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By Jaileen F. Jimeno, Philippine Center for
Investigative Journalism
First of two parts
THEY are not drug dealers or smugglers.
They’re not even video pirates. But many nongovernment
organizations in the city of Manila are feeling as if they were
involved in an illicit trade. They do their transactions on the sly,
with furtive glances cast here and there to check if someone is
watching.
The NGOs say that under the administration of
Mayor Lito Atienza of Manila, they are being forced to provide
contraceptive pills and other artificial birth-control materials in
the shadows and under the table.
Under Atienza, this congested city of more than
1.5 million population has become staunchly pro-life and
uncompromisingly against any form of artificial birth control.
Pills, condoms and the like are no longer available in any of the
Manila’s barangay health centers and city-funded hospitals.
Women’s groups plan to sue Atienza, saying
that by depriving Manila’s women a choice of family-planning
methods, he is violating the Constitution. They are gathering
evidence to show that Atienza is infringing on women’s
rights.Meanwhile, NGOs that are still making contraceptives
available say there is a creeping yet coordinated effort to stop
their efforts. Some groups even say that the city seems determined
to drive them away and are worried that their permits to operate
will not be renewed once these expire.
Some NGOs have been told that “what they do is
abortion, even if they’re just into family planning and
contraceptives,” says Carolina Ruiz-Austria, director of Womenlead
and one of the lawyers of the Reproductive Health Advocacy Network (RHAN).
“They were told that what they are doing is forbidden in Manila.
It’s unnerving.”
The National Statistics Office says the
country’s population will reach 85.2 million this year. In 2002
more than 20 percent of the 11.6-million married women had “unmet
needs” for family planning. That translates to more than 2
million women who wanted to space or limit their children, but were
unable to get the support they needed.
Chances are their numbers have only grown since.
Public-health workers and NGOs alike say that President Arroyo’s
silence on the issue of population has left women at the mercy of
local government officials, who may not always recognize the
separation of Church and state or appreciate the reproductive rights
of women.
For sure, there are officials like Gov. Victor
Agbayani of Pangasinan, whose province is a role model for
population control. But there are also those like Atienza, who has
thwarted even the Department of Health’s (DOH) “Ligtas
Buntis [Safe Pregnancies]” campaign in his city.
Recently, the Philippine Legislators’
Committee on Population and Development received reports that some
towns in Batangas, Camarines Sur, Palawan and Bukidnon are following
Atienza’s lead.
President Arroyo, who in 2003 admitted to having
used birth-control pills as a young wife, has no specific program to
deal with the country’s high-population growth in the 10-point
agenda she issued last year. Through her spokesman, Ignacio Bunye,
Mrs. Arroyo said she was leaving the issue to local executives.
The President is an advocate of natural family
planning, although she doesn’t “impose it.” But the lack of a
national population-control program has left health workers
confused—and often forced to follow local officials who are
imposing their religious beliefs on their constituents.
Dr. Marie Lorraine Sanchez, Manila’s city
health officer, says, “We always put in the natural family
planning teachings of our Lord. This is our choice for you, we tell
them.”
Manila has had negative population growth in
recent years, but only because many of its residents have been
migrating to less crowded areas. Census records show that in 2000,
the city’s population density stood at 41,282 a square kilometer,
the second highest in the National Capital Region, and more than
three times that of Quezon City, which has the largest number of
residents. Manila’s population density was also almost thrice the
NCR average.
Not all Manila city health workers share
Atienza’s stand, especially those who have been in the service for
decades. But the fear of losing their jobs has been enough to
silence them into compliance with the mayor’s orders.
Ultraconservative mayor
Atienza, after all, chairs the ultraconservative
Pro-Life Philippines, which was founded in 1975 by Sr. Mary Pilar
Verzosa. He insists, “Sex must always be related to
procreation,” and believes that artificial contraception will
ultimately lead to legalized abortion.
