In February UNICEF published its State of the World’s Children Report 2012. In its summary the authors remark that “although disadvantaged children may live minutes away from schools and clinics, for example, they are cut off from them by poverty and discrimination.” When we visited Baranguay 105 in Manila, we heard many stories that fit this description of exclusion by poverty and discrimination.
The harbour area in Manila City – home to hundreds of thousands of urban poor: The hospital is in walking distance across the main harbour road, where health consultations should be free for most inhabitants in baranguay 105. Especially mothers and their young infants should undergo regular checkups in order to safeguard good development of the child. Yet, only few of them use the health facilities regularly. Unfortunately, this situation is not limited to the area of health; other basic services such as education, employment assistance and access to financial services suffer from similar barriers.
During our interviews with people and NGO workers on the ground we learned about many barriers that prevent people from using the services. The mentioned challenges included (in no particular order):
- Mental overload due to extreme poverty, due to the daily struggle to earn enough income for food, which can lead to negligence of the children’s needs. At the end of the day, parents do not have enough energy left to bring their children to the respective facilities
- Lack of knowledge/awareness
- Restricted eligibility
- Rude staff and long queues
- Feeling ashamed about own poverty
NGOs are attempting to remedy the lack of access to these essential services in two ways. Most NGOs opt to provide a direct service duplicating a government service only making it more accessible. It will be free of charge and often located within the settlement of the urban poor. While this solution does improve the living conditions of the Poor temporarily, it is not financially sustainable. When donor funding subsides, the organisations are forced to downsize their service provision and eventually shut down. In addition, their coverage is very arbitrary and depends on the NGO professionals knowledge of the local environment and availability of funds.
The second option to attempt to bridge the gaps in service provision. By reaching out to the poorest families, helping them to identify their biggest needs and refer them to existing services (Gov and NGO). In the beginning this can include accompanying the family during a hospital visit, or simply writing a referral note. Both strategies have proven effective in strengthening the people’s confidence to make use of services such as free health care. Since information travels rapidly within the slum, this kind of intervention often has a positive spill-over effect.
Stay tuned for more analysis in our written bulletin about Manila’s poor – Coming soon!