Truck on the Way to the Clinic

A truck has been parked on the street leading to the clinic for months now. It is a disabled dump truck parked with its box in an elevated position. Since it is a convenient distance from a concrete wall, an enterprising fellow stretched some tarps across the intervening space and turned the truck into a dwelling, complete with a refrigerator. To make it feel a bit more like home, he also painted various parts of the truck in brighter colors: purple, yellow, green. I say “he”, but I’m pretty sure there were multiple people living there. A family?

Well, someone evidently persuaded them to move out, for the truck is now no longer inhabited. It’s not running either. But that doesn’t mean its usefulness has been exhausted. Behold, what Pinoy ingenuity has devised:

 

Yes, that is a basketball hoop. And it is at a pretty good height, with what can only be called a very expansive backboard. You could hit all kinds of interesting bankshots off that box.

Return to Leyte Part 2: In Imelda’s Bedroom

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Waiting for breakfast at the Haiyan Food Stop, refreshed after a good night’s sleep and ready for another day!

After our two long days of driving, we slept late on Tuesday morning. The grand opening of Cumpio Midwife Clinic was not taking place until evening. We ate a delicious breakfast and set out for Tacloban, about half an hour away. Our delays the previous day meant that we would not have time to see all the places that I’d hoped to visit with Naomi and Gabriela, but we meant to make the most of the time we had. Driving to Tacloban, I was amazed at how many changes there had been in the 5 months since I had left. It was so encouraging and heartwarming to see shiny new roofs where six months ago there were weather-beaten tarps. The recovery and rebuilding had clearly come a long way!

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Morning refreshment — fresh buko juice (coconut water) and tiny single-serving pineapples, eaten off the stem like a lollipop.

Naomi and Gabriela agreed that of the various landmarks that we could visit (the scenic Leyte-Samar bridge, the MacArthur Landing Monument, the several large ships that had been washed into town by typhoon Yolanda) they were most interested in the Sto. Nino Shrine and Heritage Museum, built as both a museum and one of the 29 residences of President Marcos and taken over by the Philippine government in the 1980s after Marcos was ousted. Tacloban is former first lady Imelda Marcos’ hometown, and the museum was built on her family’s property. The mansion suffered extensive flooding and damage during Yolanda (link goes to a news site photo slide show) but has since re-opened. Our tour guide, who told us she was already part of the staff in the days when the Marcos family still used the residence on their visits to Leyte, was clearly devoted to the building and grieved over the damage caused by the typhoon. Despite the storm damage, the girls were impressed by the grandeur and opulence.

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The ballroom with its enormous, octopus-like chandeliers.

Naomi was particularly fascinated by the dioramas depicting Imelda Marcos’ life, from her childhood in Leyte to her benevolent good works as First Lady of the Philippines, in each of the downstairs guest bedrooms.

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Example of one of the dioramas: a youthful Imelda is crowned beauty queen.

The second-floor rooms had sustained less damage than those on the ground floor, as they had not been flooded (apparently the mud was knee-deep after the waters receded.) These included the ballroom, the larger of the two dining rooms, and the family bedroom. Our guide insisted I take a picture of the girls sitting on Imelda’s bed:

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This picture does not do justice to the size of the room. The luxurious ensuite bath was quite a big larger than my bedroom.

Our tour complete, we left Tacloban and headed south to Dulag, where I had spent four weeks in the spring volunteering at Bumi Wadah’s “birth camp” clinic, which at the time was located in San Jose elementary school. We drove past the school, which is in session but still under construction (a Japanese NGO began repairs to the school shortly after I left Dulag.) Bumi Wadah has a lovely clinic building now which they share with the rural health unit. We visited there and were treated to a delicious lunch (eggplant salad, pumpkin soup, rice, vegetable lumpia, and fruit salad – yummy!) Because our lunch visit was a day later than planned, most of the midwives were attending a seminar and I would not get to see them until later that day at Nerissa’s opening, but it was great to see the new clinic building and see old friends again.

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Lunch at Bumi Wadah.

One of the things I enjoyed most about my time in Dulag was the beach right across the street, where I went walking almost every day unless it was pouring rain or we were extremely busy with patients. In Davao, it’s easy to forget we’re on a tropical island since the city is so built up and the water so polluted — to get to a beach from Davao we have to drive a long way down the coast, or first drive and then take a boat to Samal Island. So after lunch we walked across the street to enjoy the fresh ocean breezes and the lapping waves.

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Naomi enjoying the beach in Dulag.

