HEALTH

A family’s thanks to barangay health workers

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Alnur, 4, plays at home in Buadiposo-Buntong, BARMM. Photo by MARTIN SAN DIEGO/HIGHWAY CHILD/UNICEF

(UNICEF) — Norsainah and Baniamen have four children. Alnur, four, was hospitalized with measles when he was 10 months old. “We thought we were going to lose him,” says his mother, Norsainah, who responded in Filipino.*

Babies born in Bangsamoro Autonomous Region in Muslim Mindanao (BARMM) are more at risk from vaccine preventable diseases in comparison to children in other parts of the Philippines, and around the world.

The Philippines ranks fifth globally among countries with the highest number of unvaccinated children, where one million children have not received a single childhood vaccine. Within the country, 60% of “zero-dose” children live in BARMM.

A view of Marawi City in Lanao del Sur province, BARMM. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

BARMM is in Mindanao, the southernmost of the three major Philippine island groups. It was created as a newly autonomous region in 2019 following decades of conflict across its provinces and a five-month siege in Marawi City from May to October 2017. During the height of the conflict, 98% of Marawi residents were displaced.

Norsainah was pregnant with Alnur when the family fled from Marawi, to Buadiposo-Buntong, 16 kilometers away. Ash, a volunteer health worker, was there for Norsainah’s labor. “The power was out so we were feeling our way around in the dark,” says Ash. “Alnur was born by the light of mobile phones.”

Health worker Ash (center), with parents Norsainah and Baniamen and their children, including Alnur, four, (blue and red vest top), who Ash helped to deliver into the world during a power cut. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

The family’s home was flattened during the 2017 conflict. The family evacuated Marawi city during the siege and Alnur was born later that year, in October 2017. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

During Alnur’s first year of life there were a number of health scares. At four months old, he underwent surgery for an umbilical hernia. “He was [at] death's door,” says his father, Baniamen. “He was intubated to receive oxygen as he couldn’t breathe on his own. I couldn’t go out to work as I was worried he might die. We had to watch over him constantly.”

Following this traumatic episode his father avoided vaccination services. “I wanted him to take a little break so his body could recover. I thought that would be better for him. Little did I know he would end up with measles. I really regret not having him vaccinated,” says Baniamen.

Alnur came down with measles, just one month after his vaccination had been due. Norsainah recalls what happened: “His body suddenly got really hot and it appeared as though he couldn’t see.”

“We didn’t immediately think [of] measles, because we had never seen it before,” she continues. “But our parents recognized it, as what we call ‘abas’ in our language. My mom got really scared because she remembered that a lot of children died back in the days before there was a vaccine for it. So, we brought him to the rural health center immediately.”

Alnur was rapidly referred to a specialist at the hospital. He was in a critical condition and isolated for treatment, where he would spend the next 10 days. Alnur was one of the 20,827 measles cases recorded in 2018, along with 199 deaths. The worst epidemic was yet to come. In 2019, the country witnessed the region’s largest outbreak, totaling 47,871 cases and 632 deaths.

Alnur (right) playing football with his brother, Saiben. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

Ash (left) and Injilah (right) go door-to-door in Buadiposo-Buntong. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

Village health workers, Ash and Injilah, continue to regularly check-in with the family, and all households in their community. UNICEF has supported their training and procured the vaccines that they administer.

Ash and Injilah continued this work throughout the COVID-19 pandemic, dressed in brightly-colored personal protective equipment (PPE). “As we went house-to-house, families would call out and say, ‘Here come the teletubbies!’” Ash says.

“Barangay health workers are from the community, they’re an essential help,” says Evelyn Saro, midwife and manager of the Marantao Rural Health Center. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

The health workers visit families who can’t get to the health center, and help make arrangements or provide essential services at home.

“Barangay health workers are from the community, they’re an essential help,” says Evelyn Saro, midwife and manager of the Marantao Rural Health Center.

“They’re our ‘CCTV’ as they live right in the community. They inform us of who needs what and who can’t make it to the health center. They were indispensable during the measles and polio outbreaks. We need to be able to offer more incentives — we can’t make it without them.”

Alnur, 4, arrives at school. He was hospitalized for measles when he was 10 months old. “He's still small for his age, but he’s healthy,” says his mother, Norsainah. Photo courtesy of UNICEF AND U.S. CDC/ UN0723286/MARTIN SAN DIEGO/HIGHWAY CHILD

“We are over the moon seeing Alnur today, so full of life,” says his mother. “I want to say a big thank you to all the doctors, nurses and midwives, especially at the rural health unit, because they really helped save our child.”

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*Respondents all answered in Filipino and were translated for the article.