Wednesday, March 26, 2014

Joy and Hope

By Lilia G. Hernandez, M.D.

To all those I know or have met: There is very little I can do; I can at least write about them and the people who dedicate their lives to help them.

Many donors, local and international, have expressed the desire to direct their aid to rehabilitation, even only a few days after Typhoon Haiyan, called Yolanda locally. There seemed to be adequate international emergency response. Many however were aware that the rehabilitation of the people will take months, if not years. 

On the first 2 weeks of March, I went with a team on medical missions to Burauen Leyte, ravaged by Yolanda in Nov, and visited Tacloban City on my own; then to Inabanga Bohol, destroyed by an earthquake a month earlier. On March 22-23, I went with the same team for psychosocial follow up visits to Daan Bantayan and San Remegio, both at the northern tip of Cebu mainland. Part of the team proceeded to the island of Quinatarkan. All these were hard hit by Yolanda.

Dr. Lilia Hernandez examines a patient during 
the medical mission in Burauen, Leyte on March 8, 9, 2014.

What I came away with these experiences were joy and intense sorrow and some confusion. Joy and hope with the dedication and focus of the community workers. Joy and hope at the resilience and Faith of the people, many whom described themselves as "malampuson ug naningkamot" (persevering and keeps trying).

When I returned to the Holy Spirit Convent to spend the night, before I took the ferry home, I knelt before the Blessed Sacrament and cried. Tears could not have burned hotter in my confusion: why O God do so many have so little, suffer so much, yet thank God first of all for their survival; and why do those who have so much, pay so little, think of the poor as lazy? Why are the nations so responsible for pollution that changes the climate, not bear the brunt of its tragic effects? Where is justice? How can modern youth keep Faith, seeing this so universal unfairness: the 1% vs the ninety nine? Is the parable of the rich man and the beggar Lazarus at his gate really believable?

Donors need not be concerned. In the over 36 years I have been away from the Philippines, many sectors have achieved pride in their nationality and identify with its people, the majority of whom still remain poor or live very remotely. The "1% vs the ninety nine" cannot be owned by any country. Many Americans already claim this.

What I had the privilege of witnessing and working with were groups of citizens who have coalesced to be relief workers in disasters; community organizers, teachers and conduits of aid from international agencies during recovery and "normal" times. Most are young who have spent part or much of their lives, part time or full time, trying to realize their idealism: health professionals or graduates of the Arts, farmers, fisher folk, housewives or school dropouts.

When I discussed with a Washington psychiatrist about training the community workers on the psychosocial aspect of disaster response and rehabilitation, I was very happy thinking it was a novel idea. But they were on the 3rd year of intermittent training, which started when they realized the need after a medical mission following the 2012 earthquake in Guihulngan Negros Oriental. The workers were grateful for the present funding, as it allowed the hiring of professional speakers to train more workers and give updates to those previously trained.


VPHCS psychosocial team poses with residents 
in Barangay Mohon, Daanbantayan, Cebu, during their second 
psychosocial session this March. 
Dr. Lilia Hernandez is seated on the extreme right.


The Visayas Primary Health Care Services is the team I have worked with for decades, and for whom the FilAm Center for Community and Development (FACCHD) has given financial support since 1995. The "development of relevant, effective, affordable, and accessible health care" is its goal. Over the years, it has linked with many other privately funded groups: CERNET (funding from Germany); FARDEC (funding from Bread for the World); MAGNA (funding from a Protestant group) etc. Some of the organizations they link up with (MAGNA for example) worked through the DOH or DSWD during this disaster, such as in the psychosocial training. So I am hopeful that with the same training given to governmental agencies, they too will conscientiously conduct the psychosocial sessions I have seen being done on my trips.

These psychosocial interventions happen after the initial relief services of food and temporary shelter distribution and response to immediate health care needs. As one community leader aptly put it "after a natural calamity always follow health problems." (Human sa katilingban, musonod gyud ang problema sa panglawas.")

There are at least 3 sessions lasting half to a full day each. The first session is allowing the community to unload; very emotional, many express grief, some express anger; children sessions apart from the adults. The teams bring the food which the communities prepare or cook so everyone can eat until the session is over. Sessions are facilitated initially by psychologists in the presence of those trained in disaster responses. Subsequent sessions are conducted by the trained community workers.

The community is then allowed to process and come to grips with their loss and new situation: lost means of livelihood or crops, homelessness, etc. The team returns several weeks later for a follow up session. This time the facilitator tries to evoke responses by allowing each to draw the Tree of Life: the roots are his/her name and Barangay, the trunk how the person perceives her or himself; the leaves are his/her dreams; the fruit what gives happiness and to write on the side who he or she wish to thank. The third session is brainstorming and planning with the people on what they can do for disaster preparedness, with the trained facilitator giving pointers/ideas that the community might decide they can adopt.

In the Barangays I went to, the families decided to form into a cohesive group. FARDEC or Farmers’ Development Center will supply materials for reconstruction; labor will be "bayanihan" or community effort.

I reviewed the drawings before they were returned to the people. Their self-perception was encouraging: malampuson or persevering; maloloyon or compassionate, matinabangon or helpful. Their dreams were so universal; except for "makatindog akong balay" or reconstruction of my house, many wrote the education and prosperity of their children. Who they felt grateful to had one consistent answer: God. Then came family and the relief workers.

There is much more that need to be done; many more resources needed from government and private sectors. But I feel hope that with a little material help, these people shall rise again. Their lives are simple; their needs are the basics of life. 

Come to think of it, maybe the wealthy need our prayers more, "kay ang mga pobre kanunay nga dunay malampusong pangandoy". (For the poor always have their persevering hope").

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March 24, 2014


Lilia G. Hernandez, M.D. is a very good friend of the VPHCS and an ardent advocate of community-based health programs in the Philippines. She practices pediatrics in California and visits the Philippines regularly to render her services in the communities served by the VPHCS. She is the President of the Board of Trustees of the Fil-Am Center for Community Health and Development (FACCHD) in Pleasanton, California which has supported the VPHCS since 1995. 
She is a graduate of the University of Santo Tomas, Class 1974 and a Silver Jubilarian Awardee for Community Service in Philly (1979). She wrote these reflections to her classmates in the USTMedicine1974@yahoogroups.com on Mar 24, 2014. 

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