The Visayas Primary Health Care Services has just completed a 20 -month primary health care project supported by the LandsAid in Germany.
The project was implemented in three barangays from May 2015 to December 2016 in northern part of Cebu affected by Typhoon Yolanda, namely: Barangays Paypay and Dalingding Norte, Municipality of Daanbantayan, and Barangay Tindog, Municipality of Medellin. The project partnered with the people’s organizations in these communities, namely: the NagkahiusangKababayen-an sa Sitio Mayjo (United Women in Sitio Mayjo, Paypay), NagkahiusangLumolupyosa Hacienda Gomez (United Residents in Hacienda Gomez, Sitio Gomez, Dalingding Norte, and NagkahiusangLumulopyosa Sitio Manan-aw (United Residents in Sitio Manan-aw, Tindog.
The project aimed to achieve the following objectives, namely, (1) to develop the capacity of community health workers (CHWs) to respond to the primary health needs of the communities, (2)To respond to the basic health needs of the community, (3) To develop the capacity of the people’s organizations to build a community-based disaster management program.
After 20 months of the project, under the leadership of the people’s organizations using the primary health care approach, the residents have reaped valuable gains in terms of enhanced health awareness, improved health practices and benefitted from the services of the CHWs. Community involvement and participation is the essence of community-based health programs
Health skills trainings and education
These services were possible with the knowledge and skills garnered by the CHWs in a series of three basic health skills trainings and special skills trainings conducted in the project which enabled them to render basic health information and health services, launch community health campaigns, and mobilize their residents to promote health and prevent disease.
The topics of the three basic health skills trainings included the following, namely : a) naturalhealing of commonillnessesusingherbalmedicine, acupressure and water therapy, (b) childhealth care: control of acute respiratory infections and diarrhealdiseases, basic nutrition, immunization, and nutrition, c) properhygiene and environmentalsanitation, (d) maternalhealth and family planning, (e) chronicdiseasesincludingtuberculosis and hypertension, (f) basic humananatomy and physiology, (g) simplifiedhistory and physicalexamination, (h) commondiseases.
Health educations were conducted to address common health issues existing in the barangays, providing information to the residents to enable them to prevent illnesses and maintain health and launching community endeavors together. Primary health problems included the following, namely: (a) infectious diseases particularly acute respiratory tract infections, diarrheal diseases, and pulmonary tuberculosis, (b) chronic diseases such ashypertension and osteoarthritis. (c) child health care particularly nutrition and growth monitoring, and skin infections and (d) reproductive health including family planning, safe motherhood.
Health campaigns under the leadership of the people’s organizations included nutrition program to address the problem of malnutrition among children, prevention and control of hypertension, and family planning.
Child health care
Children’s health was a key concern in the project. Foremost is the nutrition program that has been sustained in the barangays. The program worked for the nutritional rehabilitation of malnourished children identified in operation weighing and growth monitoring. A health campaign on nutrition was conducted. A total of 580 children were weighed in the three barangays. They were given deworming agents and iron supplements. Of these, 175 were malnourished and all of them have regained normal weight at the end of the project. The project also has a feeding program to address the problem of malnutrition. Green leafy vegetables, squash and bitter gourd are also grown in the communal farm managed by the organization in Paypay and in the backyards of the homes in Tindog and Dalingding Norte. Nutrition is a favorite topic in the monthly health education classes. Malnourished children were followed up through home visits by CHWs who assessed the nutritional practices of their mothers or caregivers and provided information on cheap and easily available food sources.
Skin infections among children were addressed through health education on proper hygiene and treatment not by expensive Western ointments but by temple flower, moringa and hemlock stem coverings that are shredded and cooked in vegetable oil and added with paraffin wax.
Mothers were taught by the CHWs that simple cough and colds which was the leading cause of disease among children were remedied by giving the child more fluids and extra nutrition, herbal plants such as lagundi, tamarind and calamansi. These plants were grown in their backyards.
