Medical and dental mission for families affected by Typhoon Yolanda and Typhoon Ruby in Polambato, Bogo City, Cebu

The Visayas Primary Health Care Services, Inc. conducted a medical and dental mission in Barangay Polambato, Bogo City on December 14, 2014. Located in the northern part of Cebu about three hours ride from Cebu City, it was one of the barangays severely affected by Typhoon Yolanda and recently, by Typhoon Ruby on December 6, 2014. The mission was conducted in the Polambato Elementary School.

In Polambato Elementary School.

The Visays Primary Health Care Services, Inc. coordinated with the Polambato Farmers’ Association which was organized by the Central Visayas Farmers’ Development Center (FARDEC), another non-government organization, in the aftermath of Typhoon Yolanda as part of its relief and rehabilitation support services for families affected by the disaster. The local government unit and administration of the elementary school helped also to prepare for the mission. 

Members of the mission team included the following, namely: 12 doctors, 7 nurses, seven dentists, and one psychologist. The VPHCS had nine staff members which included one doctor and three nurses. The FARDEC had two staff members. The entire medical mission team consisted of 38 people. 

Services in the medical mission included the following, namely: medical consultations for illnesses for children and adults, diabetes screening for adults more than 40 years old, dental services of tooth extraction, urinalysis, and giving of reading glasses. 

For many of the patients, it was the first time that they had medical care since Typhoon Yolanda hit the Philippines in November 8, 2013. Having to work very hard to look for food after the damage to their crops, suffering from the lack of shelter after the destruction of their houses and trying to find all possible resources to feed their families, many patients had neglected their health. For many of them, going to the health center to seek medical care for their illnesses or to buy medicines for their illnesses was the least priority; the first priority was to find food. 

Registered adult patients had their blood pressure taken and the children were also weighed by the nursing team. Adults 40 years old and above had their blood sugar tested for diabetes after which they joined all other adult patients in the adult consultation room. All children were ushered to the two pediatric consultation rooms. 

Patients line up for registration.

 Registration of patients.

Consultation room for adults.

Consultation room for children.

Patients who had urinary complaints had urinalysis done. 

Urinalysis.

Adults and children who had dental problems were brought to the classroom for dental services. 

Dental services.

After their medical check-up, the patients then went to the pharmacy to get their prescribed medicines. 

Dispensing of medicines.

A total of 366 patients were given medical services, 50 of whom also had dental care, while 25 had only dental care. This brought the total number of patients to 391. A total of 147 persons were given reading glasses all of whom were also attended to by the doctors. 

A total of 100 patients had their blood sugar tested for diabetes, 5 of whom had elevated blood sugar levels. They were all given hypoglycemic medications good for three months and advised to have regular blood sugar check-up and diet control. 

Screening of diabetes.

Reading eyeglasses were provided to 147 patients. Having eyeglasses is a luxury in the rural areas in the Philippines. Even if Bogo City has optometry clinics, people could not afford their services. Those who availed of the glasses were truly happy that they could now read clearly or sew their clothes. 

Giving of reading glasses.

Hypertension was the second leading cause of illness after acute respiratory tract infections. Many of the patients said that they were not taking any anti-hypertensive medications because they did not feel any symptoms, could not afford to buy the medicines, or were not given medicines by the government health centers due to limited supply. The mission dispensed anti-hypertensive medications good for three months per patient after the doctors talked with the patients to have their blood pressure checked regularly by the barangay health workers and to take their medicines daily. 

The occurrence of acute respiratory tract infections, osteoarthritis, muscle pains, and non-ulcer dyspepsia among adults is seen in the context of the situation affecting the residents who are mostly poor farmers who have to work all day long in the fields, causing stress to them and tendency to take irregular meals, or decreasing their bodies’ immune response. 

Nine patients suspected of having pulmonary tuberculosis were referred to the city government’s health center in order to have sputum examination so that the patients can avail of free medicines if the examination is positive for the tuberculosis bacteria. There were also six cases each of pneumonia and anemia and five cases each of diabetes mellitus and bronchial asthma. 

There were 182 children less than 13 years old and 14 of them had normal findings. Majority (124 or 68%) had acute respiratory tract infection which is mostly viral in etiology. In the week prior to the mission, the weather was not good due to Typhoon Ruby resulting to lowered immune response of the children, making them susceptible to catch cough and colds. Ten of them came down with pneumonia and five had chronic bronchitis which are both lower respiratory tract infections. Five were anemic and three had skin infections while two had bronchial asthma and otitis media. One child had a lacerated wound on his foot after stepping on broken glass. A doctor in the mission sutured the wound so that the patient was not anymore referred to the city’s government hospital which would have cost money to his family. 

