economic problems. For
these reasons, following the advice of the World HealthOrganization, they have tried to reduce the effect andspread of the virus with limited and rational quarantine,
lockdown, and controlled social life. Some statistics ofthe Ministry of Health on this topic showed that thecompartmental model is useful. In addition, with theslogan of controlled social life, return to work, and social
life was initiated.
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Figure 4. The field investigation team. (from:https://www.cnnturk.com/turkiye/filyasyon-ekibinincalismalari-tum-hiziyla-suruyor?page=1)

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The possibility of a renewed discourse on
peace: An exposition of realities amid
COVID-19 pandemic-Al Flores Quillope, PhD
Notre Dame of Marbel University, the Philippines
Email: alfquillope@ndmu.edu.phAbstract
When medical scientists come to grips with scientificmeasures and tools to arrest the spread of disease,physical suffering and death brought about by the
COVID-19 pandemic, peace researchers also see violence,
modern warfare and unjust social structures as evil thatneeds to be controlled and eliminated. The ethicalcommitment of this paper is to expose the realities andnarratives of peoples and communities during this timeof global pandemic and use them in a possible reneweddiscourse on peace studies as a result of this global
health emergency. These emerging narratives arecarefully aligned with the six elements of peaceeducation, proposed by Swee-Hin and Cawagas, namely,
the Inner Peace, Intercultural Solidarity, Human Rights,
Dismantling the culture of War, Climate Justice, andSocial Justice & Compassion. Peace education aims at
providing better and life-giving alternatives to theexisting social order so that the human agency will beequipped with the fundamental moral choice towards
the realization of what is good. The good that this paper
envisions is the possibility of a renewed discourse on
peace that will eventually lead the present generation to
restructure the present social order and make it more
holistic, inclusive, and morally plausible, hence, peacefulsocial order.
Keywords: COVID-19 narratives, Peace, Peace
Education, social structures, discourse on peace
1. Introduction
There is a possibility of changing the way we learn,
speak and build peace in this present generation becauseof our diversified experiences and narratives about how
the human beings and the world experience this COVID19 global pandemic. The new normal allows us torethink about how we have fully grasped Peace
Education because of the changing perceptions abouthuman relationships, established institutions andideologies, and even about the presence of humans in theworld. Peace education is a holistic process of teachingencounters that draw from people their desire for peace,
non-violent alternatives, and skills for critical analysis.
Our experiences of this recent crisis offer rich teachingencounters about peace.
Although the story of COVID-19 pandemic is notdetached from the ancient subjugation of the superior
over the inferior, we see how the present realities about
world-power is being toppled by a microscopic virus thatpenetrated and threatened not only the lives of people
but of systems, ideologies, structures, and evenrelationships of sovereign countries. All of a sudden, themeasures of world-domination like military power,
liberal economy, dominion of culture and values,
leadership in science and technology are futile inaddressing the enemy. These measures suddenly

changed its meaning and function in order to keep theworld running.
This is where the old narrative of Peace Education
wants to begin. The Western World controls the world,the United States controls the Western World, and thus
the United States controls the world. By controlling theworld, the U.S definitely owns the measures of worlddominion. They have the most advanced military power;
they are the seat of capitalism and free market; they are
the yardstick of a civilized culture; and they are at thefrontline in the advancement of science and technology.
Over the past decade, the issue of who is up andrunning takes the public spotlight as “China isleapfrogging the U.S. in its technological capabilities.”(Fannin , xxxx) China now becomes the at-par adversaryof the U.S. not only in terms of technology but also of
military capabilities, market economy and influence in
culture. This set-up is a necessary groundwork in our
understanding of where the fingers are pointing at while
countries are being ravaged by the virus.
The opinion of Cunningham (2020) about this gives
us a new narrative to this old springboard to Peace
Education. He opined about how the Trumpadministration points a finger to China for the pandemic
mayhem that brings more than a million cases in allstates in the U.S. and killed almost a hundred thousandpeople. This is the “blame China” narrative. China
becomes the scapegoat when the most powerful nation is
not ready to accept that she is not capable of addressing
the pandemic. The U.S. claims that the Chinese
authorities knew but withheld information about thevirus since early November or December of 2019, thus,
in conspiracy with the World Health Organization,
endangered lives of millions of peoples in many
countries all over the world. Another theory is that acertain Virology laboratory in Wuhan leaked the virus
originally purported as a weapon of biowarfare program.
As a response, the China led media puts viral theconspiracy theory of an American Youtube blogger
stating that a certain U.S. military Intel was the patient
zero in Wuhan. All these baseless bandwagons are easierto accept than a story of a poor peasant who tries to buy
exotic animal for food from a black market andeventually contracted a new virus.
The abysmal failure of some of the most advanced
countries, like China, Italy, Great Britain, U.S., etc., tomitigate and address the crisis unlocked many heavily
guarded questions about the flaws of capitalistic society,covert advancement of biowarfare, illegal imposition of
powerful sanctions to sovereign countries, and evenworld-image (dominion) over human life priorities. As aresult, the COVID-19 pandemic also renewed ourquestions about the self, human rights, cultural violence,social inequality, environmental justice, and the cultureof war and domination. Thus, this pandemic brings tolight a renewed discourse on peace.
This paper attempts to offer an objective expositionof the realities present among the poor communities
who are greatly affected by the failure of the giants! It
will try to show the life-conditions of new emerging poor
communities like health workers, no-work-no-pay
contractuals, unemployed workers due to lockdowns,
out-of-school students, senior citizens, the handicapped
and mentally challenged individuals, the hand-to-mouth

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
farmers and fisherfolks, and the quarantined elite. The
realities from these emerging poor communities will be
subsumed in the old discourse about the elements ofpeace such as inner peace, intercultural solidarity,
human rights, dismantling the culture of war, climate
justice, and social justice & compassion.
2. Inner peace
Albert Camus (1981) wrote about “The Plague” morethan 70 years ago. Camus skillfully describes thevulnerability of individuals and communities to thewidespread devastation of plagues. Similar to ourexperience with COVID-19, the death toll now hasreached over 800,000 worldwide. However, the recent
pandemic is not only about death, but also about social
breakdown, disruption of the usual normal, andwidespread panic. Camus reminds us that no one will
ever be psychologically prepared for global pandemics.
In an instant, our daily routines and everyday
stresses are not only disrupted by lockdowns but havealso become meaningless. The anxiety and uncertainty
that the individual experiences are beyond what one canimagine in a lifetime. The safety bumpers of our lives likeincome, savings, job, acquaintances, authority, pleasures,etc. are pointless and the individual is at the mercy ofwhat the elected officials and experts will do.
As a result, individuals resort to things that remainedin their domain to keep their sanity. One will see auniversity of students and professors dancing tiktok insocial media, writers publish their materials, jokers
create memes, highly opinionated individuals post fakenews, mothers open their cookbooks, professionals offer
online courses, on-line selling, the lazy ones bolt
themselves in front of the television, the selfish ones
romanticize the donations they give to the poor, and thequarantined elite are now leveled among locked andhungry poor.
Quarantines and lockdowns enforce a very important
opportunity to every individual – a time to re-examine
the self. This is neither about heroism nor pointing
fingers. This is about decency of the self. Imagine an ER
doctor going home driving away his son from hugging
him because of fear that the child might be infected; or anurse air-hugging her daughter from a distance; or a
crowd of condo residents applauding the efforts of thehealth workers in a nearby hospital; or a decent home
returning the aid from the government thinking that
others are more in need than them. This is how decency
works. And this is our only weapon to counter the
anxiety and uncertainties of the self.
Let us remember that inner peace is only meaningfulwhen there is social peace. There can never be authentic
inner peace when one is neglectful of the social turmoil
that is going on around. Selfishness in hoarding alcoholand toilet paper, and in pretending to be poor to getamelioration fund from the government will never result
to inner peace. On the contrary, living the decency of thehuman spirit, protecting human life above all, andachieving global solidarity will surely result to enormous
appreciation and admiration of inner peace.
3. Intercultural solidarity
The recent encroachment of COVID-19 among theIndigenous Peoples of the Ecuadorian Amazon stirs

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global concern (Anderson , 2020). On April 10, there
was already a first recorded death among the Yanomami
tribe. It is only a matter of time when, without carefulintervention, the whole tribe and the neighboring tribes
will be wiped out.
The indigenous communities throughout the worldface incomparable risk of health emergencies such as
COVID-19 pandemic. This is partly due to lack of proper
sanitation, limited resource to clean water, crowded
living quarters and insufficient health care facilities andpersonnel. In addition, the transnational corporations
who exploit the Indigenous Peoples’ domain bring withthem deadly diseases that are detrimental to thevulnerable communities.
In his warning to his people against the recent
pandemic, a tribal leader exclaimed: “The cowori(meaning outsiders) are doing terrible things. They aredestroying the homes of the animals. Humans createdthis disease by killing the earth. Go make camps deeper
in the forest. Drink plant medicines. Eat only wild meatand fish. That will keep us strong.” (Anderson , 2020).
The sustainable living conditions of the IPs have been
existent long before modern civilizations. Thus, for theIPs, the only bearers of disease are the outsiders. The
leader’s warning also concretizes how the IPs equate
their lives with the health of the earth. When the earth isbeing killed (destroyed), the IPs are being killed as well.
What will make them strong and healthy are producedby the forest. There is nothing else from outside thatthey need. In fact, they have to be cautious with what theoutsiders bring to them. Lastly, the warning also
provides instructions to go deeper into the forest. This isalways the case. The cowori drives IPs deeper into theforest so that the former can exploit the resources left
behind by the latter.
This is not a remote narrative between the outsiders
and the IPs. It has always been a trend that because ofcapitalism and hunger for earth’s depleting resources,
the IPs are dispossessed from the forest which theyequate with their lives. However, this current global
pandemic sheds a possibly renewed discourse about
how the world neglects the cultural identity of the IPs,and exploits the vulnerability of these communities.
Inversely, this narrative can also be a point ofreflection for those who design misdevelopment for theland of the IPs in the name of progress, prosperity andeconomic advancement. The social order imposed by theadvanced cultures to dispossess the IPs of their lands
and thus cause cultural genocide among the IPs is now
turning its course toward the aggressors.6 The mass
graves in most advanced nations are lethal reminders of
the failure of the current social order. After all, we
should not be building separate worlds because peace
challenges us to build only one world for all.
4. Human rights
The COVID-19 pandemic has raised a lot of human rights
issues. Although most of these issues are already tackled
by experts and ethicists, this global crisis has renewed

6 AsiaIndigenous Peoples Pact, Victims of Development
Aggresion: Indigenous Peoples in ASEAN. Thailand: Asia
Indigenous Peoples Pact.

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

the way we argue about them. From among the many
human rights issues, this section will only discuss five.
First there is the mounting cases of domestic violence
during the community lockdowns (Ford, 2020). Reportsof partner and child abuses have increased compared toprior months before the implementation of quarantines.
Family members are now forced to be together in one
roof for longer period of time than ever before. Schoolaged children are now staying at home for an undivided
time. Parents attend to their children and deal with themwithout ever passing the burden to teachers in school.
Initially, this was taken as an advantage to family
bonding and closeness. The quarantines give time forfamily members to be productive and useful. However,as temperaments and psychological make ups
manipulate human behavior, there also mount conflicts
and misunderstanding, thus, sometimes result to verbal,
physical, psychological, and even sexual abuse. Surely,
the discourse on violence and family dynamics will alter
and will never be the same after this pandemic.
Second is the right to religion. After the lockdowns
have been implemented in many places, congregations
are no longer allowed to express their faith in usual mass
gatherings. Many religious groups have resorted tolivestreaming their services to keep the safety andphysical distancing requirements (Arndt, 2020). Other
religious leaders who insisted to hold their worship inchurches were penalized and persecuted.7 Some others
devised their spiritual services beyond what is normal
and necessary like drive-thru confession or online
counseling (Torres, 2020). Even Easter, one of the mostimportant celebrations of the Catholic faith, thesolemnity of solemnities, was celebrated by the pope at
the Vatican, attended by few members and livestreamedby the local broadcast media. Similarly, one of the mostimportant celebrations for the believers of Islam is theEid ul Fitr. This year, the celebration is quite different
than how it has been celebrated for decades. All thesewere unimaginable before the pandemic. Had it not by
this recent crisis, all these stories will be taken as an
infringement of the freedom of religion. However, thistime, the right to religion is not just about freedom tochoose one’s religion and the profession of faith in one’s
religion but how we can freely express the religious
rituals without restrictions. Certainly, there will be somemajor adjustments to some religious structures andsystems after the pandemic, thus, changing the way weunderstand the right to religion.
Third is the right to education. The global pandemic
produced another poor sector in the community – theeducation sector. This new emerging poor sector is poor
because the lives and identities of teachers, students andacademic supervisors become instantly uncertain. The
closure of most schools had never happened in thememory of the recent generation. The initial excitement
and the lasting anxiety of students are incomparable to
all academic demands in the classroom combined.
However, quick to adjust to the changing needs, someschools immediately devised some mechanisms andprocedures to proceed with online instruction(Gonzales, 2020). This too must have provided a lot
more anguish especially to those students and teachers
who do not have the facility and capacity for online
learning. In addition, we cannot also disregard theconcern of private school teachers and contractual
employees in terms of continuity of income. The lack ofreadiness to address global pandemic, particularly in theacademic sector, will necessarily become the subject of
discourses shortly after this crisis.
Fourth is the civil rights of the senior citizens. During
COVID-19 quarantines, the elderly have been identified
as the most vulnerable victims of the virus. As a result,the senior citizens are sternly instructed not to go out of
their homes, thus, restricting their freedom. This scheme
too has never happened before. Inasmuch as the elderly
want to be free and independent, the quarantine
guidelines are limiting them on the contrary. The
limitation is very understandable because the authorities
do not want to jeopardize the health of older adults.
However, this results to feeling of repression anddiscrimination on the side of the senior citizens. Onceagain, these liberties will find their new tastes in peace
discourses after this contagion.
Lastly, and perhaps most importantly, are the rightsof persons with disability. This is the most vulnerable
sector in this time of crisis because most of them do notunderstand what is going on. Naturally, their welfare andprotection depend on the critical standards provided forby the policies and guidelines during global health crisis.
Maboloc (2020) strikingly writes “[t]he COVID-19
Pandemic is often seen in terms of its impact on theeconomy and the social life of the general population.
But reports say nothing about the potential impact of the
disruptions of services needed by persons with mental
disabilities in mental healthcare centers.” In terms ofpeace narratives, this account will possibly change thedirection of human rights discourses.

7 The

8 Department

Associated Press, Louisiana Church Packed for Services
Again Despite Charges Against Pastor Amid Pandemic.

5. Dismantling the culture of war
A gross deal of most countries’ budget allocation
prioritizes the advancement of military power. In thePhilippines alone, the 2020 budget for the Department of
National Defense is way higher than the budget
allocation for the Department of Health.8 This alone
communicates that our government weighs peace &order, security and militarization more seriously thanpublic health. No wonder that in times of health crisis
like this COVID-19 pandemic, the government scrambles
to provide the necessary health facilities and apparatus
for sick people, notwithstanding the needed personal
protective equipment (PPE) for the health workers in thefrontlines (Gartland, 2020).
Moreover, we also hear physical assault against
health workers who are doing their duties in treating
COVID-19 positive patients (Mayol, 2020). The attacks
are perpetrated by random people because of stigma.
Health workers are no longer allowed to go home totheir rented apartments, or even allowed to take public
transportation. Since the people are not fully aware of
the nature of this new Corona virus, the health workers
of Budget and Management, President Duterte
signs P4.1 Trillion 2020 National Budget.

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)are stigmatized as bearers of infection. Therefore, while
the health workers are already exhausted in working
under long shifts, they also endanger themselves incontracting the virus because of lack of PPE, and theyfurther risk their safety and security when they are in
public places.
In the western countries, especially in the U.S., wehear stories of racial discrimination against Asian ingeneral and Chinese people in particular (Hobson, 2020).
Asian health workers in American hospitals are bothcelebrated and abominated. They are hailed because of
their sacrifices in attending to the health needs of the
COVID-19 positive patients. At the same time, they arealso victimized when they are outside the hospital.
These are new narratives that have evolved since thebeginning of this pandemic. All of a sudden, we realizethat health is not the government’s priority, and thehealth workers are living their lives miserably. In otherwords, this pandemic brings to light another poor sector
in our community – the health workers.
Digging further, this realization about healthsituation in the world brings us back to the ground zeroof this pandemic. As soon as the health crisis broke out in
Wuhan, China, speculations about biowarfare researches
have already emerged. The use of biohazard chemicals
and poisonous materials during war is not new tohumanity. Biowarfare has been a dirty strategy ofmilitary powers dating back in antiquity until its massive
harmful effects in both world wars I and II (Hooker,2020).
The Wuhan biohazard-leak theory did not come as asurprise to many. The U.S. strategists are quick inclaiming that China, in cahoots with their alliedcountries, has carelessly failed in its biowarfare researchin Wuhan, and collaborated with the World HealthOrganization in keeping the epidemic secret until it
became uncontrollable. On the contrary, it also says thatthe “Trump administration has been constantly raising
the issue of growing Chinese global competitiveness as adirect threat to American national security and economic
dominance. [I]t must be possible that Washington has
created and unleashed the virus in a bid to bring
Beijing’s growing economy and military might down…”(Giraldi , 2020).
Whatever is the true about this will have to beunconcealed after the crisis. However, there is one thingthat will possibly dominate our renewed discourse on
dismantling the culture of war – that the health sector
together with other frontline sectors like food sector,
basic services, and even public leadership are all
jeopardized when the government gives more emphasis
on global military domination.
6. Climate justice
We are glad to have known some of the hard-line
environmentalists over past decades. Greta Thunberg,
the TIME’s 2019 Person of the Year, surely has moved
many leaders throughout the globe to do something
about the environment as she fiercely faced Trump’s
rhetoric head on (Alter, 2019). We might have thoughtthat indeed the environment needs people like her. Now
we realize that this is not actually the case. The sudden
disappearance of people on usually busy thoroughfares
in metropolitan areas; the vanishing visitors from parks

305

and zoos; decreased dependence on crude oil because ofloss of movements of travelers on land, water and air;and the fading production of pollutants by factories andmachines, all contribute to the sudden yet readily
observable healing of the environment.
The wildlife starts to reclaim vast spaces previously
occupied by rushing people. Some peacocks and gazelles
were sited on Dubai’s superhighways (Vohra, 2020).
This is something truly unimaginable without the
lockdown of people and their expensive cars. More andmore hatchlings of endangered sea turtles freely findtheir ways to the sea without the ever-destructive
interference of tourists and beach goers (Geggel, 2020).
We even notice the clearing of thick smog of pollution on
big cities due to lessened human activities. This reduced
volume of pollution produced by cities everyday wasscientifically verified by experts and compared toprevious readings before the lockdowns (Gardiner,2020). The most encouraging of all is the satellite imageof the damaged ozone layer slowly healing itself as aresult of reduced greenhouse gases. All these aremanifested within weeks of human inactivity. What is
this telling us?
Nature heals itself. The environmental principle thatsays that everything is connected to everything elsetakes a very different meaning after the human beings
are removed from the equation. Without us, the wildlife
reclaims their life being wild, and the atmosphere does
its job in preventing the devastating effect of global
warming.
The lockdowns of humans are probably only
temporary. Human ingenuity, intelligence and might canovercome this pandemic. Eventually, the world willslowly reopen to the usual human activities. Necessarily,
bringing back humans to the equation will also undo
what nature has done without us. However, thesenarratives caused by COVID-19 may also serve as a
striking
eyeopenertofutureemerging
environmentalists. Possibly, this will change the way welook at our existing environmental international
protocols and policies. This may also change the way welook at ourselves in relation to our common home.
7. Social justice and compassion
One compelling issue on social justice and compassion is
who receives the aid from the government. Theoreticallyeveryone should have an equal share of the food rations
provided for the local government units who rightfully
imposed lockdowns in cities and provinces. Given thateveryone is contained at home, and obtaining an income
to buy food is not possible, it is mandatory that the
government will provide food for everyone. However weare new to this scheme. First, the government cannot
afford to run for months without opening businesses,
thus, exposing the vulnerability and ill design ofcapitalism. Second, everyone is considered poor andunfree, a quarantined community. This must be beyond
our usual notion of justice and fairness and social strata,
but, not everyone locked at home can go without foodrations. There are some who can survive for weeks andmonths without literally going to work or opening theirbusinesses. On the contrary, a pedicab driver, forexample, who survives a family of five will surely go306

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

hungry the following day without going out and earningfor his family’s survival.
Moreover, the power of the government to impose
quarantine guidelines to individuals, communities andinstitutions seemingly presupposes their tendency toharass, abuse and humiliate the violators (Krishnan,2020). Will this qualify as an act of compassion? While
the majority faithfully suffers the boredom of staying athome, going outside without observing precautionary
measures, and presumably spread the virus, is sociallyuncharitable. Surely, the government and individual
citizens have opposing perspectives about the pandemic.
On the one hand, individuals are just so afraid to get sick!
So, while they suffer boredom and hunger during
lockdowns, just the thought of becoming infected anddying in hospitals alone is enough reason to stay at homeand postpone everything. On the other hand, thegovernment just wanted to open up everything andnormalize businesses and government operations. Thus,
it is not surprising that billions of funds are loaned andoffered not to feed the poor but to aid the alreadymultibillion businesses.
Social justice and compassion takes a new face in thisnew scheme. We realize numerous narratives ofcompassion from unexpected people. We see young
volunteers go for groceries and pharmacy runs for theelderly neighbors and health risk individuals (Kaplan,2020). Also, a sixth grader, whose imaginative
innovations and deeply seated compassion, helps in 3D
printing some facemasks for the frontliners from his
kitchen. Another is a story of one doctor in Davao City
who was flagged by a checkpoint officer who happened
to be the husband of the doctor’s patient who just gavebirth to a child. Knowing that the husband cannot bewith his wife because of his duty, the doctor cancelled
her professional fee (Lumantas, 2020). On a bigger scale,the Chinese government sends its remaining COVID-19
experts to other countries which are still ravaged by thevirus (CNN Philippines Staff, 2020). Narratives like thisare common during normal times, but are especiallyhighlighted during this time of uncertainty. This perhaps
is a phenomenon of creating and redefining compassion
other than the common dole out of the rich giving their
extra to the poor.
The most uncompassionate narrative that we wish to
un-hear during this time of chaos is the imposition of
sanctions by the powerful nations to some poorer,
underprivileged nations. Concrete example is Iran. It has
almost a hundred thousand cases of COVID-19 with morethan five thousand deaths. Yet the Trump administration
sees it fit to not only maintain harsh sanctions on
Tehran; it has actually added three more rounds ofsanctions against Iran since the epidemic occurred(Cunningham, 2020). We cannot fully comprehend how
the most advanced and most civilized nation terrorizes
other sovereign nations already ravaged by the
pandemic.
Perhaps the mass demonstrations amid the pandemic
going on around the globe, although apparently about
the causes of the “Black Lives Matter” following thedeath of George Floyd in Minneapolis, can alternatively
be viewed as the tipping point of human consciousness(Fernandez and Audra 2020). The piling of abusive
narratives going on around, from the uncertainties of thepandemic, loss of jobs, fear of untimely death, corruption
in subsidies, chaos in the educational system, unethicalmedia, hunger, poverty, political divide, social unrest,and now death of an unarmed man choked under thecustody of the police, and so on, are just too much tobear for an ordinary human being.
COVID-19 has changed the landscape of how weunderstand compassion and social justice, thus, possibly
changing the way we take discourses on peace. The newnormal reveals the previously unrecognized acts ofcompassion and generosity by the unheard individuals.
At the same time this global pandemic also reveals thecallous and cruel ignorance to social justice by thepreviously looked-up-to institutions.
Conclusion
Life under community quarantine is far from over. The
silent yet lasting effects on people and communities andsocial order will soon be discovered. What is evident so
far is that the COVID-19 pandemic eradicated the longaccepted world divide such as east-west, north-south,rich-poor, developed-developing countries, etc. The virus
never exclusively victimized the poor, the uneducated,
the unemployed, the unhealthy and the like. It devours
everyone in its path without distinction. This powerfulvirus stopped the operations of the world and exposed
the least heard narratives of peoples and communities.
These realities are brought to light by careful
examination and appropriation of the six elements ofpeace. Further, these realities change the way peace
researchers and educators teach and work for peace.
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A new social work approach for Sri Lanka:
Buddhist social work
- Rev. Omalpe Somananda
Senior Lecturer, Pali University of Sri Lanka
Visiting Researcher, Shukutoku University, Japan
Email: omalpes@bpu.ac.lk
Introduction
Social work is a method of solving human problems thatare studied at a professional base, at university level. The
social work of Western European origin is present in all
countries of the world today. Originally from England, it
has historically developed into a subject in North
America. It has developed into a professional subject forresolving social problems. At present in Sri Lanka, thenumber of dependents is highly increasing. There aremany reasons. Every government in Sri Lanka has
implemented various welfare programs (Janasavi,
Samurddhi, etc) to alleviate poverty aiming to addressthese problems. However, the high level of dependency
is still not showing that these welfare programs aren’t
successful. The solution to this is the need for a welfare
program tailored to Sri Lankan culture. Bhikku society
has a huge role to play in a close and friendly humansociety in Sri Lanka. The monk has to intervene in thetask of organizing the basic welfare services of themonastery/Temple and uplifting the people. A suitableapproach is to identify the subject of Buddhist social
work. This study will discuss the need for Buddhistsocial work based on social work in Sri Lanka. It focuses
on factors that influence the development of the social
work profession. The purpose of this study is to identify
the need for a Buddhist social work approach and toinvestigate the prevailing situation. But this study does
not focus on statistical data on poverty in Sri Lanka.
This knowledge is important to understand the needfor a Buddhist social work approach that can be easily
adapted to Sri Lankan culture. The reason is that thesocial work approach, which originated in the West, isdifficult to adapt to today's Sri Lankan society. The
existing social work systems in Sri Lanka are based onWestern teaching. Western culture and Sri Lankan
culture are different. Western culture is person-centered308

