Doctors' Statement on Medical Findings on the 43 Health Workers

Reference:

Julie P. Caguiat, MD

                                       

We, volunteer medical doctors, strongly condemn the continuing psychological torture inflicted upon the 43 health workers illegally detained by the Armed Forces of the Philippine at Camp Capinpin. We also deplore the military’s disrespect for the basic human rights of the detained health workers, including their right to medical services. 

Despite repeated requests from lawyers and family members, we have been denied entry by the camp authorities nine times. We were only allowed to see the detainees on February 11 (six days since their illegal arrest) and only upon the intervention by the Chairperson of the Commission on Human Rights, and on February 24, when only one of the 3 physicians was allowed to enter. Under severely restricted conditions, the check-ups merely lasted for 10-15 minutes and under the scrutiny of 2-3 guards standing in close proximity, which made our patients feel uneasy. Such is the violation of their right to health and their right to privacy. 

After the medical check-ups, we still endorsed our patients and their particular medical needs to their custodians. However, to date, no medical intervention has been made accordingly.

According to reports from the families, our colleagues who are now our patients continue to suffer from various physical and mental conditions. Two of them asked their custodians for emergency medical help but no medical attention was provided.

Under Republic Act 7438 Sec. 2(f), “Any person arrested or detained or under custodial investigation shall be allowed visits by or conferences with any member of his immediate family, or any medical doctor or priest or religious minister chosen by him or by any member of his immediate family or by his counsel... The person's "immediate family" shall include his or her spouse, fiancé or fiancée, parent or child, brother or sister, grandparent or grandchild, uncle or aunt, nephew or niece, and guardian or ward.”

These provisions, meant to recognize both the needs and the rights of the detained health workers, are being violated on a daily basis.

Hence, we demand that the rights of the 43 detained health workers be recognized. We demand an immediate end to torture.

Free the 43 health workers now!

Community Health Worker shot in Negros

Ronald Capitania, 24 years old, single, a habal habal (motorcycle) driver and a resident of Brgy. Manlocahoc, Sipalay City, Negros Occidental was shot  February 23, 6:45 am in Brgy Manlocahoc, Sipalay City, Negros Occidental.  He was one of the 30 Community Health Workers (CHW) who graduated in a 1 year ladderized health training of Community Based Health Program sponsored by Council for Health and Development (CHD) and Negros Island Health Integrated Program (NIHIP) on November 22, 2009. He is also the Public Information Officer of Camindangan Small Farmers Association (CASFA), a partner organization of NIHIP in southern Negros.

While on his way to Brgy Cambugiot, Sipalay to fetch a regular passenger, he noticed 2 bonnet-wearing men riding a motorcycle following him.  Sensing danger, he fled with his motorcycle but was shot thrice and hit on the shoulder and abdomen.  The gunmen continued to chase and shoot him.  Despite the pain, he still remembered the Basic Health Skills Training 1 given to him by volunteer nurses of NIHIP.  Hence, he applied pressure on his wound to minimize the bleeding.

Capitania is now confined at the Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH) in Bacolod City.  His colleagues suspect that the military is behind the shooting because their organization was active in the campaign calling for the withdrawal of the military detachment inside the barangay hall. 

Dr. Merry Mia-Clamor, one of the 43 health workers illegally detained at Camp Capinpin, Tanay, Rizal together with NIHIP representative and Brgy. Capt Elijer Borris of Camindangan distributed diplomas for the graduates of the South CHW Association where Capitania served.

Still Detained... but Pressure Mounting! Your support is of great help!

We've had a reply from Ambassador Brillantes, which was not much more than a reassurance that the Philippine government will have to present their evidence to the trumped-up charges in court, but this can take months. In the mean time, we are still extremely concerned for the safety of our friends. 

Letters of concern and solidarity are still very important at this time, so please consider writing.

Here are some photos I received today from a protest on Negros Island. 

 

 

CHD to AFP: Educational attainment not a hindrance to learn health skills

Media Release
Reference: Dr. Eleanor A. Jara

February 13, 2010

CHD to AFP: Educational attainment not a hindrance to learn health skills

Health groups today slammed the military’s malicious statement regarding some of the health worker-trainees’ capacity to learn health skills with regard to their educational attainment. Lt. Col. Noel Detoyato, spokesperson of the Armed Forces’ 2nd Infantry Division said in an interview that the trainees’ profiles revealed that some of them reached only elementary and high school levels while only a very few were college levels and graduates. Thus, why give them health training?

“For 37 years, community-based health program practitioners have been training volunteers who would like to become Community Health Workers (CHWs) regardless of their educational attainment. We do not discriminate against a person’s educational background as long as he or she has the heart to serve other people in the villages. In fact, we have CHWs who are illiterate but are efficient and respected healers in their communities,” Dr. Eleanor A. Jara, Council for Health and Development’s Executive Director said.

In a country where 7 out of 10 Filipinos die without ever seeing a doctor and where public health services lack or are inaccessible, Dr. Jara said that it is CHD’s and COMMED’s mandate to bring health into the people’s hands. “This means, our health professionals and health workers go out of their way to reach underserved communities and organize health committees and train Community Health Workers. That way, the people themselves can prevent and cure common illnesses and practice first-aid even with the absence of government services in their communities,” Dr. Jara explained.

She added that health skills should not be an exclusive property of a few who can afford to buy it -- it should be learned by as many people as possible as long as they have the passion to use that knowledge to serve their fellowmen especially the poor and the oppressed.

Tuition fee in Metro Manila medical schools ranges from P55,000 to P85,000 per semester.

“It is a shame that the AFP discriminates the capacity of our people to learn health skills just because they only reached elementary or high school levels. The AFP should be the ones ashamed of themselves for persecuting health workers that genuinely serve the people. If the Armed Forces is questioning and suspicious as to why we train these people without high educational attainment, the answer is there is not enough health workers and health services in the country and the blame is on the government’s incapacity and skewed priorities,” Dr. Jara ended.

Open Letter to Ambassador Brilliantes

February 8, 2010

Ambassador Brilliantes
130 Albert Street, Suite 606
Ottawa, Ontario, Canada
K1P 5G4


Dear Ambassador Brillantes,

We are writing you to express our strong concern over the recent abduction of 43 health workers by the Philippine Army and Philippine National Police on the 6th of February in Rizal, Philippines. These workers were illegally abducted while attending a health training put on by the Council for Health and Development (CHD).

One of the abducted health workers, Dr. Merry Mia, is a personal friend, one of the hosts to me and my family when we spent seven months in the Philippines in 2008 as volunteer community health workers. Dr. Merry is a committed health professional who works with the poor and marginalized of Philippine society. The idea that Dr. Merry is involved in violent or criminal actions is absolutely ridiculous to anyone who knows her, as we do. She is committed to social justice and human rights and works with legal, popular movements of Philippine society.

As concerned Canadians we are watching the actions of the Philippine government very carefully. Please convey our concerns to the appropriate authorities in the Philippines. We look forward to hearing of the speedy release of Dr. Merry the other 42 health workers currently being illegally detained.

