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Ugat ng Kalusugan in December

As with every month since we started working in the Philippines, December was another very busy month for Ugat ng Kalusugan!

I started off the month with 3 days of back to back to back meetings in Manila with other organizations focused on maternal and child health and reproductive health. The people I met with were incredibly helpful and I am so thankful for their generosity in sharing their time and best approaches and practices with me. I really learned a lot and left the meetings eager to return to Palawan and use some of the wise advice I’d been given. Reflecting on the meetings made me feel so thankful for how supportive the nonprofit and NGO community has been here in the Philippines. Everyone we have met with has been so happy to help us and Roots of Health / Ugat ng Kalusugan is benefiting and will continue to benefit greatly from all of these relationships.  

Back in Palawan, Susan, Marcus and Lyn Lyn were busy preparing for our end of year Christmas party in Pulang Lupa and when I returned I helped organize our activities as well. Christmas is a very big deal in the Philippines, and we had decided in late November that though we wouldn’t be able to begin our educational outreach activities before January 2010, that we could at least have one session to formally launch our activities in the community before we closed for the Christmas holidays. We decided to have a short program for the women and children in Pulang Lupa. We planned to gather all the women in one area and introduce ourselves and our work more formally and give them an update on what we would begin doing in January. We decided to have a few games related to our work, serve a simple merienda (snack) and give each woman a small gift of food/groceries for her household. We decided to have a brief program for the kids as well and planned to have games and stories with the little ones in a nearby area, serve them a merienda, and give each child a toy that we had purchased. We tried to guesstimate how many people would attend and decided that probably around 50 women and 130 children would attend. We planned for that many number of gifts and rounded up a bit for food. We knew that the party was probably going to be a bit chaotic but we also believed that it would be fun and we hoped to have a good number of women in attendance.

The Christmas Party

On December 11, party day, we showed up in Pulang Lupa 40 minutes before our start time, fully expecting that we would need time to start rounding up some of the women and children. We had planned to start our activities when we had about 40 kids and about 20 moms in attendance. We were surprised upon arriving to see that a small group of children had already gathered. Within 15 minutes, there were about 50 kids waiting and a few minutes before our scheduled start time, there were more than 100 participants patiently waiting. Some of the moms and kids did come a bit late, but we had nearly all our participants ready and waiting at our scheduled start time. There were so many people! We estimate that there were about 150 kids and about 60 women all together. In addition, there were about 10 men from the community - fathers and husbands - who came to join in our programming as well. The extra numbers made things a little bit more hectic, but we were so pleased that we had such a high turnout, and we were happy that everyone, including the men, had decided to come out. We were thankful for the extra food we had brought because it allowed us to also give the men a small merienda. Not all of the women got a bag of groceries, but all households did get a bag of food (some households had more than one woman in attendance.) And we had candy that we gifted the extra kids with. So in terms of supplies, it all went fine.

Susan and Lyn Lyn and I handled the program for the women, and it all went better than we could have hoped for. All the women in our group were cheerful and excited to participate and were interested to learn more about our planned programming for January. Before we began we asked the women to write their names on nametags, and we called on each individual by name. We think they really appreciated this, and it was helpful to us to place more faces with names as we hope to know every member of the community on a first name basis before too long. The games and activities we’d planned all had something to do with reproductive health and we were pleasantly surprised to see the women really engage and really get into the games and discussions. We don’t think that they have very many chances to talk about their lives and their thoughts and ideas, and it was fantastic to see how much they enjoyed participating in our activities. The men were mostly on the periphery, just listening, but I think they are also happy to know more about our plans, and they enjoyed listening to the women and watching them engage. My dad, Oscar, also came to the party and he stood with the menfolk and chatted with them quite a bit. We don’t yet have programming for the men in the community but we are very glad that they came and now know more about what we are doing as we think this will make it easier for the women to come to our sessions without eliciting any suspicion from their husbands about what we might be teaching them. 

