BIRTHING BLUES

Photo courtesy of  www.ph.undp.org

The Philippine Government faces greater challenges in meeting some of its UN Millenium Development Goals (MDG) as the deadline draws near. One of these targets is to lower maternal morality rate (MMR) to 52 per 100,000 live births by 2015. The latest statistics indicate that instead of dropping, MMR jumped from 162 in 2008 to 221 in 2011. And the Department of Health (DOH) knows this only too well.   

According to Dr. Diego Danila (national program manager of DOH’s Maternal, Newbord, Child Health and Nutrition Task Force) reducing MMR is indeed a tough task because it is such a complex issue. It requires the national government and the local government units (LGU) to work hand in hand and address the issue more efficiently.

Still, various programs are unceasingly conducted by the DOH to improve health services for mothers and their babies, especially those who belong to the poor communities. “It may be difficult but the efforts of the government are continuous. The indicators show positive signs in some areas like facility-based delivery going up both in public and private [health units],” said Danila.

The doctor identified the top five factors that contribute to the rise of MMR in the country: non-belief in pre-natal care because some mothers were able to give birth successfully even without it; far distrance of health centers; poverty; lack of moneu to buy pre-natal vitamins; and teenage pregnancy  (which are usually not being reported as this is still a taboo in the Filipino society).

One of the initial steps taken by the DOH to lower down MMR and encourage mothers to seek professional care during pregnancy and delivery was the passage of the “No Home Birthing Policy” during the administraiton of then-president Gloria Macapagal-Arroyo. Presiden Benigno Aquino III retained the said policy and updated it to maternal, new-born, child health and nutrition (MNCHN) stragegy.

But the policy faced opposition from various officials and organizations. They argued that banning home birthing is not the right solution for the rising toll of maternal deaths in the country for it would just make birth-giving more difficult for poor mothers, especially those who dwell in remote areas where health facilities are scarce.

Danila clarified that there is no law that prohibits mothers to give birth in their homes if they want to. “What we have is an advocacy, a recommendation which you can either follow or not,” he said.

Their message to mothers, however, is that if there is an available health facility near them, make use of that. “We’re increasing the number of facilities and trained doctors, nurses, and midwives; plus we enroll you to Phil Health (a health card), “ Danila added.

He also said that if mothers really want to have their delivery at home because they think they’re safe there, they could. “However, we can tell you that studies sow that it is safer for mothers to give birth in a health facility than in her house. Doctors, equipment, and medicines are available in a facility,” the health official stated.

BRIGHT SIGNS

Despite the criticisms, the DOH pursues the strategy together with programs aimed at improving and bulding more birthing facilities. It also targets the training of more health personnel in basic as well as comprehensive emergency obstetric and new-born care.

As of the latest DOH data, there are 1,598 basic emergency obstetric and new-born care facilities in the country and 270 comprehensive ones. Danila is positive that thes programs are encouraging a number of mothers to give birth in birthing facilities.

Interview with Dr. Danila of the DOH

The latest stats of the DOH indicated improvement in maternal and child health care in the country. Antenatal care coverage has increased from 77.8 percent in 2008 to 78 percent in 2011, closer to the 2015 target of 85 percent. The study also indicated that 73 percent of mothers received assistance from health professionals compared to 62 percent in 2008.

Frequency of postnatal care received by mothers within the first week of delivery also boosted to 84 percent, almost hitting the 2015 target of 85 percent, while the frequence of postnatal care received by new-borns wthin first week of delivery registered at 86 percent.

The campaign has also reached indigenous communities that observe tribal birth-giving rituals and preger delivery by trraditional birth attendant (TBA) or hilot, and normally rejecting the modern and scientific way of delivery. Danila cited the case of the Mangyan tribe in the mountains of Mindoro. Traditionally, when a mother is about to give birth, all the members of the tribe gets involved—making the situation too crowded for a common birthing facility space to handle.

This custom is one of the reasons why mothers of the tribe did not want to deliver in a birthing facilty. To address the issue, the DOH and LGU build a huge hut near their community to serve as a bithing center. The hut is equipped with facilities and medical professionals, and is spacious enough to accomodate the accompanying tribesmen. “We respect their ways,” Danila said.

Dr. Danila admits that hitting the MDG by 2015 is a hard nut to crack but he is optimistic that the Philippines’ maternal and child health will eventually improve further. But that would also depend on the political will of the local government units. “In public health, you have to understand all stakeholders. If you don’t, the beneficiaries will suffer. A lot of governors, LGU executives in the country are not callous about health care; they just don’t understand it. So you need to expalin it to them. The bottleneck also occurs with municipal doctors who do not know how to advocate. Some of them are not active in pushing [health] advocacies,” he said.

