Mercy in Action – Philippines
Mercy in Action provides free, comprehensive woman and newborn care to people living in extreme poverty. These include the Aeta people, who are an internally displaced tribal group, and those living on the local garbage dump, who survive off of scavenged recycling materials. Care is directed by United States and Filipino licensed midwives, and guided by WHO International Mother Baby Childbirth Initiative guidelines.
MMBH has a strong educational emphasis and highly values the sharing of knowledge and skills. Students are always under supervision, receive hands-on experience, and often are welcomed into people’s homes. MMBH offers an ongoing clinical internship program that attracts midwifery and medical students from the USA and Europe. It also provides an internship for Filipino midwifery students.
Location & Community
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.
Volunteers fly into the international airport in Manila. They will be picked up at the airport by a hotel shuttle and will stay the first night in Manila. MMBH staff will meet the volunteer at their hotel the next day and accompany them on the 3-4 hour by bus ride to the birthing home.
For current information, please visit the embassy website appropriate for one’s home country. United States citizens can receive a Tourist visa at the airport valid for 21-days. After 21-days they can renew the Tourist visa at immigration for a small fee to extend their visa to 59 days. Visit the Philippines Embassy in Washington, DC for complete details.
Traveler’s Health & Safety
Philippines require no special health precautions. There exist pockets of malaria and some dengue fever. Vaccinations against hepatitis A and B and tetanus should be up to date. Insect repellant is a useful. One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information.
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.
Medical Care Services
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.
Public Health Initiatives
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.
Healthcare Profession Staff
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.
For Medicine: Mercy In Action sponsored birth centers provides free comprehensive maternity care to people living in poverty in the Philippines, and act as a training site for healthcare students. Care is directed by Philippine licensed midwives in licensed and accredited freestanding birth facilities, and clinical care follows the FIGO and ICM approved “International Childbirth Initiative (ICI) 12 Steps to Safe and Respectful MotherBaby-Family Care.” The midwife-led maternity care provided implements evidence-based care and acknowledges the interaction between the family, the environment, and their interactions with health systems. Mercy In Action supported sites have a strong educational emphasis and highly value the sharing of knowledge and skills between health care providers, patients, and trainees. Students are always under supervision while receiving hands-on experience. In addition to the inpatient facility, students may participate in our First 1,000 Days program, going into patients’ homes to monitor the growth and wellbeing of the babies we deliver until their second birthday.
For Public Health: Mercy In Action sponsored birth centers offer clinical training sites that emphasize preventive care and health promotion throughout their many services. The midwife-led maternity care provided implements evidence-based care and acknowledges the interaction between the family, the environment, and their interactions with health systems. Students will participate in our First 1,000 Days program, going into patients’ homes to monitor the growth and wellbeing of the babies we deliver until their second birthday. Community-wide resiliency is developed not only through quality patient care, but also through equipping and training of local community health visitors, and through the cultivation of highly nutritious Moringa plant leaves and other foods. Public health students are invited to participate in the full range of health promotion activities associated with Mercy In Action sponsored sites, including prenatal education, breastfeeding support, vaccination information, and child nutrition. In doing so they will also become more familiar with the common issues surrounding the promotion of health in this particular cultural context, including language barriers, limited resources, and varying acceptability of health interventions.
Previous INMED Learners who served at this training site include these Graduates.
Student Lodging & Meals
Dormitory housing is provided to students and is complete with running water, washer and dryer, and individual bunk beds. Visitors generally buy their own food and prepare it themselves. Markets are located close by and a kitchen is provided. A cook can be hired as requires.
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.
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 personnel to become involved in this important aspect of international healthcare.
Student will enjoy at least one free day each week. Resorts are close by with restaurants, ocean beaches, and swimming pools. Many prefer to swim seaside with the dolphins or to visit wildlife at the zoo, including a chance to feed the tigers. There are also plenty of hiking opportunities in the surrounding mountains and jungles.
Behavior & Dress
Protecting the excellent reputation of MMBH is the paramount principle. Dress should be modest, with tops not too low cut nor shorts too highly cut. The area is tropic, humid and hot. Shorts and T-shirts are acceptable in most settings. Scrub tops are appropriate for clinical duties and designated slip-on-shoes are worn in the delivery rooms.
What To Pack
Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. A carry-on bag should be packed that contains essentials items just in case one’s luggage becomes lost. Bring clothes appropriate for the weather. Pack very lightly – just a few changes of shorts and t-shirts. While one can buy almost anything locally, contact solution and prescription drugs should be brought from home. Do not bring any appliances that require high electricity demand, such as a hair dryer, or 110v. The local electrical current is 220v.