Though the villages are separated by sea, people are never strangers. All happily greet each other as they gather at the local health center to avail of their contraceptive of choice during an outreach mission led by Roots of Health with support from the Australian Embassy in the Philippines. 

Our nurses discuss the contraceptives available to the women gathered at the local clinic.

Armed with a handy poster illustrating the female reproductive system, our nurses start orienting the women on contraception and the different kinds they can get during the mission. With many women unfamiliar with contraceptives – particularly long-acting reversible contraceptives (LARCs) – fears about the procedure and possible side effects are foremost in their minds. Our nurses thoroughly explain the procedure, debunk misconceptions, and answer their questions to ease their worries. 

Busting contraceptive myths through high-quality non-judgmental service 

Rita*, 39, shares her misunderstanding of the implant, “I used to think getting the implant meant undergoing an operation where I had to be unconscious […] I was scared I might not wake up from it and I got anxious believing that. That’s why I didn’t have it before.”

After giving birth to nine children, two of whom died from complications, Rita does not want to have another baby, especially at an older age. 

In Rita’s case, getting enough prenatal vitamins during her last pregnancy might have helped prevent her child’s birth defect which led to the baby’s death. Unfortunately, living two hours away by boat from the nearest clinic and the lack of prenatal vitamins at the health center kept her from having a healthy pregnancy and led to childbirth trauma. 

With strengthened resolve and her worries about the procedure allayed, Rita decides to proceed with the implant insertion that will protect her from unwanted pregnancies for three years. 

“I didn’t realize it would be that easy to go through. The reality was very different from what I imagined,” she shares. 

While contraceptive access in far-flung communities has improved through the years, there is still a lot of ground to cover in disproving myths that hinder women from availing LARCs. Despite efforts of providers to increase reproductive health knowledge, many are still more inclined to believe myths that they hear from their elders or neighbors. 

“This is one of the major roadblocks we face as providers when encouraging others to switch to LARCs,” shares Nurse Piety, one of our mission team leads. 

Although it helps to get the facts out there to challenge existing misconceptions, sometimes it is not enough. 

“As healthcare providers, it is important to be seen as trustworthy by the people we serve. This is why we continue to embody our values in being non-judgmental, rights-based, and science-based in our approach,” Piety explains. 

“Giving women a positive experience when they avail of LARCs can help encourage more to do the same, especially in a tight-knit community that puts a premium on the advice of their peers,” she added. 

Rita hopes to inspire more women in her community to get implants too, “As someone who has already gotten it, I will tell them it’s not painful like I used to believe.” 

Easing women’s economic burden 

Nimfa*, 40, decided to use contraception to prevent another pregnancy after she lost her seventh baby because of a miscarriage. She also had difficulty sending all her children to school with her family’s meager income, more so with the COVID-19 pandemic affecting their livelihoods. 

Raquel*, 23, echoed the same sentiment, especially when having children one after another at a young age. Limited access to contraceptives affect the well-being of the whole family when there are not enough resources to support a growing household. It especially puts a lot of pressure on her, Raquel says, and there are days when she just doesn’t know how to cope. 

Nurse Piety conversing with a client during the pre-implant insertion assessment.

Although contraceptives are available in their local clinic, sometimes pills run out. Restocking is often delayed as the mainland is far away. Compared to pills and injectables, LARCs offer women longer protection without having to worry about running out of supplies. Reaching more women with LARCs especially in remote areas is vital. 

Roots of Health Nurse Daisy shares her realizations during the Agutaya mission:

“Not needing to buy a pack of pills when the health center runs out, women can spend their money on food instead. Mothers face a lot of hardships in child rearing. By helping them access contraceptives, an unplanned pregnancy is one less thing for them to worry about in life.”

Rita, Nimfa, and Raquel are only some of the women Roots of Health had the pleasure of getting to know during the four-day mission, but many more share similar experiences in family planning and accessing reproductive health services in and out of Palawan. 

The 16-hour trip by sea with multiple boat rides in between left the Roots of Health team feeling exhausted but accomplished.

Daisy shares, “Despite the tiring travel, there’s a sense of fulfillment in being able to help ease the burden of women when it comes to family planning.” 

—

* Not their real names.

