GUIUAN, Philippines – In the crowded tent, the women shyly covered their mouths and began to giggle. The facilitator was holding up a sanitary napkin and talking about the need for hygiene and changing their napkin and underwear regularly.

In another part of the tent, two other groups of women listened to two separate facilitators talk about the symptoms of sexually transmitted infections (STIs) and the importance of breastfeeding.

Outside, babies wailed as their mothers put them on a weighing scale to be weighed and checked by a doctor.

This is a typical scene in a reproductive health (RH) health mission. In times of disaster or conflict, these health missions are carried out by the United Nations Population Fund (UNFPA) in cooperation with the local health department and with the help of barangay health workers (BHW). Pregnant women get prenatal exams, lactating mothers get advice on continuing breastfeeding, young women and girls get advice on hygiene and personal care and knowledge about STIs, and babies can get a check up with the doctor.

Disrupted healthcare

An estimated 432 health facilities were damaged by Typhoon Yolanda (Haiyan) when it hit central Philippines on November 8, 2013. Majority of those damaged, around 296, were barangay health facilities where these women would have otherwise gone to get these services. The Department of Health (DOH) estimates that P1.7 billion pesos is needed to repair the damaged health facilities.

The UNFPA estimates that there are some 200,000 pregnant women who will need maternal and newborn healthcare services post Yolanda. (Read: Why pregnant women need urgent care and attention after a storm)

“With the destruction of health facilities, these RH missions help minimize the effect of disruption of health care services that are crucial to pregnant women and to newborns,” said Arlene Alano, UNFPA Communications Officer.

It also provides much needed information and awareness on other issues that are a consequence of displacement.

The aftermath of a natural disaster like Yolanda extends beyond destroyed homes, flattened lands and fallen trees. Toppled trees cut off electricity and literally put people in darkness, crumbled homes forced survivors to seek shelter in cramped evacuation centers and live in even tighter spaces in tents. Loss of livelihood and cessation of school leave many with idle time. Limited access to clean water and latrine facilities pose hygiene challenges.

In this setting, young women and girls become more vulnerable to sexual abuse and untimed pregnancies and STIs. Discussions conducted in tents by a trained health facilitator provide awareness and information about these issues.

Similar RH missions are done by organizations like the Family Planning Organization of the Philippines (FPOP) who focus on providing RH services in emergency situations.

Tracking the pregnant

As with many RH missions, the women come in droves. Some came from the previous RH mission in another barangay and lined up again to be seen by the doctor.

“Naubusan kami ng listahan kahapon,” said one woman, waiting for her turn while carrying her baby. (We ran out of lists yesterday.)

A barangay health worker (BHW) through pure sweat equity and footwork does the rounds of evacuation centers and homes to check for the pregnant and lactating mothers to inform them about the date, time and location of the RH mission. They keep a list of the pregnant and lactating women and prepare dignity kits which are filled with necessities like underwear, sanitary napkins and a malong which she may use for covering when breastfeeding or dressing.

“Sometimes it is only during these times that they get this kind of medical care and attention and the women take full advantage of the opportunity,” said Alano. Even before Yolanda, barangay and rural health clinics, the nearest and most accessible to residents, are faced with the challenge of limited supplies and manpower.

“Often, even with the BHW doing the rounds, we run out of kits with the deluge of people coming in from other barangays,” added Alano.

Men welcome

In the midst of this structured chaos and activity, two men stood out conspicuously even though they were standing quietly in the background. Men are most certainly welcome, but usually an uncommon sight at these RH missions because they are out most of the day working.

The two men seemed to be fidgeting in the otherwise female surroundings, but upon closer look, they were actually cradling their newborns.

JR Salbede, 24, was working as a security guard in Tacloban. Since he lost his job, he and his wife went back to their relatives in Samar. He now has more time to take care of his wife and 1-month old baby. “Sinasamahan ko si misis, ayun sya sa harap,” said Salbede. (I’m accompanying my wife. She’s over there sitting in front.)

Arnel Yodico, 27, is a fisherman. Since Yolanda struck, he has not been able to fish regularly and is taking on odd jobs that become available.

“Baka mapagod misis ko sa kakabuhat kaya nan dito ako,” he said, shyly holding his 11-day old infant close. (My wife might get tired of carrying the baby, that’s why I’m here.)

In the tent felt to the rafters with women, these men were right at home. – Rappler.com