We knew going into the Christmas party that the kids would be a bigger and wilder group so we recruited some extra help for Marcus and were so thankful for the help that Jane, Evetha, Gonie, Jennie, Jong and Jen lent us. Marcus and his team entertained the kids with games and songs and Evetha, who is an amazing story teller, told the children a few stories. It was a huge group but they managed to keep everyone engaged and entertained. Distributing the toys was the only portion of the afternoon that did not go as smoothly as other parts because of the extreme enthusiasm and excitement from the kids, but even that didn’t go too badly. In the end all the kids went home happy and were all very appreciative of their new friends and new toys. 

After we cleaned up we piled into our cars and went home exhausted, but really thrilled with how well the afternoon went, and really excited about starting our programs there in January.

Other Activities

On December 14th Susan and I held a Board Meeting with our New York and Vermont based Board of Directors. Unfortunately Susan and I could not attend in person, but technology allowed us to participate in the meeting via phone. Our Board of Directors is comprised of intelligent and enthusiastic women and we had some great discussions about the work we’ve already done and our work ahead. One Board member, Suneeta, has already visited us in Palawan and we hope that in 2010 the rest of the members of the Board will be able to come to Palawan to see our work firsthand as well.

During the last week of work in 2009, we focused on organizing our materials and workshops so that we can hit the ground running in January 2010. Within the first few weeks of January we plan to test some of our workshops and activities with students at Palawan State University, start the programming for women in Pulang Lupa, and begin the nutritional support program for undernourished children in the community. We are so excited to begin our programming and for all that lies ahead in 2010. 

All of us at Roots of Health / Ugat ng Kalusugan would like to thank you for your support and enthusiasm for our work since we started in August, and we look forward to your continued support and interest in 2010. We wish you all a wonderful holiday season, and send our best wishes for a peaceful and prosperous New Year.

Starting our activities with women

Evetha and Jong with some of the kids

Some of the men with Oscar

Distributing gifts

With the women

A little boy enjoying his new toy car

To view more photos from the Christmas Party, please click here.

Pulang Lupa

November has been a busy and important month for Roots of Health. Since my last blog update, we completed our needs assessment. In analyzing the data as well as our general observations from being in the communities, we have decided to begin our programs and service delivery in a community in Santa Lourdes called “Pulang Lupa” (meaning “red earth”) which is a part of Purok Matahimik. It is the community that I mentioned before that is also referred to simply as “Dumpsite”. Based on the income and size of the local families as well as health and nutrition patterns, education levels and knowledge on reproductive health, Pulang Lupa is clearly the most underserved community and we believe they will benefit greatly from our programs.

Upon selecting Pulang Lupa as our first program site, we mapped all the households within the location and spent 4 days conducting in-depth surveys within every household in the community.

Photos of the community are available here.

The following are some of the data from the surveys:

• Number of households - 59

• Number of people living within the 59 households - 315 (average of 5.3 individuals per household)

• Percentage of households with access to their own toilet facility - 61%

• Percentage of households with access to their own electricity - 44%

• Percentage of households with connection to their own supply of water - 5%   (95% of the people in the community do not have their own connection to a water supply and have to walk down a steep hill to collect water from a well for bathing and cleaning and they buy water directly from a water company for drinking and cooking).  

• 100% of the respondents live in homes made of nipa or thatch, and 95% of the houses have only one room for all of the inhabitants to share.

• 42% of the respondents do not have a job

• The average salary in the community is around P3,330 ($66). However, this figure is skewed because of outliers-- two households have a monthly income of around P10,000 ($200) and many more have a monthly income between P500 ($10) and P1000 ($20).

• Less than 30% of the respondents practice some form of family planning.

• 62% of respondents said that the ideal number of children is either 2 or 3.

• Only 54% of respondents have been pregnant 3 times or less

• Of the remaining women, 8 (13.5%) have been pregnant 4 times. 3 women (5%) have been pregnant 5 times. 6 women (10%) have been pregnant 6 times.  3 respondents (5%) have been pregnant 7 times. 2 women (3%) have been pregnant 8 times.  3 respondents (5%) have been pregnant 9 times. 2 women (3%) of respondents have been pregnant 10 times and 1 woman has been pregnant 12 times.