(Article originally published in Philippine Rotary magazine December 2013

Photo: Carmen Dela Cerna)

LISTEN TO THEIR STORY

Rotary PID scholars: (standing) Hanna Olivares,
Charles Munoz, Marjobelle Estrologo;
(sitting) JV Cielos, Kirvy Tejada, Daryl Pilotin

It’s a bright Monday morning. Elementary and high school students line up at the school grounds for the flag-raising ceremony. A young lady goes in front to conduct and leads the singing of the National Anthem while the Philippine Flag is being slowly raised on the flagpole. With right hand on chest, every pupil sings “Lupang Hinirang” with energy. This may look like a regular flag ceremony but it is not—because this kids singing in unison actually have hearing and speech problems.

They are students of the Philippine Institute for the Deaf (PID), a school founded in 1988 by the late Dr. Sergia G. Esguerra, considered as the “Mother of Special Education in the Philippines”, and her daughter Julie, an outstanding special education and speech correction teacher.

PID teaches persons with speech and auditory problems to speak and communicate like individuals with normal hearing. The system that the institution is called oral education—a training on how each sound is produced through mouth and tongue positioning, drawing of speech profile, feeling the vibration of vocal and nasal muscles, transcribing visually hard words, and hand analogy of mouth movements. It includes endless speech drills and constant feedback on how to master the everyday language through one-on-one speech therapy classes with the help of powerful hearing aids. PID also conducts auditory training activities that teach the students how to interpret, master, and respond to what they hear in their environment.

Hanna shows a sample
 of her artwork compiled
in her sketchpad

According to the World Health Organization, 360 million people (5.3 percent of the world’s population) suffer from disabling hearing loss. Thirty-two million (nine percent)  of them are children.  The report also indicated that the prevalence of hearing loss in both adults and children is greatest in the regions of Sub-Saharan Africa, South Asia, and Asia Pacific, which includes the Philippines.

For 15 years, the Rotary Club of Makati has been helping PID with scholarships as well as donations of learning facilities, like computers, through the initiative of Cesar Campos, past club president.

Evelyn S. Cataga, PID assistant director and marketing manager, acknowledges these significant contributions of Rotary for their continued operation. There are a number of students who belong to poor families that could not afford the high cost of special education in the said institution and the school only receives minimal assistance from the government.

This is why the management, faculty, and scholars of PID are indeed grateful that Rotary is always there to hear their plea and help them.

Training Techniques

Jasmine Concepcion
and PID Acting Principal
Maricris Ibayan

Aside from the speech therapy and classes, PID teaches its students academic subjects according to the K+12  curriculum of the Department of Education in a more simplified approach.

Maricris P. Ibayan, curriculum planer and acting principal, said the institution emphasizes on helping the students live normal lives by building their confidence, an essential factor in developing their speaking skills, and to be comfortable in interacting with other individuals.

Ibayan added that they also stress upon the parents that speech development practices should not only be done in school to further the child’s progress. “We always remind the parents to constantly work out their children’s speech and confidence even at home so they won’t be discriminated against. Persons with normal hearing get harassed or bullied, how much more those who have hearing problems? So we advise them to give their child more experience and exposure to boost  their self esteem,” Ibayan said.

Whenever the PID faculty sees a potential talent in a student, they assist him to develop it. Like they are doing to grade eight student Jasmine Concepcion, 15, the girl who led the singing of the National Anthem earlier. 

Students do some exercise

Jasmine expressed her passion for music despite her congenital hearing impairment. It is really difficult for her to hear sounds. So to cope, she relies mostly on lip-reading or sign language in communicating without hearing aid. And yet, she aspires to be a music artist someday like her idol, Taylor Swift.

According to Cataga, PID is training Jasmine to further improve her talent, with the hope that someone from the music industry would notice her and help the young lady live her dream.

Normal Lives

Jasmine’s case is not a frist for PID. A former student, Denisse Lincuando, turn out to be the first deaf ballerina of Ballet Manila, the company of prima ballerina Liza Macuja-Elizalde.  (Check her
 amazing ballet performance in the video below)

Aside from Lincuando, there are other PID alumni who are now professionals and entrepreneurs, proving that they could succeed in life like normal people.

Lisa Madeja lecturing her pupils

Another alumna the institute is proud of is Lisa Madeja, 29, who now teaches math, languages, speech, reading, writing, music, arts, and physical education to kindergarten pupils at the PID.

