It was a year of major scaling of our programming in order to reach more women and young people not only in Puerto Princesa City, but in the whole province of Palawan.

During the year, we significantly expanded our programming for young people in high schools. In addition to our existing Reproductive Health curriculum, we also taught young people about puberty, and about Tuberculosis. We not only taught in all the major high schools in our city, but we also expanded our programming into northern and southern Palawan. Our team of traveling teachers taught at schools from Narra in the south to Roxas in the north, and a number of municipalities in between. The team found that the need for information – and the eagerness to get it – increased with the remoteness of the area. (There are still high schools in Palawan with neither electricity nor cell phone service!) Our team became so adept and skilled at teaching and managing large groups of students, that they started thinking an audience of only 50 or 60 was quite a small group! Over the year, our team taught 15,192 young people about their health and how to protect it. Given Palawan’s high rate of teen pregnancy, we are so pleased to have taught so many young people and believe their newfound knowledge will help them avoid unplanned pregnancies and stay in school.

In 2015, we continued providing maternal health education workshops, clinical services and training for Community Health Advocates (CHAs) to nine resource- poor and isolated communities in Puerto Princesa. Recognizing that the further away from the city center we get, the greater the need is for information and services, we piloted a program of service delivery to two communities outside Puerto Princesa’s central business district. Because these communities (Candes Dos and Talaudyong, both in barangay Bacungan) are very isolated and difficult to access, there has been a high demand for our services. We’ve had to adjust our workshops, service delivery and CHA training since we can only go to these communities twice a month. However at the close of the year we felt secure knowing that our model for service delivery outside our city is one that can work. We will continue to tweak and adjust this model as needed in 2016, in order to reach even more women and girls who need our services and programming.

Knowing that 2015 would be the last year of our Financial Literacy programming, we sought to make as big of an impact as possible by reaching greater numbers of people with basic finance knowledge and skills in order to empower them to manage their finances more wisely. We taught 113 women within our communities using our traditional style of classroom-based training. In addition to this, we also trained 22 of our Community Health Advocates who had already completed our Financial Literacy course on how to teach their peers the basics of Financial Literacy. With our support, our CHAs then taught 716 of their peers some of the most important basic information regarding finances, bringing the total number of community members educated to 851. We also launched an Enterprise Development program which started with 100 women participating in workshops on the various aspects of starting a small business and culminated with us awarding small grants to 12 women entrepreneurs who made business plans and proposals for starting their own small businesses. Finally, we created a financial literacy program geared for young people focused on wise spending, saving, and employability.

When I think back to 2009 when Susan, Marcus and I started Roots of Health, I don’t think any of us could have dreamed that in six short years, we would be helping change lives and improving health outcomes to the extent that we’re doing today. Thank you for supporting us along this incredible journey!

2015 Annual Report

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Position Summary

Ugat ng Kalusugan is seeking a teacher to work in our community outreach programming. Working with our other teachers and clinical team, the teacher will help create and teach workshops and education sessions focused on financial literacy and reproductive health to women in our community sites. This is a full-time position for 8 months. Salary of P12,000 per month plus benefits including Phil Health, SSS, 10 paid vacation days, three months paid maternity leave, 13th month pay, and two weeks paid leave between Christmas and New Year. Additional relocation benefits for applicants outside of Palawan.

Responsibilities

• Work with Ugat ng Kalusugan staff in creating and disseminating workshops and education sessions focused on financial literacy and reproductive health in our six community sites.
• Assist colleagues in creating and teaching sessions for youth in our Community Teen program
• Implement pre- and post-intervention surveys to participants in the community outreach workshops.
• Enter and analyze data from the pre- and post-intervention surveys.
• Provide general support to staff of Ugat ng Kalusugan with other administrative and programmatic needs including other data entry and analysis, attending meetings, etc.

Job Qualifications

Required:
• College or university degree, preferably in Social Work or Education
• Interest in working with women in community settings
• Highly organized and detail oriented, enthusiastic, flexible and good-humored

Desired:
• At least one year of teaching or community organizing experience
• Experience in teaching material related to math or finance

Send cover letter and resume to jobs@rootsofhealth.org as soon as possible.
Desired start date: May 5, 2015.
Interviews with shortlisted applicants will be conducted on a rolling basis.

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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.

