Adolescence is a period marked by confusion, as adolescents try to make sense of the changes in their physical appearance, as well as to establish their own identity. It is a crucial stage where being curious is not enough; that curiosity has to be satisfi ed, and the consequences can often be dire. One of the pressing concerns facing adolescents is the rise of unwanted pregnancy and incidences of sexually transmitted infections (STI) among this particular age group.
Sexual initiation among adolescents is occurring at a younger age; the typical age for boys is 13 and 14 for girls. More alarming, most of fi rst time sex were either
unplanned or non-consensual. The 2002 Young Adult Fertility and Sexuality Study (YAFS) conducted in the Philippines showed that 57 percent of fi rst time sex fell in
the unplanned or non-consensual category. For unplanned - and therefore unsafe - sex, the risk of unwanted pregnancy and/or getting STI becomes higher.
Tuesday, June 30, 2009
Thursday, June 18, 2009
Similarities and Differences of Traditional and Professional Health Care Systems
This study examines the convergence and divergence of traditional and professional health systems among the B’laan communities in the municipality of Sarangani in the context of their child health care services. The B’laan is an indigenous tribe living in the southern island of Mindanao, in the Philippines.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
Background of the Study
The Alma Ata Declaration in 1978 enunciated health as a basic human right. This reserves the right of individuals to access the highest attainable standard of health through the provision of basic health and social services. Specifically, the principle has defi ned access to health care as the affordability, accessibility, availability, and cultural acceptability of health care services amongst peoples across cultures. It also identifi ed the roles of governments, non-government organizations (NGOs), and international institutions in providing the health care needs to achieve a better health for all. This international pact also identified the basic elements of health that are vital to the management and provision of services to the people.
Child Labor
Child labor is actual manpower coming from people below the age of 18. It is work that exceeds a minimum number of hours, depending on the age of a child and on the type of work. For children aged fi ve to 11, beyond one hour of economic work or 28 hours of domestic work per week already constitutes child labor. The hours increase as the child becomes older. For children 12 to 14 years old, 14 hours of economic work or 28 hours of domestic work per week is considered child labor. For minors 15 to 17, the minimum is 43 hours of economic or domestic work per week.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
It comes in different forms. Children can work as household help or as workers in farming and fishing industries. Some are given work in quarries, mines, brick kilns and construction sites. On an even more dangerous note, children are increasingly becoming more involved in the drug trade or serve as providers of sex services. It is reported that children living in the poorest households are most likely to be involved in child labor, especially those in the rural areas.
Wednesday, June 10, 2009
Domestic Violence in Vietnam: Situations and Challenges
Though national level statistics on gender-based violence do not exist, existing research shows that domestic violence is a problem in North Vietnam. A number of
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
recent studies in North Vietnam suggest that about one third of women experience domestic violence, and one in every three abused women suffer more than one kind of violence.
Social norms and cultural attitudes pose a challenge in program intervention. Violence against women is a socially acceptable behavior amongst Vietnamese men; it is seen as a punishment for their wives when they transgress the traditional roles. In addition, Vietnamese women are expected to quietly endure the hardships and protect the harmony and reputation of the family. Many abused women, therefore, do not seek support.
Multisectoral action against domestic violence Vietnam has made many efforts in response to this issue. In 2007, the government issued a Law on Domestic Violence Prevention and Control, which clearly defined domestic violence as “any intentional action by a family member to cause damage or potentially cause damage in terms of physical, spiritual, and economic damages to another family member” and provides a legal framework for the intervention and prevention of domestic violence.
Tuesday, June 09, 2009
The ties that bind: untangling the socio-political context of Maternal and Child Health
Maternal and child health (MCH) is not an entirely new concern, but its inclusion in the Millennium Development Goals (MDG) gave its attainment priority status. Goal 4 calls for the reduction of under-fi ve mortality by two-thirds by 2015, while Goal 5 aims to reduce maternal mortality rate by three-quarters.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Barely six years before the deadline, the global community still has a lot of catching up to do. At best, efforts to reduce maternal and child mortality ratios produce patchy results, with some countries attaining a level of success, while
others further slide down the ladder.
Maternal health
According to The Millennium Development Goals Report 2007, while child mortality
is on the decline, more than half a million women worldwide still die of pregnancy and/or childbirthrelated complications every year. In the Asia-Pacific region, South Asia posted the highest maternal mortality ratio of 546 deaths per 100,000 live births in 2000. East Asia, on the other hand, had the lowest ratio of 55 per 100,000 live births. From 1997 – 2002, 31 percent of maternal deaths in Asia was due to hemorrhage.
