MOTHER BABY FRIENDLY TENT: CARE PRACTICES AND PSYCHOSOCIAL SUPPORT

7/31/2019 MOTHER BABY FRIENDLY TENT: CARE PRACTICES AND PSYCHOSOCIAL SUPPORT

1/83

ACF INTERNATIONAL

MOTHER BABY FRIENDLY TENT: CARE PRACTICES ANDPSYCHOSOCIAL SUPPORT

A capitalization document on response to typhoon in the Philippines


2/83

Mother Baby Friendly Tent: a capitalization document of an emergency response in the

Philippines

2

RESPONSE TO EMERGENCY Sendong , PHILIPPINES

Mother Baby Friendly Tent : Care Practices andPsychosocial Support

A CAPITALIZATION DOCUMENT IN THE PHILIPPINES

ACF INTERNATIONAL

Anne Filorizzo

Head of Project Psychosocial

January March 2012


3/83


Philippines

3

Photo on cover page: ACF Philippines

STATEMENT ON COPYRIGHT

ACF International

Reproduction is permitted providing the source is credited, unless otherwise specified. If

reproduction or use of textual and multimedia data (sound, images, software, etc.) are

submitted for prior authorisation, such authorisation will cancel the general authorisation

described above and will clearly indicate any restrictions on use.

Non-responsibility clause

The present document aims to provide public access to information concerning the actions

and policies of ACF. The objective is to disseminate information that is accurate and up-to-

date on the day it was initiated. We will make every effort to correct any errors that are

brought to our attention. This information:

is solely intended to provide general information and does not focus on the particular

situation of any physical person, or person holding any specific moral opinion;

is not necessarily complete, exhaustive, exact or up-to-date;

sometimes refers to external documents or sites over which the Authors have no control

and for which they decline all responsibility;

does not constitute legal advice.

The present non-responsibility clause is not aimed at limiting ACFs responsibility contrary to

requirements of applicable national legislation, or at denying responsibility in cases where

this cannot be done in view of the same legislation.


4/83


Philippines

4

OBJECTIVE OF THE BOOK

To support the mandate of ACF in the fight against malnutrition by providing a capitalization

document regarding the experience of care practices and psychosocial support as part of the

response to emergencies in the Philippines.

TABLE OF CONTENTS

OBJECTIVE OF THE BOOK ........................................................................................................................ 4TABLE OF CONTENTS............................................................................................................................... 4INTRODUCTION....................................................................................................................................... 5

1. PRESENTATION OF MOTHER BABY FRIENDLY TENT........................................................................ 8

2. HUMAN RESOURCES IN THE PROGRAMME: RECRUITMENT ........................................................ 11

3. TECHNICAL TRAINING.................................................................................................................... 14

4. SUPERVISION................................................................................................................................. 17

5. team management: the 5 weekly action points............................................................................ 17

6. PRoject monitoring........................................................................................................................ 19

7. RESULTS......................................................................................................................................... 29

8. ACTIVITIES DEVELOPPED............................................................................................................... 39

9. COORDINATION............................................................................................................................. 57

10. RECOMMENDATIONS.................................................................................................................. 59

11. PERSPECTIVES OF THE PROGRAM............................................................................................... 62

12. CONCLUSION ............................................................................................................................... 64


5/83


Philippines

5

INTRODUCTIONThe island of Mindanao, Philippines, was hit by Tropical Storm Sendong with an international

name Washi on the December 15, 2011 affecting 7 regions of the country. The regions

Cagayan de Oro (CDO) and Iligan were severely damaged due to flashfloods and landslides.

The Inter-agency Initial Rapid Needs Assessment (IRNA) led by OCD/OCHA last December 19,

2011 reveals that 24 out of 80 barangays of CDO were affected, 9 being severely damaged.

Iligan City on the other hand, has 21 out of the 44 barangays affected, damaging worse its 10

barangays.

Approximately 300,000 population in CDO and 135,000 in Iligan City were directly affected.

From the same report, 6 evacuation Centers (ECs) in CDO shelter 3,762 families, while 3,635

families are housed in 6 ECs of Iligan City. From both provinces about 87,000 of the total

affected population belong to 0-59 months and 23,000 are pregnant and lactating women.

In December 20, 2011 updates from OCHA, out of the 927 death toll from all affectedregions, 94% (875) of all deaths were :

579 from CDO,

279 from Iligan City

17 from the province of Bukidnon.

In response to this emergency, the nutritions emergency pool from ACF international

(Madrid) and the coordinator on medical and nutrition program of ACF wrote a proposal

with two types of results expected:

1. A screening in the city of Iligan into the 44 barangays in order to evaluate how manychildren were suffering of malnutrition and prevent the outbreak of severely malnourished

children.

2. The second was about opening mother baby friendly tent in 7 evacuation camps in order

to promote breastfeeding and give some psychosocial support to the direct and indirect

victims of Sendong, the most vulnerable people: pregnant women, lactating women and

mothers with children below two years old.

Both results tend to advocate on the activities against the unmonitored distribution of infant

formula and powdered milk.

At the same time Save the Children were conducting similar activities in Cagayan de Oro.

It was the first time that the mission Philippines welcomed a psychosocial program in its

department. They asked for some adjustments and understanding for every department of

ACF.

This response to emergency in nutrition and psychosocial participated to the good

acceptance in Iligan city of ACF. They were approved by the large majority, by Unicef and

Department of Health (DOH).


6/83


Philippines

6

This capitalization is meant to be a report of the different steps of the program, its results,

and the coordination needed but should, hopefully, be used too as a guideline of psycho

socials interventions for the next response to the emergencies in the Philippines.


7/83


Philippines

7

Part IPRINCIPLES AND CONCEPTS

ACF-Spain

1 Presentation of baby friendly tent 9

2 Human Resources 12

3 Training 15

4 Supervision 17

5 Team management 18

Mother Baby Friendly Tent: a capitalization document of an emergency response in the Philippines


8/83


Philippines

8

1. PRESENTATION OF MOTHER BABY FRIENDLY TENT

The child well being is the results of different components: health, food and economical

resources and the caretakers behavior toward him. As the following scheme demonstrates,components are linked with each other. If the situation is unstable, the repercussion on the

growth and/ or the development is direct.

Care practices are in the center of this distribution of these components. Malnutrition or

serious delays in child development are usually the result of multiple factors.

ACF chooses to define Care practices as:

the behaviors and practices of caregivers (mothers, siblings, fathers and child care

providers) that provide the food, stimulation and emotional support necessary for childrens

healthy growth and development. These practices translate food security and health care

into a childs well-being. Not only the practices themselves, but also the way they are

performed (with affection and with responsiveness to children) are critical to childrens


9/83


Philippines

9

survival, growth and development. It is impossible for caregivers to provide this care without

sufficient resources, such as time and energy1

.

Six care practices have been selected in the Initiative Care Manual which was published by

UNICEF in 1997: care for women, breastfeeding and feeding practices, psychosocial care,

food preparation, hygiene practices and home health practices.

Breastfeeding is an unequalled way of providing healthy growth and development of infants

and it also has important implications for the health of mothers. In emergencies,

breastfeeding can make the difference between life and death. Research proves that

suboptimum breastfeeding contributes greatly to child disease2

and mortality3.

Experience has shown that breastfeeding can become more problematic in emergency;

among others due to trauma, stress and worry interfering with the milk flow; as well as due

to wide spread myths and misconceptions, lack of time of the mother, insufficient support to

the mother, wide spread unsolicited and unmonitored distributions of breast milksubstitutes and other reasons. Most mothers can continue or re-start breastfeeding, if

appropriate technical and psycho-social support is available, the caregivers coping capacity is

promoted and supportive environments are created.

