By Rina Jimenez David
Philippine Daily InquirerEvelyn Talino wanders among the many stalls in the exhibit area of Lakbay Buhay Kalusugan (LBK), tarrying longest in front of those on pregnancy and baby care. Perhaps it is information she is really seeking, despite her experience.
Now 43, she is pregnant with her 12th child, and when asked if and why she has not practiced family planning, she says a bit defensively: “I can’t take the pill or the injection because I am already old and have high blood pressure.”
But Evelyn, a B’laan, did practice a form of indigenous contraception: drinking a concoction made from tree bark. It may have worked for a while, because her youngest is already 5 years old.
“But this time I really don’t want to get pregnant anymore,” she declares. “When my oldest child, who is 21, found out that I was pregnant, he confronted me. ‘What have you and Tatay been doing?’ he wanted to know. How did you get pregnant?’ I was so embarrassed!”
It turns out that Evelyn’s primary means of avoiding pregnancy was sleeping with her four daughters, while her husband slept among the seven boys. Well, something might have happened during the day!
If tubal ligation is not possible because of her health condition, how about convincing her husband to have a vasectomy? Evelyn’s face lights up. “He says he’s willing to have one. He says I already have a hard time giving birth and taking care of the children, so it’s his turn to take responsibility.”
She smiles even more brightly when told that a nonsurgical vasectomy is much simpler and safer than a tubal ligation, and costs so much less.
LBK caravan
Lakbay Buhay Kalusugan (literally, life journey to health) is a government health promotion caravan that is visiting Barangay Aflek in the town of T’boli in South Cotabato.
Conceived as a campaign to promote good health practices nationwide, LBK aims to bring “quality health information, education and services” to what are known as “geographically isolated and disadvantaged areas.”
LBK is a project of the National Center for Health Promotion of the Department of Health (DOH), with technical assistance from the US Agency for International Development through its Health Promotion and Communication Project, and coordinated by the Probe Media Foundation Inc.
Local governments plan and implement each LBK stopover by providing logistical support, personnel (doctors, nurses, midwives, school teachers and volunteers), and a location for the perya (fair).
For that is what an LBK stopover is—a country fair that promotes good health instead of livestock, agricultural products or local cuisine, and that drums up enthusiasm for modern health practices while providing basic health services to communities hardly reached by government health personnel.
In fact, the perya in Aflek caters not just to its residents (70 percent of whom are T’boli and B’laan), but also to folks from five other barangays who are literally trucked in on dump trucks.
After registering at desks staffed by teachers of the local public school, the townsfolk are each given a “passport” to visit the exhibit area, the family health desk, the “Usapang Macho” which gathers men talking about men’s health issues, the seniors’ health desk, a dental outreach area, the maternity clinic housed in a retrofitted bus, and the pharmacy.
Bus cum clinic
The biggest sensation in every stopover is the LBK bus, a tour bus donated by Victory Liner Inc. that has been transformed into a maternity clinic. It serves as not just an area for consultation and services but also a potent symbol of the “journey to health” that LBK promotes.
Patients sit on about six rows of comfy seats in what serves as a waiting lounge where they can watch DVDs on health or listen to an interactive lecture on women’s health. Two tiny offices serve as consultation rooms, and two other rooms in the back serve as examination rooms, each with an examining table. Personnel from the Provincial Health Office, the regional DOH office, and local rural health units provide the services and ensure follow-up checkups.
But it isn’t the air-conditioned interior that draws most folk, especially the kids, to the bus. The exterior is covered with bright murals that on one side tell the story of a family’s journey through life’s many stages (courtship, marriage, childbirth), and on the other show a community united in good health.
One of the mothers seated in the bus is Gina, 29 and five months pregnant. She holds her older child, a boy of three years, on her lap. She says she has been going for prenatal checkups but is taking advantage of LBK so she can save on tricycle fare.
Another mother in the waiting area smiles shyly when asked how old she is: “Seventeen.”
That’s not even a record, LBK project manager Rey Soriano says, adding: “The youngest patient we’ve had is a 12-year-old pregnant girl in Compostela.”