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

and an economic-based social culture. Sri Lankan Culture
has been based on agriculture and social support system.
The Western model is difficult to adapt to Sri Lanka
without modification. What is discussed here is“professionalization” of social work in Sri Lanka ingeneral. There are social services and social work has adifferent meaning. Sri Lankan cultural values are toohigh to distinguish between social service and social
work. Therefore, most of the time it is difficult to
introduce the difference between social work and social
service; people think of social service as social work. The
welfare services carried out based on monasteries/
temples should be distinguished.
Buddhist social work
Buddhist social work is a new term to western
professional social work. It can be used as an alternative
to the field of social work. The debate on this should takeplace among academics to find out a clear word for that.
The occurrence of this condition is also unavoidable. The
term was first introduced to an academic discussion by
the Social Work Research Institute Asian Center for
Welfare in Society (ACWeIS) Shukutoku University incollaboration with Japan College of Social Work. An
educational article on this was published in the 2014
issue of Asia and the Pacific Association for Social Work
Education’s Magazine. It was headed by Professor
Tatsuru Akimoto (Former president of APASWE and atpresent the director of Asian Research Institute ofInternational Social Work, Shukutoku University ofJapan) and edited by Etsuko Sakamoto. Its title was“Professional Social Work and Buddhist Work as its
Functional Alternative”.
It is appropriate to quote the very first chapter.
Akimoto (2014) mentions: “The commonsense of theworld is “social work”, “professional social work” butthere are many other entities and people that havecarried out the same or similar functions as “professionalsocial work (ers)” in a society. We tentatively term themits functional alternatives. Some of which can be called
Buddhist practice and activities of Buddhist monks, e.g.
Baudda samaja mehewara in Sinhalese in Sri Lanka, are acase in point. Here, some of commonalities anddifferences between “professional social work” and thiskind of Buddhist work, which must be translated as“Buddhist social work” in English, are hypotheticallypresented. Having the differences, “professional social
work” insists on its authenticity as social work, andbehaves as if it tried to monopolize social work. Othersocial works seem to be expected to use it as a yardstick
to conform them to it. The difference is not insuperiority, but “from which side do we discuss,“professional social work” or Buddhist social work?” It is
my contention that, to establish a global social work
beyond western countries and regions, both have to beplaced within quotation marks -as it were- and be
ascribed an equal position and the concept of social work
must be inductively defined from various social works.
(p.133).
At the beginning, attempts have been made toaddress the disparities between social work andBuddhist social work; of course, it is true that social
workers and Buddhist monks perform different tasks. It
is their duties. They both have deferent tasks to play andthey both are working with people, but the problems
here are the way of functioning change. Social workers
intervene in people's problems with theoretical subject
knowledge and practical training. Social workers study
human behavior using subject knowledge such as
psychology, social science. They have a clear
understanding of the problem-solving process andunderstand resource coordination and people linked
with resources.
Akimoto (2014) mentions: “They are working for andwith the poor, children, the elderly, people withdisabilities, offenders, refugees. Providing various
services such as consultation and counseling, advice,referral, meditation, advocacy, networking andmobilization of social resources and organization(p.133).
But the purpose of the Buddhist monk is to serve twomain purposes. The main purpose is self-liberation. The
second objective collides with the first objective andmoves on. That's how; the Buddhist monk pursues hiscause by living with people and serving the community.
In this case, most of the time Buddhist monks do not
perform their services with the help of scientificknowledge or planning. But most of the time, they dosocial service. Social work educators have noted that
there is a clear difference between social work andBuddhist social work. In that sense, we can agree withthe following view expressed in the above statements:“We tentatively term them its functional alternatives.
Some of these can be called Buddhist practice andactivities of Buddhist monks.”
There are contradictions and similarities betweensocial work and Buddhist social work. Although theabove is the first academic article on Buddhist social
work discussed in 2014, 1990 Ken Jones has also
discussed the subject of Buddhist social work but it was
just explaining the way of the worker to think before
going to the charity work. The title of his article was“Three requirements for an effective Buddhist social
work”. Ken Jones was a quintessential scholar andpopular author on engaged Buddhism in the US andoffers three dimensions to promote Buddhist social workfrom his article. Jones (1990) said; “Firstly, Buddhism,
however, maintains that although there are positive andradical social developments which can relieve muchsuffering by themselves. These will always ultimately
disappoint us. Secondly, we do nevertheless need todevelop a Buddhist social theory which will both betaken seriously by educated non-Buddhists and which
can explain the complexity of modem social life without
secularizing or diminishing Dhamma. Thirdly, ourBuddhist social analysis must be extended so as to bepractical and helpful to all who are socially oppressedand exploited” (p.4.). This indicates that by 1990 there
was a discourse on Buddhist social work. Thus, it isevident that he had knowledge of Buddhism as well associal work.
The scholarly symposium which was held byHasegawa Research Institute for Buddhist Culture, Asian
Center for Social Work Research, Shukutoku University,
Japan in 2016 is an important factor in studying thedevelopment of Buddhist social work in the world. The
theme of this seminar was the Buddhist "Social Work"and Western-rooted Professional Social Work.” TheEubios Journal of Asian and International Bioethics 30(6) (August 2020)
seminar was coordinated by Prof. Tatsuru Akimoto andmembers from Myanmar, Nepal, Sri Lanka, Thailand
Vietnam, and Japan attended it. The seminar was held in
Chiba, Japan on October 8th 2015.
In this Seminar, According to Venerable Achaya
Karma Sangbo Sherpa's (Buddhist Monk- Ex Vice Chair,
Lumbini Development Trust; Thrangu Tashi Choeling
Monastery, Nepal) the Buddhist activities which are
current practices would like the work done in Nepal as acollective, rather than a separate identification of
Buddhist social work. According to Gohori (2016): “Theengagement of Buddhism benefits society andpractitioners. The traditional approach to Buddhism isthat they mostly begin the practice in the monastery.
There is a real chance to reflect on the larger issues ofsociety in general. Due to advanced technology andmodernity in general, the society has changed a lot.
Patterns of thinking, behavior, attitudes, and living
standards have changed. The Buddhist monasteries in
Nepal, the Buddhist practice, and social engagement
must be viewed together. We don’t have any differences.
We always do together with the lay people and engage
the monks and nuns in social work (p.13)”. In his honest
opinion, there is no understanding of western social
work. He focuses on all the Buddhist activities that are
taking place in Nepali culture. Accordingly, the fact thatthe ability to distinguish between Buddhist social workand the existing system does not reflect Buddhist
activities is currently underway.
Further, the role of the monasteries in his
presentation is as follows in general• Educationo Secular educationo Religious educationo Spiritual educationo Formal education for monks
o Formal education for lay students• Education on traditional medicine and astrology• Provided free medicine (clinic service)• Global dental camps
This indicates that the role of Buddhism in Nepal has
been around the field of education and health welfare
services in dealing with the rural community. Here some
sort of social work intervention strategies can be seen
but these programs’ outcome of reflection should be toclearly understand whether it is a success or not.
In Thailand, this situation takes a different form;
there are two Buddhist Universities that conduct social
work-related courses. Namely, Mahachulalongkorn
Buddhist University and Mahamakut Buddhist
University. Thailand is a Buddhist country and they havea closer relationship with monks and lay people there.
Some characteristics which are provided by Thailand
Buddhist temples were explained in the same seminarproceeding. Gohori (2016): “The first one is providing
shelter, food, clothing and medicine to target groups whoare in need such as children, elderly, disabled people andpatients suffering from chronic illnesses. The second one isorganizing social welfare in the community” (p.20).
Every Buddhist monastery is primarily engaged insocial service activities. If there is a program to organize
the community in parallel with social work and tostrengthen the organizations and thereby improve the309

welfare of the rural community, it is a social
developmental social work approach.
The panel discussion at this seminar addressed
several important issues. Professor Masatoshi Hasegawa(Daijo-Gakuen, Inc., Director of Hasegawa ResearchInstitute for Buddhist Culture, Japan) who represents
Shukutoku University has focused on a very important
issue. He wonders whether the temple-centeredintervention is being done in a systematic way to meetthe needs. He points out that: “So when we encounter
various difficulties or sufferings in our lives, the temples
and Buddhists do not necessarily respond or meet theneeds of people. Or rather the monks who can do thatare quite limited.”
The distinction between social work intervention andsocial work discretionary intervention is questioned
whether Buddhist social work is usually a matter of
meeting the needs of the people or engaging in asystematic intervention with formal training or not.
Buddhist social work is about solving human problems
by a skillful person with an intervention of theoreticalknowledge from scientific training. The above statement
has been confirmed by Professor Hasegawa. He says
Gohori (2016): “I thought that at the training of Buddhist
monks, in a practical sense, these precepts are accepted
and received. So this is an important principle of practiceof Buddhism, but they are nevertheless there in order to
respond to the needs of the people, basically. So perhaps
it is very difficult to separate Buddhism and social workor social work from Buddhism and that is how it is being
accepted widely.” (p.39)
This was a very fascinating comment and idea. This isa curious and inexplicable condition in the minds ofscholars interested in this particular field of Buddhistsocial work. A different viewpoint has been put forward
by Professor Herath H.M.D.R. (Department of Universityof Peradeniya, Sri Lanka). His view is that (Gohori,2016): “Buddhism and social work cannot be viewed as
two aspects. In Buddhism, Lord Buddha himself says wehave to work for others, their satisfaction- therefore
there is no big difference between Buddhism andBuddhist social work. Buddhist social work always is
directly connected to reduce or disconnect the eternalsuffering. (at the same comment he explained westernsocial work also) according to him- Now we are movingfrom two different angles. Western social work is about
professionally qualified people, about institutionalized
ethics with definition. From time to time they try to
introduce different definitions with the globalizedchanges.” (p.40)
This is an important point to understand. If wecompare Buddhist social work with western social work,
westernsocialwork
isawell-developed,
institutionalized profession. Here two main points need
to be addressed. Social work should be understoodseparately as a "social work profession" and"Professional social worker". Like that, Buddhist social
work should be understood separately as “Buddhistsocial work (profession)" and "Buddhist (professional)social worker"
Professor Nguyen Hoi Loan (Associate Professor,
Department of Social Sciences and Humanities, Vietnam
National University, Hanoi, Vietnam) is of the opinion
that Buddhism is a great support for social work.

310

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)(Gohori, 2016): “Buddhism really pulls spirits into social
work and really gives life to social work, if Buddhist
activities can be tied with social work, I think you canalso broadly define- these Buddhist and charitable works
that we also show as work activities, we have to look at
Buddhism itself and try and redirect the course into theright direction.”(pp.40/41)
This is a real fact; Buddhism is bringing values andethical spirits into social work to develop a way ofpractice. “If Buddhist activities and these can be tiedwith social work”, of course it should be. In that case,social work will become more and more popular, and it
will also be able to take on new faces.
Monasteries/temples are currently in the process of
implementing programs that are applicable to Buddhistsocial work in Sri Lanka. The Buddhist monk works
towards human welfare by applying Buddhist principles
in parallel to engaged Buddhism. For example, K.
Piyarathana said: (Gohori, 2016) “our temple functions
as a center for a large number of religious and social
activities such as consoling activities, memorial
ceremonies for deceased people, running the Sunday
school, Monks’ School for 20 monks, establishing welfare
societies in all 18 villages, supporting to protect thesepeople from the dreaded kidney disease, providing themwith safe drinking water, advising them on food safety.
We formed volunteer organizations to play a crucial rolein educating the people about the prevention of
diseases” (p.50)
Social work interventions can be seen here. The mainfunction of community work is to empower people to dotheir work and build strong relationships with eachother. In fact, these services are more related to social
work intervention strategies.
According to Professor NorikoTatsuka (Dean ofCollege of Integrated Human and Social Welfare at
Shukutoku University, Chiba, Japan), Buddhist social
work can be identified as a very interesting field and thephilosophy of vanity is a very important tool forthinking. The problems are that today complex problems
are increasing. Can Buddhist social work address such
issues? This was her question. Based on this point she
explained: (Gohori, 2016) “There are people who sufferfrom the disease, people who are frightened of death. At
one time, you feel an inferiority complex, in other times
you feel you are suffering from agony. That is oursuffering. But, how can Buddhist social work addressthat today and tomorrow? And perhaps this is one topic
that would merit exchanges of views and discussion”(p.66)
It is fair to raise her questions. New diseases are
spreading like never before, not only in Japan but also all
over the world. They also change in nature day by day.
Yes, it is true but it should not be the purpose of
Buddhist social work to answer human problems. The
purpose of Buddhism is to study the causes of the
problems instead of answering them. Therefore, theability of Buddhist social work to identify new models
such as remedial model and preventive model discussed
in Western social work should be studied. The sourcesthat apply to it can be found in Buddhist teachings.
World Health Organization points out that the number ofpeople who die from non-communicable diseases ishigher than the number of people who die from

communicable diseases. For example, psychosocial
stress, living in deprived conditions can mean
experiencing adverse environmental, living, working,and social conditions that create stress. Coping withmechanisms for stress varies according to individual
resilience and levels of social support, but ways to cope
may include smoking, drinking alcohol, and excessive
eating, all of which contribute to inequalities in noncommunicable diseases. Prolonged experience of stressalso directly triggers mental health problems andphysiological responses that contribute to noncommunicable diseases. Buddhism's view on this is thatmental wellness is about managing stress and life
pattern. Man has been busy in the present movementwith unachievable future expectations.
Professor Ishikawa analyzes the development of
Buddhist social work. According to his vision, he focuseson three steps: (Gohori, 2016) “The history of Buddhistsocial work has been conceptualized like this. Startingfrom Buddhist charity work at a personal level, and thenorganized Buddhist social work. The third level isinstitutionalized Buddhist social work” (p.82)
In his view, it is clear that the beginning of the
Buddhist social work approach has come from charity
work. To prove his point, he refers to the establishmentof Buddhist welfare services in Japan. It is the true. In
every country where culture is embodied in Buddhist
philosophy, donations are used. Volunteerism can be
identified as one aspect of improving Buddhist social
work.
Buddhist social work -Sri Lankan situation
A closer view confirms that the western-rooted social
work education encounters rough surfaces during its
journey in Sri Lanka. For instance, social work
practitioners find it difficult to apply and match certain
approaches, tools, and methods within the Sri Lankan
context. One simple example is that social work
approach in providing solutions to a person in a family
setting cannot be tuned precisely because the effect of
the family on the individual’s issues is much more in Sri
Lanka than in the West where the subject of social work
has been nurtured. The form or the texture of the social
setting in Sri Lanka can be viewed as the cause of theabove-mentioned lack of tuning of certain aspects ofscientific social work. Therefore, it is more scientific tofocus attention on factors that have evolved this social
texture. Buddhism is the main religion and the culturethat has kept all communities together, and the way ofliving practice over centuries in Sri Lanka can be
identified as the main factor for the specific context of Sri
Lankan society. In other words, the influence of
Buddhism has acted as the key contributor and thematching aspects of the other religions such as helping
the needy, valuing the peaceful living, etc. together withother aspects that have strengthened the other cultural
bindings. When it comes to social work, Buddhist
teachings have much in common and it is apparent that
Buddhist teaching can be precisely introduced to form a
consistent social work component that is more
acceptable to the communities in Sri Lanka.
Compassion and making others’ lives easy is at thecore of Buddhist teaching. Therefore, the essence of
Buddhist teaching promotes and motivates all humanEubios Journal of Asian and International Bioethics 30(6) (August 2020)
beings to help fellow humans when they are in distress.
Not only Buddhism but also all the religious beliefs
motivate them to commit themselves to provide services
to fellow beings. Philanthropy was originally motivatedby religious teachings. A charity such as almsgiving andvolunteer work, considered as social philanthropy,
mainly focuses on providing basic needs such as food,and shelter for people who are deprived. Individuals also
engage in social philanthropy. Organized services
provided by the government and non-governmentalorganizations directed towards meeting the needs of thepoor are called social service. Disabled, destitute,orphans, abandoned, displaced, marginalized, sociallyexcluded, dispossessed, vulnerable and those at-risk aresome of the adjectives used to describe the poor or
needy in the society.
The influence of Buddhism gives more priority toaltruism, magnanimity, and equality. Empathizing andbecoming sensitive in the distress of another is asignificant characteristic of the Sri Lankan culture.
Buddhism also promotes the cause and effect processthat is a scientific approach that is again congruent withsocial work principles. Social harmony is greatly
influenced by Buddhist teaching. In fact, professionalsocial work emphasizes on rights-based approaches in
unleashing the potential of the needy in providing
solutions. But, the harmony-based approaches of
Buddhist teaching in unleashing the potential of humans
can enrich the social work approaches.
The policymakers and strategic managerial personnel
are ignorant about the importance of social work in
improving the quality of life of people in the country. In
addition, the Buddhist monks whose guidance isconsidered respectfully by the community in solving
their problems are not motivated to learn social work.
However, if Buddhist social work is nurtured withteachings in Buddhism, the trend of learning social workand applying it in a broader setting will improve. Thisrequires analytical studies of this nature, pooling ofadequate literature and encouragement to do further
research in this regard so that Buddhist social work
education will be developed at a sustainable pace. The
concepts, approaches and tools can be carefully
extracted through “Sutta Pitaka”.
Conclusion
Buddhist social work initiatives are still in the infantstage within the scientific professional Social Worklandscape. One of the key factors for this situation is that
Buddhists themselves do not use the term “social work”
or even they do not identify a category called “social
work”. Therefore, the need for an appropriate social
work approach to work with people in an indigenous
community with a multi-cultural environment has been
identified. As a step in the discourse, Buddhist social
work has come to the fore. Therefore, the Buddhist
society needs to know exactly what it is. Prof. Tatsuru
Akimoto commenting on the matter said: (Somananda,
2020) “It does not matter to Buddhists whether people
translate or name such activities as “social work” orwhether the Western-rooted professional social work
approves them as social work or not. It only matterswhether Buddhist temples, monks and followers can311

address the difficulties and problems of life people faceand how effectively and how much” (p.24)
It implies that Buddhist social work mainly deals withsolving human problems. In this context, Sri Lanka's
experience is that Buddhist temples stand for humanneeds. It is done through two approaches. One approachis related to the spiritual life of people, and one approachis related to the life of people. But from a social work
perspective, it is clear that the intervention must be asystematic plan and scientific approach. For thispurpose, Buddhist social work has to be properly
defined.
References

Akimoto, T. (Head) Sakamoto, E. (ed) (2014). Asia and Pacific
Association for Social Work Education. Social Work ResearchInstitute Asian Centre for Welfare in Society (ACWeIS) under
the Japan College of Social Work
Bond, George. D. (2004). Buddhism at Work Community
Development, Social Empowerment and the Sarvodaya
Movement, Kumarian Press. Lnc., USA.
Bhattacharya, S. 2006. An Introduction to Social Work, ( copied)
Wright, H., “Similarities and Differences in social work
education as seen in India and North America” Internationalsocial work, jan.1959, Quoted by Khinduka,S.K,op.cit.
Gohori, J. (ed) (2016). “Buddhist Social Welfare in Nepal”,
Buddhist “Social Work” and Western-rooted Professional
Social Work – the next first step- (Proceedings) Shukutoku
University. Chiba
Healy, L. (2001). International social work: professional action
in an interdependent world. NY: Oxford University Press.
Hammoud, H.R. (1988). International Social Work: Social Work
education in developing countries: issues and problems inundergraduate curricula. 31(3)Jones, K., 1990. Three Requirements for a effective Buddhist
Social Work, Retried 14.March.2020 Copy from:http://www.buddhanetz.org/texte/social.htm
Kendall, K. (1950). Training for social work: an international
survey. Lake Success, New York: Department of Social
Affairs, United Nations.
Matsuo, K. (2015). The birth and development of Asian andpacific
Associationforsocialwork
educationInternationalization and Indigenization, Social Work
Research Institute Asian Centre for Welfare in Society(ACWELS) Japan college of Social Work
Singh, S., (?). History of Social Work in India, op.cit.
Somananda, O. (2020). Understanding of the Sri Lankan Society
as a Premise to Understand the Buddhist £Social Work”
Tatsuru. A. (ed) (2020). Buddhist Social Work in Sri Lanka
Past and Present. Exploring Buddhist Social Work. ARIISW –Shukutoku, Gakubunsha.
Sarvodaya Shramadana (1974). Growth of a peoples Movement(booklet), Sarvodaya Press, Moratuwa
Vasudevan, V. (2014). Indigenization of field practice in Social
Work Education in Sri Lanka, Matsuo, K. (ed) (2014).
Internationalization and Indigenization of Social Work
Education in Asia. Asian and Pacific Association for Social
Work Education (APASWE) (FOREWARD) note. ARIISWShukutoku University

312

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

The impacts of social distancing during
COVID-19 pandemic on human health evidence from Bangladesh- Md Masud Parves Rana, PhD, MPhil
Department of Geography and Environmental Studies,
University of Rajshahi, Rajshahi, Bangladesh.
Email: mprgesru@yahoo.com
Abstract
Objective: To investigate the impacts of social distancing
measures on human health, such as physical and mental
illnesses.
Study design: Questionnaire survey
Methods: A 15-minute online-based questionnaire survey
was conducted from 31 March, 2020 to 30 May, 2020
during the COVID-19 pandemic in Bangladesh.
Participants were asked to provide their perceptions onfood habits changes, and physical and mental illnesses
for recently imposed social distancing measures, such as
stay-at-home, for overwhelming transmissions ofcoronavirus in various regions of Bangladesh. A focus
was given to test the impacts of social distancing
measures across categories of susceptible individuals
and their age groups. The susceptible individuals wereclassified as non-COVID-19 patients and non-patient
susceptible individuals.
Results: Social distancing measures have considerable
impacts on human health. The findings show that social
distancing may not significantly impact on the food
habits changes and physical fitness in the beginning of apandemic, but may create huge impacts on mental
illness, such as panic, anxiety and stress.
Conclusions: Social distancing is an effective measure ofcontrolling virus transmissions during a pandemic, butcauses significant concerns of mental health for nonCOVID-19 susceptible individuals, particularly who areelderly in Bangladesh. Thus, ‘stay-at-home, but stayconnected’ might be an alternative way of reducing thismental illness.
Introduction
The world is in a great danger now for the outbreak of apandemic of an infectious disease called COVID-19.
Previously, the world experienced pandemics like severe
acute respiratory syndrome (SARS) in 2002-03, Ebola in2016 and influenza H1N1 in 2009 (McConnell, 2010;
Nabarro and Wannous, 2016). But, the COVID-19
pandemic, caused by the novel coronavirus, has
outnumbered all of the previous records of infection
rates and deaths in the 21st century. As of 20 June, 2020;
the COVID-19 has spread over 185 countries/regions,with 8,525,042 confirmed infections 456,973 deaths
globally (WHO, 2020a), since its first outbreak in Wuhan,
China (Dong et al., 2020). The World Health Organization
also reports that, as of 22 June, 2020, Bangladesh has
already 115,786 confirmed cases of coronavirus
infection with 1502 deaths (WHO, 2020b).
Extensive non-pharmaceutical local and international
interventions, like vacations of educational institutes,
closures of government and non-government offices,
restrictions on travelling and daily activities, andsuspending all social and political events have been

implemented to combat the COVID-19 pandemic.
Notably, to reduce person to person transmission ofcoronavirus, social distancing measures have also been
deployed by many countries who are suffering from itvery badly. This non-pharmaceutical measure has largely
been practiced for reducing the rate of infections, while
pharmaceutical measures like vaccination and antiviraldrugs are yet to be successful (Fong et al., 2020). Manyargues that China was successful to limit the outbreak ofcoronavirus by social distancing,5,6 (Lewnard and Lo,
2020; Zhang et al., 2020). United State of America (USA),the most adversely affected country by now, has alsostrongly been practicing social distancing (CDC, 2020).
During the 2009 H1N1 pandemic, social distancing was
found very helpful to reduce influenza transmission in
Mexico (Stephenson, 2011). In addition, a handful
number of epidemiological, behavioral and scientificstudies also have assessed the strategy of social
distancing measures for epidemic control and developed
mathematical modelling and simulation (Kleczkowski etal., 2015; Shim, 2013; Valdez et al., 2012; Kozlowski etal., 2010; Broderick et al., 2008).
Despite the facts, little is known about the impacts ofsocial distancing on human health during a pandemic. In
addition, there are studies argue with the connotation of‘social distancing’ and its effective outcomes to allindividuals and communities (Edison, 2020; Lim andBadcock, 2020; Chowdhury, 2020; Leung et al., 2018;
Halder et al. 2011; Cacioppo and Hawkley, 2003). For
example, Edison (2020) notes that the term ‘social
distancing’ emphasizes on reducing physical contact as ameans of interrupting transmission, rather than
reduction of social connectedness. Similarly, Lim andBadcock (2020) claim that humans are innately social,hence social distancing will be a challenge for many
people. Leung et al. (2018) found that social distancing
in the beginning of an epidemic can prevent outbreak ofthe disease while moderate social distancing may
worsen the outbreak. It was evident in their study that
there is a tendency of finding new social ties replacing
lost social connections in a situation of moderate social
distancing.
Drawing upon this gap, this study argues that social
distancing requires further research to understand its
health effects during partial lockdown for disease
outbreak. This research does not reject the importanceof social distancing, rather it suggests further revisiting
its impacts to the susceptible individuals in thecommunities who need alternative ways of social
connections and exercise facilities for physical andmental wellbeing. To unveil these impacts, this researchaims to investigate the relationships between social
distancing measures and human health in Bangladesh.
The human health conditions have been measured by thesusceptible individuals’ perceptions on food habitchanges, daily calorie intake, and physical and mental
illnesses.
Materials and methods
A 15-minute online questionnaire survey based on
Microsoft Form was administered at the third week(from 31 March, 2020 to 30 May, 2020) of COVID-19
pandemic in Bangladesh. The participants were invited
through emails and Facebook groups/friend lists. AllEubios Journal of Asian and International Bioethics 30(6) (August 2020)
participants were requested to fill up the form after
consulting with the head of the households. Particularly,
the perceptions of the younger age groups were carefully
scrutinized as if their responses are reliable. A total of 96
respondents were considered for analysis. Selection ofsample respondents/size was based on the location(rural/urban), gender and different age groups of the
respondents to ensure greater representation of regionaland demographic dynamics of Bangladesh. However, theparticipants were requested to read the objectives of theresearch and give their consent to participate. They werealso informed that anonymity is highly protected, data
would be kept confidential and would only be published
as research article.
Statistical analyses were performed by IBM SPSS
Version 20. The respondent characteristics were
described by frequency and percentage distribution. Chi
Square test was conducted to assess the relationships
between factors of human health and social distancing
measure. Table 1 summarizes the variables and factorsof human health conditions.
Table 1- Variables and factors of human healthconditions
Human healthvariables
1. Food habits
2.

Physicalillness3.

Mentalillness

Factors of human health conditions
a)
b)
a)
b)
c)
d)
e)
a)
b)
c)
d)

Food habits changes
Calorie intake increases
Opportunities of physical exercise
Options for physical exercise
Exercise was mandatory
Social distancing causes physicalillness
Access to doctors for consultancy
Physical illness has a relation withmental illness
Social distancing creates mental
traumaNo-exercise opportunity decreases
immunity system
Exercise can increase mental
strengths

Table 2- Frequency and percentage of the respondent
characteristics
Variables
Location
Urban
Rural
Family size
<5
5-6
>6
Age groups
<25
25-45
>45

Male (n=)(%)

Respondents
Female (n=)(%)

Overall(n=) (%)

55 (75.3)
18 (24.7)

15 (65.2)
8 (34.8)

73 (76.0)
23 (24.0)

45 (61.6)
22 (30.1)
6 (8.2)17 (74.0)
3 (13.0)
3 (13.0)62 (64.6)
25 (26.0)
9 (9.4)22 (30.1)
28 (38.4)
23 (31.5)

15 (65.2)
7 (30.4)
1 (4.4)37 (38.5)
35 (36.5)
24 (25.0)

Results
Table 2 shows demographic characteristics of the
respondents. Almost two-third of the respondents live inthe urban area. A similar number of them are male. The
average family size and age of the respondents are 4.46
and 34.80 years respectively. About 65% respondents

313

belong to the family, consisted of less than 5 members. A
small quantity of them are from a family has more than 6
members. Table 1 also depicts that approximately one
quarter of the respondents belong to the age group of
45+ years and the rest are younger of them.
Practicing social distancing
In a technical report, published by the European Centre
for Disease Prevention and Control (ECDC) on 23 March
2020, social distancing was defined as “an action taken
to minimize contact with other individuals; … aimed at
reducing disease transmission and thereby also reducing
pressure on health services” (ECDC Report, 2020; p. 1).
The World Health Organization (WHO) also definessocial distancing as to maintain at least 1 meter (3 feet)distance between you and anyone who is coughing or
sneezing (WHO 2020). The government of Bangladesh
has also announced the directions of social distancing
measure following WHO and many other countries who
are dangerously affected by COVID-19.
Interestingly, most of the respondents define social
distancing following the same language what has alreadybeen broadly announced and suggested. For example,
one respondent defines social distancing as maintaining‘distance between two persons to avoid contagious
disease’. Another one defines, social distancing is to‘ensure at least 1-meter physical distance with others inpublic place and also maintain a safe distance from thepeople who have been infected from contagious disease’.
In short, as one respondent defines, social distancing is‘avoiding mass gathering’. Several also note that itshould not be ‘social distancing’, rather ‘physicaldistancing’. However, this type of conceptualization
indicates that the people of Bangladesh are quite
concerned with the recent COVID-19 pandemic, and they
are evidently following necessary instructions for social
distancing.
The survey found that about 60% of the respondents
are strongly maintaining social distancing by stopping
going outside of home. For rest of the respondents, only
the male-head of the households are going outside withall necessary protections on emergency and to buy
essential needs for their families. Figure 1 summarizes
the following measures of social distancing.
More than half of them experienced ‘no relativevisiting’ at their home, children are not allowed to playoutside, family members are mostly staying in theirpersonal rooms, daily newspaper is off and maidservants are not allowed. In addition, many of them are
not allowing home tutors, car drivers, sweepers andother outsiders like electricians at their homes. In
response to a question ‘how many days are your family
prepared for not going outside’, it was found that amajority of them have bought their daily needs (foods,
medicines etc.) for two weeks in advance. At least 10% ofthem are prepared for 30 days and the same proportionof them are also ready to maintain social distancing as
long as it requires or the government authority asks to
do.
Impacts of social distancing measure on humanhealthThere is plenty of evidence that social distancing is awell-accepted measure by the Bangladeshis in response314

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

to the COVID-19 pandemic. The perception survey, in thethird week of COVID-19 in Bangladesh, on ‘social
distancing and human health’ for this research also finds
similar responses from the susceptible individuals.
Nonetheless, it aims to experiment whether there are
impacts of social distancing measures on human health,particularly to the susceptible individuals who are NonCOVID patients or simply susceptible, and elderly (>45)
in the community. The following sections analyse these
impacts through the relationships between social
distancing and food habit changes, and physical andmental illnesses.
OthersRegular health…
Family members are…
Vegetables/foods…
Relatives are not…
Children are not…
Home tutors are on…
Outsiders…
Sweepers are not…
Drivers are given rest
Maid servent is not…
Daily Newspaper is off

18
28
64
22
84
67
45
52
46
28
54
57

0 102030405060708090

No. of respondents

Figure 1- Different measures taken for social distancing(multiple answers)
Relationship between social distancing and food
habits changes
The survey found that there is a statistically significant
association between social distancing and food habitchanges (r<0.05), which concludes that the variables are
dependent. The row percentage also show that 66.7% of
the respondents, who are practicing social distancing,disagree with ‘food habits changes for social distancing’in comparison to only 33.3% of the respondents, who are
not practicing social distancing (Table 3). The survey
also found that changes of food habits does not have any
association with the type of susceptible individuals andtheir age groups. This relation indicates that bothcategories of susceptible individuals of different age
groups perceive almost similar.
The survey also examined the relationship betweensocial distancing and perceptions on family calorieintake. It was found that only 31 out of 96 respondents
believe that social distancing has resulted a state of lowintake of calorie in their family, while more than half ofthe respondents accept that the amount of calorie-intake
has not been changed for social distancing. In contrast,
14 respondents share that calorie intake has been
increased. None of the relationship between calorie
intake and social distancing across different susceptible
individuals and age groups were found statisticallysignificant.

