Monday, May 18, 2015

The Ladder System of Midwifery in the Philippines

The Ladder System in the Philippines - from Midwife to Doctor

This is my friend, Gigi, who lives and works and volunteers in the Philippines.  I spent my first week in Mindanao with her.  She has just finished her third year of midwifery school and was suppose to volunteer in the summer before she started a  year of nursing school in the fall.  

She and her other class mates are part of an amazing program, in which they complete three years of midwifery school and then can go on to complete a year of nursing school and then go on to medical school.  They can stop at any point in the program or just keep on going.   To qualify they must be chosen by their community or Baranga.   She was chosen for her obvious enthusiasm, intelligence and dedication.  

Her school is a large modern building. It is great, but what is amazing is the village of traditional houses across the field where all the students live, cook and study.   It is a remarkable model of improving healthcare in remote communities.   

Gigi and I had so much fun together.  We did prenatal care and taught classes and gave presentations as well as so much singing and riding motorcycles up to the communities and cooking and telling stories.  What was so impressive about her and the community health workers, was their true wish to help their communities and a sense of volunteerism.  She is becoming a doctor, via becoming a midwife and a nurse but her mission seemed so much larger.  It was to make her country a better place for everyone and most all of all those who have the least. She is eager to understand her country's history and the culture of the people she serves.  

There is much that can be said about maternal health in the Philippines but I want to start with this amazing woman and her path to becoming a doctor.   Her courage was as big as her heart and her smile.   

You may be surprised that it starts with 3 years of midwifery.  I think its inspiring  because its basically saying," let's start at the beginning of life and get that right."  A midwife also does many things including prenatal care, births, immunizations and family planning.  Each midwife there covers a large area that includes many remote villages.  There job is very hard, even with the help of community health workers from the World Health Organization.  There is no doubt that when Gigi graduates her community will be so happy to have her.  As part of the program, she made a commitment to stay in her country and return to her rural community.  

**** Just a note of caution, the Philippines did not meet the millennium goals in maternal and newborn health and the communities we visited had no prenatal care and no access for transport or even trained traditional birth attendants.  It is currently agains the law to have you baby at home with no ability to serve women in birth centers that they can have access to.   Gigi is part of the solution but in the mean time there ei much that can be done.

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