The Malita Experience Speech

Wednesday, August 26, 2015

When WHO asked me to introduce the AVP for Himsog na Malita, I was bothered. With the number of maternal deaths in Malita, how am I supposed to lighten that. It was during conversations with my husband and Dr. Coloma that an idea came. And with the help of my husband, I was able to deliver this message during "The Malita Experience". Please respect that these are my words. Should you wish to get excerpts here, do let me know and do acknowledge where you got it. Here goes:

"To our distinguish guests, ladies and gentlemen good morning.

As you may have known by now, Malita was the pilot area for the WHO SNI. At first, nobody knew much about Malita except for it being a very far away place. Before WHO came, we were having problems on how to better engage with the community. Every time we get the barangay officials involve, all they could think of was to let the barangay health workers attend to the municipal health personnels and then prepare for our meals. We were barely engaging with them, how much more with the community. 

In terms of development partners, there were none. Though we get a few medical missions with some foreign aid, but medical missions are different from being development partners. 

Plus maternal deaths continue to be high. Facility-based deliveries  were very low and traditional birth attendants were rampant despite the efforts of warning them against legal actions.

So when WHO came, there was a complete turn of events. We started of with the Malita Heath Summit, showcasing the health profile of Malita to the different stakeholders. After that came the real work. 

With the technical assistance of WHO and DOH, we started reaching out to the communities by getting in touch with the barangay captains. We showed them the different health indicators, showed them the problems in achieving the different health indicators and showed them the LGU scorecard. 

We got in touch with our MLGOO and together with the WHO, came up with the Barangay Performance Audit. We also reached out to the tribal leaders, the different indigenous women, and the traditional birth attendants in the hope of making them understand the importance of having their pregnant women be seen by our health personnels and them being our partners in reducing maternal deaths. 

The most difficult thing to change, be it in beliefs or in practices, is the culture.  Malita is 80% composed of indigenous people. We have recognized 3 different tribes and 1 group. We have the Tagacaolo, Manobo, B'laan and the Muslim. 

As our beloved mayor, the Honorable Benjamin P. Bautista Jr. said, "you cannot expect the indigenous people to adapt to you. You have to adapt to them. You have to dig into their culture and understand the way they live." And so came changes to policies. We opted for skilled birth attendance rather than facility based deliveries if the situation calls for it. Incentives for our partners are put into place to encourage them to bring in patients. We are constantly searching for new strategies to answer the diverse problems surrounding the community. 

Our journey with WHO was never easy. We tried different approaches to better understand why such events occur.

As of today, we have the Handicap International as one of our development partners in the combat against hypertension and Diabetes. We are also happy to have KOICA's funding assistance until 2018. We also have the IMPACT TB of the PBSB USAID to provide assistance to Malita. 

We still have the highest maternal mortality, but we also have high facility based deliveries. For our RHU birthing home, our monthly deliveries is around 25-30 from last years 5-10 deliveries, about 300% increase; while hospital deliveries in Malita district Hospital would range from 180 to 200 deliveries from 28-38 deliveries per month, about 600% increase. I have not included those who delivered in our private clinics. 

To better cater to the pregnant women, CVD patients and TB patients in far flung barangays, we are doing the RHU-on-wheels in partnership with the provincial medical outreach team and the provincial disaster risk reduction team. And I have my husband here with me, Dr. Glinard Quezada, who is the Chief of Hospital, to thank for the support. 

I also have with me our Municipal Administrator, Engr. Bryan Bautista, who is representing our Mayor. 

We already had our initial conversation with the representative from IP-MNCHN who will look into the culture of the indigenous people to better understand them and to search for ways to better engage with them. 

Next month, we will start with the "ALAGA ka program" of the Philippine Health Insurance Corporation in partnership with the Municipal Social Welfare and Develoment Office,  the Pantawid Pamilya Division in Malita, Municipal Health Office and the Municipal Local Civil Registrar in the hope of providing all Pantawid Pamilya beneficiaries their own correct and updated Members Data Record which will help them in times of hospital admissions.

On a personal level, there is still much work to be done for Malita. But looking at the progress it has achieved, and with continuing partnership with the different agencies, it is looking brighter an ever. 

I do not know how the SNI will help the other municipalities, I do not know what programs they have in store for them. But here's my advice, work with them, appreciate their presence in all levels of being, make them understand, show them how you see your municipalities and probably they will show you another perspective in looking at the current situation to better understand and better plan for your constituents. But that's it. I cannot tell you more. Everything else will come.

At this point, I think it's best to show you how our journey with the WHO SNI has prospered. I think it is best to listen to our partners as well. 

Thank you very much and once again, good morning."

- Anne Margaux Bautista - Quezada, MD, MPH