In case of emergencies (natural disasters, severe conflicts), ACF used to assess the needs in

water, livelihood and the risk of malnutrition outbreak. Because of the importance of the

care practices, most of the missions adopted the concept of Mother Baby Friendly Tent in

order to:

To prevent increase of malnutrition, morbidity and mortalityTo help the family to adapt care practices to the emergency and post-emergency

context

To improve the wellbeing of the beneficiaries (infants, young children and their

caretakers, pregnant women), taking into account life experience and past and

present suffering

To show families how to facilitate child development and survival

To prevent or reduce the negative effects of unsolicited and unmonitored distributions

of breast milk substitutes

To provide appropriate and sustainable solutions for infants for whom breastfeeding is

not an option

1Engle, P.L., M. Bentley, and G. Pelto, The role of care in nutrition programmes: current research and a

research agenda. Proceedings of the Nutrition Society, 2000. 59(1): p. 25-35.2

Black R. et al., Maternal and child undernutrition 1: global and regional exposures and health consequences,

The Lancet, DOI:10.1016/S0140-6736(07)61690-0, January 17, 2008, Published online: suboptimum

breastfeeding results in 1,4 million deaths and 10% of disease burden in children younger than 5 years.3

Save the Children UK, Hungry for Change, 2009


10/83


Philippines

10

The main objective and conduct line is to take care of the mother/caregiver and let her/him

take care of the child.

The concept of the Mother Baby Friendly tent is to create:

A place, where infants, young children and their caretakers as well as pregnant women

are welcomed and given support.

A safe place, where sharing of experiences and confidentiality are possible; yet privacy

is ensured.

A space where women/caretakers and their children can get together to spend an

agreeable moment together.

A place where sensitization, guidance and support is given to mothers/caregivers of

infants and young children and future mothers.

A place for promotion and reinforcing care practices for the child by parents,

caretakers, families and communities.

A place to reinforce community links, to meet and exchange thoughts; which can create

opportunities to exchange on subjects such as breastfeeding, hygiene, nutrition,

A place where mother/caretaker-child bonding can be developed and reinforced; as

well as where mothers/caretakers capacity to care for their children despite the

difficult living conditions can be reinforced.

A place to prevent and detect acute malnutrition in infants, young children as well as

pregnant and lactating women.

A place to identify people in emotional distress; where psycho-social support or

psychological care is offered.

A place where the care to the infants might be provided in security and with good

quality (ie give a bath, breastfeeding if too much proximity in the camps, etc..).

A context in which optimal care practices are safeguarded and promoted through family

support, community awareness and removal of barriers.


11/83


Philippines

11

Action Against Hunger has been involved in the IASC guidelines. This psychosocial program

should provide support to the first and second grades of the pyramide. Nevertheless, a

close coordination with the special unit is expected and must be developed since the

beginning of the program.

The response to the Sendong emergencies is a program of three months in the city of Iligan,

with seven tents in six different barangays (evacuation camps or close to the district health

centers.

2. HUMAN RESOURCES IN THE PROGRAMME: RECRUITMENT

In many emergencies, ACF recruits people locally in the affected area. This is beneficial, asthese people know the situation and the culture; and it is also positive to be able to provide

people in need with a job. However, it is important to be aware, that many of these people

are affected by the emergency as well. They may be displaced, are survivors of a natural

catastrophe have lost loved ones, have lost their belongings One must take into

consideration the mental state these people might be in and work in a way that respects

their grief.

It is hard to say what background or diploma Care Practices staff should have. Instead of

pinpointing a certain profile, it might be better to indicate the qualities that are needed to

be a counselor:

Special

-ised

care

Basic Individual Aid

Individual guidance and

support

Access to the Baby Friendly Tent, Baby

Corner or Mobile counsellor teams to meet,

chat with others, relax, breastfeedGroup activities: education sessions, group

discussions, relaxation exercices, play

Caretakers with children less than 2years old or pregnant women with

difficulties

All caretakerswith children lessthan 2 years old &

pregnant women

Caretakers with children less than 2years old or pregnant women withproblems that could seriously impacthealth and development


12/83


Philippines

12

Have a minimum knowledge on infant and young child care practices, including feeding;

and have the capacity and motivation to learn more in a short space of time. Having

advanced knowledge on IYCF is an asset

Have good listening and communication skills

Have good empathy and be patient

On the case of the Sendong emergency, most of the appliers were nurses with a background

on psychological studies.

This profile was very handful to response to health questions from the mother, more over

the team was already aware a breastfeeding technique and nutrition elements.

Furthermore, the medical knowledge helped the member of the team not to jump on

conclusion, and think about plausible explanations before orienting the beneficiary to thepsychologist.

Example of Test for social worker

Explain in few sentences what PSYCHOSOCIAL means for you?

What are the skills and qualities of a psychosocial worker?

Choose one topic for a group discussion among pregnant women. How will you organize and

conduct the activity? What do you think are the possible challenges and how will you handle

it?

What are the needs of a child while growing up between 0 and 2 years old?

What kind of information you would look for when defining poor mother-child

relationship?

What are the benefits of playing in child development? Give three examples of play

activities you can suggest to a one-year old child.

One of the mothers in the evacuation center does not want to come to the nutrition centre.What do you think are the reasons why she does not want to come to the centre? How will

you motivate this mother to join the activities?

What are Care Practices and Malnutrition? How are they related to each other?

What are the principal consequences of malnutrition on a childs development and

behavior?

What are the benefits of breastfeeding in the mother-child relationships and development of

the child?


13/83


Philippines

13

What will you do if a mother starts to cry during the interview?

What do you think are the feelings of the parents of a malnourished child?

What are the differences of working for an NGO and any other type of company?

Most of the beneficiaries (refugees) and their caregivers in the therapeutic feeding centre

are mostly women.

Is it better to have a male or female psychosocial worker? Explain your point of view.

Example of test for psychologist

Describe an occasion when you found it difficult to work with someone from a differentbackground?

What is Mental Health? To your opinion, is there a link between Mental Heath and

Nutrition?( Justify your answer

Why do you think Mental Health and Care Practices component is important in the ACF

intervention context?

You should organize a Focus Group Talk with women who lost one of their children because

of malnutrition. Explain the activity, methodology, objectives and scope/limitations of your

activity.

Give five indicators (warning signs) to consider mothers depression Explain why each

vulnerability indicator is important to consider and how you suggest managing them in a

short term follow up.

Give five indicators to consider that a child is in distress by just observing him.

If a mother comes to you in the therapeutic feeding center and complains about lactation

difficulties but the child does not seem malnourished, what kind of hypothesis could you

make about the relation between mother and child ? what would you plan to do with this

dyad ?

How do the parents of a malnourished child feel? How will you help these parents manage

this situation?

One of members of your team refuses to welcome the sister of a malnourished baby inside

the tent because its a mother baby friendly area. Do you think he is right? What would you

do if you were in that kind of situation?


14/83


Philippines

14

In this specific program :

7 social animators and a psychologist have been hired.

14 Barangays Health Workers, volunteers from health centers of Iligan have been

included on the program, thank to the city office who accepted to discharge themfrom some of their tasks in the district health centers.

Note : 7 social animators, one by Mother Baby Friendly Tent were not enough to support the

program. The BHW were working 2 to 3 mornings by week with the midwives in the health

center. Sometimes, the social animator has to deal with 25 mothers and their children in the

tent by himself. The program had sometimes lost on quality because of the over crowed of

the activities.