On February 29, 2000, Atienza issued Executive
Order 003, declaring city hall’s “commitment and support to the
responsible parenthood movement.” It vows to “[uphold] natural
family planning . . . while discouraging the use of artificial
methods of contraception like condoms, pills, intrauterine devices,
surgical sterilization and others.”
The order doesn’t explicitly ban artificial
birth-control methods. In reality, however, city hall has slammed
the door on the pill and its kin and no longer prepares any budget
for such. In previous administrations, city hall had even provided
the state-run Jose Fabella Memorial Hospital in Manila’s Santa
Cruz District with artificial contraception materials.
These days, phone calls to Manila’s health
centers yield these standard replies: “The mayor has banned all
forms of artificial contraception” or “Manila is pro-life.”
There are religious arguments: “Family planning is not in the
bible.” There are scare tactics: “[With birth control] there
will come a time we will no longer have young people to take care of
the aging.”
Most health workers even refuse to give out
information on how to use the pill. Instead, they warn against the
“evils” of artificial family planning methods. Those who are
less prone to preaching, however, refer clients seeking ways to plan
their families to the health centers of nearby cities or to NGOs.
Side effects of artificial methods
Population experts and women’s health NGOs
themselves say that natural family planning is ideal and that some
forms of artificial birth control may have detrimental side effects
on some women. Unfortunately, they say, natural family planning,
which involves monitoring a woman’s fertility cycle, is not always
practical or doable.
“Often, [the woman’s] period is not
regular,” says Corazon Raymundo, president of the University of
the Philippines Population Institute. “And there are many events
or situations that do not allow natural family planning . . . If the
man is an [overseas Filipino worker], how could the woman say they
can’t have sex [because it’s not the right time]?”
She adds that since 1968, their studies have
shown that couples do not like natural family planning methods.
Freedom of choice
Raymundo adds, “We should give accurate and
sufficient information on the [various] methods because everyone has
a different take. No one method is good for everyone for the rest of
their lives. They should have freedom of choice and they should be
able to make their own decisions.”
But Manila’s city government seems to have
other ideas, and NGOs there say they have been feeling increasing
heat from city hall as a result. Dr. Junice Melgar, executive
director of the NGO Likhaan, says some of the member-organizations
of RHAN in Manila have received letters from, or have been visited
by, city health officials. Others have been “summoned” to city
hall.
Ruiz-Austria says that such “summons” lead
to a viewing of the antiabortion film, The Silent Scream, among
other things. The lawyer also says that these sessions constitute
“harassment.”
She says one NGO recently received a letter
where it was “recommended” that the organization’s information
kit be “edited” by the Manila Health Department. “It’s
tantamount to censorship,” she says.
Ruiz-Austria also says that NGO forums on the
topic of reproductive health provoke a visit from city hall
representatives. She recounts, “They’d come and ask, ‘Do you
have a permit? Because this is not encouraged in Manila.’”
Besides Melgar and Ruiz-Austria, no one from any
of the Manila-based NGOs agreed to be interviewed on record for this
piece. Melgar says these NGOs want to continue to operate in Manila
and do not want to antagonize Atienza. Other NGOs, though, have left
Manila for “friendlier” areas, she says.
Vasectomies, tubal ligation banned
Melgar says some barangay officials who play
host to reproductive-health NGOs are also wary of going against
Atienza’s pro-life policy. Still, they recognize that these groups
provide their constituents with a needed service now being denied by
city hall.
Manila’s four city-funded hospitals also no
longer do vasectomies and tubal ligation. Inquiries at these
hospitals about such procedures yield replies like, “Pro-life si
Mayor”; “Bawal sa amin”; “Ayaw ni Mayor”; “Basta,
mag-anak nang mag-anak ang gusto niya.” (“The mayor is
pro-life”; “We’re not allowed”; “The mayor doesn’t like
that”; and “He wants everyone to just keep on having
children.”)