Sincerely,

Ormond-Roberts Family

Martha Roberts, R.M.
Aiyanas Ormond
Sophia Roberts, age 13
Billy Grayer, age 8

URGENT ACTION by KARAPATAN (Alliance for the Advancement of People’s Rights)

Health workers, including the wife of Karapatan Deputy Secretary General, illegally arrested in military raid in Rizal province, Philippines

Case: Violation of Domicile; Destruction of property; Abduction, Divestment of Property; Illegal Search and Seizure; Illegal Arrest; Illegal Detention; Torture; Threat, Harassment and Intimidation, Fear for Safety

Victim/s :
Abducted, Illegally Arrested and illegally detained(partial list)
1. Dr. Merry Mia, Health Education and Training Services coordinator for Council for Health and Development (CHD), wife of Mr. Roneo Clamor (KARAPATAN Deputy Secretary General)
2. Dr. Alexis Montes
3. Gary Liberal, Registered Nurse (Jose Reyes Medical Memorial Center)
4. Teresa Quinawayan, Midwife
5. Lydia Obera, community health worker
6. Reynaldo Macabenta, community health worker
7. Angela Doloricon, community health worker
8. Delia Ocasia, community health worker
9. Jane Balleta, community health worker
10. Janice Javier, community health worker
11. Franco Remoroso, community health worker
12. Ailene Monasteryo, community health worker
13. Pearl Irene Martinez, community health worker
14. Elen Carandang, community health worker
15. Dany Panero, community health worker
16. Rayom Among, community health worker
17. Emily Marquez, community health worker
18. Emelia Marquez, community health worker
19. Glenda Murillo, community health worker
20. Ace Millena, community health worker
21. Ely Castillo, community health worker
22. Lalyn Saligumba, community health worker
23. Jovy Ortiz, community health worker
24. Samsung Castillo, community health worker
25. Mark Estrellado, community health worker
26. Miann Oseo, community health worker
27. Selvia Pajanosta, community health worker
28. Lolibeth Donasco, community health worker
29. Jenelyn Pizaro, community health worker
30. Ramon de la Cruz, community health worker
31. Jacqueline Gonzales, community health worker
32. Maria Elena Serato, community health worker
33. Mercy Castro, community health worker
34. Lea de Luna, community health worker
35. Judilyn Oliveros, community health worker
36. Valentino Paulino, community health worker
37. Yolanda Yaun, community health worker
38. Edwin Dematera, community health worker
39. Sherilyn Riocasa Tawagon, community health worker
40. Gerry Sustinto, community health worker
41. Jenmark Barrientos, community health worker
42. Mark Escartin, community health worker

Place of Incident: Residential compound of Dr. Melecia Velmonte in Bgy. Maybangcal,
Morong, Rizal

Date of Incident: 06 February 2010

Alleged Perpetrator(s): Joint elements of the 202nd Infantry Brigade of the Philippine Army (202nd IBPA), and Rizal Philippine National Police (PNP) headed by Colonel Aurelio Baladad, commander of the 202nd Infantry Brigade of the Philippine Army based in Tanay, Rizal and Police Superintendent Marion Balonglong of the Rizal PNP.

Account of the Incident: On February 1, around 40 medical practitioners and health workers participated in a one week First Responders Training, sponsored by the Community Medicine Foundation, Inc. (COMMED) and Council for Health and Development (CHD) at Dr. Melecia Velmonte’s Farm, a conference and training facility in Morong, Rizal.

Dr. Velmonte is a renowned and respected infectious disease specialist and a consultant at the Philippine General Hospital. Her farm is a regular venue of health trainings, with participants coming from both the communities and the academe.

At around 6:15 am on February 6, 2010, around 300 heavily armed elements of the military and police forced their way into the farm of Dr. Melecia Velmonte in Bgy. Maybangcal, Morong, Rizal. At gunpoint, the military forced the caretaker to open the gates. Inside, the soldiers fanned out to different directions. They also kicked the main door to get into the building.

When Dr. Velmonte and her son, Bob demanded for a search warrant, they were merely brushed aside by the military. All medical practitioners and health workers, were ordered to line up at the garage, frisked, and handcuffed. The victims were also questioned and photographed by the military, while another took a video recording of the interrogation. The male victims were then blindfolded with old shirts brought in by the soldiers and secured with packaging tape. All of the personal belongings of the victims were also taken by the military.

When the participants were already handcuffed, it was only then that Police Superintendent Marion P. Balonglong showed Bob a search warrant for a certain Mario Condes of Bgy. Maybangcal, Morong, Rizal, charged with illegal possession of firearms. The search warrant dated February 5, 2010 and issued by Judge Cesar A. Mangrobang of Branch 22 of the Imus, Cavite Regional Trial Court, did not indicate the exact address of the Velmonte compound.

Bob asserted that the warrant did not specify their address, and that Mario Condes, who is subject of the warrant, is not even the owner of the house, but he was ignored by the authorities.

Outside the compound, were eight (8) vehicles. Along with the four (4) 6 x 6 military trucks were two (2) Armored Personnel Carriers (APC), a KIA Pride car, and an ambulance. Some of the vehicles had no plate numbers while the rest of the license plates were either covered, or smeared with mud.

The male health workers were loaded into the military trucks while female health workers were forced into the cars and vans. They were brought to Camp Capinpin in Tanay, Rizal, headquarters of the 202nd Infantry Brigade of Philippine Army.

The military declared that the victims were members of the New People’s Army because of the explosives allegedly found inside the compound. However, according to witnesses, the military conducted the search of the compound’s premises only after all of the victims, as well as the residents, were already outside the buildings. Witnesses also said that the military have brought in with them plastic bags with the GMA Kapuso logo printed on it.

Allegedly found were C4 explosives, a pistol with seven bullets, 3 grenades (one allegedly found under a pillow); beside the grenade were some improvised landmines. However, Bob said that they were not issued a receipt of the inventory of the said firearms and explosives.

The military and police arresting team were led by Col. Aurelio Baladad and Police Superintendent Marion Balonglong.

The illegal search of the Velmonte compound ended at past 9:00 in the morning of Saturday, February 6, 2010.

Prior to the incident, one of the participants related that on February 4, the grassy portion outside of the Velmonte compound caught fire at around 8:00 in the evening. Everyone panicked and went out of their sleeping quarters fearing the fire will cross over to the compound. Fortunately it did not and the fire died on its own.

On February 5, at around 11:00 pm, the dog tied near the male sleeping quarters and the geese nearby made a raucous. Then at around 12 midnight, the chickens in a coop nearby were also disturbed and cackled furiously. One of the male participants went out twice to check but did not see anybody.

In the afternoon of the February 6, Karapatan Deputy Secretary General Roneo Clamor, husband of Dr. Merry Mia, Olive Bernardo, Karapatan Services Head, along with Karapatan counsel, Atty. Ephraim Cortez, Dr. Geneve Rivera and Dr. Edelina De La Paz, chairperson of Health Action for Human Rights (HAHR), went to Camp Capinpin to inquire about the victims. They were not allowed to enter the camp premises.

On February 7, families and relatives of the illegally arrested went to Camp Capinpin to try to visit and see the conditions of the victims. They waited at the gate and held a short program but the 2nd Infantry Division played very loud music trying to drown the speeches of the family members and their supporters. Two groups of fierce-looking dispersal units (with firearms and shields) were dispatched and blocked the gate of the camp. Later, Mr. Clamor and Dr. Caguiat were allowed to enter the camp premises but once again were not allowed to see the victims because allegedly they will be presented for inquest. They waited until very late in the afternoon no inquest took place.

On February 8, the team remained in Camp Capinpin. It was heard over the radio that the 2nd IDPA issued a statement that an inquest took place at past 9:00 in the evening of the previous day. The Commission on Human Rights (CHR) issued a statement condemning the act of the arresting team. A team was dispatched by the CHR to Camp Capinpin. It was allowed to enter camp and Chairperson Leila De Lima was to follow later.

Suddenly, the 2nd IDPA provided a tent, chairs, breads and juices for the people at the gate. The loud music was turned off.

When Chairperson De Lima arrived, the relatives requested her to intercede to allow them to see the victims. She agreed. However, only Chairperson De Lima with Dr. Rivera and two relatives were allowed to enter the camp. The other victims were denied entrance despite the agreement that all the relatives would be allowed to.

At around 3:00 pm, Chairperson De Lima went out of the camp and briefed the waiting families and relatives. She told the soldiers to allow the relatives to see their loved ones. They were finally allowed to enter. They entered by batches of seven. There were three batches.

