maternal education - Roots of Health

Bright Lights, Big City

Oct 052010

Manila – a place where everyone living in the province dreams of going. I was always one of those people wishing for the chance to go, but I didn’t really think I would have the opportunity to go any time soon. So when Ami told me that she was a finalist for a contest organized by the United Nations Millennium Campaign and the Probe Foundation and that she was going to take me to Manila to attend the awards ceremony with her, I was so thrilled. I couldn’t wait to go! I was so excited to see the capital city and to ride in an airplane and to see something outside of Palawan. As our departure drew nearer I had some mixed emotions because I was a bit nervous about the flight and the trip, but by the time we got to the airport I was mostly just excited. I told myself, “This is it”! I did feel a little worried when I boarded the airplane but soon I relaxed. The take off and some turbulence was a bit scary (I couldn’t even look out of the window) but the flight was mostly smooth and it passed by quickly.

Once we arrived in Manila, the first thing that I noticed is that there aren’t lots of tricycles roaming the streets like in Palawan. Instead there are lanes and lanes of cars and buses. In Palawan you only see buses at the terminal area because their routes all go outside the city. Thank goodness they aren’t in the main city or else there would be chaos! Although the traffic in Manila is definitely chaotic, in fairness the roads in Manila are much wider than in Palawan. There are a lot of intersections too. And so many billboards showing the different directions of places, and advertising clothes and other products. They also have underpasses and overpasses. And such huge buildings! And trains! Wow! It is really modern. When we got to the hotel, I was so amazed with their facilities and even the employees. They were so accommodating and they really entertained their visitors. Everyone in Manila seemed to move quickly, like they were running out of time. Even the temperature was different! It was hot outside but all the buildings were air conditioned and really cold. Life in Manila is really different than it is here in Palawan.

The evening of the Awards Ceremony arrived, and we were so excited to wear our formal Filipiniana outfits! Before we left for the event we mingled with our co-finalists at our hotel and took lots of photos with them. Everyone looked so nice in their Filipiniana clothes! It was so great to have the chance to meet and speak with the other MDG finalists. Everyone was really nice. I felt so blessed to have the chance to meet so many people who are helping so many others in their respective fields. I was so thankful that the Probe Foundation and UN Millennium Campaign put this program together!

The Awards Ceremony was elegant and fun. The event was my first time to meet and mingle with well-known people in the Philippines, including Congresswoman Imelda Marcos, Congresswoman Aliah Dimaporo, and Probe Foundation President Che-Che Lazaro. The evening was so much fun and truly a once in a lifetime experience.

But the Awards Ceremony isn’t all we did in Manila. We really maximized our time there to make the trip worthwhile. We also had the opportunity to attend the Women Deliver conference focused on improving maternal health, which was organized by Likhaan. This was my first time to attend in a big, international conference and it was fantastic! I learned so much about different aspects of maternal and child health, from the human rights perspective, to the RH bill, to maternal and infant mortality and how to decrease it (we need more midwives!), to midwives and the challenges they face in their work. The panels on midwives especially interested me. In so many parts of the Philippines, midwives are the only health workers available to people and yet they are paid very low wages, and their voices and concerns about their work aren’t always heard. But ensuring that each Barangay in the Philippines has at least one midwife is one of the only realistic ways that the Philippines can attain its MDG goals of decreasing maternal and infant mortality. In fact, the sessions inspired me so much that I think I want to go back to school at some point and study midwifery so I can continue working on maternal health in rural areas, but in a different capacity. More midwives really seem to be an important step the country has to pursue to improve maternal and child health!

After a very busy three days in Manila, it was time to go back to Palawan! I had a great time but I was so happy to go home to see my family. Marcus and Ami dropped me off at the airport. I was kind of nervous at first because the airport was so big and so different from the airport in Palawan and I wasn’t sure where to go or what to do first. “What if the airplane leaves me? What if I can’t find the right direction going to Palawan? What if I can’t go home?” Before I let myself panic, I decided to just keep my eyes open and I observed all the people around me, especially those going to Palawan, so I could figure out where to go after checking my bag in.

As I was in line, watching the people around me, I started chatting with a fellow passenger named Jonathan Gerodias. I found out that he used to work on health issues with a private NGO and then the City Government of Palawan, and now he works with the Provincial Government of Palawan. His focus is also on improving maternal and child health in Palawan. I was so happy to meet him. Not only did he help me find the plane, but while waiting to board, he introduced me to his colleague, Dr. Eduardo Cruz, who happens to be the Head of the Provincial Health Office in Palawan. He was also one of the hundreds of participants who attended the Likhaan Women Deliver conference. Dr. Cruz asked me about my work so I told him about Ugat ng Kalusugan (Roots of Health) and our work – that we focused on maternal and child health by not only giving people extra food but also by giving the moms information regarding reproductive and family health and human rights and empowerment. Dr. Cruz seemed really impressed with what Ugat ng Kalusugan is doing to help increase the health of moms and kids. Dr. Cruz told me a bit about the work they are focusing on and he said Palawan’s new governor, Governor Abraham Mitra, has listed health as his number one priority. Dr. Cruz then asked me if Ugat ng Kalusugan might want to partner with the Provincial Government to help tackle maternal health issues. I was so excited at the invitation to partner with them! It was a good initial meeting with Dr. Cruz, and we will definitely be following up with him in the coming weeks.