Relationship between social distancing and physicalillness
The survey found that social distancing measure has
considerable physical health impacts on the susceptible
individuals. A majority of the respondents (65.6%)
accept that at least one member in their family has
stopped physical exercise due to social distancing up to
the third week of COVID-19 pandemic in Bangladesh. It
was also evident that the non-COVID-19 patients aremostly affected for social distancing measure. As can beseen in the Table 4, the factors ‘stopped physicalexercise’ and ‘exercise was mandatory’ are significantly
associated with the categories of susceptible individuals.
Approximately 80% non-COVID-19 patients havestopped physical exercise though it was mandatory forthem. In a situation like this, a majority of the
respondents irrespective of categories of susceptible did
not have alternative facilities for physical exercise athome and could not even consult with doctors. For
example, only 22% of the non-COVID-19 patients wasable to consult with doctors while majority (78%) was
failed. Nonetheless, social distancing measure waspositive up to the third week of COVID-19 since amajority of susceptible individuals (62) including nonCOVID-19 patients believe that social distancing has notdeteriorated physical fitness yet (Table 4). The reason
behind this perception was a considerable number of thesusceptible individuals have opportunities of formal
exercise at home and also many of them doing free-handexercise on their rooftop, in balcony and even in theirliving-rooms.
Table 3- Relationship between factors and food habitchanges for social distancing
Factors

Practicing SD
Yes
No
Type ofsusceptible
individuals
Non-COVID-19
patients
Non-patient
susceptible
Age groups
<25
25-45
>45

Do you agree with the statement: Food
habits have been changed for practicing
social distancing (SD)?
Yes
No
c2
r value
n (%)
n (%)
5.747
0.017*
2040(33.3)(66.7)
21
15(58.3)(41.7)
1.078
0.299
20
21
(48.8)(51.2)
21
34(38.2)(61.8)

14(37.8)
17(48.6)
10(41.7)
Note: **r < 0.01; *r < 0.05

23
(62.2)
18(51.4)
14(58.3)

0.861

0.650

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
Table 4 - Relationship between physical illness andcategories of susceptible individuals
Factors

Categories of susceptible individuals
NonNonc2
r value
COVIDpatient
19
susceptible
patients
n (%)
n (%)
4.897
0.027*
9 (22.0)
24 (43.6)
32 (78.0)
31 (56.4)

Stoppedphysical
exerciseNo
Yes
Exercise was
mandatory
6 (14.6)
No
35 (85.4)
Yes
Alternative
facilities at
24 (58.5)
home
17 (41.5)
No
Yes
Deteriorate
physical fitness 22 (53.7)
No
19 (46.3)
Yes
Consulted with
doctors
32 (78.0)No
9 (22.0)
Yes
Note: **r < 0.01; *r < 0.05

50 (90.9)
5 (9.1)38 (69.1)
17 (30.9)

40 (72.7)
15 (27.3)
50 (90.9)
5 (9.1)56.2260.000**

1.144

0.285

3.734

0.053

3.119

0.077

Table 5 - Relationship between physical illness and age
groups of susceptible individuals
Age groups of susceptible individuals
Factors
<25
25-45
>45
c2
r value
Stopped1.885
0.390
physical11
11(11.5)
11
exercise(39.7)
24(11.5)
No26(25.0)
13
Yes(70.3)(13.5)
Exercise was24
25
7
11.519 0.003**
mandatory(64.9) (71.4)(29.2)
No
13
10
10
Yes
(35.1)(28.6)(70.8)
Alternative
7.481
0.024*
facilities at
30
20
12
home
(81.1)(57.1)(64.6)
No
7
15
12
Yes
(18.9)(42.6)(50.0)
Deteriorate
8.608
0.014*
physical29
23
10
fitness(78.4)(65.7)(41.7)
No
8
12
14
Yes
(21.6)(34.3)(58.3)
Consulted
3131(88.6) 20
0.442
0.802
with doctors (83.8)
4 (11.4) (83.3)
No
6
4
Yes
(16.2)(16.7)
Note: **r < 0.01; *r < 0.05

The relationship between social distancing andphysical illness was also tested across the age groups ofsusceptible individuals. As can be seen in the Table 5,among the five factors, ‘option for physical exercise’,‘alternative facilities at home’ and ‘deteriorate physicalfitness’ were found dependent to the age groups. In case315of ‘option for physical exercise’, the column percentages
show that advice of mandatory exercise was mostly forthe elderly respondents (>45). A similar response wasalso found in case of deterioration of physical fitness. As
the column percentages show, 58.3% of elderly (>45)
are high on ‘deteriorate physical fitness’ in comparison
to only 21.6% of younger (<25). On the contrary, theother two variables ‘stopped physical exercise’ and‘consulted with doctors’ were found independent to theage groups. The column percentages indicate that amajority of the respondents have stopped physicalexercise and could not have access to doctor for
consultancy during this pandemic, though the number of
respondents does not significantly vary across the agegroups.
Relationship between social distancing and mental
illness
According to the perceptions of the respondents, there isa statistically significant association between mental
illness and ‘stopped physical exercise’ for social
distancing (c2= 5.544, r<0.05). This indicates thesusceptible individuals who have stopped physicalexercise for social distancing believe that there is achance of increasing mental trauma. As many as 67
respondents report that the recent social distancing
measure has caused mental trauma at least one memberin their families (Table 6).
Table 6 - Relationship between mental illness andcategories of susceptible individuals
Factors

Categories of susceptible individuals
NonNonc2r
COVIDpatientvalue
19
susceptible
patients
n (%)
n (%)
0.004 0.953
9 (19.5)
11 (20.0)33 (80.5)
44 (80.0)

Exercise relateswith mental
illnessNo
Yes
Social distancing
creates mental
10 (24.4)
trauma31 (75.6)
No
Yes
No-exercise
affects immunity
3 (7.3)system38 (92.7)
No
Yes
Exercise canincrease mental
1 (2.4)strengths
40 (97.6)
No
Yes
Note: **r < 0.01; *r < 0.05

19 (34.5)
36 (65.5)

8 (14.5)
47 (85.5)

5 (9.1)50 (90.9)

1.149

0.284

1.210

0.271

1.774

0.183

We statistically tested relationships between some of
the factors of mental illness and categories of
respondents based on health conditions and age groups(Table 7). In both of the cases the relationships were
statistically insignificant. This indicates that the relevant
variables of mental illness do not vary whether they are
non-COVID-19 patients and non-patient susceptible. A316

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

similar relationship was found in case of categories ofage groups. Nonetheless, as can be seen in the column
percentages, a majority of respondents for both of thesusceptible individuals and age groups accept that social
distancing measure has an impact on mental health,which affects to human immunity system anddeteriorate mental strengths (Figure 2).
Table 7 - Relationship between mental illness and age
groups of susceptible individuals
Factors

Age groups of susceptible individuals
<25
25-45
>45
c2
r
value
1.284 0.526
97
3 (12.5)(24.3) (20.0)
21
28
28(87.5)(75.7) (80.0)
2.147 0.342
910
10(24.3) (28.6)(41.7)
28
25
14(75.7) (71.4)(58.3)

Exercise relateswith mental
illnessNo
Yes
Socialdistancing
creates mental
traumaNo
Yes
No-exercise
affects
6
immunity(16.2)
system31
No(83.8)Yes
Exercise canincrease
2 (5.4)
mental35
strengths(94.6)
No
Yes
Note: **r < 0.01; *r < 0.05

3 (8.6)32(91.4)

2 (8.3)22(91.7)

4(11.4)
31(88.6)

0 (0.0)24(100.0)

1.344

0.511

3.734

0.053

Figure 2 presents a summary of the types of mental
illnesses perceived by the susceptible individuals. A totalof 67 respondents out of 96 believe that at least one
member of their families is suffering from mental
illnesses as a result of social distancing for COVID-19. A
majority of them (48) feel emotionally broken. The
secondlargest
group
(36)
feels
mentaldepression/fatigue. More than half of them could not
sleep well at night. A considerable number of them alsofeel unwanted emotional tension, fear and panic for
COVID-19.
Others
Panic
Fear
Depression/fati…
Unwanted…
Feeling high…
Emotionally…
Sleepless at night5

No. of respondents: 0

10 20 30 40 50 60 70

32
26
39
24
8
48
36

Figure 2- Types of mental illness for social distancing
during COVID-19

Discussion
Social distancing is one of the effective mitigation
measures has largely been recommended during
pandemic. As found by Fong et al. (2020), Ahmed et al.
(2018) and Caley et al. (2008), the findings of this study
also accept the importance of social distancing during
the outbreak of a disease as a strategy of keeping
physical distance between susceptible individuals andinfectious to reduce virus transmissions. Despite thispositive implication, the findings also show that social
distancing measures during pandemic may be very
challenging to sustain and easily practiced for its
negative impacts, such as physical and mental sicknesses
to the considerable number of susceptible individuals in
the community. The challenges may be exacerbated forlack of alternative exercise facilities at home, feelings ofsocial disconnectedness and panic about diseasetransmissions and access to treatment facilities, if thepandemic last long.
Social distancing measures should not lead thepeople socially disconnected. As the findings suggest, thedanger of this effect is the mental illness which might
reduce mental strengths and weaken immunity systemof the susceptible individuals. The findings largely alignwith previous criticisms of meaning of ‘social distancing’(Edison 2020), and the study proposes that theterminology should be ‘physical distancing’ since theactual target is to maintain physical distance between
non-COVID individuals and infectious to reduce furthertransmissions of virus.
One of the negative impacts of the present social
distancing measures is it reduces physical exercise
opportunities. As the people are advised to stay-at-home,many of them cannot continue regular exercise for theirfitness. Results also indicate that access to doctors or
physicians for elderly non-COVID-19 patients during
pandemic is a great challenge. As it appears, hospitals
and clinics are the hotspot for virus transmissions, andsimultaneously doctors are redundant to visit patientssuspecting COVID-19 infectious. Restrictions on
travelling around the city and limited mode oftransportations availability during this period of social
distancing also cause panic to the non-COVID susceptible
individuals.
Policy makers thus must include mechanisms ofalternative ways of physical exercise and releasing
mental sickness, particularly for the elderly, in the
instructions of physical distancing procedures. It is also
very important for public health professionals to prepare
the physical distancing plan during a pandemic
considering the needs and demands of the people ofvarious age groups, genders and locations, who need thefacilities most. Consistent with previous research (Baumet al. 2009), the findings of this study also recommendthat public engagement in the decision-making process
is very important for effective and successful
implementation of physical distancing measures. The
proper use of social media might be an additional
support for communicating the reasons of physicaldistancing, to pre-empt false rumors and panic (WilderSmith and Freedman 2020) and to reduce disease
related social stigma (Chowdhury 2020). In addition, it isa prerequisite for the respective authorities to upholdEubios Journal of Asian and International Bioethics 30(6) (August 2020)
peoples' trust in government support and policies tofight pandemic.
Conclusion
Social distancing measure has its positives and negatives.
Undoubtedly, this is a fruitful measure to reduce diseasetransmissions in the time of a pandemic. Nonetheless, it
has negative impacts on human health as well. Notably,
this study finds mental health impacts to the susceptible
individuals, particularly to the non-COVID-19 elderly
patients who are already suffering from diseases likediabetes, obesity, blood pressure, heart problems etc. A
big portion of them do not have alternatives
opportunities of physical exercise at home, while
exercise was mandatory physician’s advice to them. Noopportunity of physical exercise also increases mental
illness. In a situation like this, social distancing hasinterrupted their normal lives through restraining fromphysical exercise, sudden social disconnectedness andfear of disease contaminations and no-treatment.
Consequently, social distancing measure has led thepeople to a social isolation and mental depression.
Therefore, it is important to advise people to stayconnected with their friends and relatives as much as
possible through social media, virtual conferences,
phone calls or other available ways. Besides the
directions and order of social distancing, a complete
guidance of ‘stay connected and stay safe’ for relieving
mental depression should also be announced by thegovernment authorities. Firstly, the way of continuing
physical exercise from home should be advised throughelectronic and print media. Secondly, mental healthshould be a priority in the mission of fighting COVID-19.
The provision of community mental health services
might be a fruitful strategy in this regard. The healthofficials should include ‘stay-at-home, but stay-sociallyconnected’ advice in their guidance instead of only ‘stayat-home’ order without proper human health support
and advice.
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318

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

The role of nursing withdisability and COVID-19 crisis

respectto- Dr. Dhastagir Sultan Sheriff,
Faculty of Medicine, Benghazi University, Benghazi,
Libya
Email: drdsheriff@gmail.com
Introduction“I think one’s feelings waste themselves in words, theyought all to be distilled into actions which bring results.”- Florence Nightingale
Florence Nightingale’s life and service gave dignity to
Nursing Profession and education. One of her quotes
defines who is a Nursing professional: “No man, not evena doctor ever gives any other definition of what a nurse
should be than this ‘Devoted and Obedient’.”
She furthers stated that “Someone who cares for sick,old or young people someone who provides medical
assistance” is a Nurse. She also said “The first veryrequirement in a hospital is that it should do the sick noharm.” She also said “How very little can be done under
the spirit of fear”, which echoes the spirit of serving
under COVID 19 pandemic condition. There are real
stories that speak volumes about the service of Nursing
professionals during COVID 19 pandemic.
Apprehension, uncertainty, waiting, expectation, andfear of surprise haunt the mind of patient inside the ICU
unit, which brings more harm than exertion. The patientis facing the enemy, the virus all the time. With suchinternal environment the nurse starts the day holding
hands of her fellow colleagues together saying “staysafe”. We promise to each other that they will take careof each other, They make sure that everyone is wearing
the gloves, masks and protective gear properly.
Many a time ventilator stands between life and death.
How to provide care is discussed taking into
consideration the age of the patient, underlying healthcondition, their response to the virus and likelihood ofrecovery.
On one of those days she was instructed to take theventilator of a 50-year-old woman patient with very
poor prognosis. She was given the responsibility ofremoving the oxygen supply allowing the patient to die.
The only person to witness the death of the patient was
the nurse who had the responsibility to carry her duty as
well as provide a virtual connection to the daughter
listening to the last stage of her mother. Nurse is put in adilemma of discharging her duty as well as giving mental
solace to the dying woman’s daughter.
With increasing admission and surge of patients,
forcing one nurse to take care of more than one patient
she is in such a mental stress that needs rock solid
mental resolve to serve and remain calm. She further
said that with the help of a colleague, she has the deadpatient a bed bath, wrapped the body in a white shroud
and placed her in a bag. She put a sign in a cross on theforehead of the patient before closing the bag.
Apart from the fear of contracting an infection alongwith the physical discomfort of wearing a protective gearfor hours together and the scenes of patients dying had
eaten her mental resolve. She was getting burn out andthe level of stress saps her energy. She started having
nightmares. She had a history of tuberculosis with an
immunocompromised health. She was given a rest andrelieved of her service as she remained a vulnerable
person. This case clearly demonstrates the scene ofservice inside ICU and the routine tasks doctors andhealth professionals face every day.
“People with disabilities are vulnerable because of
the many barriers we face: attitudinal, physical, andfinancial. Addressing these barriers is within our reachand we have a moral duty to do so...... But mostimportant, addressing these barriers will unlock thepotential of so many people with so much to contributeto the world. Governments everywhere can no longer
overlook the hundreds of millions of people withdisabilities who are denied access to health,rehabilitation, support, education, and employment—
and never get the chance to shine.”
Stephen Hawking(Speech-generating devices, or SGDs, produce electronic
voice output, allowing the individual to communicate.
These portable electronic devices allow him or her toselect letters, words, and messages, alone or in
combination, to be spoken aloud in a pre-recorded orcomputer-generated voice (text-to-speech) In 1963,
Hawking was diagnosed with an early-onset slowprogressing form of motor neuron disease (also known
as amyotrophic lateral sclerosis (ALS) or Lou Gehrig's
disease) that gradually paralyzed him over the decades.)Disabled population
Over a billion people i.e. about 15 % of the population
form the disability group. As per Census 2011, in India,
out of the 121 Cr population, about 2.68 Cr persons are‘disabled’ which is 2.21% of the total population. In an
era where ‘inclusive development’ is being emphasized
as the right path towards sustainable development,
focused initiatives for the welfare of disabled persons
are essential. This emphasizes the need forstrengthening disability statistics in the Country. Eighttypes of disability (disability in seeing, in hearing, inspeech, in movement, in mental retardation, in mental
illness, any other and multiple disability) has beencollected.
Definition:“Disability is an umbrella term for impairments, activity
limitation, and participation restriction.” Disability is theinteraction between individuals with a health condition(e.g. cerebral palsy, Down syndrome and depression)and personal environmental factors (e.g. negative
attitude, inaccessible transportation and publicbuildings, and limited social support. Article 25 UN
Convention on the Rights of Persons with disabilities(CRPD) reinforces the rights of person with disability toattain the highest standard of health care without
discrimination.
Among the persons classified as disabled, 56% (1.5 Cr= 15 million) are males and 44% (1.18 Cr = 12 million)
are females. In the total population of India, the male andfemale population are 51% and 49% respectively. About
70% of the disabled people live in rural area.

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
People with severe mental disorders have greater
vulnerability to comorbidities -pressure ulcers, urinary
tract infection, osteoporosis, pain. Schizophrenic
patients have more susceptible to Diabetes mellitus (15% compared to normal people -2-3%). Premature aging
is more prevalent in them.
The prime concerns of delivering health care:• Prohibitive costs, limited availability of resources(UP, TN).
• Physical barriers: uneven roads, inaccessible medical
equipment, poor signage, bath room and parking
facilities.
• Communication barriers- the advisories prepared forcases with visual or auditory problems need themessages to in larger print, in Braille language as wellas in audio or video representations.
• Social Barriers- The environment the disabled people
live have social stigma and preformed opinions about
their capacity to work, skills and efficiency.
• Program Barriers- social programs conducted do nottake into consideration the special requirements ofdisabled people.
• Transport Barriers- the disabled people need special
areas for parking as well as special transport facilities
including boarding a vehicle or special sitting
arrangements.
• The health care professionals are reported to haveinadequate skills, knowledge of health service.
Disabled people are more vulnerable, ill-treated oreven refused treatment.
COVID-19 and disability
COVID-19 presents many challenges including serving
disabled person. A pandemic has to follow certain
guidelines:
1. The duty to safeguard (supporting workers andprotecting vulnerable persons)
2. The duty to plan (managing uncertainty)
3. The duty to guide (contingency levels of care andcrisis of standard care
The needs of the disability persons are different.
From the perspective of abled people, disabled persons
are vulnerable population. Identifying conflicts ofinterest among the population affects older andimmunocompromised patients. Few people’s prosperity
becomes more significant and devalues the levels ofelderly and the disabled.
Ageism states that one’s age can be used as proxydetermination of skill and ability It refers to prejudice
and discrimination with age. Ableism means all bodies
and mind work in the same way but it creates a binary ofnormal and abnormal. This type pf conflict is termed as
structural discrimination. But one must remember
viruses do not discriminate to cause infection.
The concept of equity states that providing everyone
what they need to be healthy and informed. Whencontrasted with equality it is treating everyone the sameand through it looks to adhere to the principle offairness. The principle of equality can work only ifeveryone has the same needs.
The equity principle is unfair to cases with disability.
Those disabled people with mental health issues,

319

Dementia or Alzheimer’s Disease requires special type ofcare giving. The caregivers’ physical presence andinteraction play an important role in alleviating theirsufferings. With the lock down as well as social
distancing requirement visual communication do notmeet the needs of these disabled people. Rather it drives
them into more serious complications.
In other words, unmet needs of the disabled people
are many. Women with disability receive less screening
for breast cancer compared to women without disability.
Dr. Etienne King, WHO Director for Management of
noncommunicable diseases, disability, violence andinjury prevention, says it is important to collect data
based on the model disability survey. “It is critical forcountries to be able to identify the number of people
who experience disability as well as unmet needs,
barriers and inequalities they face. By doing sogovernments are better placed to provide the services
people with disability need.”
The Nursing Profession and the service they rendersilently in the corridors of Intensive care Unit and indifferent hospitals are lamps that lit the hearts andminds of patients and people with gratitude and grace.
The many who lost their lives serving COVID-19 patientsneed not only the support of the government but also the
support of each and every citizen of India irrespective ofcaste or creed or ethnicity. In USA students from Medical
schools visit the family who have donated the body ofthe near ones for Dissection of the human body in the
Anatomy Department of Medical School. They pay theirrespect to the family, share their grief and give social
support. Likewise, every member of the community
needs to share their social responsibility to the familiesof Nurses who serve in COVID-19 hospitals. The
community must show their solidarity to such families
who lost their daughters or sons or mother or father
serving COVID-19 patients. Such a support must be in theform of physical, moral and economic gestures. The
nursing family need to be shown that they need no othersupport other than the community they serve to help
them as the angels of service have done to them.
References

Centers for Disease Control and Prevention, 2019. National
Center on Birth Defects and Developmental Disabilities,
Division of Human Development and Disability. Disabilityand Health Data System (DHDS) Data [online]. [Accessed
August 6].
Government of India. 2016. Disabled Persons in India. A
statistical Profile.
Houtenville, A. and Boege, S. (2019). Annual Report on People
with Disabilities in America: 2018. Durham, NH: Universityof New Hampshire, Institute on Disability. Available athttps://disabilitycompendium.org/sites/default/files/useruploads/Annual_Report_2018_Accessible_AdobeReaderFrien
dly.pdf
World Health Organization. 2001. International classification offunctioning, disability and health. Geneva: WHO. p. 214.
World Health Organization; at https://www.who.int/
mediacentre/news/notes/2012/child_disabilities_violence_2
0120712/en/

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

People’s personal ethics and responsibilities
duringthepandemic:
storiesandexperiencesofrecipientsofsocialamelioration program (SAP) of Digos City
-Rogelio P. Bayod-Erikka June D.Forosuelo-Marianne Eve S. Sanchez
Cor Jesu College, Philippines
Email: roger.bayod@gmail.com
Email: erikkajunedecrepito@gmail.com
Abstract
The poor people are among the vulnerable during
disasters or pandemic. To ensure their safety, thegovernment, through the Social Amelioration Program(SAP) provides cash assistance to the identified poorestof the poor in the Philippines. While there had been
many reported cases of problems in the SAP distribution,
mostly in the National Capital Region, like lack ofbaseline data to determine the real economic status of
the persons, the lingering party politicking lead to put
others to a disadvantaged position: some attitudes of therecipients such as using the cash aid for gambling andbuying prohibited drugs and liquor, others were tempted
to buy unnecessary material things, while some paid theamount to their long term debts and also spared anamount for their families and friends in need. We
gathered stories and experiences of SAP recipients in
Digos City to learn from what they have gone through,including how they viewed SAP and how they used themoney after they received it. In this paper, we will
present the personal ethics and responsibilities of ourstudy participants especially during Covid-19 pandemic.
We will argue that the poor are poor not because they
are lazy. They are poor because they lack opportunities
at the same time they cannot also turn their backs tothose who are in dire need. Having endured poverty forhow many years, some of them also took the opportunity
to transitorily enjoy life after receiving the cash
assistance from the government.
Introduction
The Social Amelioration Program (SAP) of thegovernment aims to provide cash subsidy to thevulnerable sectors of the society affected by the ongoingenhanced community quarantine. The aim ofgovernment’s social amelioration measures is to“mitigate the socio-economic impact of the COVID-19
health crisis and the Enhanced Community Quarantine
guidelines.” (Aceron, 2020).
This has become an immediate aid against our battlewith Covid19 which helped majority of our fellow
Filipinos in the country. The government is able toexecute its responsibility through this type of initiative.
Several government agencies were tasked to implement
SAP, spearheaded by the Department of Social Welfare
and Development (DSWD). Aceron (2020), further
emphasized that the government’s social amelioration
include support to 18 million Filipinos who will be mostaffected by COVID-19.
The target beneficiaries are senior citizens, persons
with disabilities, pregnant women, solo parents, OFWs

