A Great Day in Ormoc

A late morning boarding on to the SuperCat started our day destined for Ormoc. It was a bit of a rough ride and the winds were against us, but we arrived safely and into the open arms of our rotary hosts of RC Ormoc. We had a great lunch with our new friends before our vocational visit to the OSPA Farmer's Medical Institute.

Upon arrival we met Dr. Sandra Angelica Fiel-Chiong, the medical director of the hospital. She gave us some basic insight on the private facility. OSPA (Ormoc Sugar Planters Association) Farmer's Medical Institute was established in 1971 for the benefit of the sugarcane laborers. The facility has 125 patient beds currently but started with just 25 when they opened. OSPA is considered to have complete facilities for the area and cares for patients referred from physicians up to 3 hours away. As seen before in Ramiro Hospital in Bohol, wards were plentiful in the hospital and were broken down into female, male, pediatric, charity wards, and wards for sugar cane planter dependents. The charity wards are reserved for indigent patients.  Planters and planter dependants receive a discount of 50% off accommodations and 25% off of their medications.

The GSE team with Dr. Fiel-Chiong, Lyra Dela Cerna (Administrative Officer -both on the right), and nursing staff (background) of OSPAFMC)

The hospital faces similar problems as what we have seen elsewhere, with a shortage of physicians due to them moving away for better money. Additionally, the majority of the population is indigent and cannot afford insurance, medicines or treatments. Though they do have some older equipment still in use, they seem to have a larger amount of new technology, including a 2009 GE Lightspeed 8 slice CT scanner.




Stacey with the Radiology Department


The hospital is equipped with wi-fi for the patients also. The part that we loved to see was the Philippine style of decor, including open spaces, bright paintings, and murals painted on the walls in the pediatric areas (done completely by staff volunteers).

Mural in the Charity Pediatrics Ward

The OSPA Farmer's Medical Institute is a very nice hospital overall. It appears to have a good system worked out for its community members, including a shuttle bus for those that need transportation into the city, and has very accommodating spacious rooms, with some even having a balcony that has a beautiful and therapeutic view of the sunset over the water. It was a great visit with some very friendly people.



The team with RC Ormoc
l to right:  Dennis Deveyre,  Lyra P. Dela Cerna, Anna Bumagat, John, Nicole, Stacey, Dr. Sandra F. Chiong, Rina Rodriguez; in front: Dr. Jerry Chiong, DGE Peter Rodriguez.




After our hospital visit we situated ourselves with our host families before attending our joint dinner meeting with RC Ormoc and RC Ormoc Bay. The dinner was great and of course included a delicious lechon and irresistible fresh pineapple from their local plantations for dessert. The food was great but the people and entertainment were better. The clubs had such high energy and were so friendly and it showed in all of the projects they did and are working on now to help the province. Unfortunately the night had to come to an end, but it sounds like another great day of Ormoc ahead.
-Stacey



The members of the Rotary Club of Ormoc and Rotary Club of Ormoc Bay gathered to honor the GSE visitors





RC Ormoc poses with the team after giving us beautiful bamboo trays




RC Ormoc bay presenting the team with iComplete Ormoc shirts



Mental Health Care in the Philippines

This is Nicole blogging today.  This morning’s visits were clearly all designed with me in mind as they focused on the mental health systems of Cebu in particular and the mental health resources available to Filipinos in general.


Led by Marybeth Chan, the president, and members of the Rotary Club of Cebu Gloria Maris, the first stop was the Vicente Sotto Memorial Medical Center for Behavioral Sciences, an inpatient and outpatient mental health facility that serves mainly indigent individuals in both areas.  The facility was in a gated compound in a central part of Cebu and included two one-story buildings. A number of people sat on benches apparently waiting for resources.  Many of them seemed uncomfortable about making eye contact and we tried to respect their privacy. We toured the main building, viewing the testing area, the counseling rooms, and administrative area. The facility was very well maintained and orderly. 