3. TECHNICAL TRAINING

The team was trained on the 16th to the 18th of January. The first two days were only for

the national staff.

The training dealt with different subjects:

Nutrition: supplementary feeding, relactation (SST techniques), use of MUAC

Breastfeeding: explanation of the physical and emotional processes,

Psychosocial: development of the child, play with a child under two years old

Mother Baby tent: what is expected, how to welcome beneficiaries

Every session has been ended up by role play to insure that the participants understood the

focal point of the training.

A pre and post test has been done at the beginning and the end of the session. The average

of the results on the pre sessions was 13 / 20 and at the post test at 16/20. The basics were

understood (for instance: composition of milk, the fact that a mother can lactate twins at the

same time), there were still misbelieves about relactation techniques. To insure the better

take care of the mother in need, the nutrition team will assist the first relactations process.

Examples of questions :

Breastfeeding shouldnt be day and night and on demand

There is one type of milk produced by the mother providing the same elements

A mother that is not well fed or a malnourished mother cannot breastfeed

Trauma, shock and stress make mothers milk dry up

Mothers can not breastfeed twins successfully because have not enough milk for both.

The weaning means to stop totally the breastfeeding and give the child food at 6 months


15/83


Philippines

15

On the 18th

, the national staff and the 14 BHW had been working together on the different

activities expected in the mother baby friendly tent followed by role play. One hour was

dedicated to breastfeeding.

Planning of the three days of training.Day 1

9hWelcome / presentation of team and

training

9h30 Presentation of ACF international

10h -10h30 Pre - test breast feeding

10h30-10h50 break

10h50 - 12h Breastfeeding : global axes

12h - 13h Lunch break

13h - 14h Care practices & breastfeeding

14h - 15hNutrition : suckling technique +

complementary feeding

15h - 15h15 break

Role play in group about mother having

troubles with breast feeding

15h15 - 16h30

Debriefing about the role play

Day 2

9h - 10h post test/ corrections

10h - 10h30 Dealing with common BF problems

10H30-10h50 break

10h50 - 12h How to welcome mother & child / role play

12h - 13h lunch break

13h - 15h Psychosocial support : play, massage, FGD15h - 15h15 break

15h15 - 16h Role & function of a psychologist in a BFT

Day 3

9h30 - 10h15BFT : objective & activities (with

participation of ACF team )

10h15 -10h30break

10h30 - 11h30Introduction to Care Practices


16/83


Philippines

16

11h30 - 12h

12h -13hlunch break

13h - 14h Introduction to Psychosocial activities

14h- 15hRole play " how to welcome mothers in bft

"

15h- 15h15break

15h15 - 16hOrganization of the program

The hand over training

Following the disaster the city of Iligan needed a support as to prevent malnutrition

outbreak and maintain the well being of the survivors.

The BHW have been working with the team during the 3 months. The team tried as much as

possible to coordinate with the midwives. Because the Mother Baby Tent are an emergency

response and evacuation centers are closing for relocation ones, ACF had to figure how

maintain this type of activities without the structure.

The focus had been on the midwives and the BHW form the main health center in Iligan. At

the end of the program, they benefited from one day and a half training session.

The afternoon is focused on refreshment about the breastfeeding and nutrition (SST,

complementary food). The second day is dedicated to psychosocial activities. The objective

is to find how they could can provide that type of activities into their health centers and be

able to lead it, maintaining it in a sustainable way.

An introduction to child development and mother signs of depression has been performed.

They were provided of key elements around non pathological behaviors who have a impact

of the children; how to help the mother to take care of the children, developing play

sessions for instance while the family are waiting for consultation.

All the participants left the training with a booklet (validated by the Department Of Health of

Mindanao and Unicef) in Tagalog, with pictures, illustrations of breastfeeding and good

care practices expected from a mother. It gathered the 6 care practices highlighted by

Unicef. This should the tool that they can use in every situation, like guidelines to follow of

the different advices with messages to transmit to the mothers.


17/83


18/83


Philippines

18

Some of them work on their way to deal with the focus group like accepting silence and

encourage the mothers to express themselves, some others about the tidiness of tent (being

strict with the no shoes entering, cleaning the toys), some tried to get the BHW more

involved into the psychosocial activities.

The weekly objectives helped the member of the team to identify their weak points and

work on it. Moreover, while the evaluation process; it has helped them to situate theircapacity to deal with the program.

From a managerial point of view, it helped to understand better the need of the team in

term of supervision and training, tools ect

The self weekly assessment took 15 minutes by week and was very helpful. Its strongly

recommended to maintain it.


19/83


Philippines

19

Part IIPROJECT MONITORING AND RESULTS

ACF-Spain

6 Project monitoring 21

7 Results 30



20/83


Philippines

20

6. PROJECT MONITORING

1.Operationnal

Choice of sites.

The implementation of the tents was planned considering:

the spaces in the camps allocated for a 42 square meters tents

the number of pregnant and lactating women into the evacuation camps thanks to listing

provided by the DOH

a coordination with other NGOs or association providing services in this area in order to

decrease the risk of overlapping activities.

The target was, as already mentioned, the evacuation centers. The Mother Baby Friendly

Tent to be really effective need to work in coordination with the midwives. More over ACF

works with victims of the disaster that means, not only iDPs but home based too. For these

reasons two reasons, two tents have been implemented in the barangay and not in the

evacuation centers.

The seven tents were implemented in:

Tambacan

Ubaldo laya, elementary school

Santa Filomena, hugh school

Barabgay of Santiago

Madrassah in upper hinaplanon barangay

Luinab, Gym 1

Luinab, Soa Shleter box

There are two tents in the barangays of Luinab. The first one is an evacuation camp and the

second a relocation camp.

SSB is one of the biggest relocation camp In Iligan. It welcomed IDPs from different

evacuation centers in the city including from Ubaldo Laya and Santa Filomena. ACF

implemented the 7th tent in March there in order to :

be able to follow up the mothers who left the two other camps and were into the

program

to welcome new IDPs from other barangays where the Mother Baby Friendly Tent hadnot been implemented.

In the end of February, 8 relocation camps have been indentified:

Name of the camp N of IDPs ( family )

welcomed or

planned

Santa Filomena Elementary school 176

Santa Filomena High school 181

Tambo tent city 154


21/83


Philippines

21

San Roque 50

Santiago ( Santa Elena) 107

Luinab ( Gym 1) 75

Diocesan 264

Siao Shelter Box Luinab 557

ACF is implemented in five of them, with a little exception for Santiago, the Mother Baby

Friendly Tent which is in the barangay of Santiago not into Santa Elena relocation camp.

Even after the transfer of the IDP s from the gym to Santa Elena, the beneficiaries still came

back to the tents.

ACF had tried to open in Tambo tent city but there were no space available to install the

tent.

Implementation process

After defining a first short list of evacuation camps with highest number of pregnant and

lactating mothers, the manager should cross check the information with the Mental Health

and Psychosocial clusters (if it exists) to get to know the different activities already on going

in the camp.

Then, he must visit the site and meet the camp manager. This responsible will provide a

space. This space needs to be assess as secure and close from latrines and a bladder, should

be shadowed by a tree (if there is no risk of earthquake ) and have enough space all around

to catch the wind. The temperature inside the camp can be very high. If it is possible, the

tent should be far from the road but not isolated for questions of security.

Work plan

The program should be run with a proper and validated work plan. All activities should be

planned to avoid logistic issues. For instance, the end of admissions or distributions of baby

kits have to be planned from the beginning. This work plan should be updated monthly.

