Eda White,

OPINION: Dolomite as Antidepressant: Still Expensive, Absolutely Useless

5/21/2021 05:50:00 PM Media Center 0 Comments



Photo credit: Janela Mendoza

Unfortunately, national depression is not cured as the second phase of the Manila Bay Dolomite Sand Project kicks off with almost half the budget of the National Mental Health Program along with a new batch of freshly dumped therapeutic dolomite sand. Makes you wonder—why does the presidential spokesperson expect synthetic sand to “take care of our mental health”?

In response to qualms about the dolomite sand, Harry Roque in a press conference dated September 6, 2020 suggested that the "beautification of the bay" was not for naught because it may prove ideal for our collective mental health. In Roque's defense, multiple studies have shown that calming and scenic environments do help in one's mental state. However, the current mental healthcare system coupled with the atmosphere the dolomite dumping has fostered presents an incredibly hollow attempt of promoting mental health in the Philippines.

The problem with the Manila Bay Dolomite Sand Project, other than its absolutely awful timing in a global health crisis, is that it’s probably as murky as the Manila Bay waters it was trying to restore.

For one, the project doesn’t show up in documents that detail Manila Bay rehabilitation activities. It’s not even included in the National Economic and Development Authority’s Manila Bay Sustainable Development Master Plan.

In fact, groups like OCEANA PH and Greenpeace Philippines have reasons to suspect that the rehabilitation has violated at least five laws, like the National Culture Heritage Act of 2009. They also noted that the project failed to undergo consultations with stakeholders. The most notable instance of this regards the main source of dolomite for the project—Cebu. The Cebu Provincial Government didn’t even greenlight the extraction of dolomite in the first place, which allegedly destroyed natural corals near the mine site.

Not wanting to be left out, the budget also has a problem with transparency. As reported by the Department of Environment and Natural Resources (DENR), only P28 million was used for the first batch of dolomite overlay, from crushing to shipping. Now, that's a reasonable amount—until you remember that there’s another P370 million unaccounted for. The P265 million for its second phase was said to include installation of solar lighting, a temporary fence, and a fishing wharf, but still remains as dodgy as anything in the dolomite sand project.

And honestly, the budget we can account for—the P28 million—is impractical. Many experts and environmental groups have said that the dolomite sand will be easily eroded even with artificial structures as wave breakers. The UP Marine Science Institute explains that the nature of Metro Manila coasts during storm seasons will just lead to the sand inevitably washing out.

This is not even touching on the ping-pong match between environmental experts and the government debating on whether the dolomite sand is even good for the environment in the first place.

Reports by the DENR say that the synthetic sand grains are too small and bear similar biological components to the corals endemic to the area, making it “harmless” to the coastal ecosystem. Though environmental groups and experts point out that dolomite contains heavy metals that are harmful to the aquatic life of Manila Bay. Crushed dolomite is also not native to the area to begin with, which can lead to the disruption of the bay’s biodiversity.

As much as it is understandable that beaches are calming for some people, just looking at the synthetic sand in Manila Bay seems to cause more stress and bewilderment than anything due to its controversial existence. Seeing as it has already received enormous public backlash and mockery, it’s not impossible to think that the “Dolomite Beach” is doing more harm than good for our mental well-being.

But let's say—what if the dolomite dumping isn't as questionable as it is? What if it wasn't done during a pandemic, was irrefutably environmentally friendly, had little repercussions to our health, and didn’t seem to have bypassed multiple laws? Would it still improve the Filipino's mental health?

Perhaps a bit, but the reason why mental health is such a problem in the Philippines is the system (or lack thereof) itself.

Sadly, it is common knowledge that the mental health sector is deeply neglected. The budget for the sector is far from being able to successfully aid in the worsening mental health crisis here in the country.

Mental health only makes up an estimated 2.65% of the health budget, with most of it being allotted towards mental health hospitals like the National Center For Mental Health (NCMH) as there is no specific mental health line in the budget.

