Surveys in Purok Matahimik

Earlier this week we returned to an area in Santa Lourdes called Purok Matahimik which means “quiet place”, also known as “Pulang Lupa” or red earth because of the color of the soil, and is also simply known as “Dumpsite” because of the community’s proximity to the Puerto Princesa landfill. This community is a top runner for where we might begin our services as it is quite isolated and very poor and has high numbers of malnourished children.

Photos from our visit of Purok Matahimik.

We interviewed 13 women between the ages of 17 and 56.

Family Planning Usage
We asked the women about their family planning usage and just over 30% of the women we spoke with use artificial forms of contraception. Three use the injectable DMPA (Depo Provera) and one uses birth control pills. All four women pay for their contraception themselves. Three of the women we spoke with use natural family planning methods including the calendar/rhythm method and the withdrawal method. One woman just recently gave birth to a baby and isn’t on any contraception but plans to be when her period returns.

Five of the women we interviewed do not use any form of family planning. One of them gave no explanation for why she prefers not to use any contraception. One woman said that she had been living in an isolated and rural area and did not have any access to any healthcare or family planning methods. Another woman said that she isn’t using anything because she doesn’t have a husband any longer and is on her own. Another respondent said that she didn’t think she had to use anything because she’s already old (she is 56 and has a four year old daughter.)

37 year old Helen, who has three children, said, “I’m not practicing any family planning right now, but there were 5 years between my last two children so I think that’s a good thing – but I’m not using anything. I tried using pills before but I only lasted about 2 months. I got so dizzy from the medicine. I actually thought I was already done with kids but then I got pregnant again. I just gave birth two weeks ago. I’ll probably go on something now – maybe the injectable [DMPA]. It’s really hard when you think you’re done with kids but then you suddenly get pregnant again.”

How many is a good number of kids?

We asked the women we spoke with what their ideal number of children is. The two youngest respondents, aged 17 and 18 and each with one unplanned child, said they would like to have 3 children. Both of them are now using contraception. Other respondents with 3-4 children answered that their ideals are the same as the number of children they do have. One woman, Carolina, 36 years old, said her ideal is three kids but she has five because she didn’t know of any ways to control the number of her pregnancies. Merleta, who is 34, has four children, which she says is her ideal, but she has had eight pregnancies, and none of them were planned. Edita, 56 years old, says her ideal is three children. She has four living children but has had nine pregnancies in her life – none of which were planned. 39-year-old Marlyn said her ideal is three or four children, but she has nine children – none of them planned. She actually gave one of them up for adoption some years ago because she did not have the resources to feed and care for another child. 48-year-old Angelita’s ideal is four children but she has eight. She lived in an isolated, rural area and had no access to contraception. Marilyn, who is 25 years old, says her ideal is four or five children. She has seven and is not on any contraception. She told us, “I can’t do anything because my husband doesn’t want me on any contraception. I actually asked my sister to adopt one of my kids because I have malnourished children and I can’t handle all of them myself.”

Pre and Post Natal Care
10 of our 13 respondents did receive prenatal care with their last pregnancy, but most only had two to four appointments before they delivered. Of the three women who did not seek prenatal care, one went to a traditional healer and two said they just took care of themselves.

After giving birth, five of the women we spoke with saw a health professional for at least one postnatal check up. One woman saw a traditional healer. Another did not have any check up but her doctor sent her a bottle of postnatal pills which she took for one month. More than half of the women we spoke with did not have a postnatal check up and four of told me they didn’t even consider it because they just don’t have the money to spend on a check up.

Health Care
Nearly all of the women we spoke with said that when they or their children are sick, they prefer to see a doctor when they can afford it, or seek free care from Barangay Health Workers. Two women said they they just buy their own medicine when they are ill rather than spend money on a consultation. One woman with no experience or training in herbs or alternative medicine said, “When I have money I like to go to a doctor. But when I don’t have any money I just use herbs that I find around where I live.”

