I am glad to see that both sides of the reproductive health camps see the recent Supreme Court decision as a triumph—the pros jubilant that the law can now be implemented, and the antis happy that several provisions were declared unconstitutional.
Now is the time to cross borders and tackle the urgent issues around reproductive health in the Philippines, some of which I am listing here. I do this not just because of the breakthrough with the RH Law, but also because the Vatican called last year for a “survey” of the needs of Catholics—who form the majority of the population in the Philippines, albeit with different degrees of adherence to dogma and practice—in preparation for a synod (an assembly of bishops) on the family. Some countries literally conducted surveys while others conducted consultations.
The concerns of the RH Law overlap to a large extent with those of the coming synod, and my list of issues here is from the perspective of a social scientist interested in establishing where we are today, and where the RH Law will bring us.
Young and old
First, it is clear that teenage pregnancies are on the rise: The latest Young Adult Fertility and Sexuality Study or YAFS, conducted by the Demographic Research and Development Foundation and the University of the Philippines Population Institute, found that the number of teenage mothers has almost tripled over the last 10 years.
In previous columns I described the problems that result from teenage pregnancies, for both the mothers and their children, ranging from poor health to the higher risks that the children themselves will become teenage parents. Put more dramatically, expect more women becoming grandmothers in their 30s, or even younger. (If a girl gets pregnant at 14, and the daughter who is born also becomes a mother at 14, the result is a 28-year-old grandmother.)
The RH Law is more than the distribution of contraceptives. It has a strong component of sexuality education; the pros hope this education will bring down teenage pregnancy rates, and the antis say this will lead to more pregnancies. Well, the only way to find out is to monitor the quality of sexuality education that comes about through the RH Law and to examine the teenage pregnancy rates across time.
Second, beyond teenage pregnancies we have to look at females of all ages, married or unmarried, and their access to RH education and services.
We need to look at the women who are the most vulnerable to the adverse impacts of neglected RH. The government’s CCT (conditional cash transfer) program for the poorest of the poor should be one focus. Questions may simply be added to the monitoring program to determine the mothers’ access to RH services, and what happens to their child-bearing.
But it is not just the poorest sectors that suffer from a neglect of RH services. I’m thinking of migrant women. When they hear the word “migrant,” people immediately think of overseas workers, but we should not forget, too, the many local migrants, meaning women who have to leave their hometowns to work elsewhere. Just think of the armies of domestic workers who leave their children behind, usually with Lolo or Lola.
The lives of domestic workers are well-known, but not talked about. Many come to Manila as young single girls; they get into a relationship with (married) street-smart men who abandon them once they get pregnant. The dalagang ina—unmarried mother—ships her baby home for Lolo or Lola to care for, and then wises up to the ways of urban men, but is still vulnerable to new relationships and pregnancies.
There are other permutations in the lives of migrant women. Some married women leave their hometowns to work, and the husbands left behind make up another set of potential problems.
As does the case of men who migrate elsewhere, leaving their wives behind. I used to travel overseas frequently and always, on the flights home, I would hear male overseas workers teasing one another about the possibility of coming home to find a new baby that they didn’t father. Others would talk about how they had been “hit” (tinamaan) by a sexually-transmitted disease, and I would shudder to think that HIV/AIDS might have been among the unexpected pasalubong, or gifts, they were bringing home.
There are other important variations that affect RH and families. I have had staff in my offices who work in Manila but live in what is now called Mega Manila, which includes some of the more distant towns or cities in Laguna, Cavite, Bulacan, Batangas and adjoining provinces. Last week at a meeting with students living in UP dorms, a number reminded me that there are towns in Bulacan and Rizal that are so far-flung it’s easier to get to Angeles in Pampanga or even to Olongapo in Zambales.
My point is that there are growing numbers of people from these “neighboring” provinces who can go home only once or twice a month to see their spouses and children. The RH needs here are very different, and in many ways more unpredictable and unplanned, or in many ways more similar to overseas workers who come home once every few months, or years, and are intent on having sex… and reproducing, even if their partner does not want to.
How do we package RH education and services for these populations? More than condoms and pills, we are talking here about people tackling feelings and emotions, of being away from home, alone.
Family life
The third area where we need more information is family life in the Philippines. “Family” is a much-abused word. People pay lip service to it: Oh, we go out on weekends, one big happy family. Sure, a weekend outing to the mall, with everyone doing his or her own shopping and getting together for a sort-of-happy meal, each one busy with a cellphone or tablet.
RH is about family life, too. How much are people talking to each other, relating especially to young people’s needs to talk about relationships, about sexuality? I said “especially” the young, but even older people may have their problems concerning relationships and have no one to turn to for good advice. We need to establish what those needs are, and how both the government and the private sector can be more effective in responding to the needs.
Then we have the needs of sexual minorities. There was so much focus from the antis on same-sex marriage when in fact the priority for the RH Law now should be, quite simply, addressing how stigma adversely impacts lesbian, gay, bisexual and transgender people.
My last area of concern is the threats to reproductive health. We keep talking about the wonders of the Internet, and indeed those advances must be tapped to allow people greater access to RH information. But we need as well to recognize how the Internet, social media included, can be a barrier, a threat, to RH with all the misinformation floating around, as well as predatory forces such as those promoting online sex trafficking, or those who roam Facebook looking for gullible prey.
The RH Law was first crafted more than a decade ago, and in the many battles that were fought, it may have been overcome by many new developments. Now is the time to address those developments, and what these will mean for the law’s implementation.
The urgency of the RH Law is that of addressing problems that have been simmering for decades and are now going into a furious boil.
(E-mail: mtan@inquirer.com.ph)