Philippines

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In the Philippines, our organisation concentrates on support to disabled people through projects on rehabilitation, inclusion and rights of disabled people, especially those living in conflict-affected areas.

CONTEXT
The Philippines is among the poorest countries of South-East Asia, with a poverty incidence of 28 percent.

The Philippines are experiencing structural, financial and economic problems and there is an unequal distribution of resources. The combination of an unbalanced budget, massive external debt and a low level of tax collection are posing a real threat to the country’s stability and of creating “another Argentina” unless quick and coherent measures are taken.

For over 30 years, the Philippines have also face civil unrest in Mindanao, particularly bad in 2003 (more than 300 000 displaced people) and more sporadic in 2004, despite a number of truces and peace talks brokered by the Malaysian government. There have been terrorist attacks in Manila and several parts of Mindanao. Mindanao is the poorest region in the Philippines but the security situation makes it impossible for aid agencies to work safely.

Job opportunities are scarce: 2,500 Filipinos leave the country every day to find a job abroad and 10% of the GDP comes from Overseas Filipino workers. The towns are overcrowded: rural poverty, “dreams of the city” and industrialization have resulted in movements of the population towards areas of growth. In the towns, there are many street children, and in rural areas, many children work.

Health services have improved, but there are still wide disparities in this field according to population groups, income categories and geographical areas. Accessibility is still very difficult for poor people and the situation is critical for people with disabilities.

The country is prone to natural disasters: every year there are 20 or so typhoons, as well as earthquakes and flooding.

BACKGROUND

1988 - 1994: Handicap International set up of 15 orthopaedic workshops and a network of orthopedic NGOs throughout the country.

1997 - 2002: support to the SHEPACC project, an educational project with the Manobos, an ethnic group in Mindanao.

2000: the orthopedic NGO network asked Handicap International to provide additional technical support.

2001: Handicap International opened an office in Manila. Launch of a reconstruction project in Negros after a typhoon. Start of CAHD (Community Approach to Handicap in Development) in a rural community. Training of orthopaedic technicians.

2003: training of orthopaedic technicians. Opening of offices in Cotabato and Cagayan de Oro cities in Mindanao. Community-Based Rehabilitation projects in conflict areas.

2004: Launch of Hilwai project, an orthopaedic boat for the islands in the central part of the country.

ACTIVITIES

1. Support to war victims in Mindanao
The conflict in Mindanao between rebel groups and army has created a lot of displaced persons and war victims.

The initial project started in 2003, consisting in training social and health workers from NGOs to include disabled people in their activities or refer them to existing structures. The project has now developed a more systematic approach with multi-sector and multi-level action based on the training and transfer of technology to existing actors in the field of inclusion of disabled people.

A CBR project is also providing technical assistance and support to community volunteers.

A rehabilitation centre was opened in 2004 in Mindanao and the staff has been trained to provide orthopaedics and physiotherapy services.
Finally, a comprehensive referral system is being built up to refer people in need to existing services in Mindanao.

2. Hilwai, a mobile rehabilitation unit
The Philippine archipelago is composed of 7,100 islands; about 400 are inhabited, most of them are remote, without basic services such as rehabilitation services. In partnership with partners and local authorities, Hilwai - a 15 meter boat equipped with an orthopaedic workshop - is now used to cover islands in the central part of the country, the Visayas. In addition to orthopaedics, the project also focuses on CBR, community awareness, disability prevention and organizing local support groups.

3. Wheelchairs for Mindanao project
Wheelchairs are the most commonly used mobility devices but are still not appropriate to the Philippines context, especially in Mindanao. A comprehensive project focusing on wheelchairs is being implemented, focusing on setting up a production centre of low-cost wheelchairs and distribution throughout Mindanao. The project also includes socio-economic components (e.g. employment, sport, accessibility).

4. Diabetes Project
Diabetes is the sixth cause of death in the Philippines and when not properly managed, could lead to disabling complications such as chronic ulceration, amputation, hemiplegia and low vision. The project aims to avoid the onset of the disease among people at risk (physically inactive persons, smokers, hypertensive, obese, etc.) through awareness-raising, delay or prevent people with diabetes from developing complications through capacity-building of local medical workers, and prevent mortality among diabetics with complications by improving the quality of patient care. Handicap International is expected to manage and coordinate the project activities by mobilising technologies and resources available through its international network, as well as take the lead in project monitoring, research and publication of selected activities.

5. Solid waste management
The project seeks to improve the living conditions of some of the most vulnerable urban households in Mindanao through an innovative implementation of a solid waste management system. It seeks to target 10,600 households in Cotabato City that can be found along the city’s two major rivers and near big market establishments. Poor sanitation and waste disposal in the area pose a great threat to the health of the people, causing the spread of diseases such as dengue, diarrhea, worm and viral infections that could lead to death and permanent disabilities especially among children. Project strategy will involve: the promotion of waste reduction practices and of responsible behaviours with respect to health hazards posed by waste disposal at the household level; village empowerment through solid waste “public-private governance,” and the enhancement of institutional capacities of local solid waste management authorities.

BENEFICIARIES

Figures for 2006
• 528 PWDs were given various assistive and mobility devices
• 288 rural health, humanitarian, emergency and reconstruction workers were trained on disability identification, primary intervention and community-based rehabilitation therapy
• 1,196 students, teachers and school staff participated in disability awareness activities
• 313 persons were given community-based rehabilitation therapy
• 3,767 persons were assisted during medical missions in Southern Leyte


RESOURCES
In the Philippines, Handicap International's team is made up of  48 national staff and 3 including 1 Japanese volunteer international staff.

CONTACTS
E-mail: bgobin@handicapinternational.ph