On the beach, as well, signs of recovery were evident. Though the debris of ruined houses remained in many places, the surviving coconut trees, which had been almost bare of leaves in March, were green again and new fishing boats lined the beach. Naomi splashed in the waves while Gabriela and I visited with a new Bumi Wadah midwife volunteer who had just arrived from Australia. All too soon, it was time to head back toward Tanuan, for the most important event of our trip: the grand re-opening of Cumpio Midwife Clinic.

Return to Leyte

A few weeks ago, I got a message from Nerissa Cumpio. “Good morning Sora, the opening will be on September 16th, I hope you are available that day.” For several months, I’d been getting updated photos of the building project progress and finally, the date was set for the (re)opening celebration of Cumpio’s Midwife Clinic! I immediately started to plan my trip.

Rather than fly into Tacloban airport, I decided to make it a bit (more) of an adventure and drive to Leyte. I figured that the cost for gas and the ferry would be comparable to flying and that this plan would allow me to see more of the Philippines, and bring Naomi and Ezekiel with me. Unfortunately, I had a very tight schedule for when I needed to return to Davao, requiring some very long days of driving! Ezekiel decided the long days in the car did not appeal to him, and Matt had classes to teach in Davao, but Naomi came with me, along with Gabriela, one of our friends from Davao.

We set off on Sunday afternoon, well-provisioned with snacks and water bottles. The plan was to drive from Davao to Surigao City on the north-eastern tip of Mindanao, spend the night there, and take a morning ferry, reaching our final destination in Leyte in time for lunch. I had not been able to find a working phone number for the port or the ferry company in order to confirm schedules, but I had the all-important copy of my vehicle’s OR and CR and I had found what looked like a fairly recent ferry schedule on a travel website so I wasn’t too worried.

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Our route.

The drive from Davao City to the ferry terminal in Surigao City is estimated at just over 5 hours by the google maps app. All I can say, is, whoever created the algorithm for the google maps travel times must never have driven in the Philippines. Our trip was on the Pan-Philippine highway the entire way, but most of the Pan-Philippine highway (outside of the major cities) is only two lanes, and there are frequent landslides and bridge repairs requiring constant maintenance.

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Road works ahead.

When road construction limits the two lanes to one, there are never any flaggers directing traffic nor lights at night. And when passing through the numerous small towns the road becomes full of slow-moving tricycabs, bicycles, pedestrians, motorcycles laden with anywhere from four to six passengers plus cargo, dogs, chickens, carabao, etc. (Most of these also have no lights at night.)

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Small-town traffic!

Gabriela had been working day shift at the clinic so we did not depart Davao until 2:00 pm. We reached Surigao City around 10:00 pm, completely exhausted. I had planned to go to the ferry terminal before we slept to confirm the ferry schedule and find out how early we needed to show up to secure our place on the ferry, but we were so tired we by the time we were approaching Surigao City that we chose to just check into a hotel and set our alarm for 5:30 am, figuring the ticketing office was probably closed already and that getting to the ferry at 6:00 ought to be enough for an 8:00 am departure. (Rookie mistake!)

We slept well and arose bright and early, headed for the ferry about 10 minutes away. As we got closer, the lines of parked cargo trucks on both sides of the road led me to suspect I might have made a tactical error in not taking the time to visit the port the night before. My inquiries at the port quickly confirmed my suspicion. I was permitted to hand in a photocopy of my vehicle registration to secure my place in line, but not to buy a ticket yet. I was told the morning ferry was already full and the noon ferry was “probably” full as well. The driver of the first car in line to board informed me that he had arrived at the port a little after midnight. Ooops! I texted my friends at the birth camp in Dulag to let them know we would not be there for lunch after all (“Maybe supper, then?”) and we decided to make the best of it by driving around Surigao to see the sights and maybe finding a (more pleasant than the ferry terminal) place to relax for a few hours.

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The Surigao beach where we spent most of Monday morning.

We bought some pandesal at a local bakery and found a place where we could rent a beach cottage (picnic table with a roof) for 100 pesos. Naomi played in the water and Gabriela took a nap. We’d been told to check back in at the ferry terminal at 11:00 am, so right on time, we headed over. The ticketing agents were clearly overworked and stressed. When I finally got their attention, I was told my name had been called half an hour before! (I protested that I had left my cell phone number… but that was with a different agent, who had gone off duty in the meantime.) It was okay, we still had our place in line for the next ferry and were allowed to buy our tickets — a multi-step process involving no less than 5 different people all in different offices. I continued to hope for a lunchtime departure though there was no sight of a ferry yet, we parked our car where we were directed… and waited.