All patients were properly given medicines bought from the funds from Lands Aid. They included essential medicines such as antibiotics, analgesics, anti-pyretics, anti- hypertensives, antacids, ferrous sulfate, anti-diabetic, mucolytic, deworming agents, bronchodilator, multivitamins, skin antibiotics, and many others. 

In general, the mission was indeed successful and the patients expressed their appreciation and gratitude to the team. The team members were also very happy that they were able to serve the farmers and residents of the community who are continuing to strive hard to regain their normal lives after Typhoon Yolanda one year ago. 

The medical mission team after all was done.

CRM Trainings for VPHCS staff and community health workers in Bantayan conducted

As part of the ongoing project of the Visayas Primary Health Care Services, Inc. (VPHCS) to provide mental health services to families affected by Typhoon Yolanda in the northern part of Cebu, trainings on community resiliency model (CRM) were recently conducted for the VPHCS staff and community health workers in the affected areas in Bantayan. 

The project, Integrating Community Resiliency Model (CRM) in Community-based Health Program (CBHP) in ten villages in northern Cebu affected by Typhoon Yolanda is funded by the Unitarian Universalist Service Committee (UUSC), a human rights organization based in Massachusettes, U.S.A. and working in more than a dozen countries worldwide. 

The six-month project which started in October 2014, addresses the mental health in the ten communities through application of the CRM so that the residents can help themselves and help others as well. 

Trainings on CRM for the VPHCS staff were conducted on October 17 – 19, Nov. 8 -9, 2014, in the Institute of Religion and Culture, Cebu City. Resource persons included three nurses trained on CRM and members of the Philippine Association of Community Resiliency Model Trainers (PhilACTs), Edgar Gahisan, Lord Sidney Relon and Irish Grace Ramirez, and UUSC consultant Rainera Lucero. 

Community Resilience Model (CRM) trained nurse 

Lord Sidney Relon facilitates a workshop 

on CRM with VPHCS staff.

VPHCS staff Juliet Abing presents her body map 

as part of developing the skill of resourcing.

A workshop during the CRM training. 

UUSC project consultant Rainera Lucero (standing) 

adds some inputs during a workshop.

CRM trained nurse Edgar Gahisan talks 

on the different skills in CRM.

The trainers then gave community-based trainings on CRM to community health workers of the ten barangays. The first trainings were held in Patao in Bantayan on Nov. 29 – Dec. 1, and Kampinganon in Bantayan, and San Agustin in Madridejos on Dec. 2 – 4.

Ten CHWs in each barangay attended the trainings which were conducted by Irish Grace Ramirez, Pearl Templado, Tardy Guardiario, and Lucila Carrreon of the VPHCS. 

Community health workers in Barangay Patao, Bantayan.

Community health workers in Barangays Kampinganon 

and San Agustin, Bantayan Dec. 2-4, 2014

Participants during a training on Community Resiliency Model 

in Bantayan on Nov. 29 - Dec. 1.

 VPHCS nurse Pearl Templado explains about CRM skills.

VPHCS nurse Tardy Guardiario talks about CRM skills.

“Community Resiliency Model (CRM) of the Trauma Resource Institute embodies a community-oriented approach that promotes independence, education about the biology of the human body and how it responds to traumatic events and most importantly, how to restore or enhance resiliency. It trains community members to not only help themselves but to help others within their wider social network. CRM aims to “make the skills a part of healing in daily life, to increase a sense of one’s ability to help him/herself, to learn how to bring the body, mind and spirit into greater balance and to encourage people to pass the skills along to friends and loved ones.”

“The primary focus of this skills-based, stabilization program is to re-set the natural balance of the nervous system. CRM skills help individuals understand their nervous system and learn to track sensations connected to their own well-being, which CRM calls the “Resilient Zone”. CRM’s goal is to help to create “trauma-informed” and “resiliency-informed” communities that share a common understanding of the impact of trauma and chronic stress on the nervous system and how resiliency can be restored or increased using this skills-based approach. 

“CRM has largely been used with individuals and communities, which have been marginalized either by economic challenges, ethnicity or specific events. Applying CRM proactively with an entire community or neighborhood that is chronically stressed can alleviate the symptoms of chronic stress placing the community and its members in a better position to change their situation by increasing their resiliency.” 