Dr. Ann Clara P. Alvez, DODT met with us and toured us around. In the outpatient offices they mainly conduct evaluations of children (primarily learning, developmental, and behavior concerns) and adults (people going to work abroad, or seeking positions in government or private companies that require assessments). Most often presenting concerns for teens are behavioral (in trouble with the law, involved in gangs) and most children are referred for behavioral concerns in school, like ADHD and disruptive behaviors. Most of the work they do is assessment and recommendation, though some therapy services are offered. In our discussion, we learn that the Center for Behavioral Sciences was named this in an effort to avoid the stigma associated with seeking psych or mental health services. John had a long conversation with Lemuel F. Sagaral, one of the staff counselors. He confirmed the difficulty of creating the safety that allows Filipinos to reach for the honesty that effective therapy requires. The level of shame attached to common issues (e.g., addictions, domestic violence) complicates the therapeutic relationship.

Nicole with Ann Clara P. Alvez

Next we toured the inpatient hospital that is part of the center (no photos were allowed for this part of the visit).  It first opened in 1965 in a building initially used as a hospital for people quarantined for tuberculosis and was then abandoned for a decade or more before it was repurposed. The staff has tried to make the facility work, but it is clearly not ideal. Patients are first held for 3 days in observation in a front area. After three days, if they are better, they are released, if not, they are admitted to the unit. the hospital currently houses 138 patients (have the capacity for 91 men and 55 women) on two stories: the first level is for the men; the second for the women. When we arrived, the men were outside in a large outdoor area about the size of a football field.  In one corner some men were playing basketball.  In another, the staff were working with a small group of patients. Most of the men were either sitting, lying on the ground, or walking around.  A number of patients expressed curiosity and approached John. All of them were friendly and a few could track a conversation.  Introductions were made. They were impressed we came to visit them from the U.S.

In the living quarters, there are multiple beds to a ward (the one we saw had 12 beds consisting of metal grate supports and pads that are removed daily for safety). There are also isolation rooms for patients in need of being separated from the population.  Theses consist of a square cell with a grated door that locks and when needed, patients are placed in there without clothing so they are not able to hurt themselves with anything. The walls of all the units are bare except for the marker and pen graffiti that is everywhere. Student nurses are in charge of developing and providing daily OT, Recreational Therapy and Music Therapy (they were singing in the yard to the patients today), and group therapy.

We then visited the women on the second level. When we arrived there was a recreational group in process. About 50 women were seated on benches and staff in starched white uniforms were performing skits, holding up signs with words to describe the actions and concepts they were acting out. Almost all the staff was female. The conditions of women seemed more orderly and socialized than it was for the men.
We learn that mental health services (assessment, therapy and medication) are NOT covered by insurance in the Philippines, so individuals either need to have the means to pay out of pocket or be declared indigent by the Department of Social Welfare and Development. There are also private facilities (this was government run) but we were not granted access to these. 


Before leaving, the GSE team had a supply of candy and treats that we were pleased to donate to the hospital for the patients. We wished we could do more.

Ann Clara P. Alvez, Mental Psychology Section, Center for Behavioral  Sciences, briefs the GSE team on the work of the Vicente Sotto facility. Bernie Lumapas, member RCCGM stands to the left of Ann Clara.

We next went to Intelliprime, Educational Consultancy and Human Development Center, a clinic established two years ago and the first in Cebu city that mainly does assessments for children and adults; most clients are teens or adults who are referred for job related testing (e.g. teachers). We met with Dr. Russell Velasquez-Makilling, PhD, a licensed guidance counselor and clinical psychologist (psychologists are not yet licensed in the Philippines) to discuss mental health care and the state of psychology in the Philippines. She reported the main concerns that children present with to her are ADHD, Autism, and other developmental concerns. We discussed the stigma related to mental health care, the lack of insurance coverage that keeps children and adults from receiving the care they need (including ADHD medications), and the cultural issues related to emotional and behavioral expressions of distress. We also learned that as there has been in increase in Call Center work here, there has been an increase of problems related to stress and working conditions for these workers, which has required more services to assist them. Currently, there are very few clinical psychologists in the Philippines, and Russell is the only one in Cebu. There is a movement to professionalize psychology and require licensure, but that is still only a movement. My teammates were quite gracious in allowing me the time to sit and talk with Dr. Velasquez-Makilling, who was likewise gracious in giving of her professional time. Overall, I was very appreciative of the whole morning as I learned so much.