Sample of work plan

week 8 week 9 week

10

week 11 week

12

week

13

week

14

Program

Baby kits end of

distribution

cloture

of

tents

Food

vounchers

end of

distribution

cloture

of

tents

Admission end of

admission

cloture

of

tents

Special


22/83


Philippines

22

activities

8th march

Celebration of

end of

programAdmin BFU BFU

LOG

PR Assess

if more

BK are

needed

PR BK if

relevant

last

PR

D3AF

Report

Capitalization

Unicefmonthly /final

Data collection

Every day, the social animators send data of the day :

The new beneficiaries (mother with children below 2 years old, pregnant and lactating

and number of children below 2 years old)

The frequentation of the tent (number of mother with children below 2 years old,

pregnant and lactating and number of children who attended activities) in total.

Same for the psychologist who send:

The new beneficiaries (1st consultation)

The number of one to one consultation

The number of partcipants to psychosocial activities he animated.

All this information is registered on a day-to-day data base.

(Note : data base and forms in annex)

The team registered in a form the admission and follow up. On Friday, these data are

collected by the manager who :

Check if the informations send by textos are the same than on the file,

Can react faster if a tent has a decrease of frequentation or if an activity has not been

ruled all week long.

It is a real tool of supervision which allows intervening quickly and provide support to the

member of the team who faces the issues.

Logistical point.


23/83


Philippines

23

A list of the material which is used into the tent should be provided very quickly. It helps the

team to monitor the material and be able to anticipate the needs.(Note : list of the material

in annex).

Profiles of beneficiaries

Each woman who enters the program has been asked several questions regarding her

marital situation, her number of children, if she is pregnant or lactating and her problematic.

Her needs are evaluated and certain activities are proposed regarding her actual issues. All

these datas allowed to design the profile of the beneficiary.(Cf annex)

Linked to the food vouchers distribution planned, the social animators have been gathering

information about the closest supermarket, the number of food distribution the idps and

home based already benefit and the providers. It was a good way to establish for example

that inhabitants of Ubaldo Laya had three more distributions than in Madrassah.4

Sometimes these questions have been asked by the BHW or days of special influx. Some files

were not complete.

The marital situation

Most of the women are married, in particular in Madrassah. Few single mothers had been

registered.

The number of pregnancies post disaster (less than 3 months) into the program.

4these informations have been transmitted to the food security department and not treated in this

capitalization.


24/83


Philippines

24

Total of

Women

Total of

Pregnant

Total of

pregnancy after

Sendong

Santiago 305 57 13Tambacan 485 101 61

Santa Filomena 185 50 18Madrassah 176 49 18

Ubaldo laya 247 67 6

Luinab, gym 1 227 39 5

Luinab SSB 51 7 5

Total 1676 370 126

22% of the women who entered the program are pregnant. 30% of them are pregnant from

less than 3 months, which means after the Sendong. In Tambacan, 60% of these women are

after sendong pregnancy . The health center of Tambacan should provide a special focus

on them.

Number of lactating women into the program.

total of

womenyes no mix

Santiago 305 193 64 34

Tambacan 485 291 121 4

Santa Filomena 185 98 56 9

Madrassah 176 99 26 9

Ubaldo laya 247 141 52 2

Luinab, gym 1 227 129 70 4

Luinab , SSB 51 25 15 0

Total 1676 976 404 62

The lactating women represented 58% of the program. This percentage has to be taken with

an extreme cautious. A lot of women said that they breastfeed their children in order to be

sure that they will benefit of the program.

Number of children by women.


25/83


Philippines

25

Most of the women gave birth to 1 or 2 children. A special focus should be put on the

number of mothers who had their first child. This could demonstrate that they lost the

family usual support with the displacement and the relocation far from their family (the

parents, especially from their mothers).

Still more than 20% of the beneficiaries have 3 children and more which highlights the needs

of reproductive health program.

Regarding the impact of the project, because most of them only have on child, ACF insure

good care practices and a real promoting of the breast feeding. Most of the women assure

that they will breastfeed their future children, because they understood the importance of

the mothers milk for the childs health, more over the bonding and its crucial importance in

the child development.

This data demonstrated too that if we welcomed 1676 women, it is nearly 4000 childrenwho will benefit from the direct impact of the program.

Number of family with children between 2 and 5 years old by sites

WomenNumber of family with children between 2

and 5

Santiago 305 115

Tambacan 485 285

Santa Filomena 185 92

Madrassah 176 66

Ubaldo laya 247 91

Luinab gym 1 227 100

Luinab, SSB 51 31

1676 780

Over the 1442 women who already have children between 0 and 2 years old, 49% of all the

total (lactating+ pregnant+ women with children below 2y.o) have children between 2 and 5

years old.

This information should be used by the nutrition and the food security team in order to

target the site of screening and help the helper to focus on area. For instance, in Tambacan,

58% are family with more than 2 children under 5 years old.


26/83


Philippines

26

Distribution of the age of the children who entered the program

The majority of the children had between 7 and 12 months. One more time, these results

have to be used with cautious. Some children have been registered as 24 months. There areactually older. The mothers modified the age of the children to be allowed to enter the

program and benefit from the activities, the baby kits and the food vouchers

Some green cards have been checked but most of the time, the mothers did not bring them.

The team tried as much as possible to control the situation, nevertheless, they found very

hard to refuse the entrance to mothers in distress, who needed help. We have to agree on

the fact that the more women benefit from care practices counseling the most people, the

most these will be spread into the community. Moreover, most of these women may have

others children who will benefit from what they have been learning in the Mother Baby

Friendly Tent project.

Gender of the children from 0 to 2 years old.

Gender

SitesTotal of

childrengirl boy

Santiago 307 142 165

Tambacan 415 205 220

Santa Filomena 148 72 76

Madrassah 128 66 62Ubaldo laya 229 105 114

Luinab gym 1 190 83 107

Luinab, SSB 40 15 25

1457 688 769

The program welcomed 47% of girl and 53% of boy


27/83


Philippines

27

Gender and breastfeeding practices

These data have been calculated in order to search for unbalanced care practices regarding

gender. These results demonstrate what have been observed, until 2 years old the caring of

the child seems to be similar.

Age and breastfeeding practices in percentage

These data should illustrate the decreasing of the breastfeeding with the increase of the age

of the child. In this area, it seems that more than 60% of the women breastfeed their

children until 18 months.


28/83


Philippines

28

This graphics is probably hedged; we do not know how many mothers pretended to

breastfeed to insure their registration in the program.

Pourcentage of breastfeeding by ages

The weaning transition does not seem to start from 6 months but earlier.

The 47% of the 18 to 24 months does not benefit from breast feeding.

The details by sites are in annex. It could be used as the indicators form prevention against

malnutrition.

Problematic

The mothers into the program are concerned by the socio economical situation. Some of

them described themselves as bad mothers because they can not provide food to their

family or because they can not send their children to school anymore (distance from the cam

to the school, livelihoods...).

It took a while (one month on average) for the mothers to trust fully the member of the

team and start to open about cases of maltreatment for instance.

Regarding the program, the beneficiary came regularly with questions about the

breastfeeding (Is it possible when the mother is sick, when the baby is sick).

Despite the disasters effect, the beneficiary seems to start to be ready from mid February to

be involved into projective activities. Numerous non pathological symptoms (like lack of

sleep or to eat, feeling of loneliness, and fear of new disaster ) have been raised. Most of

them were usual process after a natural disaster. Despite, studies demonstrate that 30% of

the person will develop pathological symptoms.


29/83


Philippines

29

7. RESULTS

1.Quantitative data collected

Number of mothers welcomed in the program by week .

