Trapped in cages and chained by their families, the search for survivors of Typhoon Haiyan revealed the tragic conditions in which people displaying signs of mental illness are kept in remote parts of the Philippines. Working with documentary filmmaker Simon Rawles and photographer Peter Caton – we visited several cases.
“I placed him in a cage because he hurts people. For him to be secure, we used chains,” explains Lolita Becira who keeps her 34-year-old son Joel in a cage outside her home.
Hers is a small and simple concrete house, just metres away from the idyllic yet severely storm-battered coastline of northern Cebu. The sight of a man in his mid thirties shackled in a small makeshift cage sits in stark contrast with the expanse of wild and beautiful natural landscape.
Northern Cebu in the Philippines was hit hard by Typhoon Haiyan in November last year. Though the death toll was far less than Tacloban, there was 90% storm damage, and a huge number of people lost their homes and suffered injuries.
The destruction in the immediate aftermath of the disaster prompted local disability rights organisation Gualandi Volunteer Service Programme (GVSP) to initiate a search for disabled typhoon survivors in the town of San Remigio.
Among the physically disabled, deaf and blind typhoon survivors, they were shocked to find seven cases of people with mental illness kept in cages and left outside to die during the storm.
“Haiyan opened a lot of things, a lot of realities that were kept hidden by the community themselves. It was like opening a Pandora’s box,” explains GVSP disability rights campaigner Jean Paul Maunes.
Joel’s cage is too small for him to stand up or lie flat. He eats, sleeps and defecates in the same space, and has a chain around his waist, binding him to the cage. His eyes are glazed over, and in his current state, it is hard to imagine he would commit acts of violence.
His mother Lolita brings him three meals a day. According to her, Joel lived a relatively normal life until a couple of years ago. It was after he returned from working in a distant town for an American company that his behaviour started to change. He started to show signs of aggression, and neighbours became afraid.
Lolita appears to care for her son Joel in the best way she knows how, but her son’s condition carries a complexity that surpasses the capacity of local services. “I went to the hospital for the mentally ill in Cebu. But how can I afford it? I don’t have money to pay for such care,” she adds.
As she explains her situation further, the presence of stigma and fear surrounding mental illness start to emerge, “Our community leader said I should chain him really tight because he might kill someone. If I don’t, the police will file charges against me, because he is mentally ill. That’s the reason why I have shackled him.”
Jean Paul describes the caging of Joel and others as modern day slavery, It’s like Roman era, times, he’s like the lion, like a beast for people to be afraid of, which of course he’s not.”
Around 50km away from Joel we meet Alejandro Rodrigo, another man in his mid twenties who is kept in chains and cage after displaying signs of depression.
He is virtually naked, sitting in a squat position and shivering when we arrive at his cage, which is hidden behind bushes away from the main road.
Alejandro’s father Porferio Rodrigo says his behaviour started to change after he witnessed a murder at a local fiesta. He describes how his son started visiting isolated places and spending long periods of time alone.
“We chained him because you can’t tell what will happen if there are children around, and we don’t know what he might be thinking. We just want to stay on the safe side,” explains his father.
A year on from the typhoon, psychiatrists and health officials meet at a World Health Organisation led conference to discuss increasing concern over mental health.
“If you look at hospital bed occupancy in the Philippines, it is almost 90% and even more than 100% in some psychiatric facilities, ” says Dinah Nadera, a member of the Philippine Psychiatric Association.
Expressing additional concern is psychiatrist Michelene Buot who works at the only mental health facility in the region, “Legislators need to be educated to put the money where it ought to be…education is the top priority along with training local physicians in rural parts to handle basic mental health cases.”
Acknowledging the extremely poor levels of mental health care in much of the country, the Filipino government has started to train up local health officers in rural areas to manage and refer mental health cases to city hospitals.
“We have to admit we have not yet really dealt with the problem of caging, and it is really common across the Philippines,” says Department of Health medical officer Jeannette Arellano.
In spite of government efforts, there was no sign of any referral or rural-based mental healthcare during our visit to northern Cebu. It appears it is left to local charities to pick up the pieces.
Disability rights organisation GVSP say it’s hard for them to intervene in Joel and Alejandro’s cases, though they were able to successfully help 24 year-old Ben Ermac.
Today Ben lives and interacts with his family in a way that makes it difficult to consider the conditions he endured until very recently.
GVSP discovered Ben in the days following the typhoon in a remote mountainous area under fallen trees. He had been shackled in a cage for more than 16 years. Unable to walk from over a decade in chains, he survived by eating leaves in the days following the disaster.
“When we first saw him he was naked, with long hair and a long beard…so dirty. There was human waste and he was unable to speak,” recalls Jean Paul.
With the help of Spanish doctors who had flown in to provide emergency aid following the typhoon, GVSP staff and volunteers rescued Ben and managed to rehabilitate him back into family life.
“We provided medication, counselling to the family and medical assistance, and just months later he was back to his feet again,” says Jean Paul, “The community was shocked because before the typhoon, he was someone the people were afraid of.”
Disability rights group GVSP invested significant time, money and energy ensuring Ben’s proper reintegration – something they are delighted with, though unable to replicate for others because of local sensitivities and lack of funds. Instead of focussing on individual cases, they are putting pressure on the authorities to address root causes of the problem,
“There are lots of cases of caging in different communities across the country, we feel our role is in raising awareness so the government addresses the issue,” says Jean Paul.
There remain an unknown number of people in cages across the Philippines, still waiting to be discovered.
View our film on the Guardian: http://www.theguardian.com/world/video/2014/nov/06/mentally-ill-health-typhoon-haiyan-philippines-caged-chained-video
To find out more on this issue, donate or get in touch with disability rights organisation GVSP go to: http://gvspvolunteers.org