But tonight, all the talking was over, and it was time for the midwives to rock! Any thoughts about the gathering ending on a sober note were dispelled once the program began. The first group put on a "traditional" number of folk dances, though there was a moment of excitement when the kerchief of one of the "Pandanggo sa Ilaw" dancers caught fire and the midwife demonstrated remarkable presence of mind by blowing out the flames, all the while keeping in step with the music. "That's what we midwives are all about!" an admiring colleague commented.

By the time the Western Visayas contingent strolled onstage in the dazzling costumes of the "Masskara" Festival then strutted their stuff to the disco classic "It's Raining Men," the entire ballroom was in an uproar. Spirits soared further when the Metro Manila group came up with their "Hagibis" number, complete with a "sexy dancer" whose moves were so polished, we wondered if the Well-Family network wasn't also into talent management.

The evening's entertainment closed with an elaborate and even moving paean to the environment mounted by the Davao delegation, dressed in ethnic costumes that, we quipped, must have entailed emptying the entire Aldevinco complex of t'nalak cloth.

If the midwives had wanted to demonstrate their organizational capability, as well as their individual drive and creativity, they couldn't have chosen a better showcase.

* * *

BUT really, they have more to show off than just their performing skills. In the five years or so that the Well-Family Midwife Clinics have existed, the women have shown that midwives, long considered mere "handmaids" to other health professionals like doctors and nurses, may well be the secret to the efficient delivery of quality health services at the barangay or village level.

In 1997, determined to expand private sector participation in the delivery of health services, but especially family planning, the United States Agency for International Development (USAID) and JSI/RTI launched a network of midwife-owned and operated clinics that would provide "affordable quality family planning and maternal and child health services in key urban areas and selected municipalities in the country." In partnership with 10 non-government organizations around the country, the Well-Family Midwife Clinics recruited and trained midwives from all over the country, transforming them from second-tier health professionals into health management entrepreneurs, owning and running their clinics for profit and public service.

"We used to be referred to as 'comadrona lang (just midwives)'," recalls Carol Millan, whose clinic in Barangay Rizal in Makati is so profitable she has two doctors in her staff. "Today, we're seen as professionals, and sometimes, our clients even refer to us as doctors."

* * *

WITH TWO years of training and licensed by the government, midwives used to be thought of as good only for delivering babies into the world and caring for them in their first hours of life. Indeed, having a licensed midwife as a nursemaid for one's children is still seen as a status symbol among upper-class and aspiring-for-upper-class women.

It's true also that the two-year midwifery course was, and still is, seen as a means of securing a much-coveted job abroad as a domestic, nurse's aide or, increasingly, caregiver.

But the midwife-entrepreneurs of the Well-Family network are working to ensure that public perception of their profession expands beyond such narrow definitions. "We are frontliners in our communities, we play so many roles," explains Joy Mora-Plaza from Surigao City. "We are also teachers, surrogate parents, counselors and even sanitation officers."

And sex counselors? I teasingly probe. The women around the table break out into raucous laughter. "I think the women and even the men trust us because we seem to be more approachable and open than doctors," remarks Marites Agote-Cinco of Tacloban. "Husbands feel free to ask us if it is safe to have sex while their wives are pregnant, while wives can open up to us about problems like vaginal dryness."

* * *

NOT every midwife can qualify as a Well-Family midwife. Many of those who opened the first clinics were recruited from government hospitals or health centers. To qualify, one must undergo hours of rigorous training in quality care standards, as well as in running a business. Most of the midwives I talked with agreed that the business part--preparing feasibility studies, reading profit-and-loss statements, maintaining account books, marketing their services--was the more difficult phase of the training.

And even after they're accredited, the Well-Family midwives and their clinics are constantly monitored (by the partner NGOs) and evaluated, such that some clinics have, through the years, been closed down and de-registered. Every clinic must also adhere to Department of Health guidelines and standards.

These high standards and assurance of quality are what set apart the Well-Family Midwife Clinics from similar providers. "This is our distinction," declares Carol. "Our 'brand name' is what separates us from others."

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