The first week (the opening) was always synonymous of high numbers of entries. Some

mothers never came back (which can explain that it is not always the same data basis used)

Most of them followed the program. The announcement of the food vouchers distribution

attracted new beneficiaries into the program on the weeks 6 and 7.

Number of pregnant welcomed in the program by week


30/83


Philippines

30

The rise of the pregnant mothers on the 7th week could be linked with the food vouchers

distribution and maybe the increase of pregnancy after the disaster. It matched with 2

months pregnancy for most of them and usually when they figured out their pregnancy.

Number of lactating welcomed in the program by week

Some weeks (especially 3 and 4) the rain has been very heavy. We actually could state a

decrease of the new entrances. The mothers already involved come back but it was more

difficult to reach some new ones

Number of children who entered the program by week

These data are similar to the entrance of the lactating women.


31/83


Philippines

31

Daily average frequentation of the women into the Mother Baby Friendly Tent by site.

January February March

Sites Total LW PW Total LW PW Total LW PW

Tambacan 41 21 22 60 23 11 140 42 72

Ubaldo laya 52 40 12 76 22 10 70 42 19

Santa Filomena 17 7 0 22 14 5 42 23 7

Luinab Gym 1 0 0 0 24 13 4 23 11 2,5

Sao Shleter box 0 0 0 0 0 0 20 8 2

Madrassah 16 12 4 17 12 4 33 17 7

Santiago 0 0 0 65 32 106 50 25 8

Total average 18 11 5 38 16 20 54 24 31

The daily average of frequentation should have decreased.

We assessed that the women came back on regular basis additional to the new beneficiaries.The explanations may be linked:

The choices of the evacuation camps were strategic which allowed a lot of women to

partipated actively several activities during the week without a need to take public

transport or walk for more than 20 minutes.

The dynamic of the activities, which changed from a week to the others one were

attractive. (for instance introduction of psychodrama, story telling)

Luinab gym 1 opened mid february and Soa Sheeter Box second week of March which

welcomed new beneficiairies.

Daily average of frequentation of the children into the Mother Baby Friendly Tent by site.

Sites January February March

Tambacan42 38 133

Ubaldo laya44 24 32

Santa Filomena15 19 35

Luinab Gym 10 20 13

Sao Shleter box 0 0 13

Madrassah11 14 22

Santiago0 20 31

Total average 16 19 40

The frequentation of the children is obviously linked to the presence of the mother5

5Any mother had the right to let her child by himself in the tent.


32/83


Philippines

32

Psychological support.

-Number of beneficiaries referred for individual interview : 62 beneficiaries

-Number of individual interviews conducted :100 beneficiaries

-Number of group conducted with the support of the psychologist : 758 beneficiaries(cumulative)

Number of participants in February : 310

Number of participants in March : 448

To face the demands, the psychologist decided to organize group rather than individual

counseling.

2.Qualitative datas collected

EXEMPLE OF A WEEKLY PLANNING OF ACTIVITIES

Monday Tuesday Wednesday Thursday Friday

8 to

8.30WELCOME / information time

9

RELAXATION

for lactating

women

RELAXATION

for pregnant/

lactating

RELAXATION for pregnant

RELAXATION

for pregnant/

lactating

930baby bath

/massage

baby bath

/massagebaby bath /massage

RELAXATION

for lactating

mother baby

massage with

fathers!

10FDG /

nutritionstory telling art therapy

PLAY session0 to 11

months

story telling

PLAY session

0 to 11

months11 Art Therapy

PLAY session

0 to 11

months

play session 1 to 2 yrsFGD BF/

Hygiene

12 lunch time

13play session

1 to 2 yrs

RELAXATION

for pregnant

play session0 to 11

months

play session 1

to 2 yrs

play session 1

to 2 yrs play session 1

to 2 yrs14

RELAXATION

for pregnant

FDG /

hygiene

baby

massage with

Fathers!15

FDG

pregnancy

FDG Breast

feeding

Psychodrama

16baby bath

/massage

preparation

of women's

day

Psychologist

FDG child

developpement

preparation

of women's

day

CLOSE

17 Administrative time/ cleaning


33/83


Philippines

33

This planning is displayed in every tent and adapted to the context. For instance, on Friday

morning, the Muslims beneficiaries used to go to the mosque. The tent in Madrassah did

not welcome any beneficiary. The tent was closed and the social animator was sent in other

tent to provide some support to her colleagues.

On this planning is underlying that :

all day long, social animators welcome new beneficiaries

Mothers can breastfeed their children in the breastfeeding area at any moments

of the day ( even during the lunch break

in this specific planning, on Wednesday afternoon, the psychologist has his

counselling sessions in this area

The tent is closed on Friday afternoon because the team has its supervision

meeting.

FREQUENTATION OF ACTIVITIES

Total number of participants for care practices activities (cumulative).

Camp nameFDG

nut&healthFDG hygiene

FDG

Breastfeeding

FGD

Pregnancy

Tambacan 1203 1256 1592 1130

Luinab gym 1 259 260 264 77

SSB 77 98 2 8

Ubaldo laya 109 196 406 87

Santiago 202 316 361 22

Madrassah 195 78 325 9

Santa Filomena 151 151 251 67

Total 2196 2355 3201 1400

Total number of participants for psychosocial activities (cumulative).

Camp name Relaxation Art Therapy Story Telling psychodrama group therapy

Tambacan 775 1585 1207 831 946

Luinab gym 1 103 207 23 74 119

SSB 106 8 4 0 21

Ubaldo laya 922 402 194 93 104

Santiago 1489 216 232 64 79

Madrassah 515 159 34 12 91

Santa Filomena 469 159 40 25 74

Total 4379 2736 1734 1099 1434


34/83


Philippines

34

Total of number of children into activities (cumulative)

Average of frequentation by mother in care practices activities by sites

total womanFDG

nut&healthFDG hygiene

FDG

Breastfeeding

FGD

Pregnancy

483 1203 1256 1592 1130Tambacan 2,5 2,6 3,3 2,3

227 259 260 264 77Luinab, Gym 1

1,14 1,15 1,16 1,97

44 77 98 2 8SSB

1,75 2,23 ns 1,14

241 109 196 406 87Ubaldo laya

0,45 0,81 1,68 1,30

185 151 151 251 67Santa

Filomena 0,82 0,82 1,36 0,36

255 202 316 361 22Santiago0,79 1,24 1,42 0,49

148 195 78 325 9Madrassah

1,32 0,53 2,20 ns

Mostly all the women attended to each focus group discussion about care practices.

Camp name Massage baby Bath session Play Session

Tambacan 1456 1450 2504Luinab gym 1

33 33 280

SSB0 0 84

Ubaldo laya224 95 571

Santiago511 65 1304

Madrassah349 82 393

Santa Filomena

103 17 338Total

2676 1742 5474


35/83


Philippines

35

Average of frequentation of activities by women in psychosocial activities by site

The activities which involved drawing or creating had more success than the

psychodrama. Every day starts with relaxation session which attracted a lot of mothers.

Average of frequentation of children

total childrenmassage

babybath session Play Session

415 1456 1450 2504Tambacan

3,5 3,49 6

190 33 33 280Luinab, Gym 1

0,17 0,17 1,540 2 0 84

SSB2

229 224 95 571Ubaldo laya

1 0,41 2,5

148 103 17 338Santa

Filomena 0,70 ns 2

256 511 65 1304Santiago

2 2 2

128 349 82 393

Madrassah 2,73 0,64 3

total women

relaxation Art Therapy Story Telling psychodramagroup

therapy

483 775 1585 1207 831 946Tambacan

Average/W 1,60 3,28 2,5 1,72 1,96

227 103 207 23 74 119Luinab, Gym 1

Average/W 0,45 0,91 ns ns 0,10

44 106 8 4 0 21SSB

Average/W 2,41 ns ns 0 0,48

241 922 402 194 93 104ubaldo laya Average/W 3,83 1,67 0,80 0,39 0,43

185 469 159 40 25 74Santa

Filomena Average/W 2,54 0,86 0,22 ns 0,40

255 1489 216 232 64 79Santiago

Average/W 5,84 0,85 0,91 ns 0,31

148 515 159 34 12 91Madrassah

Average/W 3,48 1,07 0,23 ns 0,61


36/83


Philippines

36

Bath sessions were difficult to implement.