They were only allowed 30 minutes each to speak to their loved ones. They could not freely talk because they were closely guarded by soldiers. But despite this, the horrors of what the victims suffered under their captors were revealed. It was learned that they were blindfolded and their hands bound behind with a plastic cuff since they were arrested until a few hours before Chairperson De Lima arrived. They slept sitting down but when the CHR team arrived, they were already placed in quarters with beds. All females were put together in one big room while the males were either given their own room or sharing a room with another with toilets. Their meals were fed to them and their guards pull down their underwears for them everytime they go to the comfort rooms. The female guards even washed the private parts of women detainee. They were deprived of sleep because they were repeatedly interrogated. Others related that the interrogation was done in unholy hours with the clear intention to deprive them of sleep.

Others related that they were physically tortured.

Dr. Alexis Montes complained to his son that his shoulders are sore from being pulled back due to the prolonged binding of his hands behind his back. He also told his son that during interrogation, he was told that he was standing at the edge of a ravine and everytime he answered a question, he was poked with a pair of stick forcing him backward. He also said that he was electrocuted. He did not lose
consciousness but was paralyzed for a time.

Ely Castillo softly whispered to his sister to avoid being overheard by the soldier accompanying her that he was tortured. He was not able to elaborate because of the presence of the soldier.

Dr. Merry Mia related to her husband that she was alternately interrogated by “kind” and harsh men. The “kind” interrogators only asked about personal details, the harsh ones threatened her by saying “You know what we are capable of doing to you and your family.” “We will soon know who your husband is.” She was also asked over and over again where she lives, where she studied, and what her task was in the training, etc. There was an instance that three men interrogated her simultaneously. Threatening to harm her family. One of whom told her, “We’re not done with you yet. I will come back for you and will not let you sleep tonight.” Although she was not physically tortured, she was worried that the others were hurt because she heard screams of both men and women in pain.

Dr. Rivera saw Dr. Mia first before her husband. Dr. Rivera told the team that she found Dr. Mia in a fetal position. When she softly called her name, she raised her eyes but it took her a long time to recognize the very familiar face of her friend.

Recommended Action:

Send letters, emails or fax messages calling for:
1. The immediate release of the health workers who are tortured, illegally arrested and illegally detained at Camp Capinpin, Tanay, Rizal.
2. The government to ensure the safety of the victims and that they are not harmed; their belongings be returned immediately to them.
3. The immediate formation of an independent fact-finding and investigation team composed of representatives from human rights groups, the Church, local government, and the Commission on Human Rights that will look into raid and illegal arrest of the health workers conducting health skills training in Morong, Rizal.
4. The military to stop the labeling and targeting of human rights defenders as “members of front organizations of the communists” and “enemies of the state.”
5. The Philippine Government to be reminded that it is a signatory to the Universal Declaration of Human Rights and that it is also a party to all the major Human Rights instruments, thus it is bound to observe all of these instruments’ provisions.

You may send your communications
to:



H.E. Gloria Macapagal-Arroyo
President of the Republic
MalacañangPalace,
JP Laurel St., San
Miguel
Manila Philippines
Voice: (+632) 564 1451 to 80
Fax: (+632) 742-1641 / 929-3968
Cell#:
(+ 63) 919 898 4622 / (+63) 917 839 8462
E-mail: corres@op.gov.ph / opnet@ops.gov.ph

Sec. Annabelle T. Abaya
Presidential Adviser on the Peace
Process
Office of the Presidential
Adviser on the Peace Process (OPAPP)
7th Floor Agustin Building I
Emerald Avenue
PasigCity1605
Voice:+63 (2) 636 0701 to 066
Fax:+63 (2) 638 2216
osec@opapp.gov.ph



Norberto Gonzales
Secretary, Department of National
Defense
Room 301 DND
Building, Camp Emilio
Aguinaldo,
E. de
los Santos Avenue, Quezon City
Voice:+63(2)
911-9281 / 911-0488
Fax:+63(2)
911 6213
Email: osnd@philonline.com

Atty. Agnes Devanadera
Secretary, Department of Justice
Padre Faura St., Manila
Direct Line 521-8344; 5213721
Trunkline 523-84-81 loc.214
Fax: (+632) 521-1614
Email: soj@doj.gov.ph

Atty. Leila De Lima
Chairperson, Commission on Human
Rights
SAAC Bldg., UP Complex
Commonwealth Avenue
Diliman, Quezon City, Philippines
Voice: (+632) 928-5655, 926-6188
Fax: (+632) 929 0102
Email: chr.delima@yahoo.com




Please send us a copy of your
email/mail/fax to the above-named government officials, to our address below.

URGENT ACTION Prepared by:

KARAPATAN (Alliance for the Advancement of People’s Rights)
National Office
2/F Erythrina Bldg., #1 Maaralin
cor Matatag Sts., Brgy. Central, Diliman, Quezon City
1100 PHILIPPINES
Voice/Fax: (+632) 435 4146
Email: urgentaction@karapatan.org
Website: www.karapatan.org

CHD to AFP and PNP -- release abducted doctors, nurses, and Community Health Workers in Tanay, Rizal

MEDIA RELEASE

CHD to AFP and PNP -- release abducted doctors, nurses, and Community Health Workers in Tanay, Rizal

As thousands of Filipino health professionals are driven away from the country because of lack of enough opportunities, the government terrorizes the very few who chose to stay and serve their fellow citizens, Council for Health and Development revealed in a press conference held in Quezon City.

In a statement, Eleanor A. Jara, medical doctor and Executive Director of Council for Health and Development said that at 6:15 am yesterday, February 6, 2010, medical doctors, nurses, and Community Health Workers (CHWs) were frisked, blindfolded and forcibly taken by combined heavily armed elements of the 2nd Infantry Division of the Philippine Army and the Rizal Philippine National Police. The troop numbered to about 300, reports said.

Council for Health and Development is the National Secretariat of more than 50 community-based health programs in the entire Philippines.

"The raiding team showed a bogus search warrant and herded our doctors, nurses, and Community Health Workers conducting health skills training-seminar in the house of Dr. Melecia Velmonte," Jara said.

"CHD denies the claim of Col. Aurelio Baladad of the Philippine Army's 202nd Infantry Brigade to the media that the participants were undergoing a bomb-making training. We further condemn the AFP and PNP’s action of planting evidences such as guns and ammunitions in the training venue. In truth, the participants were holding a first responders’ health skills training-seminar aimed to facilitate the exchange of knowledge and skills of health professionals and Community Health Workers to develop their capacities in providing health care services to the poorest of the poor,” Jara added.

Dr. Julie Caguiat of the Community Medicine Foundation further explained that such brazen act was clearly a state effort to terrorize health professionals and health workers that work among the people.

Dr. Jara lamented that the abducted health professionals and CHWs are among those that serve far-flung villages where government personnel and services are lacking or are nonexistent. Because of their passion and dedication to serve their fellow Filipinos, these health professionals and CHWs brave difficult work environments and meager salaries just so they could be of service where they are most needed, Jara added.

"Instead of supporting and lauding their efforts and sacrifices, what does Mrs. Arroyo's government do? Her military and police abduct these health professionals and CHWs and violate their rights. In effect, the delivery of health services in the poorest communities is derailed," Jara said.

The ratio of doctor to patient in the Philippines is pegged by the Department of Health at 1:30,000.

As of press time, the military has denied the relatives and co-workers of the victims to see or speak to them.

"The military has done it again, this condemnable incident adds up to the long list of human rights violation against health workers and community-based health practitioners.

We call on all health professional organizations, entire Filipino people, and the international community to denounce state terrorism in the strongest possible terms. We enjoin our colleagues in the health profession as well as the entire Filipino nation to stand united and demand for the release of the abducted health personnel," Jara concluded.

Behind the times...

For all following my blog, I am behind in my writing since we have been so busy this last little while. I am working on a couple more entries, so even though we are flying back to Canada today, please stay posted!

