2022 BHW Training Academy/Play Therapy Mission Report
On June 6, 2022, volunteers for Isla Medical Foundation (IMF) returned to Siargao Island, Philippines with new goals to train Barangay Health Workers (BHWs) and help the local children cope with the emotional trauma experienced during the Super Typhoon Odette in December 2021. CPR/First Aid classes were also taught to the community and healthcare workers. The 3-day BHW training took place in Burgos while the CPR/First Aid classes and Play Therapy took place in both Burgos and General Luna. The IMF team was met by eager participants from each branch of the mission.
Barangay Healthcare Worker Training Academy- Burgos
The IMF team, led by Cassey Villacarlos coordinated with the Burgos Rural Health Unit (RHU) led by Municipal Health Officer, Dr. Christel Mendoza. They used the BHW Academy handbook along with other training devices to complete the program that suits the needs of the community, mastering healthcare skills, and teaching knowledge in current healthcare issues. The 3-day BHW training mission had 47 participants from 6 Barangays of Burgos, Surigao del Norte Municipality namely, Poblacion 1, Poblacion 2, Baybay, Bitaug, Matinao, San Mateo. A pre-test was conducted to provide an objective assessment of the knowledge and skills of the participants and be able to focus on the help needed rather than the subjective assessment of the Rural Health Unit staff. Pre-test results averaged at 14.27/45 questions, without any participants passing. Post-test and return demonstration were conducted at the end of the training, where post-test results averaged at 31.94/50 questions. 13 participants have attained and/greater than the 75% on written examination and 80% on BLS Return Demonstration passing rate. Certification of Training and Barangay Health Worker t-shirts was awarded to these participants and Certification of Completion was awarded to those who finished the full 3-day training. Asa Bravo, certified BLS Instructor, also executed BLS training using theoretical lecture, written examination and return demonstration. Participants who passed both assessments have been provided with Certificate of Training. For a full report, please refer to the full BHW Training Academy Mission Report.
Play Therapy- Burgos
The IMF team, led by Alana Fransisco and Brittany Takai coordinated with Dr. Christel Mendoza to create a list of participants for Play Therapy. A total of 54 children participated in the program on June 6-9, 2022. The original location of the program, an air-conditioned tent donated by the government, was found to malfunction and deemed unusable by Alana after the first day of play therapy. Another NGO in Burgos, Nature Kids of Siargao, graciously donated their Kids Club space for the remaining days. During this time, the volunteers led activities such as necklace-making, gratitude circles, storytelling, and arts and crafts to help them recognize children who may still be suffering from trauma endured during Typhoon Odette in December of 2021. These children are to be referred by Alana to the trained professionals in Del Carmen for further therapy.
Play Therapy- General Luna
The IMF team, led by Brittany Takai, coordinated with Baybayin Library to provide Play Therapy to the children of General Luna from June 13-16, 2022. Baybayin Library has been providing play therapy when they can, therefore we concluded that it would be best to continue their efforts with their existing participants. Over the three days, there was an average of 30 children per day. Activities included Siargao Wakepark, arts and crafts, storytelling, gratitude circle, and music. Many of the children are talented musicians, therefore the music activities were well-received. One child was identified as needing referral to the trained professionals in Del Carmen.
Basic Life Support (BLS) Training
One volunteer, Asa Bravo, is a certified BLS instructor whose assignment during the BHW Training academy was to recertify the BHWs. Before the mission began in Burgos, the team was asked to provide BLS training to members of the local community. Recently there have been emergencies that necessitated CPR, in which at least one resulted in death. During the days where the volunteers’ schedule was light, a small team branched off and offered BLS certification in Pacifico, Burgos, and General Luna. The BLS team catered to the groups by setting up the class in locations central to each respective group: Pacifico Barangay Health Center, Burgos Tourism Building, Union beachfront, Ulap Siyam, Greenhouse, and Callbox. The participants ranged in profession: teachers, surf instructors, managers, servers, resort staff, and boat operators. In addition to the BHWs, a total of 51 people received BLS certification by participating in class, passing return demos, and passing the written exam.
Feedback
This was the first mission since 2019 due to the Covid-19 pandemic, and also the first of its kind. The main goals were accomplished with the help of the entire volunteer team’s resilience and patience as changes were presented at short notice. It is not usually a goal to accomplish two new missions in one, but Play Therapy was important to offer because there are still children suffering from their traumatic experiences. Due to Typhoon Odette, facility locations were still badly damaged and communication was difficult many times. This in addition to being the first mission, it was expected that the two weeks would be a learning experience as to how to make future missions go more smoothly and efficiently. With this being said, there is a lot of feedback.