• Nearly all births are at home with a traditional healer as a birth attendant

• 10 women have had no formal schooling in their lives. 17 women went to anywhere from 1st to 5th grade in elementary school. 14 women went up to the 6th grade and completed elementary school. 9 women had some high school education but only 5 women actually graduated from high school. 1 woman went up to her second year in college, and 3 women completed vocational or secretarial school.

• All of the women have experienced difficulty in feeding their families, and very few can afford to buy meat or fish. Most women reported eating rice with either eggplant, kangkong (a type of spinach), plantains or casava when we asked them to tell us everything they had eaten the day before we interviewed them.

Support Roots of Health - Gifts with Meaning

I wanted to let you all know about a unique opportunity to help raise funds for Roots of Health.

A friend of mine who lives in Australia, Frank Mathisen, has started an online store selling Christmas cards to benefit select charities. Roots of Health is one of the featured organizations.

Each packet of 10 cards is AU$20 (or about US$18.50) and for each packet sold, AU$10 is donated to Roots of Health. Shipping to the US/UK is AU$5 and the cards are mailed within 24 hours of receiving the order and payment. The postal service estimates that it takes 4-6 working days to ship the cards from Australia to North America/UK.

I would really appreciate it if you would consider purchasing your holiday cards this year from Gifts with Meaning to benefit Roots of Health. The website address is http://www.giftswithmeaning.com.au/.

We're trying to spread the word and reach as many people as possible, so if you feel comfortable forwarding the Gifts with Meaning information on to your family and friends, that would be fantastic.

Thanks so much for your continued support!

Honday Bay Photos

We conducted surveys at Honda Bay - the last of the four sites we were considering for our programs. I'm not posting the survey results as I feel the answers have reached a saturation point - most of the results and comments were similar to previous surveys we conducted. But the photos that Marcus took of the site are gorgeous so I am sharing those here. You can also see the photos and comment on them on our fan page on facebook.

“I’d like to give birth in a hospital but I don’t have the money to pay for it. So I give birth at home.”

Surveys in Purok Matahimik

Earlier this week we returned to an area in Santa Lourdes called Purok Matahimik which means “quiet place”, also known as “Pulang Lupa” or red earth because of the color of the soil, and is also simply known as “Dumpsite” because of the community’s proximity to the Puerto Princesa landfill. This community is a top runner for where we might begin our services as it is quite isolated and very poor and has high numbers of malnourished children.

Photos from our visit are here.

We interviewed 13 women between the ages of 17 and 56.

Family Planning Usage

We asked the women about their family planning usage and just over 30% of the women we spoke with use artificial forms of contraception. Three use the injectable DMPA (Depo Provera) and one uses birth control pills. All four women pay for their contraception themselves. Three of the women we spoke with use natural family planning methods including the calendar/rhythm method and the withdrawal method. One woman just recently gave birth to a baby and isn’t on any contraception but plans to be when her period returns.

Five of the women we interviewed do not use any form of family planning. One of them gave no explanation for why she prefers not to use any contraception. One woman said that she had been living in an isolated and rural area and did not have any access to any healthcare or family planning methods. Another woman said that she isn’t using anything because she doesn’t have a husband any longer and is on her own. Another respondent said that she didn’t think she had to use anything because she’s already old (she is 56 and has a four year old daughter.)

37 year old Helen, who has three children, said, “I’m not practicing any family planning right now, but there were 5 years between my last two children so I think that’s a good thing - but I’m not using anything. I tried using pills before but I only lasted about 2 months. I got so dizzy from the medicine. I actually thought I was already done with kids but then I got pregnant again. I just gave birth two weeks ago. I’ll probably go on something now - maybe the injectable [DMPA]. It’s really hard when you think you’re done with kids but then you suddenly get pregnant again.”

How many is a good number of kids?