Coming soon:
Struggle for Reproductive Rights in the Philippines: Contradicitons and Clashes
How a National Liberation Struggle Raised the Peasants of a Nation: Reflections on the contrast between Vietnam and the Philippines
Making Sense of It All: The final assessments of 7 months of Solidarity!

Masking the Faces of Urban Poverty Slideshow

Masskara: Masking the Many Faces of Urban Poverty

Martha, October 21, 2008

It was ironic that our Bacolod urban poor integration fell on the final weekend of the Bacolod Masskara festival; ‘Masskara’ meaning ‘many faces’ referring to the positive outlook of the Bacolod residents, smiling in the face of adversity; the festival where revellers don smiling masks and dance in the streets, ignoring the cares and the woes of daily life; a festival whose budget exceeds P 5 million while thousands face demolition and homelessness.

During these past few days I witnessed how the city of Bacolod throws a grand festival to distract the attention of tourists and locals alike from the true plight of the majority of residents of Bacolod. The 41 of 61 Barangays that live in poverty; the residents of the approximately 40,000 homes targeted for demolition by the year 2010. The thousands of youth whose lives are a daily struggle for survival, without education, without livelihood, without a place in society.

Struggles for Land and Housing

Many urban slum residents fled to Bacolod from the countryside due to O’plan Thunderbolt, the counterinsurgency operations that cleared the countryside of the ‘water’ (the people) to force out the ‘fish’ (the New People’s Army or NPA). While O’plan Thunderbolt was not successful in squashing the NPA, it was successful in forcing thousands of farmers away from their lands and into the squalor of urban poverty, with no option but to squat public lands in an attempt to survive. While the farmers were displaced from their lands, mining corporations moved in and claimed the land for extraction of minerals, including copper and gold. The end result? The poor are displaced and the corporations are lining their pockets from the misery of the people.

To add insult to injury, the very project that will see many homes demolished is a P 52 million international sea port in Bacolod funded by GMA to facilitate the export of raw mineral resources and agricultural products from the plunder of the countryside. The remainder of the homes to be demolished are making way for real estate and tourist resort expansion. It seems particularly unjust that the Bacolod 2010 Comprehensive Land Use Development Plan has earmarked thousands of squatter homes for demolition with no feasible relocation plan for those who will lose their homes.

The Myth of Relocation

It is law in the Philippines that in order to gain a writ of demolition for squatters, whether on public or private lands, the government must provide a site for relocation. Yet, it is explained to me that many judges are corrupt, friendly with the land owners, or simply are not up to date about the law, and so demolition orders are given without adequate relocation plans.

In the case of some squatter communities, particularly those on the future port site, their relocation lands are inland, far from the seashore and the source of their livelihood in fishing or in working the ports. In the case of other squatter communities, the plan of the landlord is to abandon development and garner a profit selling the land to the tenants through the government-mediated ‘Community Mortgage Program’ or CMP. The CMP is not a feasible plan for the urban poor, who struggle just to cover the basics of food, clothes, and transportation to work; if enough remains it goes to the education of their children. If someone gets sick, it is a major financial crisis that puts the family on the brink of starvation, and often the sick die from lack of health care. These families simply cannot afford to pay a 25-year mortgage for housing.

The condition of the slums is appalling, with few government services for the poor: no potable water, no sanitation, no waste disposal, open pit latrines flowing into the ocean where children bathe and play, sewage running in the ditches, garbage littering the ground, stagnant water providing dengue-carrying mosquitoes ample breeding ground. In many communities, residents have struggled and won some services, such as a public school for elementary students, and wells to provide clean water for washing and bathing (but not safe for drinking since the wells are below sea level). But these few services come as the result of a consolidated effort of the local squatter organizations.

How to Earn a Living?

The residents of the urban poor communities struggle daily to earn an income for their families. Vending, driving tricycles or jeepneys, working on the ports as haulers or day labourers, fishing and collecting shellfish, washing clothes in middle class suburbs, working construction, running small sari sari stores, and even working for the government in low level positions. Every family member must work to contribute, even the children, who help prepare the shellfish for market, wash clothes, assist in sari sari stores, and a myriad of jobs for the income of the family.

Without access to social services and government health insurance there is simple not enough to go around; what is earned is not enough to make ends meet. Many youth turn to prostitution and the drug trade to survive – a product of economic exclusion and a sad testimony of injustice.

In Sickness until Death

The natural outcome of such living and working conditions is ill-health, a physical, a financial, and an emotional crisis for entire families.

Many suffer and some die from malnutrition and perpetual hunger, ulcers, skin infections, diarrhea, respiratory infections including tuberculosis, hepatitis A and B, undiagnosed and untreated diabetes and hypertension, liver cirrhosis, and kidney failure – just to name a few.

I heard many stories of families who struggled and saved to gain title for their small plot of land and their meagre house, and then a family member fell ill with the result of all savings lost, and all family members working to pay health care debts.

The ultimate price of urban poverty is the life of the poor.

Urban Uprising

While the picture I painted in this blog entry is one of a loss of hope, the strength, vitality and resolve of the urban poor is astounding. I took such great inspiration and drew many lessons from the many Bacolod affiliate member organizations of Kadamay, the national umbrella organization of the urban poor.

Do not think that the urban poor are meek victims of capitalism and imperialism; do not be fooled by their poverty, for it is a spark against the tinderbox of injustice! Eventually the smouldering social volcano that is Negros will erupt.

I am invigorated by the organizing that I witnessed in these past few days. Now I am almost ready to go home to Canada and take up my work with the Alliance for People’s Health and the Organizing Centre for Social and Economic Justice.

One last stop for us: the urban poor in Manila and the situation for urban poor home deliveries.

Stay posted for upcoming entries on the organizing lessons I have learned and the struggles for reproductive health in the Philippines!

Mining is Murder: Mining, Militarization and Corporate Plunder in the Philippines

Aiyanas Ormond: October 18, 2008

Standing at the seashore looking out over the blue expanse towards the distant islands of Palawan, Tatay Putot scoops a handful of fine brown earth from the shallows. This is evidence, he says, of an environmental disaster that has already begun with the latest Philex Gold exploration here in south-western Negros. The Canadian mining company is only in the very beginning stages of its operations here, having sunk only 20 of up to 96 exploratory holes, but already the Bacuyangan river runs brown into the sea bearing silt from the mines and the earth stripped away from the mountaintops. The potential impact on the local people is concerning – the rice farmers of the fertile valley rely on the river water to irrigate their crops while the coastal communities rely on the sea for their livelihood.

We have accompanied Tatay Putot, an organic farmer and leader with the local farmer’s organization, to see first hand the impacts of the mining exploration on the coastal fisherfolk communities. A group of fisherfolk gather to meet with us outside a small house, just meters from the sea. They tell us that the catch is very bad this year, and point to the brown beach, clogged with fine silt as the cause. Joking with one of the mangingisda (fishermen) that last year he borrowed money from him but this year it will be the other way around. Everyone laughs in the usual Filipino way, but the fisherfolk are no longer laughing as they explain that their children are going hungry now because the catch is so little.

Across the highway and a little inland we visit with members of the irrigators association, small scale rice farmers who irrigate their fields from the Bacuyangan river. The association, representing all of the 100 or so households in the community has taken a clear position against the Philex mine. Based on previous experience in the region, they are certain that the chemicals and heavy metals involved in the mining process will end up in the river, and as farmers they know that what is in the water ends up in the rice.

Mountain Journey

At some point between fording the river, climbing a 15 foot shear rock face and trudging through bamboo thickets which cut at the our bare arms and faces, Martha turns to me, her face red and shirt soaked in sweat, and says “I can’t make it”. We are approaching the Philex mine by the ‘back door’ in an attempt to avoid the military and security. They have stopped previous fact-finding missions from reaching the mine site.

