When Philippine president Rodrigo Duterte came to power in June 2016, he immediately declared a “war on drugs,” ordering a dedicated police force to carry out a massive crackdown that has resulted in the arrests, surrenders and deaths of suspected drug users and dealers. So far, human rights groups estimate that the campaign has claimed the lives of 7,000 to 12,000 Filipinos, most of them from Manila’s poorest neighborhoods.

Recently, photojournalist and TED Fellow Ed Ou traveled to the Philippines to document the situation for NBC’s Left Field. There, Ou captured the effects of this crackdown on the family of Kosa Bulaclac, a man who was killed by Duterte’s forces on June 27, 2017. Soon after Ou’s documentary on the family, The Kill List (see below) launched, Duterte was forced to call off the drug police in the midst of scandal around the deaths of several teenagers. However, the leader continues to defend his stance — one that President Trump has praised as “a great job.”

It remains to be seen whether Duterte’s recent cease-fire will hold. On the eve of President Trump’s visit to the Philippines today, we asked Ou and his co-author Aurora Almendral to what exactly the situation on the ground looks like, and how it compares to the war on drugs in the United States.

While the Philippines does have a real drug problem, its severity appears to be exaggerated, especially when you consider usage in other countries. According to United Nations data, The Philippines has the highest use rates in Southeast Asia for meth (which is locally called shabu). But, say Almendral and Ou, overall drug use rates — defined in the Philippines as the number of people who have used any type of recreational drug, including marijuana, within a year — is about 1.8 million, or less than 2 percent of the population, according to a 2015 survey by the Philippine government’s Dangerous Drugs Board. Compare this to US overall drug use rate, which is about 10 percent.

When Duterte took power, Almendral and Ou say, he estimated the number of drug addicts first at 3 million, then at 4 million. Critics say the number is inflated, and in an interview with Reuters, the chief of the Philippine Drug Enforcement Agency said Duterte “just exaggerates it so we will know the problem is very big.” In May 2017, Duterte fired the head of the Dangerous Drug Board for contradicting his estimate. Then, in September 2017, Alan Peter Cayetano, the Foreign Affairs Secretary and a close Duterte ally, estimated the number of drug users in the Philippines to be 7 million, a significant spike from just a few months earlier.

From June 2016, when Duterte assumed office, until October 2017, the Philippine National Police ran the bloody anti-drug campaign. How the government had targeted drug users and dealers: people on watchlists drawn up by local officials were monitored by beat police officers, CCTV, and special police units dedicated to drug enforcement. According to the police, the drug enforcement units — plainclothes officers unknown to the community — conducted surveillance, gathered intelligence and built cases before they carry out a police operation. These units usually say that suspects were killed during police operations because they fight back, and so they are killed in self-defense.

Kosa Bulaclac, the father killed in this documentary, did use drugs, say Almendral and Ou. His family and friends say that undercover policemen and district officials had been monitoring him on the ground and on CCTV. The police say he was killed because he fought back, but, as can be seen in the film, there were ligature marks on his wrists, and according to witnesses, he was already in a van in police custody when he was killed. One witness told the family that they saw the police shoot him as he begged for his life.

According to a recent survey, 54 percent of Filipinos doubt that suspects killed by police fight back. Witnesses and human rights organizations regularly accuse police of planting evidence — guns, drugs and cash — on a suspect, say Almendral and Ou. “As shown in the film, some suspects show up at the morgue with welts on their wrists that appear to be ligature marks — or gunshot wounds on their forearms which suggest the suspect was shielding himself at the time he was shot.” In addition, the police operate under the legal concept of presumption of regularity, and with little oversight. Only the most egregious cases of police abuse are thoroughly investigated.

Duterte’s tactics seemed to be reinforced by mainstream support, driven by some sectors of the media. To justify their extreme measures, Duterte and his administration claim that 75 percent of heinous crimes are committed by drug users. However, they have not been able to point to studies or proof of the statement. While some mainstream news media have taken more adversarial positions towards the Duterte administration, others actively support and defend the president. “Local radio and television show the killings nightly as cautionary tales and as a form of modern public execution, not necessarily as a way to criticize,” say Almendral and Ou. Pro-Duterte bloggers command massive audiences online, don’t adhere to journalistic principles, and are rewarded with special access to the president — and sometimes even posts in the Duterte administration.

