PROMOTING PARTNERSHIPS FOR
WOMEN’S HEALTH AND SAFE MOTHERHOOD:
THE EASTERN VISAYAS EXPERIENCE
(Published
December 2000) The Context What’s in a name? A lot, as you will soon see. Bagahupi. Palid. Maasin. These three words in the Waray language of the Leyte-Samar region in the Philippines describe unique landmarks or characteristics of a geography or terrain. Bagahupi literally means “somewhat sunken,” palid is “rice chaff or drifted trash,” and maasin in “salty.” In many areas of the country, landmarks such as trees or plants have been routinely appropriated as official place-names. Thus, we have places like Naga, Catmon, and Kawayan, which carry the names of local fauna. But there is often a twist here. Neutral terms for geographic characteristics like Bagahupi, Palid, and Maasin have been used as discriminatory local labels for the residents in their vicinities. In this case, the words assume a negative moral dimension that reflects deep-seated social prejudices. In the global environment, nations have been divided into rich and poor ones, with the latter often at the mercy of the former. In this scheme of things, the rich nations play a major role in the struggle of the poor nations for survival. A parallel division of peoples exists in Third World countries, but this time along ethnic, linguistic, economic, and social lines. In the Philippines, for example, people are classified into mainstream lowlanders or tribals (Muslim, Aeta, Igorot, etc.), or native speakers of regional languages (Tagalog, Cebuano, Ilocano, Waray, etc.). Of course, these same people also belong to different economic classes as rich, middle class or poor. And their expected social roles are further divided along gender lines, with the dominant males at the top and the submissive women and meek children at the bottom. In this overall context, it is easy to tell why women of reproductive age (15-45 years old, usually married) from poor families in the Leyte villages of Bagahupi (now Barangay Gov. E. Jaro), Palid, and Maasin are in difficult circumstances. It is already bad enough that they live in gender-biased households with the barest amenities. But they also live in negatively labeled remote villages in a far corner of the Third World, are socially ignored by their counterparts in more urbanized areas or higher economic classes, and virtually crushed by the adverse impacts of the presently imbalanced global economic order. In short, the women of Bagahupi, Palid, and Maasin are pinned down at the bottom of a massive and inequitable gender, socio-cultural, economic and political heap, from where they should be helped out. They are the targets of an ambitious project funded by the European Union (EU) aimed at improving their health, nutrition, and family status. The Project The Women’s Health and Safe Motherhood Project - Partnerships Component (WHSMP-PC, called “the Project” from hereon) is a special project of the Government of the Philippines funded by the European Union (EU) and implemented by the Department of Health (DOH). This five-year project has women of reproductive age in the barangays as its target clientele. The Project is presently operating in five administrative regions of the country: Cordillera Administration Region (CAR), Region V, Region VIII, Region X, and the Caraga Region. The Project is headed jointly by a National Co-Manager and an EU-designated Co-Manager based at the Project Management Unit (PMU) in Manila. At the regional level, each Regional Project Management Unit (RPMU) is jointly headed by a DOH-designated Co-Manager and an EU-hired Co-Manager. The RMPU is responsible for assisting local barangays in the various phases of planning, implementing, monitoring and evaluation of activities undertaken specifically by women living in deprived and remote villages. Vision Empowered and healthy Filipino women and their families living in productive, dignified and peaceful communities that value self-reliance and gender equality. Mission We exist to facilitate institutionalization of enabling and empowering processes and structures, particularly through establishing self-renewing and sustainable partnerships for the promotion of women’s health and safe motherhood in the Philippines. Objective The main objective of the Project is “to improve the health, nutrition and family status of women.” Planning Mechanism
The Project observes an overall logical framework for its operation. The Logical Framework Approach follows four Key Result Areas from which strategies and activities for planning, implementation, monitoring and evaluation are based. These key result areas are: Result 1: Strengthened capacity of women beneficiaries in communities to develop their own reproductive and productive health improvement actions in collaboration with social support network - DOH, local government units (LGUs), non-government organizations (NGOs) and other community-based organization and auxiliary groups. Result 2: Health service for women in communities improved by means of strengthened networks for capacity building, training and access to the DOH and LGUs. Result 3: Locally driven Advocacy and IEC (Information, Education and Communication) mechanisms strengthened through community, DOH and LGU partnering networks to increase public awareness and improve knowledge, attitude and practices on women’s health and social development issues. Result 4: Increased DOH, LGU and other social support networks integration and application of management systems for sustainable, replicable, gender responsive community-based health care for women. The Concept of “Partnerships” in the Project