Of course I know what we’re doing here in Palawan, but the trip to Manila really made me realize how much so many people all over the country and the world are doing to try to improve maternal and child health. We all want changes right? If we all put in some effort, we CAN fight maternal and infant mortality!

“And Then, Something Happened…”

Reproductive Health No Responses »

Sep 142010

It’s usually a girl who is a little bit quiet, smart, but not brilliant, pleasant. She is often from a far-flung municipality and the first in her family to go to college. During her first semester she is intensely homesick and misses her family and her high school friends terribly as she grapples with cooking for herself, washing her own clothes, studying new and difficult things, and making new friends.

By second year she settles down. By the end of the year she has a boyfriend. By her third year she’s pregnant, and soon after the baby is born, she quits school.

This is not an isolated incident. I have witnessed it many times during the past ten years here in Palawan; the question is, “Why does this happen?”

Partly this occurs because students lack basic information about sex and how to prevent pregnancy. To help counter this, we have been doing Reproductive Health Education seminars with some of the classes in Palawan State University. In Ami’s first few months here, she and Lyn did a three part, nine-hour workshop with my second year class from the College of Teacher Education. In the last month, the team – this time Ami, Lyn, and our nurse Josh – conducted two three-hour workshops with second year students from the School of Social Work and Nursing. For the most part students were quite interested in these classes and asked some pretty basic health questions: i.e. How can we stop getting so many UTI’s? How can we prevent cramps during our periods? How can we deal with all this tension and stress?

The seminars have shown that many of the students have wrong information and a lot of misunderstandings about Reproductive Health. However, despite a lot of the misinformation they’ve picked up about the basics of preventing pregnancy and sexually transmitted infections, they do seem to understand that sex can lead to pregnancy. So why are there so many unplanned pregnancies among these students?

As a teacher I am inclined to attribute some of this to underdeveloped critical thinking skills. Students rarely plan ahead or look ahead in terms of the consequences of their actions. If I go out tonight, will I still have time to finish my paper by tomorrow? If I engage in unprotected sex, might I get pregnant? If I get pregnant, how will I manage to finish school? I also think that because of the strong cultural overlay which demands lip service to fairly puritanical moral values, students will not really admit to themselves that what they are getting into is in fact, a sexual relationship. Six months down the line they will be writing essays for me that say “And then something happened.” Sex and pregnancy seem to come as a total surprise, unpredictable and unpreventable. They just happen.

Our guest researcher, Margeaux Berroth, has not yet finalized her work assessing student health and health needs, but she did draw some interesting tentative conclusions even while she was still here in Puerto Princesa. It seemed clear to her that generally, students did not feel empowered to control their own futures or determined to make the most of those futures. They seemed to feel that life would just happen and they would not get very much further from where they started out. However, students in challenging programs such as Petroleum Engineering, or those in student leadership positions, did feel more in control of their lives and did not report so many unplanned pregnancies or boarding house abortions.

What does this mean for us? I am convinced that Margeaux’s findings show that these students are in definite need of Reproductive Health education, as well as education on critical thinking and empowerment. The students at PSU actually ARE privileged and empowered people – they are college students – and the sky should be the limit. We can help them grow to the point of recognizing that, and building on it. We can encourage both boys and girls to form the sort of respectful and responsible relationships that will serve them well in the future.

The current groupthink is hard to oppose, so we simply have to try to modify it. Since the current culture of our students is one of casual sex, unplanned sex, unprotected sex, we have to work on changing behavior – or at least attitudes – within groups, one group at a time. I think of each class as a community – I know the students support each other unfailingly. So we have to work on that level.

Of course to accomplish this, we have to find ways of interacting with students more intensively than what is possible in a three-hour time slot, but I am confident that the longer we work within the university, the more effect we will have. We recognize that the needs are great in the many high schools and colleges in the city. We are working to expand our programming to try to reach as many young people as possible. We hope that with increased resources, we will be able to move into more schools to help equip Palawan’s future leaders with the information they need to make responsible decisions.

To support our work on reproductive health education, click here.

Why Reproductive Health Doesn’t Equate to Abortion

Reproductive Health No Responses »

Aug 172010

I get so frustrated with how the debate for reproductive health here in the Philippines nearly always gets shut down because of the strong insistence of many, particularly those influenced by the Catholic church, that reproductive health equals abortion. It does not. What good reproductive health can do is prevent the need for abortions. Good reproductive health leads to healthier women and girls, which leads to healthier families, and ultimately healthier communities.

