santo nino festival, samar style

samar is a large island, the third largest in the philippines, which lies just northeast of tacloban. it is one of the poorest and most undeveloped areas of the country. yesterday ariella and i joined a local intern, mel, on a trip to see the annual santo nino festival in a town called paranas, about 2 hours north of tacloban. the festival is modeled after a much more famous one in cebu, an island to the west. it is a syncretistic festival that combines elements of catholicism and the animistic religions of the area prior to colonization. the different barangays (villages/neighborhoods) of the town each prepared their own large and elaborate dance presentation, complete with ornate costumes, for a massive weekend-long competetion between neighborhoods. each troupe had a theme, examples being fishermen, birds, shellfish, and fairies of the night. each group of performers had about 50 participants, mainly children, as well as their own musical emsemble, primarily drums and trumpets. first they had a parade around the streets of the town, which ended at the town square. everyone crowded around, folks teetering on plastic chairs, hastily constructed bleachers, and the roofs of surrounding structures, all to catch a glimpse of the presentations. the festivities began with an arduous and underwhelming 20 minute reading of the official rules of the competition in english, a language which almost none of the attendees know. then, each group presented their 10 minute long, cirque-de-soliel-style choreographed dance routine. it was truly amazing! the last group to go had a feathered theme, and their dance centered around a morbidly obese teen, evidently the town’s most popular individual. she fluttered around the stage decked out in real feathers to deafening roars of excitement from the crowd, while her physically diminutive peers danced voraciously in the background. a winning team will be declared, and will be gifted a statuette of a saint to parade around, as well as a cash prize for their neighborhood, ideally used to purchase supplies for next year’s elaborate costumes. great way to spend a day!

filipino approaches to rural community health

the medical school we are rotating at here, the leyte branch of the university of the philippines, uses an interesting model. it has a special mandate to train primary care phyicians to work in rural communities. all its students complete a fifth year of medical school, one more than other medical students in the philippines. this year is spent as an “intern” in an assigned rural community, and major focus is placed on becoming an integral member of the community as opposed to just its physician. to attract students, medical education at this school is subsidized by the government and provided free of charge to the students, provided they pay back the time working in rural areas. prior to typhoon haiyan last year the school was based in the nearby town of palo, but the campus was completely destroyed, so it was moved to some buildings in tacloban which survived the typhoon.

this week all of the local class of interns returned to tacloban from their work sites to attend a training session on how to train community health workers. we were priveleged to be able to attend as well. the village units in the philippines are termed “barangay,” and it is at this level that many decisions are made, as government in the the philippines is in general rather decentralized, thanks to geographic isolation and countless disparate ethnic groups and languages. the intern’s focus is on developing good relations with the mayors and other leaders of the barangays, in an effort to address some of the social determinants of health – a preventative effort at the community level as opposed to simply dealing with individual’s acute health needs. the training session focused on how to give good presentations and effectively run a meeting while remaining cognizant of the best interests of all stakeholders. icebreakers and frequent dancing were a major theme. also discussed were strategies for identifying public health issues and how to go about fixing them using the community’s ideas. this was primarily in english, which all educated filipinos speak, thanks to the history of american occupation. often however, talk will trend into “taglish,” a combination of english and tagalog, the national language which almost everyone speaks. filipinos love acronyms, indeed even more than americans do. the medical system here, at least at this school, is profoundly non-hierarchical. the faculty and school leadership attended the training, and if we didn’t already know who they were we could never have guessed, as they were following orders and joking around just as much as the interns. get a group of filipinos together and there will be a joke told at least every 30 seconds, and everyone will laugh even at things which aren’t meant to be funny. people here love laughing, and its great!

made it to tacloban!

we finally made it to tacloban! our flights were delayed for a day due to a tropical storm that was bad enough to cut the pope’s time here short, and then delayed further as a plane carrying prominent filipino government officials had crashed and remained on the runway at the tacloban airport. it is far warmer and more humid here than it was in manila. tacloban is an endearing little dirty city of about 200 000 that only really became famous after it was decimated by typhoon hayain last year. most of the downtown has been entirely rebuilt, and the place really seems to be booming. it has apparently become a lot more cosmopolitan since the typhoon, as lots of businesses (western-style coffee shops, fine dining establishments, and even used book stores) have opened up to cater to all the aid workers and to take advantage of the influx of aid money. seemingly the first things rebuilt after the typhoon were shopping malls and fast food restaurants. there is a dunkin donuts franchise quite literally every block, but none of them have coffee. its on the menu, they just don’t have it. despite the fact that one can live a luxurious life here with money, obviously most people don’t have those kinds of means, and life remains very tough economically, not to mention all the terrible loss of life from the typhoon.

tacloban is on the island of leyte, on the eastern edge of the philippines about half way down the archipelago. the vernacular of the area is called waray-waray, although the national language tagalog is spoken by everyone as well, and educated people speak english quite impressively. after much searching we found a place to stay. with all the aid workers who came after the typhoon the prices for rent increased exponentially. an average room with air conditioning, hot water and wifi rents for about us$1000/month. we weren’t prepared to spend that kind of money for rent in the philippines, so we found a couple rooms with none of the above amenities at a hostel called ron and fire’s place on the outskirts near the bus station. ron is an australian and fire is a filipina, and there are occasional travelers sifting through which is cool! something (we can only speculate that it is a trapped bat) flaps around in the rafters when the fan gets turned on, and the neighborhood rooster ensures we wake at the crack of dawn.