The Project puts much emphasis on the development of a network of partners and stakeholders in its effort to promote community-based response to health services in a sustainable way. Much of the Project time is spent involving, orienting and meeting, coordinating and agreeing policy with its stakeholder groups, of which the women groups of beneficiaries form a part. Baseline data gathering is conducted through Participatory Rapid Appraisal (PRA) and related processes and tools at the community level. The data gathered are used to formulate Community Health Plans and Barangay Women’s Health Profiles. Women beneficiaries, organized into Barangay Health Resource Teams (BHRTs), are involved in the planning process and actively collaborate to prioritize their problems and solutions with targeted strategies to test feasibility. All these participatory processes depend upon the active collaboration of LGUs and NGOs. The process of community organization, the core of the NGOs’ role in the Project, is essential to assure future sustainability. Municipal Core Fieldwork Teams (MCFWTs) composed of key staff from the municipal level facilitate the collection of baseline data for Planning, Monitoring and Evaluation (PME) and the development of Community Health Plans. The BHRTs extend the organizational link between the community (especially the women beneficiaries) and the formal sectors. The network depends upon the commitment of the LGUs to take up the Project agenda of promoting women’s health. Provincial Steering Committees (PSCs) or the Provincial Health Boards at the provincial level and MCFWTs or the Local Health Boards at the municipal level are established or activated to support the implementation of the Project by bringing together point persons from these two LGU levels, as agreed upon with the appropriate official authorities. The multi-sectoral Regional Steering Committee (RSC), headed by the DOH Regional Director, and the PSCs are expected to provide technical assistance in project implementation and financial and logistics support for addressing community needs outside the scope of the Project, as well as to participate in the monitoring and evaluation of project activities. The DOH Regional Office also attends to similar needs and liaisons and enters into formal agreements with provincial governors, municipal mayors, barangay councils, women’s groups, NGOs and people’s organizations. The support of the PMU and RPMU is essential in developing clear understanding of the limits and potentials of the Project inputs and in enabling the network to function with confidence. Within the DOH, there are at least three departments or programs that have interest in the Project or seek its services. The PMU liaisons with the DOH, the National Economic Development Authority (NEDA), and the European Union. The prime aim of this network setup is to establish pervasive communication that is clearly and effectively conveyed to all stakeholders. All projects and activities require constant feedback and forward access for monitoring and planning for appropriate interventions. Maintaining linkages also continues to be a major requirement here. Strategies for Implementation
Activities to achieve the Project objectives focus on four main strategies: a) Capability Building; b) IEC/Advocacy; c) Women’s Health Actions; and d) Women’s Health Care. A. Capacity Building The Project seeks to sustain the concept of partnership in promoting women’s health, rights and actions beyond the project duration. Included in the program for capability building are trainings on Management Information System, Reproductive Health, Identification of Health Savings Scheme Projects, and other training needs identified through Capability and Needs Assessment. Moves to recognize and involve women’s organizations in the community’s social, economic and political development would be supported and facilitated by the institutional partners. The integration of Community Health Plans into Barangay Development Plans and Municipal Development Plans, and increased financial allocation from the LGU for health and women’s concerns are envisioned to be continuing thrusts of the project. Most importantly, efforts to institutionalize the Project thrusts within the structure of the DOH and the LGU would be worked out. B. IEC/Advocacy The strategy employed by the Project to get community women actively involved in health issues is mainly through locally driven Information, Education and Communication (IEC) campaigns. Awareness-raising activities through focus group discussions (FGD) and IEC techniques like the holding of symposia/forums were also undertaken to ensure better appreciation by people of the issues and problems affecting women and their communities. C. Women’s Health Action The major activity of the Project is to help improve women’s health status in the community through the implementation of community-based sustainable women’s health actions (WHAs) or micro-projects. The community health actions should be identified and prioritized in the Community Health Plan and implemented by the women in the community themselves. WHA proposals are prepared by the BHRTs with the assistance of the community organizers of the respective NGO partner, the MCFWT, LGU and RPMU. All throughout the process, the principle of equity sharing must be observed. D. Women’s Health Care One of the main thrusts of the Project is to help communities meet their immediate needs in reproductive health in such aspects as pre- and post-natal care, obstetric emergencies, access to family planning, and management of sexually-transmitted diseases (STDs), of reproductive tract infections (RTIs), and of cervical cancer. A means to achieve this objective is the institutionalization of a two-way Community-Managed Referral System (CMRS), directed primarily to respond to immediate needs in reproductive health and emergency maternal and obstetric care (EMOC). Documentation of the Project processes would involve Evolutionary Monitoring by the women themselves. The Project in Region VIII