Nicole with Dr. Russell Velasquez-Makilling



Marybeth Chan, president, RCCGM, with Bernie Lumapas, member RCCGM

Following our morning vocational visits, the ladies of RCCGM took Stacey and Nicole to the local shopping area for a wonderful lunch of fellowship, while John met with a PDG and journalist for a lunch time discussion.  After lunch, the ladies gave Stacey and I some time at the Ayala mall while we waited for John.  This was a cultural experience in itself.  Although on the surface it seems like an American mall (albeit a very big one, and somewhat high end) when you go in and shop around, you see the difference.  First, there are the security guards at every entrance to the mall and to each store.  They look in your bag briefly, and it is unclear what, if anything, they are looking for or even if they are paying attention.  In fact, when Grace and I pulled into the parking garage the previous night, there was a security guard that opened up the rear doors to Grace’s car to look in.  Again, for what?  Grace responded that they (the guards) likely don't even know what they are looking for but have been told to look anyway.  I don’t think this would be tolerated in the US.  The other thing that was notable, was that the sales staff in the malls are intensely pushy and not unlike the women that were swarming us selling their wares on the beach in Bohol. They keep asking, and more come, and they hold things up and shove them at you.  When we finally did make a purchase and are ready to leave, the sales staff took our bags, asked us where we are going next and escort us out. Apparently, shoplifting is a big concern and they appear to take security seriously as we were led not just to the store entrance, but to our next destination in the mall.  Who knew that a short shopping trip would be a cultural journey?


Our evening was filled with fellowship at a birthday dinner for John's home stay host, Joe Soberano, and attended by all of us (plus others). There was much food and singing (by us included), and a good time was had by all.

All Around Cebu

Today's site visits were hosted by members of RC Cebu Gloria Maris (an all female club). To start, we visited the LAW (Legal Alternatives for Women) Center. This non-stock, non-profit, non-government organization started as a group of 5 women in 1996, but now has twenty-three members that work to help empower women against discrimination, harassment, abuse and exploitation in the home and workplace. The group aids in raising the level of awareness of urban and rural women of their rights, such as being able to go to work, school or even socialize outside the home. The center provides free legal and psychosocial services for the women, including individual and group counseling.  In some cases the man its also asked to attend counseling sessions through the center. LAW assists women with obtaining Barangay Protection Orders (like our PFOs) that are good for 15 days, and Permanent Protection Orders (PPOs).  Though these often don't seem to work in the US, they are taken very seriously by men in the Philippines because jail is so feared. In many cases the women lack skills to make a living, so the LAW members teach them trades such as sewing, cooking or basketry. They are then able to sell their goods with the help of LAW to earn money. The LAW Center also has the StepUP program in which people (especially young women) are trained to help eliminate human trafficking, and cyber exploitation. So far they have had 200 graduates from the program, 54 of them just recently.

L to r. Tita A. Caballes, member Rotary Club of Cebu Gloria Maris (RCCGM), Dolores Alino, Executive Director, Legal Alternatives for Women, Inc, Marybeth Chan, president RCCGM, Stacey, John, Nicole, Lilu Alino, PR Chair District 3860 and past president RCCGM,  and Fe Cabatingen, consultant to Legal Alternatives for Women.

Filemon Yongco is the husband of Attorney Arbet Sta. Ana Yongco, who was assassinated in 2004 for her advocacy for women's rights. Filemon has offered the house where she was murdered for use as the offices for Law, Inc. to further the work that she championed and for which she gave her life.  He presented John with a copy of a book about the murder and the failure (thus far) of the Philippines justice system to bring the offenders to justice.

Next was a stop at the Sun Star newspaper building. The Sun Star is one of 6 local papers and 1 of the 3 that are English-language; the others are in Cebuano. The Sun was started in 1982 and currently has a staff of 24 reporters and 16 editors.  Journalism is a dangerous profession in the Philippines and we learn that physical attacks on journalists are the second highest in the Philippines, mainly in the Mindanao region. Luckily for Cebu reporters, most common attacks they face are verbal or written complaints. The visit was quite informative. We are able to meet with Isolde Amante, editor-in-chief, and the Sun Star president, Gina Garcia-Atienza. Both women graciously gave of their time and were able to provide us with much information regarding their paper and also Philippine newspapers in general. We greatly enjoyed our visit.

