By Julie S. Alipala
LAMITAN CITY, Basilan Province – Before the sun rises in the village of Malo-ong San Jose, Fe Alingco, a seventy year old grandmother is already up, preparing her tools for a whole day’s duty.
Fe is no ordinary granny in the community of 2,068 population, with a height of 4 feet and 4 inches, yet her aura among her villagers exudes like a towering figure, especially in matters of community health services.
She has been a household name since 1976 where she started volunteering for maternal health care. Whenever a member of the community gets sick, giving birth, processing live birth certificates, sprained joint, fever, animal bite, or bridging other health related concerns to the local government unit, Fe is always active in responding to calls.
Health kit inspection, this is how Embong Ballaho, starts her day, before she sets off for her regular duty in their health station in Maganda village, with a population of 6,692.
It has become habitual for Embong, a 67 years old hearing impaired grandmother, to ensure all the items in her small kit were cleaned, replenished and disinfected, “our responsibility is to ensure safety and health of our people.”
She used to be one of the on-call elder healers in their community, where she led a traditional way of giving birth, providing deep tissue and bone massage, offering herbal treatment. These practices were set aside when she was tapped to be part of one of the village’s health workers in 1987.
It was a challenging pursuit for Embong as she was trained by her mother in their family to keep the family’s tradition, but for the sake of the village’s wellness, she embraced a modern way of saving lives and keeping the community healthy.
Embong and Fe were part of the silent communities’ traditional health system until they were recognized in 2013, a few months after former Mayor Rosita Furigay was sworn into office. There were no actual statistics as to the number of traditional health attendants in those days, but according to Lilibeth Mata, each barangay has around two to three hilots or healers that catered to households who preferred to deliver babies or treated at home.
Both admitted it was not an easy transition, especially to Embong, who didn’t receive formal education and training on community health care. Fe graduated with a Bachelor of Science in Secretarial Administration at the Universidad De Zamboanga and used to work at the Neighborhood’s Family Planning Center.
“I was a high school graduate. I was trained by my late mother Jalilan Jaafar Macrohon to be a panday, but being a panday was dangerous and it was not recognized by the local government. I am also afraid of legal liabilities if in case a mother dies while giving birth,” Embong said, who finished her high school education at Maganda Barrio High School.
Almost 200 barangay health workers were working, committing their precious time for free, “under the heat of the sun, during the rainy season, we responded to all types of calls for help for free. If we get sick, met accident, we don’t have any insurance,” says Lilibeth Mata, 45, president of Lamitan City’s Barangay Health Workers.
Barangay Health Workers existed since 1985, “there was no allowance, no salary, just kind thank yous’ or tokens from people we helped,” Mata said. She said BHW had a taste of gratitude when Roderick Furigay was elected mayor in 2004. Finally, the barangay health workers received a monthly allowance of 500 pesos (8.9USD).
ROSE POWER
When Rosita rose to power, elected as mayor in 2013, she started empowering traditional health attendants and volunteers by recognizing their existence and organizing them in 45 barangays.
Mata said the community volunteers and the traditional health attendants were organized into one umbrella of yellow women, known as Barangay Health Workers or the Yellow Armies of Rose.
“It’s not a political group, the color intended to highlight the presence of our health attendants in the community, like sunshine or light to every household,” Mata explained.
Their monthly stipend also increased, from 500 pesos to 1,500 pesos. They were also provided with health insurance, bonuses and incentives. The group regularly meet in their respective barangays and they also meet the mayor on a monthly basis, providing regular health updates from their respective communities.
“Mayor Rose was really hands-on when it came to barangay’s health affairs. The birth of a child, a mother successfully gave birth, no one is getting ill, it made her happy and accomplished. She treats everyone as a family and as a member of a family, she ensures that everyone is healthy and no one dies due to lack of medical attention, I am one of the thousand recipients,” Fe said, who got ill and comatose in 2015. She learned that Rosita stayed with her and spent a lot to make her well.