A Profile of Region VIII The Eastern Visayas Region (Region VIII) is probably the most depressed and underserved among the Philippines’ 16 administrative regions. It has 4,390 barangays (villages) in 139 municipalities and four cities, and its regional capital is Tacloban City in Leyte Province. It is home to some 3.59 million mainly rural Filipinos (2000 census) living in the provinces of Biliran, Leyte, and Southern Leyte on the southwestern portion and the provinces of Samar, Eastern Samar, and Northern Samar on the northeastern portion of this region located in the eastern-central part of the country (see Figure 1 for the Map of Eastern Visayas). Its low population growth rate of 1.38 percent can be attributed largely to rapid out-migration from the region and not to a reduced birth rate. In an area covering more than 21,431 square kilometers, there were only 7,259 kilometers of passable roads (in 1978) providing limited access between population centers. By 1999, some 2,288 kilometers were national roads. Concrete roads totaled 1,209 kilometers, mostly in Leyte; asphalted roads along Eastern Samar totaled 179 kilometers; the rest remained gravel roads. Such poor infrastructure has limited social and economic growth of the population, which has been compelled to adhere to subsistence farming and fishing as a way of life. Region VIII could have been neglected by government agencies concerned. Considered one of the most impoverished regions in the country, Eastern Visayas registered 40.8 percent of all families living below the poverty line in 1997. Aside from a high rate of under-employment, about 25 percent in 1985, Region VIII had also registered a labor productivity of only 37 percent in 1987, among the lowest in the country. Government officials claimed Eastern Visayas, particularly the island of Samar, still wallows in poverty because of an active communist insurgency that still plagues a significant number of the region’s interior barangays. Depending on traditional export crops such as coconut, abaca and sugar to survive, Region VIII continues to suffer from the adverse consequences of price fluctuations in the international market. There is also an imbalance in infrastructure development among the provinces in the region. Food production remains slow for lack of roads, irrigation systems, waterworks and rural electrification. Often overlooked by the published official reports was the annual destruction caused by typhoons and such “new” ecological concerns as the “red tide” in Maqueda Bay in western Samar. The latter first occurred in 1984 and randomly paralyzes the region’s shellfish industry. The region also experiences frequent lowland flooding, a result of decades-old commercial logging, deforestation, and swidden-farming activities in its uplands and public forests. By 1998, the leading causes of mortality in the region were cardio-vascular diseases, pneumonias, tuberculosis, malignant neoplasm (cancers), and accidents. Acute respiratory infections, diarrheas, influenza, diseases of the heart, and dengue fever were the leading causes of morbidity. Among infants, the leading causes of mortality were pneumonias, congenital debility, septecemia, prematurity, and diarrheal diseases. Schistosomiasis japonica and malaria are also important public health problems in the region. Neither the pattern nor the rate of these diseases has changed significantly in recent years, despite considerable government effort to control them. In 1990, the infant mortality rate (IMR) was about 56 per 1,000 live births for the Philippines, one of the highest in the Asia-Pacific Region. The figure for Region VIII was much higher, about 76 per 1,000 live births, with the provinces of Samar, Eastern Samar and Northern Samar, respectively, occupying the top three provinces with the highest IMRs (Philippine Health Matters 1995). The 1993 National Demographic Survey gave figures on domestic violence and physical harm suffered by women during pregnancy. The figures for Region VIII were all higher than the national figures. Here, 15 percent of the women reported ever being physically harmed; the national figure was 9.7 percent. Women still being physically harmed constituted 4.5 percent; the national figure was 2.8 percent. And 6.3 percent of the women reported being ever forced to have sex while pregnant; the national figure was 2.6 percent. The same survey showed that the total fertility rate among women aged 15-49 years in Region VIII was 5.70; the national figure was only 4.95. The statistics for health facilities and workforce in the region as of 1998 show an overall stagnation of the government health services whose ratios have not caught up with the regional population in over a decade. The hospital bed-to-population ratio was 1:1,232 in 1998, worse than its ratio of 1:1,102 in 1984. Rural Health Units (RHUs) are located in the towns, with one Barangay Health Station (BHS) for every six to seven contiguous barangays. The physician-to-population ratio for the region improved from 1:9,564 in 1970 to 1:5674 in 1987 but worsened to 1:7,659 in 1998. The nurse-to-population ratio worsened from a ratio of 1:2,917 in 1987 to 1:4,488 in 1998. The midwife-to-population ratio of 1:4,137 in 1998 was almost the same as the 1987 ratio. This trend is probably associated with the full devolution of the health services to local government units starting in 1994, in accordance with the provisions of the Local Government Code of 1991. Before 1994, government hospital and public health services in the country were centrally managed and coordinated by the DOH through its regional offices in the different administrative regions of the country. Starting 1994, the staff and operations of Rural Health Units and Barangay Health Stations were fully devolved to the municipal governments, and the staff and operations of provincial and district hospitals were fully devolved to the provincial governments. The regional health offices were reduced to the role of technical coordination and supervision of field health programs and of the “retained” government’s regional hospital. The importance of some 16,500 voluntary and village-based Barangay Health Workers (BHWs), mostly women, can be readily seen in the worsening professional staff ratios, especially that the government health workforce in the region is heavily hospital-based or curative-care oriented. Barely one-fourth of the government health workforce and resources are actually assigned or allocated to front-line primary health care activities. This health-related profile underscores the urgency of implementing and expanding the Project in Eastern Visayas. Establishment of the Project The Women’s Health and Safe Motherhood Project - Partnerships Component officially started in Region VIII in March 1998 with the establishment of the Regional Project Management Unit (RPMU) that would be responsible for planning, implementing and monitoring the project activities. The RPMU is jointly headed by a DOH-designated co-manager and an EU-hired co-manager. Activities during the first year were primarily directed at establishing systems and structures and the network of locations and partners through which the project would be implemented. These