A few weeks ago the Center for Reproductive Rights (CRR) in New York City released a report on the Philippines, Forsaken Lives: The Harmful Impact of the Philippine Criminal Abortion Ban. Since the release of that report, there have been countless editorials, news articles and blog entries here in the Philippines on the highly controversial subject of abortion. Abortion is illegal in the Philippines and the CRR report demonstrated that the illegality of abortion has not eliminated the need for it, and that more than half a million abortions are performed in the country each year. The crime of abortion can carry prison terms for the women and the providers involved, and any legitimate medical personnel who are proven to have carried out abortions are stripped of their licenses to practice. It is no surprise then that for the majority of the population, abortions are carried out in covert, back-alley procedures. Women seeking abortions most commonly take herbal concoctions that induce contractions, or engage the services of a manghihilot or traditional healer, who performs such intense stomach massages that miscarriages are induced. Many women also take the drug Cytotec which is intended for preventing stomach ulcers, but which can also induce uterine contractions and cause miscarriages in pregnant women.

According to CRR’s research findings, of the 560,000 abortions performed in the Philippines each year, around 90,000 women face complications from the procedure and about 1,000 women or girls die each year. That is about three women dying from abortion related complications each day. Add to that number the high maternal mortality rate of the Philippines with 162 women dying during pregnancy, childbirth or shortly after childbirth for every 100,000 live births, and one can begin to see more clearly why becoming pregnant is one of the most dangerous things a woman goes through in the Philippines. (In comparison, the average maternal mortality rate in developed countries is 20 deaths for every 100,000 live births). Because of a lack of reproductive health services, education and access to contraception, most Filipina women go through pregnancies multiple times in their lifetime, with the poorest women in the country frequently becoming pregnant up to 10 times during their lives.

Unfortunately, in the Philippines most women and girls are not equipped with the knowledge and tools that will allow them to have a safe and satisfying sex life, and that will allow them to plan the number of pregnancies they will have in their life time. It is so difficult for women and girls to get scientifically sound information on how their bodies work, how pregnancy happens, and how one can prevent pregnancy from occurring. There are so many myths and misconceptions about pregnancy and general reproductive health, and some of the beliefs women have are very harmful. If and when women and girls do know enough about contraceptives, there are still many barriers to actual procurement and use of these technologies. Most notably the biggest barriers for poorer women and girls are the prohibitive costs of condoms, birth control pills and other forms of contraception, and the difficulty and stigma associated with going into a drugstore or public health clinic to try to procure the contraception.

Roots of Health does not fund, promote, or assist women seeking abortions. We support women with life-saving information about how to protect their health and how to plan their pregnancies. We believe that by providing comprehensive education on reproductive health is an integral first step in preventing unplanned pregnancies. We believe that when women are equipped with the knowledge and tools necessary for controlling their fertility, the number of unplanned pregnancies will decrease, as will the need for abortions.

We recently had a full time summer intern, Margeaux Berroth, who conducted research into the health needs and behaviors of students at Palawan State University. She learned much about the realities that face many students, including the fact that sexually active teens who do try to get contraception in order to prevent pregnancy and sexually transmitted infections (STIs) are routinely turned away from free public health clinics because they must show a marriage certificate before being given free contraceptives. She also learned that abortions occur at alarmingly high rates and many students end up needing emergency care because of heavy bleeding, infections and other complications. The methods the students use are gruesome – from ingesting poisons to inserting metal rods in their vaginas to throwing themselves out of trees or other high areas belly first so as to harm the fetus and induce miscarriage. We believe that if these students were more educated and more empowered to protect themselves that these situations would not occur.

The Philippine Congress is about to vote on the passage of the Reproductive Health bill, which would mandate the government to provide reproductive health services, including education and access to contraception, to Filipinos. The bill has languished for years because opponents insist that the bill is pro abortion and that providing contraceptives and information on sexual health will lead to promiscuity. The bill is for the health and empowerment of the Filipina, and it most definitely does not promote abortion. I recently came across an article on Senator Miriam Defensor Santiago, a proponent of the RH bill. When asked by reporters, she said that she’s not concerned about opposition to the RH bill, especially from those who allege that the bill promotes abortion. “Read the bill first. The bill is not pro-abortion; it is pro-life. It ensures that women who need care for post-abortion complications shall be treated and not left to die,” she said. This quote struck a chord with me. When the abortion debate gets heated, opponents are quick to point to the fetus whose life is ended when an abortion takes place. But what about the women whose lives are at risk from the pregnancies and from post abortion complications? Their lives have value too. And we truly believe that if we equip women and girls with life saving information about their bodies and their health, that they will be able to plan their pregnancies, and the need for abortions will be reduced.

To support our reproductive health work in Palawan, click here.

New Developments in Maternal and Child Health Programming

Maternal Health No Responses »

Aug 032010

The last six weeks or so have marked a time of transition in Ugat ng Kalusugan – transitions that have seemed very natural and have gone along with the seasons. First of all, the women in Pulang Lupa completed the whole twenty week program in Reproductive Health – an expanded program which included pre and post natal care, Human Rights awareness, discussions of family life and bringing up children, empowerment, and other health and human rights-related topics. While the formal classes for the women came to a close, we had many internal discussions on how to keep up our relationships with these women, who had all become our friends. We wanted to make sure there was sustainability in what we taught and had no intention of simply packing up and leaving. We also want to maintain Josh’s nursing services – she is monitoring several pregnant women and helping others with various family planning options, plus advising on infections, fevers, illnesses like malaria, etc.

