Journey to advocacy: Barangay Sumaoy: Journey to advocacy: Barangay Sumaoy

Leilanie Arellano, MSN (Leadership and Health Education), BSN, PCCN Founder Inspirational Alignment Advocacy Foundation, Inc.

Leilanie is currently enrolled at University of Phoenix pursuing Doctorate Degree in Health Administration

The purpose of this article is to present some of the health needs and problems of an underserved community in the province of Camarines Sur, Philippines. The municipality of Garchitorena is subdivided into 23 barangays which include Barangay Sumaoy. Barangay Sumaoy has over 2,000 population, and I had the opportunity to visit this community several times this year. As a humanitarian and registered nurse in the United States, it is my desire to spark inspiration in advocacy to vulnerable populations such as Barangay Sumaoy. Collaboration with relevant stakeholders through health promotion and disease prevention programs will help protect and promote health in this community.

Following my passion in advocating for underserved communities has taken me to many places in the Philippines and my experiences have given me new perspectives. With the foundation’s humble beginnings in giving back to the society in 2014, each experience is unique and motivating. As I traveled to different places reaching underserved communities, the lack of resources and education in vulnerable populations gave encouragement to work harder on charity missions. I was inspired to continue to reach out with compassion and contribution. Passion must be in alignment with action and it is imperative to help those in need to make our world a better place.

My first trip to Sumaoy was in June and I am grateful to Raymond Borja from Bright Lights Academy Charitable Organization for the opportunity to get to know the community. From Manila, my flight took about an hour before arriving in Naga City. Sumaoy is about 4 hours away from Naga City; almost 2 hours by public transportation called jeepney and two hours by boat. The commute can be uncomfortable because of crowded seats. Since there is only one boat that set sail to Sumaoy every day and no scheduled time when the boat leaves, the safest thing to do is to arrive at the port area by sunrise. We waited for almost 5 hours before we sailed the sea.

Barangay Sumaoy’s economic threshold is below the poverty line. Sources of family income are from farming and fishing. Most of the homes are made of bamboo, called nipa hut with weak structures. The community has limited access to electricity (from 4 pm to midnight only) and limited water sources. Only a few families have toilets, and there are no public toilet facilities in the community. The residents have limited access to health and educational services. One of the health concerns I observed during my visit was the lack of education in preventing the spread of diseases. The community had cases of pink eye, mumps, scabies and upper respiratory infections. Children affected continue close contact and run around with others which increases the risk and prevalence of spreading the diseases within the household and in the community. There is also lack of knowledge about the disease processes and treatments. I gave instructions to some of the parents and children about preventative measures in spreading the diseases and interventions, however as a healthcare professional, there is a need to create programs to help assist in dealing with health needs and problems in the community.

Advocacy is essential to underserved community settings for health promotion and disease prevention. A systematic approach must be developed to help protect and promote health in the community and vulnerable populations (Ezeonwu, 2015). The core attributes of advocacy are to promote the well-being of individuals through safety, autonomy, coordination of care, and engage in improving policies that directly impact the health of the community (Ezeonwu, 2015). Over the centuries, nursing pioneers such as Florence Nightingale and Margaret Sanger pursued health advocacy and reform in poverty, poor housing, communicable diseases, lack of family planning information and lack of access to health services in underserved communities (Ezeonwu, 2015). Through shared advocacy and collaborative efforts, programs can be created and implemented in Barangay Sumaoy to help improve the lives of the residents in this community.

My second trip to Sumaoy was in July, and another unique experience guided me to continue contributing to this community even in a small way. Sumaoy is an indigenous community, but a few miles away lies a hidden paradise of different islands. Raymond and I with four children explored an island for a day of swimming, hiking, and pure enjoyment. The turquoise waters were warm and rich with relatively unexplored diverse marine life. The sand was rich with beautiful jewels that the sea has generously brought to the shore. The children collected seashells, and I appreciated that each of them gave beautiful and rare shells as a souvenir from the island. We swam and played with the gentle waves of the sea. The crispy laughter of the children filled my heart with joy and appreciation. However, a near drowning experience by one of the children turned the joyful experience into a terrifying experience for a moment. I saw the child went limp in the sand coming out from the water, and lost consciousness for a few seconds. I immediately assisted him, and when he responded, he complained that he could not breathe. I could hear him wheezing, and he turned very pale. Thankfully, after intense arousal, the child returned to full consciousness and vomited ingested water. His color was no longer pale, and he stopped wheezing. After a short break, he was back in the waters and played like nothing happened. As I watched the children play, the experience made me reflect on the scarcity of resources in life-threatening situations, such as near drowning or drowning. Raymond had also shared that a child in the community died a week before our arrival and no resuscitative efforts were provided due to lack of resources and trained health care professionals.