In the 2021 budget, P1.6 billion was allotted for the NCMH, which is admittedly higher than the P1.2 billion allotted last year. But at the same time, the national hospital was refused P440 million from its P840-million requested funds for maintenance and other operating expenses. This, paired with the virus and the rising rates of mental disorders amidst the quarantine, is a spell for management disaster.

The budget allocation for mental health-related medicine has also been slashed, amounting to P84 million—half of what the Department of Health (DOH) had initially requested. This equates to P23 for each Filipino—a far cry from the usual cost of P40 to P300 among common psychotropic medicines.

And yes, the government has undoubtedly made strides to vitalize the sector, the most notable being the passing of the country’s first mental health act—Republic Act 11036, simply known as the Mental Health Act. With this act, the government aims to integrate mental health into the primary care system and decentralize mental health services from the National Capital Region.

However, after two years since its enactment, there is little progress towards accessible and affordable mental healthcare.

Healthcare facilities are still mainly found in Metro Manila, and even then, they are few and far between. There are only four mental hospitals, 46 psychiatric inpatient units, and 29 outpatient mental health facilities for the whole country.

And as expected, along with the lack of facilities comes a lack of professionals. As of writing, there are estimated to be 548 psychiatrists practicing in the country, approximately 0.5 per 100,000 Filipinos.

The World Health Organization (WHO) recommends 10 psychiatrists per 100,000 population.

What’s worse is that the majority of our psychiatrists work in for-profit services and are mainly based in the major urban areas. Because of this, many provinces depend on health workers that have been trained in psychosocial interventions to support those with medical issues, not actual psychiatric specialists themselves.

To top it all off, per section 43 of the Mental Health Act, a mental health division was supposed to be created. But, the Department of Budget and Management has yet to authorize the recruitment of eight mental health office personnel needed to make the division. Instead, the DOH opted to hire a contractual staff in its place.

And with the knowledge of the dolomite dumping's budget being less transparent than what should be the norm for government spending, it's depressing to see such an important matter as mental health pushed to the side.

In actuality, the reason why the act appears to be so ineffective is the neglect that the national government has for mental health. The 2021 allocation for the national mental health program is only P615 million, which translates to a measly P5.69 for every Filipino.

No wonder why resources for mental healthcare are in scarcity.

Now, some may argue that the budget for health is being saved for a bigger problem—the ongoing pandemic. But they fail to see the data and studies that point to another health emergency that is getting worse alongside the said global health crisis.

According to the Philippine WHO Special Initiative for Mental Health conducted in the early part of 2020, at least 3.6 million Filipinos suffer from one kind of mental, neurological, and substance use disorder. And both the DOH and WHO agree that this number may be bigger, if not for the stigma and the lack of mental healthcare in more provincial parts of the country.

The NCMH’s hotline has reported an increase in monthly calls regarding depression, with 1,000 calls every month on average compared to the average of 40 calls pre-lockdown.

The average monthly calls for suicide-related concerns have similarly risen to 289. On a report by the Philippine Statistics Authority, deaths attributed to suicide have also, unfortunately, risen to 26%.

This is not to say that the government should spend less on the COVID-19 response—far from that. This is just to shed light on why it’s frustrating to see mental health still left to the wayside in favor of ill-timed and ill-managed rehabilitation projects, especially during a pandemic where more and more people find themselves depressed and handicapped.

In a metaphorical sense, the scars in our healthcare are deep and in need of immediate and proper care and attention. A band-aid in the form of sand with an ongoing history of controversy will not help the victims of a failing system.

In the end, the most sensical thing to do would be to stop the Manila Bay Dolomite Sand Project as soon as possible and redirect its funds to mental health.

Besides being full of issues regarding its environmental impact and legality, it is also impractical. The sand can be easily washed out. And, again, the money can be better spent on actual mental health response, on our actual mental health.

With the money and attention it rightfully deserves, we’ll be able to strengthen the foundations of our mental healthcare—achieving accessible and affordable health services for all. Because again, as Roque said, we need to take care of mental health, but to do that, we need full government support. // by Eda White

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