Massage to baby were supposed to be effective enough to allow the mother to apply it at

home with her baby.

Play sessions are the one dedicated to child development. While mothers were having

activities, often the BHWs were taking care of the children playing with them.

Frequentation by activities comparative of two months by sites

Tambacan february march total

Activitiestotal in

month

total

participants

total in

month

total

participantstotal

total

participants

FDG 46 1191 80 2534 126 3725

Massage for baby 8 17 25play sessions 38 25 63

Bath sessions 9

753

8

2408

17

3161

story telling 0 0 5 5 0

psychodrama/ GT 4 101 11 90 15 191

relaxation 9 23 111 32 111

Art therapy 13 40 14 27 40

The frequentation in Tambacan had stand very high and had an impact on the quality. The

social animator in charge tried to organize several activities simultaneously. She asked some

mother to lead the focus group discussion on breastfeeding and hygiene in order to reinforcethem and to be able to check on the other activities, lead by the BHWs.

Madrassah february march total

Activitiestotal in

month

total

participants

total in

month

total

participantstotal

total

participants

FDG 13 341 26 598 39 939

Massage for baby 6 22 28

play sessions 23 27 50

Bath sessions 5

231

16

404

21

635


psychodrama/ GT 1 20 3 62 4 82

relaxation 0 6 6 0

Art therapy 5 6 11 0

Madrassah was closed every Friday. The opening a social animator rules the activities. Two

weeks later, he highlighted the difficulty for certain muslims mothers to talk with a men. He

has been replaced by a women and the frequentation increased.

Santa Filomena february march total


37/83


Philippines

37

Activitiestotal in

month

total

participants

total in

month

total

participantstotal

total

participants

FDG 30 431 27 643 57 1074


play sessions 36 25 61Bath sessions 4

3764

4938

869



relaxation 9 142 7 16 142

Art therapy 19 57 10 29 57

The activities and the frequentation have increased in a stable way. The activities have been

developed to respond to demand. The social animator showed initiative on art therapy

encouraging the mother to learn others ways of expressing their feelings and emotions.

Ubaldo Laya February march total

Activitiestotal in

month

total

participants

total in

month

total

participantstotal

total

participants

FDG 46 1093 11 1183 57 2276



Bath sessions 9

473

16

632

25

1105



relaxation 9 25 157 34 157


A really good management of the planning made Ubaldo Laya a site where mothers come

back very regularly. A special focus has been made on the drawing and activities providing the

opportunities of using its creativity.

Santiago february march total

Activitiestotal in

month

total

participants

total in

month

total

participantstotal

total

participants

FDG 17 1297 15 899 32 2196



Bath sessions 10

871

11

572

21

1443



relaxation 21 33 262 54 262

art therapy 10 4 14 0


38/83


Philippines

38

Santiago is the only site where the frequentation has decreased, still welcoming a high

number of beneficiaries. The social animator has decided to reduce the number of

participants in order to focus on quality, decision totally supported by his manager.

Luinab Gym 1 february march total

Activitiestotal in

month

total

participants

total in

month

total

participants

total

act

total

participants

FDG 18 430 19 415 37 845


Play sessions 22 29 51

Bath sessions 8

376

9

237

17

613

Story telling 4 4 0

Psychodrama/ GT 3 39 3 30 6 69Relaxation 17 6 23 0


The site had difficulty at first to welcome mother because of the camp manager who refused

to let the home based enter the site. The issue has been raised to the CCCM clusters in order

to receive the support of IOM and other camps manager.


39/83


Philippines

39

Part IIIACTIVITIES

8 Activities 45

ACF-Spain



40/83


Philippines

40

8. ACTIVITIES DEVELOPPED

1.Psychological support

The psychologist of the team had different follow up with the beneficiaries. The social

workers were the one supposed to be able to identify the mothers who needs psychological

support.

The principal problem was at first link to the disaster. Indeed, some mothers were suffering

from grief, with a mourning process on stand by. Some of them lost their children and could

not cope with this situation. For instance, one beneficiary mother of a severely handicap

child (William syndrome) was wondering why God save this child and killed the one who

was healthy. Mothers with guilt of saving their own life and loosing their babies in the flood

was a common topic and very hard to handle.

Some cases of maltreatment have been raised and feeling of loneliness, with husbands who

ran away from their duties and ole in the family.

As expected, the majority of the non pathological symptoms found their explanations into

the socio economical situation (living in Evacuation Centers, no job perspectives, no money,

no food). Lack of sleep, feelings of insecurity, fears of heavy rains came back regularly on

the one to one counselling.

Examples of follow up files

date age problematic psychologist intervention date problematic

Lost 2 children during the

flood

Stress debriefing try to cope up within the existing

resources

Depressed for 1 week

already

One on one counseling Able to smile and laughed

Have enough food inside the tent

03 feb 30

Not in good shape, sad and

very emotional

Relaxation technique

28 feb

Life must go on as verbalized by the

beneficiary

Lost all of her 4 children Stress debriefing Husband has worked already from

DOLE

Angry and depressed One on one counseling Trying to cope with the help her

husband and familyCant sleep well, feels

tired, mentally block

Relaxation technique She is presently 6 weeks pregnant

Angry with the LORD Had hope that even her 4 children

were gone life must go on

Can now sleep even if its raining

Accept the lost of her children

07 feb 22

Only 1 body of her child

found, 3 still missing

Used emotions releasing

technique like pulling of pillows,

tearing down papers into

pieces, punching sausages

pillows to release anger

1 march

Feels sorry about what she had

been saying about God


41/83


Philippines

41

Every two weeks, the psychologist provided a specific clinical case about a case he had to

deal with.

PRESENTING PROBLEM:

Lisod kog tulog pila na ka adlaw, saba daghang mag siyagit..hubog og katawa katawa sa

palibot...sige kod mata mata sa gabii labi na kung muulan dili gyud ko matulog kay mahadlok

ko.

Kung makakita kog mga bata nga 1 year old makahinumdum ko sa akong anak og mag hilak

ko as verbalized by the beneficiary.

I can not sleep at night recently, because its so noisy, some people talked very loud,

laughing and drunk people around the tent. Remains awake in the middle of the night. I can

not also sleep when rain comes at night; remain awake till the rain stop.

Beneficiarys profile.Mrs. J, 27 yrs old, married A, 26 yrs old. She is two months pregnant. They had (four) 4

children ages 8, 7, 6 and a 20 months baby boy Al Rhased who is still missing from the flood.

Religious catholic, currently living in the tent city at evacuation, Iligan City.

She finished 3rd

year high school and was forced to stop when she got married.

BEHAVIORAL OBSERVATION:

During the initial contact and first interview, the beneficiary seems surprise when her

husband woke her up from sleeping at around 2:50 pm under the shade of the tree. I was

then introduced by her husband and we sat at the bench. She appeared anxious and

apprehensive.She looks fair in hygiene with dirty hair and untrimmed nails. Blouse seems not clean,

crumpled and slightly lowered unto her shoulder.

