'MOTHERING' THEIR COMMUNITIES
Rina Jimenez-David
At Large, Philippine Daily Inquirer
September 30, 2003
URL: http://www.inq7.net/opi/2003/sep/30/opi_rjdavid-1.htm

WHAT if you ran a business and part of your "costs" came in the form of the children of your clients? What if one of the "hazards" of your job is having one of your clients come to you asking you to look after her child?

The normal businessperson would rightly view this as an unfair burden, for after all raising another person's child is not a one-shot proposition but a lifelong responsibility. And yet this is part and parcel of the many challenges midwives face.

Midwives to whom this happened, though, wax philosophical about this business "risk." "What can I do but look on them as God's blessing?" says one midwife who ended up raising two adoptive children who had been entrusted to her by clients. "With hard work and prayers," she says, she was able to send both of them through college.

They are literally the "mothers" of their communities, looking after the health of women, children and entire families, while ensuring that mothers and babies not just survive pregnancy and delivery, but enjoy good health throughout their lives. At the same time, midwives find themselves playing auxiliary roles like that of counselor, teacher, family therapist and community negotiator and leader.

The vital role that midwives play in their communities was brought home to me recently when I sat as one of the judges in the Well Family Midwives Clinic (WFMC) Diamond Awards, which are being granted for the first time this year.

The Well Family Midwives Clinic Partnerships Foundation is a network of over 200 family care clinics owned and managed by midwives. Set up with funding from USAID through John Snow Institute, the WFMC last year spun off into an independent foundation, having proven that providing quality and compassionate care to poor people is not only socially beneficial, but profitable, too.

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I SAT as one of the judges in the "Centenary Diamond Award for Excellence in Business Management." We were looking for excellence not just in management procedures, record keeping and accounting, but also in marketing, creativity and resourcefulness.

Flordeliza Caspe, one of the finalists in this category, relies on a core clientele composed of members of Iglesia ni Cristo religious denomination, but has since expanded her reach to market vendors and tricycle drivers and their families, known to marketers as "the working poor." Flordeliza was about to leave for the Middle East, she recalls, when her brother offered the use of the ground floor of his house for a clinic. But even now, she confides, she is anticipating the day when her brother would need the space, and has already bought a lot in Laguna where she plans to put up a "satellite" clinic. Proudly she claims to be earning much more today than she would have earned had she worked in "Saudi."

Lolita Delfin went from house-to-house in the Toril district of Davao City to canvass for prospective clients and inform the community about the opening of her clinic in 1997. Though there are some 15 other private clinics in the area, including some owned by doctors and obstetricians-gynecologists, Lolita proudly reports that her clinic enjoys the largest client base. For now, her dream is to expand her clinic capacity from the present two to five beds, to as many as 10 beds.

Carolina Millan, who set up her clinic along Cattleya Street in Makati City in 1991, has quite a number of "promos" to entice clients. She holds a "buntis party" for all the pregnant women in the community, offers deep discounts on special occasions like her birthday, and offers comprehensive packages, including pre-natal/delivery/post-partum/pediatric check-ups. On average, she handles some 30 deliveries a month but during peak periods she counts as many as 60 deliveries a month.

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THE OTHER category where I sat as a judge was the "Regent Diamond Award for Excellence in Leadership," which measured a midwife/owner's impact on the larger community by way of her advocacy, networking, training and related activities.

Anita Alajado's clinic has become a "showcase" of the WFMC, a regular stop in the visits of foreign and local visitors. Anita is especially recognized for her pioneering work with traditional birth attendants or "hilot", confessing that she was concerned about stories of the death of mothers and/or babies due to the ignorance or mismanagement of births by traditional birth attendants. "My problem was how to convince them to be my partners," confides Anita, testifying to the natural "hostility" between them since they could very well have seen her as "competition" for the hilot's services. But together with Davao city health officials, she was able to reach out to the hilot community and provide basic training on sanitation and safe motherhood practices. Today, says Anita, the hilot have even set up a referral system, referring their "mothers" to her for family planning and child care services.

Lourdes Mangahas was a rural health midwife for 14 years before she took the challenge of setting up her own Well Family clinic. A recognized authority in the village of Sapang Palay, outside Manila, on family health matters, she is regularly tapped to be a resource person by schools and neighborhood groups and has even appeared on TV where she talked about the importance of family planning.