We could also see that the Education programs for the kids were becoming better and better, and more children were participating. And those same children have been profiting from their nourishing snacks as well. But we did have some concern for the smaller children, those under three, who were not joining the class and sometimes missed out on the extra food too.

In June and July the rains intensify here in Palawan, and the older children go back to school, leaving Pulang Lupa a rather quiet village on week days. So we planned our new programming carefully and moved into it in July. It includes:

A Nutrition supplement for very small children, mostly under three, twice a week.

Class and snack for children aged four to six twice a week.

Classes for older children, and light snacks, on Saturday.

Clinic hours with our nurse, Josh, on Saturday.

We are continuing the nutritional supplement for all children on alternate Saturdays. (We partner with Aloha House on this program.)

By the third week in July we had 27 participants for the under threes, and 16 to 18 for the four to six year olds. We hold these two programs simultaneously in separate locations – just as the small kids are finishing their food and starting to move on, we see the four to six year olds parading down the road from their classroom to where we are. The supplement alternates between brown bread or cookies made with oat cereal, and milk, and a cooked dish such as oatmeal (old fashioned oats, lots of milk, oat bran) or chicken porridge (brown rice.) We are recording weights once a week among the under threes and have already seen some slight weight gains. Since these children have to be brought to the program by their mothers, this also serves as a time for quiet conversation with them, most of whom were in the Reproductive Health classes.

Saturday classes: Evetha and Marcus worked out a comprehensive curriculum for the older children that covers reading and writing skills, math, English, and even some science and geography. The Saturday group tends to be a bit unwieldy, with 70 or more children involved, but Evetha has tested them all and classified them into various levels so that they can be both taught and monitored more efficiently.

Clinic: In the past we experienced some difficulties in getting people to commit to appointments with the nurse, and sometimes those who had made appointments did not show up. However if Josh, our nurse, is there in the make shift clinic on Saturday mornings, many women do drop by. The pregnant women come in for pre-natal check ups, and others come in for pregnancy testing or to request contraception or for other concerns. Josh is very easy going and the women seem to like her a lot and feel free to sit around and chat for some time – an excellent time and space for bringing up other medical and health concerns that they would hesitate to bring to a more formal health center.

We figure we can maintain this program in Pulang Lupa even as we move into another site with our Reproductive Health work, as well as doing more programming in Palawan State University. We are especially interested in working in PSU now, at the start of the school year, and when heavy rains sometimes make it difficult to go out into the countryside for field work. Our guest researcher, Margeaux Berroth, held discussion groups with students in June and July and these talks revealed really serious needs for work in reproductive health and attitude change: we still have too many pregnant students – and too many boarding house abortions. On the bright side, we feel that many of the college students, especially the women and girls, can be empowered to take control over their own lives because they are not yet married, not yet mothers, and are on their way to many career possibilities. We are especially interested in working with first year college students who are not yet dating; we want them to know they can make their own hopes and aspirations a future reality.

Lucky in Life

Maternal Health, Reproductive Health No Responses »

Jul 212010

Lucky are the mothers who complain of leg pains after a long day of shopping. Lucky are the students who experience headaches after completing long school assignments. Lucky are the children who get disappointed because they don’t like the new toy their parents bought them. If you have experienced any of these situations, you should be thankful enough because these everyday situations are only dreams for most of the residents of Pulang Lupa, Puerto Princesa City.

For nearly three months I have been working for Ugat ng Kalusugan as a nurse focusing on the health of the mothers and children in Pulang Lupa. I perform check-ups and Pap-smears, provide pre-natal and post-natal care as well as contraceptives, reinforce the idea of family planning and teach basic health concepts. I have seen the picture of life in Pulang Lupa and I now understand how hard it is to live there. I can see this clearly from the windows of my improvised clinic and even more clearly when we conduct house-to-house visitations and interviews.

Kids aged seven and up usually help their mothers in taking care of their younger siblings instead of having fun outside as more fortunate children do. Most of their fathers work as garbage collectors or are locally described as “pajob-job lang”, which means they pick up short term jobs where they can, but don’t have steady income. The majority of the mothers in Pulang Lupa stay at home, caring for three to eight children, and waiting for their husbands to come home with some money so that they can buy something to cook for dinner. It is these mothers that I see regularly for scheduled check-ups. I also drop in on families, to gather data for Roots of Health or to see how the women are doing.

I once visited a family whose children were wearing soiled clothes and had dirt on their faces. I sat there while they ate their lunch, which consisted of only plain coconut (niyog). The mother explained that they didn’t have any other food to eat or even water for baths. Like all parents she wished she had something more to give her children such as toys and new clothes, but she couldn’t provide these things because there was barely enough money to satisfy their daily needs.

