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Dr. Christine E. Gonzalez (Wellness Institute; Pasig, Phils ; firstname.lastname@example.org)
The Reproductive Health Bill continues to spur heated debate in the Philippines, with emotions raging and virulent attacks flying from all sides. Opponents of the bill accuse supporters of heresy and perversion, while supporters accuse them of archaism and fear mongering. Each proclaims with certainty the heartlessness, blindness and idiocy of the other. Our common goal can and will never be realized in an environment of pride and indignation, evidenced by the fact that this bill was proposed more than a year ago and we have scarcely come closer to resolution. First and foremost, we must approach this debate with the understanding that Filipinos on both sides ultimately aim for improving the health, wellbeing and quality of life for its citizens, especially women and the impoverished. Let us put all pettiness aside and focus on enacting solutions and a merciful response to the urgency of those in need. As it is the devil that scatters and divides for the end of human misery, we must harness the understanding, respect and brotherly love that come from God to achieve the common good. A house is divided against itself cannot stand, and whether we like it or not we are all in this together. Only as a unified people can we truly and effectively fight poverty, need for education, and the health challenges of Filipino women and families. RHBill.org supplies the complete text of the bill here. The bill includes as its guiding principles “freedom of choice” (Sec. 3.1), “maternal health” (Sec. 3.3), “provision of medically safe, legal, accessible, affordable and effective reproductive health care services and supplies” (Sec. 3.4), and ideal “spacing of children” (Sec. 3.6.1). Portions of the bill outline measures for providing emergency services, obstetric care, training of midwives and barangay health workers, and reproductive health education. However, the prime objective of the bill is clearly family planning and contraceptives as key solutions to complications and death during pregnancy and childbirth, illegal abortions, STDs and poverty. Statistics from all over the world prove that this approach actually accomplishes the opposite of what it claims to solve: aggressively promoted condoms continually fail to alleviate the AIDS epidemic in Africa, risky sexual behavior and STDs are rampant in spite of mandatory and comprehensive sex education in the United States, and European governments scramble for solutions to the social and economic issues arising from rapidly declining populations. Our answer 1
to reproductive health problems in the Philippines cannot be for women to poison their bodies with pills and embracing a mindset that only leads to more dysfunction and disease, but instead providing families with adequate medical care and educating women on how to nourish and care for themselves and their children. Although the prevailing ideology touts contraceptives as the solution to global epidemics of STDs, STIs and AIDS, this has been demonstrated in many countries as simply NOT TRUE. In the United States and Europe, contraceptives are readily available on school campuses, organizations like Planned Parenthood, local health departments and clinics, pharmacies and even bars and restaurants. The Museum of Contraception and Abortion in Austria boasts that “morning-after pills can be found in all first-aid kits at secondary schools in Sweden and France and are distributed free of charge in Great Britain before the Christmas holidays.” The RH Bill seeks to employ such easy access to contraceptives to combat reproductive health issues in the Philippines, on the premise that they are effective solutions to unwanted pregnancies and disease. Yet, the European Men’s Health Forum attests a “growing incidence of STDs throughout Europe,” and STDs have reached epidemic levels in the US especially among teenagers. The Guttmacher Institute published a study in 2003 on the relationship between contraceptives and abortion, which found that abortion rates rose simultaneously with contraceptive use in half the countries studied. These statistics would tell a different story if easy access to contraceptives effectively prevented the spread of diseases and unwanted pregnancies, as contraceptives have been increasingly widespread, promoted and distributed for decades. Furthermore, Dr. Edward Greene from the Harvard School of Public Health reported that the University of California “found no evidence of condoms working as a primary HIV-prevention measure in Africa” and “major articles in other peer-reviewed journals such as The Lancet, Science and BMJ have confirmed that condoms have not worked as a primary intervention.” (Washington Post, March 2009). These findings illustrate the insufficiency and in some cases inefficacy of the standard, contraceptive-based approach when tested in real life situations. Birth control pills demand even greater attention and scrutiny, as they result in a plethora of serious health problems, chronic disease and cancer. The Journal of Sexual Medicine published a study that showed “women who used the oral contraceptive pill may be exposed to longterm problems… potentially leading to continuing sexual, metabolic, and 2