Maternal & Child Health: the unpleasant truth
Mother and child has been a recurring theme in arts, owing mainly to the powerful images it evokes - that of the mother as a life-giving and caring creature, and that of the child as a personifi cation of purity and innocence. But the adage of art
imitating life certainly does not apply to this particular theme, for the truth about maternal and child health (MCH) situation is far from pleasant.
The latest issue of Health Alert Asia Pacific newsletter, provides untangles the sociopolitical context of Maternal and Child Health (MCH), providing an overview of the scope of the problem -- high incidences of maternal and child deaths, and mother to child transmission of HIV-- making MCH one of the pressing health concerns worldwide. This also features domestic violence situation in Vietnam which details the learnings of a Vietnamese organization in handling a gender-sensitivity and anti-violence against women program. The article also provides a few insights on how other organizations can help eliminate gender inequality and violence against women in their respective areas. Another article provides comprehensive look at the global burden of child labor including using children as child-warriors. Another article entitled, “Similarities and Differences of Traditional and Professional Health Care System in B’laan Communities,” explores the divergence and convergence between Western medicine and the traditional beliefs and practices of the B’laan tribe, an indigenous peoples living in the Philippine island of Mindanao. This issue of Health Alert also focuses on adolescent reproductive health and how the lack of information and services makes the youth more vulnerable to sexually transmitted infections and early pregnancy.
To request for copies of the newsletter, please write to hain@hain.org.
Thursday, June 04, 2009
HEAD on drugs in the Philippines: “Still neither affordable nor accessible”
One year after the Universally Accessible Cheaper and Quality Medicines Act of 2008 (Republic Act 9502) was signed into law by Mrs. Gloria Macapagal-Arroyo, medicines are still neither affordable nor accessible.
According to Health Alliance for Democracy (HEAD), this is not surprising since the law is inherently flawed, especially when the more salient provisions like regulation were removed before it was passed.
“The landscape of the pharmaceutical industry has not changed because the law is anchored on deregulation than on regulation, and because the law favors the business sector rather the consumers,” said Dr. Gene Alzona Nisperos, HEAD vice-chairperson.
According to HEAD, the law perpetuated, instead of dismantled, the status quo. As such, the monopolies enjoyed by transnational corporations as well as the practice of monopoly pricing persist.
According to Health Alliance for Democracy (HEAD), this is not surprising since the law is inherently flawed, especially when the more salient provisions like regulation were removed before it was passed.
“The landscape of the pharmaceutical industry has not changed because the law is anchored on deregulation than on regulation, and because the law favors the business sector rather the consumers,” said Dr. Gene Alzona Nisperos, HEAD vice-chairperson.
According to HEAD, the law perpetuated, instead of dismantled, the status quo. As such, the monopolies enjoyed by transnational corporations as well as the practice of monopoly pricing persist.
Monday, May 25, 2009
Health Issues and Situation in the Philippines
Eighty percent of the Philippine population, or about 69 million Filipinos, struggle to survive on P96.00 or less (about US$2). The US$2 benchmark is based on World Bank’s defi nition of poverty threshold. The threshold for the Millennium Development Goal is lower at less than US$1. Of the fi gure, 46 million Filipinos go
hungry everyday.
Based on the projection of the National Wages and Productivity Commission, a family of six living in the National Capital Region needs a living wage of P911.00, but the daily minimum wage is only P382.00. The low wage is a part of the conditions of the International Monetary Fund to ensure that the Philippines would be able to pay its debts.
The gap between the rich and the poor is getting wider, with the net worth of the ten richest Filipinos (US$12.4 billion in 2006) equivalent to the combined annual income of poorest 9.6 million families.
hungry everyday.
Based on the projection of the National Wages and Productivity Commission, a family of six living in the National Capital Region needs a living wage of P911.00, but the daily minimum wage is only P382.00. The low wage is a part of the conditions of the International Monetary Fund to ensure that the Philippines would be able to pay its debts.
The gap between the rich and the poor is getting wider, with the net worth of the ten richest Filipinos (US$12.4 billion in 2006) equivalent to the combined annual income of poorest 9.6 million families.
Wednesday, April 15, 2009
Crash and Burn
Humanitarian aid workers and staff of non-government organizations (NGO) are often praised for their selfless devotion in making the world a better place to live in. But put the accolades aside, and the question begging to be asked will surface: who takes care of this sector’s mental health needs?
