maandag 23 april 2007

Dusty Manila


Manila.. sticky, hot, dusty, chaotic, strange, friendly, jeepney vivid, but most of all a city with extreme contrasts.. Where the extreme poor can watch and smell (though not taste) how the extreme rich leaves their food untouched food on the tables of expensive restaurants.
Where the richest neighbourhood is 1 block away from the new smokey mountains in the coconut-valley. Where most children in the slums die of simple asthma attacks, while the richer kids who are getting as fat as in our countries are easily taking insuline tablets (for elderly diabetes) on their 15th. The 1st and the 3rd world all combined in one city with all the contrasts succeeding it.
And this is only day 2 in chaos-city.
But I don't hate this town, I can't hate it. I feel ok here, even better than yesterday when I just arrived.

Frightened I took the public transport for the first time this morning in the traffic mess.. Afraid to be mugged, afraid to draw too much attention, afraid to take the wrong jeepney (see film), afraid to get out the wrong stop. Aarghh its so terrible not to be able to communicate in their language! Im lucky they had the colonial past of the Americans, and everybody can speak English, mais o menos, but it just doesn't feel right. (I bought my dictionaries already! ;))


On my way to Gabriela, the women's party of the Philippines, to visit a medical community project in the favelas (slum) south of Manila. Because most of these slums are never visited by doctors and the people living there simply have no money to go to the doctor themselves (health care is completely privatised), Gabriela has put up free health care services for them. Through charity and funding they have created a mobile Pharmacy and every community is visited twice a month by a volunteering doctor and health workers (women living in the slum themselves) are educated by gabriela to provide local first line care.

If only I could describe for you the situation in the village, so you could visualize the pictures which are still running in my head. Tiny square houses, as big as my kitchen, filled with large families, 5 on top of each other and in each house another family. Sewage water running throughout the village, children playing in it, some dressed, most naked, women washing their laundry in the end stream, men playing cockfights. Smelly and incredibly dusty, located next to a large paint factory where most of the inhabitants work. The doctor was sent in from Belgium by Intal, assigned to work for Gabriela for a period of 4 years.
And then I remembered Im a fourth year medicine student... I took place next to the doctor and started to examine the long line of patients who had not seen a doctors for a long time one by one. Many cases of TB, most children suffering from asthma because of the extremely dusty environment, lots of allergic reactions and an extreme demand for vitamins.
Even though it was such a great experience to be able to finally make use of the advantage I have gotten to study medicine, to be able to contribute, I feel so strange... I have a strong feeling of powerlessness and injustice... What can we do for these people? We looked at them, examined them and prescribed, for we can not send them in for further investigation, operations.. We cant even prescribe them most of the life-saving medicine some of them needed. These people will never be able to afford any real medical care. And yet they were so incredible grateful to us to visit them. Just something so simple as insulin injections, needed for worsened cases of diabetes is incredibly expensive, even though it is the only remedy for most people not to go blind or even die because of diabetes. Sickness and health is not a question of medical possibilities and advantages in medical science. It depends on where you live and how you were born. And then of course there is the question if I, a 4th year med student with almost no practical experience, should take the responsibility to examine these women and children and men, with serious illnesses... (don't worry, I think I did ok)
Through it all... when i drove back in the jeepney in the night, I didn't feel so scared anymore, I didn't feel like I was extremely far from society, that because Im a tourist its obvious im so much richer and I shouldn't confront the people with that. Because of this fear my behavior was awkward, and when riding back in the night, after seeing all these people from a completely different world , but still having faced them, talked to them and even touched them... I felt so good.

Tomorrow will be a big day! I will fly to Mindanao with doctor Romy (my extremely nice and active assisting doctor). Chiquita banana has given permission (this was actually a really long story) to come and take interviews of the plantation workers to monitor the pesticide- use and effects! This is extremely important and also very strange since you may know that chiquita is the new name for United Fruit, a terribly corrupt company with involvements in establishments of dictatorial regimes in middle-america and CIA(see link). Romy has previously been sued by another banana plantation of the Philippines for exposing them on their pesticide use. Im secretly praying that this will not be a trap and that they will abduct us as we arrive in the plantation. Anyway.. if you dont hear from me for a long time...... ;)

Sorry for making it again so long... thanks for reading! I hope to make pictures soon!

vrijdag 20 april 2007

Voorbereidingen...

Uiteraard kan de lang gemaakte belofte tot een weblog vol met avonturen en overpeinzingen uit de Filippijnen pas 's nachts, zo'n 10 uur voor het daadwerkelijke vertrek waar worden gemaakt.
Maar hier is ze dan: bij deze zal ik proberen regelmatig iets te vertellen over mijn onderzoek en de situatie in de Filippijnen, met name de regio Mindanao, waar ik de komende drie maanden zal verblijven om onderzoek te doen.

De bedoeling is dat ik voor mijn studie een zogenaamde KAB(Knowledge, Attitudes and Behaviors)-studie zal doen naar de kennis en het gedrag van Filippijnse boeren omtrent pesticiden.
In de regio waar ik zal werken (Davao del Sur) maken de meeste boeren gebruik van extreem toxische pesticiden. Al eerder verrichtte onderzoeken hebben laten zien dat het hoge aantal doden in ontwikkelingslanden ten gevolge van pesticiden voor een groot deel wordt veroorzaakt door het verkeerde gebruik ervan.
Met mijn onderzoek hoop ik een beeld te kunnen creeeren van de kennis en het gedrag van de boeren en te kijken of dat van bepaalde factoren afhankelijk is, zoals geslacht, leeftijd of eerder doorgemaakte ziektes. Het is ook belangrijk om aan te tonen of de boeren wel voldoende zijn geinformeerd over de gezondheidseffecten en de juiste manieren van toepassing.
Het uiteindelijke doel is de beste manier te vinden waarop de boeren zouden kunnen worden ingelicht over pesticiden en het gebruik ervan. En natuurlijk dat ze dan allemaal de mogelijkheid krijgen om op zo'n veilig mogelijke manier hun pesticiden toe te passen waardoor er geen onnodige slachtoffers meer vallen. Maar goed.. Ik focus me voorlopig op het verkrijgen van de onderzoeksresultaten en daarna begint het redden van de wereld! :)
Ik ga uiteraard niet in m'n eentje de donkere paden van de bananenplantages betreden. Ik wordt bijgestaan door de NGO (non governemental organization) PANAP: Pesticide Action Network Asia & Pacifics (www.panap.net).

Hoewel mijn onderzoek alleen al ontzettend interessant is :), hoop ik ook meer over de situatie in de Filippijnen te kunnen vertellen. Op het moment gaat het namelijk niet zo goed met de mensenrechten in deze 'voormalige' kolonie van Amerika: sinds mevrouw Gloria Macapagal-Arroyo (GMA) aan de macht is, zijn er deze afgelopen 7 jaar al meer dan 800 politieke moorden gepleegd. Hoewel je er nooit iets over hoort, de Filippijnen is na Irak het gevaarlijste land voor journalisten om hun beroep uit te oefenen. In de aanloop naar de verkiezingen in mei lijkt het deze periode steeds onrustiger te worden, met als absolute dieptepunt de arrestatie van een van de belangrijkste oppositieleiders afgelopen maand.

Ok.. nu wordt het toch echt tijd om te gaan slapen en te dromen over het vliegtuig, dat mij in de ongelovelijk korte tijd van 12 uur naar de andere kant van de wereld zal brengen en me uit zal leiden in een volkomen verschillende omgeving, met andere kleuren, temperaturen en omstandigheden.... Philippines... here I come!