On social media, Duterte’s supporters circulate anecdotes of often gruesome crimes allegedly committed by people under the influence of drugs, drawn from news reports as well as fake news, propaganda sites or rumors framed as personal anecdotes. “These are meant to illustrate the severity of the drug problem and justify the need for extreme measures, though some have been proven to be exaggerated or false claims,” say Almendral and Ou.

“Duterte himself often says that the reason why he is cracking down on drugs is to save the Philippine nation and create a future for the next generation without the scourge of drugs — an idea that resonates with many Filipinos.” Reports of killings broadcast on TV and radio serves the government’s purpose of scaring would-be criminals into compliance, they say.

To confuse matters further, the Duterte administration and his supporters create a fog around the drug war. These muddy facts and rationalizations suggest that the killings are not really happening, the numbers are exaggerated, or that Duterte himself is not responsible, say Almendral and Ou. Some argue that Duterte has not ordered the killings. Some suggest they are carried out by rogue policemen, despite Duterte’s weekly statements threatening to kill drug users.

Meanwhile, the Philippine government challenges the number of deaths, using a campaign called “Real Numbers,” that suggests, among other things, that there are no more killings happening now than in previous years, and contradict the numbers previously released by the police — which they’ve since stopped releasing.

Those who oppose Duterte and bring up human rights issues are often threatened and intimidated by Duterte himself and Congress, which Duterte’s party overwhelmingly controls, say Almendral and Ou. “He jailed Leila de Lima, a senator, longtime rival and former head of the human rights commission, after she spearheaded an inquiry into the killings,” they say. “She was imprisoned for alleged ties in the drug trade, which critics have argued were trumped-up charges. These attacks against opponents creates a chilling effect on political and civilian opponents, as well as critical media.”

As in the United States and other bloody crackdowns on drugs, like in Thailand, the poor and marginalized are disproportionately targeted for the most extreme punishments. The majority of those killed come from urban poor communities in Manila, who are too fearful for their lives to speak up against the state. “These people had very little access to justice even before the drug war, and the culture of impunity in the Philippines is deeply entrenched,” say Almendral and Ou. “Few people seek justice, or even accountability from the state, and those who do are not likely to get it.”

The Catholic Church and Church-based organizations like Resbak and Rise Up do attempt to help victims’ families, and sometimes hold protests, they say. “Local human rights organizations and lawyers struggle to find affected families willing to come forward with cases,” say Almendral and Ou. “Beyond that, they do little towards an organized response against the drug war killings.”

Most of the summary executions have taken place inside the slums; very few have been killed in other areas, though the police have visited most districts except the richest to assess drug users.

As for the rest of the world, human rights organizations, foreign governments and international bodies have spoken out against the killings. However, the UN so far has stopped short of taking action, and the International Criminal Court, which has a heavy caseload and moves slowly, is not in a position to stop the drug war as it is happening, say Almendral and Ou. Critical reports by foreign media has sparked some outrage overseas, though there are also those overseas who support the drug war and the Philippines’ argument for sovereignty. “Beyond that, one problem is that foreign media don’t delve into the mechanisms that allowed the killings to happen,” say Almendral and Ou.

What now? On October 10, 2017, 15 months after the anti-drug war began, a series of scandals — including the deaths of three teenagers at the hands of police in blatant defiance of procedure — forced Duterte to suspend the drug war. “Caloocan, where our documentary takes place, was at the center of the scandal,” say Almendral and Ou. “Caloocan’s entire police force, including Officer Philip Tizon, who appears in the documentary, were relieved of duty and reassigned to other posts in Manila.”

Whether or not the killings resume, the damage has already been done — to the country’s rule of law and, most tragically, to the people who have been killed, say Almendral and Ou. “No amount of justice, either in the Philippines or by international courts, will bring back those who were killed at the behest of their president.”