mental health consequences.” (Medical News Today, 2006) Oral contraceptives are classified by the World Health Organization as Group 1 carcinogens, the most lethal class of cancer-causing substances, and have been linked specifically to “a deadly, treatment-resistant form of breast cancer called ‘triple-negative breast cancer.’” (Daily Herald, 2012) Dr. Rebecca Peck reports that oral contraceptives “increase cardiovascular events such as venous thromboembolism, pulmonary embolism, myocardial infarction, and stroke, increase the risk of the world’s most frequently occurring cancer, namely breast cancer, [and] leads to an increase in Human Papilloma Virus (HPV) infection and an increase in cervical cancer, which is the second most common worldwide cancer.” (Physicians for Life, 2010) Faced with such compelling evidence, we cannot conclude that providing contraceptives to Filipino women will promote health. Sexual, metabolic, mental and chronic diseases and cancer do not serve as suitable alternatives to reproductive health issues or unwanted pregnancies, especially considering the inadequate protectiveness of contraceptives. The RH Bill will simply compound upon current reproductive health challenges with the immense suffering of cancer and chronic disease. Over the last 25 years, I have journeyed with a stunning number of women, especially from my medical missions in different countries: Congo, Bangladesh, Nevis Island, India, Indonesia, and so many Barangay communities in the Philippines, who developed breast cancer and cancer of the reproductive system including cervical, uterine, ovarian and endometrial. My patients have shared their journey with me, revealing depths of pain, scars and lesions. Their stories allowed me to gain a greater understanding of the effects of artificial birth control, specifically the birth control pill. Yes, the pill seemingly affords women more control over their reproductive choices, but at great risk to their own health and many times their life. Ovulation suppression through hormonal drugs causes many adverse effects, ranging from mood swings, permanently diminished libido, and severe headaches to infertility, fatalities from blood clots, and cancer. A young woman came to me two years ago with collapsed kidneys from using birth control pills, and at age 29 had to decide between a kidney transplant or undergoing dialysis every other day for the rest of her life. One case stands particularly lucid in my mind. Claire, a 26-year old mother, noticed unusual bleeding that month. Her symptoms increased 3
in a few weeks to severe abdominal pain, and feeling that something was very wrong she visited her gynecologist. After a battery of diagnostic tests, Claire was diagnosed with stage-4 cervical cancer. This healthy-looking young woman, full of life and aspirations, died and left behind her only child before she could even start school. Claire’s only risk factor was birth control pills that she took every day from age 17, except when she and her husband decided to have Ana at age 23. While statistics depict alarming realities, they never fully convey the living experience of human suffering behind them. In addition to the damaging effects and poor efficacy of contraceptives in preventing unwanted pregnancy, the RH Bill’s push for “mandatory age-appropriate reproductive health and sexuality education” poses its own problems. Comprehensive sex education emphasizing disease and contraceptives begins in kindergarten and continues through the end of high school in the United States. Dr. Miriam Grossman, a child and adult psychiatrist, writes and lectures on the health impacts of sex education in the United States after experiencing its consequences on college campuses. She states, “People need to understand that the primary goal of sex education is not eradication of disease, it’s social change. Groups like Planned Parenthood and SIECUS inculcate students to value openness and acceptance of nearly any consensual sexual encounter. […] The primary objective of SIECUS and its cohorts is to protect your child’s freedom of sexual expression, not her health. And when sexual freedom reigns, sexual health suffers.” (National Review Online, 2009) The RH Bill preserves this attitude by naming “freedom of choice” as its first objective. Since the goal of sex education in the United States is sexual freedom and not disease prevention, epidemic rates of teen pregnancies, STDs and STIs, and abortion are predictable consequences. Defining freedom as uninhibited autonomy and instilling this as a primary value naturally removes the structures within which health thrives. Optimum health is achieved through a wholesome and balanced diet, exercise, proper rest and practiced spirituality, all of which require an amount of discipline and restraint. Perhaps one feels more “free” at the moment they choose to eat junk food and smoke cigarettes, but what a meager trade off for the freedom lost in debilitating disease. If we sincerely strive to promote reproductive health in the Philippines, our objective must be value-oriented sexual education that confirms sexuality as the beautiful and life-giving expression of love between 4