Even though the situation at Pulang Lupa is very sad, as I write this article I have a smile on my face. I think these people are fortunate in other ways: they have their own houses, they have community, and they certainly know how to smile. They have embraced Ugat Ng Kalusugan and the maternal health classes conducted by Ami and Lyn. They are eagerly working the vertical gardens that Marcus helped them set up, so that they’ll harvest safe vegetables for their food. They get excited over the stories Evetha and Jane read to their kids, and the education the kids receive. They appreciate the health care services because the Barangay Health Center is really too far away. They know and have an appreciation for each member of the Ugat staff. Their ready smiles make us feel as though our efforts are being rewarded.

Now… don’t you consider yourself blessed with what you have? Right now you are lucky because you are using your computer to read my blog entry. You may want to start thinking of ways to share your blessings — indeed many people are waiting for your helping hand!

Delving into Health and Human Rights at PSU

Reproductive Health, University No Responses »

Jul 142010

My name is Margeaux Berroth and I am an incoming senior at Brown University, studying human biology. I am here in Puerto Princesa for a two month stay on a fellowship through the Watson Institute at Brown University to study a public health issue and document my experiences with Palawan State University (PSU) and Roots of Health. It has been just about three weeks since I arrived in Palawan, and have I been busy! After resting from my long journey here, I ventured out into the world with Susan Evangelista, a professor of English at PSU and Board member of Roots of Health. She brought me to Palawan State University to meet the President, Deans, and teachers so that I could become acquainted with the campus community. I was well received by everyone in University leadership, most of whom are women (in my experience, men seem to rule universities). They were excited about my research proposal on the health seeking behavior and health status of PSU students and hope to use the data or analysis for future programming and/or policy change.

Palawan State University sits on a hill overlooking mountains and Puerto Princesa Bay and is host to between 6-7,000 students; mostly female. Many of the buildings are dated, and the infrastructure is poor, yet much better than I had anticipated. The campus is quaint. Full of nice trees and gardens, sprinkled with many signs reminding you to keep the environment clean, and preserve the land. When we arrived, the campus was a hive of activity with many new students waiting in long queues in the hot and humid sun to register and pay for classes. I was thankful for my university’s computerized system and I sympathized with, and was inspired by all the students standing in the unbearable heat determined to continue their education.

After my meeting with deans, the president, etc., I walked with Susan to her Literary Criticism course to meet her students and get familiar with the layout of the campus buildings. The students seemed very cheerful and eager to learn. It was evident that Susan was well liked among staff and students as she was greeted by friendly faces left and right. All in all, it was a good first visit and I am excited to be working at PSU with young people with whom I may find common ground — space in which they can share their health narratives, queries, and behaviors.

Two weeks ago I had my first independent opportunity to interact with students in the classroom at PSU. Susan was in Manila, so she asked me to meet her class for the day. It was an informal gathering in which I had the opportunity to introduce myself and my project. We talked about how we define health, how other groups (the World Health Organization for example) define health, and I introduced some topics taken from the Universal Declaration of Human Rights. I asked the students to speak about health in Palawan, and had them answer some questions about how they get information about health, well-being, medicine, preventative actions and care (such as reproductive or sexual health precautions). I asked about where they or their families, or communities in Palawan go when they get sick, what forms of traditional healing they use, etc. I began to notice a pattern as each student spoke up about these questions and informed me of the health concerns of themselves and their peers. Many students mentioned unwanted or “accidental pregnancy” as a very common occurrence among students, disparities in health care, poor nutrition and respiration issues. We ended the session with an activity I call Fear in a Hat, which allows the group to build trust and empathy while simultaneously allowing me to get a sense of their issues or concerns about health. I had them write down a fear or concern related to their own personal health or the health of their friends or fellow peers at PSU while remaining completely anonymous. Then we had a couple of students pull the papers out of a hat and read them out loud to the class, and describe how they would feel if they were in that position or what they would do. The activity gave everyone in the class an opportunity to voice their thoughts without fear or pressure of judgment. There was a vast gap between the discussions we had been having during the sessions and the topics written about because the students could be more open and candid.

I took the rest of the papers home and looked through them as my eyes welled up with tears. Students wrote about multiple abortions, TB, prostitution, and dehydration/ malnutrition. What surprised me, as it came up so often was the perception of illness and lack of knowledge surrounding basic or general health issues. Many students cited being concerned about dizziness, fatigue, and breathing issues. Others mentioned being afraid of cancer and other non-communicable diseases as though they could catch these diseases from other people.

Exhausted from the morning, I sat looking out over Honda Bay pondering this fellowship opportunity with ROH and PSU. I realized that the only topics/questions worth pursuing are the ones that are hardest to talk about, because those are the ones that matter most. I feel as though I have many doors open to me in this internship, working with great people, with more freedom than I am used to. It is my sense that I will run into a few hurdles as I pull off the band-aid and pick at the scabs of a conservative society struggling to provide adequately for its people. We shall see what the following weeks have in store for me and these students!

