While encouraging open conversation about psychological distress is vital, the dominant discourse remains trapped within a narrow, individualized frame. We are told that mental health is a personal matter—a question of neurochemical balances, individual coping mechanisms or personal resilience.

Yet, as community medicine practitioners engaging daily with agrarian and marginalized populations, we see a very different reality. Psychological distress does not exist in a vacuum; it is deeply rooted in the social, economic and political conditions under which people live and work.

To truly address the mental health crisis in our country, we must look beyond the individual and interrogate the structural determinants of health—and the neoliberal framework that systematically abdicates state responsibility.

The WHO definition and the social reality

The World Health Organization (WHO) explicitly defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Furthermore, mental health is understood as a state in which an individual can realize their abilities, cope with normal life stresses, work productively and contribute to their community.

When social conditions prevent people from meeting their basic human needs, framing their suffering as a purely psychiatric or clinical issue is a grave error. Poverty, landlessness, debt, food insecurity and environmental destruction act as severe, chronic stressors. What we are witnessing across vulnerable sectors is not a collection of isolated mental illnesses, but a social epidemic of distress caused by structural inequality.

Neoliberal trap: Commercialization and individual guilt

Under the dominant neoliberal economic model, healthcare—including mental health—has been commercialized and converted into a market commodity. Quality psychological support and psychiatric care are largely privatized, remaining out of reach for the vast majority of Filipinos who survive on informal labor or small-scale farming.

Worse, neoliberal ideology reframes structural problems as personal failures. When a small farmer, driven to financial ruin by severe drought and low crop prices, experiences paralyzing anxiety and depression, the market logic suggests the solution lies in individual resilience or private clinical care.

By hyper-individualizing distress, the state effectively absolves itself of accountability. It escapes scrutiny for its failure to provide adequate social safety nets, irrigation infrastructure, fair crop prices, and climate adaptation support. Mental suffering is turned into private guilt, while the policies that drive people to despair remain intact.

El Niño and the lessons of Kidapawan

The intersection of climate shock, rural neglect, and structural distress is starkly illustrated by the plight of agricultural workers during extreme climate events.

When El Niño strikes, fields dry up, crops fail and debts compound. For thousands of farming families, extreme weather brings immediate existential dread. The surge in agrarian distress and suicides during prolonged droughts is not a failure of individual coping strategies; it is the direct consequence of economic abandonment.

Recall the April 2016 Kidapawan protest. Thousands of drought-stricken farmers gathered on the highways of North Cotabato, not to ask for psychiatric interventions or self-care seminars, but to demand rice and government relief to feed their starving families. They sought structural relief for a structural crisis. Instead of receiving aid and solidarity, their distress was met with state violence and forcible dispersal.

Kidapawan stands as a tragic reminder that when institutions fail to protect livelihoods, they turn socio-environmental crises into state-inflicted trauma.

Shift to transformative care

In recent years, “Trauma-Informed Care” has offered an important shift by asking “What happened to you?” instead of “What is wrong with you?” However, within a privatized medical framework, trauma-informed care can still fall short if it confines itself to clinical walls without challenging the conditions that generate trauma in the first place.

We must move toward Transformative Care.

Transformative Care recognizes that personal healing is inseparable from community empowerment and social justice. It acknowledges the social context of affected individuals and families, shifting the emphasis from passive clinical consumption to collective agency. Transformative Care demands:

1. Addressing Root Causes: Protecting land rights, ensuring food sovereignty, securing living wages and implementing real climate justice.
2. Community-Grounded Systems: Integrating mental health care into local Primary Health Care networks that prioritize collective healing, peer support and social protection rather than commercialized remedies.
3. Reclaiming State Responsibility: Treating health as a fundamental human right and a public obligation, not a privilege for those who can afford it.

Anticipating the climate crisis

As climate scientists warn of increasingly severe El Niño cycles and extreme weather shocks, the government cannot afford to rely on reactive, piecemeal disaster responses.

Anticipating a Super El Niño requires a comprehensive, proactive strategy that integrates mental health into primary disaster preparation. This means guaranteeing debt relief, crop insurance and immediate food support for agrarian communities before despair takes root. It means reinforcing community-based support networks through a strengthened Primary Health Care framework that meets people where they are.

Mental health is not merely a matter of individual wellness; it is a barometer of social justice. Until our health and economic systems address the structural forces that push people to the brink, true healing will remain out of reach for the majority. (davaotoday.com)

Basarte, president of the Masupit Women Farmers Organization, planted vegetables on her farm in Lamanan, Calinan in June, taking advantage of the intermittent rain. She hoped the rainwater would be enough for the vegetables to thrive if the forecast El Niño begins.