Chance to serve
Starting with the first LBK caravan in Capas, Tarlac, in March, the bus has visited towns in Pangasinan, Nueva Ecija, Negros Occidental, Bohol, Bukidnon and Compostela Valley. After South Cotabato, it is scheduled to visit Maguindanao and Zamboanga del Norte, the last stop in the caravan.
When required to go from island to island, the LBK bus is loaded onto a “Ro-Ro” (roll-on, roll-off) ferry, and then driven to its next destination by retired bus driver Domeng Lumibao.
A driver for 19 years with Victory Liner, Mang Domeng, 52, began driving an “ordinary” bus then graduated to air-conditioned and “de luxe” buses mostly plying the Manila-Baguio route.
When he began having difficulty driving at night (“but I can see fine during the day,” he clarifies), Mang Domeng chose to retire. But he was called back a month later and asked if he wanted to drive the LBK bus. He has been at it for a year.
“It doesn’t seem like work,” Mang Domeng says of his LBK stint. “I look at it as a chance to serve.” The father of two teenagers says he is most touched by the plight of children in impoverished areas, especially the Aeta in Tarlac.
3 components
The people behind LBK say it has three main components: service delivery, health education and health entertainment.
Education and entertainment are combined in the interactive exhibits, designed to promote good health practices and allow members of the public to “access” the information by themselves.
For instance, there is a rack of cotton dusters that illustrate the stages of pregnancy, with flip-over cards showing the approximate size and appearance of the fetus. Round folding nylon fans bearing a health message are found in the pocket of each duster. (“Walk around a lot,” says the fan for the fifth month of pregnancy.)
There’s also a portable sink and faucet teaching the value of proper hand-washing, and a “pachinko” game illustrating various methods of family planning.
The entire LBK area, as prominent signs announce, is a no-smoking area.
Even more entertainment is provided by youth volunteers who regale children and adults with games, karaoke competitions, dance numbers and comedy skits.
Priority: health, ed
The formal program/press conference that kicks off each LBK stopover is graced by South Cotabato Gov. Arthur Pingoy, provincial health officer Dr. Rogelio Aturdido, Mayor Ernesto Manuel of T’boli town, and, resplendent in her colorful, beaded T’boli outfit, Barangay Aflek Chair Elsa Kayawan.
“Health and education are our priority,” declares the governor as he welcomes the LBK team. He announces that health programs during his term will be based on a “community health living standards survey” that took about two years to complete. But, he laments, much as he wants to improve the province’s financial health by promoting its many tourism opportunities, “there is a problem of perception, with many of our country folk mistakenly thinking that in South Cotabato peace and order is a problem.”
Later, Pingoy issues a personal invitation to visit Lake Sebu on the other side of the mountain and even try the zip line. “You’ll pass through seven waterfalls on your way down, and even spot a rainbow,” he promises.
But there is sufficient fun and festivity beneath the steel frame of the Aflek gym the day the LBK caravan comes to town. In the two days of the stopover in Aflek, some 495 families (or 1,186 individuals), plus 315 young people taking part in the Youth Festival avail themselves of the LBK menu of health education and services.
“We will turn over the bus and the program to the DOH to manage when this project ends,” Soriano says. Or, as the background materials state: “[We] would like the audience to feel that they are not just passengers but also drivers of this journey; that long after the LBK bus and the exhibit have left their community, they are still involved by continuing to safeguard their health and that of their family.”
Hopefully, when that time comes the LBK slogan— “Walang iwanan sa biyaheng kalusugan (No one left behind in the journey to health)”—will have translated into everyday reality.
The partners in Lakbay Buhay Kalusugan are Victory Liner Inc., Melawares, Air 21, OMF Literature Inc., Dakila-Philippine Collective for Modern Heroism, Center for Community Journalism and Development, Manila Broadcasting Co., UNTV, Philippine Press Institute, Alliance of Young Nurse Leaders and Advocates International Inc., and Philippine Daily Inquirer.
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