Published December 3, 2004
Perilous journeys
In rural Philippines, a trip to the hospital includes miles of walking and hours of driving; most people do not survive
Second in a series
BAGUMBAYAN, MINDANAO, Philippines — After a two-mile hike on a moonless night through corn and rice fields, 60-year-old Mendeg Tilok, an indigenous Manobo elder wearing a white head wrap, entered a dirt-floor hut bustling with local officials, indigenous people, a Catholic priest, health workers and two lay people from Anchorage.
Without electricity, wicks, burning with kerosene and diesel fuel in glass bottles, lit Tilok’s face as he talked about what happens when people get sick in this remote area of the Philippines. His hilltop village of Salumanan, like most villages in the area, does not have a safe source of drinking water or sanitary latrines, no medical clinic or pharmacy. Tilok said diarrhea, malaria, tuberculosis, measles and influenza are treated with herbal medicines and traditional remedies.
When those methods lack a cure, sick people set out on a long journey — walking the steep paths from their villages, then hiring a motorcycle or horse and later crowding into a jeep for a painstaking crawl down the lush mountains. After that, there’s still a two-hour drive on paved roads where wayward chickens and military checkpoints halt trucks piled high with dozens of people and even more 50-kilo bags of rice.
Of all the sick people that have begun the journey, Tilok said only one in 10 have lived to return to Salumanan.
This is also about the same route that two of the seven members of a delegation visiting the Philippines from the Anchorage Archdiocese made last month, guided by members of Catholic Relief Services, the U.S. bishops’ overseas relief and development agency. The agency helped forge a "global solidarity partnership" with the Cotabato Archdiocese in Mindanao, the main southern island of the Philippines. The Anchorage visitors separated into small groups to learn from and live among the people outside of Cotabato City.
Zennia Manibpel, a 31-year-old dentist from Mindanao, helps coordinate a community-based health program supported by Catholic Relief Services in this agricultural area. Holding onto a handle inside a bucking pickup truck, she said an indigenous Manobo mother recently made this trip with her dehydrated child to a Catholic-run hospital in Cotabato City.
When they arrived, there were still cultural misunderstandings to navigate. Manibpel said the mother thought her son was being tied up to be sold like a farm animal when she saw the intravenous tube implanted in his arm, perhaps like a rope strung through a water buffalo’s nose.
To speak with people here in Bagumbayan — a region, or "barangay," encompassing about 14 Muslim, Christian and indigenous villages in southern Mindanao — comments are sometimes translated into four different languages. People living only a few miles apart may not understand each other’s dialect, explained translator and Bagumbayan’s vice mayor, Ariston "Jun" Panaligan.
Twenty-nine people — health volunteers, local officials and barangay police — spontaneously joined the Anchorage visitors and their Catholic Relief Services guides on a three-day immersion trip through five villages in the area. Panaligan left his office to spend two days transporting visitors on the back of his motorcycle, hiking the trails to Salumanan and sleeping alongside men crowded onto a raised bamboo-slat floor.
In the glow of orange firelight while crickets chirped and mosquitoes buzzed, a local leader told the group he enjoyed seeing visitors from many different places "walking one behind the other," for miles and miles on the trails, "the way the natives walk," he said. "This is what we do."
Bagumbayan is "well past the end of the road" said Neil Murphy, a St. Anthony parishioner from Eagle River. Murphy, a physician at Alaska Native Medical Center, said that people here suffer from "very preventable front-line illnesses that we (in the developed world) take for granted should be controlled."
But they also use any available resources wisely and efficiently to improve their quality of life, he said. Hollow bamboo poles double as rice-cookers boiling over a fire. Truck tires become garden planters. Colorful food labels decorate walls woven from nipa, a type of palm leaf.
Pregnant Manobo women endure about an hour of labor after ingesting a certain plant, and after having three children, many chew another kind of tree bark that prevents them from conceiving more. The Philippine government endorses ten herbal medicines that many Filipinos grow, such as "lagundi," for colds, the flu and asthma. "Bayabas" is a wound antiseptic and "akapulko" treats fungal skin infections.
One villager approached Murphy with her 10-year-old daughter and opened a pouch in the girl’s hand-made white dress to reveal a transparent colostomy bag containing part of her daughter’s colon. The child was born without an anus and underwent an emergency surgery in a hospital four hours away where doctors created an opening in her abdomen through which her colon could empty into a bag. Unable yet to pay for at least three more needed surgeries, her mother cleans and changes the bag regularly.
"It’s very clean," Murphy commented to the mother; he said he was impressed with the girl’s care.