We asked the women we spoke with what their ideal number of children is. The two youngest respondents, aged 17 and 18 and each with one unplanned child, said they would like to have 3 children. Both of them are now using contraception. Other respondents with 3-4 children answered that their ideals are the same as the number of children they do have. One woman, Carolina, 36 years old, said her ideal is three kids but she has five because she didn’t know of any ways to control the number of her pregnancies. Merleta, who is 34, has four children, which she says is her ideal, but she has had eight pregnancies, and none of them were planned. Edita, 56 years old, says her ideal is three children. She has four living children but has had nine pregnancies in her life - none of which were planned. 39-year-old Marlyn said her ideal is three or four children, but she has nine children - none of them planned. She actually gave one of them up for adoption some years ago because she did not have the resources to feed and care for another child. 48-year-old Angelita’s ideal is four children but she has eight. She lived in an isolated, rural area and had no access to contraception. Marilyn, who is 25 years old, says her ideal is four or five children. She has seven and is not on any contraception. She told us, “I can’t do anything because my husband doesn’t want me on any contraception. I actually asked my sister to adopt one of my kids because I have malnourished children and I can’t handle all of them myself.”

Pre and Post Natal Care

10 of our 13 respondents did receive prenatal care with their last pregnancy, but most only had two to four appointments before they delivered. Of the three women who did not seek prenatal care, one went to a traditional healer and two said they just took care of themselves.

After giving birth, five of the women we spoke with saw a health professional for at least one postnatal check up. One woman saw a traditional healer. Another did not have any check up but her doctor sent her a bottle of postnatal pills which she took for one month. More than half of the women we spoke with did not have a postnatal check up and four of told me they didn’t even consider it because they just don’t have the money to spend on a check up.

Health Care

Nearly all of the women we spoke with said that when they or their children are sick, they prefer to see a doctor when they can afford it, or seek free care from Barangay Health Workers. Two women said they they just buy their own medicine when they are ill rather than spend money on a consultation. One woman with no experience or training in herbs or alternative medicine said, “When I have money I like to go to a doctor. But when I don’t have any money I just use herbs that I find around where I live.”

Birthing

All of the women we spoke with except for one said that their preferred birth attendant is a traditional healer or a midwife. One person prefers a doctor. Seven of the women prefer giving birth at home and actually did have their children at home. Three women said they gave birth at hospitals just to make sure they would have the help they needed had there been any problems with their deliveries. One woman had her last baby at a hospital but the rest were born at home. She’d had eight pregnancies and four live births. One woman who has had nine pregnancies and four live births said, “I’d like to give birth in a hospital but I don’t have the money to pay for it. So I give birth at home.”

Thoughts on Family Planning

We asked the interviewees what their thoughts on family planning are and some of their statements include:

“You’ll probably be more successful if you plan your pregnancies.”

“You really have to do family planning because otherwise, you can’t make a good future for your family.”

“When you have lots of children its hard to support all the children’s needs.”

“You should plan your family so that you can give them a good life.”

Food and Nutrition

Most of the respondents breast fed their babies. The majority of them breast fed until their children were two years old though some breast fed for shorter periods (one to six months or a year) and some breast fed for longer (until age three).

We asked if any of them receive supplemental food support and nearly all of them have children who are fed in the biweekly Aloha feeding. (To read about Aloha’s program, see my previous blog entry by clicking here.) One woman said that she does not receive any support and added, while pointing to her daughter, “I really need some help for her - she’s so skinny.”

Household Income

We asked the women we spoke with what their monthly household income is and whether they or their husbands have work. Most women reported very small amounts of income that have to support multiple people for a month. One woman with four children said their monthly income is P1,000 ($21). She doesn’t have any work but would like to do anything to make more for her family. Another woman whose 84-year old husband is paralyzed sells fish in homes around the neighborhood and makes about P500 ($10) for her family of six. Another woman is a single parent and makes about three straw mats a month that she sells in the market. She can make about P500 ($10) to support herself and her son. Another single parent makes about P1,500 ($31) making and selling mats and this supports her and her eight children.

