The secret of their success
Posted:0:46 AM (Manila Time) | Nov. 22, 2002
By Rina Jimenez-David
URL: http://www.inq7.net/opi/2002/nov/22/text/opi_rjdavid-1-p.htm

IN THE YEARS since she set up the Cattleya Well-Family Midwife Clinic in the Rizal area of Makati City, Carol Millan has hired a number of doctors as consultants. In time, two of them set up their own lying-in clinics nearby, doubtless hoping to duplicate, if not surpass, the success of Carol's set-up.

Did the competing clinics present a problem? "Both of them are now closed," Carol says with a smile, her voice only just betraying a hint of smugness that a "simple" midwife prevailed over two physicians.

To what does she attribute the success of her clinic and others in the network? For Carol, it's the "pag-aalaga" or care that clients expect and receive from them, "huling-huli namin ang kiliti nila (we know exactly what makes them happy)."

One difference, they say, is the "personal service" they provide, never leaving the mother's side while she's in labor, soothing and stroking and showering her with "cariño" (show of affection) which, they claim, mothers miss sorely when they choose to give birth in a busy hospital with even busier doctors.

Easter Dasmariñas, resident advisor of the JSI Research and Training Institute which, with the USAID, conceived of the network of midwife-owned and managed clinics five years ago, says that even if many of the midwife-managers are already so successful they can afford to hire a team of assistants, "they still want to personally look after the mothers who come to the clinics to give birth. That's how much they care about their patients."

Every Well-Family Midwife Clinic offers maternal and child health services, including pregnancy tests, pre-natal care, delivery and post-natal care, as well as basic well-baby care, including immunization. They also offer family planning counseling, services and supplies, as well as basic and emergency health services.

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BEFORE being accepted into the network, a midwife must go through rigorous background checks and a battery of exams, including one for psychological fitness. With a partner NGO, she is also asked to prepare a business plan, to ensure that she has a large enough market to sustain her clinic's operations. These days, say the midwives, they are expected to meet the minimum net income target of 15,000 pesos a month to assure sustainability. Pricing of services varies from clinic to clinic, depending on the prevailing rates in the area, though a clinic's rates are usually about a third of those charged by a hospital. To remain viable, though, every clinic must have a minimum of 20 paying clients a day, with at least five family planning "acceptors" among them.

The midwives I met said the most daunting aspect of joining the network is the capital they need to invest in constructing or renovating their clinics and in buying the necessary equipment. Many have used their hard-earned savings or retirement money, borrowed from family or friends, or approached banks. But banks, they say, can't seem to believe that a clinic owned and managed by a midwife can make enough money to justify a loan. One of their goals, then, is to tap venture capitalists or gain access to sources of "soft loans" to help qualified but undercapitalized midwives put up their own clinics, especially in underserved areas.

Some of the Well-Family midwives have also gone to Hong Kong to talk to midwives who have been working there as domestics and are thinking of returning home for good. They hope to convince them, as well as other midwives working elsewhere, to invest their savings in a venture that will not only make money but also provide them the opportunity to use their skills to serve their communities.

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WHEN I ask the women how much they make as midwife-entrepreneurs, they demur and laughingly warn that "the BIR (Bureau of Internal Revenue) might be listening."

One indication of their success, though, is that many husbands, some of whom joined their wives at the Cebu convention, have left their jobs and contributed their retirement pay or savings to capitalize the clinics. "Our husbands are our accountants, bookkeepers, janitors, drivers, carpenters, handymen, electricians and even nursing aides," jests Baby Daria of the San Isidro area of Talisay City in Cebu province. More enterprising "hubbies" also operate a sari-sari store or eatery to provide food and other necessities for husbands and other "watchers." "They even help out as counselors," adds Baby, "talking to the husband of a woman who has just given birth about family planning options."

The husband's cooperation and support is crucial, the midwives say, because their clinics are open seven days a week, 24 hours a day. When a patient comes knocking on their doors for an emergency or a delivery, they have no choice but throw open their doors, even if, they all say giggling, "the call comes in the middle of an orgasm."

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THE CONVENTION in Cebu, the first for the network, marked a turning point in that the USAID is phasing out its support for the venture. To manage the transition and mainstream the network into a viable business, the Well-Family Midwife Clinic Partnership Foundation was established, led by the midwives and their NGO partners.

Also launched at the Cebu gathering was the WFMC Diamond Awards, to "honor excellence in midwifery, entrepreneurship and partnerships in serving the Filipino family and in making a difference in the way Filipinos value the midwifery profession." Six awards will be given, all named after famous diamonds and recognizing specific aspects of the work done by the Well-Family midwives. As far as I'm concerned, though, all of the midwives are already shining exemplars of their profession and their communities.