Madeja, deaf since birth, is a graduate of computer technology and early childhood development and education at Miriam College. She shares that her hard working parents and former instructors at the PID inspired her to persevere in reaching her goals, a trait she wishes for her pupils as well.

For more information about PID and how you can help their students, please visit their website: www.pidmanila.com.

(Photos by: Carmen Dela Serna)

Originally published in Philippine Rotary magazine, December 2014

SERVICE BEHIND BARS

In the late 2014 the controversy in the New Bilibid Prision, the Philippines maximum security prison, was among the top stories in the news. The Department of Justice discovered that some high profile, rich inmates were getting special treatment behind bars and imprisoned drug lords still operate their dirty business behind bars.

When I heard this news, it reminded me of one extraordinary experience I had in 2014 when I covered a story about a Rotarian doctor who conducts free medical services to diabetic inmates in  Bilibid. I and our photographer had the opportunity to enter the New Bilibid Prison and talk to some prisoners there. Words could not describe the feeling I had when I was there-- in the midst of convicted criminals. The emotion was a mix of fear, excitement, and sympathy.  I was also surprised to see that, contrary to the images projected in the movies, Bilibid  is actually a community, like a barangay of prisoners where they could roam around and hang out. They have stores, basketball court, tennis court, restaurants. No wonder why some inmates wouldn't want to get out of that place!

 Here's my story published in the July 2014 issue of Philippine Rotary magazine:

SERVICE BEHIND BARS

Dr. Nick Villatuya

Norman Talibot, 77, has been incarcerated in the compound of the New Bilibid Prison (NBP) for 35 years, serving a life sentence. Though restricted within the high, barbed wired concrete walls of the country’s maximum security prison, Talibot still looks forward to waking up every day to serve his fellow inmates who are afflicted with diabetes. Behind bars, he has found a new meaning in life as amember of the BuCor Inmates Diabetes Association (BIDA), a group of NBP prisoners who are trained to educate and assist prisoners with diabetes.  

BIDA was organized by Dr. Melanie Duran, resident diabetologist at NBP Hospital, in 2006. It treats around 300 inmates with diabetes, a lifelong and costly condition that could result into serious complications like heart disease, kidney failure, nerve damage, stroke, amputation of limbs, and blindess. Every day the members of BIDA, including Talibot, monitor diabetic prisoners confined in the prison hospital ward, most of whom are already in their late years and had already been abandoned by their families. BIDA also conducts checkups and give lectures about the disease.

In 2012, BIDA partnered with the Rotary Club of Alabang to strengthen their efforts toward this initiative. Led by Dr. Nick Villatuya, a diabetologist and RY 2013-2014 club president. RC Alabang is also spearheading a signature service program on diabetes awareness as well as supports BIDA’s initiatives by providing medicines, insulin, and medical equipment. Villatuya also conducts medical services for diabetic inmates every week.

BIDA members checking up diabetic inmates

Villatuya, founder of Diabetes Education Assistance and Research Foundation Philippines that assists underprivileged diabetic patients, says that the service program in the NBP is one that is close to his heart, despite of the high risk involved. Weekly, he is exposed to 13,000 convicted criminals belonging to 13 rival prison gangs. “There are things that I gain from the prisoners that are greater t what I receive than the ones I provide them. These are knowledge, experience, insights, stories, and even care. The risk is outweighed by what I receive, which can never be stolen from me. Material riches fade away, but these things that make you wiser in understanding your fellowmen is irreplacable,” said Villatuya, who also works as a medical consultant at the Alabang Diabetes Clinic in Muntinlupa City.

Dr. Villatuya checks up a patient in the ward

The World Diabetes Fouation recognized BIDA for its notable effort during the 2012 Global Diabetes Walk. In this activity, 1,000 inmates from different gangs joined the walk within the NBP compound. The gangs set aside their differences and formed a big blue circle, showing their unity in the fight against diabetes. The individuals who witnessed the scene described it as “a rare moment of civility” as members of notorious prison gangs peacefully gathered in one place.

Inmates from different prison gangs in the New Bilibid Prison show their unity in the fight
against diabetes during the 2012 Global Diabetes Walk (Photo courtesy of Dr. Duran)

Such a feat is among the priceless rewards that inspire BIDA and RC Alabang to continue their service behind bars—proving that “Service Above Self” knows no boundaries and trancends through the high concrete walls of a maximum security prison. “It is very rewarding. Service to fellowmen does not choose places. Even inside or outside a prisons or in the church, if there’s someone who needs help, we will be there,” Villatuya said.

(Photos by: Carmen Dela Cerna)