Saturday, November 23, 2013

Diaries from the Field: A personal diary on three delays & “why no woman should die giving life”

Nonoy





Two days before Christmas morning in 2011, someone gave me a notebook with an inscription “no women should die giving life.” She said she wanted me to have that, along with a UNFPA bag and mug, as token for having traveled from Mindanao to attend my final interview for a job at UNFPA I was applying for. It was the beginning of another journey. After a year and 9 months, I was with some health service providers in the Province of Masbate crossing the clear sea waters of Masbate mainland to Ticao Island to conduct a Maternal Death Review cum Community Dissemination Forum.  Two women just recently died while giving birth in San Jacinto Municipality. In 2012, 22 women died while giving birth in the Province of Masbate. Although, the numbers are decreasing from 35 in 210 and 29 in 2011, these figures are still alarming contributing to the some 230 women for every 100,000 live births who die each year in the Philippines while giving birth.  These figures make MDG 5 the least likely MDG goal to be achieved by the Philippines in 2015. 

Delay in Accessing Health Care and the Road Network
The recent obvious development in the Island is the construction of kilometers of roads connecting the four fourth class municipalities of Batuan, Monreal, San Fernando and San Jacinto. I was with our Maternal Health Officer, Angel and five other health service providers from the Province. The more than an hour boat ride from Masbate City mainland continued with a 45 minutes land trip to reach the Municipality of San Jacinto. The almost two hours of journey lead us to discussions on the renowned politician who died of plane crashed in the middle of the sea we were traversing to the  issue of road development in Ticao Island. 

Debbie, the provincial family planning coordinator, shared that it will take them more than three hours to travel on an uncemented road from Batuan to San Jacinto before. But the new road network is allowing the population to access services, including health services, in 45 minutes.  However, some communities are still very difficult to reach due to distance of health facilities, poor roads in geographically isolated barangays, and availability of transportation. In 2012, I witnessed a Maternal Death Community Dessimination Forum in Lebak, Sultan Kudarat held a remote barangay with a very poor road network. The community was successful deciding to put up a “bayanihan” system of a involving the barangay officials by providing a “pre-paid” motorcycle that will bring the woman to the birthing clinic, blood donation from family members to assure blood transfusion in case of blood loss, and some homes nearer to the birthing clinic as halfway homes for pregnant women while waiting for the delivery period.

Delay in the Decision to Seek Care and a Personal Experience

The death of two women in Ticao is a result of delay in reaching care. Presumably, health service providers in the island have been providing “community-based” awareness campaign maternal health. I couldn’t imagine the daily sacrifice relayed by some midwives during the forum on traversing mountains and slippery slopes while conducting maternal health advocacy campaigns. However, Ticao Island, with four 4th municipalities, have very poor families which can may have resulted to low status of women in seeking health care and its financial implications. Furthermore, the maternal death may also happen as when the pregnant woman and her family have “poor understanding of complications and risk factors in pregnancy and of when medical interventions are needed.” In 2006, my sister died after giving birth to her second child due to pregnancy related complications. The physician said it is my sister’s incapacity to seek care which resulted to this tragic event in our family. She has a heart disease which the doctor already warned when she gave birth to her first child in 2002 (the child also died a month after). She was already advised to use family planning method to save her life but she didn’t. The women in Ticao, Lebak and my sister have one thing in common—their late decision to seek care due to lack of knowledge, financial incapacity and poor understanding if the risk of pregnancy. 

Delay in Receiving Adequate Health Care

As the Maternal Death Review cum Dissemination Forum in Ticao is heating, Dr. Angel quickly pointed out that the review process shall never be a fault-finding exercise but an avenue to discuss measures reduce maternal deaths in the future. San Jacinto has a total population of 27,974 (as of 2010) for its 17 barangays. As to number of midwives per 5,000 population, San Jacinto has enough. But, it is not the number of midwives that concerns adequacy in health care but the terrain and location of areas of assignments of the midwives. Many of the barangays in San Jacinto belongs to the “geographically isolated and disadvantage area or GIDA” which might lead to inadequate referral system in tracking high risk pregnancy and difficultly of health service providers to reach these GIDAs. As of 2012, it is worth mentioning that the Province of Masbate has already 18 of its 21 RHUs certified birthing clinics and MCP accredited.  Coupled with more support from UNFPA and other stakeholders on trainings and capacity development on maternal health and family planning, this development will eventually result to more motivated health service providers and increase their referral system for a delivery of birth by a skilled birth attendant.   

Hopes in the Future 

As I peeped from terrace of the Municipal Hall of San Jacinto, I saw the crystal water of the sea and it seems inviting me to take a deep. Surely, I think, more children will swim in that sea with their mothers with them. The MDR cum Community Dissemination Forum is only an awakening exercise for San Jacinto and the whole Province of Masbate to reflect on reducing maternal deaths.  As we travelled back to mainland Masbate late that afternoon, I am already starting to feel the breeze of the “ber months” (Filipinos’ concept of celebrating early Christmas starting from September to December) and for now, one of my wish list is to reduce maternal deaths and make that inscription in my notebook a reality, that, “no woman should die giving life.”
 

Masbate and UNFPA renew commitments to achieve universal access to SRH

Nonoy

Note: This is an old article written on August 2013. 