Martha does make it, and even little Billy survives the three hour hike with only a few tears and a short stint on my back. As we approach the drilling site we begin to see evidence of the erosion – areas where the mountain is stripped bare of its plentiful vegetation and the mud runs down into the lowland streams and creeks. The company has taken mandatory measures to try to mitigate the erosion, but from what we can see the sand-bagging and planted grasses are ineffectual against the combined force of gravity and the torrential rains that are almost daily at this time of year.

We need to clamber up another slippery steep incline to reach one of the actual drilling sites, but we manage to get there and the workers, reticent at first, become helpful and friendly as the local organizers begin talking with them. Billy gets right in there to have a look at the machinery.
The operation is impressive, especially since we have seen almost no real industrial equipment aside from the rare tractor since leaving the city. Yet here in the middle of the country side, where farmers still plough by carabao and the major means of mass transportation is the hable-hable (motorbike), we find this multi-million dollar piece of equipment. Martha and I talk about the implications of this. Like all the communities we’ve visited there is real need for capital here. Farmers need tractors and threshers and mills for their rice production, fisherfolk need access to refrigeration and both groups need roads and transportation to get their products to market. But there is virtually no money available from the government, corporations or mainstream NGOs for this kind of grassroots development. But if there is gold to be had... The history of mining in the Philippines indicates that the mining companies will come in for a few years with lots of capital, employ a few local people, and then disappear, leaving nothing but displacement, militarization and environmental destruction.

The workers here at the drilling site show us the 240 meter hole they have drilled into the side of the mountain, and a handsome young engineer makes Billy’s week by giving him a piece of volcanic stone. They also show us their safety equipment, which to us looks inadequate for this kind of heavy industrial operation. Local men are happy just to have a job in the prevailing context of poverty, where millions of Filipinos have to travel overseas for work. Unfortunately the lifespan of these mines is short. The nearby Philex Vista Allegre gold and copper mine operated for only about 5 years. It closed in 1997, just as the workers began to unionize (though this was only one factor in the closure of the mine). Retrenched workers from the previous mine are still in the courts trying to get compensation for a wage structure which paid locals significantly less than workers doing the same jobs who were brought in from other areas of the Philippines or abroad.

The Military and the Monetary

We were able to get the mining site without any interference from the military, however militarization in the community was evident. In addition to the Armed Forces of the Philippines detachment at the mine site, we also observed elements of the Philippine National Police’s Regional Mobile Group, an assault rifle carrying quasi-military group, in the community. And like in the other areas we’ve visited, organizers with the farmers organization, including our host Tatay Putot, have been branded as ‘communists’ and ‘rebels’ and face harassment and intimidation from the military.

This is a pattern in the Philippines where, as part of the policy of extrajudicial killings under the GMA regime, 21 environmental activists have been murdered in the last 7 years - 15 of them having been directly involved in anti-mining activist. The assassinations of activists is an just the most reprehensible aspect of a generalized campaign of fear waged against communities that resist the corporate profit-centred ‘development’ model being imposed by GMA and her political masters – the IMF, U.S. and big business in Canada, the U.S. and other rich countries.
Rather than asking why there is so much resistance to the large foreign owned mining operations in the country, the GMA regime is actively encouraging the mining companies to set up their own paramilitary groups saying, “the security of mining operations should be a common responsibility of mining firms, the government and local communities”.

In this region of Sipalay where the Philex exploration is happening the link between mining and militarization of the countryside is longstanding. From 1988 to 1992 under the Aquino regime a massive military and counter-insurgency program was mounted in the area as Operation Thunderbolt. The mountainous areas were virtually cleared of people under the conception that if you want to catch the fish (the guerrillas) you need to drain the pond (the communities that support them). The military, paramilitaries and anti-communist fanatic groups like the ‘greenan’ (known by their green uniforms) were mobilized in the area. At that time the military paid a bounty for the ears of supposed rebels, and groups like the greenan did not distinguish between real guerrillas and those who might sympathize with them or share common ideals.

The clearance of the population from the mountainous areas made possible the first large scale mining which had been impossible previously due to strength of people’s organization and the presence of the New People’s Army. Thus the military operation fulfilled the dual (and connected) purpose of suppressing people’s organized movement for meaningful social change, and creating conditions for profit for large multi-national mining corporations and their local “partners”, including the government.

The current situation looks very much like history repeating, with militarization, human rights abuses and a general climate of fear accompanying large scale open pit mining. And this is just the tip of the iceberg. The Philex claim itself is more than 4,000 hectares, but fully ¾ of Sipalay and a large part of the entire land-mass of Negros is covered by mining claims. If significant gold is found, the mining corporations are poised to strip this island bare.

Development or Plunder

Like so much of the ‘development’ under capitalist globalization, mining only seems to develop the bank accounts of the rich and leaves very little for the people. On our way back to Bacolod we stopped at the now closed Mercalor mine in San Jose. The huge open pit mine and the bare hillsides are still there but with no indication of any kind of sustained prosperity. Quite the opposite, there is strong sense of industrial depression here. Rusting buildings and shut gates, a good road with very not much traffic, poor farms and a town with little in the way of productive activity. This model of ‘development’, pushed by the international capitalist establishment, offers no way out from the poverty which is the legacy of more than 400 years of colonization, feudalism and foreign domination.

But this is after all, a very rich country. Aside from the fertility of the soil, the plentiful fish in the sea and the wealth of human capacity and creativity, there are vast mineral resources. If all these resources and capacities were to be harnessed for a program of development that put the welfare of the people first, that broke the cycle of foreign debt payments that suck up 70% of the national budget, and that shrugged off U.S. economic and military domination – so much would be possible. This is the hope of the national democratic struggle – an end the exploitation and plunder which has persisted under more than 400 years of colonization and foreign domination.

Mining is Murder Slideshow

View from the Mountains: Final Kalabaklabakan Entry

September 30, 2008

As I sit and write this final Kalabaklabakan blog entry the rain pours down again, I wonder if this is the start of number 4 in a series of 12 active typhoons. I hope that it rains today and is sunny tomorrow, since we head down the mountain tomorrow; I hope that the power holds steady at least until after bedtime! Travel is so difficult in the mountains to begin with, but after days of storm, the mud is ridiculous – I had no choice but to ditch my useless shoes and go barefoot, or land on my butt deep in the palay!

The weather leaves me feeling really exhausted so this blog entry will be scattered. Yet there are a few things I want to document.

Pregnancy and Hypertension in the Mountains!



First, this month was one of challenging management of pregnancy and birth. Hypertension and pre-ecclampsia/ecclampsia is a major cause of maternal mortality in the Philippines. In September Nanay and I had two very different cases: one patient admitted to hospital and delivered prematurely due to unmanageable and severe hypertension with baby number 12; one woman relatively mildly hypertensive (I suspect chronic) managed by me and Nanay at home on daily rest periods and frequent BP and urine monitoring. Good outcomes in both cases, after a great deal of worry on my part! In the mountains, hypertension in pregnancy is no easy matter; there is no such thing as ‘outpatient’ management – either you’re ‘severe’ and in-hospital (if you’re lucky enough to have your BP monitored) or you’re at home in the mountains. Being at home in the mountains essentially means no care at all, while being in hospital usually means selling your animals to pay the bills, pulling your older kids out of school to care for the younger kids; making tremendous financial sacrifices, bearing a lot of emotional stress and strain.

I was glad to be there for our mildly hypertensive patient, and Nanay and I hiked to her home every few days to check her BP, dip her urine, discuss warning signs, listen to baby, and encourage resting left lateral, which really did bring her BP down nicely. She was open to my stretch and sweeps, and was very happy when her baby was delivered, a strapping boy weighing in at 3.4 kg! (No IUGR in this case). And yet she remains hypertensive – chronic. Our severely hypertensive patient is back home with her daughter who weighs in at 1.5 kg (growth restricted and premature) and a handful of 5mg bite-and-swallow nifidipine capsules she was instructed to take once per day; the meds are not controlling her hypertension – last reading I took at home was, once again, 190/110. I read and re-read the BCRCP, SOGC, and WHO guidelines I brought with me, and wrote out a couple of medication suggestions, but now Nanay has the challenge of finding the appropriate medicines for management and monitoring the effectiveness and dosage, and the families have the burden of affording such medicines.