The Ripple Effect

Maternal Health, Nutrition, Reproductive Health No Responses »

Jun 222010

I had a little ‘wow’ moment during our recent Board of Directors meeting teleconference. I was sitting there, ear glued to the phone, feeling extremely impressed with our powerhouse Board in New York City, when I suddenly thought yes, here we are, with all these incredible people, and all of them are focusing right then on something that started out as a simple idea shared between Ami and myself – sort of a ‘what if we . . . ‘ type idea, but an idea that grew and spread and activated people across the globe, from New York and Vermont to Manila and Puerto Princesa.

Since starting our programming in January, we have tended to focus on the people of Pulang Lupa, the mothers we have been teaching, and the children we have grown attached to – and we know we have made a difference in their lives. Ami and Lyn have now finished the cycle of 20 weeks of Reproductive Health and Human Rights classes and discussions, with five women achieving perfect attendance for the entire six months. Many children have gained up to five or six kilos each and have learned so many songs and have responded so eagerly to reading lessons, have learned to love their teachers, and have really had fun.

But during the Board meeting I was suddenly conscious of how much our work, our organization, has changed not only our clients but also our staff – Lyn and Evetha and Jane and Joslyn. We have provided each of these beautiful young ladies with her very first full time, substantive job, and we have challenged each of them to use her initiative and creativity to contribute, however possible, to the community and the organization. They have already gone beyond all of our expectations – they’ve all just marched into the community and made friends, started teaching, set up medical exams, etc. They know everyone there, mothers and children. Lyn Lyn is the ‘right hand person’ for Ami, Marcus, and myself, and Evetha has been planning the overall curriculum for our Child Health outreach work and reflecting on the learning sessions to improve them.

Ami and Marcus and I ourselves have been challenged and have grown and are doing all sorts of things we didn’t know we could do. On Saturday morning a visitor watched me stirring a pot in which six pounds of red kidney beans were boiling in preparation for the day’s nutrition supplement for children and mothers, and she said she had always wondered about cooking for huge groups like that. The beans were part of an experimental new dish to keep things interesting, but we’ve gotten five or six recipes down solid. We’ve become used to recipes that require 58 cloves of garlic and 24 onions. We even have a chicken soup recipe into which we stir 48 beaten eggs at the end.

For one thing, I now drive a pick up truck. The other day I went to the market and had five 100 lb. sacks of rice loaded into it. Marcus has been using the truck for vertical gardens – and he has learned all kinds of things about organic agriculture. The truck has transported all manner of things, from chairs for the children to sacks of soil for the vertical gardens, to huge pots of food and drinks, to some of the children themselves!

Ami has always said she didn’t want to teach, but she has done a magnificent job with the reproductive health classes. She seems quite comfortable now, and the moms love her. Marcus is really a teacher, but now he has been tasked to plan and oversee, with Evetha, a whole curriculum of our own making, in a culture that is new for him, and he is doing brilliantly.

Ami has also done a magnificent job of keeping Roots of Health organized, keeping the budget straight, writing updates and reports and grant applications. Maybe these aren’t new skills for her, but I had no idea that she would be that wonderful and professional at doing them. Marcus’s computer and website skills are also amazing, so as an organization we are really out there where we can be seen.

We have a wonderful advisory council here too, comprised of my eldest daughter Sara, Mae Legazpi, Ana Javarez and Rhoda Manalon from PSU, Dr. Socrates, Narcy Mikkelson of Aloha House, and Carlos Celdran, the writer and tour guide artist from Manila.

We have also involved a number of neighborhood cooks, one of whom put together 20 kilos of rice for us today, and of course Joseph the taho man, who dishes out his tasty drink at our Saturday Nutritional Support Program.

As a teacher I am used to trying to stir 25 or so people into mental activity, and sometimes what goes on in class ripples out in increasing circles too. But this – this little idea we had a couple of years ago – has gone wild! We hired our first staff member, Lyn Lyn, at the beginning of June, 2009, and here we are just a year later activating so many people! Happy Anniversary Roots of Health / Ugat ng Kalusugan!!

Becoming a Maternal Health Worker

Education, Maternal Health, Reproductive Health No Responses »

Jun 102010

“Excuse me, may I interview you? It’s questions about your life. When did you get married? How old were you when you had your first baby? How many children do you have?” These are some of the questions that I asked mothers that I interviewed last year for my job with Ugat ng Kalusugan.

I started to work at Ugat ng Kalusugan in June 2009. At first, I really didn’t know exactly what I would be doing. I was a teacher, and a young mother myself, but I didn’t know much about reproductive health, or public health, or working within the human rights framework. There was a lot I didn’t know but I was eager and excited to learn and grow into my job. At that time I was the only employee of Ugat ng Kalusugan, but I didn’t feel sad. That June was the first month that Ugat ng Kalusugan started to operate in the Philippines, (in Palawan specifically).

