Japanese Red Cross medical team addresses the fragility brought by poverty

Helping to transfer a critical ill patient (blue t-shirt) to a district hospital.

Helping to transfer a critical ill patient (blue t-shirt) to a district hospital.

A country’s or community’s health services are under the most stress when they are most urgently needed.

Such was the situation when Typhoon Haiyan swept across the Philippines in November causing a vast swath of death and destruction, and members of the Japanese Red Cross Emergency Response Unit joined by team members from Australian Red Cross, French Red Cross and Hong Kong Red Cross were deployed to help survivors.

The dilemma was highlighted in Maya Barangay, Daanbantayan District, located in Northern Cebu. The violent winds virtually flattened the village—90% of houses were destroyed. No one was killed and Maya is beginning the long job of reconstruction. But the region’s high poverty rate and its fragile medical infrastructure pose a challenge to what the ERU can contribute to the community.

One morning a 25-year-old woman was brought into the clinic by her young cousin, six days after giving birth to her fourth child. Her legs, ankles, hands and waist were swollen. She had a high fever and difficulty in breathing.

French Red Cross doctor Aleth Abidine examines local patients at a mobile clinic. Dozens of patients visited the clinic in a two-hour period.

French Red Cross doctor Aleth Abidine examines local patients at a mobile clinic. Dozens of patients visited the clinic in a two-hour period.

Aleth Abidine, a French Red Cross doctor said her life was in danger because she was suffering from a post-partum infection, hypertension and low blood oxygen.

However, she refused to go to a district hospital. Even though there is a system to reimburse medical expenses for the poor, the transportation fee of 60 Philippine Pesos (1 US dollar) was too expensive and no one could take care of her baby while she was away.

Team members had almost given up trying to persuade her when her husband, who did not show up at the clinic, finally agreed to send her to a hospital. Eventually, members of the Japanese ERU team gave her a ride to the hospital, but acknowledging that she could have died but for this unusual intervention, they reaffirmed the necessity of an educational programme to decrease the cases of preventable diseases.

Dr. Kevin Hung from Hong Kong Red Cross, discussing health problems with a local midwife.

Dr. Kevin Hung from Hong Kong Red Cross, discussing health problems with a local midwife.

The Japanese team implemented a community health program in conjunction with a mobile clinic, working closely with local midwives and barangay (commune) health workers to enhance their training and knowledge and provide necessary information.

Hypertension, early and young delivery of babies and unhealthy diets are among the most common problems in Daanbanyatan District, which has 20 barangays, and midwives are on the frontlines of the health system.

Each barangay has a midwife who is available for consultations free of charge and provide guidance on family planning, immunization, health check-ups and appropriate medical care.

Says Dr. Kevin Hung of the Hong Kong Red Cross, in charge of the community based health program: “Each barangay has a different problem so thorough assessment is indispensable. I don't want to create a situation where (midwives and patients) come to rely too heavily on external support” so the visiting medical staff has to be careful in what kind of help it provides.

Three days later, doctor Aleth and Philippine Red Cross volunteer Wilinda headed to the hospital to see the referred patient and were confronted with new problems.

No hospital beds were available. She was sitting on a wooden bench receiving an intravenous drip but there were no pillows or sheets. One doctor was on duty and 3-4 nurses manned the registration desk. In the Philippines the ratio of nurses to patients is one in sixty.

The patient had suffered a stroke overnight and had a high fever and numbness in her left side and face.

The hospital doctor had suggested she transfer to another, larger hospital in Cebu city, but though the ambulance service was free, the patient was concerned with further hospital expenses and refused to go or take her medicine.

The hospital doctor eventually assured the Red Cross officials the patient could stay until at least her blood pressure was stabilized and she might be included in a charity program which would cover hospital medical expenses.

Dr. Satoko Otsu, team leader of JRCS ERU says: “we are here for only a few months. We cannot leave them a hospital with doctors or nurses. That is why we put emphasis on the community health programme, and our assistance can be shared by the local communities.”