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The proponents of the bill are saying that 11 Filipino women die every day when they talked about maternal mortality. They have not, however, supported this claim with accurate and consistent data. Kung tutuusin sa pinagawa ko sa mga staff ko, hindi pa nga umabot man lang sa kalahati ng 11 maternal deaths ang nakalap nila sa mga hospitals sa Pilipinas nung 2011 eh. For example, sa Nueva Viscaya Provincial Hospital, ang maternal deaths na naitala nila ay 2 lamang sa 2011. … Sa Batangas Regional Hospital, 7 out of 2584 deliveries ang naitala .27%. Hindi pa nga umabot sa 1%. … Kaya ang hirap paniwalaan ang kanilang figure na 11 mothers die every day.

Sotto failed to grasp that a small number – such as the 0.27% he calculated for Batangas and belittled – becomes large when multiplied by a huge number like the millions of births per year.

If we assume that the Batangas data can be applied to all births in the country2 in 2011, the national figure becomes 2,385,000 births × 0.27% = 6,461 maternal deaths per year, or nearly 18 per day.

Put in another way, if the Batangas Regional Hospital had a maternal mortality ratio equivalent to the country’s MDG target of 53 deaths per 100,000 live births, then Sotto’s staff should have counted only 1 death out of the 2,584 deliveries recorded. Six women should have survived. Malaysia and Thailand had had MMRs of 50 and below a decade or so ago.
Sotto should learn from this mistake and take the data gathered by his staff seriously, and not let his biases cover-up the tragic reality of women’s deaths.

Alfredo Melgar

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1. See http://senate.gov.ph/press_release/2012/0815_sotto1.asp
2. As estimated by the UN Population Division; see http://esa.un.org/unpd/wpp/unpp/panel_indicators.htm

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When you make a donation to Roots of Health, you can select a short video of our clients singing a holiday song and we will send that holiday greeting to your recipients. We’ll also send information about your gift and what the donation supports.

Make this holiday season more meaningful and help empower women in the Philippines today!

Select how much you would like to donate and then click on the “Donate Button” below

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So last April, when I got the chance to to attend a HIV-AIDS Educational Awareness Workshop, I jumped at the opportunity. The event was sponsored by Peace Corps Philippines with speakers from USAID, UNAIDS, PAFPI (Positive Action Foundation Philippines, Inc.) and Babae Plus, PNAC (Philippine National AIDS Council) and Bernardo Health Center and Social Hygiene Clinic.

During the first day of training, Dr. Recardo J. Mateo – HIV and other diseases specialist — restated the basic HIV information. We then learned many activities to explain the tranmission of HIV. This was particularly helpful to me as I teach health education classes, in which many of the participants cannot read.

I was also informed of the current statistics of HIV in the Philippines.

• The Philippines is one of only 7 countries with increasing HIV cases;
• 72 out of 80 provinces have reported cases of HIV;
• From 1984-2010 there were 6,015 reported cases. In 2010 alone there were 1,500 new cases;
• In 2000 there was one case reported every 3 days. In 2010 there were 6 new cases a day;
• In 2015 9,800 new cases per year are predicted;
• The most “at risk” age group is 20-29 year olds both male and female;

The behaviors that put Filipinos most at risk are:

• Having unprotected sex with more than one partner,
• Having sexual intercourse early (average age here is 15),
• Using injectable drugs,
• Males engaging in anal sex with other males

I was surprised to learn that the Philippines was the first country in the world to enact a law that provides free antiretroviral therapy (a combination of multiple drug to slow down the reproduction of the virus in the body). The government currently has 32 public voluntarily counseling and testing centers established to prevent the spread of the HIV/AIDS epidemic .*

I believe the first step in fighting HIV would be to adjust our attitudes towards HIV. We need to stop ignoring the issue and face up to it. If we don’t, it will soon be another serious problem one that our country can do without. At present we have statistics only for reported cases; how about those who aren’t submitting themeselves for blood tests but are at high risk of acquiring the disease?

We have to be responsible in our actions. Let’s start by spreading the correct information. Health awareness and advocacy is not just merely talking, but providing knowledge that will hopefully result in behavioral change.

Protect yourself and know your status by accessing basic and comprehensive prevention services and submitting yourself for testing and treatment.

*R.A 8504 was enacted on February 13, 1998

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To begin with, we conducted informational interviews with key informants in Puerto Princesa, including with representatives from the City Health Office, the Population Commission, and representatives from Palawan State University and other local NGOs. Once these informants had highlighted communities that are particularly underserved, we visited City Hall and analyzed the most recent census data from those communities. We then narrowed down the possible communities to five different locations. We went to those communities and met with the Barangay heads and health workers to find out more information about the families living there. Finally, after all these meetings, Lyn-Lyn and I began conducting house-to-house surveys in each of the locations. In preparing for our interviews, I was inspired by something that Ms. Habaradas, one of my former mentors at PSU College of Nursing and Health Sciences, told us when we met with her. She said, “Every community has their own need and you’ll see it if you just deeply search for it.” I felt excited and as we prepared for our surveys, I thought to myself, “I want to discover what this community needs, and see what I can do help.” Armed with our clipboards, interview forms, pens, umbrellas and water, we set off. Unfortunately in all our excitement we forgot to bring the camera, but we can go back and take some photos later.