"We have a huge amount to learn from the people there," Murphy added — "appreciating the simple things of life — having clean water, toilets, uncontaminated food, and their basic strength and spirit. … I think in a way, through our modern conveniences, (we) have forgotten some of the basics of community on a personal level and family level."
Murphy said the Catholic Church here plays a strong role in people’s lives by "looking at the whole parishioner." Parishes in the Philippines are a network of "basic ecclesial communities," or family groups. In the Bagumbayan region, priests teach parishioners about crop rotation and health practices and families rely on each other to share water as well as prayer.
Father Ben Torreto leads an archdiocesan effort to encourage social action and justice and peace committees in parishes and is also helping to implement community-based health programs in Bagumbayan. As the sun set Nov. 4, he translated comments from a group congregated outside the home of a health volunteer.
"There is no difference between the tri-people (Muslim, Christians and indigenous people), always respect," he relayed as a woman spoke. "They are all the same. They each love and care for each other," Father Torreto added.
Then a man stood from behind a row of people and said in English, "We are all poor. Between tri-people, no one is poor, no one is rich."
Community-based health programs launched through Catholic Relief Services have taken hold in at least 14 other Philippine barangays and are getting started in Bagumbayan.
In Manila, Mila Lasquety, Catholic Relief Services’ health program manager, told the Anchor that the agency trains local leaders to surface health issues so villagers can find solutions to their own problems.
The goal is "building self-reliance in the community," Lasquety said.
Eight months ago, 14 Filipinos were elected by their Bagumbayan communities to become members of a local research team. The group of Christian and Muslim volunteers includes a college student, a 74-year-old man and mothers who leave their families and farms for a week at a time to hike house to house collecting health information and analyzing statistics.
They are unpaid and receive only t-shirts that identify their positions and sometimes hats or umbrellas to shield them from the sun. There has been 100 percent attendance at all three training sessions in Cotabato City, a "big deal," Lasquety said.
"They’re a wonderful group. They’re really very poor; when they attend the training, they don’t even have a towel. We are very much inspired by these people," she added. "They have not gone to college and we’re talking about research. They are willing to learn."
One member, Lilian Secil, lives in Danggoan, a Muslim village on the Kabulanan River made up of 63 households. Three-story-high rusty cables and unevenly spaced bamboo slats make up the 70-foot long bridge that arcs across the chocolate colored river.
When it rains, overflow from the river contaminates the well and causes diarrhea. Stagnant water and dead worms are removed daily from the well. Between the river and well is the village’s one latrine. A blue tarp wrapped around four poles surrounds a plastic carton that empties into a shallow hole.
To get to elementary school, children here leave at 5 a.m. and walk two-and-half hours over deeply rutted terrain packing a lunch of rice, sweet potatoes, bananas or corn. This is also the route to a solar cell that charges batteries that can light a 20-watt light bulb through the night or pick up one station on the radio.
Danggoan also has a mosque, a nondescript open-air wooden building where a row of woven mats points east.
Manibpel translated for Danggoan’s imam, Usman Lumenda, who speaks Maguindanao. The Muslim leader said he wants to "continue the partnership between Muslim and Christians no matter what. We don’t want war. We want development and education for our people."
In each of the five Bagumbayan villages, people counted the number of high school graduates on one hand. Some knew of one person who had gone to college.
Bagumbayan’s local research team leader, Joseph Sumatra, 24, was one of those people. He has dreams of serving his community as a police officer and was studying criminology at the Institute of Southern Mindanao. He was a point guard on the basketball team and an ROTC officer with a scholarship maintained by a high grade point average.
But then word came that an infestation of rats had destroyed two of his family’s grain harvests. With no way to fund his $70 annual tuition, he returned to the farm to help his family, earning money shuttling up to four people at a time on a motorcycle from village to village.
Sumatra said he still wants to finish college, and that he’s frustrated by the poverty that keeps him and many others from reaching their goals. But, he added, he’s committed to improving the quality of life in the region through the community-based health program.
"The most common problem here is the poverty," Sumatra said. "I cannot just leave the barangay and pursue my own dream," he explained. "I’ve found other ways to help the people and continue to study and lead the people. … I’m equipped with the knowledge that others don’t have. I want to share that."
Back in Manila, Catholic Relief Services’ Lasquety said community-based health programs have "developed the spirit of cooperation" that communities needed to sustain more than just safe water projects but also health insurance programs and small income-generating projects.
"We provide the funds," the health program manager said, "but before we provide the funds … we need to have a solid organization."
She continued: "They can decide for themselves. They have the power to do what is needed. Now they are partners, not merely recipients of service."