Taguig City--“This is not just something personal but a respond to the majority population of Province of Masbate who are asking for access to reproductive health services.” This was the acceptance message of Governor Rizalina Seachon-Lanete during the Partnership Meeting and Signing of 2013 Annual Work Plan between the United Nations Population Fund (UNFPA) and the Province of Masbate on 19 August 2013 in F1 Hotel, Taguig. “Our population needs this support,” the Governor added. 



Meanwhile, Ugochi Daniels, former Country Representative of UNFPA Philippines, noted the significant contribution of Masbate during the 6th Country Programme. Daniels recognized Masbate’s effort towards a 70% increase in the number of pregnant women completing antenatal visits as a reflection of the multi-sector support extended to the pregnant women including its Buntis Baby Bank micro-financing and 18 of its 21 Rural Health Units are already MCP- accredited and with BEmONC trained personnel as of 2012 and early 2013.

Working on the gains of the 6th Country Programme, the Province of Masbate is the 10th Province to have entered into partnership with UNFPA. UNFPA noted that more needs to be done to address current challenges and disparities especially between the 6th CP pilot municipalities and the province as a whole in the areas of facility based delivery, contraceptive prevalence rate, functionality of Women Crises Protection Units and Local Health Board, and addressing unmet need for modern family planning method to about 45,797 women of reproductive age (one of the highest in Bicol).

Under the Medium Package of Assistance, Masbate will be receiving support based on quality improvement, accreditation and compliance to standards needs of the Province. The 2013 Annual Work Plan for Masbate will focus on support 18 out of 21 BEmONC certified RHUs in providing long acting and permanent method of FP to women with unmet need in CCT/ NHTS areas, strengthen capacities of 74 Barangays (both CCT and non-CCT) in providing family planning services through integrating Family Planning Action Sessions, masterlisting of women with unmet need, and referral of clients towards becoming FP acceptors (as well as mobilizing CHTs/ WHTs). The plan will also ensure the implementation of a solid STI prevention and control program for high risk young people and male and female freelance sex workers.  It will also support the completion of ‘province-wide’ CBMS incorporating key data related to gender and sexual reproductive health needs of the population. Finally, it will strengthen the gender and development program of the Province through supporting the functionality of its Women Crises Protection Unit and review of its draft GAD Code towards enactment.

In closing Daniels said that, “By 2016, we hope to be able to ensure that we will make significant strides in ensuring that every pregnancy is wanted, every birth is safe, every young person's potential is fulfilled.”
 

AIM-World Bank Mindanao Bridging Leaders Programmme (MBLP)

AIM-World Bank Mindanao Bridging Leaders Programmme (MBLP)
CLICK ON PIC FOR LINK: The overall objective of the program is to build a cadre of Bridging Leaders in Mindanao, who can address issues like peace, education, health, land conflicts, poverty, and poor local governance, among others. The MBLP is implemented by AIM Center for Bridging Leadership.

Bamboo Craft

Bamboo Craft
South Cotabato is proud of its bamboo craft. Please call ProTech Center for orders: 083-228-9738 or DTI SC at 083-2282659

B'LAAN INDIGENOUS NITO PRODUCTS

B'LAAN INDIGENOUS NITO PRODUCTS
Let's help B'laan Communities in Tampakan earn additional income by buying their products made of nito. Products include plates, baskets, hats, and others. Call directly the Municipal Agriculture Office of Tampakan at (083) 227-2902.

SWEET, SPICY AND CRUNCHY

SWEET, SPICY AND CRUNCHY
Mommy Juling's Atsara of BKR Foods continue to increase productivity, hence increasing its job generation and income. On its launching of its expanded processing plant on Oct. 23, BKR reported that it has increase its production from 60 kgs a month in the late 2008 to 600 kgs a month in 2010. Mommy Juling's Atsara is available at Gaisano Mall, KCC Malls, ACE Centerpoint and other convenient store. See its processing plant at Bayan, Polomolok, South Cotabato. Rona Ortiz will be happy to hear and know from you through (+63) 0919-461-0152.

CORN HUSK NOVELTY ITEMS

CORN HUSK NOVELTY ITEMS
Help protect environment, help our rural women and out-of-school youth from Surallah. Buy Novelty items for Christmas and any occasions (souvenirs and corporate giveaways) to Pag-Asa Youth Association of Centrala, Allah Valley Crafters Association and Neza's Novelty Items. Text or call (+63) 0917-347-0832.

HEALTH AND WELLNESS! CLEANSE TO A HEALTHY LIFE

HEALTH AND WELLNESS! CLEANSE TO A HEALTHY LIFE
Food supplements are never expensive and should never be. What we need now are 100% natural products (no synthetic materials or foreign bodies and no artificial preservatives added). For Jong Bajunaid of Tupi, South Cotabato helping others is very important. Her advocacy of natural healing and remembering old ways of healing and bring that to present scenario is never old. Buy mangosteen tonic, papaya cider, and coco-papaya vinegar from JNB Industries in Tupi, South Cotabato. Mam Jong will be happy to share her knowledge on the wonders of natural healing. She is a Gawad-Saka Awardee (farmer-scientist). You can reach her through (+63) 0916-795-3154.

BDS

BDS