The Cordillera Administrative Region (CAR) is a contiguous 1.8 million-hectare territory of 7 major groups of Indigenous Peoples and is the only region in the Philippines where Indigenous Peoples are the majority population. Composed of 6 provinces and one urbanized chartered city, CAR has a population of 1,797,660 (2020 census). The most populated is the province of Benguet with 460,683 and the least is Apayao with 124,366. Urban Baguio City’s population is 366,358.
Compared to other groups of Indigenous Peoples in the country, CAR shares a healthier health system. This can be seen from the 2020 Field Health Services Information System of the government with the following data on health services:
| Category | Target/Ideal Ratio | Regional Data | Range Across Provinces |
| health centers (rural, municipal and district health centers) | 1:20,000 | 1:36,795 in Benguet to 1:9,163 in Abra | |
| barangay health stations | 1:5,000 | 1:3,086 in Benguet to 1:1,211 in Ifugao | |
| doctor | 1:20,000 | 1:16,434 | 1:29,896 in Benguet to 1:9,896 in Abra |
| nurse | 1:10,000 | 1:2,274 | 1:3,466 in Benguet to 1:1,567 in Abra
|
| midwife | 1:5,000 | 1:2,237 | 1:8,815 in Baguio City to 1:1,309 in Ifugao |
Except for health center and doctor ratio in the province of Benguet, the aggregate data indicate that public health facilities and health workers in CAR are within the ideal or targeted ratio based on the standard set by the government. However, given the widely dispersed communities in geographically mountainous and steep terrain, access to these health services remains difficult for communities in far flung areas.
The relative availability within the targeted or ideal standard of health facilities and health workers in the region is similarly manifested in the state of health response to the COVID-19 pandemic.
COVID-19 Vaccination
As of August 29, 2021, the region recorded a cumulative total of 51,393 people infected with the COVID-19 virus and 926 deaths. The highest infection is happening in Baguio City at 33% of the regional total, followed by Benguet at 22%. Cumulative testing was undertaken among 23% of the region’s target adult population. Thirty percent (30%) of those tested are in Baguio City which could have included non residents such as tourists and visitors.
As of August 8, the Cordillera region was reported next to the National Capital Region (Metro Manila) in highest percentage in the entire country of vaccinated population of 18 years and above. Twenty-one percent (21.43%) or 253,212 of the projected adult population of 1,181,739 were fully vaccinated (https://news.abs-cbn.com/spotlight/multimedia/infographic/03/23/21/philippines-covid-19-vaccine-tracker). Baguio City recorded the highest number with 36% of its population fully vaccinated.
Vaccination allocation is being done by the Department of Health at the national and regional offices under a complex standardized formula using population data. Thus, except for health workers with an actual figure, the allocation may not precisely be set against the actual number of vaccinees. For instance, a municipality in Mountain Province can hardly comply with 100% vaccination for senior citizens because the DOH target is higher than the actual number of this sector. In other areas, the World Health organization-COVAX donation intended for senior citizens was administered to non seniors as the vaccines had expiration dates, apart from the issue of sensitive handling. Quite a number of the elderly have also been proposing that priority vaccination should be given to those engaged in production or those with young children. As some seniors remarked, their days are coming to an end so why should they be the priority. For some indigenous seniors, they apparently find it hard to understand the concept of reducing community burden on transmission, disease and death by prioritizing the protection through vaccine for the older population.
The CDPC noted that in its service areas in Mountain Province and Kalinga, all health workers and most senior citizens and persons living with comorbidities have been vaccinated, except for those who opted not to get the shot. Vaccines were made accessible by conducting the vaccination at the barangay level by rural health doctors and workers. Home service is being administered to those who are incapable of going to the vaccination sites. Health workers trekked through steep terrain to deliver the vaccines. In some areas with road networks, the local government units ferried people from their communities to the vaccination sites.
Other far flung areas in the Cordillera however have yet to be provided sufficient information for them to come up with informed decision. In such areas, some are holding on to the belief that their remoteness provides protection. Others are fearful of the adverse side effects which they hear or see from radio and social media. Meanwhile, terrain difficulties contribute to deterrents for those living in far flung villages.
In an unusual case, a group of barangay health workers have decided not to be vaccinated yet due to a concern on the storage and handling of vaccines.
Mass Testing to Curb Community Surge
Outbreaks in community transmission happen every now and then in indigenous communities where traditional social gathering is a way of life. In several incidents of a surge in infections in the region, the widespread transmission occurred in social activities, especially customary practices. In a recent case in a village in Mountain Province, the community surge was believed to have been brought about by village mates who attended a funeral ritual in Baguio City. One of them tested positive. But before knowing his health status, the villager, a Pastor of a “Born Again Church,” led the Sunday service habitually conducted in a member’s house. His wife died; she was not vaccinated and had comorbidity. Mass testing was immediately conducted among the church attendees and their families that yielded 18 positive individuals. Another round of mass testing was done among family members and those whom they worked with in the reciprocal labor exchange called ug-ogbo. The results showed infection had extended to a number of ug-ogbo members.
Another mass testing was conducted which covered more than two-thirds of the adult village population of around 200 that showed continuing infection largely among household and ug-ogbo members. The village was subsequently locked down, and the practice of ug-ogbo was forcibly halted for the time being.
In conclusion, in this particular case, the rural health system’s response of immediate contact tracing and mass testing has demonstrated what is popularly called a best practice in responding to a community surge. However, indigenous villagers find it hard to refrain, albeit momentarily, from funeral rituals, reciprocal labor exchange as well as church services which result in continuing transmission amidst mass testing, village lockdown and home quarantines.
#Public Information and Communication Team – CDPC#