The ferry showed up around 2 pm and unloaded. Then the loading process began, and I realized this was going to take a while. The order of priority for ferries is passenger buses (which get on the next departing ferry after they show up), private vehicles (like mine, which apparently usually need to wait a while!) and finally cargo trucks, which explains the lines of trucks on the side of the road leading to the port. And all of these vehicles, crammed as tightly as possible in order to fit as many as possible, are required to back into their place on the ferry… the ramp only works on one side of the boat.

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Finally, the ferry’s here!

The crossing itself was pleasant and uneventful, taking a little over an hour. The sea was calm and by leaning over the side into the breeze we could avoid the smell from the large truck full of pigs directly below us. Though there was some nervousness in certain quarters due to the unfortunate ferry accident that had occurred just two days before, I saved all my anxiety for the night driving.

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Naomi, enjoying the fresh sea breeze and avoiding the smell (though not, alas, the sound) of the pig truck.

As the San Ricardo ferry terminal came into view, we enjoyed the beautiful views of the sunset over the mountains (the sun sets early near the equator!)

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The welcome sight of the Benit (San Ricardo) ferry terminal, late afternoon on Monday.

Unfortunately, we still had 170 km to drive, mostly in the dark, on winding mountain roads. Again, we pulled into our destination around 10:00 pm, tired from a long day of travel. Nerissa and her husband Alex were waiting to meet us at the Haiyan Foodstop, a restaurant built after (and named after) the typhoon. The Haiyan hotel is still under construction but two guestrooms are open, and that was where we were staying for the night. A joyful reunion and a good night’s sleep (with no 5:30 am alarm this time!) and we were ready for the next day’s adventures.

 

“My little finger shall be thicker than my father’s waist!”

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Ezekiel shoots a jump shot in happier days. He’ll be sitting on the bench for the rest of the season.

Basketball is not intended to be a contact sport. Unfortunately, during team practice today Ezekiel’s little finger made contact with the ball and he came home with a swollen pinkie that was jutting out at an odd angle, which he could not straighten or move without extreme pain. After icing it and hemming and hawing a little bit we headed to the ER of one of the private hospitals in town (it was late enough in the evening that no clinics or doctor’s offices would be open.)

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Who needs a lead apron for a little old hand x-ray?

The ER  experience was smooth, easy, and efficient, an incredible contrast to understaffed, overcrowded ER at the public hospital where we usually bring any patients who need transport for higher-level care. Ezekiel was unquestionably the healthiest patient there but we were still seen immediately. Within half an hour of arrival we had paid for our x-ray (in the Philippines, you pay first and then get treated: that’s why there’s no wait time in the ER) and Ezekiel was getting zapped. The radiology tech was surprised when I asked him to put the apron on my kid for just a hand x-ray.

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Probable diagnosis: chip fracture. (They x-rayed the uninjured hand too to compare but I only got a photo of the first one.) No orthopedists in house at 7 pm so Matt’s going to take him back tomorrow.

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The ER doctor offered to admit him so he could have first crack at the ortho in the morning rather than having to wait around in the outpatient clinic (Seriously? Seriously! “Since there is a fracture, we are allowed to admit him.”) This was obviously overkill so I said we’d just come back tomorrow. They settled for immobilizing the hand and finger (which Ezekiel considered excessive), telling us to keep icing, and writing a prescription for mefenamic acid which we probably won’t bother with since the swelling is fairly minimal (post title notwithstanding) and he’s not in pain unless he tries to move his finger.

The most remarkable part of the whole thing (besides being in and out and home in about an hour and a half, half an hour of which was spent driving?) Total bill for ER visit with x-ray: 823 pesos. (At today’s exchange rates, that’s USD$18.39.) Plus $0.65 for the bandage. Except… that this is at the expensive private hospital that very few families can actually afford to go to. It’s still hard to fathom that what seems like such a small amount to us is an insurmountable barrier to care to so many others.

Overseas Filipino Workers

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image credit: the kaya collaborative

It is a truism that the Philippines’ biggest export is people. The number of Filipinos overseas is more than 10% of the Philippine population, and money sent from overseas workers to family members back at home represents more than 10% of the national GDP.