Thumbnail photo shows the Roots of Health team, together with local health workers, traveling to a village in Agutaya, Palawan to provide more women with contraceptives of their choice.   

###

About Roots of Health

Ugat ng Kalusugan (Roots of Health), founded in 2009, works to empower women, young people and families in Palawan, Philippines to lead healthy reproductive lives by providing rights- and results-based educational and clinical services. The organization improves women’s and young people’s reproductive health and decreases the number of unplanned pregnancies and HIV incidence by providing sexuality health education and access to modern contraceptives through a clinical services program. 

Roots of Health (ROH) is registered in the United States as a 501(c)3 nonprofit organization. Ugat ng Kalusugan (UNK) is registered in the Philippines as a non-stock, non-profit organization. ROH exists to fundraise for UNK. All program activities take place in the Philippines under UNK. For all intents and purposes, the two are one organization. 

In the Philippines, Ugat ng Kalusugan is accredited by the Department of Health (DOH), the Commission on Population (POPCOM), the Department of Social Welfare and Development (DSWD), the Department of Labor and Employment (DOLE), the Provincial Government of Palawan, and the City of Puerto Princesa. We hold Memorandum of Agreements with the Department of Education, Palawan State University and Western Philippines University.

The post No island too small: Extending contraceptive access one boat ride at a time appeared first on Roots Of Health.

In celebration of International Day for Disaster Reduction, Roots of Health takes a stand for reproductive health services. Birth control, prenatal care, and HIV testing and treatment remain essential as we build disaster-resilient communities, and especially more so in immediate disaster response.

Disasters increase sexual health risks that women and young people have already been struggling with under normal circumstances.

 

To minimize the effects of a disaster, whether its a pandemic, an earthquake or a typhoon, vulnerable groups should continue to have access to essential health care services–including birth control, maternal health care, and HIV testing and treatment.

Here’s to a meaningful International Day for Disaster Reduction!

The post Reproductive Health in Disasters appeared first on Roots Of Health.

by Alicia di Giovanni | Photo: Isabel Corthier

When 16-year-old Tina’s* water broke, it was the last thing the ninth grader expected to happen in her high school campus, just a few miles away from the city center. She had thought that she was only seven months pregnant. Because she’d never had an ultrasound, she had no idea that she had been pregnant for nine months already and that the baby was due.

Every two and a half minutes, a teenage girl like Tina gives birth in the Philippines. That’s 24 babies born to teen mothers in an hour, or 566 in a day—one of the highest teen pregnancy rates in the world.

As young girls lack access to education on sex and pregnancy, they are left in the dark, not knowing how to protect themselves from major life changes that they aren’t ready for. And, like in the case of Tina, early unplanned pregnancy can disrupt their education and put their own health at risk.

“As far as she knew, she was only seven months pregnant.”

Like Tina, teenagers in Palawan don’t receive enough sexual education. In fact, teenagers have little to no information on the health services available for young expecting mothers. Having a child at a young age can affect both your health and your baby’s too (Papri et al., 2016). This is an important area of concern as Tina is among hundreds of thousands of teenage girls in the Philippines who get pregnant every year. In fact, one out of every ten Filipino women between 15 and 19 years old is already a mother (Philippines National Demographic and Health Survey, 2013).

Help young people access high quality reproductive health care.

The age of consent in the Philippines is 12 years old. This, combined with the lack of education, makes the high number of early unplanned pregnancies in the Philippines not very surprising. Unfortunately, the number continues to grow. Palawan, meanwhile, has one of the highest teen pregnancy numbers among all provinces in the country.

Early unplanned pregnancy is harmful to one’s health. It is associated with an increased risk of maternal complications during pregnancy and delivery. Teenagers need to be aware of these risks so that they can try to avoid it altogether through contraception. Or, if they are already pregnant, they should access prenatal care throughout the pregnancy.

Health Risks for the Mother

Regular checkups are incredibly important during a pregnancy to monitor a mother’s and fetus’ health. Women who don’t seek medical care, are at higher risk of health problems and birth complications. This is exacerbated in teenage pregnancies. Girls younger than fifteen are more likely to develop anemia, or low blood iron, along with pregnancy-related high blood pressure (Jeha et al., 2015). 

