Mercy in Action (formerly Mercy Midwives Birthing Home) is located in Olongapo City on Subic Bay on the island of Luzon, a two-hour drive northwest of the capital city of Manila. Subic Bay, which once was the site of a US Naval base, is a city built on mountains that lead up to the edge of the bay. The Birthing Home is located on the perimeter of the city in a region with little infrastructure.

December and January are the coolest time of year. The hottest time of year is between March and April accompanied by high humidity. The rainy season is June through October, which coincides with monsoon and flood season.

Become familiar with Philippines’ culture, history and economy by reviewing the Wikipedia Philippines Profile. Rich resources for Philippines health information include the Institute for Health Metrics and Evaluation IHME Philippines Country Profile and the World Health Organization Global Health Observatory Philippines Data.

MMBH is strategically located in between two pockets of extreme poverty – the Aeta, who are an internally displaced tribal group, and those living on the local garbage dump, who survive off of scavenged recycling materials. Although Filipino people are generally kind, humble, and hospitable within their own society, both of these groups are often despised by other Filipino’s and considered second-class citizens.

The Aeta have been internally displaced due to the volcanic eruption of Mount Pinatubo that destroyed their native homeland. Life in the resettlement camps can be harried by crime and corruption, but generally the people survive by cultivating small gardens and carving a few bamboo native crafts to sell. These people are not accustomed to coming for modern maternal care, and their trust is won through actions of kindness on the part of MMBH personnel like visits to their homes.

English is a national language of The Philippines, along with Tagalog. English-speaking Volunteers will have no problem communicating in public. However, English is not widely spoken amongst the poor if they did not receive a primary education.

MMBH provides free, comprehensive woman and newborn care. Natural family planning is the mainstay of contraception and is appropriate to the local religions. Prenatal care includes monitoring the health and growth of the mother and fetus, prenatal education sessions, testing for HIV and other sexually transmitted diseases, vaccination against tetanus, deworming medication especially against hookworm, and vitamin supplementation.

For women in labor, MMBH provides care by licensed midwives that includes labor and fetal monitoring, delivery, and contingencies against common complications such as postpartum hemorrhage. Labor augmentation is seldom utilized, but administration of IV fluids, IV medications, anti-hemorrhagic medications, and non-inflatable-anti-shock garments are available when indicated. Vacuum assisted delivery is practiced when indicated. Labor management is per the WHO International Mother Baby Childbirth Initiative guidelines. MMBH provides care for 20-25 deliveries per month, with a complication rate 75 percent lower than the national average.

In the postnatal period breastfeeding is emphasized, and women are encouraged to take advantage of postpartum visits, either at MMBH or via home visits by midwives. Newborns receive vaccinations at the health center and are followed for weight, growth, and development. Sick children are also provided care, most frequently for wounds, pneumonia, urinary tract infections, malnutrition, diarrheal disease and tuberculosis.

MMBH is a ministry of the Vineyard Manila community of faith since 1993. Their experience includes the launching of seven other birthing centers in the Philippines that have since been transferred to other leaders.

MMBH emphasizes preventive care and health promotion throughout its services. For non-pregnant women contraception, nutrition, and general education are emphasized. For infant and children vaccination, well child check ups and nutritional needs are addressed routinely. Community-wide resiliency is developed not only through quality patient care, but also through equipping and training of local providers, and through cultivation of highly nutritious Moringa plant leaves.

Public health students as well as those in primary care and nursing are invited to participate in the full range of health promotion activities associated with MMBH. In doing so they will also become more familiar with the common issues surrounding promotion of health in this particular culture context, including language barriers, limited resources, and varying acceptability of health interventions.

Clinical leaders of MMBH include:

• Vicki Penwell, LM,CPM, licensed in midwifery in the state of New Mexico, USA, and a Certified Professional Midwife by the North American Registry of Midwives. She holds a Masters of Science Degree in Midwifery from the New Mexico based National College of Midwifery, and a Masters of Arts Degree in Intercultural Studies from a seminary in the Philippines.
• Cecille Manioas, LM, a licensed Midwife in the Philippines since 1991, a faculty member of the National College of Midwifery, and an approved preceptor for student midwives at the Associate level.
• Imelda Catama, LM, a licensed Midwife in the Philippines since 1979 and a faculty member of the National College of Midwifery, and an approved preceptor for student midwives at the Associate level.

INMED invites all participants to consider raising extra funds to financially support this facility. While such efforts are not required, they provide opportunity for INMED learners to become involved in this important aspect of international healthcare.

MMBH has Wi-fi on site and Internet cafes are in proximity. Students should bring their own portable computers. Electricity is intermittent and usually goes out for a few hours each week. Phone SIM cards are readily available and cell phones can be purchased at low cost.