A few months after we arrived, one of the other missionary families asked if we’d be interested in a part-time cook — they loved the woman who was cooking for them but she really wanted full time work and they didn’t need her for that many hours. We agreed and soon grew to greatly appreciate Helen’s cooking and baking as well as her honesty, industry, and cheerful attitude. Helen was a grandmother and her income helped support an extended family including an aging father and a 10-year-old grandson for whom she was the primary caregiver. Some years before, Helen had responded to the recruiting advertisements and gone to Kuwait as a domestic worker on a two-year contract. It wasn’t long before she discovered that all was not as advertised. Her story is not an unusual one: overseas Filipinas working as domestic servants are frequently exploited and even abused. Helen left her first employer and was able to find another job “under the table” in order to keep sending money back to her family in the Philippines. She was reported for working illegally and spent months in a Kuwaiti jail before returning to the Philippines.

Helen eventually left us for a better job in Manila. A few months later, we learned that the sister-in-law of one of our apartment complex’s security guards was planning to go overseas to work, leaving her husband and two young children in hopes of better financial security for her children’s schooling and future. Her brother-in-law was trying hard to dissuade her: even if she were to get a “good” job with a reputable agency, she would not see her family for several years. It did not take much persuasion for us to offer her a job with our family. Of course, this solution is not generally available for the hundreds of thousands, perhaps millions of Filipina mothers who leave their children behind to work overseas, believing this is the best choice they can make for their families.

Getting a good job here in the Philippines is difficult. Because of an abundance of workers, the job market is saturated and even college-educated workers often struggle to find employment or make a liveable “middle-class” income. Employers can pick and choose and job specifications, especially for retail work, almost always list specifications that would be quite illegal in the U.S.: “Must be female, over 5’2″, and under 25 years old.” (To work at a grocery store check-out counter.)

Mary, one of my former patients, texted me today to tell me she was planning to apply to work overseas. She is 26 and had been working at the grocery store where I usually shop, so I saw her regularly. Her contract had expired and despite her experience and work ethic she was not going to be hired back again because she was “over the age limit.” She saw overseas work as her only option now.

“Maguol ko sa akong mga anak … wala ko trabaho wala sila makaon,” she texted. (I will be sad for my children but if I don’t work they are not able to eat.)

(She is still looking for a job here in Davao as well though she is running up against the “age limit” in many of the retail jobs for which she is qualified; please pray with me that she will find something.)

Isla Verde Outreach

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Children playing on the street in Isla Verde.

The birthing center where I volunteer as a midwife has several outreaches intended to make it easier for women who would otherwise have difficulty accessing care to get regular prenatal check-ups right in their neighborhood. The one I have attended most frequently is in Isla Verde, a slum neighborhood with a large Muslim population and a Badjao settlement. The streets are narrow and crowded with people, children playing, tricycabs and bicycle taxis.

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Our prenatal team today after we’d finished seeing patients. From left to right, Brittany (a second-year midwifery student), me, Charlyn (holding her daughter), Sharon (a nurse and summer intern at the birth center) and Ate Ana, one of our Filipina supervisors at the birth center.

We do our prenatal check-ups in a somewhat makeshift clinic in the covered “carport” in front of the home of Charlyn, a Filipina whose family moved to Isla Verde to minister to the people there.

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Britanny and Ate Ana interviewing (medical history) first-time prenatal patients.

We come to Isla Verde every two weeks and usually have between six and twelve prenatal patients show up each time, almost always including several new patients.

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Badjao grandma watching her daughter’s prenatal check-up

Most of the Badjao patients who give birth with us get their prenatal care at our Isla Verde outreach as they cannot afford to pay for public transportation to come to the birth center for checkups.

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These were not our patients but they came in while we were there are and I had to take a picture.

Our prenatal clinic is only a very small part of Charlyn’s ministry; she hosts other free health care clinics and regularly organizes medical teams to visit isolated mountain villages in rural areas as well. You can see more pictures of the work she’s doing on her NGO’s Facebook page.

Isla Verde is right on the edge of the ocean. Around the corner from Charlyn’s home are shanties on stilts above the sea water, which is a mass of trash and unidentifiable sludge.

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Garbage floating on shallow sea water. All the houses are on stilts.

The Badjao village is built out over the water with narrow wooden walkways from house to house.

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Apparently the “Badjao bridges” have been improved considerably in recent years… they still felt quite precarious to me!

The streets are full of children and they all LOVE to have their picture taken. Pull out a camera and they’ll start posing and yelling, “Ako! Ako!” (Me! Me!)

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Hamming it up for the camera.

I showed these boys the pictures on my phone screen as I took them and they delighted in making silly faces and then laughing at them.

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Silly faces.

You can’t help but smile.