Community Health Evangelism/Education (CHE) Antique, Philippines
Medical Ambassadors in Southeast Asia (MASEA)
Rhodora T. Mendoza, Ph.D. Email: rtmendoza@mybizlinks.net
The Community Health Evangelism (CHE) Program in the Philippines was introduced by
Medical Ambassadors International (MAI) in 1989.
Medical Ambassadors in Southeast Asia (MASEA), the partner in mission of MAI was given
the task of establishing the first model CHE communities in eight regional areas in the
Philippines, using the CHE strategy, a holistic approach in Christian development designed
to help people in poor, underserved and depressed communities to take responsibility for
meeting their physical and spiritual needs.
One of these regional areas, located in the island of Panay, is the Province of Antique
where a team of four(4) full-time Christian workers, together with the other seven (7)
MASEA Teams went through a five day Training of Trainers course on how to implement
the CHE Strategy.
One of the first communities they identified is a village named Igdalaguit, near the foothills
of a town called Sibalom. This was considered one of the most depressed villages in the
area and it had the sad experience of being visited by an epidemic every year, especially
when the rainy season sets in.
The first few months were the most trying months that tested the faith and commitment of
the team. While most of the village leaders, with whom they shared their vision, showed
great interest in adapting the CHE program, they also encountered stiff opposition from
some leaders who suspected the team as coming to their village to “convert” them to their
own denomination.
And so, although the village leadership voted overwhelmingly to adapt the CHE program
and began to identify from among themselves people who will be trained as the Committee
to oversee the implementation of the program, the team continued to encounter not only
opposition, but also discouragement especially from government and non-government
agencies who kept giving them negative feedback about the attitude and behavior of the
village people, some agencies calling the people,lazy,uncooperative, ungrateful and so
forth.
One lady, who headed the powerful association of the Catholic Women’s League of the
village continued to oppose every action and activity of the team. After each training
activity or visitations made by the team, she would immediately visit each participant and
tell them not to follow what they were being taught because these people (the team) were
actually being used by Satan to mislead them and lead them away from God.
One night, this lady was lighting her small kerosene lamp to prepare the evening meal. She
did not know that her son borrowed her bottle container to buy gasoline for his motorcycle.
When she poured unknowingly the contents of the bottle in her lamp and lighted it, the
whole lamp burst into flames and ignited her whole dress. She panicked and started
shouting for help. Fortunately, the team was in a nearby house visiting a family, and when
they heard the cries for help, they immediately ran and helped put out the fired that
engulfed the woman. They hired a vehicle to bring her to the nearest hospital in the capital
town of San Jose, Antique and stayed with her while she was being treated, and bought all
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the prescribed medicines for her. Everyday the team was in the hospital, looking after her
needs and praying for her. On the second week, as she was recovering, she quietly asked
the team who was visiting with her, “Why are you doing all these, in spite of what I have
done to you?” The team simply answered, “We do this because of the love of Jesus. And
we want to share this love with you.” And the woman, upon hearing this began to cry and
between her tears said, “I want to know your Jesus.” And that night she received Jesus into
her heart. Upon her complete recovery, she became the most vocal champion of the
program and she went from house to house, encouraging families to get involved in the
implementation of the program.
This remarkable incident completely turned around the program in the village. The village
Committee completed their training and began identifying people who were trained as
CHEs by the team. They formed the core of volunteer health workers in the village.
Included in their training were physical lessons on diarrhea, malaria, dengue, skin diseases
and other sickness that regularly visited their village, and other lessons on sanitation,
hygiene, gardening, latrine making. After each physical lesson, they also taught spiritual
lessons on the significance of having a right relationship with Jesus. The focus of the
training was on prevention of diseases, promotion of good health and on how to live their
lives under the leading and blessings of God. After each session, these villagers under
training would immediately practice what they learned in their own homes. Then they
started visiting their neighbors, sharing the lessons they have learned. And because these
CHEs were practicing what they were teaching, and visible signs of changes began to show
in their homes and in their lives, they became very credible teachers of what they shared.
Because of what happened in the first village, the team was able to expand to four more
villages. Presently, the Team is serving 7,478 villagers in 1,469 households. In addition,
they have recently initiated work in the municipality of San Enrique in the other province of
Iloilo.
Twenty-nine (29) Community Health Volunteers are now actively visiting homes in these
communities under the supervision of their local committees. As of the first quarter of 2003,
the team reports the following results:
Spiritual Results
2,825 home visits
314 Gospel presentations
529 professions of faith
131 people who completed follow-up Bible studies, and
404 people in 26 Bible study groups
In the same period of time, the team facilitated the immunization of 99.25 percent out of 633
children ranging from ages 1-5 and provided perinatal support for 188 women. They also
helped 33 families gain access to safe drinking water, and enabled 89 percent of families to
dig rubbish pits, 84 percent to build approved latrines, 76 percent to grow bio-intensive
gardens, and 43 percent to start raising animals for protein. They have taught seminars on
prevention of STDs, AIDS, sexuality, and premarital relationships with 250 young people in
two different schools.