Low blood iron is more common for girls between the ages of 15 and 19 compared to women who are 20 to 44 (Jeha et al., 2015). This is because teenagers are less likely to receive the recommended healthy caloric intake required during pregnancy. It is important to receive qualified prenatal care to make sure your baby has the right amount of nutrients to prevent iron deficiencies.

Another risk for mothers during early unplanned pregnancies is high blood pressure, which can cause early delivery or low birth weight. This is not safe for mother and child and must be monitored closely by a health care professional. 

Health Risks for the Baby

Low birth weight in newborns is common among young mothers. PHOTO BY SHEEN CUBILAN

Early pregnancy also increases health risks for newborns. Babies born to mothers under 20 years old face a higher risk of:

• low birth weight, 
• early delivery and 
• future health complications (Combs-Orme, 1993).

With the lack of early and regular prenatal care, these risks can be harmful to a baby, and can lead to death.

Help more moms raise healthy babies.

Low Birth Weight: Low birth weight in newborns is common among young mothers. Low birth weight can affect a child’s learning ability. Some may develop infections or other illnesses. Nearly ten percent of teenage mothers will deliver a low-birth weight baby. Babies born with a low-birth weight are then twenty times more likely to die in their first year of life, compared to babies of normal-weight (Kirchengast and Belizan, 2009).

Early Delivery (Premature Baby): A premature baby is one born before 36 weeks of pregnancy rather than 40 weeks. Premature babies miss out on the important growth and development that take place in the final weeks of pregnancy. Early unplanned pregnancies are more likely to result in premature birth. This is due to lack of nutrients and prenatal care necessary for the full 40-weeks of pregnancy (Khashan, Baker and Kenny, 2010).

Baby Health Complications: When organs don’t have enough time to develop, babies may suffer from health problems such as:

• breathing problems;
• developmental delay;
• hearing issues;
• vision issues;
• difficulties with feeding; and
• other health complications (Papri et al., 2016).

“As young girls lack access to education on sex and pregnancy, they are left in the dark, not knowing how to protect themselves from major life changes that they aren’t ready for”

Early unplanned pregnancies also affect mental health. As a young teenager, and without education on sex and pregnancy, it can be a scary experience to find out you’re pregnant. Young pregnant women have greater emotional and social needs compared to older ones. This is usually because young girls feel unprepared and unsure on what to expect. Young mothers are less likely to finish school, experience higher rates of depression after birth, live in poverty, and have children who experience developmental problems (Combs-Orme, 1993). 

Why don’t teenagers seek medical advice?

Many teens moms don’t access the health services available to them and don’t visit the doctor throughout the duration of their pregnancy. This is usually due to a combination of: 

• embarrassment or shame;
• no time;
• lack of education; 
• lack of money; and
• lack of awareness. 

Low health-seeking behavior is a major health risk, especially for early unplanned pregnancies. It increases the risk of pregnancy related complications and harms the unborn child (Neal, Channon and Chintsanya, 2018). It is important to have consistent health care to minimize these risks.

What can we do?

At our new youth-friendly clinic, our nurse Daisy explains how contraceptives work to a group of girls. PHOTO BY ISABEL CORTHIER

Early unplanned pregnancies require comprehensive prenatal care from the start to ensure a healthy baby. Risks of early unplanned pregnancies can be avoided altogether when teens have access to reproductive health information and services. 

This is why Roots of Health opened a youth clinic in the Puerto Princesa city center as a place to ask questions, seek support and access services. That’s why Roots of Health exists–to provide reproductive health services in Palawan, offering a place of support and knowledge. The team and professionals at Roots of Health ensure to encourage good prenatal care, while keeping in mind the developmental and personal needs of the teenagers. 

Roots of Health aims to ensure that all women are aware and have access to contraception to help prevent the number of unplanned pregnancies in Palawan. To support our health education programs to help young people prevent early unplanned pregnancies pregnancies, support our work here.

*Additional reporting by: Amie Perez

Sources:

Combs-Orme, T. (1993). Health Effects of Adolescent Pregnancy: Implications for Social Workers. Families in Society: The Journal of Contemporary Social Services, 74(6), pp.344-354.

Jeha, D., Usta, I., Ghulmiyyah, L. and Nassar, A. (2015). A review of the risks and consequences of adolescent pregnancy. Journal of Neonatal-Perinatal Medicine, 8(1), pp.1-8.