included hiring of staff, organizing, and setting up of office procedures that would allow for smooth administration. Towards this end, the technical staff and their counterparts attended a series of training and orientation seminars. The Regional Steering Committee (RSC) for the Project, headed by the regional director of the Department of Health (DOH) and comprising of the regional directors of the Department of the Interior and Local Government (DILG), National Economic Development Authority (NEDA), Department of Social Welfare and Development (DSWD), and two non-government organizations (NGOs) was officially created through a Memorandum of Agreement signed on August 31, 1998. The RSC would be responsible for providing policy direction and support for the Project. Leyte was identified as the pilot province for the Project, which has now been expanded to four other provinces of the region. The list of implementing provinces, municipalities, NGO partners and barangays is found in Table 1. Table 1. The Project Areas
The Project at Midterm What’s the Project up to? After two and a half years of implementation, the Project in Region VIII has identified indicators of institutionalization that may be considered experiential foundations of its concept of sustainability and replicability, especially at the community level. The pursuit of foundations for sustained participation by communities and the LGU-NGO-community partnerships was subsumed in the Project design. This was premised on the belief that increased awareness and better understanding by the communities and their partners of critical issues affecting women’s health and safe motherhood is crucial to the attainment of the sustainability objective of the Project. A number of activities implemented and successful outputs that could contribute to project sustainability are outlined below under the respective strategies for implementation: Capability Building q Memorandums of Agreement (MOAs) defining project implementation roles and responsibilities were entered into and signed by all concerned LGUs and NGOs. q The continued functionality of the Regional Steering Committee (RSC) is being maintained through regular quarterly meetings. q Municipal Core Fieldwork Teams (MCFWTs) have been organized in all target municipalities. q Team-building activities and orientation have been undertaken for all project partners and implementers. q Women’s Health Plans (WHPs) have been integrated into the Barangay Development Plans in all project barangays, and the health projects were made integral part of three Municipal Development Plans. q Nine (9) Project Implementation Plans (PIPs) for NGOs and LGUs have been formulated for the Provinces of Leyte, Southern Leyte and Samar. IEC/Advocacy q Awareness-raising activities have been carried out. These included radio broadcasts, community billboards for general and health profiles, newsletters, production and distribution of IEC materials, IEC campaigns, forums/symposia on waste management, gender issues and sensitivity, etc. q Preparations for the conduct of community-based knowledge, attitudes and practices (KAP) research on WHSM issues and concerns have been undertaken. q Barangay-based IEC plans have been formulated. q The Child-to-Child Approach was piloted in Barangay Gov. E. Jaro in Babatngon. q Design and development of functional literacy methods and schemes have been initiated in partnership with the Non-Formal Education (NFE) office of the Department of Education, Culture and Sports (DECS) and the Public Information and Health Education Service (PIHES) of the DOH. q “Water-sealed toilet” ordinance was adopted in one pilot barangay and envisioned for replication in other areas. Women’s Health Actions q Eighteen (18) Barangay Health Profiles have been formulated through PRA. q Skills upgrading and trainings for Barangay Health Resource Teams (BHRTs) were conducted. q Developed communal and household herbal and vegetable gardens. q Fund generation activities have been initiated by the BHRTs in all pilot barangays. Women’s Health Care q Sixty-four (64) Barangay Health Workers (BHWs) and sixteen (16) Traditional Birth Attendants (TBAs) have been trained on various health-related skills. q Health education seminars were conducted in target barangays. q Barangay Health Stations (BHSs) were renovated and/or constructed and provided with needed equipment and facilities. q Organized and developed a network and pool of community-based health practitioners for sustained health-related service referrals. q Tapped the Philippine National Police (PNP), Department of Social Welfare and Development (DSWD), RHU, etc., in one municipality as integral parts of the health resource network. Indicators
of Project Accomplishments
The first half of the Project involved the implementation of a wide array of imaginable activities applicable to its four main strategies. The initial freewheeling experiments and adaptations of other success stories in other parts of the country evolved a pattern of relevant and practical methods and activities at the community level that are acceptable and affordable to both the official and social cultures of the region. The evolved pattern is reflected in the following statement of intention of the Project in the last two expansion provinces: “In Northern Samar and Biliran, orientations on the Community Development Process, the Community-Managed Referral System (CMRS), as well as the Planning, Monitoring and Evaluation System for the Project will be conducted. The mechanics of Evolutionary Monitoring will be introduced and the Project’s core indicators, known as Objectively Verifiable Indicators (OVIs), will be clarified to the partners. Installation and operationalization of Community-Based Monitoring and Evaluation involving the beneficiaries themselves will also be done in the project areas.” The community-based monitoring and evaluation system has been installed in the Project barangays. All partners, especially the women, now play active roles in monitoring and evaluating all project processes and activities. Achievement of key results targeted through each Project Strategy is measured through a set of Objectively Verifiable Indicators. (The progress update on 18 core indicators as of December 2000 is found in Table 2.) Table 2.