Our primary objective was to gain information about each of the sites we were considering. We planned to interview at least 15 women from 15 different households to gain knowledge about their health beliefs and practices, as well as about their socio-economic status. The 15 surveys from each community are not statistically representative of the whole community, but can paint a useful picture of what some of the community needs and issues are.

Our first site was Purok Matiyaga in Barangay San Jose. To our surprise, we found that the informal name for the area we were looking for is “ Little Tondo”. Tondo is known as one of the poorest areas in Manila with many slums. It is one of the most densely populated areas of land in the world. Contrary to our expectations based on Manila’s Tondo, this “Little Tondo” in Puerto Princesa is not very populated, and is peaceful and simple. Most of the residents are from the Tagbanua tribe – one of the three main groups of indigenous peoples in Palawan. The community is near the sea, there are lots of trees and it is pretty. When we went there it was quite muddy due to the previous day’s rains. Most of the families we came across were busy peeling the kasoy (or cashew) seeds. This is the main source of income for many of the families in the community.
To give you more of an idea of what the community is like, here are some of the key data we gathered:

Socio-Economic Indicators
• 1/3 of respondents have a monthly household income between P501 and P1,500 (roughly $11-$34). Another 1/3 live on between P1,501 and P3,000 ($34-$68) each month . The last 1/3 live on between P3,000 and P6,000 ($68-$136) per month.
• Only 40% of respondents have work or a way to earn income.
• The majority of respondents store excess food in containers with lids. Three respondents share a refrigerator, and two more store leftovers in baskets. One respondent said that her family never had any leftover food.

Water and Sanitation
• All of the respondents obtain their drinking water from a well.
• Half of the households do not have a toilet so residents use their neighbor’s toilets, or urinate and defecate outside their homes. The other half of respondents have a water-sealed toilet (toilet without a cistern or flush mechanism – one pours water into the toilet to get rid of waste).

Pregnancy and Children
• Only 6 out of 15 respondents are practicing a family planning method. The other 9 respondents are not currently using any family planning methods.
• Of the women using modern forms of contraceptives, 1/3 pay for the medicines themselves but 2/3 must rely on free supplies.
• 9 of the women have had 3 pregnancies or less. On the opposite end of the spectrum, 2 women have had between 9 and 11 pregnancies.
• Before their last pregnancies, 33% of respondents were using contraceptives and stopped in order to conceive. In contrast, 66% of respondents had not been using any form of contraception before they became pregnant.
• The majority of women interviewed said their ideal number of children is between 2 and 3.
• Many of the women had more children than their reported ideal number so we asked them about the difference. Some women had more children than they wanted because they were trying again for a boy or a girl, but more respondents said they had more children than they wanted because of unplanned pregnancies.

Healthcare
• When they or their children are sick, nearly half of respondents seek care from a doctor, a quarter see traditional healers and the rest access care from the Barangay Health Center. One woman said she just mixes herbal medicines to cure herself.
• When asked for their preferred attendant at birth, 10 respondents said they wanted their birth attended by a traditional healer, 3 said they prefer a midwife and 2 said they wanted a doctor to attend their births.
• When asked where they preferred to give birth, 11 respondents said they prefer to deliver at home, 2 said they wanted to deliver in a hospital and 2 said they wanted to give birth in a health center.
• After their last pregnancy, 6 of the respondents had 1-3 postnatal visits at the health center. 9 of the 15 respondents did not have any postnatal check ups because they did not know about them.

Beliefs about Family Planning
When asked about their beliefs on family planning, 8 of the 15 respondents said they thought that when one drinks hormonal contraceptive pills that they do not dissolve or get absorbed into one’s body, and can become tumors, or cause cancers that necessitate cleaning out the uterus.

Some other beliefs include:
• “DMPA (the injectable contraceptive) will cause baldness”
• “If a condom breaks inside your body it stays there and doesn’t get absorbed or come out of your body”

Pregnancy Beliefs
More than 1/3 of the respondents believe that if you are pregnant and sit near a door, you will have a hard time with giving birth.
1/5 of respondents said that if you see a rope, that you should not walk over it but instead avoid it so that your baby’s umbilical cord won’t get coiled up.
One woman believes you should not eat any bloody foods like fish while pregnant as this might cause you to hemorrhage after delivery.