Merleta, who has eight children, said, “My husband makes P1,000 ($21). I make straw mats and in a month I can make around 5. They sell for P200-300 ($4-6) each in the market. I make a little but I use it to buy rice or food for the children. So I never have anything left.”

One woman makes P4,000 ($84) a month buying and selling scraps (mostly recyclable plastic and glass) that she collects from the dumpsite. This supports her, her husband and their eight children.

The wealthiest of the women we spoke with has a husband who works as a painter and makes around P9,000 ($190) per month. She supplements this income with around P200 ($4) a week that she makes selling items at a small store in front of her home (these stores are called sari-sari stores and are usually stocked with some snacks and basic supplies like soap and cooking oil.) She only has one child so they have a much better situation than most of their neighbors do.

One family’s experiences confirmed an anecdote we had been told by a friend who works for the city’s Department of Social Welfare and Development. Our friend told us that the city government is frequently months late in paying salaries to city employees. Most people in Palawan have no credit, so late payment of salaries really puts people in a bind. People need cash and some resourceful (and cunning?) people have stepped in and lend city employees money until they receive their salaries, but they take a huge portion of the earnings as their fee. Some people think the city government is in on this lending scheme but this is not substantiated. One of the women we interviewed with three children said, “My husband is a driver for the city and should make around P6,500 ($136) a month. But the city doesn’t pay the workers right away so then we have no money. He borrows some from lenders who then take a cut. So what he brings home is just about P5,000 ($105). I just take care of things at home and watch over the kids. Once my baby is older, I’d love to work - maybe run a sari-sari store?”

Other Resources

We asked our interviewees if they receive any supplemental support from groups conducting outreach work in their community. The women we interviewed noted that they sometimes get free care from the Barangay Health Center and the Puerto Princesa City Health Center. A Korean church group also organized a medical mission to the community once last year. They gave away medicine and clothes and performed circumcisions. They haven’t been back since. One woman remembered an outreach program that the military once had but couldn’t recall when that was or what exactly they did. One woman answered that she and her friends don’t get any other support and added, “Contraception really should be free for us. The Health center is really far away and anyway when you don’t have money, you can’t buy anything so then you’ll just get pregnant again.”

A lot of young kids have to take care of their younger siblings

A young boy playing on some of the recyclable scraps that have been gathered for re-sale

Ideally interviews are carried out in the privacy of a home but sometimes we have to speak with women out in the open with other people around. This wasn't such a big deal for these surveys but when we do our in depth surveys to gather our baseline data, we will have to ensure that surveys are conducted in more private settings.

Some moms with their children:

“We go to the doctor when we have money. When we don’t have any money, we just pray and do what we can to take care of it.”

Last week, Ugat ng Kalusugan returned to Barangay Bagong Silang to carry out a mini-survey among Badjao families. Like our first survey in Bagong Silang, our purposes for carrying out another survey were two-fold: we wanted to test out our community health survey, and we wanted to get more information on one purok (area) of Bagong Silang because it is a possible site for our work. Photos from our trip are here.

The results of our second survey are summarized below. As with our first survey, there are several caveats. These survey results are not representative of the whole Barangay. We only interviewed 11 women and one man from 12 different households, and only households in the Muslim, Badjao portion of the community. We employed convenience or accidental sampling - a type of nonprobability sampling wherein the sample (interviewees) are selected from the general population because they are readily available and convenient. There is an added bias to the group we interviewed: they were all mothers (or a father) whose children under five years of age were receiving their regular deworming and vitamin supplements distributed by the barangay health workers. We opted to accompany the barangay health workers as they went from home to home so they could provide an introduction for us to meet women within the community. Because our sample is comprised of women (and one man) whose children are being cared for by the health workers, it is important to remember that they and their children are likely much healthier and better off than their counterparts who do not access any health professionals or receive any free medicine.

While we cannot make any generalizations about the community based on our survey results, the results do offer some insights into this community, and we found some of the results interesting.