Struggle for Health = Struggle for Justice



It is true what Mammy tells us, that the struggle for health in Kalabaklabakan is not just a struggle for physical and mental health, but for social equality, for equitable land distribution, for economic justice. Families can’t achieve physical and mental health when they can’t afford to eat regular meals, their children go hungry, their clothing is inadequate, their homes lack water, electricity and sanitation, their farming techniques suffer from forced underdevelopment, the landlords demand a share of the products of the peasant labour, the multinationals and agricultural cartels fix product prices, and the government provides not a single iota of respite from the toil and travails of rural life.

The tragedy of Grace and Randy’s twins plays out over and over again in the mountains of Guihulgnan, in different form. Like with little 6-month Jonmark, who I tentatively diagnosed as Down’s syndrome, suffering chronic lung infections from what I believed was a congenital heart malformation. His parents willingly took him to the Guihulgnan hospital, where they spent over P 5,000 in consultations and diagnostic tests to be told that he has Down’s and a malformed heart. Then they were referred to San Carlos, to a bigger hospital, for more and expensive diagnostics, such as an echocardiogram, spending another P 10,000. Now they are referred to Cebu City on Cebu Island, for specialist care and a surgery when Jonmark is old enough for open heart surgery. This will cost hundreds of thousands of pisos; where will the money come from? The doctor in San Carlos suggested the parents travel to Dumaguete City to request some funds from the Congresswoman there. What little public health care that exists is completely undermined by rapidly expanding IMF-WB-WTO dictated privatization and gross government corruption. Can you imaging having to beg a politician for health care for your infant son? Even if they get the funds, it will not be enough to pay for the surgery.

In any case, I am working on a small book about health and the struggle for liberation in the Philippines, so I will save some of my thoughts for that work!

To Learn Is To Change



This is the final theme of my final Kalabaklabakan blog entry; to learn is truly to change. In some ways I know I have changed: I am tougher, my eyes are further opened to the realities of the majority of the world’s people, I am further convinced of the need to refuse neutrality and actively participate in the struggle for social justice. Aiyanas and Billy are also changed. It is very touching to hear Billy talk about the hardships he has witnessed. Aiyanas has recommitted himself to writing, and his book on imperialism in the Philippines will be an important resource for organizers and students of social justice.

Yet, we won’t really know how much we have really changed until we are home in Vancouver once again. How will what we have gained by our time in the mountains push us forward in our local organizing work? We have plenty of ideas, but putting action into our words is a challenge that awaits us. And how will we feel when we are back in the lap of imperialism? Only time will tell.

* Graphic - David Werner from “Health Care and Human Dignity: A Subjective Look at Community-Based Rural Health Programs in Latin America” published in the Council for Primary Health Care Reader’s Series, May-June, 1981

The Five Ts of Transformative Midwifery

Thursday September 25, 2008: 15:40 Kalabaklabakan Mountain Clinic

I type this on 50% computer power, and once that 50% is gone, it may be another 5 days of brown out before I can charge up again! There was a typhoon over the weekend and since Saturday we have only had power for 3 hours.

Now that I have more birth experience under my belt, I can truly consider myself a ‘barefoot midwife’. It is good to have some time to sit and reflect upon my experiences, and on the general situation here in Barangay Trinidad. With two very different cases of gestational hypertension and a tragic case of undiagnosed twins who didn’t survive, my recent experience has been more indicative of local maternal and infant health statistics. It is one thing to read that a community has a maternal mortality rate of 1/100 and an infant mortality rate of 0.8/100, but to directly experience the conditions, political, economic, cultural, geographic, that contribute to these shocking statistics is a life-altering experience.

It is simply not enough to practice as I was trained. Not to deny that at the University of British Columbia I had one of the best midwifery educations in the world, that is a privilege of which I am keenly aware; rather it is not enough to simply practice. A midwife in the Third World context must go beyond her calling, to be one with the women in all aspects of their lives, to be changed by their experiences, and to struggle as they struggle for systemic changes. It is only through mutual support and encouragement that we, as women, can tackle at the roots the conditions that give rise to so much hardship and suffering.

As a response to my recent experiences, I have brainstormed what I call the ‘5 T’s of Transformative Midwifery’.

The first T is Track. Track refers to the provision of typical midwifery care, in particular, antenatal care. It is essential for the prevention of crises to track all of the pregnant women in the community, whether or not they present for midwifery care. Through word of mouth it is possible to learn of who is pregnant and where they live. To track I am envisioning a large wall map for a visual aid and reminder of all current cases.

The visual wall map works in tandem with the second principle of track, which is to have regular rounds of home visits for all pregnant women. Home visits are imperative for a number of reasons: a) women will actually get the care if you go to see them at home – if left to attend at clinic visits this is far less likely as work often takes precedence over personal care, b) at home visits you can see the conditions of the home and judge the poverty of the family and how they will deal with a need for expensive hospital or doctor visits, c) walking the distance to the home allows you to assess the emergency transport situation and make an informed recommendation on transport and safest birth location.

Finally, tracking includes a third step, the documentation, compilation and interpretation of local maternal and infant health statistics. From the patient record, a central database can be created to monitor the common health problems and health outcomes of the community. An example for Trinidad is the incidence of goiter and the success of implementing educational programs on the consistent use of iodized salt. As a mountainous area, iodine is lacking in the diet, and many women suffer from goiter.

The second T is Treat. As midwives we are valued for the care we can provide childbearing women and their families. In a rural, Third World setting the preventative care we provide can save women from extremely costly and difficult doctor or hospital visits. Early and effective treatment of common illnesses can save women from serious illness or even death.

The focus on prevention goes hand in hand with the use of locally available herbal remedies. Encouraging each woman to have an herbal garden is a great way to boost her self-care and make effective use of local and free resources.

The production of locally-relevant patient care guides is the third aspect of treat. The liberal use of images helps in a context where the vast majority of the population stops their schooling between grade 3 and grade 6. Disseminating correct information is important, so the production of patient education materials works in concert with the training of the Community Health Workers, who can engage in door-to-door outreach and oral education.

The third T is Transport. This is perhaps the most challenging of the five Ts. Planning emergency transport in a rural, mountainous setting is extremely taxing and yet of vital, lifesaving importance for childbearing women and their infants. Each woman needs to have a transport plan in place from the first weeks of pregnancy until after delivery. This plan needs to be shared with family and neighbours.

Encouraging the People’s Organization (PO) to have a centralized transport plan will assist all women in the PO and allow for faster and more coordinated emergency transport. Encouraging the PO leadership to meet and discuss the particular needs of childbearing women and their infants could be a positive step in breaking the silence that seems to exist when it comes to the particulars of women’s health. I have noticed that this is even a weakness within the Community Based Health Programs that women’s health concerns and training in women’s health care seems to take a back seat.

Knowing when to transport is a challenge, especially when travel takes over 2 hours and the hospital fees are very expensive for the family to bear. The decision over whether to transport is truly a cost-benefit analysis; when a family has to sell animals and order their older children to leave their schooling or paid employment to mind the younger children and perform the household duties, it is not just a matter of dialling 911. The role of the midwife is to provide leadership and skilled knowledge in the decision to transport, judging the seriousness of the situation to the best of her ability; however, the role of the midwife must also be to respect the family when they decide not to transport and take risks that as a privileged midwife from a First World country, it can be difficult to accept.

The fourth T is Train. All community members benefit from the principle of a ‘Health Worker in Every Home’; hence training one woman from each family to provide care for common discomforts of pregnancy, how to support a woman in labour, and how to care for common newborn concerns would be a boost to the health of all.