THE STORY AND INTERVENTION:

We had a short conversation on the first day of interview last February 3, 2012. The

beneficiary started to recall back what was happened during the flood. At around 11:15pm ,

their neighbour was shouting that night when the water was rising so fast. They lived near

the river bank of Tambacan, Iligan City and because they were used to have the water raised

every time there was a rain, they did not listen to the shout and call from their neighbours.

She was very surprised seeing the water entered their house so fast with so many debris

She was alone that night because her husband still did not come home from peddling

peanuts in the street. She immediately picked her 4 children passing through their roof,

transferring from one roof of their neighbour to another. Since the water current was too

heavy, the place (roof) where they stayed moved and taken up by the flood going down to

the bridge. Suddenly logs bumped at them so she lost every child on her hands including her

20 months son. She struggled to swim without her children, bumped every walls, drowned

and hear the screamed of her children asking for help..(sobbing and stopped). Neighbours

helped her other children and saved 3 of them but the youngest was missing.


42/83


Philippines

42

At the end of conversation, she said that she had wished and pray that the lost child was still

alive and someone taking care of him.

Stress debriefing was done for about an hour of talking. Closure was made with a request

from beneficiary TO PRAY. I also had a one on one counselling and relation therapy was

made at the end of the session.

Follow up interview was made last Mar 1, 2012, she verbalized that life must go on after the

incident and had used every resources available to forget the past with the help of her

husband and family. She further said that she want job for her husband so they can moved

on. At the moment there were no enough food available inside the tent and giving of relief

goods and support from NGOs had stopped dropping in.

2. Drawing

Drawing is a way to express emotions. It is a tool of art therapy.

The first sessions were free sessions without any subject. Most of the women draws houses

(the previous or the one they dreamed about) or about the flood. (for instance the family on

the roof and some others locked inside the house). When they finished the activity, mothers

are invited to present their drawings and explain the content.

One of the subject is some session was about how do you imagine your children in 25

years?.The majority of the mothers draw their children being doctors or nurses, helping

people. Some mothers have been invited to draw something that represent them (a fruit, aobject, a flower..). All these times are supervised by the social animator. At the end of the

activities, the mothers should exchange about what they felt and what they tried to express.

By the time going, the team started to use scrap book techniques to develop other

possibilities of expression to the mothers.

A lot of these drawing were displayed into the tents.


43/83


Philippines

43

3.Story telling

This activity has been built with the team.

A first meeting has been organised in order to select the major problematic by sites. Eachsocial animator described the issues raised by the mother.

Once one problematic was chosen, one or several stories had been written. Handicap, role

of the step mother, early pregnancy, maltreatment, lack of support from the family (the loss

of the mother for a mother to be) and poverty are subjects picked by the team and

developed in the stories6

.

The objective of this activity is to provide the mothers the possibility to express their

emotions indirectly. They have been asked to describe what their feelings about the

protagonist, what he / she have done. Some of them shared their own experience; someothers used the protagonist to talk about themselves.

This activity should have been started from the beginning. The social animator fed back

that they have learned a lot about the mothers thanks to this activity.

6 all stories are capitalized in the annex


44/83


Philippines

44

Example of a story.

My mom only had one eye. I hated her, she was such an embarrassment. My mom ran a

small shop at a flea market. She collected little weeds and such to sell, anything for the

money we needed she was such an embarrassment. There was this one day during

elementary school. I remember that it was field day, and my mom came. I was so

embarrassed. How could she do this to me? I threw her a hateful look and ran out. The next

day at school..."Your mom only has one eye?!" and they taunted me.

I wished that my mom would just disappear from this world so I said to my mom, "Mom,

why don't you have the other eye?! You're only going to make me a laughingstock. Why

don't you just die?" My mom did not respond. I guess I felt a little bad, but at the same time,

it felt good to think that I had said what I'd wanted to say all this time.

Maybe it was because my mom hadn't punished me, but I didn't think that I had hurt her

feelings very badly.

That night...I woke up, and went to the kitchen to get a glass of water. My mom was crying

there, so quietly, as if she was afraid that she might wake me. I took a look at her, and then

turned away. Because of the thing I had said to her earlier, there was something pinching at

me in the corner of my heart. Even so, I hated my mother who was crying out of her one

eye. So I told myself that I would grow up and become successful, because I hated my one-

eyed mom and our desperate poverty.

Then I studied really hard. I left my mother and came to Seoul and studied, and got accepted

in the Seoul University with all the confidence I had. Then, I got married. I bought a house of

my own. Then I had kids, too. Now I'm living happily as a successful man. I like it here

because it's a place that doesn't remind me of my mom.

This happiness was getting bigger and bigger, when someone unexpected came to see me

"What?! Who's this?!"... It was my mother...Still with her one eye. It felt as if the whole sky

was falling apart on me. My little girl ran away, scared of my mom's eye.

And I asked her, "Who are you? I don't know you!!!" as if I tried to make that real. Iscreamed at her "How dare you come to my house and scare my daughter! Get out here

now!" And to this, my mother quietly answered, "oh, I'm so sorry. I may have gotten the

wrong address," and she disappeared. Thank goodness... she doesn't recognize me. I was

quite relieved. I told myself that I wasn't going to care, or think about this for the rest of my

life.

Then a wave of relief came upon me... one day, a letter regarding a school reunion came to

my house. I lied to my wife saying that I was going on a business trip. After the reunion, I

went down to the old shack, that I used to call a house...just out of curiosity there, I found

my mother fallen on the cold ground. But I did not shed a single tear. She had a piece of


45/83


Philippines

45

paper in her hand.... it was a letter to me.

My Son,

I think my life has been long enough now. And... I won't visit Seoul anymore... but would it

be too much to ask if I wanted you to come visit me once in a while? I miss you so much. AndI was so glad when I heard you were coming for the reunion. But I decided not to go to the

school.... For you... I'm sorry that I only have one eye, and I was an embarrassment for you.

You see, when you were very little, you got into an accident, and lost your eye. As a mother,

I couldn't stand watching you having to grow up with only one eye... so I gave you mine... I

was so proud of my son that was seeing a whole new world for me, in my place, with that

eye. I was never upset at you for anything you did. The couple times that you were angry

with me. I thought to myself, 'it's because he loves me.' I miss the times when you were still

young around me.

I miss you so much. I love you. You mean the world to me. My world shattered! Then I criedfor the person who lived for me. My Mother.

Comments of the mothers regarding this story :

This story is really heart touching and arousing respect for our parents. I am so moved

almost out of breath that I couldnt help but sit open-eyed and heart-broken. A real touching

story that reminds me of the true unconditional love of Mother, that's how mothers are...and

i always wonder why God make parents so loving and selfless while He provides them with

selfish children...this story may be fictional but it nevertheless points out the very lacking in

our human nature....the failure to fully appreciate the love of the person who loves us themost - that is, our mother.....I may have hurt my mother on several occasions, and after

reading this story, i felt terrible of those times......and I was so touch wondering whether my

own mother was ever hurt like this.

Some mothers said that this story is really a good example of the hardships they undergo in

order to let their son or siblings live their own life. They feel like a stepping stone to help

their children to become better individuals.

I Hope my children would realize how important their parents are. We hope they will

realize that without us, they can't taste the beauty of living. Naughty children won't realizetheir wickedness unless they became parents and have ill-disciplined children too.

Example 2

There was a woman named Jenny who came from a poor family and wasnt able to finish her

education. Jenny got married to a hardworking carpenter named Ricky at a very early age.

They were blessed with two children named Jane and Cathy. Even though they are not

wealthy, Jenny is living happily with her family.