Victoria Sanson, a 77 year old retired public school teacher and head of the Senior Citizens in Lamitan, described Rosita’s health advocacy as innate, “she was a health conscious person, a pharmacist, a foresight in making her city, one of the healthiest in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM).”
Rosita grew up in a small community of Campo Uno village. A daughter of Filipino Chinese family Enrique Uy Sr., and Lupe Sumergido. She graduated cum laude in the San Carlos University in Cebu City way back in 1985. Married Roderick Furigay, have twins, Kelsey and Hannah.
“She was not a willing mayor then, she was obliged to run as mayor due to heavy endorsement from the Cuevas, Pamaran, Antonio, Flores (CPAF) clans. It was not easy for her during those days, but she was an organized person and she started putting back honor to Lamitan City by starting from where she was good at, championing health care programs and bringing it down to the smallest communities,” Sanson said.
The organized traditional health attendants, volunteers, numbering around 200 were trained in maternal health and child care services in accordance with the Department of Health policy and they graduated as skilled birth attendants.
“I remember that birthing was usually done at the home of a mother, pandays utilized sharpened bamboo strips and hot water. It was long gone, now the birth attendants are similar to midwives, they used gloves, scissors, alcohol and other disinfectants to save both the mother and child,” Embong said.
BACKBONE OF HEALTH CARE SYSTEM
The barangay health workers in Lamitan City are considered the backbone for the health care program, says Dr. Afreen Amerin, the city health officer here. Amerin admitted that “without the barangay health workers, we cannot accomplish that much, without them, it’s like having a head without arms and legs.”
Lamitan has a population of 100,150 based on the 2020 national census, yet the city has only a government run hospital, the Lamitan District Hospital. There are three privately owned clinics and two lying in clinics. The city is undermanned when it comes to doctors. There are three doctors or a ratio and proportion of one doctor to 34,000 population. The ideal is 1 in 20,000 population based on PhilHealth policy.
Amerin said the City Health Office has around 80 personnel covering the 45 barangays, “if we look at the manpower to address the health care programs, its not enough, so the barangay health workers complemented areas where we cannot reach and they are all around people, they can be sanitary inspectors, even tanods for that matter.”
ZERO DEATHS
Since 2016, Amerin confirmed the city registered zero deaths in as far as maternal and child health care programs, “we’ll be in shock if we will register even one death.”
She said in 2015 there was a single case of maternal death but the mother was not from Lamitan. She sought medical care in one of the hospitals in Zamboanga City and returned to Lamitan where she died.
“The barangay health workers were instrumental in this success, they are empowered and we treated them as partners. There are few traditional health attendants who still perform home birthing but with the Mayor Rose Paanakan Program, they performed the delivery with the presence of health care workers and health personnel,” Amerin said.
Even during the pandemic, health workers fulfilled their respective duties 24-7, they became contact tracers, watchers and tanods, and conducted house to house visits for Lamitenos who came from abroad.
“First time kong gumamit ng PPE (personal protective equipment), sobrang init nya, pero kailangan naming gawin nung panahon ng lockdown para sa aming house to house, sa awa ng Diyos, kahit matatanda na
kami, walang nagkasakit o nagka Covid.”
Amerin said they registered a total of 951 positive cases from 2020 to August of 2022 and 39 deaths, “numbers swelled in 2021 where we have 639 cases with 29 deaths. Our BHW didn’t remiss in their duties during the pandemic. Many of them should have been in their respective homes because of their ages, but they prefer to go out and help the City Health, the local government and the IATF to ensure that no one in their respective communities will get sick.”
“Mayor Rose’s death is a big loss for all of us. We were assured by her husband that whatever programs Mayor Rose started, he will continue supporting it, especially the community health base programs,” Amerin said.
Under Rosita’s watch, the city earned several awards and recognition in local governance, and elevated the city by championing the delivery of basic social and health services to the city’s 45 barangays.
In an interview with Rosita’s husband, Mayor Roderick Furigay, “I have a big shoe to fill in. Before she vowed to leave politics, we agreed to continue and sustain the gains the city earned from her 3 years
term.