In the trainings of the community health workers, the participants said that Community Resiliency Model helped them in recovering themselves from the Yolanda experience, making them able to control themselves when they are out of their resilient zone.

Other communities in future trainings to be conducted include Barangay Lipayran, Municipality of Bantayan, Barangays Baterya, Malbago and Tominhao in the Municipality of Daanbantayan, Barangay North Poblacion, Municipality of San Francisco, Barangay Cagcagan, Municipality of Puro and Barangay Puertobello, Municipality of Tudela.

Medical mission in Northern Cebu

Nearly 800 residents of four barangays affected by Typhoon Yolanda were served during a medical mission conducted by the Visayas Primary Health Care Services.

The residents of Barangays Tindog and Dalingding Sur, Medellin were served during the mission in Tindog last Nov. 22 and residents of Barangays Paypay and Dalingding Norte, Daanbantayan were served in Paypay on Nov. 23. 

The mission site in Paypay, Daanbantayan.

Patients waiting  in LandsAid tent in Paypay.

Registration of patients, Tindog, Medellin.

Patients waiting for medical check-up, Tindog, Medellin.

The mission was supported by LandsAid, a German humanitarian aid organization which had earlier supported a similar mission in Barangay Tambongon, San Remegio last Sept. 14. 

Services in the two day medical mission included the following, namely: medical consultations for illnesses for children and adults, diabetes screening for adults more than 40 years old, nutritional status assessment, visual acuity check-up, dental check up and urinalysis for children six years to 12 years old, eye check-up for adults and giving of reading glasses, and distribution of toothbrushes and toothpastes for children. The mission sites were the barangay hall and day care center in Tindog and the Paypay National High School. 

These four barangays have established women’s organizations which were organized by the Women’s Resource Center of Visayas (WRCV), another non-government organization, as an offshoot of the relief efforts immediately after the typhoon. The Visayas Primary Health Care Services coordinated with the WRCV and the women’s organizations in organizing the mission. 

Invited members of the mission team included the following, namely: 10 doctors, 12 nurses, one optometrist and 5 non-health personnel. The VPHCS had seven staff members which included one doctor and three nurses. The WRCV had a five-member team. The entire medical mission team consisted of 37 people. 

In both sites, registered adult patients had their blood pressure taken and the children were also weighed by the nursing team. They were then segregated into adults and children. All adults who had eye problems were ushered to the room for eye check up, those 40 years and above had diabetes screening, after which all were attended to by the team of doctors. All children six years to 12 years old were ushered to the room for urinalysis, height and weight measurement, dental check-up and distribution of toothbrushes and toothpastes, after which they were brought to the medical consultation room. All patients were eventually attended to by the team of doctors. After their medical check-up, the patients then went to the pharmacy to get their prescribed medicines. 

Dr. Marilyn Dayrit and her daughter Milka conducted 

eye check-up and dispensed reading glasses.

Nurse Jessica Pausta and VPHCS staff Lourdes Geolin 

test urine of the children for urinary infection.

More than 400 patients were served in Paypay.

More than 300 patients were seen in Tindog.

In Medellin, a total of 362 patients were attended to, while in Daanbantayan, there were 414. This brought the total number of patients to 776. 

A total of 230 patients had their blood sugar tested for diabetes. For many of them, it was the first time that they had their blood sugar tested. Only 22 were found to be diabetic, they were all given hypoglycemic medications good for three months and advised to have regular blood sugar check-up and diet control. 

Nurse Jafe Sepulveda and Cristopher Ouano 

check blood sugar for diabetes.

Nearly all of the children had good eye vision and only five percent had urinary infection. However, more than 50 percent of the children had dental caries due to poor hygiene. Thus, the children were taught by the nurses about dental hygiene and proper use of toothbrush. A total of 400 toothbrushes and toothpaste were distributed in both missions. 

VPHCS staff Luz Carreon conducted dental check up 

for children less than 12 years old.

Dr. Erlinda Posadas with mother and child.

Nurse Hanna Liza Lora teach children proper toothbrush.

Reading eyeglasses were provided to 150 patients in Medellin and 150 patients in Daanbantayan after eye check up by an optometrist.

With new eyeglasses.

Hypertension was the leading cause of illness among the adults in the four barangays, as it is the leading cause of morbidity together with cardiovascular diseases nationwide. 

