Along with my husband Jack and my 15-year-old son, Jeff, I participated in August in a remarkable conference in the Philippines on Children and War. Lolit Suplido, a student board member, and Aurora Parong, a physician activist with our host organization, Medical Action Group, broke the conference into subgroups of five. A staff of NGOs led each group to a remote site of violence for an immersion experience--living with a war-affected community. Afterward we students came back together again to plan.
The instructional part of the conference began in Manila with a lecture by Jimmy Tan, who had served as Acting Secretary of Health. Tears came to his eyes when he described Abdu'l, a 15-year-old orphan who had been totally blinded by a mine, yet who provided for his seven-and four-year-old brothers by climbing coconut palms to collect and sell the nuts. Dr. Tan maintains that health should be in the hands of the people, not elites, and that children should participate in healing their communities.
In the Children's Rehabilitation Centre, the conference participants played games and, in the evening, entertained each other with songs and dances from their countries, as well as with some of the students' own poems. Then the groups began leaving for the field visits. My group of 20 flew to the Island of Negros, spent the night sleeping on the floor, then loaded our supplies and backpacks onto a jeepney, drove down the coast for several hours, and began climbing the mountains. The road ended in a village, where we ate lunch standing in the street surrounded by fascinated children.
We loaded our food onto primitive sleds of branches lashed together, which buffalo-like animals called carabaus dragged along the muddy trails into the mountains. At an army post we stopped to explain our presence in the area. We walked nearly four hours in blasting heat through mountains. There were lush rice paddies and cornfields, forests, palm trees and bamboo clumps. Along with us walked a little girl, Lenen, aged 11. We thought we were pretty impressive doing this hike, but Lenen does it twice a day, usually much faster. It's her normal walk to school. Climbing a muddy slope, we reached our base--a grass field in a little grove with two bamboo and thatched (nipa) huts for our Children's Rehabilitation Centre--one for meeting, one for cooking. People were building a third one for sleeping. I watched the men prepare and weave the bamboo for a wall. A pit latrine was dug for us.
The women were invited to the house to sleep. The large family simply moved over and crammed together to accommodate us. We slept beside each other on the floor on grass mats over bamboo slats, lit to bed by a tiny oil lamp. Throughout the night, a fighting cock crowed to rouse its friends on neighboring hills. The hens would wake and the pig would snort, then settle to silence again.
In the morning, I climbed in the half-dark over a dozen sleeping bodies (one family member on the table), found my sandals in the pile, and went outside to a misty mountain-top dawn. Soon cooking fires were lit and hot drinks were poured for early risers. As we ate breakfast (rice, eggs, salted fish, smoked sausage), villagers started arriving. It was to be Parents' Day. They would play the same games as the children, have a community meeting to discuss the health committee and, for the first time, discuss dental health.
These people have been displaced by the Philippines Army's efforts to remove the support of the rebel New People's Army. They have moved to less favorable land; some have left their farm implements behind. Besides tilling the steep mountain slopes where they are squatters, they also work as day laborers for large land-holders. Often they don't have enough to eat. Soap is a luxury. They have no time to repair their own deteriorating houses, or to construct any furniture.
Yet they took time off to attend days of Children's Rehabilitation Centre activities, build nipa huts, and play--even though risk was involved. That morning, suspicious military men, led by the officer to whom we had spoken, searched two houses and detained one man. The community asked Children's Rehabilitation Centre to put signs on the huts saying they were erected for the Centre. The army feared they were for the New People's Army.
Lunch, cooked in cauldrons on outdoor fires, fed about 100 people. After-ward we sat under the thatched roof of an open sided hut. A tiny boy, coached by his father, sang a song about his regret for a life of drug addiction. Another song asked God why his path involved so much suffering! A woman sang a song of her own composition about a girl sexually abused by her father, and another about having to marry a man she did not love.
I sang the Canadian children's song Skinamarinky-dinky-doo. They asked me to teach them, hand-signs and all. For all my days there I'd be greeted thereafter by children shyly murmuring Skina-marink or doing the gestures and giggling. We made up a new Old MacDonald Had a Farm with the animals of Negros and their particular sounds. (The cock says Taktarau.)
By day the sleeping hut became a day-care centre, with wall-to-wall toddlers and mothers, the babies suspended from the rafters in cloth slings. I watched children eating. Two little three-year-old girls shared a bowl and spoon. One of them alternated a spoonful for herself with a spoonful for the other child. Three seven-year-old boys shared one bowl and two spoons. Word-lessly, they rotated the spoons between them, each eating equally. These children were talented cooperators.
The next day was for the children. Divided into age groups, they sang, danced and played. Provided with paper and crayon, they drew avidly even as rain began falling on the paper. Asked to draw something they disliked and feared, child after child drew scenes of the war. Just one year before, a lively eleven-year-old in our group, Panto, held his dying three-year-old brother in his arms after his house was strafed. His grandmother also died. The teens wrote a poem together.
Hours after darkness fell, you could still hear the excited cries of children playing. (A group of teens on Mindinao told Jack it was the first time they had played since age five. They were too busy with chores and school.) How the children got home from our site by narrow, muddy trails at night is beyond me.
The last day at the site was for dentistry--extractions only. It was odd to see this done on the bamboo benches of the open-sided meeting hut. Some people didn't come because they had been told they'd have to rest three days after an extraction and they couldn't afford to do that.
We took to the jungle to visit people, walking 30-45 minutes from one house to the next on rough, beautiful trails. The men to whom we spoke had both experienced frightening encounters with the army, which led to their displacement to this area. Subsistence was difficult. I asked one of them what brought him joy. Just breathing, being alive, he said, and my community.