Khashan, A., Baker, P. and Kenny, L. (2010). Preterm birth and reduced birthweight in first and second teenage pregnancies: a register-based cohort study. BMC Pregnancy and Childbirth, 10(1).

Kirchengast, S. and Belizan, J. (2009). Editorial: Teenage Pregnancies, a Current Global Health and Social Problem. Current Women’s Health Reviews, 5(1).

Natividad, J. (2013). Teenage Pregnancy in the Philippines: Trends, Correlates and Data Sources. Journal of the ASEAN Federation of Endocrine Societies, 28(1), pp.30-37.

Neal, S., Channon, A. and Chintsanya, J. (2018). The impact of young maternal age at birth on neonatal mortality: Evidence from 45 low and middle income countries. Plos One, 13(5), pp.5-32.

Papri, F., Khanam, Z., Ara, S. and Panna, M. (2016). Adolescent Pregnancy: Risk Factors, Outcome and Prevention. Chattagram Maa-O-Shishu Hospital Medical College Journal, 15(1), pp.53-56.

Philippines National Demographic and Health Survey 2013. (2013). Studies in Family Planning, 42(3), pp.227-232.

The post Physical and Mental Health Risks of Teen Pregnancy on Babies and Mothers appeared first on Roots Of Health.

The trip was grueling. They met at the Navy at 1 am and traveled by land for six hours, then by boat for another six hours. When they were finally back on land, they thought they had arrived, but then had to hike for nearly two hours. They finally reached their destination, Sitio Melville, the most southern point on Balabac Island. The area has no electricity and although there is a spring, the water is contaminated and many of the children suffer from worms.

Once they arrived, the medical mission began. Hundreds of people had already gathered – people who had travelled up to 4 or 5 hours to be able to access medical care. Many people had come because they had specific eye or dental issues. But many others looked visibly ill. Some children had signs of leprosy. Others showed signs of malnutrition. Everyone was desperate for medical care.

It was easy to spot mothers in the crowd. They were the women and girls with at least two or three children with them. Once we had taught interested women about their birth spacing options, they were most interested in the contraceptive implants. These implants are inserted into a woman’s forearm with the aid of local anesthesia, and then the woman is protected from pregnancy for three years. The team’s very first client who decided that she wanted an implant was only 30 years old yet had 11 children. Another girl, only 17, came carrying her four-month-old while her three-year-old walked behind her. She wanted an implant, but when she took the prerequisite pregnancy test, it came out positive. She is, for the fourth time in her young life, pregnant.

Residents in the Melville area of Balabac are primarily Molbog, an indigenous tribe of Muslim Palawenos. They speak the Molbog language, and do not generally leave the area. Because there are no high schools accessible to the area, most residents have only an elementary school education, if that.

Because of cultural norms, for many girls in Balabac, their first period comes only months before their first pregnancy. Girls are “married” off at young ages in this community, sometimes to boys their own ages, but sometimes to men up to 30 or 40 years older. Local Barangay Health Centers do not have the personnel and resources needed to reach more rural areas. As a result of the lack of education, services and resources, pregnancies are unhealthily frequent. There are no obstetricians and only a few midwives in the area, so most women and girls, even those with high risk pregnancies, give birth at home, unattended by a skilled birth attendant.

When our team left for Balabac, they didn’t know if anyone would want the implants that they were bringing with them. But by the second day of the mission they had inserted all the implants and had to turn women away because they had run out of stocks.

This is why reproductive healthcare needs to be accessible: the demand for services outweighs the supply. Women in places like Balabac have no choice but to have child after child, even when they don’t want and cannot support more. Women should be able to choose if or when to get pregnant and have children.

Girls should not become mothers when they are still children themselves.

The team arrived back in Rio Tuba, wet and exhausted after a rough sea journey. Another long van ride and they were finally home. While the journey and conditions were taxing, the team was happy to have been able to improve the lives of women and girls who so desperately need the help.
I hope our team can return to Balabac in early 2016 so we can continue empowering women and providing young people with education and information that could change their lives!

*Buntis means pregnant in Filipino

The post Buntis in Balabac appeared first on Roots Of Health.