Progress Update on the Core Indicators (as of December 2000)
To date, measurable improvements in health and empowerment of women in the communities are being achieved. Establishing a functional two-way community-based referral system, particularly for Reproductive Health (RH) and Emergency Management of Obstetrics Cases (EMOC), wherein the community, especially the women are engaged in, is attaining improved health services for women and access of women to those services. The data present 5 of 7 Women’s Health Care indicators for the project barangays in the first three implementing provinces already accomplishing their targets. The number of active CVHWs has increased to 1 per 18 households (national target 1:20); 74 percent of pregnant women had received the required minimum pre- and post-natal consultations (target 50-70 percent; number of women seeking and availing of RH services in RHUs and BHSs increased by 21 percent (target 6-10 percent); 90 percent of deliveries attended by trained health personnel (target 85-90 percent); and 45 percent more referable cases have been referred (target 30 percent more). These all point to collective impacts of the IEC/advocacy, health facilities improvements, and skills development efforts of the Project. The women in the project are actively involved in community organizations and undertake health improvement actions for community development, all with equitable sharing of resources among the community, LGU, DOH and NGO partners. Of four indicators under Women’s Health Action, two stand out prominently as having been motivated by the Project. These are “Community Health Financing Schemes protecting families” (95 percent) and “percentage of households with access to potable water increased” (70 percent). Under Capability Building, the foremost accomplishment has been the “Integration of Community Health Plans into the Barangay Development Plans (BDPs) and Municipal Health Plans (MHPs)” for more than three-fourths (78 percent) of the Project barangays. Under IEC/Advocacy, the foremost accomplishment has been the “Increased number/types of identified community responses to reduce and prevent Violence Against Women” (106 percent above target). The Project needs to address the 10 other OVIs with less than 50 percent accomplishment over the next two years. One approach is the design and implementation of indicator-specific activities. A complementary approach is the realignment of project activities and de-emphasizing those time-consuming ones that do not provide dramatic impact on the indicators. In her own writing (This section contains translations and collations of accounts mostly by women writing their own observations and experiences in partnerships development in Region VIII.) The “Peso for Health” Savings Scheme
I am Corazon B. Justimbaste of Barangay Gov. E. Jaro, Babatngon, Leyte. I am the treasurer of Purok 5 – Cluster I and assistant treasurer for the “Peso for Health” Savings Scheme of the Barangay Gov. E. Jaro Health Resource and Development Organization (BGJ-HRDO). I am proud to tell you the good effect for us of the “Peso for Health” Savings Scheme. This savings scheme was adapted from the model observed by Nicandro Rosales, a fellow member of the BGJ-HRDO, during an exposure trip to Barangay Bohol in Guihulngan, Negros Oriental. We decided to copy this savings scheme because of our own urgent need of funds for emergency purposes. And this has already helped us in a significant way. Before the “Peso for Health” Savings Scheme, we often failed to bring patients to the hospital because of lack of funds, and many of those seeking emergency care often died as a result. After this savings scheme was launched, the number of deaths among people needing emergency care has been reduced. We now have some funds for them to avail for transporting their patients to the hospital. This May 2000 alone, some residents have been helped by the health savings scheme. Mrs. Evangeline Quijano had difficulty giving birth and her life was in danger. But with the help of the emergency fund, she was promptly referred to the hospital by our midwife, Rosa L. Jaro. Mrs. Yolanda Peñaranda and Mrs. Jennelyn Cordero also had to deliver their babies by Caesarian section, and they were promptly brought to the hospital using funds from “Peso for Health.” Of course, the funds are not sufficient to cover all expenses. But at least there was money to hire special vehicles for rushing the patients to the hospital in Tacloban. This helped spare the lives of three residents from the jaws of death, and also saved the lives of the babies in their wombs. Thus, we are very thankful to the WHSMP-PC for their project in our barangay and for helping us launch the “Peso for Health” Savings Scheme. Thanks for the “seed money” for our emergency fund, and we wish you would be of help to other people as well. A Poem for Women’s Health