The location for the BHW Training Academy was chosen because Burgos had done some training with the BHW Handbook before. Dr. Christel Mendoza is a great partner because she has prior experience with the BHW Handbook and she was dedicated to helping the BHWs gain more experience. She helped coordinate the logistics and was a wonderful liaison between IMF and the municipality. All six barangays of the municipality participated, which shows the full interest of the program. The BHWs indicated that they felt more comfortable with clinical skills after completing the program, even if they didn’t pass. One of the most important things learned is that their reading skills don't correlate with their knowledge. Once the test questions were read to them they actually scored better, though many didn’t pass. They also didn’t expect for us to hold them accountable for passing the test. Those who didn’t pass didn’t receive a t-shirt, which they are used to receiving anyways. In the future, remedial classes for those who didn’t pass may help them achieve passing scores and help them take the program seriously. Transportation to/from Burgos was provided by the Burgos RHU, however there is room for improvement, as some volunteers wanted to leave later than others and coordination with the driver was sometimes difficult. A remedy would be to budget for private transport. Another issue that was observed was task alignment and volunteers lacking preparation. Although there was a daily schedule, many volunteers did not read it, nor did they prepare. Volunteers didn’t have as little as a pen to write with, or thought that the mission coordinator would bring everything they needed for the day. Once this was observed, volunteers were assigned to bring the items that they needed to achieve their daily assignment. Although there was a daily assignment, a daily huddle with the mission coordinator would also be appropriate to ensure each volunteer is on the same page. As expected, the first mission of this kind wouldn’t be perfect, but we hope to take what we learned and improve on it with each mission we experience.
One of the biggest challenges with Burgos Play Therapy is that the tent provided didn’t have functioning air conditioning. This reminds us that a setup day is necessary in order to identify these issues before the program begins. Although Nature Kids helped by providing a space for us, it was still too small. In the future there number of participants should have a maximum or a larger space should be reserved. In General Luna Play Therapy, the children loved the snacks, but maybe healthier snack options should be coordinated. There were a lot of musicians at Baybayin Library, so a focus on music
therapy may be useful. For both programs, we learned that art activities were the most popular and allowed the children to be more engaged and storytime was well-received with the old kids. In future missions, it will be great to have more thoughtful learnings to help with self-esteem and gratitude. Even if the kids aren’t suffering from PTSD, these teachings are important to learn.
BLS class was a very popular class with the community and the business-owners. The participants took the instructions seriously because they know that they may be someone’s only chance of living. It has been one of our continuous initiatives, so it was fantastic to be able to provide official certification. An issue with the classes was that many participants were late, which affected the daily schedule. In the future, there should be more time in between classes, or the classes should be combined into larger groups so that the team doesn’t rush from location to location. There was more supervision of the instructor needed than originally planned, therefore other tasks were put on the backburner to accommodate for this. In the future, we need the instructors to write a full outline of their class beforehand. After the mission, we received more requests for classes, however we weren’t able to offer it because the instructor had left. In the future, it would be a worthwhile investment to pay for a local healthcare worker to become an instructor so that they provide more classes in the local language as well.
Summary
Barangay Healthcare Workers from all 6 barangays in the municipality of Burgos attended our inaugural BHW Training Academy. 13 Barangay Healthcare Workers achieved BHW certification by passing the post-test, return demonstrations, and passing the BLS test. The average test score improved to 31.94/50 questions as compared to the average of 14.27/45 questions. This shows that BHW Training Academy not only works, but that repetitive classes will help the BHWs will become more proficient and more skilled.
82-102 children participate in two Play Therapy programs in Burgos and General Luna. Activities included art and crafts, gratitude circle and storytelling, Siargao Wakepark, and handwashing class. Through these activities, at least one child was identified as needing further evaluation and possible therapy from the trained professionals in Del Carmen. It was promising to see that many of the children had acclimated to their new normal so quickly after Typhoon Odette. This reiterates what we already know: that children are resilient.
A total of 51 people received BLS certification by passing post-test and also the return demonstration of the skills for adult, child, and infant CPR, and choking. During the training every participant took the class seriously, as they know that they may be the only rescuer present on a small, remote island. One of the popular surf spots, Pacifico, received an AED donation due to the increased chance of a drowning emergency in this area. The goal is to train as many people as possible so that someone’s chance of living through a cardiac emergency is increased by having the knowledge and skills to perform CPR.
Overall, there were many goals that were accomplished during this mission. The volunteer team was great and were flexible enough to adapt to the many changes. Everyone was very happy with the results, and this is just the beginning. We will take what we’ve learned in these two weeks to improve and provide more organized and efficient training and play therapy sessions in the future.
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