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By: Marcia Metcalfe, Meadville Tribune
Quezon Province, Philippines, March 1, 2007
— The rolling green hills and tropical light softened but couldn’t hide the scars from two recent typhoons as we drove through the rural Bondoc Peninsula. There were young banana trees, but no mature plants with fruit; and long brown fronds hung broken from the towering coconut palms. Some houses made of cement block or wood had been moved from their foundations, while piles of woven mats, plastic, and pieces of tin roof marked where other less substantial dwellings had once stood.
Ellen Vor der Bruegge from Freedom from Hunger, Cleofe Montemayor from CARD, and I were here with two objectives. We would observe a new educational program on dengue fever that was currently being offered to local members of the Center for Agricultural Development (CARD). And we would also interview CARD members and health care providers about local health issues.
Dengue, or “break-bone fever”, is a tropical disease carried by a specific mosquito. People who are infected have high fever, severe muscle and joint pain, and can also suffer internal hemorrhaging or shock. The Philippines is still battling infectious diseases like TB and dengue and they also face more recent challenges from chronic respiratory illnesses, diabetes, cancer, and heart disease. We saw this first hand as the women described their fears about dengue as well as high blood pressure and stroke.
Small groups of women in the CARD credit center meeting near Catanauan huddled
around colored cards with statements about dengue that had been provided by
the center’s technical and training officer. True or False? – “The mosquito
that causes dengue only lives in dirty, stagnant water”* . They were participating
in their credit group’s second session on dengue, its causes and ways to prevent
it. Someone had heard of a neighbor who had been infected, so the threat was
real. Enthusiastic applause followed each group’s pronouncement about whether
their statement was true or false, and the technical officer discussed the correct
answers.
After the session we asked the center members about where they go and how they pay for services when someone in the family is sick. Illness is the one event that can tip the balance from self-sustaining work to destitution for these poor families. One admission to a hospital can wipe out years of hard work and the gains from the small loans from CARD.
The aim is to link health protection with microfinance services. If poor families have ways to protect themselves from the financial shocks of illness and accidents, they will be less likely to get derailed along the way to economic self-sufficiency.
One of the resources available for this effort is the Philippine government, which despite limited resources, is currently implementing a universal health insurance program called Philhealth that provides basic hospital coverage. Although not perfect, this program has already gone a long ways towards protecting Filipinos from one of the more significant financial risks of illness.
In more urban areas, where Philhealth has contracts with more hospitals, CARD is piloting a new loan program to enable its members to pay the annual premium. Enrolled members also receive education about program benefits and to help them use the coverage when needed.
In rural areas like the Bondoc peninsula, the challenge is helping people understand when and how to use care to prevent and treat illness early. Basic health care services are provided by midwives and others. These include prenatal and well-child care, and treatment for the most common diseases such as cough, fever, and diarrhea. Although too often drugs run short or diagnostic services are not located nearby, nevertheless they provide basic care to a lot of people. But many people don’t seek care until they are very sick. Members told us that when illness strikes, they first self-treat with herbal remedies or consult a local faith healer. It will be critical for CARD to learn more about this, and worth with both members and local providers to encourage and enable people to seek care earlier.
In much of the Philippines and the rest of the developing world, poor health is not only a consequence of, but also a cause of extreme poverty. These on-going efforts by CARD and Freedom from Hunger offer real hope for beginning to break the cycle of poverty and poor health for millions of the world’s poorest families.
* ANSWER – False. The mosquito that causes dengue actually prefers clean water
in which to lay its eggs, but it can lay its eggs in stagnant water too. Hence
the importance of checking and drying dish drainers as well as eliminating standing
water around their houses.
Metcalfe is a West Mead Township resident. She left for the Philippines on Jan. 19 to help with the Freedom from Hunger Program. Stories about her work there have been in the Tribune on Jan. 18 and Feb. 7.
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Established in 1946, Freedom from Hunger works to bring innovative and self-help solutions to the fight against chronic hunger and poverty. In 1988 the organization developed Credit with Education, the world’s first program that combines the provision of micro credit loans to very poor women with vital health and business education.
Freedom from Hunger’s Credit with Education Program currently serves nearly 400,000 women, most of whom live on a dollar a day or less in Asia, Africa and Latin America. The program offers women working capital loans, from as little as $20 to as much as $300, to set up and expand home based businesses. The women have proven themselves to be excellent credit risks, repaying almost every penny they ever borrowed, a total of more than $380 million, plus interest.
Though a combination of cash credit and vital health/nutrition education, women can buy more and better food, invest in their children’s education, take control of their families’ health, and help each other to have a greater influence in their communities.
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