(distress at repatriated), indigenous people, homeless,farmers, fisherfolks, self-employed, informal settlers, andthose under No Work-No Pay arrangements (e.g.,
drivers, househelp, construction workers, etc.). It is a factthat after the completion of the Social Amelioration Card
(SAC) that serves as a form of validation to check whowill need amelioration during the COVID-19 crisis, thequalified household are now legitimate to accept the said
government aid.
There had been reports on the abuse and misuse of
SAP funds by some beneficiaries in different regions of
the country. The intention of this paper is to present thestories and experiences of SAP beneficiaries in Digos
City. Therefore, we interviewed SAP beneficiaries who
gave us their consent to be part of this study. Throughthe help of some people whom we know who are SAP
beneficiaries and who were also willing to participate inour study, we were able to interview 15 participants.
As we gathered stories and experiences of SAP
recipients in Digos City to learn from their narratives,
including how they viewed SAP and how they used themoney after they received it, we will present thepersonal ethics and responsibilities of our study
participants especially during Covid-19 pandemic.
As pointed out by Mendoza (2020), “around 40% of
the country’s 45 million labor force are less likely to haveformal work arrangements, with little access to social
protection and insurance”. Hence, at least around 16
million workers and their families will need support to
immediately supplement their incomes. This only
implies that in the absence of government support along
the very fact that some are also in a “no work, no pay”
situation, majority are forced to go out and seek work
because the government aid is but temporal and thesefamilies are feeding their respective households.
In Luzon, a large number of workers were placed in a
no work-no pay arrangement as businesses went on aforced hiatus (Gutierez, 2020). More importantly, in thispaper, we will argue that the poor are poor not because
they are lazy. They are poor because they lack
opportunities at the same time they cannot also turntheir backs to those who are in dire need. Having
endured poverty for how many years, some of them also
took the opportunity to transitorily enjoy life after
receiving the cash assistance from the government. We
asked our participants the following questions: How they
perceive SAP, what they did after receiving the aid andtheir insights about SAP.
Perception about social amelioration program
According to the Department of Social Welfare andDevelopment under Memorandum Circular No. 04 seriesof 2020, the passage of the Republic Act (RA) No. 11469
otherwise known as the “Bayanihan to Heal as One Act of2020”, an intensified government response is adopted
whereby the national government will render fullassistance to the LGUs and mobilize the necessary
resources to undertake urgent and appropriate
measures to curtail the effects of the recent declarations
on the economic, physical and psychosocial well-being of
the most affected residents, thus, the DSWD ensure theprovision of safety nets as well as the implementation of
the social amelioration program that serves as subsidy ofthe basic necessities of our citizens who qualifies in theirEubios Journal of Asian and International Bioethics 30(6) (August 2020)
basic requirements and evaluation in terms of availingthe said government aid.
As to the perception of our study participants about the
SAP, we identified two emerging themes – Aid for the
Poor and Blessing.
Aid for the poor. When interviewed about theirperception on SAP, many of our informants said that it isan aid from the government for the poor like them. Manyof them said that “SAP is like aid or help from thegovernment for us who are poor”. Others said that it isa“help from the government.” While others said as“assistance gikan sa gobyerno or hinabang gikan sa
gobyerno.” (Aid or help from the government). Indeed,
they are true with their perception. SAP is really an
assistance from the government to the poorest of thepoor members of the society. This is attested by Perez,(2020) when she defined SAP as a cash emergency
subsidy program (ESP) for 18 million Filipino families
whose lives are greatly affected by the ECQ. It's
mandated by the new law, the Bayahanihan To Heal As
One Act which was signed by the President last March
25, 2020.
Although many of the informants perceived SAP as an
aid to the poor, they also contextualized it as it isbecause a lot of people have become jobless and somelowly workers also lost opportunities to earn daily wage
because of the government’s imposition of community
quarantine and lockdown due to Vovid-19 global
pandemic. This implies that they feel that they deserve
the help from the government because they were notgiven the chance to work in order to earn money for
their daily needs. Had they given the chance andopportunity to work, they would not have waited for thegovernment to help them as they can survive on theirown.
Blessing. Aside from aid, which connotes mandatory of
the part of the government, some of our informants also
perceived SAP as a blessing from the government.“Gasagikan sa gobyerno alang kanamo” (Gift from thegovernment for us),“Gasa gikan sa gobyerno alang sa
mga kabus” (Gift from the government for the poor).
Conceiving SAP to be a blessing makes our informants
become so grateful to the government for giving themsuch blessing. The stories of our informants are contrary
to how people in Luzon perceived the government’s
effort to help the poor. According to Gutierez (2020), thevoice of the hungry became louder than the voice of
those afraid of the disease not only in Metro Manila.
“Mamamatay kami, hindi sa virus kundi sa gutom (Wewill die not from the virus but of hunger),” This
statement only affirms that not all perceive SAP as a
blessing, because others who are qualified recipientswere not able to receive. Some who were able to receive
the government aid still find it insufficient to meet their
daily household consumption. Hence, they complained.
But when you perceive SAP as a blessing, it connotes
something like you are not supposed to be given but
because the other is generous, you received such gift.
From these stories of our informants, we can gleansome of their personal ethics and responsibilities. First,
we can say that these people believed that improving
their lives is their personal responsibility. They do not321

have to rely it to the government. Second, we can also
say that these people are so grateful whenever they will
be given something. We also experienced this as
responders during emergency situations. The people
whom we have given some goods were so grateful andwe can really see the sincerity of their smiles and “thankyou’s”. On the other hand, we can also say while thesepeople do not rely on the government, they might havebeen tired of receiving only promises from thegovernment especially from the past administrations
when Mindanao people had been neglected by thegovernment. This is something that we feel worth
reflecting upon. Are our government leaders really
incapable of providing the needs of the poor during
pandemic? Are the poor people poor because they arelazy or because they were not given the opportunities tomake their lives better?
What did they do with the money?
In our study, we also wanted to know directly from ourinformants what do they do with the money theyreceived from the government. Based on their answers
on what do they do with the money, we identified three
emerging themes -Buy food and groceries, share portionof it to their neighbors and relatives, and invest forlivelihood.
Buy food and groceries. All of them said that when theyreceived the money, they immediately buy food andgroceries. The following are just some of the verbatim
statements from our informants after we asked them
what they do with the money from SAP: “Gipalit ug
grocery,bugas
ug
pang
adlaw
adlaw
na
panginahanglanon sa kusina.” (I bought grocery items
and rice and the daily needs in our kitchen), “Ang akong
gi plano nga paliton sa wala pa nako nadawat ang
amelioration, mga panginahanglanon sa kusina, labina
ang bugas” (I already planned to buy what we need in
the kitchen especially rice even before I received themoney), “Gisiguro jud nako palit ang bugas” (I reallymade sure to buy rice). Indeed, the money given to themby the government was used for its original purpose andintention. This is contrary to some of the stories of SAP
beneficiaries where they used the money for gamblingand even in buying prohibited drugs and also liquor. This
only shows that our informants have a good sense of
personal ethics and responsibilities towards their own
families.
Share portion of it to their neighbors and relatives.
Despite being in dire need, some of our informants wereable to transcend from their own tendencies to focus
only to their own families and also reach out to theirneighbors and relatives especially those who were notable to receive the money from SAP. Here are some of
their verbatim statements: “Gihatagan pud nko ang
akong silingan ug amigo kay wala man siya nakadawat.”(I also gave something to my friend because he did notreceive any), “Ang uban akong gihatag sa akong paryentearon naapud sila kwarta ikapalit ug bugas.” (I also gavesome to my relatives so that they also have money to buyrice), “Human nko palit sa among konsumo sa balay, ako
pud gihatagan ang uban.” (After I bought what I need forour consumption in the house, I also gave some to322

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

others). These people, no matter how poor they are, also
have big heart for others. This is also what we havewitnessed during our relief operations here in Mindanao.
A lot of people, although they are in dire needs because
they are victims of disasters, still consider also the needsof others.
Invest for livelihood. Some of our informants were very
futuristic. After they have bought the necessary things
for their food, they invest some of their money forlivelihood. “Ang ako sir after nko napalit ang konsumo,
ang uban ako gi capital kay nag tinda ko prutas ug gulay.”(As for me, after I bought my needed consumption, I put
some money as my capital for my fruits and vegetables
buy and sell business), “Akoa sir kay nagpalit ko gamit
pangluto sir kay nagaluto man ko pritong manok paranay ginagmay na negosyo.” (For me, I bought cooking
utensil because I also cook fried chicken for my small
business). In our interviews with them, we found outthat the poor are not really lazy and do not have plans
for their lives. In fact, we found out that given enoughsupport, they can improve their lives and they can be
more productive citizens of this country. They might
have been poor because they were not able to continue
their work and livelihood due to pandemic and they also
did not receive any support from the government interms of livelihood assistance. Thus, they took theopportunity to use some of the money they received
from SAP to invest something for their small businessventures.
However, we also know of few beneficiaries in our
locality, who, instead of using the government aid to buy
their basic needs, chose to enjoy the money by buying
liquor and the others apportion the money to pay off
their long time debts. These people did not submit theirselves to be participants of this study although we
explained to them that their identities will be kept withutmost confidentiality because they are apprehensive ofthe thought that they might be caught and brought to jail.
Social media on the other hand, reported several acts ofgenerosity from people who shared their blessings inorder to help others (Gutierez, 2020). These virtues ofkindness and helpfulness are very common among
Filipinos. Our unselfish gestures in the midst of global
pandemic is highly evident because of our fervent desire
to extend our help not just to immediate family members
but also to our neighbors. In fact, one informant, who is afriend and a neighbor to one of the authors of this study,
honestly shared to us what he did with the money,“gipalit ug pagakaon ug “tuba” unya gi invite akong
amego sa balay kay naglingaw2 pud mi gamay tungod sa
grasyang anadawat.” (I bought food and “tuba” (coconutwine) and also invited my friends to come to my house to
enjoy the graces I received).
Insights about SAP
The most important purpose that we have in mind in
conducting this study is to also know the insights of SAP
beneficiaries in Digos City. We found that their insights
can be clustered to following themes – Happy that
Government really cares and also Hassle.
Happy that Government really cares. Majority of our
SAP recipients said that they are happy that the

government now really cares for the poor. We havealready pointed out in this paper that Mindanawons
have been neglected by the past governments in terms of
the priorities of the basic social services. Thus, we areforced to manage on our own and also forged a spirit ofbayanihan among our neighbors and friends. But thiswas changed when PRRD, a Mindanawon was elected aspresident. This was affirmed by our informants as theysaid, “Nindot ang gobyerno karon kay motabang jud sa
mga pobre.” (The government now is good because it
really helps the poor), “Seryoso ang gobyerno karon sa
pagtabang. Murag mahadlok pud sila mangupit kay
maaksahon man jud. Isog man si Digong.” (Thegovernment now is serious in helping the people, someseemed afraid to perform acts of corruption because
they might be sued. Digong is such a brave man), “Tinudanay jud ila pagtabang kay klarohon jud ifnanginahanglan ba jud ka.” (Honest and truthful is thegovernment today in terms of their help, they reallymade sure that you are really in need).
Indeed, they have experienced the care and concernof the government now that is why they are happy.
“Nalipayko kay nakatabang ang gobyerno ug nakatabang
pud ko sa uban bisan ginagmay basta nakapaambit.” (Iam happy because the government was able to help me
and I was also able to help others even if it’s only
minimal as long as I was able to share), “Dako gayud
akong kalipay ug pasalamat sa dakong tabang nga ilang
gihatag.” (I was so happy and thankful because of the big
help that they provide). One informant was even sayingthat she is happy but she is also sad, “Ang akong
realization kay nalipay ko nga nakadawat ko sa maong
kwarta, pero likod ani naguol pud ko kay nagamit ang
pundo sa gobyerno nga mao unta ang gamiton sa mg
aproyekto nga mugnaon sa gobyerno.” (My realization isthat I am happy because I receive the money but I am
also sad because the government used the money
intended for the projects that they are supposed tocreate). Interestingly, this person is very much concernthat the government has the money needed for theirprograms and projects. This was also the feeling of somepeople in the mountains as narrated by one of theauthors of this study. He found out that a lot of people
there are happy with the assistance of the government
but they are also sad that the on-going improvement to
the farm to market roads in their place might not becompleted because the government lacks the money thistime. But nevertheless, we heard from their mouth thatthe government today really cares. This might be thereason that despite a lot of criticism from some elites
and from the international community, majority ofFilipinos have expressed satisfaction with theperformance of President’s Rodrigo Duterte’s
administration when it comes to handling thecoronavirus disease 2019 (Covid-19) pandemic, basedon the “Global Crisis Perceptions” index released byinsights firms Blackbox Research and Toluna” (Carlos,2020).
Hassle. While there are only two of them who said thatthey find the process of the SAP distribution tiresome
and annoying as they were made to undergo a lot of
screening, we still consider this theme as significant. One
informant really said to us, “Hasol kayo mura gmaka

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
down sa akon gpagkatao” (it’s really hassle and it seemedthat my person (esteem) is brought low). Anotherinformant also said, “Kapoy kaayo sir ui, daghan man
interview, makaulaw kaayo, kung ihatag, ihatag na unta
diritso” (It’s really tiresome because they are plenty ofinterviews, I am so ashamed. If they will give, they haveto give it immediately). These were blurted out by therecipient because he said that they passed through a lotof screenings, evaluations and interviews to ensure thatthey really deserve to receive the government assistance.
They felt pity on their selves because they think they aredesperately begging for aid. Indeed, there were plenty ofcontroversies in the SAP distribution as some local
officials prioritized their allies and family members. This
prompted the national government to assign a national
agency, the DSWD or the Department of Social Welfare
and Development of take charge in SAP distribution andto strictly verify the economic conditions of the possible
recipients. This can be attested because according to
Aceron, (2020), “the vague, general, and fragmented
information being provided by the government on thequalification of SAP recipients are causing distressamong citizens and implementers on the ground”. These
have caused confusion to the people. Nevertheless, inspite of this incident, our informants were happy that the
government today really cares for them.
Conclusions
The pandemic brought out underlying apprehensions as
seen in social media coming from the various societal
classes. Criticisms mostly came from the working classor we call them the middle class against the inferior classwith blue collared jobs, who majority lost their way ofliving in the time of the pandemic. The poorest of thepoor beneficiaries became targets for criticism because
for one, they are prioritized by the government to berecipients of the SAP. “The poor are poor because they
are tamad (lazy)” was a common theme posted by the
frustrated netizens as mentioned by Gutierez, (2020). In
this time of global pandemic where everyone is affected,
the poor become poorer not because they are lazy but
because they lack the opportunities in the society where
they live.
The issue is not poverty, but the behavior andattitudes of the poor (Cummins, 2018; Garrett, 2018).
They are portrayed as mired in a state of “worklessness”,
lacking aspiration and an ability to care for others andrelying on the work efforts of others (Garrett, 2018, p.
68; Macdonald, Shildrick, & Furlong, 2014, p. 199). Thishas created a stigma to the inferior classes of the society
which added to their insecurity that hold back their
aspirations, and efforts to alleviate their conditions andstatus in life. These people also have the heart to shareas much as they could in their immediate families andmore so to their neighbors who also share the sameplight with them. We positively view the unconstructive
gestures of these people as they receive the cash
assistance because it is their temporary escape to thereal world. They grabbed the opportunity to enjoy life
which they hardly ever experience because of scarcity of
cash to sustain their family’s daily need. In addition,these people remained to be generous toward others
who are also in need. They had the opportunity andreason to be greedy, but they chose to be generous and323

to care for others. While those that can afford did panic
buying and hoarding, these people share their blessingsto others. Indeed, there is so much to learn from thepersonal ethics and responsibilities of these people.
References

Aceron, J. (2020). Challenges facing social amelioration for thecoronavirus.
Retrieved
June
3,
2020,
from
https://www.rappler.com/thought-leaders/256782analysis-challenges-government-social-ameliorationcoronavirus
Carlos, R. (2020), Filipinos satisfied with gov’t response to
Covid-19 pandemic. Retrieved June 4, 2020, fromhttps://www.pna.gov.ph/articles/1102277
Cummins, I. (2018). Poverty, inequality and social work: The
impact of neoliberalism and austerity politics on welfare
provision. Bristol, UK: Policy Press.
DSWD (2020). Social Amelioration Program-DSWD. Retrieved
June
4,
2020,
from
https://www.dswd.gov.ph/issuances/MCs/MC_2020004.pdf
Garrett, P. M. (2018). Welfare words: Critical social work andsocial policy. London, UK.: Sage Publications, Ltd.
Gutierez, F.(2020). Solidarity and sharing in an unequal
society: Covid-19 in the Philippines. Retrieved June 4, 2020,
fromhttps://www.opendemocracy.net/en/democraciaabierta/solidarity-and-sharing-unequal-society-covid-19-philippines/
Macdonald, R., Shildrick, T., & Furlong, A. (2014). In search of‘intergenerational cultures of worklessness’: Hunting the Yeti
and shooting zombies. Critical Social Policy, 34(2), 199–220.
doi:10.1177/0261018313501825
Mendoza, R. U. (2020). COVID-19: Navigating Inclusive
Recovery towards the New Normal. Available at SSRN
3598116.
Perez, R. (2020). Social Amelioration Program: How To Qualify
And How Much Can You Receive. Retrieved June 4, 2020,
fromhttps://www.msn.com/enph/money/personalfinance/social-amelioration-programhow-to-qualify-and-how-much-can-you-receive/arBB12EtA5

Ecological health: key to economic healthand human well-being- Rogelio P. Bayod, Ph.D.
Cor Jesu College, the Philippines
Email: roger.bayod@gmail.com
Economy and ecology are two important ingredients ofhuman and societal well-being. There is no sustainableeconomy without sustainable ecology. Destruction of
ecology will result in the death of economy, andeventually, of the people. Just like other natural disasters
that occurred in some parts of the world such as
typhoon, prolong flooding and drought, forest fires andeven earthquakes, Covid-19 can also be nature’s
messenger sending us important message – there is no
human and economic health without ecological health.
Thus, making peace with nature is important not only forour economy but also for our total well-being. Using Kate
Raworth’s Doughnut Economics as well as indigenous
philosophy and belief system as regards to environment,
this paper will argue that ecological health is crucial not
only for human health but also for inclusive andsustainable economic development and also the people’s324

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

capacity to deal with present and future pandemic like
Covid-19.
Keywords: Ecological Health. Economic Health. Doughnut
Economics. People’s Capacity. Covid-19
Introduction
Last week, when the local border restriction in our
province was lifted, I decided to visit my small farm
located in a far-flung village of Davao del Sur. I found outthat the land was already infested with weeds andgrasses. But the ginger seedlings, which I have alreadyprepared and distributed strategically in the farm lot
before the lockdown, have managed to grow up alongwith the weeds and grasses. So I decided to just clean thesurroundings of the ginger and put additional soil on topof their roots. It took me four days to finish my task. The
local people gave their suggestion to me to just spray thearea with herbicides so that they will be clean and I do
not have to spend much of my time cleaning it. They
even shared that almost all of them sprayed herbicides
to clean their farms and they were able to save time andmoney because they do not have to hire plenty of people.
I asked them why they are doing it, where in fact, it will
really destroy the natural fertility of the soil. They
answered, “in order that they can save, and eventually,
will have more income.” As an advocate of natural andorganic farming, I became more motivated to show themthat, if they want to have sustainable income, they needto make peace with their land, take good care of it andtreat it like a human being that is so dear to them.
In this paper, I will highlight the importance ofensuring the health of our ecology if we want to havesustainable economy that will cater not to the gluttonous
wants of corporations and companies but to theequitable needs of people and communities. To be able
to do this, I will show that development paradigms being
advanced by capitalist economies cannot be sustained in
the long run because they will result to devastation ofenvironment and the depletion of natural resources.
When ecology bleeds, economy suffers. When economy
suffers, the people, especially the poor, will be gravely
affected. To achieve economic health that is needed toanswer the basic needs of all people, ecology must bebalance and healthy. When the ecology is healthy, it will
not only continue to produce resources needed for the
economy, it will also provide healthy air, water andliving environment necessary for peace and well-being ofpeople and communities. When people are healthy, they
can continue to enhance their capacities to benefit fromdifferent opportunities to make their lives and thesociety better.
Before I procced with my arguments, I have toconfess first that I am not an economist. Hence, I am notgood in computing and projecting income per hectare or
acre of a farm. Much more, in computing a GDP or GNP ofa country. As a development worker and an
environmentalist, the many challenges that confront
societies today such as natural disasters like typhoon,
earthquakes, prolong flooding and also drought as wellas the outbreak of viruses which have been proven tohave correlation with environmental degradation anddeforestation (Climate Council, 2020, Walsh, et al, 2017,
Kessler, et al, 2108, Plowright, et al, 2015, Martin, et al,2018), have ushered me into moments of reflection on

how to build and create development programs, projects
and policies that will cater to the basic economic needsof peoples and communities without jeopardizing
ecological health and harmony.
In order to achieve ecological health, there is a needto go back to the very basic - establishing a deep spiritual
relationship with Mother Earth characterized byreverence and respect as shown by the indigenous
communities (Bayod, 2020). This kind of attitude andvalues run in conflict with the values of the capitalist
societies who are heavily influenced by consumerism somuch so that they only see the earth as an object to be
exploited to satisfy their greed.
Economy and ecology: Two inseparable ingredientsfor genuine development
I think everybody will agree that economy and ecology
are two important ingredients for human and societal
well-being. There is no sustainable economy without
sustainable ecology (Raworth, 2017). But you might also
agree with me that past development paradigms which
promoted so much the concept of industrialization as arising tide that will lift all boats have often resulted in
the destruction of environment which has tremendous
effect to the local people whose economic survival
depend heavily on the abundance of their surrounding
ecosystem (Mander and Tauli-Corpuz, 2004; Gaspar,
2000; Gaspar, 2011, Shiva, 2012, Shiva, 2016).
Development that is often conceived in strict
economic terms followed an evolutionary process thatcommenced from basic commodity suppliers, throughcapital accumulation to industrialization, in turn leading
to urbanization (United Nations Permanent Forum on
Indigenous Issues, 2010). Hence, in this case,development is equated with mushrooming of industries
and infrastructures. Because of this, there was a shift in amindset in a lot of people – urban life is a happy andcomfortable life. A lot of rural people migrated to mega
cities in search of good life. Good life during this time isdefined in terms of economic status and bank accounts.
With plenty of wealth and assets, you can buy and dowhat you want. The culture of consumerism andcapitalism became the norm for a good life.
There is no denying that capitalism resulted totremendous economic growth in many societies. Since
economic growth achieved by capitalist economies
brought benefits to billions of people (Juniper, 2012),
can we now claim that capitalist economies are theanswers to the economic problems that beset a lot of
people and communities? I think we need to pause for awhile and reflect before claiming its unmitigated success.
Covid-19 pandemic reveals the same – that money is noteverything.
However, in capitalist societies that promote
consumeristic and materialistic culture and values,
people take everything from the earth, exploit anddestroy forestlands, mountains, oceans and rivers
without considering that in the process, the earth bleeds
and drains its capacity to give abundantly and equally toall her children (Bayod, 2020). In the name of what theycall as “development”, government, technocrats and evenscientists that promote this concept of development,
wage war against our Mother Earth. According to Shiva(2016), this war has its roots in an economy which fails

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
to respect ecological and ethical limits such as limits toinequality, limits to injustice, limits to greed andeconomic concentration. Shiva further said that the main
agent of this war is the global corporate economy andglobal capitalism that advocate insatiable accumulationof profit and ravenous consumption of the earth’s
resources (Bayod, 2020).
How does this global corporate and capitalist
economy played its war game? Openly and in astraightforward manner it tried to project to peoples andcommunities that they would like to promote
development for the people to experience the good life.
But covertly, they employed coercive means to advancetheir capitalist agenda through trade policies andtechnologies of production that are based on violence,
domination and control (Bayod, 2020). The end point ofthese technologies according to Shiva (2012) is
destruction of the environment which eventuallydeprives people the basic necessities such as food andwater. Thus, slowly killing the web of life.
The doughnut economics of Kate Raworth
In this section, I will discuss briefly Kate Raworth’s
Doughnut Economics and its relevance in today’s
discourses of what should be sustainable and systemic
development that considers ecological and economic
health. According to Kate Raworth (2017), theeconomics of today need a major overhaul. She criticizes
the many layers of outdated assumptions that supportand uphold the current development models andeconomic systems especially from the West. She thenproposes a new set of seven principles that will serve as
guide towards an economic system and development
models that will work for both people and planet(Breewood, 2018). These principles are the following:
1. Change the goal.
The goal of the previous and current economic system ofcapitalist economies is basically geared toward pushingfor endless economic growth. It is of no doubt that the
proponents of this model wants to help the society. But
Raworth points out how myopic the goal is and how thisnarrow measurement ignores many of the importantfunctions of any economic system such as equitable
distribution of wealth which basically affects the qualityof life for people. She then offers another perspective.
She illustrates the economy as two circles, one within theother. These two circles of the doughnut - the ecologicaland the social are considered ceiling or boundaries from
where people may judge the impact of development or
economic activities. If resource use and environmental
pollution are so high that they damage the planet, thenthe economy is stepping above the planet’s ecologicalceiling and is going outside the outer ring of theDoughnut. On the other hand, if people cannot meet theirbasic needs such as food, water, clothing, housing andeven education and other economic necessities, then thesociety or community is fallen inside the inner ring of thedoughnut. Thus, both social and ecological impacts haveto be measured across a range of different factors suchas climate change, biodiversity, health, energy access andothers as staying within the doughnut means staying inthe safe and just space for humanity because the society

325

guarantees minimum social welfare while avoiding
excessive environmental damage (Breewood, 2018).
Sadly, as Raworth points out, this has not been thecase in many economic models. The focus of thesemodels was geared towards accumulation of wealth andprofit even at the expense of the environment. Becauseof this, capitalist societies that advocate this economic ordevelopment model, engage war against the earth’s
resources. This form or war according to Shiva (2012)
involves both the transformation of living mountains,forests and rivers that support life bountifully into deadraw materials for making metals for the industrial needs
and as receptacles for the dumping of toxic wastes whichpose imminent threats to the lives of people as well as tothe interrelatedness of lives in the entire ecosystem.
2. See the big picture
The second key concept of Raworth implies systemic
thinking. She emphasizes the interrelatedness of factors
in the economy and that, instead of viewing markets as
isolated, she points out the importance of consideringother components of the economy like the politics andbureaucracies in the government, families andhouseholds and resources in the environment. After all,the entire economy is embedded within larger systems:society, the earth and the solar system (Breewood,2018). The concept of interrelatedness of life is verymuch present and practiced by the indigenous peoples.
For them, their life and their existence is inseparablyinterconnected with their lands, rivers, forests,
communities and even the entire ecosystem (Bayod,2020).
3. Nurture human nature
Raworth (2017) emphasizes the many facets of humannature such as our desire to help others, our values anddecisions to participate in different collective projects
for the common good as well as our concept ofinterdependence on others. For liberal societies thatchampion individual rights, this might be challenging but
it does not mean, it is impossible to achieve. For
communitarian societies like the indigenous peoples,
this is not a problem. In fact, they have practiced a“communist” way of life (Bayod, 2018). Despite theencroachment and the penetration of liberal culture andneo-liberal economies that advocated individual rights,
responsibilities and achievements, still a lot of
indigenous peoples preserved their communal way oflife.
In the Philippines, this is practiced by many
indigenous communities during this pandemic. Asidefrom their indigenous cultural practice of lockdown andcommunity quarantine, they also practiced sharing theirfood and other resources to their fellow IPs who haveless in order that the whole community can hurdle thechallenge brought about by Covid-19 pandemic. Duringextended community lockdowns, these traditional
communities have practiced and enforced theirtraditional culture such as exchange of labor where
community members, especially, those who have more
will extend help to those who are in dire need, and also
the concept of ayyew, meaning to not waste anythingfrom food to water (Kasiyanna: Cutlural Survival, 2020).

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Since indigenous peoples are no strangers to disease
and disaster, they have established responses and coping
mechanisms to different circumstances affecting theircommunities. These are grounded in traditional
knowledge, customs and practices and founded on one
fundamental principle - to ensure that the community
survives (Kasiyanna: Cutlural Survival, 2020). Theirconcept of community even transcends from their
immediate community or village to the larger
community. In fact, during this Covid-19 pandemic, one
municipality in Luzon, Philippines, which is
predominantly an IP municipality, chose not to accept
the aid from the national government saying that they
can still survive because of their spirit of bayanihan(helping each other). Thus, it would be better that thesaid aid will be given to those who are in dire need.
Sadly, this is not common to many capitalistic society. In
capitalistic society, people are driven by the idea of
accumulation of wealth and resources for themselves. It
is seldom that they will consider the needs of others.

and power right from the outset (Breewood, 2018). In
other words, she is not buying the idea that we need tohave economic growth first to solve the problem ofinequality. Since we are part of the whole economic
system, we might as well design an economic ordevelopment model that distribute income andopportunities right from the start. This is very
challenging because the reality of our society today isthat there is so much disparity between the rich and thepoor. Some even the buy the idea that the poor are poor
because they are lazy. While there is some truth in thisclaim and while there are stories of poor people who
become rich because they worked hard, there are also
evidences that prove that the poor are poor because they
have been deprived of opportunities to advance in life.
Social structures brought then to their miserable
conditions.
To be able to provide solution to the problem of
distributive justice, John Rawls insists on the idea of
arranging social structures in the society to benefit
everyone, especially the worst-off (Rawls, 1971). But
while Rawlsian society supports the promotion of public
goods and services, its primary concern is that ofprotecting individual welfare and does not adequately
consider the shared commitment of communities andcultures to protect and secure goods that are basicallycollective. Rawls’ Difference Principle can just be seen as
his way of telling the poor people not to cry because
there will be help coming from the rich but the truth ofthe matter is that, he is encouraging the rich to growricher. Amartya Sen also presents his concept ofdevelopment as freedom (Sen, 1992). Sen is concernedwith fair distribution of opportunities and capabilities
for the people to make their lives better. While this might
still be problematic in many societies, this might not thecase of the IPs. While there is inequality in power andinfluence in many tribal communities as the “datus”(chiefdoms) are the most influential in theircommunities, the people are having no difficulty in termsof distribution of benefits and burdens as they arepracticing a communal life.

