this is a sad one

hi friends... this is a sad blog but i had to write it. we're immersed in the struggles of the poor here and it is something i experience every day - the adversity of the Philippines. it should be brought to the attention of those willing to listen...

there is a struggle between two different worlds here in the Philippines: the world of have and the world of need. the root of the conflict is the apathy of those living in the world of have... or rather, the willingness to turn a blind eye and praise Cebu for "doing so well", when in fact, the majority of the Filipinos living here belong to the world of need... they need food and clean water among the most basic of needs. they need medicine and a decent hospital for when they are sick, schools, supplies and scholarships to get them successfully past high school and prepared to go onto higher eduction. they need to be held accountable. the challenge is that the C class, as one of our mothers referred to it, is disproportionately large, which means that although the need for each individual person is basic and not much to ask, when you multiply it by the millions living in starvation and disease, it is a demand overwhelming to wrap your mind around. unfortunately, the A class (and what little proportion of the population could be considered B class - there really is no middle class here), would prefer to remain oblivious to the poverty plaguing their neighbors... on such a small island, everyone is your neighbor, and living on Cabreros Street I've come to realize that the majority of my neighbors need a lot but are given little by those who have...

not to sound too pessimistic, and to avoid offending those trying to make a difference in the world of need, i should say that there are good people here doing what they can to help. Hilary and David are the epitome of what everyone from the world of have could be doing to change the lives of those in the world of need. and there are others here like them, though few and disappointingly far between... unfortunately, those wonderful "haves" trying to help cannot expect support from the authorities here or the government or organizations that should be in place purely to help those in need. They are alone in their efforts. they try to report neglect, there are no authorities to help the children, no legal system in place to prosecute the guilty. they go to the town hall here and speak about the afflictions of the poor and promises are made to send help, to make changes, but nothing happens. it is frustrating, and seems futile at times, but they don't give up. the world could use more like them. willing to make sacrafices to help the world of need...

to augment the problem there is further disparity in the Philippines, unrelated to social class, it is the inequality between men and women - not a new struggle by any means, but fortunately becoming obsolete in much of the world; sadly, not here. in this primarily matriarchal society (the women work, and tend to the house, and care for the children), the man always has the last say on decisions to be made. whether this pertains to family planning, or him quitting his job, or how the woman's income should be spent, or if he has other women - it is his word that is the law and the women are obedient. This is the tragedy of the Philippines... the women work hard, they can support themselves and their families, they are reliable and do their jobs well, they usually have an education comparable to that of the men, however, they will not stand up against the rules laid down by the men in their lives. even if the husband is out of the country or has other wives or does nothing to support the family, still the women will listen when they are told what to do... it is frustrating. (it is interesting too... in fact it is a little refreshing, if i didn't understand the implications, to see that when the bill comes at the end of a restaurant meal the waiter brings it to the woman, that is the culture here, no assumptions that the man is the bread-winner).

the stories I hear and what i learn of the culture convinces me more and more that the solution to so many of the problems in the Philippines is to empower the women. this is not a new idea.... educate them, teach them skills, give them jobs: empowered women can drop the fertility rate (substantially reducing problems of overpopulation), they can reduce the infant mortality rate (which subsequently leads to fewer births and smaller families), they will slow the spread of disease, boost the economy, raise healthier children who grow to be a stronger working class of people... empower women and you can change a country. the problem in the Philippines is that the basic steps have been taken to empower the women here: they are educated, they do have jobs, and still they are submissive to the orders of the men. there needs to be a shift in the social hierarchy to put women on a level field where they have the authority, the confidence, the power to have a say... it could mean big changes for the Philippines, particularly for those living here in the world of need.

I'm sitting in the ultrasound room, which doubles as the office here, and we were just doing an ultrasound because the fundal height of the patient who came into the clinic today was alarmingly small for her estimated due date. The ultrasound showed us a head and femur of a full term baby, however the abdomen and arms of the fetus are very out of proportion and much smaller than what would be expected. we anticipate that the placenta has maybe detached some from the wall of the uterus, maybe because her husband smokes (terrible!) and apparently she didn't comply for a diabetic screen early in the pregnancy. the cost for this screening is P300 (about 6 US dollars), and she couldn't afford it. now her baby will most likely not make it. she has few options, but those that might save the baby she can most likely not afford. tragic.

the ultrasound before that the woman has had 3 miscarriages and a still birth. more tragedy. she labored for three days with the still birth, it's no wonder the baby didn't make it - what stress!! we make up excuses for her to explain why her pregnancies have been so unsuccessful: she didn't know better? maybe. she didn't have money for proper prenatal care and delivery? most likely. She is now on her 5th pregnancy and we're hoping this one will make it... with the proper prenatal care and a delivery assisted by certified nurses and midwives she might have a chance. then again, what kind of a world is this baby really being brought into? a world of need...

you want to talk about tragic? about loss? how about some statistics to show you how far behind the Philippines really is. to reinforce what I've been saying about the struggles here... to demonstrate the magnitude of need in this world of need... here you go! according to information conveyed to us through Hilary: the infant mortality rate here: 35/1000 live births. compare that to the US, about 6/1000... wow. The Philippines has the highest Maternal Mortality Rate of this area of the globe, I believe it. About 11 mothers/day die due to complications. There is a saying here in Cebuano "when you get pregnant, you have one foot in the grave". women here are 300 times more likely to die during childbirth as a result of complications than women in developed countries (many are age 15 to 19... children still by our standards). 28.5% is the probability of dying under the age of 5 years old... check out the world factbook or any other reliable site with information about country demographics. check out the country I'm currently living in. it's impressive in the most terrible way.