August 22

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Arriving with a bump – Mindanao – Day 2 Episode 2

Today we visited a rural health unit and a health centre in the municipality of President Quirino, also where GSK’s project on maternal and child health is being implemented. The ride was bumpy as we progressed into the countryside but travelling to these facilities with a bump can be much worse. Women arrive by motorbike tricycle, which is expensive, or sometimes by catching a ride in the back of a water buffalo’s cart to reach a birthing facility… a sure fire way to speed up labour. It must be so stressful.

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It was a quiet day here today, save for a baby girl brought in for a check up by her grandmother and father. She had been born at home earlier that morning. We were told the labour came on too quickly to get to the facility in time and was delivered by a hilot – a traditional healer, rather than a skilled birth attendant. It is unclear what the mother’s health status is and whether breast feeding had been initiated. Thankfully, this new arrival is fine and healthy….and very beautiful.

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It was interesting to learn how pregnant women are being tracked, educated and supported throughout their pregnancy and after delivery. Individual and group sessions are delivered by nurses and midwives using visual aids to promote understanding during their pre-natal care.

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Training and education on Maternal and Child Health care for Community Health Workers, with particular emphasis on pregnancy tracking is improving the collection of this valuable information, without which, the risks to the health of mother and newborn are increased. Essential Intrapartum & Newborn Care (Basic Life Support) training for healthcare professionals is helping to equip doctors, nurses, and midwives with the skills to respond to emergency cases, but not pre-term deliveries or other complications, which require specialist facilities, equipment and expertise.

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Delivery ward – has basic equipment and oxygen

Accessing the indigenous communities further afield is challenging. The midwives tell me that they bike out to these areas to monitor and educate the mother’s. The Mother & Baby book is explained in local dialect because it’s only produced in Tagalog or English. In these communities, the midwives have close relationships with the mothers and community leaders, however pregnancies are not captured in areas where is difficult to access or unsafe to visit.

Our next visit was to San Jose health center and I talked with 3 teenage mothers (17, 18 and 19) who were visiting for immunisations.

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It was the 18 yr old mother’s second pregnancy; the first was delivered at home, but not in this Barangay and was not recorded. There had been no birth plan or immunisations for her firstborn, but with this pregnancy, a birth plan had been completed and said she felt more confident to be delivering her second child in a safe place. She was happy also that her first baby was able to ‘catch up’ on immunisations.

The 17 yr old mother’s pregnancy was an accident and there has been little involvement from her partner during the pregnancy – already a great deal of burden on her shoulders, unlike the 19 yr old, whose pregnancy was well planned with her husband.

Their situation and needs vary and these young women are receiving good support from the staff at the health centre, but access to services, facilities and information remains a constant challenge in the rural communities.

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Day 2 Episode 3 to follow…speak soon, Alli 🙂