NGO staff and aid workers are often at the forefront of humanitarian work. It is inevitable that in the course of their work, they are exposed to a dreadful environment where death and suffering are common occurrences. In some instances, they themselves are threatened with bodily harm. In his paper, “Mental Health and Aid Workers: The Case for Collaborative Questioning,” Thomas Ditzler of the Center of Excellence in Disaster Management and Humanitarian Assistance, asserts that “the nature of humanitarian assistance puts workers in contact with the local environment in ways that can erode the normal personal / professional boundaries which provide some measure of psychological protection.”
A 2001 study published in the Journal of Traumatic Stress showed that 30 percent of returning aid workers reported being stressed, while ten percent could be suffering from PTSD.
NGO staff and aid workers are often at the forefront of humanitarian work. It is inevitable that in the course of their work, they are exposed to a dreadful environment where death and suffering are common occurrences. In some instances, they themselves are threatened with bodily harm. In his paper, “Mental Health and Aid Workers: The Case for Collaborative Questioning,” Thomas Ditzler of the Center of Excellence in Disaster Management and Humanitarian Assistance, asserts that “the nature of humanitarian assistance puts workers in contact with the local environment in ways that can erode the normal personal / professional boundaries which provide some measure of psychological protection.”
A 2001 study published in the Journal of Traumatic Stress showed that 30 percent of returning aid workers reported being stressed, while ten percent could be suffering from PTSD.
Sunday, March 08, 2009
Community-based Mental Health Programs: Back to Basics
In the report ”Integrating mental health into primary care : a global perspective,” the World Health Organization and the World Organization of Family Doctors bat for the integration of mental health care program with primary health care since it results in greater access to much needed services.
The report resonates with truth, considering that confinement in mental asylums or rehabilitation centers is a common treatment modality for mental disorders. For poor countries dealing with fund scarcity and the lack of specialists, a psychiatric hospital-based approach alone may not work. However, there are cost-effective models of community- and home-based programs that work well.
Community-based mental health program
A community-based mental health program is not meant to replace the treatment and services offered in hospitals; it rather complements these services by making these more accessible to the people.
Such a program is also more culturally appropriate and capitalizes on the tightly-woven social fabrics of most Asia-Pacifi c countries. The involvement of the
community and family members in caring for a patient helps ease stigma and provide a more healing and nurturing environment for a patient.
The report resonates with truth, considering that confinement in mental asylums or rehabilitation centers is a common treatment modality for mental disorders. For poor countries dealing with fund scarcity and the lack of specialists, a psychiatric hospital-based approach alone may not work. However, there are cost-effective models of community- and home-based programs that work well.
Community-based mental health program
A community-based mental health program is not meant to replace the treatment and services offered in hospitals; it rather complements these services by making these more accessible to the people.
Such a program is also more culturally appropriate and capitalizes on the tightly-woven social fabrics of most Asia-Pacifi c countries. The involvement of the
community and family members in caring for a patient helps ease stigma and provide a more healing and nurturing environment for a patient.
The Hidden Battlefield
The destruction brought about by war and armed confl icts transcends the structure of cities and communities and encompasses the mortality and overall well-being of those who engage in it and those who are dragged into it. The victims, the perpetrators, and defenders may not share the same goals in war but they all share the trauma and suffering surfacing from such violent events.
The effects of war, according to a study by R. Srinivasa Murthy and Rashmi Lakshminarayana of the Regional Offi ce for the Eastern Mediterranean of the World
Health Organization (WHO), are varied and some are not even included in most available literature.
The known effects, the study said, included endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, among others. The
authors said that only when confl icts and mental health problems are fully understood can effective strategies be developed to deal with the effects of war.
"The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Death as a result of wars is simply the 'tip of the iceberg,'" the authors said.
The effects of war, according to a study by R. Srinivasa Murthy and Rashmi Lakshminarayana of the Regional Offi ce for the Eastern Mediterranean of the World
Health Organization (WHO), are varied and some are not even included in most available literature.
The known effects, the study said, included endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, among others. The
authors said that only when confl icts and mental health problems are fully understood can effective strategies be developed to deal with the effects of war.
"The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Death as a result of wars is simply the 'tip of the iceberg,'" the authors said.
Thursday, March 05, 2009
Intended Death: A look at suicidal behavior
The World Health Organization (WHO) noted that suicide is taking the lives of more and more people worldwide. In the year 2000, the WHO revealed that approximately one million people died from suicide, representing a mortality rate of 16 per 100,000 or one death every 40 seconds.
In the last 45 years, it also noted that suicide rates have increased 60 percent worldwide; suicide is now among the three leading causes of death among those aged 15-44 (both sexes). These fi gures, however, do not include suicide attempts that are up to 20 times more frequent than completed suicide.