The report found that one in three children, or 33% of the country’s children aged zero to five years-old are stunted, or are too small for their age.

What does this have to do with teen pregnancy and a lack of family planning?

The report found that a majority of mothers at risk of having underweight babies are teenage mothers. Teenagers also face greater pregnancy complications because their bodies aren’t yet fully developed or ready to support a pregnancy.

Teenagers and women who are not using any contraceptive method are also far more likely to have unplanned pregnancies. This often leads to women and girls not realizing they are pregnant, refusing to believe it, or hiding it until they’re well into their pregnancy. This means they don’t get prenatal care in their first or second trimesters, including access to important vitamins or folic acid, which are crucial to a baby’s proper development.

Babies whose mothers do not breastfeed for two years are also at higher risk of stunting and malnutrition – and the most common reason for not continuing breastfeeding for two years is the arrival of a new baby.

When pregnancies are planned, expectant mothers are able to prepare their bodies by eating more nutritious meals, and taking prenatal vitamins even before they get pregnant. They can also wait at least two years before having another baby. Not only can this make the difference between life and death, it affects other health outcomes, including whether a child will have stunted growth.

Save the Children’s report also states that a child’s first 1,000 days – which starts at conception until the child’s second birthday –is the most important time to prevent stunting. Children who aren’t able to achieve optimum growth within this 1,000 day period have a higher risk of problems with cognitive development, which can affect how they perform in school and whether they are able to have successful employment later in life.

Palawan was not mentioned in the report, but we know from City and Provincial Health Offices that malnutrition is a serious problem within our province. So is teen pregnancy, and we can see that this is linked to malnutrition.While stunted growth or being short is just one negative outcome of malnutrition, there are other serious complications from having low birth weight. These include being at risk for asthma and other chronic illnesses that can affect a child for his or her entire life.

Roots of Health advocates for birth spacing and educates young people so they avoid teen pregnancy. This not only leads to healthier and more productive lives for women and girls, it also protects the health of babies and children. When pregnancies are planned, pregnancy outcomes are better. My hope is that in the future, if we can decrease teen pregnancy and encourage proper birth spacing, improved nutrition and breastfeeding, we’ll see the next generation rise up – in height, in general health, and in stature.

The post Why Are Filipinos So Short appeared first on Roots Of Health.

When she arrived however, it was the mother that required attention. She complained of severe dizziness, so May took her blood pressure. It had dropped to 70/60. May was alarmed, so she asked Janine if she could perform an internal exam. When May removed the blanket that covered her, it was dark red and the mat underneath her was thick with blood. Janine was bleeding heavily and suffering from blood loss. May called for our nurse, Deng, and they swiftly administered Oxytocin and Methergine, drugs that help prevent post partum hemorrhaging. May then removed pieces of the baby’s placenta that were still in Janine’s womb and that had been left there by the traditional healer who had assisted with the birth.

The Roots of Health team placed an ice pack over Janine’s abdomen to promote the contraction of the uterus and further prevent post partum bleeding. May also inserted vaginal packing to help stop the bleeding, and massaged Janine’s uterus to promote uterine contractions. After an hour of continuous monitoring and care, Janine’s blood pressure had risen to 80/70 and she was no longer dizzy. Her vaginal bleeding had also subsided. Janine and her new baby were referred to the Barangay midwife for continued monitoring.

As for the newborn, the ROH health team found that his umbilical cord had been tied with thread, which is not strong enough to properly keep the cord stump tied. They replaced the thread with a cord clamp and taught Janine how to properly clean and care for her baby’s umbilical cord. A routine Vitamin K injection was given to the infant to promote blood clotting and prevent hemorrhagic disease in the newborn and Erythromycin was applied to the baby’s eyes to prevent infection.

Janine was so thankful to our staff for immediately responding to her situation. We can only imagine what would have happened if our clinical team had not been in the community. In the future we hope that the women in Aplaya will come to trust nurses and midwives over traditional healers. Until then we will provide the best care we can to our clients. Indeed it’s always a wonderful feeling to be able to help save the life of a mother.

* Not her real name.
*Aplaya is a small, coastal community in Barangay Tagburos, about 30 minutes drive out of Puerto Princesa City, Palawan. The programming there has been made possible though the crowdfunding website, Catapult.

