Watching over mothers
By Nilo A. Yacat
19 March 2009, Philippines -- Gemma Sabinay, 29, already mourned the death of her firstborn who died in 2007 from a genetic heart defect. When she got pregnant a year after, she swore to do everything so that her next child would survive.
Gemma completed all the required pre-natal check up visits, watched what she ate, and dreamt only of happy thoughts. “Kailangan daw masaya ka para maayos ang panganganak mo. Kaya yun ang ginawa ko noong pinanganak ko si Ronron (I was told that I should be cheerful so that the delivery would go smoothly. So I did just that when I gave birth to Ronron).”
Gemma lives in a remote village called Midtungok in the province of Sultan Kudarat in the Central Mindanao region. There are about 1,550 people, mostly Ilonggo-speaking Christians and a few Manobos. The village center is at the foot of rolling hills and mountains. Around 50 other families, mostly belonging to the indigenous group of Manobos, live on the mountain slopes.
At the health center of Barangay Midtungok, Gemma received a pre-natal health record. She would bring this record every time she paid a visit to midwife Marcy Andaya. But like many midwives in rural Philippines, Marcy serves more than one village.
Marcy is one of 171 registered midwives who are assigned to 249 barangays in Sultan Kudarat. One midwife covers on the average about 4,000 people in the province. Marcy is the lone midwife to the villages of Midtungok, Kiaman, and Nati, serving about 3,500 people.
“Ayos-ayos lang. Kaya nga dapat may sistema para maayos ang trabaho. (We get by. Hence, we should follow a system so that our service is in order),” Marcy says.
A tracking system for pregnant women
In the villages she covers, Marcy has set up a tracking system called “Bantay Nanay” (literally, to watch over mothers). At the health center, a notice board lists down the names of pregnant women in the village and other essential information such as expected date of delivery, pre-natal check up date, number of surviving children, and significant medical history.
In its landmark publication, the State of the World’s Children, UNICEF cites the continuum of care to integrate maternal, newborn, and child health care. Essential services for mothers, newborns, and children are most effective when they are delivered in integrated packages at critical points in the life cycle of mothers and children. Monitoring the progress of a pregnancy is one of these packages.
“Bahala na (Come what may),” says Joyce a bit despondently when asked how she is preparing for the birth of her next child. “Hindi naman natin talaga alam kung ano mangyayari bukas (We don’t know what will happen tomorrow).”
Unlike Gemma and her happy thoughts, Joyce cannot seem to conjure up sunny dreams as she moves along with the pregnancy. For happy thoughts are not aplenty these times in Midtungok. Three days before Christmas in 2009, Joyce fled with her daughter to the forest when armed men attacked the village and ransacked houses. Her daughter, Charice, turned three amidst gunfire and explosives.
When a mother dies
Marcy also gets somber when she tells how she lost one Manobo mother during the siege. Langini Gamboa, 31, gave birth to her seventh child at the height of the conflict but died due to excessive bleeding. “She was supposed to deliver at our health center,” Marcy recalls.
It would have been a breakthrough for Marcy’s record as a midwife. Most women in Midtungok, Christian and Manobos alike, still give birth at their houses and are attended to by a “hilot” or traditional birth attendant.
Today, Marcy is literally watching over another Manobo woman, Jocelyn Subing, 40, who with the rest of her family, has taken refuge at the health center. “Takot pa siyang bumalik sa kanilang bahay (She is still afraid to go back home).”
Marcy’s job becomes even more difficult when fear rules the lives of pregnant women. “Wala kaming ibang magagawa kundi ang magbantay (We cannot do anything but be on the guard).”
After all, in the hands of health workers like Marcy, rest the lives of many Filipino mothers and newborns.
For more information on what UNICEF Philippines does to improve the health and well-being of mothers in the country, click here.
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Children First Newsletter (Q4 2009 Issue)
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