At a different site, Jeff saw a seven-month-old baby whose parents came asking for help. Malnourished and dehydrated by diarrhea, it was too weak to be revived by oral rehydration. It would need intravenous infusion in hospital. The parents couldn't afford this. Jeff and his group put together their cash to save the baby.
Subsistence Living. To live below sufficiency means being hungry, not having time to repair your house, which is falling apart. For children it means walking two hours to and two hours from school to be part of a class of 50-60, with no time to play. When a child injures his foot, there is no clean water to wash it, no soap, no antiseptic, no dressing. It gets infected.
Living with insecurity. Theirs is primarily from the military, which would like to harass them into leaving. As squatters, they are also insecure with respect to land and livelihood. For infrastructure development (e.g. a well) they need security.
I wondered whether they had considered making a Peace Zone of the area--a strategy of negotiating the removal of both the Philippines Army and NPA.
In another way they have more security than others in the Philippines. You could leave anything anywhere with no fear of theft. The houses have no locks or fences. In Manila, armed guards are everywhere. Houses are protected by razor wire and broken glass on top of walls.
Community. The people delighted in being together, in rhythmically building a nipa hut together. Small children were skilled in cooperating. Watching the pleasure a group of teenage girls took in each other as we sheltered during a downpour, I thought of the sad faces of the teenage girls I see in my office. My girls have broken families, no community. These girls have those precious things.
Simplicity. Sleeping on bamboo slats close by others, bathing and washing my clothes by the spring--I discovered how much I enjoyed it. I didn't suffer as they do, from hunger or hard work, but I can consume less than I do. These people tread so lightly on the earth.
Natural materials. Beauty surrounded us. The mist rolled off the mountains at dawn to reveal green contours. The huts are wonderful for hanging things--wet clothes when it rains, babies in cloth slings--and for children to climb on. My bamboo walking stick made a sonorous thump on hikes and, with a stone, served as an excellent rhythm instrument.
Solidarity. People who are hounded saw others coming to say, We care about what you've gone through. Tell us about it and how we can help. Of course, solidarity is only the beginning. Compassionate, intelligent action can flow from there.
Play Oddly, I was surprised by the importance of play for the community and NGOs. As a child psychiatrist, play is one of the modalities of my work. And yet I remain uncertain whether play therapy was occurring--in the narrow sense of symptom reduction in traumatized children. Even if it should become clear that the play was not doing what it was originally intended for, I think it should be continued and developed. The joy of adults and children as they played and created art showed its importance. The interweaving of adult play, community organization, and health education worked well.
We said, We have heard you have suffered from the war and that your children are upset. We have come to listen, to sing and dance and play games together, to help you organize your health services--and to pull your painful teeth! Extraordinary!
Dedication. I have the privilege of working with wonderful people who spend their time making the world better and reducing suffering. The Children's Rehabilitation Centre workers took this to another level. The psychologists, physicians, and dentists work full-time at low pay, and at some risk to their lives to help the oppressed. They are in the field most of the time. Sleep on the office floor? That's nothing. Stay up all night to get something done? Sure. Interrupt studying for your final exams to organize an international conference? No problem. The medical students were clearly inspired by their older mentors and several were considering alternative careers instead of the usual elitist ones.
What this experience means in our own lives. We gathered in regional groups to discuss next steps. In some places, addressing domestic, school, and street violence seems a high priority. In others, working refugee camps may be best. The African students intended to expand their work on land-mines. The Filipino students wanted to influence their medical school toward more community-based, problem-solving health care.
My own issues are:
1. To explore further how health initiatives can expand peace; to look at possible opportunities in the Philippines and elsewhere.
2. To take the suffering of children in war to the decision-makers in war, so that they face what war does to children. Senior workers in the Philippines suggested that this was unlikely to be possible or helpful, but I'll explore further if I can.
3. My research on what happens to children in war impels me to explore how to prevent war. It is not enough to heal war-impacted children.
Our interventions may not work in the narrow sense. I intend to keep on trying to find out whether this is so--especially in my Health Reach work in the former Yugoslavia. But even while I plan these interventions, I think, When you lose a parent, a leg, a childhood, a belief in your own worth or the goodness of others, why should we imagine that therapeutic interventions are going to fix this? If it could, one might as well think, We'll bomb this water supply, shatter these children, and after we've won, we'll put the pieces back together.
Healing takes place, but who knows how? I feel sure that the solidarity with war-affected communities is right. I can see the joy that play brings. So, however it works, it's right and I want to support it. But I will save some time and energy to contribute to preventing war.
My path will have a strong Filipino influence. For years I've learned from the thinking of Ed Garcia, a Filipino scholar and activist. He is part of the Gaston Z. Ortigas Peace Institute, which I visited. Emphasizing citizen peacemaking, it has ties with International Alert, an organization that is forming a network of NGOs for war prevention. They envisage training people in various sectors in a variety of war prevention roles--as catalysers of dialogue, as convenors of communities and builders of peace constituencies, as mediators, as human rights and election monitors, as workers in reconciliation and healing. There may be a role for IPPNW in such a network, if we conceive of health initiatives as peace initiatives.
4. Two remarkable women, Lolit Suplido and Aurora Parong, together with a multitude of helpers including medical students, accomplished this conference. Whenever possible, IPPNW activities should be decentralized to be handled by such people and organizations. I hope that what those people gave to us will be returned to others suffering from war.
Joanna Santa Barbara practices child and family psychiatry in Hamilton, Ontario and teaches Peace at McMaster University.