Jenny loves to sew clothes which she used to sell to her neighbours. Everything that Jenny

earned from selling clothes that she made was used to put up a little display area for herproducts. They just get the budget for their needs from her husbands earning. It didnt take


46/83


Philippines

46

long for her business to grow because the customers loved the designs and quality of her

products. Years have passed until Jenny was already able to afford a huge place to sell their

products. Because their business was doing really good, Jennys family moved from a small

house to a big one which was located near their store. By that time, Jenny already had

several employees which she trained herself.

Jenny and her family were living a very prosperous life for several years until a very strong

earthquake hit their place. Jenny and Ricky quickly held Jane and Cathy and they ran to the

nearest hilltop for safety. They stayed there for the entire night with their neighbours for

safety. When they returned on the following morning, Jenny and her family were so

devastated when they saw that all the establishments on their area have been ruined

including their house and store. They were saddened when they learned that lots of people

didnt survived and were buried alive under the fallen building and trees.

Jenny and her family are forced to live on the evacuation center because its unsafe to live

again to their place. She had been crying for several nights because everything that sheworked hard for are already gone, but she realized that theyre still very lucky because her

family is still complete and thats more than enough for her to be able to carry on.

At the evacuation center, they received so many used clothing as donations. Unluckily, most

of the donated clothes didnt fit them. So Jenny decided to cut these clothes and stitched

them into rugs. She then sold those rugs to her fellow evacuees. Since classes are

postponed, Jane and Cathy helped in selling the rugs that Jenny made.

Jennys earnings from those rugs are then used to buy materials to sew some clothes again.

She was so excited about the idea of starting her clothing business again. Her husbandconstructed a little store for her products. It didnt go well at first, but Jenny didnt quit. She

persevered until her effort paid off. Her business started to grow again and they were able

to buy a bigger place for their products. This time, Jenny ensured that their store is already

shock proof and she also made sure that half of her earnings would go to the bank in case

another calamity would come.

Comments of the mothers regarding this story:

One mother asked if the story was real. The social worker answered that it had happened in

order to help to realize that they could be the protagonist.

One mother said it was similar to her own life story. She came from a poor family, but

managed to start a small business that was gone after Sendong. She said that like the story,

theyre still on the chapter when the family is struggling at the evacuation center but

that they are still heading where the family was able to get up from the misery that theyre

experiencing.

Another said that she learned a lot from the story because during the typhoon Sendong, lots

of family really lost their savings because they kept their money on their respective houses.

If she would have enough money, she would start saving her money in the bank and if shewould be able to buy or build a new house. This mother added that almost every mother at


47/83


Philippines

47

Madrassah are like Jenny. They got married early and were not able to finish schooling to

focus on their children. According to her, the story of Jenny could serve as an inspiration

because even if they dont have a college degree, there is still a huge possibility for them to

succeed. If they would just have the right attitude; they know that in time, they would also

prosper.

One other mother said that she was somewhat relieved when she heard the story because

she used to have a business which she lost after Sendong hit the city. Like the character, she

was also devastated and she almost lost hope because she lost almost all the material that

she and her family used to have. But right now, she was starting a buy and sell buisness

which helped in her familys finances.

A other beneficiary was thankful of the story because she got an idea that even with the

simple resources, she could be able to make money out of it. This mother said that she

would try. Her house and business were entirely ruined by the flood, but she was still

thankful that her husband and all her 11 children survived. She said that she will try her bestto be positive for her family. Right now, she still has so many worries, but she is trying to

overcome it. She will be starting a small jewellery business soon and she is hoping that it

would also succeed like her former business.

4 Psychodrama (activity lead by the psychologist)

The psychodrama is a role play involving the beneficiary to play an unwritten role. In this

role, the beneficiary is supposed to express true feelings toward individuals. The

psychodrama setting should be provide to the beneficiaries with a safer and less threatening

atmosphere than the real situation. When the drama has been completed, group membersfrom the audience discussed the situation they have observed, offered feedback, expressed

their feelings, and relate their own similar experiences. In this way, all group members

benefited from the session, either directly or indirectly.

The first psychodrama was over the flooding. It ended up in tears for the player and the

audience. It has been very difficult to handle by the team.

It has been decided to focus on psychosocial problematic like a sick mother who does not

know how to feed her baby, knowing that she can breastfeed but stooping it because of the

familys pressure.

One session was about a teenager discovering that she is pregnant and how to tell her

parents. Some mothers played and threatened their daughter to shave their hair in signs of

shame, some played the fathers a debriefing one mother said that rather than creating

new problem why not trying to solve this one .

They played again and agreed that the best way to act is the mother to talk with their

daughters previously to prevent any risks and if their daughter goes back home pregnant

they will convince their husband to support her.


48/83


Philippines

48

In Madrassah, the psychodrama was around maltreatment or husband having different

wives. The subject is taboo. This is reason why it was so interesting to observe mother

evolving into the play, finding a free space to express true emotions and feelings, protected

by the rules of the game ; indeed it was only a play role

5. Group talking

The psychologist overwhelmed by the demands of one to one counselling could not be

available for the beneficiaries who need support. The team decided to rule some groups of

expressions of emotions.

The three different groups talk of identification to are meant to be a first step to talkabout the emotions. Because it was very difficult to the beneficiary to open themselves to

unknown mothers, we choose to use symbolic element to help them to talk about

themselves.

Identification to a fruit.

The psychologist asks the mother if they were which one they will be. The objective is to

conduct the mother to identify their main state of mind.

The mango was identify to a sweet person, avocado to bitter person, the orange to a

dynamic one, the banana7

the type of person who helps the other one, the avocado because

it is green is linked to someone healthy

Identification to a tree.

The bamboo was picked by women who fought their had good roots and even when it is

windy they come back straight, the eucalyptus by mother who give the feelings to strong to

the other but are in reality fragile, the coconut is the symbolism of the one who save lives (

7 the lnk does not seem to ease to understand. The banana is good when someone suffer from stomach ache,so if you eat it, you feel better. Conclusion helps to soften the pain


49/83


Philippines

49

coconut tree saved the life of a lot of survivors), the mango for the one who thinks providing

shadows to their beloved when they need it.

Identification a flower.( few examples)

The orchid, beautiful flower and stronger than the roses.The gamamillo for the mothers who wants to perfume their lives and the one of their

families.

The sempageto is the one for the believers in god, a saint flower used to decorate the saint

status.

The ten more important things in their life.

The objective was to help the mothers to learn of to prioritize. The mothers first have to

write on a piece of paper there own list. There are asked to borrow five of them and be able

to explain why they are less important than the other one. Then three other have to be

deleting with the same process of justification of why.

At the end, the list was very different from one to the others. Certain mothers kept their

own mother on the top list rather than their husband, certain their husband rather than

their children. Some mothers put the neighbours on the top of their list or their siblings

The last talk group what happens next

One of the exit strategy and to prepare the mother of the cloture of the tents, some talk

groups have been launched with a subject what will happen after the cloture of the

mother baby tent . Each mother has to design one objective, in order to have a goal in their

life.

Same process than before, mothers write on a piece of paper their own objectives and the

share it with the group.

Some mothers would like to go back to school; some others would like to open a small

business. Others are to focus on the relocation status. They think they can not start a new

life till they are living in a relocation site. Some of the women said that they will find the

strength to leave their husbands who maltreat them (and be supported by their new friends

met into the tent)

6.Specific activities for pregnant women.

Pregnant women need a special attention. The activities should be conduct

Documents

MOTHER BABY FRIENDLY TENT: CARE PRACTICES AND PSYCHOSOCIAL SUPPORT