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The first visible changes of development were the physical changes in the homes and
environment in the village. In addition to these, the building of a village learning center was
started by the committee in one of the villages which would serve as a meeting center and
a worship place during Sundays, and a day care center at the same time where the
malnourished children were fed. As the community continued to work together for their own
development, attitudinal and behavioral changes eventually followed. Quarrels between
husbands and wives decreased, gambling eventually disappeared, and even the regular
drinking sessions of the men folk in the village grew less in frequency. Bible study cells in a
number of homes began meeting every week. In less than two years of the CHE program
in the village, those who received Jesus as Lord and Savior started meeting in the village
center for worship.
One significant contribution the CHE project made to the development of the communities
is bringing organizations together with a common vision and purpose. Changes on the
social life of the villages happened because of the team’s collaboration with other groups
such as government organizations, non-government organizations, churches, and residents
who aim to promote good health and facilitate Christian development. These groups include
local governments, village organizations, PTAs, Department of Social Services and
Development, World Vision, United Church of Christ in the Philippines, government
cooperatives, and the 4-H club.
Some unexpected benefits in the form of recognition and awards came to the people of
these CHE Communities from the Provincial, Regional and National government. Among
the highly prized awards Igdalaguit received was the prestigious “HAMIS” (Health and
Management Information System) Award which was given to the village in recognition of
the impressive changes in the health condition and situation of the people in the village and
their cooperative efforts in bringing about this change. They received the Bronze Award and
the leaders were called to Malacanang Palace, the seat of the government, to receive the
award from the President of the Philippines.
Another CHE community in the area was among the 12 runner-ups in the national “Clean
and Green” contest sponsored by the First Lady of the Philippines.
In May 2001, Dr. Milton Amayun and Dr. Allan Talens of International Aid ,submitted an
evaluation report on this program. The external evaluation was conducted between
October 2000 and March 2001, and focused on two communities served by the team:
Mapatag and Igdalaquit. The evaluation team reached the conclusion that “CHE is an
effective program for individual and community transformation. Households participating in
the program are generally healthier and more spiritually focused than their non-CHE
participating counterparts”. Specifically,
CHE communities were clean and green
CHE communities demonstrated community-wide collaboration
Members of the CHE communities showed increased self-confidence
CHE participating households were healthier across a set of health
indicators
CHE households and volunteers were spiritually active and growing
CHE stakeholders claimed to enjoy holism and balance life
Some of the more noteworthy evidences of the success of the program were the following:
97% households reported receiving a visit from a CHE volunteer;
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88% of respondents claimed they prayed to receive Christ during a CHE worker’s
visit
Respondents from the program communities reported only a third of the mortality
reported from the control community during the past year
92% of respondents strongly attributed their community awards to the CHE program
There is a positive index of association between the CHE program and the following events or
statements in the same community:
Preparation of meals from the three basic food groups (1A=1.40)
Breastfeeding within one hour after birth (1A=1.33)
Use of ORS (1A=1.32)
Preschoolers maintaining normal weight (1A=1.23)
Child given medical attention for high fever (1A=1.23)
Full vaccination of infants by age one (1A=1.22)
Child’s weight monitored regularly(1A=1.15)
Delivery attended by a health professional or trained TBA (1A=1.13)
Regular Bible reading (1A=1.44)
Prayer before meals (1A=1.41)
Witnessing about Christ (1A=1.22)
CHE was associated with increase use of family planning and reduction in typhoid
fever, tuberculosis, and hepatitis
CHE was associated with the reduction of severe malnutrition among children.
There were no major failures experienced by the project implementers in Antique. There were only a
few disappointments whose causes were immediately responded to.
One of these is the closure of a new project site because of change in leadership in the village. The
incumbent village leader lost during the local elections and was replaced by one who did not support
the projects of his predecessor, regardless of the benefits they gave to the community. The reason
was purely political motivation. So the team had to withdraw from the area and wait for the right
time to resume work there. Incidentally, this community was the “control” community during the
external evaluation which led into the decision of introducing CHE to help the people do something
about their plight.
Another is the economic hardship of some CHE volunteers which hinders them from regularly doing
home visits for the reason that they have to address their survival needs first. This problem was
addressed by introducing Micro-Enterprise programs with the CHE volunteers as primary
beneficiaries whom they in turn taught to the families they visit. Their home gardens and livestock
raising activities also helped them in meeting their daily food needs.
In the next three to five years, the Antique CHE team will concentrate on the holistic development of
the 28 villages of San Enrique, Iloilo. The endorsement of the town council headed by a Christian
Mayor, provides the unique opportunity to implement CHE in cooperation with the local government
as public policy.
To continue the growth of their work locally and the expansion of their ministry internationally, these
veteran workers have made it their goal to multiply themselves by hosting and mentoring interns who
will work with them in San Enrique, and in the other communities they are serving. Interns will come
from different areas around the world through Medical Ambassadors International CHE Internship
Program. As of this writing, 18 Interns from different countries in South Asia, Central Asia, Korea,
China, Canada and the US who are participating in this program for the period August 11 to October
3, 2003 are preparing to spend two weeks in San Enrique and Antique as part of their field exposure.
From there, they will divide into 4 teams and spend another week in 4 of the mature areas in the
other regions in the Philippines and experience with people in these communities the exciting
development process of transforming peoples and communities through the Community Health
Evangelism (CHE) program.
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