“Our squash did not flower and the corn was very small and did not form ears,” she told Davao Today in Cebuano.

Dry weather persisted through July and August, leaving soil ‘very dry, almost powdery,” Basarte said. Other organization members report similar problems—some corn developed ears, but plants withered and yields remained minimal.

“Their corn had formed ears, but the plants withered and the ears were very small,” she said.

Davao region agri losses at P410 million

On its Oct. 15 El Niño report, the National Disaster Risk Reduction and Management Council (NDRRMC) recorded 109 cities and municipalities under a state of calamity, affecting 451,889 people, or 121,185 families.

The council reported the country incurred about P6.6 billion in damage to agriculture.

In Mindanao, NDRRMC data showed that El Niño has been affecting 5,950 people in farming and fishing communities in the CARAGA, ZAMBOANGA, DAVAO and Soccsksargen regions. It recorded about P540 million in agricultural losses, with Davao region posted the highest damage.

The NDRRMC also reported 39 wildland, forest and mountains fire incidents, water supply interruptions in some cities and municipalities in CARAGA. Due to extreme heat, 33 cities and municipalities in the region suspended classes in recent months. 

In Mindanao, El Niño has affected the largest number of people in CARAGA, affecting 140 barangays, 291, 381 persons or 45,507 families.

Crops losses mount 

MASIPAG Mindanao received reports from its members that some parts of the Davao region and Northern Mindanao, particularly in Misamis Oriental, are experiencing dry weather and crop damage, resulting in declining fruit and vegetable production. 

Leo XL Fuentes of Masipag Mindanao said fruit-bearing plants in some plots of 200 to 400 square meters in a South Cotabato community withered and died in July’s heat.  

He said affected farmers have turned to driving motorcycles and vending goods to provide for their families daily needs

“The mothers bear the biggest burden of looking for money to sustain their families when their farming income declines.” he added, saying MASIPAG has been disseminating information on El Niño preparedness since January and it has not recorded any assistance reaching farmers within its monitoring coverage. 

Calls for El Niño aid

The Kilusang Magbubukid ng Pilipinas (KMP) urged the Marcos Jr. administration to expedite El Niño aid and disclose the actual disbursement figures of the proposed P45-billion fund.

“It is not enough for the DA to say there is P45 billion for El Niño. Farmers ask: How much have they actually received, when will the others receive assistance, and how many will benefit?” KMP Secretary General Ronnie Manalo said in a statement in Filipino.

According to KMP, the Department of Agriculture (DA) has released P6.2 billion of the requested amount under the UPLIFT program: P2.2 billion for fertilizer subsidies, P1 billion for farmer fuel subsidies, P1 billion for fisherfolk fuel subsidies, and P1 billion for the Presidential Assistance for Farmers and Fisherfolk program (PAFF).

The KMP said agriculture department expects an additional P10 billion allocated for solar irrigation systems and pumps, with fuel subsidies for mechanized farmers scheduled to begin in late October or November.

DA data as of October showed agricultural damage and production losses totaling P5.56 billion across 223,497 hectares, including 41,164 hectares with total crop loss. Cagayan Valley, or Region 2, incurred the highest agricultural losses totaling about P4.9 billion. 

KMP called for transparent accounting, subsidized fuel and fertilizer, irrigation infrastructure development, and guaranteed government procurement of rice.

“Assistance is needed before crops are damaged and debts increase further,” Manalo said.

Drier months ahead

The PAGASA Regional Services Division forecasts below-normal rainfall across Mindanao from October to March 2027, with way-below-normal rainfall from January to March 2027. Areas under this category are expected to receive monthly rainfall of 40% or less than the normal amount. 

Some regions may experience 21 to 25 dry days per month, while portions of Mindanao could see 26 to 31 dry days during the first quarter of 2027. The outlook indicates expanding dry conditions, with drought likely becoming more widespread by March. Temperatures will remain near to above-average levels.

In its climate advisory issued Sept. 23, PAGASA said a strong El Niño active in the tropical Pacific is expected to intensify into a very strong event between September and December 2026, potentially persisting through the first half of 2027. 

In a video posted on the Facebook page of the University of the Philippines on Oct.1, Dr. Rafaela Jane Delfino of the Institute of Environmental Science and Meteorology of UP Diliman explained El Niño occurs every two to seven years when weakened easterly winds allow warmer Pacific waters to shift toward central and eastern Pacific, creating drier conditions in the Philippines. 