By Arsenia L. Mogeno A big change has occurred in this world In both attitudes and status Because of this change in the world Women now have their rights. In the olden days There was no democracy for women Their rights were dictated upon By Hispanized foreigners. In our time we have to remember Women already have their rights It is the new program of government That we would no longer be oppressed. Women, let us all awaken Let us open our eyes There is now a program that supports us Its name is Women’s Health. Health Center Improvements
Barangay Maasin Health Center had a communal garden in its
front yard, which was maintained by the Barangay Health Workers (BHWs) and the
Barangay Council. However, since 1998,
this garden could not be maintained because of conflict of interests between
the two groups. The Barangay Health
Resource Team (BHRT) came in and offered a suggestion for them to take over the
maintenance of the communal garden from the two contending groups. The BHWs and the Barangay Council agreed,
and the BHRT planted vegetables as one of their Women’s Health Actions (WHAs). The BHRT conducted their first “tagbo”
(literally, meeting) for vegetable gardening in June 1999 and conducted this
activity every Saturday morning. The
result can be observed in garden plots already planted to pechay and
eggplants. (Handwritten answer in a
questionnaire by the “Tagbo” Committee, July 1999.) As midwife in charge of Barangay Maasin Health Center, I
have observed changes brought about by the implementation of the Project. Before, there were only 10 BHWs to assist me
in my work. This time around, there are
already 12 BHWs. The Barangay Council
also actively supported the Project by adding improvements to the health
center. They extended the floor area
towards the back of the building and converted this into a Family Planning and
Pre-Natal Area. They also provided a
pre-natal table that could also be used as delivery table during emergency
situations. One other thing I have
observed is the enthusiasm of the local women who participate in seminars and
trainings sponsored by the Project. (From
the handwritten note of Liezl, October 1999.) A successful women’s livelihood project
We have learned various lessons in cooperation and understanding from our group’s livelihood activity – selling of dried fish and animal feeds. This activity now preoccupies us and helps us make decisions for ourselves and for our respective families, especially on health matters. For the period May to July 2000, our project-supported livelihood activity earned a profit of Php 3,794.50. As had been previously agreed upon among women engaged in various livelihood activities, 83% of the proceeds would go to Personal Share, 10% for Health Savings, 5% for Capital Share, and 2% for Organization Share. Using the agreed sharing formula, Php 3,149.50 went to Personal Share, Php 379.45 to Health Savings, Php 189.70 to Capital Share, and Php 75.90 to Organization Share of KASAMA NA (Katawhan sa Maasin Nga Nagkahiusa). The Personal Share of Php 3,149.50 would have been divided among the five us involved in this livelihood activity. Instead, our group decided not to divide the whole amount. We just got Php 1,000 for ourselves, and the other Php 2,149.50 was added to the capital investment, so we could order more goods. This livelihood activity is rather tedious because this involves detailed recording of ordered items and sales. But this has taught us the value of recording and record keeping for a business. This is aside from the fact that we the members have to go around to sell the products by ourselves. We are very thankful for the Project because out livelihood activity has also enabled to meet and befriend many mothers that we rarely interacted with before, not only among others members of KASAMA NA but other mothers as well. (From the group report of Myrna Corpuz, Epifania Sarsonas, Milagros Cribello, Lucia Abasola, and Rosita Peladas.) A man’s tale
When the WHSMP-PC was still being introduced into our barangay, I thought this project was intended only for women. But I found out during the training for Participatory Rural Appraisal (PRA) that this was for the good of the entire community. Then I thought that the project would end after the conduct of all those trainings. I was one of the facilitators of the PRA training in Barangay Maasin, and it was my first opportunity to face and teach village mothers. I decided to participate in later trainings as well, and I learned a lot of things that are useful for my own life. The lessons taught were not only useful to the community but for my future role as a father. In the past, I was rather confused about the roles of men and women in the house. This was because even since I came to my senses, it always seemed that it is the man who should make the household decisions. Now I realize this is not supposed to be the case. It is also important that the women are involved, since they give birth to the children that the men want. Through this project, I learned how to handle meetings, how to make budget proposals, etc. And my little knowledge about Family Planning has been improved. Thus I am very thankful that, contrary to my previous
belief, this project is not only for women.