More intensive training for the community health workers (CHWs) on the common illnesses and health issues of pregnancy, on childbirth emergencies such as breech and shoulder dystocia, and warning signs of pregnancy and labour and when to transport would be of major assistance to the midwife and to the women of the community.

Providing targeted community training and public education on how to prevent and treat the most common health issues identified through the first T, Track, would help to improve the incidence and outcomes of these health problems.

Finally, working in cooperation with local Hilots (traditional birth attendants) and inviting them to all educational events and opportunities will raise the level of care for all women in the community. Respectfully asking the Hilot to send someone to fetch you when she attends deliveries gives the midwife the opportunity to observe practice. Watching the Hilots work gives midwives insight into local traditions and allows the midwife to make small and achievable suggestions for improvement and change while learning about the rich culture of childbirth among the women in the community.

The fifth and final T is Transform. The last T, but perhaps the most important! Ultimately the roots of the health crisis lie in economic exploitation and political and social oppression. Midwives have a history of taking action on behalf of the women we care for; now more than ever we need to take that action in an organized and coordinated fashion, to address the economic and political roots of women’s ill health.

Joining the activities of the PO, using the contact made with women during the course of midwifery care to encourage women to join the PO, and increasing the participation in mass organization at the community level is a good first step.

Attending rallies, carrying placards, making speeches, writing press releases and statements on the conditions of women in the community are some positive ways to raise the consciousness of the community. Making it known that, as a midwives, we deplore the lack of public health care services, decry militarization in the community, and are outraged by backward and corrupt land ownership and grossly inadequate wages and unsafe working conditions allows community members to understand, through our actions, the link between poverty, oppression and the health crisis in their communities.

We must, as health care workers, take sides; we cannot remain neutral, for in this struggle for life there can be no neutrality. To be silent is to give consent to those who steal life from the poor. To take action is to say I stand with the poor; I am on the side of justice.

DOH: Department of Hoodwinking

August 30, 2008

It has happened; I have fallen in love with the Philippines. I know this to be true because at the CHD health sector picket to demand access to cheaper essential medicines outside the Department of Health I feel such a passionate anger that I have to pace around to burn off the energy. What I see painted on the walls of the DOH is in such stark contrast with the reality I witness in the community that I rename the DOH the ‘Department of Hoodwinking’.

Why hoodwink? The government propaganda is everywhere in Manila, convincing the middle class and the upper echelons of the working class that the government responds to the needs to the people and provides adequate health services. Check this out!



First I see a mural lauding the DOH clinics in the community. OK, I am confused. No community I have visited has had a clinic, but rather the odd Barangay health centre, which, when it exists, is far too often little more than a room with a very few supplies, occasionally staffed by an over-worked, under-paid midwife (cum doctor, cum nurse). Patients often have to walk very far for the few services, such as vaccinations, which are offered. Although in government propaganda TB medicines are provided for free for all infected, in reality even if there are TB meds, they are very expensive. Most do not complete the multi-drug formula for the necessary 6 months. What else can the Community Health Workers do but teach about preventing communication! In San Isidro, there is actually an ambulance, which looks terrific; in practice the fee is 1,500P paid in advance for the trip to the hospital! The average daily wage, when sugar work is available, is less than 100P per day, so that explains why the ambulance still looks so shiny and new – people can’t afford to use it!



Next I pass a beautiful mural lauding the provision of safe drinking water. It’s a joke, right? What community is that? Any place I have visited that has safe drinking water, it has been the People’s Organization, and NOT the government, which has ensured clean water to drink and bathe by piping water down from upland springs, or building enclosed cisterns over deep wells to prevent contamination from shallow ground water. Most rural communities I have visited have few toilets so people use the fields as their toilet and then use ground water or stream water to drink and to bathe. Given the incidence and death toll from diarrhea, the 3rd leading cause of death in children, this isn’t merely about good health, but a matter of basic survival.



Now, my personal favourite! The DOH Superman delivering iodized salt to the people. This really is a joke – the irony is sadly hilarious. I can’t even keep track of the number of women I have seen in the mountain provinces with goiter. Keep in mind, women of childbearing age, having many babies, with such a terrible risk to a diet inadequate in iodine; as the mural explains: still birth, cretinism, dwarfism, poor cognitive development to name a few. Women struggle to use iodized salt, as there is little incentive for sari-sari store owners to sell it as they make less profit from it.



Another beauty, the smiling kids with lovely white teeth, visiting the what? The dental clinic? I never saw one, personally, in my many months of travels to rural communities. I did, however, see countless children with poor dentition and many carries, in terrible need of dental care. I saw children who were refusing to eat due to pain from rotting teeth. It was heartbreaking. I can think of several great programs that would increase prevention and provide basic dental care at the community level – but alas, despite the lovely propaganda, the DOH does not really care for children’s dental health.



There were many lovely murals to describe, but in the interest of brevity, I will conclude with the mural lauding environmental protection. Can anyone say “PhilEx”? Let our coming testimonials on the impacts of multinational mining operations attest to the GMA position on ‘environmental protection’ in the Philippines.

Called to Deliver a Baby ‘Half-Born’: the Struggle to Survive in Rural Philippines

*Warning -- this blog entry is graphic*

After lunch Aiyanas and I were playing chess when there was a commotion in the clinic, and I heard “Martha” and “bata” (baby) and a bunch of excited talking, so I poked my head out front to see what was going on. The ‘ice candy lady’ from the elementary school was in the clinic with Josephine and Erwin, saying that Grace had delivered, but the baby was breech and only half-born; the Lola was there delivering the baby and now they need help. What is going on? I am full of disbelief; the baby is half-born? Why are we standing here talking? Josephine calls to Nanay, who comes running back to the clinic, I grab my backpack with my birth equipment, Aiyanas grabs me some pesos to pay for a hubble-hubble (motorcycle) and Nanay and I are off at a run up to the road to catch a ride to Grace’s house. It must have taken us 20 minutes to get there from the time I first heard the news of the baby half-born; we arrived just after 3:40 pm.

Why didn't they come get us sooner? I learned that Grace was afraid because the military detachment is across the road, and last night they were firing at random.

Entering the house I am struck by Grace’s position; Grace is up on the sleeping platform lying supine, knees bent, legs covered with a blanket, and Lola has her hands under the blanket. It is dark in the house though it is still light outside. Is there a baby I ask? Yes, they say, half-born up to the neck. Without thinking I am pulling off the blanket and calling for Grace to turn so the breech hangs; somehow I have gloves on, but I barely remember getting them and my kit out as we entered the house. I put my hand inside Grace’s vagina to feel what is going on. I feel the baby’s face anterior, his little body is so blue and cold and his back is anterior, his neck is twisted, he is obviously dead. He is so small I am suspicious, since it doesn’t fit with how pregnant we thought Grace was.

I feel another head following - twins. Gently I push the second head back up the vagina; Nanay gives me some suprapubic pressure and the first twin disimpacts and is delivered onto Grace. Then directly the second twin is delivered up onto Grace. I feel the cords of the babies and the second twin has a pulse, so I grab my clamps from my kit and clamp the cords, free the second twin first, and start to ventilate him. I check his heart rate, but it is so chaotic in the house I can barely hear, I think I get about 60 beats per minute. I show Nanay how to do chest compressions while I ventilate, but we can’t get coordinated, so after perhaps 15 seconds I listen with my Doppler and count 100 bpm! We clear the small table and place the second twin onto a pair of soft track pants I grab from the clothes pile nearby. I instruct Nanay how to ventilate, make sure his little chest is rising and he is getting at least 40 breaths per minute.

Time to switch my attention to Grace, who is lying supine with her eyes closed. Is she conscious? Is she bleeding? Is she in shock? I cut the cord of the still born twin, bundle him, and set him next to his brother. I coax Grace awake and up into a squat to get the placenta out, intact, great, just to be safe I quickly draw up one of my precious vials of oxytocin and give it to her. Her BP is good, 120/80. Nanay checks Grace’s perineum, and there is only a very small tear, which is good because there is no time to suture. I am very worried about Grace and her emotional state, so Lola comes to sit with her and hold her hand. Time to switch back to second baby boy and make sure he is doing OK.

