Ma.

Via Jucille Roderos

HI -165

Maternal health care in the 19
th
century Philippines

Health system is defined by the World Health Organization as a body consisting of all
organizations, people and actions whose primary goal is to promote, maintain and/or restore
health. A health system goes beyond the sphere of privately owned companies that facilitates
the provision of health care services. Moreover, health systems may also include a mother
attending to her sick child, vector-control campaigns, lifestyle and behavior change programs,
health-insurance organizations or health-safety policies and legislation. According to the
WHO, a good health system must deliver quality health services to all people, wherever and
whenever they need them. They may vary from one community to another, as the needs of
one may not be the same with the needs of the other, but more or less it must require a robust
financing mechanism. It must also have a well-trained workforce and well maintained
facilities to deliver good quality medicines and technologies as well reliable information
system as basis for policies and decisions to be implemented in a certain community.
This framework set by the WHO as to what an ideal health system became a guide in
improving the health of the community as a whole. Today, people enjoy the benefits of
having pre-natal health care, vaccinations, PhilHealth insurance, cheaper medicines law, etc.
because of the improved and organized health system.

However it is not the same situation for the people who lived in the 19
th
century
Philippines. Although the health system now is not ideally as perfect as what it was
conceived to be and there are still cracks in the system, the 19
th
century health system was not
as sophisticated, as organized and as efficient as what exists right now. This may be
attributed to the fact that the idea of a health system being a body that focuses mainly on
health promotion and improvement was not conceptualized in these times. However, there are
also other factors which may have contributed to the inefficiency and disorganization of the
19
th
century health system.

Health system encompasses all aspects of health however this paper focuses on the
aspects of maternal health care, particularly during giving birth and sanitation prior to child
delivery as it is reflected in the descriptions of writers who wrote about the Philippines as
they see it in the 19
th
century and in literary works like the novel Noli Me Tangere. The paper
will also focus on how the health systems affect the health and well-being of the people as a
whole and what reforms can be done to improve the health of the community particular in
terms of maternal health and sanitation prior to childbirth.

Practices of pregnancy and childbirth were not at the cutting edge state during the 19
th

century. People do not have the luxury of having an ultrasound machine and other resources.
The practices were also inefficient and often times unsanitary which would lead to problems
especially in the well being of the baby and mother, like infection, deformities or even death.
There are also no facilities which cater to labor and child-delivery. Often times pregnant
women who are about to give birth stay in their homes and deliver their child there with the
help of a mabutin hilot or a good midwife who only acquired the reputation because of they
have grown old in the practice. Some of the birth-giving practices include placing hot bricks
on stomach of the woman while pressing the bricks, often with the help of a tenedor who
presses the base of the uterus. This is noted to cause some complications or disadvantages
especially in the part of the infant since the bone structure of a new-born baby is not that
strong nor compact. This may cause deformities or amputations of limbs or other body parts.
After the child has been pulled out of the womb, they place a foot on the vacuum caused by
the childs exit. This can cause sepsis especially if the foot is not properly disinfected. The
hair of the mother is also pulled if she experiences fainting fits or uterine hemorrhages.
Fainting fits and hemorrhages are supposed to be handled with proper care and sensitivity so
to prevent further loss of blood and infection. It was also recorded that the baby is placed in
warm ashes and his umbilical cord is cut using a piece of sharp bamboo. This poses a
problem to the baby since he is prone to diseases and may pick-up some sorts of bacteria and
viruses and thus may cause complication.

Maternal health care and sanitation are keys to the overall health of a newborn baby
and his mother. Improper maternal health care and unsanitary practices may be one of the
pressing causes of high infant and/or maternal mortality during the 19
th
century. This problem
may be reflected in literary works such as Noli me Tangere particularly in the 6
th
chapter of
the novel where Pia Alba, the mother of Maria Clara died in child birth. This may be due to
the fact that the person who handled her delivery did not practice the proper maternal health
care and sanitation given to women who are about to give birth.

If the framework of an ideal health system is to be followed, there may be many
solutions to this problem. The main objective is to see to it that proper maternal health care is
given to the mother and the child should be well taken care of. One solution is providing the
community with a maternal clinic or maternal hospital. The facility would also include a
well-trained staff particularly doctors and midwives who are trained in facilitating deliveries,
a clean maternal ward with sterile and complete equipment (based on the technology of the
century), a delivery room and a nursery where the baby is cared for properly. The maternal
hospital would also have to observe proper protocols in handling child birth. However, it is
not enough that the proper care should stop at the hospital level. The members of the system
namely the mother and the staff should work hand-in-hand in ensuring the safety of both the
mother and the child. The staff has to see to it that the mother is well equipped and
knowledgeable when she decides to leave the hospital. The mother in turn has to follow what
she has learned in managing both herself and her baby after child birth. The hospital should
also cater to the rich and poor alike as the charge of the services are very minimal. This
would provide not only physical but economic accessibility to proper maternal care.

Minimizing the causes of the health problems is the key to an improved overall health
of a community. Having an efficient and organized maternal health care system would ensure
an improved health of the mother and thus this can also affect the well-being of the baby. In
turn this would lead to an improved health of the whole community which would have
positive effects not just in the productivity of that community but of the whole country as
well.

References:
Health Systems. World Health Organization. n.d. web.
<http://www.who.int/topics/health_systems/en/>

Rizal, J. Noli Me Tangere. The Bookmark, Inc. 1996

Bowring. Physical Characteristics and Mores of Indios. n.d.