Under normal condition, easterly wind blows the warm surface water to the west across the Pacific.

Delfino said “super El Niño” is not a technical term, and neither are “super,” super-sized” and Godzilla,” which are used to describe the size of the sea surface temperature anomaly, or how much warmer it is than normal.

The anomaly had reached 2.7 degrees Celsius, and El Niño was developing toward its peak when the video was released. 

Delfino recommended to plant drought-tolerant crops, utilize rainwater harvesting facility particularly in farming areas relying on rainfall, prepare dam management system and reduced household water consumption.  

“But let’s not forget that we still need to prepare for heavy rains,” she said.

PAGASA warned the western Philippines could face above-normal rainfall from the the southwest monsoon and tropical cyclones. 

While tropical cyclone frequency may decline through the first quarter of 2027, projections show tracks shifting southward, increasing the risk to Mindanao. 

Water supply concerns

Masipag Mindanao educational materials highlight impacts on agriculture, fisheries, and water systems.

“Many farms in Mindanao lack irrigation and rely only on seasonal rainfall,” said the organization in its Cebuano language materials.

Stream and small water system drying threatens inland fisheries, reducing catches and incomes for fishing-dependent communities. Lower water levels affect fish habitats and breeding, while warm temperatures and low oxygen levels stress fish cages and ponds.

Declining surface and groundwater also pressures urban distribution systems, potentially resulting in weak water flow, supply interruptions, or water rationing depending on source capacity.

Fuentes pushes for diversified farming systems, water conservation measures, small-scale water infrastructure, and integration of suitable crops with livestock or aquaculture where feasible.(davaotoday.com)

Fernandez, who earned a bachelor’s degree in communication and media arts, said she has struggled to find work related to her degree while also needing to support herself financially. 

Her experience comes as the Philippine Statistics Authority (PSA) reported that the youth employment rate fell to 84.3% in August 2026 from 88.3% a year earlier. The country’s overall unemployment rate rose to 5.3% from 3.9% over the same period.

For Fernandez, the challenge is not only finding a job but securing one that pays enough and allows her to use the skills she developed in college. 

“The biggest obstacle I encountered while looking for a job was the amount of experience companies require from applicants,” Fernandez said in Filipino.

She acknowledged that employers want applicants familiar with the industry demands. But she questioned how fresh graduates could meet those expectations without opportunities to learn on the job. 

Fernandez also worried that graduates could end up working outside their fields because jobs suited to their qualifications are difficult to find.

“Why spend four years studying communication and media arts if I will not be able to use it after graduation?” she said.

She entered college believing that internships, student leadership and a university degree would help her find work. Instead, she has spent time searching job websites and trying to determine whether the listings she encounters are legitimate.

For graduates without extensive experience or top academic honors, she said, finding work requires persistent searching and competing for limited openings. 

Financial pressures add urgency

Fernandez’s situation has made the search more urgent.

Originally from outside Metro Davao, she still lives in the dormitory she occupied while studying at UP Mindanao. With her family’s allowance and financial support discontinued after graduation, she must find ways to cover her living expenses while continuing to apply for jobs.

As the eldest child, she also feels responsible for eventually helping support her family, including contributing to her younger sibling’s education.

Those obligations have made salary a major consideration, sometimes outweighing whether a job is related to her degree.

Fernandez said some graduates reach a point where their immediate concern is finding a job that can cover rent, bills, loans and other expenses, even if the work is unrelated to their training.

She observed that virtual assistant and customer service jobs have become options for graduates struggling to find work in their chosen fields.

While such jobs can provide income, Fernandez worries that financial pressure can push graduates away from the careers they prepared for and limit their chances to build relevant skills. 

She urged employers to be more open to hiring fresh graduates and giving them with opportunities to learn and gain experience.

Companies may prefer applicants who can immediately meet their requirements, she said, but new graduates also need opportunities to show  what they can do.

Davao Region’s employment figures

Regional data offer more localized view of the labor market, although the latest monthly figures for Davao Region available for this report cover July 2026 rather than August. 

PSA Regional Statistical Services Office XI reported that Davao Region’s unemployment rate rose to 3.9% in July 2026, from 3.5% in July 2025. Its employment rate stood at 96.1%, down from 96.5% a year earlier.