Further, suicide worldwide is estimated to represent 1.8 percent of the total global burden of disease in 1998, and 2.4 percent in countries with market and former socialist economies in 2002. Although suicide rates have been traditionally highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of both developed and developing countries.
In the last 45 years, it also noted that suicide rates have increased 60 percent worldwide; suicide is now among the three leading causes of death among those aged 15-44 (both sexes). These fi gures, however, do not include suicide attempts that are up to 20 times more frequent than completed suicide.
Further, suicide worldwide is estimated to represent 1.8 percent of the total global burden of disease in 1998, and 2.4 percent in countries with market and former socialist economies in 2002. Although suicide rates have been traditionally highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of both developed and developing countries.
Sunday, March 01, 2009
Untangling the Mental Haywire
Globally, an estimated 450 million are suffering from mental and neurological disorders such as epilepsy, dementias (e.g. Alzheimer’s disease, vascular
dementia), and bipolar affective disorder. According to the 2001 World Health Report entitled “Mental Health: New Understanding, New Hope,” depression ranked fourth in the global disease burden; it is projected to jump to second place by 2020.
In the Asia-Pacific region, an estimated 13.7 million have dementia; as the region’s population ages, the number of those with dementia is expected to hit 64.6
million by 2050.
Substance addiction, whether alcohol, drugs, or tobacco, is also considered a mental health issue. Asia accounts for close to 55 percent of amphetamine-type stimulants (ATS) abuse worldwide, and majority of ATS addicts are youth. Alcohol abuse, on the other hand, account for 5.5. percent of the Asia-Pacifi c region’s burden of disease. In some Pacifi c countries, the percentage of alcohol-related abuse and violence is staggering: in Papua New Guinea, close to 90 percent of emergency room trauma are due to alcohol; while in Guam, 62 percent of murders are also alcohol-related.
dementia), and bipolar affective disorder. According to the 2001 World Health Report entitled “Mental Health: New Understanding, New Hope,” depression ranked fourth in the global disease burden; it is projected to jump to second place by 2020.
In the Asia-Pacific region, an estimated 13.7 million have dementia; as the region’s population ages, the number of those with dementia is expected to hit 64.6
million by 2050.
Substance addiction, whether alcohol, drugs, or tobacco, is also considered a mental health issue. Asia accounts for close to 55 percent of amphetamine-type stimulants (ATS) abuse worldwide, and majority of ATS addicts are youth. Alcohol abuse, on the other hand, account for 5.5. percent of the Asia-Pacifi c region’s burden of disease. In some Pacifi c countries, the percentage of alcohol-related abuse and violence is staggering: in Papua New Guinea, close to 90 percent of emergency room trauma are due to alcohol; while in Guam, 62 percent of murders are also alcohol-related.
Sunday, January 18, 2009
First Aid for Panganganak
*What will you do if you happen to be with a pregnant woman who, all of the sudden, goes into labour?
In emergencies such as this, it is important that we equip ourselves with pieces of information on initial steps to aiding parturients.
I am to share an article, which was published in Reader’s Digest (November 2008), entitled Call 999! by Leo Hickman. This tells the writer’s experience of attending to his wife’s delivery. Because this was their third child and Jane Hickman’s previous labour had only lasted 45 minutes, they were advised to have a home birth. Unfortunately, the midwives were stuck in traffic so he made an emergency phone call.
Here is the recorded call that details the whole procedure.
17:28:12 (Call answered)
Operator: Emergency ambulance. What’s the problem? Tell me exactly what’s happened.
Leo: Hello, my wife is in labour and is having the baby at home, but she’s really feeling the urge to push. (Leo gives her his address, postcode and telephone number and answers her questions about Jane’s medical history, condition and contractions.)
Operator: OK, I’m organising help for you now. Just stay on the line and I will tell you what to do next. Allow her to sit in the most comfortable position and have her take deep breaths between contractions. Have you got clean towels and blankets?
Leo: Yep.
Operator: Right, I want you to look at her vagina very closely to see how close the baby is being born. (Pause.) OK, do you see any part of the baby now?
Leo: Yeah, I think I can see a head. Yes, I think the top of the head. I think.
Operator: With each contraction, place the palm of your hand against the vagina and apply firm but gentle pressure to keep the baby’s head from delivering too fast and tearing. (She asks who else is in the house and says someone should open the front door for the ambulance crew.)
Jane: (Screaming.) Ohhh, I need to push! I NEED TO PUSH!
Leo: Hang on.