We interviewed 11 women ranging in age from 19 to 35, and one man who is 48. We generally plan to interview only women but in one household the woman we wished to speak to was sick and resting and her husband offered to answer our questions.

Family Planning

We asked the interviewees if they practice family planning. Two women answered that they do use contraception. One uses hormonal pills and the other uses the injectable DMPA (Depo Provera). Both women pay for the contraception themselves. One of the women is Catholic and the other belongs to the Iglesia ni Christo church.

The rest of the women in our sample do not use any form of family planning, artificial or natural. When asked why, every single person said that they do not use any form of contraception because it is forbidden as it is against Islam. Several of the women who do not use contraception because it goes against their religious beliefs are young (ages 19-21) and as yet each have only one child. Among the older respondents (ages 28-40) most women have had multiple pregnancies and children. Maida, who is 28, has 5 children. Sherwina is 29 and has four children but has had five pregnancies. Tina, who is 30, has three children. Her friend Adea, who is 32, has three children but has had eight pregnancies. Sandra is 35 and has had seven pregnancies and has six living children. 48 year old Cesar’s wife has had 13 pregnancies, and has nine living children.

We asked the respondents what they think the ideal number of children is and most of them answered that the ideal is between two and four children. Some of the women with multiple children said that two or three is ideal, but that they couldn’t achieve their ideal because using contraception is against Islam. One women said the ideal is two or three but she has had seven pregnancies. She says she is too scared to use contraceptives. Cesar’s wife has had the greatest number of pregnancies and children (13 and 9 respectively) and in answer to what his ideal number of children is, he said, “Allah forbids planning. But in terms of what I think, this number [9] is enough. We’re already having a hard time and more children would be difficult. But if it is Allah’s will, then we will have more.”

Islam and Contraception

While we were carrying out our surveys, we asked the interviewees their beliefs and practices and we recorded their answers. We did not question people further about their religious beliefs but I was very confused as to why everyone was telling me that Islam forbids the use of contraception. I didn’t think Islam forbade family planning, but I wasn’t sure, and even if I was, I did not feel that it would have been appropriate to give an impromptu lesson on Islam and contraception. We completed the surveys and upon returning to our office, I conducted some internet research and found that Islam very clearly allows the use of contraception. I was stumped and continue to be. How is it possible that a large population of Muslims in this one particular community believe that Allah and the Koran prohibit something that in fact is allowed? These Muslim families are some of the poorest in the province, and most households are too large to support with one or two people’s meagre salaries. Yet families are large because men and women wrongly believe that their God prohibits planning their families. I have to assume that this group’s imam or their community elders have received incorrect information about Islam’s view of family planning and have successfully spread this misinformation among the population. I suppose that spreading the misinformation could be intentional, though I cannot comprehend why anyone would do that. This remains a mystery to me and I hope to have the opportunity to speak further with some of the people we interviewed to find out more about how they came to have this erroneous belief.

Care from Health Professionals

Eight of the women we interviewed had prenatal check ups with their last pregnancies. Among these eight women, none had regular checkups throughout her pregnancy. Most had only two or three check ups before delivering. The other four interviewees did not have any prenatal check ups and cited lack of money as the primary reason for not seeking care.

When asked what type of health professional they consult when they or their children are sick, six respondents answered that they seek care from Barangay Health Workers, four see doctors, and one goes to the City Health Center. One of the interviewees said, “We go to the doctor when we have money. When we don’t have any money, we just pray and do what we can to take care of it.”

When asked what type of birth attendant they prefer, eight stated manghihilot or traditional healer, two like doctors and one prefers a midwife. One respondent said she would really prefer to have a doctor, but her family cannot afford one so she uses a manghihilot or traditional healer.

Unlike their counterparts in other neighborhoods in Bagong Silang, the Badjao women we interviewed overwhelmingly prefer to give birth at home. When asked where their ideal birthing place would be, all but one of the interviewees said that they prefer to give birth at home. One women said she prefers the hospital. All the women who prefer home births did actually deliver their children at home, save for one woman whose parents took her to a birthing center because it was her first delivery. One interviewee noted that the home is best because their family does not have the money for a hospital birth, and another women said that she prefers the home because she is scared to give birth in a hospital.