The region’s underemployment rate declined to 9.0% from 10.5% over the same period. Underemployment refers to employed people who want additional hours in their current jobs, another job or a job with longer working hours.

The figures show why unemployment and underemployment must be distinguished: unemployment measures people without work who meet the criteria for unemployment, while underemployment captures people who have jobs but want more work or better-paying work.

In its preliminary 2025 annual labor statistics, the PSA also reported that Davao City had the region’s highest unemployment rate among its provinces and highly urbanized city, at 3.8%. Davao Region’s annual unemployment rate was 2.9%, while its underemployment rate was 3.9%.

The data provide context for the local employment situation but do not specifically measure the difficulties faced by fresh graduates or determine  how many young people cannot find jobs related to their degrees. 

Bayan-SMR calls for changes in employment policy

Bagong Alyansang Makabayan (Bayan) Southern Mindanao Region (SMR) secretariat member Abdul Rauf Sissay blamed the country’s employment woes on the neoliberal economic framework he said the administration of President Ferdinand Marcos Jr. promotes.

The system favors foreign multinational corporations and their local partners, which Sissay said profit from low labor costs and contractual work arrangements. 

The prevalence of service-sector jobs, including business process outsourcing (BPO) and other white-collar industries, combined with low wages and contractualization, feeds unemployment and underemployment—pushing some Filipinos toward informal and platform-based work to make ends meet.

Sissay also faulted the government for underdeveloping manufacturing and other industrial sectors, which he considers essential to generating domestic jobs and advancing national industrialization.

His prescriptions: prioritize national industrialization and genuine agrarian reform, developing strategic industries such as steel and chemicals to support agricultural production, and reform the mining industry to serve local communities and public interests while maintaining environmental safeguards.

On labor policy, Sissay called for abolishing regional wage boards and replacing them with a national wage pegged to the recommended living wage, and repealing neoliberal and repressive labor laws, including the Herrera Law.

He also urged directing public funds toward education, health care and other social services instead of pork barrel allocations for politicians and other officials.(davaotoday.com)

When an extreme weather event strikes communities already displaced by militarization or territorial disputes, the result is a catastrophic “double displacement.”

Yet, in public discourse and conventional humanitarian frameworks, internally displaced populations—our Bakwits—are almost universally reduced to passive recipients of emergency aid. 

They are portrayed as helpless victims awaiting standardized, top-down relief. This framing not only misrepresents the reality on the ground but actively undermines the sovereign agency and self-governance that communities build to survive.

The reality of ‘Bakwit’ power

In evacuation centers, gymnasiums, and makeshift tent settlements, Bakwit communities do not sit idly by. Faced with severe public health deficits, inadequate sanitation, and culturally inappropriate relief—such as non-halal food packs distributed in Muslim-majority evacuation sites—communities organize.

Through self-established camp committees, Bakwits manage communal kitchens, coordinate health monitoring, maintain security, and establish alternative learning spaces like Bakwit schools so their children’s education continues amidst exile. 

This collective self-governance is not merely a coping mechanism; it is an assertion of dignity and human rights.

Effective disaster risk reduction and management (DRRM) must transition from top-down charity to genuine co-management that centers local leadership and indigenous knowledge.

Deconstructing the fallacy of “medical neutrality”

For health professionals and humanitarian workers operating in conflict-vulnerable areas, supporting community autonomy requires navigating complex ethical and operational terrain. A crucial distinction must be made between medical impartiality and medical neutrality.

• Medical Impartiality is our non-negotiable professional mandate: we deliver health care based strictly on medical need, without discrimination. A wounded civilian, a soldier, and a combatant deserve the exact same standard of care.
• Medical Neutrality, however, becomes a dangerous fallacy when interpreted as remaining silent in the face of human rights violations, blockaded aid, or the destruction of community health infrastructure.

To stay silent when military checkpoints delay emergency medical transfers, or when relief supplies to displaced populations are restricted, is not taking a neutral stance—it is aligning with the structural forces causing harm. Impartiality in clinical care must never be confused with neutrality toward injustice.

Defending the civic space for public health

Across Mindanao, autonomous disaster response and community-based health initiatives face severe systemic barriers. Frontline health workers, volunteer responders, and community organizers routinely face red-tagging, surveillance, administrative delays, and criminalization under counter-insurgency frameworks. Relief operations are at times weaponized, conditioned on political compliance or military clearance.

We must recognize a fundamental truth: the defense of civic space IS a public health imperative. You cannot implement Primary Health Care (PHC) if community health workers are vilified, nor can you build disaster resilience if grassroots leaders are criminalized.