As I write this blog entry, we are still finishing our surveys and analysis from the other four communities we are considering. We hope to choose the most underserved community based from the results of our surveys by early December. We hope to begin our work in our new location by mid to late January 2011.

I want to end this blog by leaving you this quotation: “Don’t ask what the world needs. Ask what makes you come alive and go do it, because what the world needs is people who come alive”- Howard Thurman

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Since we began our work in Palawan, we have been fortunate to have formed many positive partnerships with other organizations and individuals working on various issues and projects in Puerto Princesa.

The Local Masons of Lodge 99, under Master Rolando Bonoan, had been to Pulang Lupa before, when the group donated some school materials such as writing pads, crayons, paints, and some wonderful blue portfolios for the children to carry their work home in. Last week they installed two water purifiers to help provide safe drinking water to the community. Because residents of Pulang Lupa don’t own the land, and therefore do not qualify for city water service, people are forced to use wells of questionable safety. So the water purifiers are a very valuable gift to the community.

The National Masons group had gotten interested in the community outreach work that the Local Lodge was doing and while in Palawan, carved out time to see the project first hand (as well as to cut the ribbon and formally present the purifiers to the Pulang Lupa residents). Much to our surprise, the very pleased Grand Master Razon immediately committed to donating five more purification units! This news was greeted by excitement from the community. The Masons then walked around Pulang Lupa to inspect some of the vertical gardens and speak to the residents. We now have 24 gardens set up in households, some with just young shrubs, and some filled with lush greenery.

The mission of Roots of Health is to empower women and girls to secure their right to health and freedom from violence, and to support and protect the health and well being of their children. This mission focuses on reproductive health education and child nutrition, and we realize the virtues of staying within the boundaries of that mission. But in many of the underserved communities in Palawan, the challenges all run into each other. Better nutrition necessitates better financial resources and that means more employment, but of course better education (and fewer children) makes better employment more possible. Good nutrition and good basic services in health (and especially access to potable water!) enable both work and education. We continually feel ourselves being pulled in other directions as we become more immersed in Pulang Lupa.

But somehow good local resources have begun to find their way to us and have enabled us to help facilitate services for the community that we ourselves do not provide. My husband Oscar is a Mason, and provided the initial connection between Lodge 99 and our organization. It seems that once the Masons visited our program site, they were hooked. (It is always a good experience to go to Pulang Lupa! The mothers and children are absolutely charming and everyone is open and friendly.) Mark Lim, one of the former Masters of Lodge 99, introduced his friend Richard Arambulo to the community and to our work, and soon Richard’s group, Bayanihan ng Palawan, sponsored one of the nutritional supplement sessions and provided new slippers for the children and many of the mothers. They also did a tooth brushing demonstration and gave every child a toothbrush.

Other local schools, businesses, and NGOs have also helped us to further serve the community. Anthony Palanca of Heavenly Desserts makes a special whole-wheat pan de sal (bread roll) as one of our weekly snacks for the children. Our neighborhood organic farmers, Simon Gill of Bountiful Harvest, and Keith Mikkelson of Aloha House, along with Philippe Girardeau guided Marcus through the creation of the different models of vertical gardens – an effort we originally considered a “special project” but one which has been taking on more and more importance. Keith’s wife Narcy has also been instrumental in guiding us through our first year as a community NGO. The ‘safe water’ organization, A Single Drop, advised us on the water purifiers and facilitated the installation. Our relationship with Palawan State University’s College of Teacher Education and College of Nursing and Health Sciences has developed and we plan to expand our programming in the university next year.

So the bottom line seems to be that while we focus on our mission, which is Health Education and Nutrition, we can serve as a magnet to attract other organizations and individuals – groups and people who want to help. Being able to facilitate their help and harness their energies makes it possible to provide expanded services in Pulang Lupa (and hopefully in future communities that we work in) while allowing us to continue to keep our focus on our mission.

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We aim to increase the reproductive health and overall well-being of women and girls, and decrease malnutrition in babies and young children.

Roots of Health empowers women and girls to secure their right to health and freedom from violence, and to support and protect the health and well-being of their children. Roots of Health conducts educational workshops and provides health counseling and nutritional support. Our activities are guided by the international human rights framework, which includes a core belief that health is a human right, and are carried out using a community-based approach.

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