Reproductive Health in the Philippines: It’s a numbers game
By Ana Santos
When it comes to reproductive health in the Philippines, it’s all a matter of numbers–all growing at exponential speed, all with increments large enough to secure us places in many of the “most” lists of the world.
The Philippine population is growing at an annual rate of 1.95% (source: National Statistical Coordination Board). Experts from the University of California in Berkeley Bixby Center for Population, Health and Sustainability predict that the Philippine population of 94 million could reach 150 million in just 10 years.
Already, the Philippines is the 12th most populous country in the world and a recent documentary, the BBC labeled Manila as the most densely populated city in the world.
No surprise that we also have the highest fertility in the region at 3.03%. There are four babies born every minute and more than 3 million pregnancies each year; half of which are mistimed or unwanted.
And according to the 2010 Global HIV Report released by UNAIDS, the Philippines remains one of the seven remaining countries in the world where HIV infection continues to rise. So while the rest of the world has been able to control, and even drive down new HIV infections, the Philippines has seen an unprecedented rise in the number of cases.
The United Nations Population Fund (UNFPA) estimates that there are 11 mothers who die every day because of pregnancy related complications, which can be avoided with proper pre-natal / emergency obstetric care and access to the services of a skilled birth attendant. In developed countries, the mere idea of women dying while giving birth is a medieval concept; a cruel anachronism in this day of Twitter and Facebook.
Actually, reproductive health in the Philippines is a matter of numbers and a matter of religion; a collision of modern times with archaic dogma perpetuated by men who are neither supposed to have children or marry.
So while the numbers all point to the need for it, the Philippines remains the only country in the region with no Reproductive Health (RH) Bill to institutionalize universal access to reproductive health information and services
Is this all just a function of being an overly repressed Catholic country where guilt, threats of eternal damnation are wielded to manipulate and coerce, and anything with the word “sex” in it makes one recoil with shame or turn up their nose with self-righteous piety?
Judging by the number of babies born in the country, there’s a lot of sexual activity going on, but not enough proper information to temper it.
Take for example, a 2005 research study that was made by the Remedios AIDS Foundation that showed that three out of ten young people think that jumping after sex prevents pregnancy. I would have easily dismissed this as an outdated study, but about 6 months ago, I received a call from a perplexed gentleman whose friends were all getting their girlfriends pregnant and couldn’t quite figure out why. The boys were all making their girlfriends jump after having sex, he told me.
Jump after sex to avoid getting pregnant?
I wryly suggested that perhaps it was because the girl had not jumped high enough.
These boys were from good schools, educated, technologically savvy and I can even suppose, well-travelled. Their girlfriends were most likely of the same profile.
While the Catholic Church and the inherent culture of conservatism certainly exacerbate the problem, we also have to blame ourselves for our self-censorship; our own deeply-rooted inhibitions that prevent us from getting proper information about the biology behind our bodies and how they work.
It reminded me of the time when I thrown out of a medical university in the middle of a sexual health workshop that I was conducting.
The teachers and other student officials who were watching unceremoniously stopped the lecture and asked the more than 100 students in attendance to go back to their classrooms. Without barely acknowledging that I was still there, they pronounced that the session was “now over”.
I later learned that before the session, the student affairs head already interrogated the student leaders who had invited us to conduct the workshop. The student leaders had attended the same workshop and wanted to replicate it in their school so they knew full well what to expect.
I was also heavily interrogated by the student affairs head. He asked for my CV, called me a day before the workshop and asked if I could just breeze through the condoms portion. “Siguro naman you’ll just quickly brush on that topic, right?” I was asked.
Maybe I should have taken that more as a command than as I request. (But if I had taken it as a command, I would not have proceeded with the workshop at all.)
I did not acquiesce and explained that I could not, in my good conscience as a sexual health educator, avoid speaking about proper condom use. Condoms—and their correct and consistent use–are the one device certified by the World Health Organization to provide protection against STIs and unwanted pregnancy. Surely, they, as a medical university, knew this.
I could only assure them that our teaching principle of edutainment (education + entertainment) was aligned with internationally accepted standards to teach sexual health to the youth. I assured them that I was trained by international development agencies to conduct such workshops and that I was not a porn star, aspiring starlet or someone who was delusional enough to think that she could make a fortune peddling condoms. (In case you’re wondering, as a principle, I don’t sell condoms, I teach people how to use them and then give them away.)
I was deeply perplexed.
This was a medical school; an institution whose students are going to someday be looked at as authority figures on matters of sexual health and family planning. Until then, I did not understand why the medical students were so adamant about having a sexual health workshop in their school. They were all unanimous in telling me that STIs and HIV & AIDS were topics that were not discussed in detail. I was even told that some medical universities promote only natural family methods and medical students are not even taught how to perform tubal ligations.
Wasn’t religious dogma and belief—which by nature, is often incongruent to science—supposed to take a back seat to the medical practice? But instead, would be medical practitioners, the ones who are supposed to be experts on the subject, are also left in the dark about matters of reproductive health –as is most of the country.
And yet, everywhere we look, we are getting conflicting messages about our sexuality—from the billboards with crotch hugging underwear models along EDSA on the way to the barangay where condoms cannot be bought without a prescription to the Church where abortifacients are openly sold.
We are a nation of the blind leading the blind. And until we take those blinders off. Reproductive health maternal health, teen pregnancy, HIV & AIDS–things that are a matter of life and death–are going to remain a numbers game, where everything will be left to chance, rather than choice.
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