Frontline teams navigate these spaces using strategic institutional shields—partnering with academic institutions, faith-based networks, and medical associations—while leveraging domestic and international legal protections, including International Humanitarian Law, Republic Act 10121 (The Philippine DRRM Act), and constitutional remedies such as the Writ of Amparo.

A framework for action

Reclaiming grassroots principles in disaster response requires three concrete shifts:

1. Defend Frontline Responders: Stop the red-tagging and criminalization of community health workers and humanitarian volunteers. Professional medical societies and civil society coalitions must actively shield frontline teams.
2. Uphold Community-Based DRRM: Reallocate resources and decision-making power from centralized bureaucracies to local, community-led structures that understand the cultural and geographical context.
3. Stand with Bakwit Communities: Treat displaced populations not as passive charity cases, but as sovereign agents fighting for health, dignity, and their right to return to their ancestral domains.

We practice impartiality in who we treat—but we refuse neutrality in the face of injustice. Supporting Bakwit agency is not just good humanitarian practice; it is the core of structural health justice. (davaotoday.com)

There is a growing effort to frame commercial sex as merely “sex work”—an economic choice and a matter of labor rights. Proponents argue that paid sex provides an income stream, enabling individuals to support their families in an increasingly harsh economic landscape. But this framing masks a deeper structural truth. When we analyze prostitution through a Primary Health Care lens and measure it against genuine social rights, the claim that commercial sex is an empowering opportunity quickly collapses.

A true right functions as an “equalizing opportunity”. Rights such as quality education, comprehensive healthcare, social welfare, and secure shelter expand human capability, protect bodily integrity, and foster genuine equity. They level the playing field so that every person can thrive regardless of socioeconomic status. Viewed through the social determinants of health, these rights are not luxuries—they are the conditions that keep entire communities well.

Prostitution stands in direct opposition to this definition. It does not equalize; it reflects and deepens existing vulnerabilities. It is not an alternative created by choice but a default mechanism driven by poverty, unemployment, and the absence of basic safety nets. From a Primary Health Care perspective, commercial sex is not a livelihood—it is a vector of violence, trauma, and disease that concentrates harm among those already least protected.

Neoliberalism and the deprivation of social services

To understand why commercial sex is framed as a “survival choice,” we must examine the macroeconomic forces shaping our communities. Under neoliberal policy, the state systematically retreats from its obligation to guarantee social welfare. Public spending on health, housing, and education is slashed, privatized, or commodified.

When social services are gutted, three things follow:

– Essential needs become market goods. Healthcare and education are transformed from fundamental rights into costly commodities that must be purchased.

– Safety nets vanish. Families facing catastrophic illness, joblessness, or displacement are left without state support.

– Survival is individualized.The burden of structural failure falls entirely on the individual, forcing marginalized people—predominantly women—into high-risk survival strategies to secure food, shelter, and medicine.

In this climate, governance favors corporations and commercial elites, prioritizing profit margins and deregulated markets over human well-being. The expansion and normalization of the commercial sex industry fits seamlessly into this paradigm.

Who truly profits?

The argument that legalizing prostitution empowers marginalized women ignores the realities of political economy. In practice, full legal recognition of sex establishments primarily benefits third-party exploiters: brothel owners, agency operators, “casa” managers, and traffickers who capitalize on women’s bodies for commercial gain.

When commercial sex is absorbed into the market as standard enterprise, the state abdicates its responsibility to provide real economic alternatives. It effectively tells marginalized women that instead of social protection, education, or decent work, their primary economic asset is commercial access to their own bodies.

The path forward: Decriminalizing women, penalizing exploitation

If our goal is human rights and health equity, policy must rest on two uncompromising principles:

1. Decriminalize the individual. Women and marginalized people in commercial sex must be free from police harassment, arrest, and prosecution—and must be offered real options: comprehensive healthcare, housing, educational pathways, and social welfare support.

2. Penalize third parties and buyers. The financial incentives for exploitation must be dismantled. Pimps, establishment owners, buyers, and traffickers who profit from economic vulnerability must face civil and criminal accountability.

This approach—the Equality or Nordic Model—treats commercial sex not as a legitimate substitute for state welfare, but as a symptom of structural inequality.

We cannot allow neoliberal policy to redefine survival under poverty as a human right. A just society does not ask vulnerable people to compromise their bodily integrity to survive; it restructures its economy to guarantee education, health, shelter, and dignity for all. (davaotoday.com)