The occurrence of acute respiratory tract infections, osteoarthritis, muscle pains, non-ulcer dyspepsia, tension headache and anemia among adults is seen in the context of the situation affecting the residents almost a year after Typhoon Yolanda devastated the northern towns of Cebu. With the destruction of their crops and trees (sugar cane, corn, coconut, banana, mango), the farmers had lost their source of income and food and they are still trying to cultivate their fields of food crops. Osteoarthritis, muscle pains and tension headache are common among farmers who have to work hard in the farms in order to put food on their tables, thereby putting their bodies into stress and exertion. Non-ulcer dyspepsia was also common since being farmers, they have the tendency to skip their meals while working in the fields or simply because there was no food to eat at all. Acute respiratory tract infections can be attributed to their lowered body immune system or resistance.

Medicines and medical supplies in government health centers are still lacking to meet the needs of the people. The mission dispensed appropriate medicines for the illnesses. 

The few patients with other problems that needed further work-up and management were referred to tertiary hospitals in Cebu 

In general, the mission was indeed successful and the patients expressed their appreciation and gratitude to the team. For the team members, it was also a meaningful experience for them to have served the farmers and residents of the community who are continuing to strive hard to live a decent life after the devastation of Typhoon Yolanda. 

 Happy patients.

The mission team.

Psychosocial support services extended to four Typhoon Yolanda affected barangays

Psychosocial support services were recently rendered to more than 200 residents of four barangays in north Cebu that were devastated by Typhoon Yolanda. Trainings for community health workers were also conducted.

The services were rendered by the Visayas Primary Health Care Services in Barangays Tindog and Dalingding Sur, Medellin, and Barangays Paypay and Dalingding Norte, Daanbantayan. 

The program is part of a 15-month project, “Community – Led Disaster Preparedness and Resiliency: Grassroots’ Alternative in the Face of Climate Change,” which is implemented in the four barangays by the Women’s Resource Center of the Visayas (WRCV) based in Cebu City. The project proponent is the Philippine Network of Food Security Programmes, Inc. (PNFSP). It is funded by the Terre des Hommes International Federation (TDH). 

The project aims to ensure that the four barangays have fully recovered from the main impacts of the typhoon, restored their livelihood and established safety and disaster prevention, response and recovery mechanisms and achieved their basic rights to food for their children and families through livelihood assistance and food security alternatives. 

As part of the rehabilitation process, the VPHCS conducted a series of psychosocial sessions in October and November for more than 500 adults and children who were affected by Typhoon Yolanda. Teams of nurses, psychologists and trained health care givers conducted lectures on disaster orientation and preparedness followed by in-depth stress debriefing sessions and trauma healing to small groups of residents. During the sessions, the residents who were all survivors of Typhoon Yolanda ventilated and shared their experiences on Yolanda which were then processed by the psychosocial team so that they were relieved of their fears and stress and resolved to face future life’s challenges.

VPHCS staff nurse Tardy Guardiario 

explains about disaster preparedness in Paypay.

WRCV Executive director Leny Ocasiones talks with women 

in Dalingding Norte during the psychosocial session on Oct. 4.

VPHCS staff nurse Pearl Templado explains about 

why typhoons occur in the Philippines during 

the disaster orientation in Dalingding Norte on Oct. 4.

Psychologist Gilbert Carredo facilitates 

a psychosocial session in Dalingding Sur.

Children and the youth also had play and art therapy to express their feelings and experiences during the typhoon. 

Play therapy for children in Tindog.

Children engage in art therapy in Dailingding Sur.

Gilbert Carredo with youth in Paypay.

Youth in play therapy in Paypay.

Trainings for 22 community health workers were also conducted.

During the first training on “Health disaster preparedness and mental health orientation” on Oct. 25-26, the CHWs were able to understand disaster risk reduction and preparedness and management. Disaster mapping of their particular barangays was also done in order to pinpoint the specific disasters, particularly typhoons, that they are vulnerable to and how to address them. The CHWs were also taught the health measures related with disaster preparedness and management. 

VPHCS staff Luz Carreon with health workers 

making disaster maps in the training 

on disaster preparedness on Oct. 25-26.

Furthermore, the CHWs were taught the basic elements of mental health problems resulting from disasters as exemplified by Typhoon Yolanda and how to deal with people with such problems, particularly how to do simple stress debriefing. After the training, the CHWs were thankful of the knowledge and skills that they learned that will enable them to help their community members. 

Community health workers pose after the training on Oct. 25-26.

