“Population control defeats the rights-based, health-based, pro-poor characteristics of the RH Bill. As we call for the removal of population control provisions in the RH bill, the retention of pro-poor provisions lifted from Gabriela’s Comprehensive RH bill is non-negotiable.” – GWP Rep. Luz Ilagan
By INA ALLECO R. SILVERIO
Bulatlat.com
MANILA — Maternal and child health care or population control?
In the escalating debate over the proposed reproductive health law, Gabriela Women’s Party Representatives Luz Ilagan and Emmi de Jesus said President Benigno Aquino III is engaging in double-talk. Aquino has previously declared his support for the RH bill, but, the Gabriela lawmakers said, instead of increasing allocations for public health services, the administration has in fact slashed it.
This has prompted some quarters to conclude that Aquino’s support for healthcare for women and mothers is fake, and his interest lies more on the RH bill as a population control measure.
“Aquino is saying one thing yet doing the opposite. How can he claim support for programs on reproductive health or even responsible parenthood when he has cut the budget for health?,” said Ilagan.
Ilagan was referring to statements made by Aquino, September 22, when he appeared at the annual meeting of the International Monetary Fund (IMF) and the World Bank (WB) in Washington DC in the United States. Aquino said he supports the RH bill because it will help educate parents about birth spacing and responsible parenthood. Aquino also said the proposal was never meant to be solely a means to promote contraceptives.
“For all of his supportive words, Aquino has done the opposite – he has immobilized the government agencies and institutions tasked to provide health services by implementing budget cuts. Responsible parents must first have access to services to raise a healthy family,” Ilagan said.
The Gabriela solon explained that in the 2012 budget, five of the 12 Metro Manila-based special hospitals, and 18 of the 54 local hospitals nationwide did not t receive an increase in their allotment for maintenance and operating expenses. The Department of Budget and Management cut the DOH’s proposed budget from P80,143,863,00 (US$ 186,381,076) to P42,771,536,000 (US$994,686.883)) The government hospitals’ presentations also showed the negligible help that patients get from PhilHealth. At the Philippine Children Medical Center, for instance, PhilHealth accounts only for 14 percent of the total bill of PCMC patients for the year 2010. Majority of the expenses were shouldered by the patients, with 27 percent of the rest of the expenses covered by promissory notes.
The budget for “Health Facilities Enhancement program” which, based on Aquino’s budget message, is geared toward the improvement of maternal health, and the well-being of infants was slashed from P7.1 billion (US$162,790,697) in 2011, to P5.1 billion (US$116,27,907) in 2012.
“President Aquino should put his money where his mouth is and demonstrate his sincerity in upholding women and children’s rights to healthcare.”
US population control scheme in the guise of health projects?
President Aquino’s alacrity in supporting the RH bill, even as he allotted a minuscule budget to health services, has already prompted questions. Some quarters have said that Aquino’s stance on the RH bill is heavily influenced by groups that promote population control because these agencies are already giving financial and logistical support for population control programs in the guise of health projects.
The allegations of several anti-RH bill senators such as Sen. Tito Sotto that the RH bill is the handiwork of political and economic forces that want to impose population control over the Philippines appears to have some truth to it.
According to reports, he US Agency for International Development (USAID) mission in the Philippines has, since 2007, been implementing the PRISM Project, or the Private Sector Mobilization for Family Health (PRISM) Project.
The USAID is the United States federal government agency primarily responsible for administering foreign aid. It was established by former US president John F. Kennedy in 1961 via an executive order to implement development assistance programs in the areas authorized by the Congress in the Foreign Assistance Act of 1961. As an independent federal agency, it receives overall foreign policy guidance from the United States Secretary of State. USAID’s stated goals include providing “economic, development and humanitarian assistance around the world in support of the foreign policy goals of the United States.” It operates in Sub-Saharan Africa; Asia and the Near East, Latin America and the Caribbean, Europe, and Eurasia.