(Long pause while Leo does an examination.)
Operator: How are you doing?
Leo: OK. You know, I don’t think it is the head actually.
(Leo is very scared now: instead of a smooth baby’s head, what he is looking at has become rippled and ridged in appearance and blotchy in colour. He realises that telling the operator he has doubts that it is a head will frighten Jane, but he knows he has to tell the operator everything.)
Leo: Something’s coming out, but I don’t know what it is.
(Jane moaning in the background.)
Operator: You don’t know what it is?
(Jane experiencing another contraction in the background.)
Leo: I think . . . I think it’s part of the sac that hasn’t burst yet. It’s got liquid in it.
Operator: Liquid in it? You need to get a safety pin in case the baby is born in the sac. You need to burst the sac. You need to do that now.
Leo: OK. (To Jane.) OK, wait there, Jane.
(While Jane moans and screams, Leo leaves the bedroom. He runs out on to the landing and freezes, trying desperately to think where he might find a safety pin. After 30 seconds of panic and incoherence, he returns to the bedroom to see that the waters have now started to break.)
Leo: There’s a lot of meconium.
(Meconium - the baby’s first poo - can cause complications, especially in a home birth.)
Operator: There is? (Pause.) OK, you’re still going to need to support the baby. Is it the sac coming out? The baby must be in the sac.
Leo: Yep.
Operator: Is the head coming out?
Leo: OK, the head’s coming!
Operator: Right, you need to support the head and shoulders and hold the hips and legs, OK? It will be slippery so don’t drop him!
Leo: I can see the head. I can see the face!
(The baby’s eyes and mouth are closed and there is no movement in his face at all. Leo had expected the baby to breathe as soon as the head was born, so is feeling frightened now.)
Operator: OK, that’s fantastic. Just keep supporting the baby, OK?
Leo: OK. (Pause.) Jane, you’re doing really well.
Operator: Tell her she’s doing fantastic, OK?
Leo: There’s lots of waters breaking. Come on, little baby. (Jane screaming and moaning.) OK, one shoulder’s coming.
(One arm is now out – in the panic, Leo has said “shoulder” by mistake.)
Operator: OK.
Leo: Come on, little baby. OK, the baby’s out!
Operator: Is the whole baby out?
Leo: It’s quite messy. There’s a lot of meconium.
Operator: Right, what I want you to do is wipe the baby clean. (Pause.) Right, is the baby crying or breathing?
Leo: It’s not fully out yet.
(Perhaps it’s the sight of the thick umbilical cord that makes Leo say this. The baby has in fact been born; he is covered in meconium, including all over his face. The clean towel referred to earlier is now dirty and of no use. Leo is on his knees holding the baby up off the floor, unable to put him down to run for a towel. Jane is unable to turn round to hold him because she can’t get her leg over the cord. Both parents are worried because the baby is only making very small body and facial movements. He looks very blue.)
Operator: Is the baby crying or breathing?
Leo: Yes, it’s crying.
(The baby is making small crying noises.)
Operator: Right, what I want you to do is gently wipe off the baby’s mouth and nose. And dry the baby off with a clean towel. Then wrap the baby in a clean, dry towel, OK?
(Leo shouts t his mother-in-law to bring more towels.) . . .
. . . (Long pause as towels arrive and baby is cleaned and swaddled.)
Leo: Shall I give the baby to Mum?
Operator: Is he wrapped up in a towel?
Leo: Yes.
Operator: Don’t pull the cord too tight and put the baby in mother’s arms. Now make sure to keep the baby and the mother warm.
(Knocking heard downstairs.)
(Two midwives enter he room.)
17:39:28 (Recording ends.)
-Amanah Busran Lao
HAIN Research Associate
Citation:
• Leo Hickman “CALL 999!” Reader’s Digest, November 2008, page 121-125.
In emergencies such as this, it is important that we equip ourselves with pieces of information on initial steps to aiding parturients.
I am to share an article, which was published in Reader’s Digest (November 2008), entitled Call 999! by Leo Hickman. This tells the writer’s experience of attending to his wife’s delivery. Because this was their third child and Jane Hickman’s previous labour had only lasted 45 minutes, they were advised to have a home birth. Unfortunately, the midwives were stuck in traffic so he made an emergency phone call.
Here is the recorded call that details the whole procedure.
17:28:12 (Call answered)
Operator: Emergency ambulance. What’s the problem? Tell me exactly what’s happened.
Leo: Hello, my wife is in labour and is having the baby at home, but she’s really feeling the urge to push. (Leo gives her his address, postcode and telephone number and answers her questions about Jane’s medical history, condition and contractions.)