My former teacher, Susan Evangelista, became my boss and she started explaining more to me the work of Ugat ng Kalusugan. She explained that we needed to conduct needs assessments and start finding out the health and nutritional needs of women, especially young mothers. She asked me to start conducting research in a community called Golden Valley, which is also where I lived. I looked for and interviewed women and girls who got married and had babies when they were still at a young age, mostly 15 to 19 years old. They all said to me: “It is too hard to have a baby when you are still young. You don’t know what you should do if the baby starts crying.” One of the moms said that when her baby was crying she would just put a bottle of milk in front of it because she didn’t know what else to do.

Two months went by and then Ami and Marcus came to Palawan. And then we were three! We began our work. We looked into different places where people needed special attention. We went to a community called Bagong Silang and conducted interviews about people’s lives. Families there are huge and we also learned that three to four families all lived in one house. Many of the residents there live very hard lives. But, Bagong Silang residents are so lucky because they have energetic barangay officials who are supportive of them and who help them so much. We investigated other places including a community called Pulang Lupa. We conducted in–depth surveys with all the households in Pulang Lupa and we realized they really needed our help and attention. This is where I realized that they all really needed the services of Ugat ng Kalusugan.

Because residents in Pulang Lupa have very little money and education and food, and don’t have any health workers or Barangay officials near them, we selected Pulang Lupa as our first project site. At first, I was like a stranger to the residents of Pulang Lupa and I didn’t know many of them individually. But now I know nearly everyone by name, and I consider many of the moms we work with to be my friends. When we began our work, we made a plan for the moms and for the kids of the community. We held two sessions per week for women and children and also had two Saturdays a month for our extra Nutritional Support Program. Ami and I taught the moms, and we had a part-time teacher who handled the kids.

Looking back now, I cant believe that so many months have already passed, and now I am celebrating my first anniversary at Ugat ng Kalusugan. I never imagined that I would do so many positive things. I’ve met and gained the trust of many different people. I do a lot of lesson plans for the sessions for the moms. I’ve learned a lot! In a nutshell, I have evolved and I am still evolving! We didn’t have a lot of experience when we started and I am so glad that all the moms who attended our sessions trusted us and believed in us.

Pulang Lupa is just the first place where we reached our hands out — there will be more communities! And as we wrap up our work with moms in Pulang Lupa and transfer to another place where we can extend our assistance, Pulang Lupa will always be a part of my life. The memories and the experiences I’ve had there will stay with me. And I know I will continue to learn more from wherever we work next!

Maternal Health in May

Maternal Health, Nutrition, Reproductive Health No Responses »

May 272010

As we approach June, I find it incredible to believe that Roots of Health has been in operation for nearly an entire year. It was June 2009 that we held the first Roots of Health Board meeting during which we adopted by-laws and made concrete plans for activities for the year. It was also in June that in Palawan, Susan and Lyn Lyn started the incorporation process for Ugat ng Kalusugan and began the preliminary work of making contacts and finding out more about the various communities that we considered first working in. We have accomplished so much in the last 12 months and it has truly been humbling to see firsthand how far our small programs have gone to improve the health and lives of women, girls and children in Pulang Lupa and among various groups at Palawan State University.

Just in the last month Roots of Health has had a variety of new developments, initiatives, and new people who have committed their time joined our team.

Child Health Programming
We’re working hard to expand our outreach work with children in Pulang Lupa and we’ve taken several steps to support our goals. Rather than continuing on with the day-care model of simply entertaining the children in our sessions with songs and games, we have started implementing an ambitious curriculum in order to also teach the children basic math, literacy and English language skills. To that end we have hired a full time teacher, have a part time teacher, and have a third teacher who we hire on a day-to-day basis. This allows us to have three teachers present at every session we hold, which allows for the kids to be divided up according to age so that age-appropriate lessons are easier to implement. The children love the individualized attention, and this also allows our teachers to get to know each child better.

Increased Weights Among Children
After each of our twice-weekly sessions for the children, the kids are served a nutritious, heavy snack. All of these same children also attend our Saturday Nutritional Support Program sessions where they are served a heavy soup or porridge that always includes chicken or beef, eggs or milk and a variety of vegetables. At the weekend NSP sessions the kids also have fresh milk, or taho, a sweet soy drink.

Since February we have been monitoring the weights of the children who come to our Saturday sessions. Some come more regularly than others, but we have data for 168 children who have attended our NSPs. Of those children, 114 attend one or both of our weekday sessions. We recently analyzed the children’s weight data and found that since we began our NSPs, 72 children have an increased weight of an average of 2.2 kilos per month. Of the 72 children with weight gain, 71 attend our weekday sessions. While we of course want to increase the number of children who are gaining weight, we have been thrilled to see the gains that have occurred. At this point we do not have enough data to definitively say that these weight increases are due to our programming alone. However, it is heartening to see that the weekday sessions may be making a real difference and could be the main factor involved with boosting the weight of undernourished children.

Reproductive Health Outreach with Mothers
We’ve continued on with our sessions with moms in Pulang Lupa, and are entering our 17th week with our groups. We have been operating with a 20-week module of sessions so our activities with moms in Pulang Lupa will begin winding down after this next month. We will continue to have informal contact with the moms once or twice a week, but will no longer hold the formal education sessions.