Nurse theorist Jean Watson was an advocate for human caring and compassion (Lukose, 2011). As a healthcare professional, I embrace the philosophical and ethical implications of nursing based on theory and practice of Watson’s Caring Model. As a humanitarian, I believe that human beings are interconnected and our experiences can help create in-depth awareness to assist in healing process whether in the work environment or on missionary work. Jean Watson believed that human caring to patients, families and communities create a vital consciousness of human connection (Lukose, 2011). Caring can foster the development of authentic relationships and assist in healing process (Lukose, 2011). With reflections of Watson’s Caring Model of Nursing during my second visit to Sumaoy, I was guided to make an action to help provide medical resources to the community specially in emergency situations.

Returning to the United States after my second trip, I reached out to potential donors for medical supplies as a gift to the community of Sumaoy. I am grateful to the generous donors who participated in this small project willing to help make an impact in the community even in a small way. Through collaboration with Raymond Borja and Caribel Iglesia (Principal of Sumaoy Elementary School), we delivered medical supplies to Barangay Sumaoy in September. Basic first aid training was provided to the participants and education on proper use of the medical supplies. I provided care to some patients with different health problems such as stage 4 wounds, second-degree burns, hypertension, skin problems and upper respiratory infections. Due to poverty, some medical problems are not treated, and some patients go through physical and psychological suffering for a long period due to lack of treatment. Lack of knowledge and education also leads to wrong decisions in health management. One of the patients who had an elevated blood pressure stated that he took Metoprolol 100 mg twice within 24 hours. This cardiac medication was not prescribed to him. A friend shared this medication to help decrease his blood pressure. These decisions can create harmful effects, and the possibility of sudden life-threatening adverse reactions.

Engaging in purposeful conversation and developing rapport with the participants and patients was rewarding. The concept of advocacy is to allow vulnerable population’s voices to be heard (Ezeonwu, 2015). Advocacy helps create a major shift and allow individuals to express health needs and problems (Ezeonwu, 2015). As humanitarians, Raymond and I have a responsibility for individual voices to be heard and assist with vulnerable population’s needs and problems. To Caribel, as a principal of the Sumaoy Elementary School, she has a responsibility to advocate for the children and ensure that health and educational needs are met.

Caring takes human beings to a deeper level of connection (Lukose, 2011). The art of caring and healing modalities integrates healing process that ensures the quality of life (Lukose, 2011). Advocacy gives the vulnerable population the opportunity of developing self-autonomy and make better decisions in health management (Ezeonwu, 2015). Informing vulnerable population about disease processes, medications, and treatments can help individuals develop responsibilities and empowerment for self-care management (Ezeonwu, 2015). Creating a change for improvement in underserved communities emphasizes social justice aspect of advocacy (Ezeonwu, 2015).

Barangay Sumaoy is now a home to Raymond Borja. Although he spent most of his life in the United States, there is a special connection that brings him back to this indigenous community. His mother grew up in this community, but due to poverty, she decided to leave the barrio. She pursued her dreams of becoming a nurse and resided permanently in the United States. Her vision was to return and give back to the community. This vision is now being realized by her son Raymond through his humanitarian efforts. As a nurse, I feel interconnected not only with the vision of giving back but her passion in caring for others. I am grateful to Raymond for the opportunity to serve this community. Sharing my experiences, my pure intention is to create a ripple effect of inspiration and action to help underserved communities, such as Barangay Sumaoy. Inspirational Alignment Advocacy Foundation, Inc. and donors will continue to provide educational resources and medical supplies to Sumaoy.

Conducting an in-depth survey and research will help identify specific needs and problems of this community. Research outcomes will guide appropriate development and implementation of systematic programs consistent with theory and evidence-based practice. Shared advocacy will help provide access information and resources to promote health, prevent diseases and manage diseases to prevent complications. Collaboration with relevant stakeholders will help protect and promote health in this community.