In the Philippines, the Prism Project is already in its second phase and, according to the USAID, it “ expands private sector provision of health services on maternal and child health (MCH), and family planning (FP), through workplace initiatives, market development and private practice initiatives.” Specifically, Prism2 is also said to provide financial and logistical support to the Department of Health, Department of Labor and Employment, local government units (LGUs) and other national and local partners when it comes to the delivery of FP/MCH products and services. The project is being implemented in 78 provinces/independent cities nationwide from 2009 to 2014.
The USAID implements Prism2 also by coordinating with companies and cooperatives to increase employees or cooperative members’ access to family health information and services.
The USAID is also implementing a whole slew of projects that are aimed supposedly to improving the quality of health of Filipinos, specifically mothers and children. Through its Health Policy Development Program (HPDP), the USAID continues to involve itself in the development of what are supposed to be “appropriate policies and build a systematic policy change process” in the DOH. The focus of the USAID’s involvement is in developing contraceptive self-reliance/FP/MCH.
When it comes to health care financing, the USAID backs the DOH as it implements schemes to ensure “sustainability of essential health services, including expansion of the National Health Insurance Program (NHIP), multi-year financing of the costs of priority health programs, and ensuring equitable and efficient distribution of health resources across the country.”
In a word, the schemes comprise “privatization.”
According to the USAID website, its health policy development program runs an operations research project in Compostela Valley. There, the agency is testing “an integrated approach for preventing mother and child deaths through information and social mobilization.”
When it comes to its dealings with local government units, the USAID has its Strengthening Local Governance for Health (HealthGov) Project and the Sustainable Health Improvements through Empowerment and Local Development (SHIELD) Project. Here, the US agency involves itself in LGUs’ operations when it comes to establishing or maintaining health systems, on matters of financing, and in health service provision. The two projects are at the core of the the US agency’s health program areas — maternal and child health, family planning, HIV/AIDS, tuberculosis and emerging infectious diseases in areas in the Autonomous Region of Muslim Mindanao (ARMM) thru the Shield Project) and non-ARMM areas (through HealthGov).
HealthGov is said to focus on maternal and child health. Through the project, the USAID develops technical assistance products such as a tool to access the health department’s MCH grants by local governments. The project also supports advocacy for increased funding support and improved programs on MCH and other health issues.
As for the Shield Project, it is the means by which the USAID involves itself in local communities in coordination with local governments. The project sends Community Health Action Teams (CHATs), which supposedly assist health service providers in caring for mothers and newborns, including early detection and referral of mothers and newborns with complications.
In the meantime, it’s not just health programs that the USAID mission to the Philippines is involved in. It also works closely with the US Department of Defense through the Joint US Military Assistance Group (JUSMAG) in pushing for peace and security programs.
“This well-established civilian-military cooperation has enhanced the effectiveness of US foreign assistance, spread the benefits of assistance more widely, and fostered goodwill towards America among the Philippine people,” the USAID described the JUSMAG in its website.
Wikileaks on RH bill
Former US ambassador to the Philippines Kristie Kenney in a cable exposed by Wikileaks has also commented on the RH bill, saying that there were ““Landmark appropriations and draft legislation reflect increasing commitment within the Philippine Government to further expand and sustain programs started forty years ago with US. Government’s assistance through USAID.
Kenney said in a cable, sent from Manila to Washington, DC in July 2008 that the US”continues to be the largest donor in the Philippine population sector supporting efforts to improve local government service delivery and increase private sector contributions to family health outcomes.”
USAID technical assistance enables pharmaceutical companies to launch lower-priced contraceptive products,” Kenny said in the cable. She also added that “Within the past three years, annual funding levels for population and family planning from the US Government have increased from around $13 million to $15 million.”
Under a section titled “So far, so good,” the ambassador noted that, “The use of oral contraceptive pills has increased steadily among the poor (by 30 percent in the past five years),” adding, “The poor spend around $0.40 for pills, and the rich pay about $1 for the same method.”
Kenny also pointed out that USAID assistance is “expanding the availability of accurate information on modern family planning methods within grass-roots communities.”
In October 2010, Kenney’s successor incumbent US Ambassador Harry K. Thomas Jr. told the media in an interview on the issue of reproductive health in the Philippines that it was not a concern of the US government.? ?“That is not an issue for the United States government or the embassy to weigh ourselves into,” Thomas said.