With Isolde D. Amante, editor-in-​chief, Sun Star Cebu newspaper, the largest circulatio​n English Language daily in Cebu.

Team leader pinning Rotary theme pin (Reach Within to Embrace Humanity) on Gina Garcia-Ati​enza, president of Sun-Star Management​, the publisher of the Sun Star Cebu and other newspapers​.

Lunch Time! We ate at a native restaurant where rice was served from barrels onto our banana leaf covered trays --- yes trays not plates. We ate a variety of foods including sweet sour soup, chicken wrapped in banana leaves, and tuna belly -- all were delicious. From there was a trip across the hall of the mall to a small chocolate cafe where we had the most decadent sweet treats.

After some fellowship with the ladies of Gloria Maris, we headed off to the Barangay Calamba Nursery School. This school is one of RC Cebu Gloria Maris' project sites. They helped in building this daycare and also help to monitor and better the childrens' health. They have physicians come in and provide yearly screenings of their general health, dental and vision checks, and have also had circumcision dates scheduled. While the children are getting screenings, the parents are attending seminars to learn how to best take care of their children's health. When we arrived the kids were all sitting in their seats and greeted us with the most loving, "Good afternoon visitors!" A few even got up to show their sign of respect and placed the backs of our hands to their forehead. The kids all sang songs with their teacher including the hand movements that go along with them, one of which demonstrated their left and right hands. We gave out some stickers that promoted healthy eating of vegetables and they all loved them.

We next visited another RC Cebu Gloria Maris project site, the Labangon Bliss Elementary School. Upon our arrival, the principal announced overhead to the students that they had visitors from the United States and everyone started yelling in joy. We spent a few minutes talking with principal, Norman Gabales, M. Ed. then moved on to see the biggest part of the clubs project, the feeding program, which we were able to help with on this day. Students in first and second grades are weighed at the beginning of each school year. Those that are considered to be malnourished are admitted into a feeding program where they are to meet at the end of school to have a porridge called Lugaw prepared for them to help aid in their nutrition. This porridge consists of rice, squash, a meat, and a green called malunggay. The kids are then reevaluated at the end of the year. In most cases their body weight increases about 20%, quite a success for the RC.

 We were only there a few minutes before the school day had ended and the kids were running about. Some parents were there to pick up there kids but others were doing everything they could to get our attention. They loved to pose for the camera and overall loved the attention. They seemed like a great group of children.

Before we left the school though we were given some porridge for us to try, to get the full affect of what we were feeding the children. It wasn't just healthy but tasted good too! Unfortunately we had to leave all the cheerful kids for the day but we left with smiles on our faces.

The last stop before our host came to pick us up was an attempt at seeing the view from "Tops", the outlook over the entire city and mountains of Cebu City. Though we could see some beautiful views from the ride up, once we reached the top their was too much fog to get the view we'd hoped for. It was a good attempt, but maybe we will have better luck the next time we visit the Philippines :) Overall, a good day!

Notes from the Team Leader: Rotary Around the World

Rotary is truly an international organization. Things are done pretty much the same way no matter what country you are in, yet there are subtle differences. As someone who has attended ten or so district conferences, I was intrigued about some of what I saw at the District 3860 district conference in Davao, Mindinao.



In broad strokes the district conference in the Philippines was similar to the others I have attended. They all place a high value on celebrating Rotary accomplishments and recognizing individual Rotarians for their contributions. But there were two developments that were new to me.


First, I was stunned to see so many Rotary Clubs in the district honored for being 100 percent Paul Harris Fellow Clubs. Paul Harris was the founder of Rotary. A Rotary Club in which every member has donated a minimum $1,000 to the Rotary Foundation gets to be a 100 percent Paul Harris Fellow Club. I have never encountered such a club in the U.S.


This fact speaks to membership makeup in Filipino and U.S. Rotary Clubs. In the Philippines, Rotarians tend to represent the highest-earning business executives. In the U.S., Rotarians are often a more economically diverse group.