husband and wife with all its biological wonder. The RH Bill includes “values formation” (Sec. 16.a) in its topics for sexuality education, but paradoxically appoints the use of artificial birth control as “responsible parenthood.” Materialism and self-interest are the only values that lie at the root of this proposal. Sex education that treats sexuality as merely a biological matter isolated from marriage and family inevitably creates problems, which applies to anyone irrespective of religious belief. In my practice, I witness firsthand the consequences of disconnecting the human being into fragmented parts. Conventional medicine views the body as nothing more than a machine, and largely ignores the social, emotional, psychological and spiritual spheres that are of equal and often greater importance. My experience with cancer patients taught me that the body recovers easily, while disease or healing originate and transpire in the soul. Thus, sex education that ignores the emotional, social, psychological and spiritual contexts in which healthy sexuality flourishes only leads to the dysfunction visible in the United States and Europe. Let us not repeat the mistakes of the West and subject our children to their devastating outcomes. Considering Europe’s bleak future from its 1.5 average fertility rate (2.1 is necessary to maintain population), proposing birth control as a solution to poverty in the Philippines utterly disregards economic realities. Forbes reporter Joel Kotkin predicts that “by 2021 there will be six people either retired or in school for every person working” in Spain. (Forbes, 2012) This places a severe, unsustainable strain on the working population and generates economic decline, already evident through Europe’s current economic crisis. Many Asian economies such as China, the world’s largest population, have boomed, but are heading down the same path due to population control measures enacted in the last century. In contrast, Hong Kong chose to invest in its citizens by funding infrastructure, education, and health care rather than population control, and now enjoys one of the top 10 GDPs in the world without the problems facing Europe and China. Moreover, the CIA World Factbook website reports, “Economic growth in the Philippines averaged 4.5% during the MACAPAGAL-ARROYO administration (January 2001 - June 2010). Despite this growth, however, poverty worsened during her presidency.” This proves the falsity of the RH Bill’s statement: “The limited resources of the country cannot be suffered to be spread so thinly to service a burgeoning multitude making allocations grossly inadequate and effectively meaningless.” (Sec. 3.12) As poverty in the 5
Philippines worsened during the economic growth of Arroyo’s presidency, the issue of poverty clearly has nothing to do with “limited resources” incapable of accommodating the “burgeoning multitude.” If Chanel can stay in business here selling ₱ 105,000 bags, undeniably a deficit of compassion and not a shortage of resources stands to blame. So what can we do to truly serve women in poverty? The RH Bill contains provisions for much-needed services and programs such as nutrition and breastfeeding information, employing midwives and barangay health workers, emergency care, and mobile health care services, all of which already exist in current legislature. The UNFPA website states that “skilled attendance at all births is considered to be the single most critical intervention for ensuring safe motherhood,” and “although many [potentially fatal] complications are unpredictable, almost all are treatable.” With the laws we have in place, so much can be done to prevent maternal and neonatal mortality, promote reproductive health, and improve quality of life. Professor Bernardo Villegas cites surveys conducted in all barangays of Metro Manila of mothers in the C, D and E income populations, affirming their support of these solutions to the challenges they face. (Manila Bulletin, 2012) Filipino mothers want regular jobs, socialized housing, scholarships for children, free hospitalization and business workshops, improved roads, and other basic necessities, not access to free contraceptives. If our