Drug treatment reforms in the Philippines race against daily killings

A resident waves his stained hands after being finger-printed as he undergoes processing by the authorities allegedly for being a drug-user in Tanauan city, Batangas province, south of Manila, Philippines. File July 18, 2016. (Credit: AP Photo/Bullit Marquez)

President Rodrigo Duterte is waging a deadly war on drugs in the Philippines, and the international human rights community has no kind words for him. But amid the snowballing death toll, some are seeing opportunity for positive change.

The Dangerous Drugs Board of the Philippines released a statement last month saying that the “surge of drug users submitting to treatment and rehabilitation [is]a happy problem.”

This surge is in fact a survival response by thousands to Duterte’s rhetoric-inspired crackdown on “drug users and pushers” – a crackdown that has resulted in more than 500 extrajudicial killings by police and vigilante citizens since his election victory on May 9.

“Happy” might not be the word they’d use, but many local advocates and leaders are ready for the long-awaited conversation on substance abuse and treatment that Duterte’s drug war seems to have pushed to the forefront.

“This has been an opportunity where we’re actually starting to hear people questioning the whole idea of the war on drugs,” said Inez Feria, founder and executive director of NoBox Transitions, a drug treatment and policy reform advocacy group in the Philippines, in an interview with Humanosphere. “So with the challenges that the current situation is presenting, are also certain opportunities in a way.”

Congressman Rodel Batocabe is one man who sees opportunity. He’s behind a proposed bill to build government-funded rehabilitation centers in every legislative state. Dubbed the “Accessible Drug Rehabilitation Treatment Act,” his bill aims to provide low-cost or even free treatment for poor addicts, who many say are affected the most by drug addiction as well as Duterte’s violent war.

“Most of the drug addicts here in the Philippines are poor,” said Batocabe in an interview with Humanosphere. “And yet … rehabilitation is way, way above their means, so if there is no subsidy from the government … these drug addicts will remain as such.”

According to Batocabe, there are only 45 rehabilitation centers in the entire country. Of those, 18 are government-run, but even those, he says, are currently too expensive for the poor, who cannot afford the room and board fees.

In Batocabe’s region, which consists of six provinces and a population of around 4 million, there are only two rehab facilities. Each facility can accommodate around 100 male residents, leaving the women as outpatients.

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“There is a dire need – a scarcity – of rehabilitation centers in our country. So how can we help rehabilitate these drug addicts who are mushrooming left and right in our society? They will just go back to their old localities and remain as drug addicts until they are arrested again or killed in the process,” Batocabe said.

Phelim Kine, deputy director of Human Rights Watch’s Asia Division, has also noticed the poor taking center stage in Duterte’s war on drugs.

“The people who are getting killed are some of the poorest, most marginalized citizens in the Philippines,” Kine told Humanosphere. “These are not the drug kingpins. These are not the people who are making the big money. These are people at the bottom of the heap, who are being targeted for this apparent retributive campaign against street-level criminality.”

For the thousands who have voluntarily surrendered in hopes of avoiding that fate or equally horrific imprisonment in overcrowded prisons, the current solution is a signed statement by the drug pusher that he or she will no longer sell and by users that they’ll “reform their ways.”

But Batocabe is adamant they need professional help and that they all have “the right to be rehabilitated.” Ideally, he would like to build and fund 150 new rehab facilities, but he admits that may be unrealistic.

Kine of Human Rights Watch, thinks it’s more than unrealistic. “There have been absolutely zero meat on the bones of these types of statements. There’s no budget, there’s no plan, there’s no talk of the types of expertise they would bring to these types of facilities.”

To that, Batocabe says he’s already proposed a complementary bill (HB 1641) imposing a tax on alcohol and tobacco sales to fund the new facilities – “It’s smart, don’t you think?”

Regarding expertise, he’s certain the centers will be “world class quality,” but “the details? It should be the Department of Health which will provide the details in implementing rules and regulations.”

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Feria has questions of her own.

“I think with that commitment to [invest in more rehab centers]should be a commitment also to invest in the people who will be providing the services … because the rehab centers are only going to be as good as the people who are running it. … Are they able to engage with the people who are coming for help? Do we have a monitoring system so that we know what exactly is helping whom?”

Feria’s organization promotes the principles of harm reduction – a holistic strategy of individualized drug treatment that doesn’t consider abstinence the only marker of success and emphasizes the rights of the drug user.

“I think the current situation has shown that rehab is only one of the options,” Feria posits.

Instead, her organization, NoBox, is collaborating with the Department of Health to invest in community-based treatment. It’s a broad term that describes a small ratio of community health workers to people seeking help. Treatment may include anything from a 12-step program to family therapy to medical attention, and success would be measured not necessarily by abstinence, but by quality of life, relationships, physical and mental health, stable employment, the ability to continue education and other indicators.

“Drug use doesn’t exist in a vacuum, and how it plays out is influenced by the social, cultural, political, economic environment,” Feria said. “And yes, the discussion should be at that level. Is it there now with us? Not quite yet.”

The president publicly expressed support for Batocabe’s bill last week, so does Feria think Duterte will be supportive of her initiatives? “I do hope so. Anyone serious about addressing this concern would be.”

But with an average of more than 100 extrajudicial killings per week, it seems reformers like Batocabe and Feria are in a race against time.

“It’s a huge challenge,” said Feria, “but with challenges come opportunities. And I think we see now some of the officials and government agencies really moving to figure out how to address this need. I think that’s something that we can look at positively. But a lot of work needs to be done.”

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Joanne Lu

Joanne Lu is a South Carolina-based writer and editor dedicated to global development, poverty alleviation and social justice. After a year in Rwanda, she now covers the Asia-Pacific and economics. Find her on Twitter @joannelu or email joanne@humanosphere.com.