Operator: OK, I’m organising help for you now. Just stay on the line and I will tell you what to do next. Allow her to sit in the most comfortable position and have her take deep breaths between contractions. Have you got clean towels and blankets?
Leo: Yep.
Operator: Right, I want you to look at her vagina very closely to see how close the baby is being born. (Pause.) OK, do you see any part of the baby now?
Leo: Yeah, I think I can see a head. Yes, I think the top of the head. I think.
Operator: With each contraction, place the palm of your hand against the vagina and apply firm but gentle pressure to keep the baby’s head from delivering too fast and tearing. (She asks who else is in the house and says someone should open the front door for the ambulance crew.)
Jane: (Screaming.) Ohhh, I need to push! I NEED TO PUSH!
Leo: Hang on.
(Long pause while Leo does an examination.)
Operator: How are you doing?
Leo: OK. You know, I don’t think it is the head actually.
(Leo is very scared now: instead of a smooth baby’s head, what he is looking at has become rippled and ridged in appearance and blotchy in colour. He realises that telling the operator he has doubts that it is a head will frighten Jane, but he knows he has to tell the operator everything.)
Leo: Something’s coming out, but I don’t know what it is.
(Jane moaning in the background.)
Operator: You don’t know what it is?
(Jane experiencing another contraction in the background.)
Leo: I think . . . I think it’s part of the sac that hasn’t burst yet. It’s got liquid in it.
Operator: Liquid in it? You need to get a safety pin in case the baby is born in the sac. You need to burst the sac. You need to do that now.
Leo: OK. (To Jane.) OK, wait there, Jane.
(While Jane moans and screams, Leo leaves the bedroom. He runs out on to the landing and freezes, trying desperately to think where he might find a safety pin. After 30 seconds of panic and incoherence, he returns to the bedroom to see that the waters have now started to break.)
Leo: There’s a lot of meconium.
(Meconium - the baby’s first poo - can cause complications, especially in a home birth.)
Operator: There is? (Pause.) OK, you’re still going to need to support the baby. Is it the sac coming out? The baby must be in the sac.
Leo: Yep.
Operator: Is the head coming out?
Leo: OK, the head’s coming!
Operator: Right, you need to support the head and shoulders and hold the hips and legs, OK? It will be slippery so don’t drop him!
Leo: I can see the head. I can see the face!
(The baby’s eyes and mouth are closed and there is no movement in his face at all. Leo had expected the baby to breathe as soon as the head was born, so is feeling frightened now.)
Operator: OK, that’s fantastic. Just keep supporting the baby, OK?
Leo: OK. (Pause.) Jane, you’re doing really well.
Operator: Tell her she’s doing fantastic, OK?
Leo: There’s lots of waters breaking. Come on, little baby. (Jane screaming and moaning.) OK, one shoulder’s coming.
(One arm is now out – in the panic, Leo has said “shoulder” by mistake.)
Operator: OK.
Leo: Come on, little baby. OK, the baby’s out!
Operator: Is the whole baby out?
Leo: It’s quite messy. There’s a lot of meconium.
Operator: Right, what I want you to do is wipe the baby clean. (Pause.) Right, is the baby crying or breathing?
Leo: It’s not fully out yet.
(Perhaps it’s the sight of the thick umbilical cord that makes Leo say this. The baby has in fact been born; he is covered in meconium, including all over his face. The clean towel referred to earlier is now dirty and of no use. Leo is on his knees holding the baby up off the floor, unable to put him down to run for a towel. Jane is unable to turn round to hold him because she can’t get her leg over the cord. Both parents are worried because the baby is only making very small body and facial movements. He looks very blue.)
Operator: Is the baby crying or breathing?
Leo: Yes, it’s crying.
(The baby is making small crying noises.)
Operator: Right, what I want you to do is gently wipe off the baby’s mouth and nose. And dry the baby off with a clean towel. Then wrap the baby in a clean, dry towel, OK?
(Leo shouts t his mother-in-law to bring more towels.) . . .
. . . (Long pause as towels arrive and baby is cleaned and swaddled.)
Leo: Shall I give the baby to Mum?
Operator: Is he wrapped up in a towel?
Leo: Yes.
Operator: Don’t pull the cord too tight and put the baby in mother’s arms. Now make sure to keep the baby and the mother warm.
(Knocking heard downstairs.)
(Two midwives enter he room.)
17:39:28 (Recording ends.)
-Amanah Busran Lao
HAIN Research Associate
Citation:
• Leo Hickman “CALL 999!” Reader’s Digest, November 2008, page 121-125.