4. Get savvy with systems
Raworth considers the economy as a complex andconstantly changing system in contrast to models whichview markets as simple, stable systems (Breewood,2018). Since economy is a complex system, there areother factors to consider in terms of economic growth.
One of these is the steady supply of resources in abalance and healthy ecosystem. But in old economic anddevelopment model, the health of ecosystem is notconsidered. It is a-well-accepted fact that the current
global economic system and the global corporations andbureaucracies that are its driving force, cannot be
successful in their development effort, and worse, cannot
survive without the steady supply of natural resources
such as forests, minerals, oil and natural gas, wildlife,
fresh water, arable land, among others, which areusually, if not always, present in the indigenous
communities. However, in an economic model which isonly based on exponential growth, all of these natural
resources are being rapidly depleted, so much so that its
depletion has already led to wars and other forms ofconflicts in many parts of the world and in many
indigenous communities (Mander and Tauli-Corpuz,
2004; Gaspar, 2011; Tauli-Corpus, 2008).
Indigenous peoples’ concept of development is basedon a holistic philosophy underpinned by the values ofreciprocity, solidarity, equilibrium and collectivity,
understanding that humans should live within the limitsof the natural world (Shiva, 2012; Gaspar, 2011).
Because they are so attached with and in fact, in a close
relationship with nature, indigenous peoples’ values,
cultures and traditions often entail a holistic andspiritually-based approach to wealth and well-being thatstress harmony with nature, self-governance with theircommunities, priority of community interests overindividual interests, security of land and resources,
cultural identity and dignity (Beek, 2000).

6. Create to regenerate
A study on local air and water pollution showed that, forsome countries, pollution increased as the country
started to climb out of poverty but then decreased as thecountry became even richer (Breewood, 2018).
However, Raworth (2017) shows that these findings
have been overgeneralized and misused to prioritize
growth over environmental protection – when, in fact,
more recent data show that material use is still growing
in rich countries. Thus, instead of using a business modelthat eats up resources and spits out waste, Raworth saysthat businesses need to take a more “circular” approach,turning waste back into valuable goods (Breewood,2018). Then, beyond simply reducing harm, businesses
can start asking what other benefits can they provide to
the communities around them.

5. Design to distribute
Raworth demolishes the influential notion that economic
growth is a pre-requisite to reducing wealth inequality
and insists that we need to intentionally design
economic systems that distribute income, wealth, time

7. Be agnostic about growth
Is economic growth necessary for human well-being?
Does economic growth necessarily harm the planet?
Raworth suggests, rather than aiming for a particularrate of growth, we should design an economy that

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
provides sustainable human welfare regardless ofwhether it is growing, staying the same or evenshrinking (Breewood, 2018). This might not be thetrajectory of state economies in the Post Covid-19 world.
Here, in the Philippines, there had been cases oftermination of employees and other cost-cutting
measures by many institutions especially in the private
sector in order to “survive”. Some institutions have been
observed to display blatant deception and irony when
they claimed that they do not have enough money tofinance the needs of their employees while
infrastructure and different construction works continue
to operate. In short, they focus on preparing theirestablishments for future economic growth even if in theprocess, they have to cut down salaries and benefits ofthe most important assets in the organization – humanresources.
The economy in different governments now is reallystruggling. In the Philippines, the government’s decision
to shift from enhanced community quarantine (ECQ) to
general community quarantine (GCQ) and modified
general community quarantine (MGCQ) was seen by
many analysts as the government’s effort to save thesagging economy of the country and not because thecountry is already safe from the virus. Despite theincreasing cases of Covid-19, some establishments are
now allowed to open, people go back to their work,
public transport gradually start to operate and liquor
ban is now lifted in some municipalities. All these to keep
the economy moving.
Challenges to Ecological Health in the Post Covid-19
But our main concern now is what will happen to theenvironment if industries are given the go signal to fully
operate after they had been in hiatus for three months?
The increased pressures on the earth’s resources mostly
in the rural areas are expected to persist until economies
rebound and governments are able to refocus onconservation. This means, we might go back to the false
impression that the protection of nature is a secondary
concern in any economic model even if it has alreadybeing proven that there is a correlation between
environmental destruction and disease outbreaks cause
by virus mutation from one species to the others and tohuman beings (Vidal, 2020, Diprose and Neal, 2020).
When will people heed the message of nature? Alongwith the many disasters that occurred such as typhoons,floods, extreme heat, forest fires, Covid-19 might also be
the nature’s messenger sending us important message –that if we will not take good care of Mother Earth, it will
result to human and economic loss.
This idea of taking care of Mother Earth is alreadypart of the life, philosophy and epistemology of theindigenous peoples. For example, among the Australianindigenous peoples, we can see different indigenous
quotes such as: “We call country the mother because as amother cares for her children so does the land care forus.”(Tyrone Bell in Pascoe, 2018), “We belong to the landbecause Mother Earth feeds us and births everything.”(Harrison, 2013: 97), “The spirits show themselves in therocks and trees in natural forms. These spirits come fromthe land the same as us. The spirit is in that rock, the spirit
is in that tree, because it is born from Mother Earth,
there’s no separation between us.” (Harrison, 2013: 121),327

and “The land is the mother and we are of the land; we do
not own the land rather the land owns us. The land is ourfood, our culture, our spirit and our identity.” (Foley, nd.)
The same concept is embraced by the indigenous
peoples here in the Philippines. My own fieldworks withthe different IP tribes and communities in Mindanao
revealed that their existence and the ecosystem are
inseparable, meaning, a symbiotic relationship between
them exists. A Tagkaolo elder said to me “for us, land is
our life and if you destroy our land, you destroy our life.”(Interview # 14, October 22, 2020). A Banwaon tribal
leader also shared to me that they have developed an
Ancestral Domain Protection Program (ADOPP) to
ensure security and protection of their lands, “With our
ADOPP, you can’t sell your land because you don’t own it,
you just given the right to safeguard it as stewards but you
cannot own it. Therefore, you cannot sell it. Our land is ourlife. Our land is like our Mother” (Interview # 1,
December 21, 2018). The same concept is shared with
the B’laan tribal leader, “our ancestral lands are our life.
That’ where we get all our food and medicine, bury ourdead and also perform our rituals. If they will destroy ourancestral lands and our forests, it’s like they reallywanting to kill us” (Interview # 2, March 31, 2019). Evenamong the IPs who became professional and has
experienced a modern way of life in the city, they still
consider their land as sacred. A Tagakaolo teacher said
to me, “environmental protection is very important for us
IPs because our life and our identity is inseparablyconnected with our environment. It is in our lands andmountains that we get our food and perform our rituals.
As a teacher, it is also very important for me to educate
the young people to love the environment because if ourenvironment is destroyed, it will be the end of us all”
(Interview # 4, October 21, 2019). Speaking of how theoutsiders who encroached in their territories havedestroyed not only their environment but also culture, A
Manobo tribal leader also shared to me, “First, they
destroy our environment. They did not show respect to thelands, trees and rivers. These are all sacred for us
Banwaons and Manobos. They came here without thecommunity’s approval. Second, because of their coming,
our culture was destroyed because they introduced a wayof life that is something new to us” (Interview # 6,
February 17, 2019). A Bagobo also shared to me hisfrustration with the government leaders in handlingtheir environmental concerns, “the only concern of thegovernment now is how to have money from the taxes sothey will always allow and even encourage corporations to
put up businesses here. They don’t care whether these
corporations will destroy the environment or the lives ofthe lumads here as along as these corporations will givethem money” (Interview # 9, March 23, 2019).
My interviews with the five indigenous tribes in
Mindanao, namely, the Tagakaolos, the B’laans, theBagobos, the Banwaons and the Manobos confirmed thein-depth study of Brother Karl Gaspar, a redemptorist
missionary brother and an anthropologist who is basedin Mindanao and who conducted in-depth studies among
the IPs especially among the Manobos in Arakan Valley,
North Cotabato, that indeed, for the IPs, their land istheir life and their existence is inseparablyinterconnected with their land (Gaspar, 2011). The

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

connection is like an umbilical cord that connects themother and the child.
But there is still a long way to go since capitalist
economies have been successful not only in waging war
against the earth but also against the original conceptionof the good life and their traditional and belief systems in
relation to their environment of many people. In
different IP communities, corporations and businessmen
and some of the ruling elites poisoned the minds of theIPs that modernity, urbanization and industrialization
will bring them so much happiness and comfort (Bayod,2020). As a result some of the IPs have facilitated or
supported the exploration of their mountains and rivers
to get the resources that will bring development to theircommunities.
Since companies cannot operate without approval
from the people, the National Commission for
Indigenous Peoples (NCIP) and some tribal leaders havefacilitated their smooth entry into indigenous territories
in exchange of lots of benefits and privileges. Because ofthis, some of the IPs started to abandon their values ofreciprocity and reverence to the earth as a living being
like a mother (Bayod, 2020). The death of Earth as aliving and nurturing mother in the minds of some IPs
have supported these companies in waging war against
their environment. After all, since the earth is now
treated as dead and lifeless object to be exploited, then,nothing is being killed (Shiva, 2016). The nurturing earth
image being embraced by the IPs since time immemorial
was considered by these companies and corporations asa cultural barrier on the exploitation of nature (Bayod,2020).
The mastery and domination framework created by
the modern science and technology removed thesecultural barriers to facilitate the exploitation of nature(Shiva, 2016). The war being waged by companies andcorporations against the spiritual and cultural values ofthese indigenous peoples started in removing thesecultural barriers and destroying their wholistic andsystemic concept of life to entice them value
accumulation of wealth to sustain their greed disguised
as the modern standard of living and good life (Shiva,2016). Hence, the destruction of nature to build modern
facilities and infrastructures to support the growing
economic demands of the society was justified on the
grounds that these are all for the “benefits” of the people
and the community (Bayod, 2020).
Learning from the doughnut economics
It is important to reflect now how to balanceenvironmental protection with social justice especially inthe aspect of redistribution of resources. While some
economists might argue that spending millions of money
to restore health of the ailing nature is detrimental to thepoor as the money can be used to uplift their standardsof living, I will argue that restoring the health of ecology
is necessary not only for economic sustainability but also
for human and societal well-being. When ecology ishealthy, the people experience peace and well-being. For
Shiva, recovering and protecting the commons such as
forest, rivers, mountains is vital to making peace withthe earth, maintaining peace within and between
communities (Shiva, 2016). Having an inner peace isprecondition for the attainment of well-being. When thepeople are healthy, they can continue to use their talents
and skills to improve societies.
Raworth (2017) has already pointed out the social
justice line in the inner circle of the doughnut which noone should fall, and the planetary destruction line in theouter circle of the doughnut which human impacts
should not rise. The social justice line includes foodsecurity, adequate income, clean water and goodsanitation, effective healthcare, access to education,
decent work, modern energy services, resilience toshocks, gender equality, social equity and a voice indemocratic politics. The destruction line or the planetary
boundary includes climate change, biodiversity loss,
nitrogen and phosphate use, ozone depletion, ocean
acidification, freshwater use, changes in land use,
particles in the atmosphere and chemical pollution(Rockstrom, et., 2009).
For Raworth (2017), the goal of development or
economic policies and programs should be to get insidethe doughnut which is the “safe and just space forhumanity” where every human has access to at least aminimum level of dignity and health without
jeopardizing ecological health. Good policy will raise up
social indicators into the doughnut without pushingecological indicators out of it, or vice versa while policy
will push one side at the expense of the other (Roberts,2012). Raworth suggests mechanism on how to achievethis. She notes, that in terms of food, meeting the calorie
needs of the 13% of the world’s population facing
hunger would only require just 1% of the current global
food supply. In terms of energy, bringing electricity to
the 19% of people who currently lack it could beachieved with less than a 1% increase in global CO2
emissions. Lastly, in terms of income distribution, shenotes that ending income poverty for the 21% of people
who live on less than $1.25 a day would only require just
0.2% of global income (Raworth, 2017). For many, this iseasier said than done. Certainly, this requires a retrievalor the basic fundamental human values of caring for one
another and caring for our common home. These values
were already practiced by the IPs since time
immemorial.
Conclusion
We have already enough framework to re-calibrate andre-tool our development of economic model. But what
we need now is a kind of “Metanoia”, a radical
conversion of mind and heart. Money and wealth will notnecessarily give us health and well-being. But healthy
ecology will surely give us not only human health but
also economic health. The Doughnut Economics ofRaworth already shows us how myopic the goals of themany economic models. They are only focused on
endless economic growth for gluttonous consumption ofindustries and people. But government leaders might
still be reluctant to question this paradigm of endlesseconomic growth especially in the post Covid-19 world.
Industries and business companies often assume that
their only mission is accumulation of capital and profit.
To reform the economic system, therefore, it might helpthat we will continue to question and challenge someassumptions as regards to economy, development andthe good life, and then, develop new paradigms that

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
focus on harmony and balance between ecological healthand economic health.
In Shiva’s “Making peace with Earth”, she said thatmanaging ecosystem must begin in our minds and it
involves changing our paradigms and worldviews fromthose based on war with nature to those that recognizethat we are all interconnected in one web of life (Shiva,2012). The Covid-19 pandemic has really revealed us
important lessons. The world will certainly betransformed after this pandemic. But our eyes should befocused on what will happen to our ecology andeconomy after this crisis. The word crisis, in Greek,“krisis” is not really something negative. In fact, it implies
decision making. Whatever decision-making process it is,
it might be good that it should come from collective
discernment. An important component in understanding
ecological and economic crisis are the decisions taken bystate leaders. State leaders must consider inputs not only
from the scientists and technocrats but also the local
people and other stakeholders in the crafting andimplementation of policies and programs.
In Kumar (2013) new trinity of “Soil, Soul, Society”, heuses three words to describe the interrelatedness,interconnectedness and interdependence of livingorganisms here on earth. In short, for Kumar, it is atrinity of wholeness and unity of life in its myriad forms.
Since we are all interconnected, it might be good that westart working together and not competing each other inour programs and projects to ensure ecological andeconomic health which is necessary for our well-being asa people and nation.
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Deaths without goodbyes: deprivation of
dignified death and objectification of deadbodies during COVID-19 pandemic in thePhilippines-Albert C. Albina, PhD
Negros Oriental State University, Philippines
Email: albertalbina@norsu.edu.phAbstract
Aside from the health, social, economic, and financial
damages brought about by the COVID-19 pandemic, oneof the most painful aspects of this phenomenon is thedeath of patients who succumbed to the coronavirus
disease without their loved ones having to at least view
their dead bodies and accord them the usual funeral andburial rites as dictated by tradition, culture, and religion.
I first outline the guidelines that comprise dignified
management of dead bodies from internationalorganizations, and the Philippine legal mandates
regarding the matter. I then argue that there isincongruence between the legal mandates and real
events regarding the dignified management of deadbodies of persons who died from COVID-19 in the
country as evidenced by some anecdotal accounts. As asubject and not an object, dead bodies of human beings
have inherent worth and value that should be respected;
their loved ones should not be deprived to have the lastview and say goodbye to COVID-19 victims' dead bodies.
Finally, I offer ways to improve the management of deadbodies in the country to ensure dignified death of COVID19 victims and offer loved ones the opportunity for adignified send-off, and pave way for better responses tofuture related crises.
Introduction
Aside from the health, social, economic, and financial
damages brought about by the COVID-19 pandemic, oneof the most painful aspects of this phenomenon is thedeath of patients who succumbed to the coronavirus
disease without their loved one having to at least view
their dead bodies and accord them the usual funeral andburial rites as dictated by tradition, culture, and religion.
As of June 24th, 2020, the COVID-19 pandemic hasrecorded an unprecedented death toll with 477,584
global deaths, and 1,186 deaths in the Philippines (Johns
Hopkins University).
Before the strict implementation of precautionary
measures to contain the spread of COVID-19 in thePhilippines, including the cancellation of mass
gatherings or public assemblies, the death of a person
usually means a reunion of family members, relatives,and friends. Funeral wakes and burials are both social
events. People who wish to condole with the bereaved
family would pay a visit to the house or funeral chapel
where the dead person is lying in state. In most cases,
several nights are spent to recite prayers for the eternal
repose of dead persons before they are finally buried.
However, with the coming in of COVID-19 pandemic,
everything related to how a dead person is honored has
totally changed, making it doubly painful on the part of
loved ones.

According to Channel News Asia (May 3rd, 2020):"Families of COVID-19 victims in the Philippines arebeing denied traditional death rites in favor of hurried,
impersonal cremations, with virus restrictions often
meaning they are forbidden a last look at their loved
ones. It is a painful and disorienting process for both thefamilies and crematory workers that has upended thePhilippines' intimate rituals of laying the dead to rest.
Burial is the norm in the Catholic-majority nation, and it
usually follows a days-long display of the embalmed
body at home or in a chapel."This issue becomes very disheartening on the part ofthe distraught loved ones of the person who died during
this COVID-19 pandemic. It undermines the dignity ofdead persons which is inherent not only when they arealive but carries with it even when they are dead. This is
the issue that I would like to argue and amplify in thispaper.
Social science studies on the COVID-19 pandemic
have tended to focus on the well-being of clinicians andpatients. Particularly in the Philippines, little to no
studies have focused on the impact of the pandemic ondeath, dying, and bereavement. Hence, this present study
addresses such a gap.
What comprises dignified management of deadbodies?
On March 24th 2020, the World Health Organization
published an interim guideline on Infection Prevention
and Control for the Safe Management of a Dead Body in
the Context of COVID-19. Many important points can be
drawn from this document including:o It is a common myth that persons who have died of acommunicable disease should be cremated.
Cremation is a matter of cultural choice and available
resources.
o To date, there is no evidence of persons having
become infected from exposure to the bodies of
persons who died from COVID-19.
o The dignity of the dead, their cultural and religious
traditions, and their families should be respected andprotected throughout.
o Hasty disposal of a dead from COVID-19 should be
avoided.
o Authorities should manage each situation on a caseby-case basis, balancing the rights of the family, theneed to investigate the cause of death, and the risksof exposure to infection.
o If the family wishes only to view the body and nottouch it, they may do so, using standard precautions
at all times including hand hygiene. Give the family
clear instructions not to touch or kiss the body.
o People who have died from COVID-19 can be buriedor cremated.
o Family and friends may view the body after it has
been prepared for burial, in accordance with customs.
Moreover, the Managing Infection Risks whenHandling the Deceased: Guidance for the Mortuary, Postmortem Room and Funeral Premises, and during
Exhumation (2018) released by the Health and Safety
Executive of United Kingdom recommends the following:Eubios Journal of Asian and International Bioethics 30(6) (August 2020)o Suitable waiting areas, including toilet facilities, and a
viewing room for families or friends wishing to viewthe deceased, should be provided.
o When families and others wish to view the deceased,
you should advise them whether there is a risk ofinfection if they touch or kiss the deceased, as well as
any controls they should take after contact, e.g.,
washing of hands.
o Certain infectious diseases will present a significant
risk, so you should inform the family about the risks
involved and provide them with PPE if appropriate.
o Alternatively, viewing could take place either at a
distance or by using a viewing panel in the coffin.
Another option is to use a viewing room with a glass
screen.
The Management of Dead Bodies after Disaster: A Field
Manual for First Responders (2016) jointly published by
the Pan American Health Organization (PAHO), World
Health Organization (WHO), International Committee of
the Red Cross (ICRC), and International Federation of
Red Cross and Red Crescent Societies recognizes theimportance of proper and dignified management of thedead in disasters, including even those who died from
infectious diseases. As such, "the proper management of
the dead also includes acknowledgment and assistanceto their bereaved families, friends, and communities."
This document details the following:o The dead and the bereaved should be respected at all
times.
o Honest and accurate information should be provided
at all times.
o A sympathetic and caring approach is owed to thefamilies throughout the process.
o Psychosocial support for families and relatives
should be considered.
o Cultural and religious needs should be borne in mind
throughout the process.
o Undignified handling and disposal of dead bodies
may further traumatize relatives and should be
avoided at all times. Careful and ethical managementof dead bodies, including disposal, should be ensured,
including respect for religious and cultural
sensitivities.
o Before starting any procedure, the family must be
prepared, with the burial process and all steps
explained, especially with regard to dignity andrespect for the deceased person. Once agreed andunderstood, the burial can be performed. No burial
process should take place until an agreement isobtained.
Philippine legal mandates on the management ofdead bodies
The Philippines, through the Department of Health,issued on February 3rd 2020 Department Memorandum
No. 2020-0067 which provides the Guidelines on the
Disposal and Shipment of the Remains of Confirmed Casesof 2019 Novel Coronavirus Acute Respiratory Disease(2019-nCoV ARD). This memorandum is further
reiterated in Department Memorandum No. 2020-0158
dated March 22nd 2020 which outlines the Proper
Handling of the Remains of Suspect, Probable, andConfirmed COVID-19 Cases.

331

Specifically, Department Memorandum No. 20200158 states, among other things, the following
guidelines:
o Always apply the principles of cultural sensitivity.
o Wakes or any form of public assemblies shall not beallowed.
o If the family of the patient wishes to view the bodyafter removal from the isolation room or area, they
may be allowed for as long as standard precautions
are strictly followed.
o The procedures for burial and cremation shall bedone within 12 hours after death. However, burial ofremains should be in accordance with the person's
religion and culturally-acceptable norms, to the mostextent possible (e.g., in Islamic rites, cremation isforbidden or "haram").
o Large gathering at the crematorium or burial groundshould be avoided.
o For those that will be buried, only adult members of
the family of the deceased may be permitted to attend
the funeral.
o For those that will be cremated, cremains shall be
reduced to the size of fine sand or ashes and packed
in a cremains container before they are turned overto the relatives of the deceased.
Also, the Department of the Interior and Local
Government of the Philippines issued Memorandum
Circular No. 2020-063 dated March 27th 2020 on theInterim Guidelines on the Management of Human Remains
for Patient under Investigation (PUI) and Confirmed
Coronavirus Disease 2019 (COVID-19) Cases. This
memorandum states, among others, that “viewing [ofhuman remains] in funeral parlors and hygienic
preparations [e.g., cleaning of the body, tidying of hair,trimming of nails, shaving, and embalming of theremains] are not allowed. Direct contact with the humanremains is not allowed”.
The rationale behind these legal mandates relative tothe management of human remains in times of COVID-19
pandemic is to prevent further transmission andinfection to others as long delays before burial andcremation may pose another risk to public health.
Except for one point that burial and cremation shallbe done within 12 hours after death, the overall legal
mandates in the Philippines regarding the managementof dead bodies during a pandemic are in consonancewith the universal and fundamental right to dignified
management of the dead bodies, and the right of families
to view the deceased for the last time. The said rights are
assured to be protected and observed through theaforementioned legal mandates.
Deprivation of dignified management of dead bodies
Truth to tell, actual situations on the ground appear tocontradict with what the legal mandates promise to
uphold. I then argue that there is incongruence between
the legal mandates and real events regarding themanagement of dead bodies of persons who died fromCOVID-19 in the Philippines as evidenced by some
anecdotal accounts.
Morgues, funeral parlors, and crematoria alike are
overwhelmed by the spike of COVID-19 fatalities whose
number goes beyond their capacity to handle. There is a

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Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

plethora of cases in the Philippines wherein loved onesof persons who died from COVID-19, and even those
non-COVID-19-related causes were deprived of even alast view of the latter’s dead body. This deprivation
among family members, relatives, and friends to have alast view of their loved one’s dead body is true not only
to COVID-19 victims but also to non-COVID-19-related
deaths.
One case is that of the father of Leandro Resureccion
IV. Aside from the acceptable protocol that he was notallowed to visit his father in the hospital while the latter
was confined due to COVID-19 infection, his family,
according to Channel News Asia: “wasn't able to say
goodbye could probably be the second most tragic thingthat happened after my dad's death. It makes the griefslower.”Another case is that of Mike Constantino's father who
succumbed to cancer. According to ABS-CBN News:"Nobody was allowed to accompany the cadaver, andnobody was allowed to be there for the cremation. It’s sadthat we couldn’t be there for dad during those moments.”
The same is true with Maricar Bautista’s father who
died of a heart illness during the COVID-19 pandemic.
Still, according to ABS-CBN News: "Not being able toembrace, kiss and even talk to our Dad makes it all themore difficult for the family. His passing has completely
left his family and relatives devastated and utterlyheartbroken. But we take comfort knowing that Daddy isin a much better place now reunited with our Creator, ourLord God Almighty.”
A similar case is that of Maximina Bautista’s husband
who had Parkinson’s disease and died due to stroke.
Maximina was not able to bid goodbye and see herhusband one last time before he was turned into ashes.
According to GMA News: “Wala na kaming magagawa
dahil sa sitwasyon ngayon ‘di na puwede ‘yong kwan kaya
noong isinalang siya, ‘di na namin nakita ‘yong mukha,
naka-zipper na ‘yong katawan tapos diretso na sa apoy.
Pero masakit talaga sa kalooban. (We have no choicebecause the situation right now prohibits [massgathering]. We were no longer able to see his face before
he was placed in the furnace. It is really painful.) Despite
not being infected, her husband was still immediately
cremated following the local government unit’s
ordinance, preventing burials.”
The aforementioned anecdotal cases of family
members and relatives deprived of having the last viewand say goodbye to their loved one's dead body are citedas risk factors that contribute to complicated grief(Burke & Neimeyer, 2013 as cited in Mayland, Harding,
Preston & Payne, 2020). Concomitantly, family members
and relatives themselves are “unable to directly support
each other through their grief” (Leong et al., 2004 as
cited in Mayland et al., 2020) because of certain
limitations brought about by lockdown measures.
Apparently, there are instances of hasty disposal of
COVID-19 and non-COVID-19 dead bodies throughimmediate cremation in the Philippines. It appears as if
there are no other options of disposing dead bodies
other than cremation when in fact, they can EITHER be
cremated OR buried (WHO, 2020; New Hampshire,
Division of Public Health Services, 2020) though withrestrictions on the number of attendees and strict
implementation of health and safety protocols.