Since we began these sessions, attendance has continued to rise. During our first week in Pulang Lupa we had 21 women attend our sessions. Last week we had 26. Overall we’ve had 39 women attending. Since we started our sessions 16 weeks ago, 5 ladies have attended every single session. 4 more have missed only one. We’ve received very positive feedback from the ladies. They really enjoy learning about their bodies and their health, and having a forum in which they can ask questions and engage in discussions about their families and their lives.

Health Care for Women and Girls
In May we hired Josylyn Gulane, a nurse with extensive experience working in rural, underserved provinces of Palawan. This month, Josylyn began providing direct healthcare to women and girls in Pulang Lupa. She has conducted 7 general health check ups, has carried out 5 pap smears, and has provided family planning check ups to 5 women who have requested condoms, birth control pills, and the injectable contraceptive, Depo Provera. We have 11 women signed up to have check ups with Josylyn in the coming week and in the future will have one or two regular clinic days for her in Pulang Lupa so that women can drop in to see her as needed. This community has long been unable to access adequate health services and the women have been thrilled to have the chance to access free, high quality care.

We are so excited with everything we’ve been able to carry out in this last year and are looking forward to implementing all our plans for the coming year. We hope to work even more effectively during Year 2 and will of course keep you all updated as we progress. Thanks once again to all of you for your continued support. We couldn’t do this without you!

Zooming in on Maternal Health

Education, Maternal Health No Responses »

Apr 272010

We were recently lucky enough to be visited by an old friend from New York City, Keefe Murren. We were doubly lucky that while he was here he volunteered much of his time to Roots of Health. Keefe is a documentary filmmaker who currently works for the Sundance Channel. He proposed creating a short one-two minute film about our work that we could use on our website and on our Facebook page. He also suggested creating a longer, 10 minute version of the film that we could use for fundraisers, grant applications, and generally to inform people more about our work. We were thrilled at his ideas and got to work planning what the videos would be like. We told the women we work with in Pulang Lupa that a filmmaker would be visiting them, and they were all very excited that they would have the chance to share their stories.

Keefe arrived in Palawan and the next day we put him to work filming a women’s education session in Pulang Lupa. He was amazed at how friendly all the ladies were and how everyone seemed to be at ease with the camera. After the session Keefe held the camera as Ami asked the mothers questions about their lives. What was your childhood like? When did you get married and start your own family? What are your hopes and dreams for yourself? And for your children?

With each session Keefe attended and filmed, he felt ever-more comfortable and the women continued to open up. Even though we have been working in the community for almost five months, we learned a lot of new things about each individual woman who was interviewed, and we were really moved by the answers that the mothers gave. They told stories of hardship, loneliness, and abuse. All except one mother cried during the interviews. But they also told stories of amazing endurance and resilience and we could not help but be awed by the strength of these women and girls.

We hadn’t expected it but the interviews gave us some real insight into not only the lives of the mothers at Pulang Lupa, but their family histories. People say that history repeats itself. I agree — in many cases it does. Here however, the majority of mothers we interviewed want to be better parents to their children than their parents were to them. They want to provide their children with the things they did not have while they were growing up, most notably the opportunity to go to school. They want their children to have better lives than the lives they have had.

And with a little help they will be able to give their kids brighter futures. By working with the women to help them plan their pregnancies and have healthier families, we hope that the mothers will be able to only have as many children as they want and can support, and that they will also be able to devote more of their energy and resources to care for the children that they do have.

In all, Keefe filmed two weeks of women’s educational sessions, one nutritional support program session and 13 in-depth interviews. Even though it was always blisteringly hot at Pulang Lupa, Keefe didn’t seem to notice the heat. He never got tired and was always up for more filming. The one time that I held the camera and filmed was when Keefe interviewed Ami. Although the camera only weighs about a kilogram, in order to get good angles, the camera forces you to stand in an awkward position. After about ten minutes of filming, my back started hurting. Five minutes later my arm went to sleep. From that point on I was juggling my personal discomfort with getting the best shot possible, making sure Ami was in focus and trying not to move around too much. Keefe always made filming look so easy and the hour I spent behind the camera gave me new respect and appreciation for just how difficult filming is –the mental challenges of setting up the best shots, the emotional and interpersonal challenges of making the interviewees comfortable and getting them to open up, and the physical challenges of operating the camera. This is hard work!

Before Keefe went back to New York City, Ami and Lyn Lyn spent hours poring over the footage of the interviews, transcribing and translating in order to allow for Keefe to begin the long and equally challenging job of editing and piecing the footage together. I am looking forward to seeing the end product of all the filming, and to have a powerful tool for showing people what we do here, and why.

Participating in this filmmaking process has given me a lot more insight into the lives of the women that we work with and a newfound respect for the women and mothers that they have become, in spite of the hardships they have been forced to endure, and continue to struggle with. These women are so strong and resilient, and live their lives with such grace and dignity despite having so many challenges. I wish you could all meet them and see this for yourselves but I’m glad that in a few months, you’ll be able to see Keefe’s film and get to know these amazing women better.

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