Before I take over ventilations again, I listen with the Doppler one more time so I can hear his heart rate clearly in the noisy, crowded hut. Why are there so many people here? We shoo some people outside, and listen, getting a heart rate of 140, with my stethoscope I can hear air entry with ventilations, his lips and face are pink. Why isn’t this little guy breathing? I quickly examine him and can see he is quite premature: smooth foot soles, smooth scrotum, soft ear cartilage, testicles undescended. Grace wasn’t 8 months pregnant, as I thought; I realize she was likely only 7 months but big due to the twins. The lack of adequate prenatal care in the communities is outrageous. This little guy needs intensive care; we need to transfer him as soon as possible. I take over ventilating again, and Nanay is freed to help with the transfer.

This discussion takes a painfully long time. The babies were born at 3:45 and 3:46, and it is now after 4:15 and they are still talking about what to do. I explain, hoping that it will be understood, that they can decide to transfer to the hospital or they can stay home and the baby will die. It sounds crass, but I realized that they have to make the decision about what is right. Now that I write this, I wonder, did it sound judgemental? It is not the way I intended it to sound and I hope it wasn’t taken that way. But this persistent little boy is taking some breaths! The conclusion is they will go to the hospital; now we need to get the truck so we can ventilate the baby on the way. This will require permission and a driver from the Barangay Capitan. There is a problem, I still don’t know what, with the local Barangay Capitan, and so they have to ask in Hilaiton which is 45-60 minutes away.

Nanay and I hunker down to business, and develop a rhythm of adding 3 breaths between each one of little baby’s so that he is getting 40 breaths per minute. I balance my newborn stethoscope on his little chest so I can time my breaths to his heart rate, hear the air entry, and monitor his independent breaths. We request some hot water bottles which we tuck around his body. I place a nasogastric tube, but I do not carry an ET tube and laryngoscope, so we use a mask to ventilate. After an hour or so I am exhausted, and I want to examine the first twin and the placenta, so Nanay does an ambubag shift. I go to pee, and see the military watching from the detachment across the road. This just enrages me – 10 times the funding of the health care system and they sit and watch as babies die.

Very carefully I pick up the first little guy and take him to the adjoining Nipa hut so I can examine him thoroughly without so many observers. He is so tiny, weighing in at 1.5 kilos including the weight of his blanket. It feels like his neck is broken, and he has dark bruises on his abdomen over his palpable liver. I wrap him in a blanket, lay him on the pretty blue fabric of my scale sling, and quickly take his photo for Grace and Randy. My belief is that these are mono-chorionic, mono-amniotic twins, with the first twin transfusing blood, oxygen and nutrients to the larger and more robust second twin, but this is only a guess. There is only one placenta with two cords of close insertion, and for the life of me I can only see one sheer set of membranes, but it is impossible to tell and I am rushing; in any case we will bring the placenta with us.

Now back to business of ensuring the ventilation is going well and preparing for transport. We hear news that the truck from Hilaiton is on its way! Great, this little trooper is hanging in there, so we will make it! I take over ventilations again and Nanay gets a board and some blankets ready so we can ventilate in the back of the truck. Finally after 6:00 pm the truck arrives and we are off on the long trip to the hospital. Sometimes the road is so bumpy the board is bouncing, I try to protect his little head, and the little guy’s heart rate is always over 100. After what seemed like an endless journey of heart beats and breaths, heart beats and breaths, we arrive at the hospital.

As the truck pulls up, Nanay calls out ‘emergency, emergency’ and an orderly comes running. We get baby boy out of the truck and quickly onto the examination table in the ER operation room. I keep ventilating until the doctor comes and takes over care of the baby. The doctor quickly concludes that the baby is premature and needs CPAP (continuous positive airway pressure) and I completely agree! Great! Let’s get it going! But… there is no equipment for premature babies at this hospital, so we will have to go to Dumaguete. Why is the nurse not ventilating the baby? What is going on?

Randy, the father of the baby, shakes his head and sadly explains there is no money for going to a private hospital in Dumaguete. The doctor then asks Randy if he will admit the baby at this hospital, and Randy agrees. But what will they do here? They provide free-flow 100% oxygen through an ET tube, which it takes 20 minutes to place because they can’t find an ET tube small enough in their ancient crash cart; the baby is only breathing ten times per minute and there is no equipment to ventilate. They give him dextrose through an IV. I know that he will die, but my heart still hopes. Randy and I sit with him, and Randy asks me why the first twin died. I gently tell him I think he was born too early and his lungs were not ready, but I can’t bring myself to mention his injuries. Randy thinks his second son is a fighter, and I agree with heavy heart, knowing he isn’t getting the care he needs to give it a fighting chance.

Nanay and I are exhausted, it is now after 9:00 pm and I need to wash and lie down. We will spend the night at Nanay’s Auntie’s. After sleeping in fits and starts we return at 6:00 to learn that the baby boy died at 3:00 am and Randy has already taken him home. I am so angry! I am so sad! The pictures of Gloria Macapagal Arroyo smiling on the wall of the hospital are enraging! How can she justify a national budget where debt payments are 63 times the national health budget? How can the military, which harasses and intimidates the people, be a priority over equipment necessary to save newborn babies? How can the military sit and watch while Randy scrambles to find a ride to the hospital? It is so backward I feel like kicking over that stupid (and grossly under-stocked) crash cart that sits nearby. I cry on the hubble-hubble ride home, thinking how Grace and Randy must be suffering, and my beautiful little patient who didn’t make it.

Now we are home and the story is already widely known. Will anything change? Perhaps more people will join the rally in Guihulgnan Town on Sunday. Perhaps the People’s Organization will gain more members as the string of injustices that lead to the deaths of these boys is discussed in the community. I am moved by the strength of the optimism, even among those who suffer terrible injustices; hope that things will change if the people are united, committed and share a common vision of justice for all.

Hey Terrence and Pipay!

We miss you!

Negros Medical Mission Slideshow

The Negros Medical Mission: Service and Solidarity

September 20, 2008

Kalabaklabakan Mountain Clinic

Last weekend, September 13 and 14, was the large and greatly anticipated Negros Mercy Mission: a Medical and Psycho-Social Mission which brought over a dozen doctors, community health workers, organizers and documenters to three rural communities of Guihulgnan, including Kalabaklabakan, in Barangay Trinidad.

The mission was spearheaded by the local People’s Organization (PO), Kaugma-on, literally ‘future of the small farmers’, and supported by several organizations from Cebu, Bacolod and Manila, including the Negros Island Health Integrated Program (NIHIP), the Council for Health and Development (CHD), and progressive party list Bayan Muna. The mission was one of service to the people, and solidarity with their struggle for justice and against the intensified militarization; Guihulgnan is now identified as a priority area for the AFP aggressive war of counter-insurgency, an operation which causes many human rights violations, physical harm and psychological trauma for the peasants.

Over 460 patients received treatment during the two day mission in Kalabaklabakan, including doctor consultations, essential medicines, prenatal care, psychological counselling and minor surgeries. Despite repeated attempts from the AFP Infantry Battalion (IB) 11 to enter the private clinic premises, and to intimidate and harass those patients entering the clinic compound, the mission was a resounding success, and many patients had their sufferings eased by the mission teams.

While the medical care provided through missions is only but a small band aid for the large wounds of the people, the demonstration of solidarity from the urban areas and the large organizations such as CHD and Bayan Muna is a tremendous boost to the local PO. Missions send a clear message to the military and the government that those struggling peasant farmers in the countryside are not forgotten, rather are of fundamental importance, to those who struggle in the urban areas.

Tuloy Ang Laban!

Back to the Mountains

Heading back to Kalabaklabakan for more mountain integration. Stay posted and send us some comments.