Further, hasty disposal of a dead from COVID-19
outrightly violates the guideline set by WHO. In fact, theCenter for Disease Control and Prevention (CDC, 2020)
affirms that “there is currently no known risk associatedwith being in the same room at a funeral or visitation
service with the body of someone who died of COVID19.” Nevertheless, touching the body of those who diedfrom COVID-19 is strongly not advised.
Objectification of dead bodies
A human being is a subject, not an object. I would like toargue that this remains the case even until a humanbeing dies or when the body is already dead; hence, it
should not be treated as a mere object. As a subject,human beings have inherent worth and value that should
be respected. We never lose this worth and value themoment we die. The ethical issue comes in when deadpersons’ bodies are reduced to the level of an object orthing when hospitals immediately transport dead bodies
to crematoria, and crematoria would throw dead bodies
in the furnace without allowing their loved ones a brief
and private moment to say some prayers and partingwords. This objectification of dead bodies is notuncommon during this COVID-19 pandemic in thePhilippines.
The act of throwing human bodies in furnaces
without giving their loved ones the opportunity to view
them for the last time, either physically or at least
virtually, and say some prayers is a clear manifestationof objectification of human bodies or treating our bodies
as objects, and not as subjects with inherent worth andvalue.
End of life (EOL) care: technology-mediated family
support and farewells
Whenever possible, in consideration of available
personal protective equipment, close family members of
COVID-19 patients who are terminally ill and nearing
death should be provided the option and restricted
opportunity to physically visit their loved ones. This idea
is part of New Hampshire’s Department of Health andHuman Services, Division of Public Health Services,
Bureau of Infectious Disease Control in its document
titled End of Life Considerations for Persons with
Suspected or Confirmed COVID-19 (2020). The said
document recommends that “when a person with
COVID-19 has imminent death, facilities must have an
equitable policy regarding visits by close family
members, bereavement counselors, clergy.” It alsosuggests that “alternative mechanisms for interactions
such as video-call applications must be considered.” Thisidea on videoconferencing is aptly supported by Gauss etal. (2020) as one of the primary pragmatic lessons fromthe SARS-COV-2 pandemic from France.
One hospital in the Philippines (referring to Medical
City Ortigas) has a very laudable practice in dealing with
COVID-19 terminally ill patients and fatalities. In aninterview with GMA News, Dr. Sally Mae Abelanes,
Emergency Medicine Physician of the hospital
mentioned above, narrated that “because family
members are not allowed to visit their loved ones during
their last moments, doctors now take the extra mile to bewith their patients and pray for them. In the ICU, video
calls with family members are allowed. It is for them toEubios Journal of Asian and International Bioethics 30(6) (August 2020)
take one last look of their loved ones before they passaway. In the ER meanwhile, they let the family members
say their last words to patients who are dying through a
two-way radio or walkie talkie.”Moral imperatives
It is a moral imperative that hospitals where COVID-19
patients die to communicate with their loved ones andarrange for the safe final viewing of dead bodies before
they are cremated or buried. Besides, Philippine
guidelines permit "adult members of the family of thedeceased and other persons whose attendance isnecessary to attend the funeral and burial of the humanremains”. Even when dead human bodies will after all beturned into ashes through cremation or buried below theground, it is also morally and ethically imperative that
prayers from their immediate families and religious
leaders should be recited.
Conclusion
Family members of persons who died of COVID-19 havethe right to mourn and grieve over the latter’s physicalbody. This is a fundamental human right that we cannot
deprive anyone regardless of the situation. A person's
death happens only once; it is irreversible. Thoughgovernment laws duly recognize this fact and allow
family members to view their loved ones dead body
before it is cremated or buried as long as necessary
health precautions are strictly observed to pave the way
for a dignified send-off, actual situations on the groundshow the exact opposite of what the legal mandates
intend to uphold.
The following points may be considered to improvethe management of dead bodies in the Philippines toensure dignified death of COVID-19 and non-COVID-19
victims and offer loved ones the opportunity for adignified send-off, and pave way for better responses tofuture related crises as a whole.
o Periodic monitoring of the implementation of legal
mandates regarding the management of dead bodies
during a pandemic should be conducted to avoid
violations from occurring on the ground.
o During hospital confinement, hospital management
should provide the necessary technology to allow
COVID-19 patients and their loved ones to see eachother via teleconference, even before the former
becomes terminally ill and dies.
o Since public transportation is suspended duringcommunity quarantine, the government should
provide free transportation to bereaved families ingoing to and from the facility where their loved one
dies.
o A mourning tent should be set up in every hospitalwhere COVID-19 patients are admitted. This issimilar to what Mayland et al. (2020) mentioned intheir study. This mourning tent will allow family
members to "say a final goodbye" to the dead person.
o Hospital and health facility managements should
establish waiting areas or viewing rooms with a glass
screen for the family of those who died during apandemic to view the dead bodies of their loved ones.
o Making the head portion of the body bag transparent
may also be considered to allow bereaved people tosee their departed loved ones physically. Doing sowould make mourning and final goodbyes more333

personal and intimate rather than randomly seeing
dead bodies fully unidentifiable because of nontransparent body bags. Or, “viewing of the dead bodyby unzipping the face end of the body bag (by thestaff using standard precautions) may be allowed forthe relatives to see the body for one last time”(Government of India, Ministry of Health and Family
Welfare, 2020).
o Cultural, traditional, and religious rites related tofuneral and burial should not be absent. They may be
modified through the institutionalization oftechnology-based support services before and after
the patient's death.
o Training of hospital human resources on pre- andpost-bereavement support services to pave the way
for the provision of appropriate palliative care thataims to "improve the quality of life of patients andtheir families facing the problem associated with lifethreatening illness" (WHO).
References

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Mayland, C.R., Harding, A., Preston, N., & Payne, S. (2020).
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Fears and Hopes of Indigenous Students inSouthern
Mindanao
DuringCovid-19
Pandemic-Rogelio P. Bayod, Ph.D.
Cor Jesu College, the Philippinesroger.bayod@gmail.com-Jenny P. Morante
Department of Education (DepEd) Davao del Sur, thePhilippines
Email: jenny.morante001@deped.gov.ph
Abstract
The Covid-19 Pandemic is one of the greatest threats tothe education of children especially to poor countries
and communities. As countries imposed a lockdown andcommunity quarantine, schools were forced to close andshift instantly to on-line teaching and learning. In thePhilippines, while schools are given the permit tocontinue the education of students for the next school
year, the government insists that there will be no face-toface education as long as there is still an imminent
danger of virus transmission. As educators, we alreadyexperienced and witnessed how difficult for ourstudents, especially the poor and the indigenous peoples,
to cope with the different modalities of learning and thecountry to provide the needed support to students andteachers during this new educational set-up caused by
Covid-19 outbreak. This present paper focuses on theperception and experiences of indigenous students inSouthern Mindanao, Philippines in relation to Covid-19
pandemic and their fears and worries concerning theirlives and their education in the so-called new normal.
This paper will further offer practical suggestions togovernment and educational leaders on how to address
the educational needs of the students, especially theindigenous peoples.
Keywords: Indigenous students. Education in Covid-19.
New Normal. Philippines
Introduction
Covid-19 pandemic has changed many things in theworld. One of the industries that was put into a virtual
standstill is the education industry. As governments inmany countries imposed lockdown, schools were forced
to close over due to COVID-19 (Toquero, 2020; Viner,
Russell, Croker, Packer, Ward, Stansfield, & Booy 2020;
Reimers, Schleicher, 2020). However, to continue theeducation of students, some schools immediately shiftedto on-line and distant teaching and learning modalities(Toquero, 2020). Some teachers recorded and uploaded
their lessons online for the students to access and somewere even more innovative and used Google Classrooms,
WebQuest, and other online sites, but most were
unprepared (Fox, 2007). As educators in Mindanao, we
have witnessed how challenging this new educational
set-up is to many students especially the poor and thoseliving in the far-flung areas for lack of gadget andequipment for on-line classes and also internet
connectivity problem. The modular mode also provided
many challenges ranging from lack of transportation todifficulty in crossing from one town to the othersEubios Journal of Asian and International Bioethics 30(6) (August 2020)
because of security and health protocols implemented bydifferent local government units.
The intention of the paper is to explore the different
perceptions of indigenous students in Davao del Sur
about the Covid-19 pandemic and also their fears andworries in relation to their lives and also education. We
interviewed seven indigenous high school students andthree indigenous college students for this paper. Thesestudents are living in the far-flung areas of Davao delSur. We asked them the following questions: what are
their perceptions on Covid-19 pandemic? What did theircommunity do to avoid being infected by the virus?, what
are their worries and concerns as students?, and what
help do they want from the government? In this paper,
we want to share their experiences, fears and worries as
indigenous students.
Indigenous students’ perceptions on the origins andcauses of COVID-19 pandemic
We wanted to know about the perception of theindigenous students about the covid-19 pandemic. We
found out that, although all of them did not really know
the real cause of the virus as most of us do, most of themperceived that covid-19 was coming from China becauseof their behavior to eat exotic food. One of ourparticipants said, “sa akoa lang pud ni kay gikan sa
pagkaon sa Chinese kay bisan unsa lang pagkaon nila.”(This is only from my own point of view, it is comingfrom the Chinese people because they just eat anything).
Another participant said that, “kung mubasi ta sa balita
gikan jud ni siya sa mga kinaon sa tao, kung tan aw nila
makaon na, kaonon pud nila, wala sila nag tan aw sa
effects anang pagkaon nga ilang gikaon.” (If we based itwith news, it’s really coming from the food of the people
because they just eat what they see as can be eaten
without considering the effects of the food that they eat).
It’s interesting that some of them point out that theorigin of the virus was from exotic food that Chinese
people eat. Study of Bhagavathula, Aldhaleei, Rahmani,
Mahabadi, & Bandari, (2020) also shows that even twothirds of doctors and half of allied Healthcare Workers
believed that the origin of Covid-19 are from bats. Many
IPs also eat exotic foods such as snakes, wild pigs, deer
and others but they really cooked their food well. The
influence of the social media and the local news about
the behavior of some Chinese people as one of thepossible reasons of the Covid-19 outbreak has
penetrated into the consciousness of some IP students.
However, despite this influence, some IP students
also perceived that there might be other causes of thevirus aside from the eating behavior of the Chinese
people. One IP college student said, “ingon nila tungod
daw kay pataka lang ug kaon ug hayop ang mga taga
China pero sa akoa basin ug naa mensahe ang Ginoo kay
ang tao wala na nag atiman sa kinaiyahan” (They said
that it’s because Chinese people just eat indiscriminatelythat is why there is this virus but for me, I think God has
a message because the people do not already take care of
the environment). An IP high school students also said
that “gikan man daw sa China pero para sa akoa murag
challenge lang ni nga gihatag sa Ginoo tungod sa siyudad
daghan na og kahilayan ug wala nay time sa pamilya.
Karon nagpuyo na sa balay.” (Accordingly, it’s comingfrom China but for me this is just a challenge given by335

God because in the city there are plenty of debauchery or
vices and that people do not have time for their families.
Now they are forced to stay at home). This is also theperception of another IP college student when she said,“siguro tungod sa Chinese nga pataka ra ug kaon ug
hayop basin nasuko ang kinaiyahan sa ilaha” (Maybe it’s
because the Chinese people indiscriminately ate animals,
perhaps the nature got angry with them). This is also thethought of Romero – a Costa Rican IP leader when hesaid in an interview that the virus, he believes, wasunleashed by human greed and ill treatment of the planet(Nuwer, 2020).
What did their community do to avoid the virus
In many IP communities in the Philippines, especially inLuzon, they have imposed their own traditional concept
of community quarantine and lockdown called bydifferent local names such as tengao, te-er, to-or, sedey,
far-e, ubaya, or tungro depending on their ethnolinguistic groups, in order to spare their community fromthe virus ( Lapniten, 2020). We also wanted to knowwhat did their community in Davao del Sur do to avoid
the virus. We found out from their sharing that, they
have not done many traditional rituals already except
some meetings to discuss and agree on sharing andhelping each other. Most of the things they do to avoid
the virus are the usual things that all of us do likewearing mask, washing our hands and staying at home.
“Permentihon lang ang paghugas sa kamot. Dili mag
gawas-gawas sa balay” (We just wash regularly ourhands and we just refrain from always going out fromthe house), “Always lang jud mag wear ug mask” (Justwear mask always), “Sa amoa kay kanang bawal jud
mugawas sa amoang balay.…isa lang katao ang muadto,
pananglitan mamalit ug kanang grocery…” (For us it’sreally prohibited to go out from the house…only one
person will go out like to buy grocery). These are not
only common responses but these are mandated things
to do from the government. However, one Bagobo
college student shared, “naa mi ritual ug pag-ampo unyawala mi ginapagawas sa balay” (We have ritual andprayer and we are prohibited to go out from the house).
In addition, A Tagakaolo college student also said, “nagritual mi ug naa mi meeting unsa buhaton. Nagsabot mina isa ka tao lang jud mogawas sa balay. Sa among
komunidad, nagsabot pud mi ug nag tabangay kung kinsa
ang wala’y pagkaon ug wala’y masugo mamalit pagkaon
naa dayon motabang sa ilaha” (we have ritual and wehave meeting what to do. We agreed that there will only
be one person to go out from the house. In ourcommunity, we also agreed that we will help each other.
Whoever lacks food and those who do not have anybody
to buy food, there will be somebody who will help them).
Indeed, aside from the usual things that they do, some IP
communities also performed rituals and prayers andagreed to help each other to ensure that the virus will
not only get into their communities but also to each one
will have food to eat during the lockdown period. As ofthis writing, there are no IP communities here that got
infected with the virus. United Nations – Department of
Economic and Social Affairs (UN DESA) said that,Indigenous peoples are seeking their own solutions tothis pandemic. They are acting, and using traditional
knowledge and practices such as voluntary isolation, and336

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

sealing off their territories, as well as preventive
measures – in their own languages.
Worries and concerns of IP students in the time ofpandemic
As educators, we really wanted to know what are thefears and worries of the IP students in relation to theireducation during this time of pandemic. We found out
from their answers that they are not only worried about
their education but they are also worried about theirlives. In fact, a B’laan high school student said, “nagworry
ko if maka eskwela pa ba ko tungod kay naglisod naman
kaayo mi karon” (I am worried if I can still go to school
because we really suffer and are in dire need now).
Bacellisco, a Filipino parent strongly disagree on the
opening of classes, when she said, Education can wait.
I’m not risking the safety of children when they go out. I
fear that when they attend school, they will come home
infected with COVID-19 (Magsambol, 2020).
We also found out that their worries are also
connected not only to their intellectual capacities to copewith the new modalities of education being implemented
by the government but also to their financial capacities
to buy the needed gadgets and equipment to be able toparticipate in the on-line classes. A Bagobo college IP
student shared, “anang if mag on-line class kay wala man
koy laptop unya wala pud signal sa bukid” (If there is online class, I do not have laptop and there is also signal in
the mountain). A B’laan high school student also shared,“nagool ko if makaya ba nko ang on-line ug modular class
kay wala man mi internet ug wala pud ko laptop unyaniuli ko sa bukid lisod kaayo ang sakyanan ug mag cge
baba adto skul kuha sa module kay gasto pud kaayo” (Iam sad if I can endure the on-line and even modular
class because I do not have internet connection and I do
not also have laptop and because I went home in themountain, it’s very difficult to look for vehicle if I will
always go down to get the modules in the school and it’svery expensive). While online learning is only one option
for the blended approach, unfortunately data shows that
not all households in the Philippines have access to theinternet.
Citing
data
from
the
National
Telecommunications Commission, DepEd said that as ofDecember 2019, 67% of the Philippine population haveaccess to the internet (Magsambol, 2020). However, theCovid-19 pandemic really forces educational institutions
to look into different modes of delivery of lesson andlearning media. For Abdelhafiz, et al. (2020) knowledge
is gained mainly through novel media channels. Novel
channels including, social media platforms, and theinternet represented the most important sources of
information.
But for the IP students who are living in the far flungareas, on-line and even modular mode of education isstill very challenging for them because of lack of gadgets,equipment and internet connectivity. Their problems arereally connected to their economic conditions. Some ofthese IP students are student scholars and because there
are no more face-to-face classes, they are not alsoneeded. Thus, they are terminated from the scholarshipgrants in order for the schools especially, private schools
to also survive. UNESCO said that the lack of access totechnology or fast, reliable internet access can prevent
students in rural areas and from disadvantaged families.

Lack of access to technology or good internet
connectivity is an obstacle to continued learning,
specially for students from disadvantaged families.
The study of Bao, Qu, Zhang, Hogan, (2020) showsthat students gain slower during school closures than ina business-as-usual academic year. UNESCO said thatwhen schools close, parents are often asked to facilitate
the learning of children at home and can struggle toperform this task. In relation to this, it is found out thatthey also have fears and worries on how to cope with theacademic demands with the new educational set-up.
Many of them said that they even encountereddifficulties to understand the lessons during face-to-faceclasses, how much more during on-line or modular
classes where supervision of teachers would be minimal.
A B’laan college student shared his fear, “isa sa akong
gikabalak-an nga ako nag-eskwela sa college unya ang
among enrolment is karong July 15 na unya nabalaka ko
kay sa among subject kay second year na murag sugod na
og kalisod. Nabalaka ko nga dili mahatag sa eskwelahan
ang quality education nga dapat nila matudlo sa amoa
kay lage online unya dili mainsakto’g tudlo sa amoa. The
same atong summer class kay giagi rag online class, dinvideo, murag self-study ra gani. Lahi ra jud dili pareho sa
una nga face to face” (one thing I’m worried about as acollege student and our enrollment is already set thiscoming July 15, I’m worried because our subjects insecond year might start to be difficult to understand. I’mworried if the school can really give the quality
education that they should teach us because it is alreadyon-line and they might not give us the exact knowledge.
Just like last summer class because it was just done
though on-line, we only watched videos, it’s like selfstudy. It’s really different if we have face-to-face classes).
Another participant shared, “basig dili na matarong ang
klase ky wala kaayo signal diri din mag online naman gud
daw. Unya basig dili me kaapas sa klase sa among
maestro ky hinay man kaayo ang signal diri. Usahay
mobaba pa gani me aron makakua og signal..” (the classmight not be done well because we have problem herewith the signal because they said our class is already online. We might not be able to catch up with our classes
because the signal here is very weak. Sometime we wereforced to go down to get some signal). The same concern
is shared by another participant, “nabalaka nga mas walanuon koy masabtan dili man kafocus samot na kanang
wala koy connection unya kana bayang bukid namu
dirihinay kaayo ug signal” (I am worried that I might notunderstand the lesson well because I cannot focus
because of internet connection. Our location here in themountain has very weak signal). Baloran (2020)
commented that though the Philippines is still at thestage of embracing the paradigm shift in our pedagogicaldelivery, schools should start training students andteachers on the application of online-blended learning
approach and improve Information and Communication
Technology (ICT) resources and capacities of bothteachers and students. These could appease our learners
worries on teaching-learning process.
There worries and concerns about on-line education
are centered on the possibility that they cannot learn
well because they lack of gadget such as laptop and also
signal. Understandably, on-line education is new to many
schools in the Philippines. While there are schools,

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
mostly in the cities, that started on-line or distantlearning, they are very few and most of them are alreadyin higher education, not basic education. There are only
few students who enrolled in that program. But in many
schools, especially in the provinces, where most of thestudents are poor, the on-line and distant learning
schemes really bring a lot of challenges to students,
especially the poor and those living in far-flung
communities that do not have stable internet signal.
According to a study, school guidelines and practices toenhance teaching and learning using digital devices are
more often observed in socio-economically advantaged
schools than disadvantaged schools (Reimers, &Schleicher, 2020). Even some students who have gadgets
and are financially capable, they still have worries andconcerns with the new mode of delivery in education in
the country. Thus, an unwillingness with the onlineblended learning approach was observed (Baloran,2020). Even to some students who have gadgets like
cellphones and laptops, they also have difficulty inmaking use of their gadgets to participate in the on-line
education using different platforms such as moodle,
google meet, zoom, skype and others. Thus, skills
training on ICT is necessary not only for students but
also for teachers. Baloran (2020) suggests that the
government should have subsidy and educational
support that include capacitating Filipino learners inusing online tools. Fox (2007) added that an ongoing
technical support to help train the teachers also is
important. In addition, the students need also to be
inducted into the use of ICTs in order to optimize thepotential of their learning experiences in this mode andtheir efficiency in using it.
What help IP students want from the government
Despite their worries and concerns, many IP students
really wanted to continue their studies. Thus, they
continue to hope and wish that the government will
support them in their education by giving them thegadgets that they need such as laptops and others. A
Bagobo college student said, “unta naa wifi ug laptop
ipang provide sa students” (I hope wifi connection andlaptop will be provided to students). This is being echoedby a Tagkaolo college students when she said, “unta naa
free internet access to Barangays and if possible, support
in buying laptops” (I hope there will be free internet
access to villages and if possible, they will give support
in buying laptops). A B’laan high school student also said,“unta naa free laptop ug unta naa internet sa among
lugar” (I hope there will be free laptop and there will beinternet access in our place).
Some of them even went beyond the concrete needs
to have gadgets needed in the on-line education to
support about their entire economic situation. A B’laanhigh school student said, “amoang gusto unta kay sa
amoang mga ginikanan man gud kay maglisod na sila ug
trabaho karun kay samot na nga naay virus. Mao nga
unta kana need namo sa amoang pag skwela ug kanang
pagkaon pud namo” (we hope and we want that they will
help us in our needs in school and also in our foodbecause our parents have difficulty looking for jobs now
because of the virus). Another B’laan high school student
also said, “Kanang financial jud. Kanang naa silay pareha
gud anang sa SAP.” (It’s really financial. I hope they havelike SAP).

337

While on-line and modular classes are not really thenormal mode of delivery of education in many schools in
the Philippines, Covid-19 pandemic has forced them toembrace this mode of delivery as the “new normal”.
Aside from the fact that schools need students tocontinue their jobs, students also wanted to continue
their studies in this “new normal”. Since education of theyoung is needed for the future of the country, thegovernment must continue to provide support to theeducation sector. This will be a challenging time for thegovernment considering the huge budget they havealready spent to subsidized the poor during theimposition of lockdowns or Enhanced Community
Quarantine (ECQ). Leadership skills of politicians andeven educational leaders in this time of pandemic istested. Some local government units in the capital have
responded to the challenges of providing gadgets(laptops, cellphones, wifi) to their students and teachers(Hallare, 2020; Ornedo, 2020; Malipot, 2020). Others arestill thinking how to do it given their budgetary
constraints. Reimers & Schleicher (2020) suggest thatthe government can also ask for partnerships with theprivate sector to extend their resources and otheropportunities for on-line education, seminars andtraining. In fact, DepEd Under Secretary Alain Pascua hasrecommended minimum specifications for laptops,
desktops, tablet PCs, tablets, smartphones, and internet
services that will be donated to public schools, teachers,
and/or students (Malipot, 2020).
Conclusion
The Covid-19 pandemic has drastically changed theeducational landscape of the Philippines. The mostvulnerable groups that are affected because of thesechanges are the poor students and those living in the
peripheries such as the indigenous peoples. While IPcommunities here in Davao del Sur are still free of Covid19, the possibility of local transmission is very real whenschools will open and teachers from the lowland
communities will come up the mountains to teach the IP
students. Strictly speaking, since there are still noschools for the indigenous peoples (IPs) that haveteachers who are really IPs living in the communities
and implement a strict curriculum for the IPs like thecommunity schools where ran and managed by the NonGovernment Organizations (NGOs), IPs were reallyforced to enroll into the mainstream schools that
implement a standardized curriculum under thesupervision of the Department of Education (DepEd).
During this time when the DepEd was forced to
implement on-line and/or modular education, the IP
students have to endure the challenges and difficulties ofthis new mode of education in the country.
To be able to help them, it might be good thatgovernment and educational leaders will listen to theirstruggles and dialogue with them on how to address
their worries and concerns. If they cannot be provided
with cellphones and laptops as well as internet
connection, the schools might assign teachers to reallygo to the communities to bring the modules and course
pack. The module or course pack must containeverything that the students need to know such as
readings materials, examples on the expected output ofstudents and the detailed instructions on what to do.

338

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

The school authorities, in partnerships with local
leaders must also explore other means of reaching thestudents in the far-flung communities like using local
radio stations where teachers will discuss their lessons
either once or twice a week so that students in themountain can still listen to them. The local leaders mightalso consider putting up a mini-library or education
center in the locality where students can get the modules
or course pack from their teachers and can also meet theteachers for short individual or small group orientation
or discussion on important and difficult topics orassignments.
The Covid-19 pandemic as a crisis entails important
decision making from school and government
authorities. Decisions have to be made in consultationand considerations of those that will be highly affected.
In times of crisis, people are called to offer sacrifices.
While the teachers, school and government leaders haveto show examples of walking the extra mile to be able toreach those at the margins of society, the people in the
peripheries also need to offer sacrifices if they want tocontinue with their education. The IPs have beensacrificing a lot. They are still willing to do another formof sacrifice for them to continue their studies. Since
online or distant learning might be the future directionsof many schools in the Philippines, government leaders
might consider building the needed infrastructure andother means of support as early as now.
References

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Alorabi, M., Ayyad, M., & Sultan, E. A. (2020). Knowledge,
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Baloran, E. T. (2020). Knowledge, Attitudes, Anxiety, andCoping Strategies of Students during COVID-19 Pandemic.
Journal of Loss and Trauma, 1-8. Retrieved June 19, 2020
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Bhagavathula, A. S., Aldhaleei, W. A., Rahmani, J., Mahabadi, M.
A., & Bandari, D. K. (2020). Novel coronavirus (COVID-19)
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Bao, Xue; Qu, Hang; Zhang, Ruixiong; Hogan, Tiffany P. (202005-13). "Literacy Loss in Kindergarten Children during
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Fox, R. (2007). SARS epidemic: Teachers’ experiences using
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Nuwer, Rachel. (2020, May 4). The Indigenous Communities
That Predicted Covid-19. BBC Travel Retrieved last July 1,2020 from http://www.bbc.com/travel/story/20200503the-indigenous-communities-that-predicted-covid-19
Ornedo, Julia Mari. (2020, June 10) Binan LGU distributes
Laptops, TVs to schools for online learning. GMA News.
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Reimers, F. M., & Schleicher, A. (2020). A framework to guidean education response to the COVID-19 Pandemic of 2020.
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https://www.pedagogicalresearch.com/download/challenges-and-opportunities-for-higher-education-amid-the-covid19-pandemic-the-philippine-context-7947.pdf
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Child & Adolescent Health.

Couple educators’ mission during COVID-19
pandemic: ensuring a meaningful andrelevant learning for students while staying
at home-Christine May D. Bayod
Department of Education (DepEd) Sarangani Province,
the Philippines
Email: cmdbayod@gmail.com-Rogelio P. BayodCor Jesu College, the Philippines
Email: roger.bayod@gmail.com
Abstract
The educational situation of the Philippines, for thecurrent school year (SY 2019-2020), has changed
because of COVID-19 pandemic. As a result, thePhilippines became one of the countries worldwide thathas suspended their classes. As couple educators, this
scenario forced us to a deep reflection on how to ensurethat education of children will not be hampered evenwhen they are forced to stay at home. Since online
education is already practiced in many countries, wethought that it might be best to explore on this possiblemode of education. We designed an assisted learning
instruction where learners are given opportunities tolearn using the available new learning platforms. It
started with a simple call through an advertisement
posted on Facebook where eighteen (18) children
participated in this free-online tutorial program. This is a

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
five-week e-learning program utilizing the Google tools
such as Google Classroom and Google Meet. Specifictasks and activities are provided where learners are
expected to complete by the end of the week with thehelp and guidance from their parents or guardians. This
paper discusses the assessment on the strengths andweaknesses of this program as reported by the parentsof our students. Results confirmed that the transition oflearning to online education became helpful andbeneficial where gained experiences can be used in the
future. This paper also presents important and practical
inputs to teachers and educational heads for policy andprogram making in the education of students in the socalled new normal.
Introduction
The Covid-19 pandemic has threatened the educationalsituations of schools around the globe. Various
institutions were forced to suspend and postpone classes
due to rapid spread of virus which can badly affect the
security and health of every school-community member.
Because of this, alternative and flexible mechanisms tocontinue learning and studying are being promoted indifferent nations.
Audrey Azoulay, Director General of the United
Nations
Educational,
Scientific,
andCultural
Organization, said in a recent statement (“Coronavirus
Update,” 2020), “While temporary school closures as aresult of health and other crises are not new,unfortunately, the global scale and speed of the current
educational disruption is unparalleled and, if prolonged,
could threaten the right to education” (Vlachopoulos, D.,2020).
To address this emerging problem, governments
across the globe have considered virtual learning,
through online education, as one of the learningmodalities to ensure continuity of learning. According toBasilaia and Kvavadze (2020), considering online
education as alternative from traditional way of learning
is one of the answers to the rising problem wherestudents are not allowed to go to school. Moreover,Vlachopoulos (2020) mentioned in his study that theCovid-19 crisis has provided opportunities for many
online education researchers and practitioners to
support both students and institutions by filling the gap
left by the conventional face-to-face education. Throughthis new normal way of learning, educators and students
can still continue teaching and learning from any
location without interruption.
In the Philippines, where nationwide case of Covid 19
positive reached 27,799 as of June 19, 2020, theDepartment of Education provides opportunities forschools to choose the appropriate learning modalities forthe opening of the new school year. Under the Learning
Continuity Plan of the Department of Education (DepEd),
the distance learning, which is delivered through online
platforms is being considered as one of the learningmodalities to ensure the continued delivery of learning(Malipot, 2020). Furthermore, in a survey conducted by
the DepEd, 80 percent or 700,000 of the teachers havelaptops and desktops in their homes. Given this data, theDepEd is optimistic and confident that distant online
learning will work in the Philippines (Uy, 2020).