stance on the RH Bill rests upon zeal for justice and alleviating unnecessary human suffering, here are the matters that need advocacy, funding and attention. By investing in citizens as our most valuable resource, we can achieve health for families in mind, body and spirit rather than following the world’s declining economic superpowers down a slippery slope. And while the Filipino people are unquestionably our most valuable resource, the Philippines possesses such a rich abundance of natural resources that no Filipino child should go hungry. Nineteen of the twenty-five best and most effective herbs in the world grow in the Philippines, not to mention the nutritional powerhouses of malunggay and coconut that supply complete protein, essential fatty acids, copious vitamins and minerals, phytonutrients and antioxidants. The food and herbs in this country are more than enough to support reproductive and total health for men, women and children. Instead of prizing meat and processed food as the so-called fare of the rich, we must educate people 6
to prize the life-giving capacities of what God so abundantly blessed us with. Education, the new medicine, will enable families to understand their bodies and take charge of their own health using simple and inexpensive methods: going back to the basics. Furthermore, sexuality and health education cannot be swept under the rug as in the past or effectively reduce the inherent dignity of sexuality to fear of disease vs. want of pleasure or comfort. By exhibiting sexuality in this way, we teach a worldview full of machinery and moving parts devoid of any value or meaning behind them. If the body merely serves as a vehicle for personal desire, with weighted risk and gain, how narrow our understanding of life is. The RH Bill emerges from this materialistic worldview and thus can only contribute artificial solutions. We cannot depend on free pills and other artificial family planning methods as a strategy for human development and reproductive health, which only develops lack of self reliance, irresponsibility and greater health risks. Likewise conventional medicine only treats symptoms while the problem worsens, so we must address the issue at its core through education. Natural family planning methods offer a human development strategy that evolves holistically, maturing the capacity to be personally responsible through knowledge and respect for one’s body. NFP methods are equally or more effective than artificial birth control in preventing unwanted pregnancies, accomplished without risk of cancer or chronic disease. With nutrition, health, and NFP education, we teach families a worldview that respects and nurtures the body and sexuality, not suppresses or poisons it. This holistic approach can genuinely and sustainably help solve reproductive health issues in this country. I hope that the Filipino people will, in unity, act upon the desperate situations that need our consideration and care now, and reject the RH Bill’s materialistic worldview that costs so much yet delivers so little. But yes, let us answer the RH Bill’s call for health, nutrition and sexuality education, barangay health workers, midwives and emergency obstetric care. Let our compassion move us to act now to provide these basic needs, and do everything we can to promote health of mind, body and spirit for every Filipino family.
“God has created a world big enough for all the lives He wishes to be born. It is only our hearts that are not big enough to want them and accept them… We are too often afraid of the sacrifices we might have to make. But where there is love, there is always
sacrifice. And when we love until it hurts, there is joy and peace. And where there is joy and peace, marriage and the family can thrive.” -Mother Teresa of Calcutta
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Rowley, J., Toskin, I., Ndowa, F. “Global incidence and prevalence of selected curable sexually transmitted infections- 2008.” World Health Organization. 2011. Web. 11 Sep. 2012. Samuelson, R. J. “The end of Europe.” The Washington Post. 15 Jun. 2005. Web. 12 Sep. 2012. Sorace, D. “Groundbreaking National Sexuality Education Standards Released.” Sexuality Information and Education Council of the United States. 9 Jan. 2012. Web. 12 Sep. 2012. Suleik, M.B. “RH Bill is unnecessary.” Manila Bulletin Publishing Corporation. 11 May. 2012. Web. 13 Sep. 2012. The World Factbook. “Economy- overview.” East and South Asia: Philippines. Central Intelligence Agency. 2012. Web. 12 Sep. 2012. United Nations Population Fund. “Skilled attendance at birth.” Web. 11 Sep. 2012. Villegas, B.M. “Priority needs of the poor.” Manila Bulletin Publishing Corporation. 2 Sep. 2012. Web. 13 Sep. 2012. White, C. “Population growth in the Philippines: problem or potential?” National Review Online. 8 Feb. 2011. Web. 13 Sep. 2012.
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