Building a future for community-based health care once the crisis has passed

Published: 9 January 2014 14:27 CET

By Asuka Suzuki, Japanese Red Cross Society

A 25-year-old woman, whose legs, ankles, hands and waist are swollen, is brought into the Japanese Red Cross Society Emergency Response Unit clinic in Cebu by her young cousin. Just six days ago, she gave birth to her fourth child. She’s feverish and has breathing difficulties and Aleth Abidine, a French Red Cross doctor says her life could be in danger if she isn’t taken to the district hospital for treatment. Finally, despite the expense, her husband is persuaded to let her go.

The case is just one of those handled by the ERU deployed in Maya Barangay, Daanbantayan District, Northern Cebu, which was hit by Typhoon Haiyan. 90 per cent of homes in this area were destroyed. The Japanese team, joined by colleagues from Australian Red Cross, French Red Cross and Hong Kong Red Cross, has been providing medical services since November 20, 2013.

Given the fact that no one was killed by Typhoon Haiyan within in a village, Maya is seemingly heading towards reconstruction. However, from the patients visiting the ERU clinic, it’s clear the root problem, common among developing countries with high poverty rates, poses a challenge to what the ERU can contribute to the community. Health services face the most stress during times of crisis.

The pregnant woman, despite suffering from a post-partum infection, hypertension and low blood oxygen, initially resisted going to hospital due to financial and family reasons. Even though the Philippines does have a system to reimburse medical expenses for the poor, she was concerned about the transportation fees from Maya to the hospital which is 60 Philippine Peso (USD 1) one way and said that there was no one who could take care of her child.

Team members had almost given up trying to persuade her when her husband finally agreed to send her to a hospital.

It was a moment for the ERU team members to reflect deeply on just what the team can do to provide support to local people. “If she had gone home, she would not have been able to survive the night,” one team member said quietly.

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

She was sitting on the wooden bench, not on a bed, at the end of corridor receiving an intravenous drip. No pillows, no sheets. The hospital does not have extra beds to accommodate all the patients, and some patients were sitting on benches.

According to the hospital nurse, the 25-year-old woman had suffered a stroke overnight. She had numbness in her left side of her body including her face, and had a high fever. Her condition was getting worse.

The doctor also raised the issue that she does not want to take medicines, but the doctor promised Aleth and Wilinda to let her stay at least until her blood pressure stabilizes and try to change her status to the charity programme so that she no longer needs to worry about the medical expenses at his hospital.

Dr. Satoko Otsu, team leader of Japanese Red Cross Society ERU said: “We leave here in a few months. We cannot leave behind a hospital with doctors or nurses. That’s why we put emphasis on the community health programme, and that is the how ERU activities can be handed over to community people.”

To enable that to happen, the ERU team is working closely with local midwives and health workers and trying to pass on as much information and training as possible during their time here – to leave something sustainable behind once it is time for them to leave.