Of the women we spoke with, only two had seen a health professional for a postnatal check up after their last pregnancy. These two women were the two women that gave birth outside the home - one at a birthing home and another at a hospital. None of the others had heard of the need for postnatal visits, and a few added that their health was fine after giving birth so there really was no need for a check up.

Beliefs about Family Planning

We asked the people we spoke with about their thoughts or beliefs relating to family planning. The following are some of their statements:

“It is forbidden by Islam to plan our families.”

“Islam forbids us to use contraception.”

“We don’t plan families because we are scared of Allah. We do not know more than Him so His will be done. Only God can let us survive.”

(-Cesar, whose wife has had 13 pregnancies and 9 living children)

You need to only have a few children so that you can

send them to school and feed them sufficiently.

(-Sonya, 19 years old with one child, not currently on any form of contraception)

“I’d like to give my children a good life -

have enough for them to go to school and to eat.”

(-Damesa, 21 years old with one child, not currently on any form of contraception)

“It’s better not to have too many children so that life isn’t too hard.”

(-Sherwina, 29 years old with four children, not currently on any form of contraception)

Beliefs about Pregnancy

We asked the interviewees about their beliefs regarding pregnancy. Most of the responses centered around a pregnant woman’s safety at night and included the beliefs that when you are pregnant you should cover your head if you go out of your home at night, that at night a pregnant woman should have garlic hanging in her house so that vampires will not be able to find her, and that generally pregnant women should not walk around at night. One woman said that pregnant women should not carry anything too heavy, and another said that when a pregnant woman reaches the month in which she will give birth, she should regularly drink ginger tea.

Immunizations

Like their counterparts whom we interviewed earlier in the week, all the children of the mothers we interviewed were up to date with their immunizations - or will complete them shortly (for babies under 1). These immunizations include BCG (Bacille Calmette-Guérin - a vaccine against tuberculosis), three doses of DPT (DPT refers to a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis [whooping cough] and tetanus), three Hepatitis shots, and three doses of the Polio vaccine. These results are probably not typical. It is important to remember that the women we interviewed were the mothers of children receiving medicine from the Barangay Health Workers. There is a bias here - these children are receiving care from the health center and thus are more likely to have completed all the requisite immunizations. If we were to randomly sample families within the community, we might not find 100% compliance with these immunizations.

Finances and Employment

Only two of the women we spoke with are currently employed. One delivers soap, and the other, who is the wealthiest of the women we surveyed, sells fish in the market. The man who we interviewed works as a street cleaner for the government. All of the other women have no work and expressed the desire to work in any kind of position that becomes available - especially being a saleslady or a maid.

Two of the people I spoke with have a monthly household income between P500-1,500 ($11-$32.) Three respondents have a monthly household income between P1,501-3,000 ($33-$64.) Two women reported a monthly household income between P3,001-4,500 ($64-$94.) Two of the families have a monthly household income between P4,501-6,000 ($94-$125.) One family’s monthly earnings totals P5,000 ($105). Another’s is P6,000-7,500 ($125-$161.) The wealthiest of the women represented had a monthly household income between P9,001-1o,500($188-$220.)

Supplemental Support

None of the children among the sample households we surveyed receives any regular supplemental feeding, despite the fact that Badjaos are referred to by city health officers as being some of the “poorest of the poor” and with some of the greatest number of children that are malnourished.

Most of the families do not receive any regular support from any outside groups but some families sometimes avail of services or food from the Department of Social Welfare and Development, Barangay Health Workers, from the city health center and from a nonprofit called Balikatan. One interviewee mentioned that her family sometimes receives free food when local officials celebrate their birthdays and feed the masses - an activity that is popular in Palawan and which Mayor Hagedorn and Governor Reyes both recently did for their birthdays.