The focus of the district conferences appears to be a little different. In the Philippines, all the business was conducted in plenary sessions. In the U.S., it is more typical to mix plenary sessions with a number of breakout sessions. U.S. district conferences tend to be more structured in terms of time, with activities being tightly scheduled. The district conference in Davao had, shall we say, a slightly looser concept of adhering to the schedule, but in a way I don't quite understand, everything that needed to happen eventually got accomplished. I appreciate the GSE program for making it possible for me to attend my first international district conference.

Conference scenes

A Busy Day

This is Nicole speaking. The main vocational visit today was to the REACH (Responsive Education for Autistic Children) Center. This is a school for children aged 2 to 16 year olds who have been diagnosed with Autism Spectrum Disorder. There are 40 children currently enrolled in the program. They range from low functioning, non-verbal, to higher functioning children who will eventually be mainstreamed. REACH is a multidisciplinary, holistic program that includes aneurodevelopmental pediatrician (who is staff at a local hospital), psychologist, special education teachers, speech therapist, and occupational and physical therapists.

REACH employs Applied Behavioral Analysis and the TEACCH method. Its program for the children includes sensory integration programming, computer work, behavior therapy, communication, gross and fine motor skill development, functional skills (ADLs), pre-vocational skills, community integration, and academic/pre-academic skills. Each child has an aide with them throughout the day (usually a parent or helper/worker hired by the family). Classrooms are capped at 4 children each.


As the program is holistic, teachers work closely with families, making house visits and providing education to families so they can continue same programming/behavioral work at home. Every Saturday, teachers are involved in trainings at the center (sadly, their teachers are so well-trained, they risk losing them to higher paying jobs overseas) and one Saturday a month is a seminar/training for parents. They also advocate for Autism awareness by bringing their ‘traveling board’ (info board) to malls and outlying regions with the help of the Rotary Club. Many of the students are indigent, and there is a scholarship program.

We learn it costs 5,000 pesos/ month per student. In U.S. dollars that is roughly $118/month. RC Cebu Fuente sponsors about 20 scholars for the past year. Sadly, there are currently about 75-80 children on a wait list to get in, and at least one current student who does not know where her second 6 months of funding will come from as her donor could only provide support for six months.

Student working on motor skills (note: photo used with permission from parent)

What struck me about REACH was not necessarily what their program contained (as it is a comprehensive, multidisciplinary program that is targeting all the areas we would expect a similar program in the US to target). No, what struck me is how they are managing to do this with so little, compared to what we would expect a school in the US—especially one serving children with these needs—to have. But the kids are getting the services they need, they are making gains, and differences are being made for kids and families. The currently have two facilities, one in Cebu main, which we visited, and a newer facility in Mandaue. I was awed and humbled by the resourcefulness of this group and the generosity of those (like the Rotarians) who strive to meet the needs of as many children as possible. I encourage anyone and everyone to visit their website to see what this remarkable group is doing: http://www.reachph.com/
We left them with a bag of goodies to use as reinforcers for the kids, but I, for one, wished we could leave them with more.

After we left REACH, we went on a short tour of the city of Cebu, starting with the Heritage of Cebu monument, a massive sculpture displaying many of the historical narratives of the city. We also toured one main market place. We wandered up and down streets teeming with goods and activity, all lined with vendors selling everything from beautiful fresh fruit, to live roosters (for cock-fighting), to stinky fish and weird sea creatures, to baskets and hand-woven items. We were stared at (could you blame them – we stick out like sore thumbs), small children waved and yelled, and a group of men with the roosters started posing in funny ways when they saw us taking pictures.

 We had to hurry to get to the port area for a lunch meeting at the Cebu Bureau of Customs, including a tour of the shipyard. Rotarian Ronnie C. Silvestre is the District Collector of Collection District VII, Port of Cebu.

 



The afternoon vocational visit was at the University of San Carlos College of Architecture and Fine Arts (CAFA), where PDG Yumi Espina is the Dean. I enjoyed this part of the day very much because it reminded me of being an art student, and made me want to be one again. The college setting looked familiar with one exception. All the students wore very conservative uniforms. We also had a conversation with a guidance counselor in the student services program. We discussed the resources available to students who need academic, career, as well as crisis counseling. We also had a short visit to the USC School of Nursing.

