If there's one place in the world that you wouldn’t want to get caught with drugs in, the Philippines is probably somewhere at the top of your list. The Southeast Asian country has spiraled into a violent drug war led by President Rodrigo Duterte, leaving over 8,000 dead from extrajudicial killings. The outspoken and vicious president has been heavily criticized across the globe (by pretty much everyone aside from Donald Trump) for his extreme human rights violations.

However, despite the president’s deadly prohibition against the use of recreational marijuana and other drugs, the medical cannabis movement is still fighting for a place in the Filipino society. Back in March, the Philippine Congress allowed medical marijuana legislation to be debated on the floor. If the bill passes, the country would become the first to legalize medical cannabis use in all of Southeast Asia. The measure was originally introduced back in 2014, but ultimately failed to garner approval.

To some extent, even Duterte himself has expressed support for medical cannabis legalization. Back when he was on the campaign trail in 2016, the president called medical use of marijuana “effective,” but also clarified his words by adding that he “must have a clear definition of what it is and it must be approved by the FDA.”

The backing from the staunch 72-year-old leader is certainly bizarre, considering that he also calls for drug addicts and dealers to be killed without due process. Nevertheless, the fear that has grown from these extrajudicial killings and extreme punishments has had a major impact on patient access to the plant. According to the pro-marijuana community MonsterBud Philippines, the drug war has created a shortage of cannabis, leading to street prices that have nearly tripled.

For now, patients in need must rely on the few people brave enough to sell cannabis on the black market. The global news network Aljazeera recently shared the story of a man under the pseudonym of Alden, who treats hundreds of Filipinos that are suffering from debilitating conditions and severe illnesses. He claims that his patients constantly check in on him to see if he’s been killed or imprisoned yet.

If the proposed medical cannabis legislation is approved by Congress, about 500,000 patients will gain immediate access to the plant. At first, users will need to enroll and participate in marijuana research studies and clinical trials. Once the research phase is completed, medical marijuana would become commercialized, but even this could take years to accomplish. Either way, with an unhinged leader like Duterte at the helm, there’s a chance even a legally approved medical market will be tainted by fearful thoughts of persecution.