Cristina Ignacio, a nurse at Fabella
Memorial’s Comprehensive Family Planning Department (CFP), recalls
that a woman once came to Fabella asking for a tubal ligation to be
performed on her. The woman has had several caesarian operations and
had in fact just given birth a month earlier; her wound was just
beginning to heal. The Fabella doctors had to turn down her request.
The procedure should have been carried out when
she was opened up for birthing, but she had delivered in one of
Manila’s city hospitals. Personnel at Fabella could only counsel
her on alternative contraception methods before they sent her home.
Recalls Ignacio: “She was pitiful. She’s recorded in our
minds.”
Dr. Enrique Samonte, officer in charge of
Manila’s Safe Motherhood Office and devotee of the Holy Face of
Jesus, confirms sterilization procedures are no longer practiced in
city-funded hospitals.
“It was included in the EO that the different
hospitals funded by the city government should only promote natural
family planning and should not do ligation and vasectomy,” says
Samonte, whose office has a poster of a weeping Christ holding an
aborted fetus and with materials used in artificial contraception
scattered at his feet.
Sex the “normal way”
A scrutiny of Atienza’s EO, however, reveals
that the city hospitals were merely instructed to “promote and
offer as integral part of their functions counseling facilities for
natural family planning and responsible parenthood.”
Sanchez, for her part, says that Manila-funded
hospitals bar sterilization not on the orders of the mayor, but
because of the hospital managements’ belief in the policy. She
also denies there is an effort to curb the activities of health
workers who support artificial contraception, saying that the mayor
is “democratic.”
Atienza himself says he is not forcing Manilans
to follow his thinking. Yet he confirms that health centers do not
provide information about the use of artificial birth control. He
says that is the job of NGOs.
Atienza credits his parents for his policy on
population control. He says he learned about sex “the normal
way,” at home, with his family. He says his father sat him down
and taught him about contraception, but advised him to postpone sex
until after he was married. Asked if he was able to comply, he says,
“I can’t say I obeyed him 100 percent, but I remember the
lesson.” He passed on that lesson to his children, he says.
Atienza and his wife had five children in quick
succession, but their sixth and last child came years later. He says
that was because his wife “took the pill without my knowledge and
I tell you, she became a devil, a demon,” blaming what he thinks
was hormonal imbalance brought on by the pill.
Atienza believes that a population boom will
pave the way for prosperity, and birth rates will drop as a
by-product of wealth. In any case, he says he would prefer not to
intervene in population growth, saying he has not read a religious
teaching that said man should meddle with the plan of the Divine
Master.
“Ligtas Buntis” aborted
Apparently, though, he has no problems with
local governments messing up national reproductive-health campaigns.
Earlier this year, the Manila city government effectively blocked
the “Ligtas Buntis” campaign from being conducted there. The
nationwide campaign was meant to inform couples on health, fertility
and contraception.
Because it was going to be done house to house,
NGOs were hopeful that women who could not go to government
hospitals or private clinics would finally be able to get
information about artificial birth control and maybe even be given
contraceptives.
But that never happened, with talks bogging down
quickly when the subject of family planning came up. According to
Samonte, the city and the DOH failed to agree on even the reading
materials for the campaign, and that the DOH “backed out.”
Atienza, however, may have a more difficult time
getting rid of RHAN. The incensed network of some 30 groups
dispensing reproductive-health services and materials across the
country is gearing up for a big fight. Since last year, it has been
gathering witnesses and evidence to bolster its planned cases
against Atienza, who they say should reverse his population
policies.
Ruiz-Austria says some women she has interviewed
were elated to find out that “artificial contraception is legal
and it is the ban that is illegal.” She points out Atienza’s EO
003 was worded without expressly prohibiting artificial
contraception because it is illegal to do so. The EO itself, she
says, is without legal basis.
“We have a strong case against him because his
local executives are interpreting it as a ban,” says Ruiz-Austria.
She adds, “The constitution guarantees the right of spouses to
family planning and this is part of health care. It is the mandate
of local governments.”
To be continued
Part 2 |
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