339

As educators in Mindanao, we have witnessed how
anxious and worried are the students and parents about
the so-called new normal way of learning, mostespecially that we are not used to this distant online
learning. Though resources, such as gadgets and internet
connectivity are present, parents and students haveproblems on how to effectively and meaningfully use
online learning platforms since our local schools areoriented with the conventional face-to-face learning.
With the given situations, we pilot tested an online
tutorial program to assess the readiness of our local
communities in embracing this online learning modality.
Intervention
In one of the webinars we attended during the peak ofthis pandemic season, we were able to explore andnavigate the use of Google Classroom as one of the online
learning platforms in this so-called new normal way oflearning. After completing the session, we were able torealize how meaningful and helpful could this be if ourstudents are given the chance to explore and navigate
this medium. Moreover, it gave us much excitement andenthusiasm to share this platform, since our students oftoday are already exposed to technology. They can spend
much time using the social media and other online sites
for gaming and entertainment. However, they lack
opportunities on how to use it in their educational
endeavors.
How it all started?
The Online Tutorial Program started through a simple
advertisement posted on Facebook where we werelooking for at least five (5) potential tutees to enrol in
our Google Classroom. After several days, many parents
extended their intention to enrol their kids in the
program so they can spend their stay-at-homeproductively. From five (5) students, it has reachedeighteen (18) students who shown willingness to
explore the distant online learning platform.
After days of planning, we launched the “Learningwith Teacher Tine” on May 18, 2020. This is a five-weekonline tutorial program advocating an assisted learning
instruction, where parent’s involvement is primarily
needed. The interested enrollees were asked to prepare
the necessary tools so they can participate in this newlearning approach. These tools are as follows:
smartphones or personal computers, internet
connectivity, Google Classroom Application, Google Meet
Application, registering in BookWidgets, Quizziz and
Nearpod. Moreover, it was strongly suggested thatparents, guardians, elder siblings or any available
learning partners should be present and help theenrollees in navigating, exploring and completing tasks
and activities in this new learning approach.
After acquiring, downloading and registering thenecessary tools to be used in this approach, students
were instructed to join the class in the e-classroom using
their respective class codes. Furthermore, this Online
Tutorial Program offers four (4) classes depending on
the appropriate learning needs and interests of thestudent. The courses offered in every class are listed on
the table below.

340
SectionLittle Sunshine(ages 4 to 5,
Preschool)
Blue Sky(ages 6-7 orGrade 1 & Grade2)
Bright Future(ages 8-9 orGrade 3 & 4)
Silver Lining(ages 10-11 orGrade 5 & 6)

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
Class Codefbofdcj
olt4ghyr4cdad3
7fvkhee

Courses Offered
Literacy (Reading &Writing), Numeracy,
Science and Arts
English (Reading &Writing),Math, Science and Arts

Figure 1 below records the important dates
parents should consider in the delivery of thisonline learning approach.

English (Reading &Writing),Math, Science and Arts
English (Reading &Writing),Math, Science and Arts

Table 1. Courses offered with their respective classname and code
Our roles as e-educators
We played the roles as the Class Managers and Learning
Facilitators of this Online Tutorial Program. Every week,
we gathered necessary learning materials aligned withthe basic competencies appropriate for the specific age
and needs of the students. These materials included
readings, non-graded exercises, assignments, videos, andelectronic charts. By the end of the week, a gradedsummative assessment is provided in every course toassess the learning performance of every tutee enrolled
in this program. Furthermore, parents were encouraged
to take photos and videos of their daily accomplishments
to record their outputs.
The program promotes flexible learning
Since this is an assisted learning approach, parents orlearning partners play significant roles to guide theirchildren in completing the activities offered in eachcourse. We took collaborative partnership with theparents or learning partners in delivering meaningful
and significant learning experiences for every child.
To make it more comprehensive a weekly schedule
was developed to guide the parents on how toaccomplish each task. And, these are as follows:
1) Monday: We, as class managers, we posted materials,
such as videos and non-graded exercises every
Monday. The child may complete these materials from
Monday-Thursday. Parents or learning partners wereencouraged to assist their children to manage theirtime effectively. They were instructed to render at
least 30 minutes or an hour daily to complete each
topic. They can consider having English on Monday,
Math on Tuesday, Science on Wednesday and Arts on
Friday, depending on their most desired andconvenient time. Furthermore, we highly suggested
not to finish all the topics within the day so it will notcause exhaustion on the part of the child.
2) Friday: We regularly provided Graded Summative
Assessment on this day. Since this is a graded activity,
we had set due date for submission of their outputs.
3) Every other Wednesday, each student was
encouraged to participate in an hour Live Learning
Session using the Google Meet. This is done sostudents can have time for socialization or
Kumustahan (in our local language) with their eclassmates. We also provided practice and reading
test during this meeting.

Figure 1. Online Tutorial Program Class Schedule
Reward system
Every end of the week, we awarded badges for students
who completed all the tasks and activities provided forthem. This is a simple motivation which inspired thestudents to take active participation in the Online
Tutorial Program. Completion e-certificates are also
provided for all students who completed the Week 5
courses. Meanwhile, for those who have not successfully
reached the week 5 due to some constraints, a certificate
of participation was also provided.
Results
This section of the paper discusses the assessment on
the strengths and weakness of the Online Tutorial
Program as reported by the students and parents. We
asked our clients, especially the parents the following
questions: What can you say about the program? Was it
helpful? Why?; What do you like most?; What do you likeleast?; and What can you suggest or recommend for future
online classes?.
What parents and their children say about the
programWhen asked what can they say about the program, mostof their responses fall into the following themes: learning
is facilitated while family bonding is enhanced, Learning is
fun and ignites students’ interests, and it promotes
independent learning.”
Learning is facilitated while family bonding isenhanced. The parents say that the program ensuresthat learning is still present while they are staying at
home. This is beautifully captured by a mother of ourstudent who is a public school teacher, when she says
“virtual schools work better when parents take an activerole in their child’s learning. We have to look at theconfluence of “relationships” within the household, and,thus, these relationships must ensure children’s learning isfacilitated for a better tomorrow.” Another parent who
works as a clerk in a private hospital also says, “theprogram is good because it promotes bonding withparents and children. Parents really give time to theirchildren to learn and in the process, bonding is alsoenhanced”. As educators, we find it interesting and alsoaffirming that our parents were able to highlight theEubios Journal of Asian and International Bioethics 30(6) (August 2020)
importance of parents’ support, especially, in the form ofestablishing good relationship with their children, while
the latter continue their educational journey and facedifferent educational opportunities and challenges. Thisis supported by Elias (2006) who stressed out that whatbuilt on caring relationships between a child and parents
are effective, lasting academic learning and socioemotional learning. Thus, parents take a big
responsibility to support their children in terms oflearning and acquiring new things and skills. Moreover,Landry (2014) mentioned that parent’s specificresponsiveness behaviors best supports a child’s
learning.
Learning is fun and ignites students’ interests. The
parents also shared during our interview with them thatthe program ignites interests of their children and that,
their children is having fun while learning. Anotherparent who is also a public school teacher says, “theprogram is convenient and interesting especially on the part ofthe learner, as what I have observed with my son since he isvery curious about the things he wanted to learn, through thisprogram it boosts more the interest of the learners with thevideo lessons, colorful illustration and quizzes games with thetimer and rank scores. It is a big help also to the learners not to
expose or being addict on online games but to learn something
new and taught them to be responsible in doing their weekly
assigned task.” The same observation is shared by anotherparent who is a high school teacher, “the program was
helpful…it promotes fun in teaching kids new lessons.”
Another parent also says, “I like so much the process
because it has many different subjects and during quizzes,
it seems like students are just playing.” Indeed, manyeducational theorists say that learning is best facilitatedin an environment of fun and enjoyment while students
explore and satisfy their curiosity to learn. Furthermore,the “fun-value” in learning has a positive effect on thelevel of motivation, recognizing what we learn and how
much of which we do retain. After all, learning isn’t aone-off event, instead it requires repetition anddedication. If a learner experiences fun along with thelearning processes, then he will stay curious and keep
coming
back
for
more:
https://www.growthengineering.co.uk/why-fun-inlearning-is-important/.
It promotes independent learning. With our free online tutorial program, the parents said that they haveobserved their children being responsible in keeping
track with their lessons and assignments. A parent who
works as a Covid-19 frontliner says, “the program hashelped my boy a lot to keep track and continue learning.”
Another parent also says, “the program that you delivered
to my child is meaningful and can boost her independent
learning.” One parent also says, “the program is helpful
because through the daily given activities she (herdaughter) is eager to do it independently.” Indeed, one of
the best features of on-line learning is really thepromotion of self-autonomy and personal responsibility
among the students. Since learning is not situated in arigid classroom structure, on-line learning promotes not
only independent learning but also sense of maturity
among the students. In their paper, “Online Learning”,
Dhull and Saskhi (2016) mentioned some opportunities

341

brought by online education which promotes
independent learning. Through online learning, students
are able to work and learn at their own pace without thetime restriction. Moreover, they added that this platform
allows a learner to complete his course work according
to his own will where he can take much time as herequires without being termed as slow by his peers.
Thus, this makes self-directed learning as the newmantra for better and meaningful learning.
Was the Program Helpful?
We also asked them if they find the program helpful andwhat they like most about the program. There answers
to these questions can be clustered to the following
themes: Meaningful and relevant time while staying athome, Interactive and Engaging Learning and A Pre-Tasteof the New Normal.
Meaningful and relevant time while staying at home.
For most of our parents, they find the program very
helpful in ensuring that meaningful and relevant
learning will continue to happen while they are staying
at home during the enhanced community quarantine or
lockdown period. In fact, one parent says, “Yes, theprogram is very helpful because instead of just using theirgadget without meaning, my child has used her time inlearning and exploring new ideas while at home.” This isalso supported by one parent, saying, “it is helpful to ourkids because they learned new ideas while at home.”
Another parent also says, “yes, it is very helpful especially
nowadays that we are experiencing this kind of pandemic,
it allows the learners to stay at home and keep them safe.
It gives also a chance to the learners to explore more andlearn something new from the varied activities given by
the teacher.” One parent, teacher herself, even provided
with plenty of explanations why she found the program
helpful and relevant nowadays, “yes, the program is
helpful since it helps the child to be an active learner andmore independent as well. It also helps in boosting theirconfidence, since a lot of kids, if not all, are very shy fromasking questions in the normal class setting. With online
learning programs, this concern is taken care of. The
platform comes with a certain level on anonymity, thus
creating a safety net for kids. Being a mother of online
learners, I believe, online learning program is of great help
in building the child’s confidence.”
Children’s education needs to continue even when
they are forced to stay at home because of different
public emergency situations. The use of on-line learningmodality is helpful not only to ensure that students willcontinue to learn but also to develop their other skills
which are very much needed in the 21st century
educational landscape such as the proper and matureuse of information and communication technology andalso critical thinking. Garcia, Roy and Alotebi (2015)
contend that blended learning, through the use oftechnology (in online settings) and inter-personal
interactions (in face-to-face settings), enables thedevelopment of critical thinking skills. Therefore, theeffective use of this blended learning does not merely
help to enhance the critical thinking skills but also helps
to prepare the students for the demands of the 21st
century work-force. In addition, De Abreau (2010)
recognizes media literacy can help enhance students’342

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

critical thinking skills, which are thereby of great value
in a globalized and technologically challenging 21st
century. Therefore, there is a significant interplay oftechnology in educating and developing the criticalthinking skills of the students.
Interactive and Engaging Learning. Earlier in thispaper, we already shared that parents found theprogram to ignite the interests of their children because
it promotes an atmosphere of fun. During the course of
our interview, they even qualified their answers bysaying that the program is helpful because it isinteractive and engaging. In fact, one parents says “Ireally like the program and its processes because it has
different topics and activities. Quizzes are also introduced
like a game that is why my children were so engaged anddid not lose their interests. The topics are also advancethat can challenge the students. I rate the program as
10/10.” Another parent also says, “yes, the program isvery helpful because the children learn to interact with
their teachers and classmates using their gadget. It’s likethey are just playing but they learned a lot of new things.
They can also get ideas on how to use their gadget to
explore more in order to have much deeper learning.” Thisis also attested by another parent when she says, “what I
really like about the program is that it has simplified acomplex topic and it introduces a simple way on how thestudents can learn a difficult subject while they are juststaying at home. The parents can also monitor theirchildren and the learning is very advanced because thestudents can do research on the topics in advance.”
According to Lim (2014), the rise of online learning
environment provides a wide range of opportunities forlearners to become more engaged and take control overtheir learning process. In fact during the course of thisOnline Tutorial Program, we, as class managers, had agreat time in preparing and ensuring that activities andmaterials provided for our students are delivered in aninteractive and engaging ways. To make this realized, we
tried exploring the online world by looking forinteractive sites such as Quzziz, BookWidgets and
Nearpod, where exercises and activities are provided
through gamification or game playing.
A pre-taste of the new normal. For most of our parents,
they said that our program is a pre-taste of the newnormal. They are already aware that in the incoming
school year, there will be major shift in the mode ofdelivery of teaching to their children. It will be a
combination of on-line and modular learning methods
depending on their capacity and competency to avail ofsuch methods. Thus, for them, the program that we
introduced to their children is already a pre-taste ofwhat will happen in the next school year. According to
one of our participants, “using platforms like this willpractice the students come a new learning modality will
be used in the new school year.” Another parent says,“what I like most is that, it provides more flexible scheduleand environment. This on-line learning that will be
introduced in the next school year, has also advantages on
the part of the learner as he/she has given a chance toresearch more regarding the topics or assignment
assigned by the teacher. This program has alreadyprepared our students. But, be sure to have strong internet

connection also in the area to be able to access the giventask by the teacher.”Indeed, that is our intention of creating the program.
We wanted to pilot-test it to different learners who havesignified their intentions to avail of our free on-line
tutorial program.
What they like least about the Program?
We also wanted to know what they like least about the
program so we can revise and innovate something. Asidefrom the expected internet connectivity problem inmany places in the country, our parents’ answers are
centered on one theme: Needs time and guidance fromparents. This is beautifully captured by one of ourparents in her answer, “aside from the fact that the
program really requires good internet connection because
e-learning is only made possible and effective in theinternet connection is good, it also requires time
management not only for the kids but also the parents….
for working parents like me, we really need to exert more
effort and spare their precious time amidst their busy
schedules to guide their children during on-line classes.”
Another parent also says, “learning online really needs
guidance and time both children and parents.” A mother
who also works as a front-liner during the Covid-19
pandemic, also says that what she liked least about the
program is her lack of time to supervise her child. “whatI like least is our time together because it’s limited due tomy work structure. We have a rule in the house that kids
could stay up only until 9pm. Prior to that time, chores andprayers should be done. I hope I can improve my scheduletoo.”
We find it interesting as well as intriguing that a lot of
parents consider giving their time to monitor andsupervise the education of their children seemed
difficult. We understand that most of parents areworking parents even during pandemic as many of them
are also teachers like us. This might be the reason thatmost parents wanted to have face-to-face classes
because they can just send their children to schools andlet the teachers handle their children. But during
pandemic, they also did not go to school and attend to
the needs of their students. They just stayed at home.
While they have works to do as directed by their bosses
and employers, certainly, they have time (if they reallychoose to) for their children. Indeed, many of them said
that what they like about the program is that, theirchildren can still continue to learn and they alsoenhanced their bonding. But we find it intriguing why
they consider it “least” when they have to really spend
time to monitor and supervise their children whilelearning at home. In fact, instead of two live learning
session via google meet as planned, we only met themonce because the parents were so busy that they could
not assist their kids.
There is also one parent who says that what she likeleast about our program is that “some of the questions
were repeated in the game.” Indeed, she is right, we also
found out that there are questions that were repeated in
the games. This parent really supervises the learning
activity of her child.
There is another parent who says that what she likes
least about the program is that, “this isn't quite the sameas the social interaction with other pupils in a physicalEubios Journal of Asian and International Bioethics 30(6) (August 2020)
classroom setting. Sometimes, I believe that, some pupils
simply learn better in a collaborative setting than they doon their own. Factors affecting with this program if theparents cannot afford loads for Wi-Fi to have internet
connection at home, and considering also the area where
the internet connection is very poor.” Aside from internet
connectivity problem, this parent still believes that faceto-face learning is still better as compared to pure online classes.
Parents’ recommendations and suggestions
When we asked what are their suggestions or
recommendations for the government, the school
authorities and teachers as well as the community ingeneral in relation to the future educational set-up of thePhilippines. We clustered their answers according to thefollowing themes: school authorities and teachers should
be resourceful, parents should have time to guide theirchildren, and it should be blended learning.
School authorities and teachers should be resourceful.
Since many our parents are also teachers, they might
have been very aware already of the pressing issues
today in relation to the proposed on-line platform in
education, such as, students lack the gadget andequipment and lack of internet connection and cellphonesignals. That is why one parent, who is a public school
teacher assigned in a far-flung area of Sarangani
province, says, “let’s expose learners to new opportunities
that are missing in schools, in order to motivate themmore and engage this kind of modality…As teachers, wewill think of strategies to help learners find their passions,talents, and interests. We will help also the learners to
expose and connect them to others who love what they
love. Of course, as public teachers we all knew thatmajority of our learners cannot afford to have internet
connection at home, all we need to do, is to find sponsors
and link to NGO’s and other government/private sectors toprovide our learners for Wi-Fi and loads as we face the socalled “New Normal.” Another parent who is also ateacher says, “teacher-facilitator should be competent indesigning and presenting his/her lesson according to thelearners’ needs and interest. They should beknowledgeable enough in using any platforms to deliver
the lessons effectively. School should also conduct “Parents
Orientation” program to forge effective communication
with parents.”
Interestingly, there is only one parent who says thatteachers should link to government to provide wifi andloads to students. The rest did not mention it. There aremany layers to interpret why majority of them did notsuggest to recommend that schools should pressure thegovernment to provide the needed infrastructure
support for education during this pandemic. For one, we
can just surmise that teachers have already seen theeffort of the government to really help the people during
this time of pandemic. Another layer of interpretation isthat, we can also posit that teachers have been tired
already of asking support from the government whose
top priority in terms programs and budget is not reallyeducation. Whatever is the reason why there is only one
teacher who says that there is a need for schools toconnect with different sectors, especially thegovernment, it is very clear from their response that they343

want that school authorities as well as teachers must be
resourceful to ensure that the education of the students
under the new normal will still be relevant andmeaningful.
Parents should have time to guide their children. The
role of parents in the education of children especially inthe new normal has been recurring in most of theiranswers from the different questions that we asked themduring the interview. But here, they really calling for all
the parents to really take time to guide their children.
For example, one parent says that “parents have toensure that children are effectively engaged in educational
activities.” Another parent says, “to enroll in on-line
education, the parents should put in their priority lists,
time to guide their children.” This is also supported by
one parent when she says, “classes during google meetshould only be limited especially with younger students
and parents should really accompany and guide theirchildren.” In order to properly guide their children, one
parent says, “parents should be engaged in interactions
using technology.” This is where the schools should also
educate the parents about this new learning modality.
One parent says, “schools should reach out to parents sothat they can also help the teachers in designing theteaching-learning materials for their kids.”
It is already an established fact that parents are really
important partners of the teachers in the education of
their children. In fact, they played a vital role. Thus, it isimportant to schools to really have home-school
partnership program and do not just rely on the Parents
and Teachers’ Association (PTA) that are alreadyestablished in many schools here in the Philippines.
According to Terry (2016), various research on parental
involvement strongly suggests that students, of all ages
and from all backgrounds, are most likely to succeed ifthey are given enough support and families actively
engaged in their learning. Moreover, Terry (2016)
recognized home-school partnerships as a product ofcollaborative effort between the home and the school towork together in various ways and share theresponsibility of bringing the best for the students.
It should be blended learning. Since the reality ofmany students in the Philippines is that they lackgadgets and other tools for on-line learning, parents alsosuggest that schools will employ blended learning. Thisis beautifully expressed by one parent, “There must also
be modular learning because it’s not also good that it ispurely on-line because the students will always be exposed
to radiation and that, the students who do not havelaptops and internet access cannot really participate in
the classes.” Blended learning or hybrid learning caught
the attention of educational leaders as alternative ways
to ensure continuity of learning. This is an integration of
conventional face-to-face, physical education and online
or virtual learning using available technology andautomation, to promote active learning, interaction anddevelop sense of creativity and deep sense ofunderstanding new knowledge. In fact, blended learning
has identified three major advantages, and they are as
follows: 1) flexibility; 2) interesting and innovative formoflearning;
and3)
extendedreach:

344

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

https://www.futurereadyedu.com/blended-learningopportunities-and-challenges-for-students/.
Conclusion
The occurrence of global crisis brought by Covid 19
pandemic has provided educational sectors to consider
alternative
learning
modalities,
replacingtheconventional face-to-face instruction to avoid physicalinteraction brought by the immediate and rapid spreadof the virus. The term blended or hybrid learning is
recognized as the so-called new normal way of learning,where exploring the use and integration of technology
through the online education is considered to ensure
learning continuity.
Our Free On-line Tutorial Program was launched toprovide opportunities for interesting and aspiring
parents and students who wanted to explore andnavigate the online education using the e-classroom.
Moreover, this 5-week free online program aimed to“test the waters” and see if the proposed on-line/distantlearning scheme by the Department of Education for the
next school year will be effective given the different
situations and contexts of the learners and their families.
Indeed, there were advantages and disadvantages of online learning as pointed out by the parents. One of theadvantages is that on-line learning supports andenhances independent learning. With independent
learning, students have the freedom and luxury of time
to explore the internet to enhance their knowledge andskills and to also satisfy their curiosity. However, thedisadvantage of this is that, they might also use their online learning time to explore other sites which may notnecessarily give them the right and appropriate
education. Thus, the guidance of the parents or mature
adults is very much crucial here.
Lastly, since on-line learning requires not only timeand guidance for parents but also, on the practicalaspect, the needed infrastructure such as stable internet
connection and also gadgets like laptops and cellphone,which are not always available to many poor families
especially in the far-flung areas, pure on-line learning
might not be really effective in this situation. Thus, ablended or hybrid learning approach might be theeffective approach in many communities, families andlearners in the Philippines in this time of global
pandemic.
References
Basilaia, G. and Kvavadze, D. (2020). Transition to Online
Education in Schools during a SARS-CoV-2 Coronavirus(COVID-19)
PandemicinGeorgia.
https://www.researchgate.net/publication/340560537
Coronavirus update: 290 Million students now stuck at home.
(2020).
UN
News.
March
5.
At:
https://news.un.org/en/story/2020/03/1058791
Gilbert, B. (2015). Online learning revealing the benefits andchallenges.
Educations
Masters.
Paper
3030.
https://fisherpub.sjfc.edu/education_ETD_masters/303
Landry, S. (2014). The role of parents in early childhood
learning. Children’s Learning Institute; University of Texas
Health Science Center, USA.
Malipot, M. (2020). DepEd allows schools to choose‘appropriate’ learning delivery methods for new SY.
https://news.mb.com.ph/2020/05/13/deped-allows-schools-to-choose-appropriate-learning-delivery-methodsfor-new-sy/
Roy, M. and Garcica, R (2018). The role of parental involvement
and social/emotional skills in academic achievement: global
perspectives. School Community Journal, 2018, Vol. 28, No. 2.
http://www.schoolcommunitynetwork.org/SCJ.aspx
Terry, JaNiece M., "Establishing Effective Home-School
Partnerships by Building Capacity" (2016). Dissertations. 174.
https://digitalcommons.nl.edu/diss/174
Uy, A. (2020). “Blended Learning” In Virus-Hit
Philippines.https://theaseanpost.com/article/blendedlearning-virus-hit-philippines
Vlachopoulos, D. (2020). COVID-19: Threat or opportunity for
online education? Higher Learning Research Communication,10(1), 16–19. DOI: 10.18870/hlrc.v10i1.1179“Why fun in learning works better that dull learning.”
https://www.growthengineering.co.uk/why-fun-in-learningis-important/

Challenges, difficulties, and opportunities
of nurses during COVID-19 pandemic: anassessment of disaster nursing careexperience- Angeline Anastacio, RN, MAN
Chair, College of Health Sciences
St. Paul University Quezon City, Philippines
Email: anastacioangie@yahoo.com
Abstract
This is a descriptive qualitative study using
phenomenological approach involving 46 nurses
working in hospitals that cater to COVID-19 patients.
This was conducted in April 2020. Results show that thechallenges of nurses during the tour of duty in COVID-19
wards includes physical, procedural, psychological andprotection. Likewise, nurses uncovered some difficultywith regard to the following experiences: struggle to be
in complete PPE and with lack of PPE, not always being
able to provide timely care, increased workload, nursing
care limitations, their risk to safety and having anxiety.
This most often leads to some opportunities that bridges
the gap towards achievement of their personal
development and professional growth, as such, nurses
became more compassionate, confident, resilient andresourceful, altruistic, and develop a stronger faith inGod. Their leadership skills were also enhanced as theylearned new knowledge and developed skills througheducation, trainings and experience. All the challenges
and difficulties became avenue for the nurses to be able
to unleash their potentials and further develop them intoa God fearing and humane health care providers.
Furthermore, the nurses being in the forefront of healthcare should be given assurance of safety and protection.
Likewise, the nurse should closely adhere to standard
protocol designed for COVID-19 infection control. It isthus recommended that there should be effective
communication system to address issues and resolve
conflicts. Lastly, emotional support and positive
feedback should be given to nurses during the criticalsituations in the ward and collaborative working
environment should be established all the time.