Remove population control provisions
The moves of the USAID and similar agencies are not lost on the Gabriela lawmakers. They said they have long put their foot down against the provisions on population control in the senate version of the RH bill.
While both Ilagan and De Jesus are both authors and staunch supporters of the RH Bill, they emphasized the need to remove population control provisions that could potentially overshadow and water down the bill’s pro-poor provisions.
“Population control defeats the rights-based, health-based, pro-poor characteristics of the RH Bill. As we call for the removal of population control provisions in the RH bill, the retention of pro-poor provisions lifted from Gabriela’s Comprehensive RH bill is non-negotiable.”
“We do not need a population control bill or a responsible parenthood bill to govern over women’s ovaries. Women can and should be able to decide for themselves whether or not they want to have children. Women need an RH law that will support women whatever their decisions may be,” Ilagan said.
Gabriela Women’s Party continues to oppose the said provisions, particularly (Sections 3 (l), 12, and 25) that promote population control; and Section 12 that states that family planning and responsible parenthood be integrated in anti-poverty programs.
“These provisions can release the floodgate for the government to carry out its population control program under the guise of pro-choice and poverty alleviation. Also, allowing the Population Commission under section 25 to serve as coordinating body in implementing the bill once it becomes law underscores government’s intent in pushing for population control,” de Jesus said.
According to de Jesus, these provisions must be deleted in the RH bill; “Otherwise, the long saga of blaming the population, and specifically women’s wombs, for the rising poverty in the country continues. This wrong notion is being deliberately peddled while government and big business interests escape responsibility for the poverty they have caused this country for decades, and the ailing Philippine health system that the government has turned its back on,” she said.
The RH Bill is about women’s health and rights
Ilagan, in the meantime, said the fight is for a comprehensive health care for women, not population control.
“Filipinos suffer from poverty, they are not the ones causing it. To address poverty is to address landlessness, lack of industries, low wages, high prices, poor services. Our population is our nation’s resource. It’s unjust and incorrect to blame the poor and Filipino women for the country’s poverty,” she said.
The former university professor said Filipino women’s right to informed choice should not be burdened or endangered by any design for population control.
“State responsibility for healthcare must not be subsumed to private profit especially by big pharmaceutical companies just waiting in the wings. The RH Bill should not be about population control. It should be about women’s health and women’s rights,” she said.
“Filipino women need access to health care services, and this does not necessarily just mean access to contraceptive pills and condoms. More importantly, this should mean the presence of skilled birth attendants in the farthest of barangays. This should mean the availability of accessible if not free pre-natal vitamins and this should mean that health centers are properly equipped for birthing or lying-in.”
Ilagan and de Jesus appealed to colleagues in both Congress and the Senate to let the arguments for and against the RH bill contribute toward the crafting of a law that will genuinely address the issue of women’s reproductive health beyond issues of contraception and population control.
“The RH Bill should not be about population control. It should be about women’s health and women’s rights,” said Ilagan.
In a forum held last week at the Jose Fabella Memorial Hospital, the Gabriela solons reiterated their position for the enactment of a reproductive health law that will focus not on limiting the number of children and the distribution of artificial contraceptives, but on the delivery of health services to women from the poorest and far-flung communities.
“Filipino women need access to health care services, and this does not necessarily just mean access to contraceptive pills and condoms. More importantly, this should mean the presence of skilled birth attendants in the farthest of barangays. This should mean the availability of accessible if not free pre-natal vitamins and this should mean that health centers are properly equipped for birthing or lying-in.”
Also among the panel of reactors in the forum were Dr. Roberto Montana (JFMH Ob-Gyne Department head), Dr. Genevive Rivera-Reyes (Health Alliance for Democracy), Dr. Sylvia dela Paz (OB-Gyne, JFMH).
Among the pro-poor provisions in the Gabriela’s Comprehensive RH bill include:
• Mobile health clinics that will ensure the delivery of health services to far-flung communities and barangays.