And what I have learned will always be part of my life even after the
project phases out. I will still
continue to inform the people about the importance of health care to the
community. (Severo Berdos, Jr.) Accomplishments of Brgy. Gov. E. Jaro Health
Center
(June-August 2000)
(Undated handwritten outline by
Rosa L. Jaro, rural health midwife.) An Exposure Trip to Babatngon
(A composite of observations translated from five handwritten reports written in Cebuano by Lorna T. Abrantes, Mila Aguspina, Luisa Corcilles, Margarita Corcilles, and Rosita Delalamon.) On June 16, 2000, we had an exposure trip to Babatngon, Leyte. There were seven of us from Barangay Maasin (Hindang) and another seven from Barangay San Vicente (Hindang) who joined the trip. The purpose of the trip was to observe the management of the small Women’s Health Action (WHA) projects by our women co-partners in Babatngon, and to observe how they manage their Health Savings scheme. We left Barangay Maasin at dawn, around 4:00 a.m. We arrived in Babatngon around past 8:00 a.m. We noticed the cleanliness of the town. We all ate breakfast at a restaurant, after which we proceeded to the town’s Rural Health Unit. Madel (a woman leader) came to fetch us and she toured us to their income-generating projects (IGPs) in Purok 4 of Barangay Rizal I. They have four types of IGP – rice retailing, puto and bibingka (rice cakes) making, and animal feeds retailing. We interviewed the women members and found out that they were managing their small WHA businesses very well. Their businesses are as efficiently managed as the ones in Barangay Maasin A participant of the trip was particularly impressed by the puto-making activity in Barangay Rizal I, because they have complete set of implements – grinder, cups and steamer - provided by the Project. An RPMU staff said this puto-making business is doing well. In contrast, the equivalent WHA activity in Barangay Maasin, barbecue making, only received a capital outlay of Php768.00 from the Project. So this participant had to bear with the teasing from the others, who commented that they were only wasting time with their small WHA. She wished her WHA group could be helped to expand to puto-making with the provision by the Project of a grinder and steamer before the end of 2000 As for the Health Savings scheme, this was not very clear in Barangay Rizal I because their reports were not complete. We noticed that the Barangay Health Station of Barangay Rizal I was very nice and clean. This BHS has new supplies and equipment provided by the Project after the submission of a proposal. Afterwards, our group proceeded to the Babatngon Municipal Building. We were ushered inside the office of Mayor Antonio Cañete, who very warmly welcomed us and accommodated us during our courtesy call. The mayor invited us to visit Busay Falls, their main tourist attraction located in a forested area of the town. There we saw a swimming pool and beautiful huts at the edge of the waterfall. We likewise noticed the dressing rooms, rest rooms, and a conference hall. After the trip to Busay Falls, we proceeded to the health center of Barangay Gov. E. Jaro for a briefing. In this barangay, we were very much impressed by the community participation in the Project. They have a good organization and an active set of officials, both men and women. And their barangay captain is active in cooperating with the women in their activities. They were also good hosts to visitors like us. We were toured around the puroks and we noticed that these were very nice because they have monitoring boards, where one can see the situation of the people living in the purok. They reflected on the boards the purok health situation, how many got fever, colds, etc. They also recorded their illnesses by purok. They hold purok meetings, but we noticed during our dialogues that there were more men and lesser number of women around. We also noticed houses that have hanging gardens of plastic bags planted to herbal plants and vegetables such as pechay. This is another project-supported activity. The “Peso for Health” (Savings Scheme) they have implemented was also very nice. Every purok has a treasurer for this scheme. If somebody gets sick and has exhausted the purok funds, they borrow from other puroks. They local residents are really focusing on health. We hope Barangay Maasin will turn out like Barangay Gov. E. Jaro. Three impressions of Samar women
Shyness gone After the Women’s Health (project) came to Calapi (in Motiong, Samar), the number of my friends multiplied. This is aside from the fact that I learned a lot from the trainings and seminars I have attended. My shyness has been lessened, and I can now talk in front of many people. I have also been given the chance to present some little talents last shown during my school years, and have been provided a diversion from a bit boring life at home through our meetings. Lots of my thanks go to Women’s Health for the opportunity to have traveled to places I have never visited before. This will be part of my pleasant memories when the project phases out of our barangay. (Unidentified author) Learning new things