Mothers with children having diarrhea cases were advised by the CHWs to use homemade oral rehydration salt solution using tablespoon of sugar and a pinch of salt in a liter of clean water or the fresh juice of coconut fruits to prevent dehydration coupled with information drives on environmental sanitation, proper disposal of garbage and wastes, and proper storage of household water for drinking brought from the springs were sustained
Tuberculosis and hypertension
To address the problem of pulmonary tuberculosis which has remained as one of the top ten leading causes of deaths in our country, the CHWs conducted health educations on the signs and symptoms of TB, such as chronic cough, weight loss, afternoon fever, and hemoptysis which increased the awareness of the residents on the disease. Patients with the symptoms were then referred to the health centers by the CHWs.
To address the problem of hypertension which is the number one cause of death in the Philippines, operation blood pressure taking was sustained by the CHWs. They did health educations, home visitations and took the blood pressure of the adults.
The occurrence of osteoarthritis, muscle pains, and tension headache as chronic illnesses which are work and fatigue related is common among farmers was addressed by the CHWs using herbal liniment made of coconut oil soaked with crushed garlic, red pepper and ginger which were cooked in the oil. The warmth of the oil with the healing ingredients of the spices soothed aching joints and headache. Cupping therapy for muscle aches and acupressure for headache were also practiced by the CHWs and taught to the mothers
Reproductive health including family planning and safe motherhood were common issues in the health educations. It is a fact that in Philippine society particularly in the poor classes, many women desire to space their births or do not want to bear children anymore but do not have the information and the services for such. Thus, information drives among the women in the project areas on family planning and methods of birth control such as the natural methods and the use of condoms and pills were conducted in the project areas. Since it is common for young people to marry early in the rural areas and bear children, they were also properly advised on child rearing and family planning.
Home remedies such as water therapy, cupping therapy, acupressure and herbal plants were constantly resorted to by the mothers for ordinary complaints such as fever, cough and colds, stomach ache, headache, body aches and body malaise. The use of common, cheap and essential Western drugs was resorted to by the mothers only when these traditional forms of medicine failed or to complement their use. These included paracetamol for fever, amoxicillin for ordinary infections, antacids for stomach hyperacidity, mebendazole for intestinal parasitism, and mefenamic acid for pain.
Medical missions and community clinics
More than 3,500 patients were served during the monthly community clinics and three medical and dental missions. They were opportunities of the CHWs to practice their skills together with VPHCS medical staff and volunteers. The medical missions were also able to reach out to more and more residents in the far-flung sitios of the barangays who needed medical help which was otherwise unavailable to them since the government health centers were far.
Services in the three medical missions included medical check up, dental consultation, tooth extraction, blood sugar testing to screen for diabetes mellitus, giving of reading eyeglasses, urinalysis to detect urinary tract infections, and dispensing of medicines.
A three-day Disaster Management and Preparedness Seminar was conducted for 12 leaders and 35 members of the committees on disaster preparedness committee (DPC) and CHWs of the people’s organizations in the three barangays.
A disaster risk reduction and management plan was then formulated by each community. The plan included disaster risk mapping, the identification of the most vulnerable as well as
measures the community will put into place to increase their resilience to disasters and health preparedness.
Another three-day training was given to the officers, CHWsand DPC on the health effects of disasters, first aid in disasters, and public health aspects in disasters including water supply, communicable diseases, food and nutrition, waste management, and environmental sanitation.
Sincedisasterresponseis a barangay-wideendeavor, itwasnecessary for the people’sorganizations to collaboratewith the diasaterriskreduction and management councils (DRRM) of the municipalities of Daanbantayan and Medellin and the three barangays. Thus, meetings of the officers of the people’sorganizationswith the barangay and municipality DRRM councils to discuss how they can worktogether in disastermanagement. However, concrete measures to be mapped out jointly in the future still in the process.
During the visit of the project manager in October 2016, the people’s organizations requested to have a health center constructed in Manan-aw and Paypay and a communal comfort room in Gomez. The health center would serve as a venue to render health services, keep their medical supplies, medicines, health education materials, patients’ records, and meeting place. The CHWs would have days of the week that each one would be on duty. With additional project funds to buy the necessary materials, the two centers and communal toilet were constructed in December 2016 by the members of the people’s
Three special skills trainings were also conducted where the CHWs were taught about (a) effective leadership, (b) program management, and (c) resource generation.
Indeed, the project was a historic milestone in the lives of the people in the three barangays.