Shattering Myths About Menstruation
First woman: Noong ako, tumalon pa talaga ako ng tatlong hagdan para maging tatlong araw ang mens ko kada-buwan.
Second woman: Ako naman, pagkatapos kong labhan ang panty kong nalagyan ng unang regla, ipinahid ko ito sa mukha.
Young girl: Ei, para saan naman po ‘yan?
Second woman: Para hindi tagihawatin.
Young girl: Talaga po? Sino po nagsabi niyan sa iyo?
Second woman: Nanay ko.
This is the conservation I accidentally overheard one late afternoon on my way home. Apparently, there are plenty of myths that have been and are still being said about menstruation and it is, usually, the young females who become susceptible (just as shown above).
Also contained in KIKAY KIT, (Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth) a booklet which was distributed by Institute for Social Studies and Action (ISSA), are the five common myths. I have chosen not to translate these into English in order to avoid changing the thoughts expressed by the production team.
1) SABI NILA: Bawal maligo habang may regla dahil baka maloka.
SA TOTOO LANG: Mahalagang mapanatiling malinis ang katawan sa lahat ng panahon, lalo na kapag may regla. Walang kinlaman ang pagliligo habang may regla sa pagkabaliw. Sa katunayan, mas nakagagaan ito ng pakiramdam. Siguraduhin ding magpalit ng sanitary napkin o pasador kung kinakailangan.
2) SABI NILA: Bawal kumain ng maasim kapag may regla.
SA TOTOO LANG: Ang mga pagkaing maaasim ay mayaman sa Vitamin C na kainlangan ng ating katawan. Tumutulong itong magpalakas ng resistensya na panlaban sa sakit kaya’t OK na OK lang kung type mong kumain ng bayabas, sampalok o maggang hilaw. Mahalaga ring kumain ng sapat na mga masustansiyang pagkain.
3) SABI NILA: Mainam ipahid sa mukha ang unang regla para hindi tagihawatin.
SA TOTOO LANG: Bahagi ng pagdadalaga ang pagiging malangis ng balat na siyang nagiging dahilan sa pagtubo na tagihawat. Ang pagpapanatiling malinis ng balat ay makatutulong para maiwasan ito, hindi ang pagpapahid ng unang regla.
4) SABI NILA: Bawal lumangoy, magbisikleta, sumayaw, mag-ehersisyo o gumawa ng mabigat na gawain kapag may regla.
SA TOTOO LANG: Kahit ano ay puwedeng gawin kahit may regla. Sa katunayan, pansamantalang tumitigil ang daloy ng regla kapag lumalangoy kaya pwedeng-pwedeng mag-swimming kahit first day. Nakakatulong pa nga ang regular na pag-e-exercise para mas maging malakas at handa ang katawan sa mga nararanasang pagbabago kapag may regla. Sa mga unang araw lang ng regla, kadalasan ay mabigat ang pakiramdam kaya dapat hinay-hinay lang at huwag namang sobrahan ang gagawin. Tantiyahin kung ano ang kaya ng katawan.
5) SABI NILA: Handa ang magka-baby ang babae kapag nagreregla na.
SA TOTOO LANG: Kahit na ang pagkakaroon ng regla ay paghahanda sa katawan ng babae para sa posibilidad ng pagbubuntis, hindi ito nangangahulugan ng kahandaan niyang manganak.
Kinakailangang lubusang handa at nadebelop na ang mga sistemang reproduktibo ng babae. Hindi ito pare-parehong nangyayari sa lahat ng mga babae. Maraming babaeng irregular pa ang pagdating ng regla sa mga unang dalawa hanggang tatlong taon pagkasimula ng pagreregla. Nangangahulugang hindi pa handa ang mga obaryo nila at malamang ay wala pang ovulation na nagaganap. Gayunpaman, para sa ibang babae, posibleng nag-o-ovulate na sila at maaari nang mabuntis.
Marahil ang pinakamahalagang tandaan ay hindi lamang mga obaryo at matris ang kailangan sa pagbuntis. Bukod sa pisikal na paghahanda, kinakailangang psychologically, emotionally at financially prepared ang babae upang magampanan ng mabuti ang mga responsibilidad ng pagkakaroon ng anak.
by Amanah Busran Lao
HAIN Research Associate
Citation:
• Ma. Georgianna Villar, Maria Melinda Ando, Rodelyn Marte, Luz Escubil “Mga Sabi-sabi Tungkol sa Pagreregla” KIKAY KIT Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth, Institute for Social Studies and Action (ISSA), The David and Lucile Packard Foundation, Quezon City, Philippines 2003
Second woman: Ako naman, pagkatapos kong labhan ang panty kong nalagyan ng unang regla, ipinahid ko ito sa mukha.