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)
Introduction
The world is struggling to control COVID-19 infectionthat has debilitated many people and has severely
affected the health care system of every country in theworld. Nurses are one of the front liners in the struggle
against this pandemic, since they are primarily the ones
providing holistic nursing care to patients and theirfamilies and act as nursing management leaders in theward. Moreover, they are trained in disaster
preparedness and management, and this current
pandemic situation could be a venue to evaluate theirability to respond effectively, personally andprofessionally, to the call of their duty during this healthcare emergency.
Watson (2008) described nursing as reconnectingwith what is involved in the knowledge, values andpractices that are essential to the nurses and nursing
itself to sustain the enduring and timeless gift of offering
informed, moral, knowledgeable, compassionate humancaring-healing services to sustain humanity in thenurses’ daily work and in the world”. This definition
best illustrates the holistic caring qualities and roles of
the nurses as they provide selfless service to their clientssick or well, across lifespan in any event where nursing
care is possible.
For many years, nurses have been involved in the
response to a broad range of natural disasters likeearthquake, typhoon, hurricane, volcanic eruption andanthropogenic disasters like industrial explosions,vehicular crash, war and terrorism. Pandemic, as a publichealth emergency, can also be included as disaster since
it creates a threat to the health security of the people andthe society in general. Zoonotic diseases that can cause
epidemic and pandemic can appear to be likeearthquakes; they emerge to be random acts of nature;they are also more like a typhoon as they can occur more
frequently and become powerful, if human beings alter
the environment in the wrong ways (Brown, 2020),
affecting large portions of population and distributed oroccurring widely throughout a region, country, continentor the entire world (dictionary.com). Nurses areprepared for variety of challenges as they are exposed toproviding nursing care and other health care services tomultiple types of patients in different environment inwhich these clients are treated. Hence, the role of nurses
involved in disaster management is multifaceted withpractice,
education,
management,
consultations,advocacy and research. This made nurses develop
variety of specialty areas in nursing that brings huge
expertise in attending to different types and levels of
people experiencing disaster (International Council of
Nursing, 2017).
Disaster is an occurrence disrupting the normal
conditions of existence and increasing a level of sufferingthat exceeds the capacity of adjustment of the affected
community. (WHO, 2002) In any form of disaster, it is
the people who matters most, disasters can happen evenin unpopulated areas since they are by nature
disruptions of nature. Disaster is a serious disruption of
the functioning of a community or a society causingwidespread
human,
material,
economicorenvironmental losses which exceed the ability of theaffected community or society to cope using its own
resources (WHO, 2020). It may cause premature deaths,

345

illness and injuries in the affected community, generally
exceeding the capacity of the local health care systems. It
may also affect the psychological, emotional, and social
well-being of the population in the affected community.
Depending on the specific nature of the disaster,
responses may range from fear, anxiety and depression
to widespread panic and terror (Purijar, 2017). These
are also experienced by the people during pandemic but
to a certain extent. In human history, there have been
many significant pandemics documented and the
pandemic related crises have caused massive negative
impact on health, economies, and even the national
securities in the world (Qui, 2017).
In previous years, the government became
preoccupied with making necessary preparations
pertinent to the occurrence of various natural
phenomena, specifically caused by natural hazards that
commonly devastated some countries such as typhoonand flooding, severe storm surge, landslides, earthquake,hurricanes and volcanic eruption. The Philippines has
recently been affected with natural health hazards suchas severe storm surge in Tacloban, civil unrest in
Marawi, earthquake in Bohol, volcanic eruptions of Mt.
Mayon in Albay and Mt. Taal in Batangas, which shook,
injured and even claimed the lives of many Filipinos anddamaged their communities. Furthermore, the smallscale disease outbreak of local epidemics like Measles,
Dengue Hemorrhagic Fever, Polio, and Influenza has
affected a good number of individuals and claimed
significant number of lives also. Nurses play importantroles in the management of the clients that were severely
affected by these calamities whether at the hospital orcommunity levels. Some of them were actively involvedin activities and programs that augment the needs of thecommunity, like relief operation, medical mission,
psychological interventions, and first aid among others.
Likewise, nurses are actively involved in theimplementation of programs and activities that attends
to clients’ health needs especially during these epidemics
like mass immunization, surveillance of cases, giving
health education and providing health care services in
the hospitals and communities. These events therefore
have heightened recognition of the role of nurses indisaster management and response.
Previously, there were epidemics that rapidly spread
globally like the H5N1 Coronavirus, SARS, MERS Cov andEbola infections that challenged the integrity andservices of nurses in affected countries. Recently the
COVID-19 infection has affected millions of individuals
and killed hundreds of thousands of people andprofessional health workers worldwide. This same
scenario is a repetition of the health care challenges that
happened way back 1918 during the H1N1 Spanish
Influenza pandemic which greatly affected the lives ofpeople and killed millions of young and healthy patients(Meltzer, 2006) from around the world.
On March 11, 2020, the Director General of World
Health Organization (WHO) declared the COVID-19
situation as pandemic due to the alarming levels of its
spread and severity, likewise with the alarming levels ofinaction (WHO, 2020). This situation sought the selflessservices of health care providers especially the nurses
who are in charge of the bedside care of severely
infected clients. Severe Acute Respiratory Syndrome346

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)

Coronavirus 2 (SARS-Cov-2) is not an ordinary virus
causing severe respiratory infection that can be treatedeasily. This has affected individuals with low bodyresistance especially those with other underlying healthconditions. This is a virulent infection that could easily
infect people through droplet spread. Moreover, this cancontaminate those who are at the forefront of infectedindividuals, and those who are not practicing a good
infection control protocol. A research study revealed that
SARS-CoV-2, like other emerging high-threat pathogens,has infected health-care workers in China and several
countries including the Philippines, USA, UK and KSA(WHO, 2020). It came to a point, that cases has reachedto the alarming number where it can hardly be contained
anymore; and the health care facilities can barely
accommodatetheclients
consideringthedisproportionate number of medical equipment and thestaffing of nurses and other health care workforce with
the number of cases who needs hospitalization andtreatment.
The following data represents an update on the casesof COVID 19 in the Philippines as of April 20, 2020. From
the DOH DataCollect app Covid-19 Tracker, there are6,459 individuals as the Total Confirmed Cases
Nationwide, with 3,199 currently admitted, 63 new
admissions, 428 deaths of confirmed cases and 613 total
facility-based recoveries and those who had completed
the 14-day home quarantine. Concerning the available
support systems as of April 12, 2020, there are 3,191
total dedicated beds for COVID-19 hospitals, 1,474
mechanical ventilators and 12,413 beds in identified
community isolation facilities across country. This data
was generated from the 48.6% of hospitals and 52.4% of
infirmaries that had reported on the DOH Data Collectapp. (DOH, 2020).
On May 13, 2020, there are 11,618 confirmed cases
reported in the Philippines and 54% are male with themost affected age group 30-39 years (21.2%) followed
by 20-29 years (16.9%). Out of 772 confirmed deaths,
65% are male with 70 years (36.2%) and 60-69 years(31.7%) as the most affected age group. 71.8% of deaths
reported are from NCR. (DOH, COVID-19 Situation
report). The report on May 21,2020 disclosed that there
are 4.97 Million confirmed cases, 1.89 Million recoveries
and 327,000 deaths worldwide (COVID-19 alert
statistics).
Health care workers are among the group ofindividuals who are proven to be at risk of contracting
COVID-19 infection. A report on May 13, 2020 revealed a
total of 2, 125 health care workers who have been tested
positive for COVID-19, including 35 deaths in thePhilippines alone. According to the Department of
Health, adherence to Infection Prevention Control (IPC)
and Personal Protective Equipment (PPE) use and theneed for special surveillance and contact tracing for
health care workers at hospital level is not enough. The
importance of proper rest for health care workers has
been emphasized by the WHO, based from the reportthat physical and mental exhaustion are attributed toincreased risk of complacency with proper
precautionary measures. (DOH, 2020)
In the face of disaster and public health emergencies,
nurses are expected to execute the following roles basedon the guiding principles of nursing during special

events from the International Council of Nursing
Disaster Preparedness and Management which includes:(1) Rapid assessment of the life situation and of nursing
care; (2)Triage and initiation of life-saving measures; (3)The selected use of essential nursing interventions andthe elimination of nonessential nursing activities; (4)Adaptation of necessary nursing skills to disaster andother emergency situations. The nurse must use
imagination and resourcefulness in dealing with a lack ofsupplies, equipment and personnel; (5) Evaluation of theenvironment and the mitigation or removal of any healthhazards; (6) Prevention of further injury or illness; (7)Leadership in Coordination patient, triage, care andtransport during times of crisis; (8) The teaching,supervision and utilization of auxiliary medical
personnel and volunteers; and the (9) Provision ofunderstanding, compassion and emotional support to all
victims and their families. (ICN, 2017). Considering thesecomplex functions of nurses in times of health careemergencies, executing these responsibilities can be ofgreat challenge to them.
Nurses are hailed as real-life heroes in the honorable
task of promoting health and preserving lives. They aretrained to be prepared in every battle even how toughand complicated it may be. The effect of this pandemic
on the personal and professional life of nurses can never
be discounted, hence, this study. Specifically, the study
was focused on determining the personal andprofessional challenges experienced by nurses working
in the COVID-19 health care facility; the difficulties
experienced by nurses while taking care of COVID-19
patients; and the personal and professional
opportunities that were opened to them during thispandemic.
Methods
This is a descriptive qualitative study using aphenomenological approach that allows exploration of
the experiences of nurses as they attend to COVID-19
patients. The participants included in the study were 46
nurses working directly in the private and public
hospitals that cater to COVID-19 patients. These nurses
are assigned in various areas in the hospitals located in
the Philippines, Kingdom of Saudi Arabia, United Statesof America, Canada and United Kingdom. They wereselected using a purposive random sampling method.
They were notified through email and Facebook
messenger and requested to fill-out the open-ended
survey questioner through an online application during
the whole month of April 2020. A Survey Monkey
application was utilized as the data gathering tool
wherein open-ended questions were uploaded to gather
the information. Likewise, one on one interview was alsodone to selected participants via messenger call tovalidate the results of survey conducted. Moreover, thedemographic data was analyzed using percentage.
Likewise, the narrative data were collated, grouped andcoded to come up with specific themes that were thebases of interpretation and analysis.
Theoretical framework
The theory of Jean Watson on Human Caring was used inanalyzing the results of this research study. Nursing is a
profession that requires the nurses to become equippedEubios Journal of Asian and International Bioethics 30(6) (August 2020)
with utmost care. This theory emphasizes that it isthrough interpersonal interaction where caring can only
be effectively demonstrated and practiced. It is guided bycertain Carative factors that marks in the satisfaction ofparticular human needs. Individuals or family growth
are promoted by effective caring. An acceptance of aperson for not only as he or she is now, but as what he or
she may become is a reflection of a caring responses.
Offering one’s potential while allowing the person tochoose the best action for himself at a given point in timeis an image of a caring environment. Even though caring
is complementary to the science of curing; caring is more“healthogenic” than curing, and central to nursing is thepractice of caring. (Current Nursing, 2012). The 10
carative factors that guide nurses as they execute theirroles in caring are: formation of humanistic altruistic
system of values (embrace); Instillation of faith and hope(inspire); cultivation of sensitivity to oneself and others(trust); development of a helping-trusting human caring
relationships (nurture); promotion of acceptance of theexpression of positive and negative feelings (forgive);
systematic use of the scientific problem solving methodsof decision making (deepen); promotion of interpersonalteaching-learning (balance); provision for a supportive,
protective and corrective mental, physical sociocultural,and spiritual (co-create); assistance with gratification ofhuman needs (minister); and allowance for existentialphenomenological forces (open). (Watson, 2008).
Nurses, having been continuously taking care ofpatients in the hospital during this COVID-19 pandemic,
are in a situation that appraises their carative behavior.
Being in a public health emergency situation, the nurse
experience challenges and difficulties that tests how wellthey utilize the carative factors in the way they interact
with the patients and their environment. They have toembrace the reality of their situation in the hospital anddeal with what they have as a reflection of care. With thenumber of nurse-patient ratio, availability of supplies
and equipment and how they work collaboratively withmembers of the health care team, the devastating
condition of their patients and the heavy workloads dueto the demands of health care they have to provide, are
all areas that would require the nurse to have a strong
sense of caring to herself, to her patients and to her
environment. This most often leads to some
opportunities that bridges the gap towards achievementof personal development and professional growth.

347

Results and analysis of data
The participants in this research study comprised ofnurses who are currently working in COVID-19 hospitals,
with administrative position (26.08%) and staff nurses(73.91%) involved in direct patient care. They are
working in the nursing service and in clinical practice foran average of 10 years and 6 months. Most of theparticipants are single (50%), working in the public(60.87%) and private (39.13%) hospitals, most of them
are working from the NCR, Philippines (41.30%), USA(17.39%), and KSA (30.43%).
Table 1. Demographic profile
A. Position
Nurses with administrative position
Staff Nurse

%
26.08
73.91

B. Average Length of Service
9 months to 3 years
20 to 40 years

26.08
17.39

C. Civil Status
MarriedSingle

45.65
50.00

D. Work Location
Canada, Nevada
Philippines, NCR
United Kingdom, Gloucester
USA, LA, California, Harlingen, Texas
Kingdom of Saudi Arabia, Najiran

02.17
41.30
08.69
17.39
30.43

E. Type of Hospital Facility
PrivatePublic

39.13
60.87

The challenges that nurses encountered whileserving in a Covid-19 health care facility
The responses made by the nurses on the challenges thatthey experienced while serving in a COVID-19 hospitalhas created the four thematic areas:(1) Physical challenges which includes the limitation of
resources both materials such as “lack of PPE, medical
supplies, testing kits and equipment”; and lack of
manpower with the “shortage of nurses” in the hospitals
causes “heavy workloads” among the nurses. Likewise,
the nurses would also say that once in PPE they were“unable to urinate in an 8-hour shift”.
(2) Procedural challenges which comprises insufficient
procedures and protocols of hospital specific to COVID19 health care management as reflected in the “poortriaging and classification of patients” and the limitationof knowledge of nurses on COVID-19 health care due to“lack of health education” and information about COVID19.

Figure 1. Schematic diagram of the study(3) Psychological challenges where nurses regard thesituation as “emotionally draining to see patient dying
alone and families could not come in”. This also includes
facing issues and concerns on the behavior and attitudeof patients and other staff nurses who are also with

348

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)“anxiety”. According to them, “some nurses do not want
to work because of fear of being infected with the virus”.
(4) Protection challenges which involve threat to thepersonal safety of nurses. According to them, they
“always have uncertainties of taking care of patients
whom they do not know if carrier or not” and theyencounter problems in “obtaining accurate history frompatients because others are not honest enough” to reveal
the truth. “Too much exposure from Covid-19 virus” leadthem to a greater risk. Based on the revelation of somenurses, “there were nurses who got infected already andare now in quarantine and cannot report for work”.
However, a positive attitude like “we always have to beready and creative to protect ourselves” and “hand inhand we will eliminate it”, are the coping mechanisms ofnurses to push through with the fight and face all thesechallenges.
Difficulties that nurses experience in taking care ofpatients with Covid-19
The key word STRAIN has emerged to represent the
responses of the nurses on the difficulties that theyexperienced in taking care of patients with COVID-19.
• Struggle: Nurses “Struggle to be in complete PPE fora prolonged period” and with “profuse sweat while
doing nursing duties” are some of the difficulties that
nurses have to bear to protect themselves from being
infected with virus.
• Timely care: This has to be provided to theirpatients while strictly adhering to the protocol of“changing and wearing of PPE in emergency situation
which is time consuming” as some nurses “cannot
attend to patient immediately even during thepatient’s cardiac arrest because the nurse has to beproperly geared up with complete PPE that takes her
3 minutes”.
• Risk to safety: Due to “lack of PPE”, “exposure to
Covid-19 patients”, “danger of being infected since
only when the symptoms show that full
implementation of protocol is done” and “patientsfrom clean wards not to get tested”.
• Anxiety: Most nurses said that they have “Anxiety”
and other psychological symptoms due to“helplessness in managing deteriorating patients”
and “less emotional support” that is being received by
the patients from the family. Likewise, with the“attitude of other patients to respond favorably as thenurse finds difficulty in explaining their need for
isolation and pacify their emotions of fear of having
the disease” adds to the apprehension of the nurse as
she tries to settle the patients and keep them
comfortable.
• Increased workload: Nurses said they have
“Increased workload due to shortage of nurses” and“increased level of nursing care”. “Nurses finds it
difficult to prioritize either self-care or patient-care”.
Attending to patients needs became “labor intensive”
and “overwhelming due to workload of nursing care
for Covid-19 patients”.
• Nursing care limitations: As nurses said, theirinsufficient knowledge on Covid-19 is also among thedilemma of nurses, they said that “we are justlearning about Covid-19 and are limited with what
we can do for safety”.
Opportunities of nurses leading to Personal
Development
The responses of nurses were clustered accordingly, andthe acronym CARES sums up the expression of thepersonal development they have gained out of thechallenging and difficult situation.
C – compassion, confidence
A – altruism
R – resilience, resourcefulE – empathy
S – self-care, stronger faith in God• Compassion and empathy, as reflected in the
response that, “at first I was scared and overwhelmedby the task of handling COVID-19 patients, but when I
am in front of them already , I felt that they are also
like other non-COVID-19 patients”, and “it feels goodthat I was able to help them feel better”.
• Confidence was enhanced as they become “confident
to deal with patients who are Covid-19 positive”.
• Altruism was developed, as nurses were “able tohelp all sorts of people in their own little ways, withthe dilemma that they can also bring harm to theirfamily” is a manifestation of selfless care in the midstof danger.
• Resilience as they become flexible in “providing
nursing care to all patients”.
• Resourcefulness and creativeness through theexpression that “I learned to make do of ourresources that we have and make the most out of it”.
• Self-care as suggested on the nurse’s realization of
focusing on “self-care” and having “self-worth” topersonally improve oneself, “taking care of my healthfirst”, also provides the nurses an “opportunity for
self-reflection”.
• Stronger faith in God, according to one of them, “Ihave faith in God that he will give his healing hands
and keep us all safe”. They consider “God as the great
healer” Some of them said “our expertise is nothing
without His guidance”, “my faith became stronger andmore stable”, “we need to start our day with prayerthat we will be an instrument of his healing power”.
Opportunities of Nurses leading to Professional
GrowthEven how challenging and difficult the situation of thenurses may be as they attend to the needs of COVID-19
patients, these experiences have created an enormous
impact in their professional growth. This is reflected in
the key word CLEAN.
C – commitment, collaboration, competency
L – leadership skills
E – experience
A – advocate
N – new knowledge and skills• Commitment, as the nurse validated that thissituation “helped me to understand more of what theEubios Journal of Asian and International Bioethics 30(6) (August 2020)
Florence Nightingale pledge is all about to dedicate
and devote myself to humanity”.” Being able to do
more and beyond my job” and “always available tohelp others”is a reflection of being “dedicated” toone’s mission. The nurses said, “we are stretched todetermine how we can further assist our patients andour employees”, and “gives us another reason torethink why we chose this kind of profession”.
• Collaboration and communication skills have
improved. Nurses “work closely with members of thehealth care team and became fully engaged” in thisfight and they said “to step up and be active in
addressing problems that arose in our unit during
this time”, and be able “to accommodate informationand instructions about Covid-19 due to frequentchanges in hospital policy”.
• Competency of the nurses in responding topandemic was improved since according to them,
they are given trainings and “opportunity to respondduring pandemic”. They also “develop a sense ofawareness and responsibility on what needs to bedone operationally”.
• Leadership skills is enhanced, as they were “able toknow more and educate others about the virus”, “ableto step-up and lead group when doing nursing tasks”.
As they are given the task to “actively participate inaddressing and developing a suitable and bestalgorithm for their unit and engage in dialogues with
their superior, doctors and colleagues”. A nurse was“given a chance to formulate and implement COVID19 task force in her/his floor and become a chair ofcode blue committee with up to date guidelines• Experience, the situation gave the nurses “real life
experiences” and gave them an edge to “obtain new
knowledge and develop skills” and “more experiencesin dealing with patients in such situation”. They get“quickly trained to accommodate the different
specialty”.
• Advocate, as being “always available to help theunits”, “listen attentively to the needs of staff”, and“be on top of the guidance from DOH and CDC anddeliver the needs to staff on regular basis” must be
demonstrated. this experience “strengthened thepower in me to become an advocate of health”.
• New knowledge and skills through education andtraining, involvement are constantly available fornurses to augment the needed services in the units.
Hospitals give “cross training to nurses to experience
different specialties like ER, ICU and SDU” to equipthem with necessary competencies to be assigned in
special areas anytime as they advance their skills.
“Online training is rushed to complete and support
the needs of specialty floor”. They also gained
information through “health education”.
Discussion
Nurses are in the forefront during this health careemergency, as they provide holistic care to their patients
especially those who are infected with COVID-19. Theircommitment and loyalty to the profession is commenced
the moment they recite the Florence Nightingale pledge:“I solemnly pledge myself before God and in thepresence of this assembly, to pass my life in purity and to349

practice my profession faithfully… I will do all in mypower to maintain and elevate the standard of myprofession and will hold in confidence all personalmatters committed to my keeping, and all family affairs
coming to my knowledge in the practice of my calling.
With loyalty and endeavor to aid the physician in his
work and devote myself to the welfare of thosecommitted to my care” (Fowler, 1984).
In this study, challenges, difficulties andopportunities of nurses were uncovered specifically how
they dealt with their patients during this COVID-19
pandemic.
The physical challenges were identified as the firstamong the four challenges of nurses. Among these isrelated to their personal safety with the use of personal
protective equipment. According to WHO, additional
precautions are required by health care workers toprotect themselves and prevent transmission in thehealth setting (WHO, 2020). However, even how prudent
the nurses may be, due to “lack of PPE, medical supplies
and testing kits and equipment” they find it hard tocomply. The WHO also proposed that the precautions to
be implemented by health care workers caring forpatients with COVID-19 should include using PPE
appropriately. This involves selecting proper PPE andbeing trained in how to put on, remove and dispose of it.
Health care workers involved in the direct care ofpatients should use the following PPE: gowns, gloves,medical mask, eye protection (goggles and face shield)(WHO, 2020). However, when in complete protective
gear, the nurses “struggle to be in PPE for long period ofhours”, they were also “unable to urinate in an 8-hour
shift” and experienced “profuse sweating while doing
nursing duties” which made them uncomfortable.
Wearing such also test their being able to implement
their timely care as they have to follow the proper
donning” which according to them “is time consuming”.
Adhering strictly to the proper donning of PPE, somewould say that there was an incident that the nurse“cannot attend to a patient immediately even during thepatient’s cardiac arrest because nurse has to be properly
geared up with complete PPE that takes her 3 minutes”
to ensure self-protection first. In addition to this, due tothe influx of COVID-19 patients in the hospital, theacceptable nurse-patient ratio becomes under strain
thus resulted to the “shortage of nurses” in the wards
and specialty areas causing an “increased workload”.
Likewise, the higher demand of nursing care needed for
COVID-19 patients has resulted to “increased level ofnursing care” consequently, their work becomes “labor
intensive” and “overwhelming due to workload ofnursing care for COVID-19 patients.”.
Another dilemma that put nurses under pressure isthe challenge to protect themselves and others. This
involves the threat of the nurses to personal safety,
beyond the problem that arise due to lack of PPE. These
nurses have a feeling of “uncertainties in taking care ofpatients who, they are not sure, are carriers or not” withthe predicament of “obtaining accurate history frompatients because others are not honest enough” to reveal
the truth. Some of the nurses “got infected already andare now in quarantine and cannot report for work”.
Relative to the studies on COVID-19 and other infectious
respiratory disease outbreaks, personal or family health

350

Eubios Journal of Asian and International Bioethics 30(6) (August 2020)in the face of direct contact with a potentially deadly
virus and the stress of balancing this concern with the
ethical obligations of continuing to provide care reflects
high concern among nurses (Jiang, 2020; Khalid, Khalid,
Qabajah, Barnard & Qushmaq, 2016; Kim & Choi, 2016;
Nickell et al., 2004;Maben, 2020). This upsurge of cases
and the novelty of disease were not anticipated by many
hospitals, that made nurses and other health careproviders at a loss, nurses would reveal that “poortriaging and classifications of patients” and their “lack of
education” and “insufficient knowledge on COVID-19”
are some of the “restrictions from their effective nursingcare”. The unavailability of procedures and protocols
leads them to develop “anxiety”, especially when they
deal with patients with whom “the nurse finds difficultyin explaining their need for isolation and pacify theiremotions for fear of having the disease”. Having been in asituation like this has affected the nurses to feel “helplessin managing deteriorating patients” and “less emotional
support is being received by the family”. They regard thissituation as “emotionally draining to see a patient dying
alone and families could not come in”. Nurses are used to
be assisting the patients with their family as they
provide bedside care. However, isolation with thepresence of family at the bedside is rarely possible
during this time, and so, nurses would stand in lieu offamily members facilitating remote access for loved ones
(Maben, 2020). Furthermore, some nurses “do not want
to work because of fear of being infected with the virus”.
Nurses are not only experiencing an increase in thevolume and intensity of their work but have toaccommodate new protocols and “new normal” ways ofworking which can be potentially highly stressful forthem (Maben, 2020).
Guided by the Carative factors of Watson’s theory,
this study proves that nurses, despite challenges anddifficulties during this time, have gained significant
personal and professional development. The provision
for a supportive, protective and corrective mental,
physical sociocultural, and spiritual or caritas field wererealized through all the experiences of physical andpsychological development of nurses during this trying
time. The difficult situations did not become a hindrance
for them to render quality care. Despite the lack ofresources and materials, nurses learn to become
resilient, creative and resourceful “to make do ofresources that they have and make the most out of it inorder to provide nursing care to all their patients”. The
utilization of creative self deepens the systematic
methods of decision making among them throughparticipation in trainings and educational endeavors that
promote their understanding and develop their skills in
addressing their inefficiencies. From the lack ofexperience and knowledge, they were able to “obtainnew knowledge and skills” and gain “more experiencesin dealing with patients in such situation”. This further
creates balance on why, what and how to act
accordingly, thus, helping them achieve a certain level ofcompetency and self-confidence. Moreover, theleadership abilities of nurses especially among the nurse
managers became fully developed as they become
knowledgeable with the protocols and procedures
relevant to COVID- 19 and experienced how to properly
manage the situations. The development of a helping-trusting human caring relationship was also evident
through working collaboratively with other hospital
staff, nurses, and doctors as they “work closely withmembers of the health care team and became fully
engaged” , “to step up and be active in addressing
problems that arose in their unit during this time”. Theircommunication skills were also enhanced “toaccommodate information and instructions about Covid19 due to frequent changes in hospital policy”.
Moreover, these experiences facilitated the formation ofhumanistic altruistic system of values among them as
manifested from their response of being “able to help allsorts of people in my own little ways, with the dilemmathat I can also bring harm to my family”. This might havecreated anxiety in them but also drove them to develop astronger faith in God, as they realized the need “to havefaith in God that He will give healing hands and keepthem all safe” and “their expertise is nothing without His
guidance”. This manifests the nurses’ deepened sense of
spirituality . The cultivation of sensitivity to oneself andothers was developed through instillation of faith andhope. A nurse becomes a minister as he/she assists in
the gratification of the needs of her/his patients toreceive quality care despite all challenges and difficulties(Watson, 2008).
Conclusion
During COVID-19 pandemic, nurses are faced withchallenges and difficulties that tests their level ofcompetencies and care such challenges would include:
physical, protection, procedural and psychological thathas affected their level of performance and care.
Likewise, the following: struggle, timely care, risk tosafety, anxiety, increased workload and nursing carelimitations are identified as the difficulties experienced
by the nurses in taking care of patients with COVID-19.
Despite all these challenges and difficulties, several
opportunities were opened to them that addressed totheir personal development and professional growth.
Their compassion, empathy, altruism and confidence intaking care of COVID-19 patients were further enhanced
as they gained competency from the education andtrainings given to them. They also learned to become
resilient and flexible and realized the importance of selfcare. Moreover, their faith in God became stronger as
they believed that God is mightier than anyone else.
Likewise, their level of commitment has also improved.
They realized the value of collaboration and effective
communication, and has improved their leadership skills
from the experience in dealing with situations during
pandemic and learning new knowledge and skills. All
the challenges and difficulties therefore became avenue
for them to be able to unleash their potentials andfurther develop them into a God fearing and humane
health care providers.
Furthermore, based on the results of the study it isrecommended that the nurses being in the forefront ofhealth care should be given assurance of safety andprotection by their employer as they render theirservices through regular provision of PPE, proper
orientation, trainings and seminars, and swab test thatshould not be limited only for those who are showing
signs of infection. Likewise, the nurses should closelyEubios Journal of Asian and International Bioethics 30(6) (August 2020)
adhere to the standard protocols designed for COVID-19
infection control like the proper donning and doffing of
PPE, thorough handwashing, social distancing andenough rest to ensure one’s protection and safety.
Moreover, the nurse managers should ensure aneffective communication system in the unit andintervene to address issues and resolve conflicts bykeeping staff updated with current protocols andregulations. They should provide emotional support andpositive feedback to the nurses for the job well done
especially during the most critical situation in the ward.
Likewise, the health care team should continue working
closely in collaboration with one another for a more
effective and efficient health care management, to help
build each one through a good support system for thestaff, patients and their families and strengthen prayer
life through daily devotions. In addition to that, thehospital administrators should provide psychologicaldebriefing for their nurses to ensure a quality of life anda sense of wellbeing is maintained. And, the hospitaladministration should strictly adhere to therecommended nurse-patient ratio in all units, especiallyin critical areas and to develop a proactive approach to
pandemic. Similarly, the government and private healthcare agencies should create a network on how they could
fill-in the gap between the needs of one another andshare best practices as bases in bridging the gap. And
lastly, the local government units should establish
facilities for every town that separates COVID-19 fromnon-COVID-19 patients thus preventing crosscontamination of cases. They should create laws,
concrete policies and guidelines to address current
issues and in preparation for future pandemic.
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