Where there are no doctors

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About a month ago I (Jeff) traveled with Mei Solocasa, Peacebuilder’s RN, to Maguindanao, a province located within the Autonomous Region of Muslim Mindanao (ARMM) and directly to the west of Davao City. It is a majority Muslim province and Peacebuilder’s Community has a program within there, which focuses on training healthcare volunteers. The program was developed as a way to empower communities, with limited access to healthcare professionals, to be stakeholders in their own health by training several individuals within the communities to provide basic medical assistance, advice and training to other community members. The class is composed of 15 students mostly women.  I assisted Mei in some of the teaching activities and then a practical clinical experience.

We were hosted by Care Channels on the Mindanao State University campus. The first night we spent the evening with a Muslim community to connect with some of the families whose members were students in the healthcare class.  The people who live in the home that we went to are the leaders of the community.  The community refers to them as Mommy and Daddy.  Mommy has a big laugh and welcoming personality.  She is also one of the people being trained by Peacebuilders as a health care volunteer.

The following day I packed medicines in the morning in preparation for our clinic and then joined Mei for the first class session.  I was nervous for the first session, but the students welcomed me quickly. I was the butt of many a joke when I tried to participate in activities by using my small knowledge of Tagalog words.  The focus of this month’s class was mostly about the effects of diarrhea, dehydration, cold and flu assessments and the use of home remedies.  The training for the volunteers occurs over 3 days a month and requires a year for completion. Two of the three days are in the classroom and focused on concept learning, while the third day is putting the learned concepts to use in a practical manner, a healthcare clinic.

For our practical clinic we set off for the clinic at 7 a.m.  I drove one of the vehicles to the clinic site. Driving here in the Philippines is very different from what I am used to in the U.S. It seemed that rather than organized traffic flow there was chaos, but as I drove I began to learn the principle rules of the road. Which are: don’t hit/kil anyone, fill the gap between yourself and the vehicle in front of you as quickly as possible, honk often to let people know of your location and intentions. We did arrive safely to the clinic. It was located in a rural community about 1 hour drive from the University campus.  We drove for about 3 miles off the main highway on muddy, bumpy, dirt roads up to the community.  A dentist and med tech supported the clinic by volunteering their services.

People who came to the clinic were mostly from the nearby village, but some walked hours to be seen. There were a large number from one Indigenous group in particular, the Teduray. After the clinic I learned more about their difficult history one in which they have experienced decades of on again off again displacement due to the armed conflict, illegal mining and illegal logging this has resulted in their being unable to establish permanent homes, secure communities, which in turn has robbed them of the opportunity for self-determination. Many of the patients that were seen in the clinic had common illnesses such as cold, cough or headache. There were some active TB cases in adults as well as malnourished or undernourished children.  There was one difficult case in the clinic that involved a 3 month-old baby who appeared to be severely malnourished because of a liver problem.  The story was heartbreaking the mother had been to the hospital, but the doctors there said the child was anemic and gave the mother some vitamins.  Mei said that anemia was just a symptom and that the underlying cause was the liver issue, but that since the woman can not afford treatment for her child she was given an easy diagnosis for her child and sent away.

I came away from the trip feeling excited at being allowed the opportunity to learn from Mei, to meet all the students, the supporters of Peacebuilders and to participate in the clinic. I appreciate the work of empowering a diverse group of people to be decision makers when it comes to their individual and communal health.