• Improvement and upgrade of equipment in public health care centers, to ensure that they are able to conduct basic reproductive healthcare procedures such as pap smears.
• Pro-bono reproductive health care services for indigent women by making it mandatory for all health care workers to provide at least 48 hours annually of reproductive health services free of charge to indigent patients, especially pregnant adolescents. 
• Paid half-day prenatal leaves for pregnant working employees for each month of the pregnancy period.
The US has created many nefarious plots but secretly reducing the population of the Philippines isn’t one of them. That the Philippines has too many people is a question for science and for quality of life. The world cannot support comfortably an increasing population and the Philippines has a population that is unsustainable. Sustainability is the capacity to maintain a population with the necessities of life over a long period without resorting to the long-term degradation of the natural resources. The current Filipino population cannot achieve sustainability, but neither can the population of the US, where I live. We’re facing a global population crisis. Reducing the population of both countries would be one component of reducing environmental damages including global warming. The article is an opinion piece, not news. No evidence is presented in the article to substantiate the assumption that population increases could be sustained. “The RH Bill should not be about population control. It should be about women’s health and women’s rights,” said Ilagan. Studies have shown that when women have access to contraceptives, they use them because they choose to use them, because they choose to limit the number of children they have. It’s impossible to separate women’s health, and women’s rights, from the universal outcome that both of these goals result in reduced population. The purpose of contraceptives, is to prevent conception. The purpose of contraceptives is to reduce the population in any given family. Reducing individual family size, reduces the overall population.
Women want smaller families. When a state “supports women’s rights” the state supports population reduction. That’s what women choose. I don’t understand why a women’s rights organization, Gabriela, would claim that the RH bill should not be about population control. That’s precise what contraceptives do–they allow women to have access to medical technology that permits them to limit the number of children they have. Privatization of health care services is a problem. To the extent that the US is pushing for privatization, that would be detrimental to public health. The assertion that the state should concentrate on delivery of health care services to the poor is better addressed in the context of the delivery of a free state-operated national health care service. The RH bill is about contraceptives primarily. That’s a good thing. Is it enough? No. All Filipinos, whether rich or poor, or female or male, should have access to free health care. Criticizing the RH bill for not being a free national health care plan raises an important concern, but it’s no argument for not immediately passing the RH bill.
Salamat sa pagsulat tungkol sa bagay na ito at pagbigay na kalinawan sa ideya ng tunay na kahalagahan ng tamang “reproductive” health law. Salamat sa Gabriela, sa paglaban ng tamang mga bagay sa kalusugan ng mga nanay.
Thanks to Bulatlat for letting us hear the voices of progressive politicians, honest ones who really know about lives of ordinary people. I know that what the Gabriela Women’s Party describes as the real need in our country, genuine reproductive assistance, is absolutely true. I know it, having witness poor people denied health care services, to the point that they are about to die for lack of blood transfusion during severe miscarriages. And the “magic” that money can do, how it brings attention to poor mothers, because a benefactor will pay for whatever it takes to save a mother’s life.
President Benigno Aquino should spend some time in birthing centers and poor people’s hospitals and see for himself how poor women die, for lack of “reproductive” health care. Noynoy, it seems to me, has not seen blood on the bed, on the sofa, coming from women who are miscarriaging. And all these can be prevented—with an enlightened women’s health care service for all Pilipinos.
Thank God you have opened your eyes Congresswoman Luz Ilagan.
The RH Bill has always been a population control bill using contraceptive methods of family planning since the 8th Congress. This is a project of the USAID/WHO to reduce the population of our country. Make our women guinea pigs like what they did in 1995 when they injected Tetanus Toxoid Vaccine laced with hCG to more than 3.4 million women from 1993-1995.This bill can make our women more sickly will all the side effects of the modern methods of contraception. Thank you for siding with the Philippine Medical Association stand.
This is simply terrible. the rh bill is rearing its ugly head. reject it!
People should never forget that real health depends how well you take care of yourself and not what health insurance you carry but I agree health insurance is important for every one. Search “Penny Health” or online for dollar a day insurance plans.