The second training, “Local health workers training on facilitation using the tool of psychological processing,” was conducted on November 15-16. The 22 CHWs were taught about Community Resiliency Model (CRM), a type of simple wellness, teaching, learning and communication skills that can be used to treat persons experiencing stress or psychological trauma. Through discussions, exercises workshops and practicum, the CHWs were taught how to handle persons in times of stress including the psychological effects of disasters. 

Trained community health workers present their body map, 

a part of the skill of resourcing in community resiliency model.

Community health workers do a practicum 

on community resiliency model skills.

With the trainings on psychosocial processing facilitation, the CHWs will be equipped to facilitate simple psycho-social processing for adults and children and undertake community activities on health disaster preparedness, especially on awareness -raising on the health effects of disasters and activities to build individual and collective coping strategies.

The participants were thankful for the new skills they learned which they can use to help and teach others, facilitate the resolution of simple problems, help families, as well as refer persons who may need special psychosocial counseling and treatment to psychiatrists and psychologists. 

Community health workers pose after the training on Nov. 15 - 16.

The CHWs were all members of the people’s organizations which were organized by the WRCV as an offshoot of the relief efforts immediately after the typhoon. 

Medical mission in San Remegio, Cebu

 The Visayas Primary Health Care Services held a medical mission in Barangay Tambongon, San Remegio, Cebu last September 14. 

The barangay reached by a three-hour bus ride north from Cebu City, is one of the barangays severely affected by Typhoon Yolanda in November 8, 2013. 

Tambongon Elementary School, the mission site.

The mission was supported by Lands Aid, a humanitarian aid organization based in Germany. Its Philippine project coordinator Andreas Schmitz coordinated with the VPHCS to ensure the success of the mission. Schmitz has been based in San Remegio since July this year to oversee the repair and construction of houses for about 300 families affected by the typhoon in San Remegio. Lands Aid had also sent volunteers of doctors and nurses to deliver relief and medical assistance after the typhoon in November. 

The 40-member team of doctors, nurses, dentists, community health workers and volunteers rendered medical and dental services and gave eyeglasses. 

 Patients waiting outside the consultation room.

A total of 185 adults and 143 children were attended to by 9 doctors. Dental services were provided by six dentists, members of the Cebu Dental Society. The Juanito I. King Foundation also provided its dental mobile van. A total of 136 patients had teeth extraction and oral prophylaxis. Flouride solution was also given to the children by the dentists in order to protect their teeth from caries.

Patients came from neighboring barangays of Tambongon and neighboring barangays of Kayam, Anapog, Dapdap, Tacop, Mano, and Batad. 

Dr.  Florespina Jeanjaquet  inside the dental van.

Dr. Lynwood Tabanao with a patient.

Volunteer Jafe Sepulveda conducts blood sugar test.

The medical mission came at a time when agriculture in Barangay Tambungon has not yet been completely restored, food security remains a problem and malnutrition is common that in turn makes one susceptible to contracting diseases. Hunger, poor nutrition and lack of income make them and their children very susceptible to illnesses while those who become sick cannot afford to buy their necessary medicines. Medicines and medical supplies in government health centers that have just resumed their normal operations are still lacking to meet the needs of the people. 

Patients waiting for services in the dental van

 of the Juanito I. King Foundation.

Acute upper respiratory tract infections or cough and colds were common among both adults and children, since, even 10 months now after Typhoon Yolanda, many families continue to live in temporary tents, makeshift houses or shelters vulnerable to harsh climate conditions, or share homes with other families resulting in overcrowded conditions that make them susceptible to easy transmission of diseases. .  

Hypertension seen among the adults in the mission was a serious concern since uncontrolled hypertension can lead to serious complications such as stroke, kidney problem or heart enlargement. Osteoarthritis, muscle pains and tension headache were also common among adults who were farmers that have to work hard in the farms in order to put food on their tables, thereby putting their bodies into stress and exertion. Non-ulcer dyspepsia was also common since being farmers, they have the tendency to skip their meals while working in the fields or simply because there was no food to eat at all. 

 

Volunteer nurse Paul Serad takes blood pressure.

A total of 23 children had pneumonia and 15 had skin infections. A total of 51 patients had their blood sugar tested for diabetes but only six were found to be diabetic. Reading eyeglasses were provided to 100 patients. 

The medical consultation room.

VPHCS staff dispense the medicines.

All patients were properly given medicines bought from the funds from Lands Aid. They included essential medicines such as antibiotics, analgesics, anti-pyretics, anti- hypertensives, antacids, ferrous sulfate, anti-diabetic, mucolytic, bronchodilator, multivitamins, and many others. 

The medical, dental, nursing team and volunteers.