Birthing
All of the women we spoke with except for one said that their preferred birth attendant is a traditional healer or a midwife. One person prefers a doctor. Seven of the women prefer giving birth at home and actually did have their children at home. Three women said they gave birth at hospitals just to make sure they would have the help they needed had there been any problems with their deliveries. One woman had her last baby at a hospital but the rest were born at home. She’d had eight pregnancies and four live births. One woman who has had nine pregnancies and four live births said, “I’d like to give birth in a hospital but I don’t have the money to pay for it. So I give birth at home.”

Thoughts on Family Planning
We asked the interviewees what their thoughts on family planning are and some of their statements include:

“You’ll probably be more successful if you plan your pregnancies.”

“You really have to do family planning because otherwise, you can’t make a good future for your family.”

“When you have lots of children its hard to support all the children’s needs.”

“You should plan your family so that you can give them a good life.”

Food and Nutrition
Most of the respondents breast fed their babies. The majority of them breast fed until their children were two years old though some breast fed for shorter periods (one to six months or a year) and some breast fed for longer (until age three).

We asked if any of them receive supplemental food support and nearly all of them have children who are fed in the biweekly Aloha feeding. (To read about Aloha’s program, see my previous blog entry by clicking here.) One woman said that she does not receive any support and added, while pointing to her daughter, “I really need some help for her – she’s so skinny.”

Household Income
We asked the women we spoke with what their monthly household income is and whether they or their husbands have work. Most women reported very small amounts of income that have to support multiple people for a month. One woman with four children said their monthly income is P1,000 ($21). She doesn’t have any work but would like to do anything to make more for her family. Another woman whose 84-year old husband is paralyzed sells fish in homes around the neighborhood and makes about P500 ($10) for her family of six. Another woman is a single parent and makes about three straw mats a month that she sells in the market. She can make about P500 ($10) to support herself and her son. Another single parent makes about P1,500 ($31) making and selling mats and this supports her and her eight children.

Merleta, who has eight children, said, “My husband makes P1,000 ($21). I make straw mats and in a month I can make around 5. They sell for P200-300 ($4-6) each in the market. I make a little but I use it to buy rice or food for the children. So I never have anything left.”

One woman makes P4,000 ($84) a month buying and selling scraps (mostly recyclable plastic and glass) that she collects from the dumpsite. This supports her, her husband and their eight children.

The wealthiest of the women we spoke with has a husband who works as a painter and makes around P9,000 ($190) per month. She supplements this income with around P200 ($4) a week that she makes selling items at a small store in front of her home (these stores are called sari-sari stores and are usually stocked with some snacks and basic supplies like soap and cooking oil.) She only has one child so they have a much better situation than most of their neighbors do.

One family’s experiences confirmed an anecdote we had been told by a friend who works for the city’s Department of Social Welfare and Development. Our friend told us that the city government is frequently months late in paying salaries to city employees. Most people in Palawan have no credit, so late payment of salaries really puts people in a bind. People need cash and some resourceful (and cunning?) people have stepped in and lend city employees money until they receive their salaries, but they take a huge portion of the earnings as their fee. Some people think the city government is in on this lending scheme but this is not substantiated. One of the women we interviewed with three children said, “My husband is a driver for the city and should make around P6,500 ($136) a month. But the city doesn’t pay the workers right away so then we have no money. He borrows some from lenders who then take a cut. So what he brings home is just about P5,000 ($105). I just take care of things at home and watch over the kids. Once my baby is older, I’d love to work – maybe run a sari-sari store?”

Other Resources
We asked our interviewees if they receive any supplemental support from groups conducting outreach work in their community. The women we interviewed noted that they sometimes get free care from the Barangay Health Center and the Puerto Princesa City Health Center. A Korean church group also organized a medical mission to the community once last year. They gave away medicine and clothes and performed circumcisions. They haven’t been back since. One woman remembered an outreach program that the military once had but couldn’t recall when that was or what exactly they did. One woman answered that she and her friends don’t get any other support and added, “Contraception really should be free for us. The Health center is really far away and anyway when you don’t have money, you can’t buy anything so then you’ll just get pregnant again.”