We capped the day off by visiting the Capitol building of Cebu where Cebu Governor Gwendolyn Garcia, the first woman governor of the province, received us graciously in the governor's private conference room. She was delighted to learn about the GSE program, and we left her with a number of materials, including an illustrated guide the Pennsylvania Capitol building in Harrisburg.

By the end of this, our brains were full, our body’s tired, and our belly’s growling, so it was back to our home stay hosts for the remainder of the evening.

 

Sand, Surf, and Sun-day

Sunday, March11


Our Sunday was one of rest, relaxation, and adventure at the Crimson Beach Resort, Mactan thanks to the generosity of PAG Ricky Dakay and his brother, Peter. We enjoyed full use of the gorgeous resort facilities, including pools, beach, and fitness center (I won’t disclose which of the team members gave up some lounging time to work out). After great conversation over a delicious lunch, Peter took us out on his jet skis. With two of us to a machine, we traveled about 8 miles each way across the Strait of Bohol to the island of Pandanon. Along the way, Stacey and I spotted a pair of dolphins (though in all honesty, at first we were not certain what they were) and got as close as we dared without spooking them too much with the jet skis. Things got a bit exciting on the way back as the weather took a turn, but it only added to the adventure. After our visit to Mactan, each of us returned to our respective home stay hosts for a wonderful evening of dinner and fellowship before the start of another busy week.

 Our fearless leader

 Don't worry, I let Stacey drive on the way back.

 On Pandanon Island

More island in the distance

Thanks, Peter, for showing us a great time!

DISCON

The 2012 District Conference (DISCON) RI District 3860 Philippines took place March 8-10. The opening ceremony started at 1PM on Thursday and included an introduction of the president of each of the over 100 clubs in the Philippines and pulling up the tail of the catwalk were the GSE teams, both inbound teams from Pennsylvania and Texas, and the outbound team from the Philippines to Texas.  Later that night was fellowship, the "Rotarians Got Talent" show, with a focus on the movie "Grease". Although we were not aware that we were to perform a “cultural dance number” until we arrived in Davao City, we still pulled off a song and dance number while dressing the part as well as we could (we went for a make-shift vagabond look). Nicole made it clear to the audience that "We can't sing or dance, but we'll give it our best shot." Throughout the song we got lots of laughs and a huge round of applause in the end -- a success in our eyes.

Introduction of the GSE team

 Day 2 of DISCON began with a call to order, followed by the invocation, Philippine National Anthem and introductions of dignitaries and GSE inbound and outbound teams. Some of the topics that various speakers presented were, "Responsible Mining and its Contribution to National Development", "New Approaches to Rotary Membership" and "Small Business Enterprise", just to name a few.

 Nicole and Stacey with Allan Limas

PDG Joseph (Yumi) Michael Espina, GSE Chair Richard (Dick) Barba, Nestor Archival, and PDG Theodore (Ted) Locson

John with Ed Chiongbian, district governor nominee and GSE team leader of the district 3860 team to Pennsylvania in 2011, and his wife Cely

The next to come on the schedule was Governor's Night, a night for cocktail dresses and ties. The night involved the presentation of many high honored awards to clubs including the 100% Paul Harris Fellow Clubs. We also heard a few words from the district governor Leoncio "Nonoy" P. Villa-Abrille. The entertainment portion of the evening included some dance presentations from various Davao clubs. After all the formal talking, it was time for some casual conversations among the big rotary family of the Philippines along with lots of dancing. It was unique to see that there was a group dance that everyone did to almost every song that was played. Nicole still showed them the Pennsylvania way to dance to "Footloose" by busting out her moves! It was great! The night was very enjoyable overall.

 The GSE team dressed up -- we clean up rather well, don't we?

RC Davao City performs
 

The final day of DISCON was presentation day for us. After a few more morning speakers the Texas GSE team took the stage and we followed. We told them about Pennsylvania, our district, a bit about ourselves, some places we have visited that have been of interest to us, and also some topics we hope to further extend our knowledge of before we leave. This part of our presentation worked well to bring some rotary members to us for conversation regarding our topics.

Stacey on the big stage

Nicole on the big stage