Young girl: Ei, para saan naman po ‘yan?
Second woman: Para hindi tagihawatin.
Young girl: Talaga po? Sino po nagsabi niyan sa iyo?
Second woman: Nanay ko.
This is the conservation I accidentally overheard one late afternoon on my way home. Apparently, there are plenty of myths that have been and are still being said about menstruation and it is, usually, the young females who become susceptible (just as shown above).
Also contained in KIKAY KIT, (Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth) a booklet which was distributed by Institute for Social Studies and Action (ISSA), are the five common myths. I have chosen not to translate these into English in order to avoid changing the thoughts expressed by the production team.
1) SABI NILA: Bawal maligo habang may regla dahil baka maloka.
SA TOTOO LANG: Mahalagang mapanatiling malinis ang katawan sa lahat ng panahon, lalo na kapag may regla. Walang kinlaman ang pagliligo habang may regla sa pagkabaliw. Sa katunayan, mas nakagagaan ito ng pakiramdam. Siguraduhin ding magpalit ng sanitary napkin o pasador kung kinakailangan.
2) SABI NILA: Bawal kumain ng maasim kapag may regla.
SA TOTOO LANG: Ang mga pagkaing maaasim ay mayaman sa Vitamin C na kainlangan ng ating katawan. Tumutulong itong magpalakas ng resistensya na panlaban sa sakit kaya’t OK na OK lang kung type mong kumain ng bayabas, sampalok o maggang hilaw. Mahalaga ring kumain ng sapat na mga masustansiyang pagkain.
3) SABI NILA: Mainam ipahid sa mukha ang unang regla para hindi tagihawatin.
SA TOTOO LANG: Bahagi ng pagdadalaga ang pagiging malangis ng balat na siyang nagiging dahilan sa pagtubo na tagihawat. Ang pagpapanatiling malinis ng balat ay makatutulong para maiwasan ito, hindi ang pagpapahid ng unang regla.
4) SABI NILA: Bawal lumangoy, magbisikleta, sumayaw, mag-ehersisyo o gumawa ng mabigat na gawain kapag may regla.
SA TOTOO LANG: Kahit ano ay puwedeng gawin kahit may regla. Sa katunayan, pansamantalang tumitigil ang daloy ng regla kapag lumalangoy kaya pwedeng-pwedeng mag-swimming kahit first day. Nakakatulong pa nga ang regular na pag-e-exercise para mas maging malakas at handa ang katawan sa mga nararanasang pagbabago kapag may regla. Sa mga unang araw lang ng regla, kadalasan ay mabigat ang pakiramdam kaya dapat hinay-hinay lang at huwag namang sobrahan ang gagawin. Tantiyahin kung ano ang kaya ng katawan.
5) SABI NILA: Handa ang magka-baby ang babae kapag nagreregla na.
SA TOTOO LANG: Kahit na ang pagkakaroon ng regla ay paghahanda sa katawan ng babae para sa posibilidad ng pagbubuntis, hindi ito nangangahulugan ng kahandaan niyang manganak.
Kinakailangang lubusang handa at nadebelop na ang mga sistemang reproduktibo ng babae. Hindi ito pare-parehong nangyayari sa lahat ng mga babae. Maraming babaeng irregular pa ang pagdating ng regla sa mga unang dalawa hanggang tatlong taon pagkasimula ng pagreregla. Nangangahulugang hindi pa handa ang mga obaryo nila at malamang ay wala pang ovulation na nagaganap. Gayunpaman, para sa ibang babae, posibleng nag-o-ovulate na sila at maaari nang mabuntis.
Marahil ang pinakamahalagang tandaan ay hindi lamang mga obaryo at matris ang kailangan sa pagbuntis. Bukod sa pisikal na paghahanda, kinakailangang psychologically, emotionally at financially prepared ang babae upang magampanan ng mabuti ang mga responsibilidad ng pagkakaroon ng anak.
by Amanah Busran Lao
HAIN Research Associate
Citation:
• Ma. Georgianna Villar, Maria Melinda Ando, Rodelyn Marte, Luz Escubil “Mga Sabi-sabi Tungkol sa Pagreregla” KIKAY KIT Kaalama’t Impormasyon sa Katawan at kAlusugan nating Youth, Institute for Social Studies and Action (ISSA), The David and Lucile Packard Foundation, Quezon City, Philippines 2003