When this Women’s Health (project) was not yet around, I hardly learned new things because I was almost always in the house washing laundry, cleaning, and taking care of the children. I even hardly had time to comb my hair, worrying about household concerns. And the farthest place I had gone to was Catbalogan (Samar). There were lots of changes in me after Women’s Health came around. I have gone to many other places by joining exposure trips. I have visited places such as Babatngon, Leyte-Leyte, Hindang, and Ormoc (in Leyte.) I have slept in fancy hotels. I have also attended many useful seminars such as the one about Herbal Processing. (Handwritten reflection of Lily Ching) Project emphasis Almost one year after the start of the Women’s Health project in our barangay, I have attended many seminars and trainings. In these activities, I learned lessons about the various approaches to dealing with problems for the good of the community and the family, particularly the health of women, which is given much emphasis by this project. Through the partnerships of the NGO and LGU, which is supported by the European Union, a lot of small WHA (women’s health action) projects have been implemented. These will be followed by the implementation of WHAs. Through this project, the viewpoints of women have been
strengthened. A lot of lessons have
also been learned pertaining to the improvement of the family for a peaceful
community life. All these will
hopefully promote Calapi as a progressive model community. (Unsigned reflection) Project improves husband-wife relations in
So. Leyte
Eyewitness I am an eyewitness of the transformation of one introvert
husband who was focused on his work to somebody very supportive of the
endeavors of his wife. This wife was
often beaten by her husband after arriving home late from a meeting or training. We convinced the husband to attend the
training of WHSMP-PC, and his attitude has changed. He is now very careful not to violate his wife’s rights. (Reflection of Delma Tagoctoc) A transformation A big change happened in my family since I attended the training-seminar conducted by Women’s Health. Before, my husband used to be indifferent to household concerns. This time around, he has been transformed into a supportive and helpful household partner. Because of this, we are very thankful that WHSMP-PC was introduced to our barangay. Both of us now view life from a different perspective and know to rectify our wrongs against each other. We sincerely hope that WHSMP-PC would be able to sustain its
noble task, not just in our barangay but also in other barangays needing its
assistance, so that the country will become a peaceful and enjoyable place to
live in. (Reflection of Liza Lim,
Barangay Ambao, Hinundayan, So. Leyte.) Newfound rights Before WHSMP-PC reached our barangay, the local women had low morale. They thought of themselves as inferior to their husbands. This (deflated) attitude gradually evolved into self-esteem when the women attended the training-seminar held here by the Project. They became aware of their rights and other gender-sensitive issues. The husbands who attended the Gender Sensitivity Training (GST) Seminar came to realize that their wives should not be confined at home. These wives have also started to open their eyes to their newfound rights. (Reflection of Nancy Aboneta) Child-to-child sa Gov. E. Jaro
Ni Corazon B. Justimbaste (Child-to-child adult facilitator) Masaya kami sa child-to-child na programa Sapagkat nakikialam na ang nandiritong kabataan Sa problema ng pangangatawan sa komunidad nila Maging sa kalusugan ng buong pamilya. Sila ngayo’y naaalarma Dahil sila rin ang magiging biktima Ng mga sakit na dala ng epidemya. Buwan ng Hulyo sa taong ito, Women’s Health na programa ay naglunsad ng panibagong proyekto; Child-to-child kung tagurian ito. At ngayo’y aming napagtanto na ito pala Ay napakaepektibo sa pagpakilos ng kabataan Dito sa aming malinis at tahimik na baryo. Kaya naman maging ang kanilang mga karamdaman, Problema at nararanasan ay agad nilang ipinapaalam; Ibinubulalas sa karamihan Upang agad maaksiyonan Nang ang mga ito’s kanilang mapagplanuhan. At ngayong sila’y trained na ay nagha house-to-house survey na, May kopya ang dala-dalang mga questionnaire Sa bawa’t bahay na kanilang tinutungo upang alamin Kung ilan ang naging biktima Ng malnutrition, diarrhea at sore eyes Na pangunahing puksang napili nila. Kami namang tita at tito nila Na nagsisilbing mga tagapayo, tagapagpadaloy at tagapagturo At ang umuunawa sa bawat kanya-kanyang hinahawakang grupo. Kami ngayo’y nagagalak kay Ma’am Kate na may pusong busilak Sapagkat tinuruan niya kami kung paano makihalubilo Sa kabataan upang sila’y aming maunawaan, mahalin at pahalagahan Ang kanilang mumunting ideyang tangan-tangan. Kaya ating ipagsigawan ang Child-to-child approach sa ating lipunan. Acknowledgment The articles here were written or translated by Prof. Rolando O. Borrinaga of the School of Health Sciences, University of the Philippines Manila in Palo, Leyte. The layout artist is Omer Oscar B. Almenario. The printing and production of this publication was contracted to the Alternative Management and Allied Services Specialist (MASS), Tacloban City. | . |