The post How To Save a Life appeared first on Roots Of Health.

A year after that first talk, Evangelista approached Paliza once more, this time to convince her to help set up an organization that sought to help women in similar situations. “Susan was so alarmed by the number of students that approached her to say that they had to give up school because they were pregnant,” Paliza says. That organization eventually became Roots of Health (ROH) and Paliza became its assistant director.

“There was just a complete lack of knowledge of how pregnancies happen. And these were smart kids, but they just didn’t know how it happened. Their hopes and dreams got derailed,” says Amina Evangelista Swanepoel, Evangelista’s daughter who moved from New York to Palawan to work with ROH, and now serves as its executive director. (Evangelista sits as deputy director and Swanepoel’s husband Marcus is its media and program director.) Today, the organization works with four communities in Puerto Princesa as well as schools within the area.

ROH’s approach is holistic, and has three priorities: education, healthy pregnancies and nutritional support. Its goal is to produce communities that are well informed and aware of all the options that are available to them. Some of its programs includes maternal reproductive health sessions, teen health sessions, community health advocate training, support programs for underweight children, and even one that includes creating your own vertical garden to help sustain a family.

Raising funds has been a challenge Swanepoel admits, given that its cause is somewhat politicized. “A lot of donors do not want to become involved in an issue that might land them in the spotlight,” she says. Still, she says that it feels amazing to know that the organization is making a difference in the lives of the people in Puerto Princesa. “Knowing that women are able to choose the spacing and number of their children and that our pregnant clients will deliver their babies safely in the presence of our nurses and midwife, and that we are helping teens stay in school and avoid unplanned teen pregnancies and provide a lot of fulfillment,” she says.

The post Planting Seeds for Tomorrow (Town and Country Article) appeared first on Roots Of Health.

Created by the global advocacy organization, Women Deliver, Catapult is a digital hub driving donations to organizations working to improve the lives of girls and women because investing in girls and women strengthens families, communities and nations. “Catapult is a connector,” said Founder, Maz Kessler. “It’s a tool for people to take direct, effective action to create change. Catapult unites online supporters with trusted organizations to help fuel the movement to end inequality for girls and women.”

Organizations, like Roots of Health, upload their projects to Catapult, and donors can search for and fund the issues that speak to them most. To ensure transparency, each Catapult project includes a breakdown of how donations will be applied. Project budgets, including administrative costs, GPS coordinates, and video are all standard features of the platform. Catapult is free for all parties.

Interested Donors can also learn about projects from Curators, who are leaders in the advancement of women and girls. Curator Gary Darmshadt, the director of the Bill and Melinda Gates Foundation’s Family Health Division, will be featuring Roots of Health’s project titled “Flat bellies and planned pregnancies,” on his curator page. “Flat bellies and planned pregnancies” is a project that describes Roots of Health’s work providing family planning services and education in underserved communities in Palawan. Darmshadt will show his support for Roots of Health by promoting the project and sharing it with his network.

Founded in 2009, Roots of Health works with impoverished families in and around Puerto Princesa City on the island of Palawan. The organization provides women and girls with reproductive health education, contraception, and support for healthy pregnancies. Additionally, they provide nutritional support and high school and college reproductive health education.

In addition to “Flat bellies and planned pregnancies”, Roots of Health will feature 5 more projects including “Clinics when it counts”, “Gardening for health”, Keep girls in school, “It all starts with mom”, and “Training community health advocates.”

To learn more about Catapult and how you can help make a change for girls and women visit www.catapult.org.
Join Catapult on Facebook and Twitter

For more information on Roots of Health, please visit rootsofhealth.org, on Facebook and on Twitter

The post Roots of Health Featured on Catapult appeared first on Roots Of Health.

We believe that providing women and girls with information and access to family planning methods allows them to secure a sustainable future for themselves and their families. Watch this short video to see the impact of our efforts.

The post Why Our Work Matters [video] appeared first on Roots Of Health.

We asked some of Palawan’s underserved and lower-income women why the RH Bill is important to them. We wanted their opinions included in the debates since they will be directly impacted by the passage of the Bill. These are their thoughts.

The post Unheard Voices: What Do Filipino Mothers Think About the RH Bill? appeared first on Roots Of Health.