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By Jaileen F. Jimeno, Philippine Center for
Investigative Journalism
Conclusion
LINGAYEN, Pangasinan: Since 1975, the year
Pangasinan’s population office was created by then-Governor Aguedo
Agbayani, Luz Muego’s life has been governed by numbers. At the
time, Muego was a researcher at the office. Now she is the
province’s population officer, but she is still preoccupied with
all sorts of figures.
Today Muego, who has a degree in nursing, is
pondering these figures: 2.4 million, the province’s total
population; 23 percent of the province’s women want to plan
their family but are unable to do so; 33 percent of the population
lives below the poverty line.
Pangasinan is the country’s most populous
province. But another number has helped make it one of the
Philippines’ role models in family planning: a population growth
rate of 1.9 percent, which is phenomenal compared with the national
figu-re of 2.3 percent, and considering the increasing strength of
religious conservatives in the crafting of population-control
policies.
‘Doing an Atienza’
In fact, Muego, now 59 years old, and current
Governor Victor Agbayani—Aguedo’s son—are reluctant to draw
attention to their accomplishment for fear of attracting the ire of
these conservatives. Already, Muego says, a mayor who is part of the
province’s contraceptives-reliance program has been approached by
a “convert” of the group Pro-Life Philippines, asking him to
“do an Atienza” in his town.
The “convert” is an employee of the
Department of Health. “Doing an Atienza” refers to Mayor Lito
Atienza of Manila’s imposition of an antiartificial contraceptive
policy on his entire city. Atienza also happens to be the
chair of Pro-Life, whose founder is a Roman Catholic nun with
ultraconservative views about birth control.
In large part, Pangasinan’s success has been
due to the provincial government ensuring that couples are free to
choose which family-planning method they want to use. But part of it
is also due to a deal struck four years ago by Agbayani and the
population office with local Church leaders to promote natural
family-planning methods.
Even now, the effort still seems unthinkable,
and it did fizzle out after a couple of years or so. But not before
the project was able to train 37 laymen in three towns in the
rudiments of family planning.
While it lasted, the memorandum of agreement
demonstrated that a population program need not necessarily mean
anti-Church. The agreement, after all, did not in any way promote
artificial contraception. But it did widen the province’s reach in
dispersing information about family planning.
‘Below the radar’
The provincial government allocated P300,000 for
the beads used in tracking a woman’s cycle—crucial in natural
birth control. Part of the fund for the training of trainers,
meanwhile, came from the budget of local officials. Says
Agbayani: “The collaboration meant our people will train their
people in the use of natural family-planning methods so they can
have trainers.”
But Agbayani says he had wanted to keep the
agreement “below the radar,” and for good reason: the Catholic
Bishops’ Conference was viewing it with concern. In the end, some
priests in Pangasinan chose not to carry it out, fearing that
jueteng money earned by some local officials were used to fund the
training.
If Pangasinan officials remain wary of catching
the eye of organizations such as Pro-Life, it is because population
experts and health workers alike say that when it comes to
population control, support from the national government is sorely
lacking. They also say that President Arroyo is even perceived as
endorsing only natural family planning, of which she is a staunch
advocate.
‘Condomed without trial’
In fact, there is no national population policy
at the moment, something that has left Sen. Juan Flavier very
frustrated. As health secretary during the Ramos administration,
Flavier had espoused population control as one of his flagship
programs. He came up with the “Kung Sila’y Mahal Niyo, Magplano
[If You Love Your Family, Plan Them]” campaign. He also helped
reduce the stigma of condom use by employing various media gimmicks,
“for which,” he once punned, “I was condomed without trial.”
Now, Flavier says, “kanya-kanyang style
to do their best to block it [population control].”
Dr. Junice Melgar, head of the Reproductive
Health Advocacy Network (RHAN), blames the weakening of the
country’s family-planning program on the government’s disregard
of women’s rights. “Women’s needs are always at the bottom of
the priority list,” she says. Yet women are often made to take the
entire burden of family planning—even as they are denied the full
range of birth-control methods.
Melgar says this is why RHAN can only critically
support Albay Rep. Edcel Lagman’s House Bill 3773, which aims to
“encourage the limitation of the number of children to an
affordable level of two children a family.” According to Melgar,
the arguments should focus not on economics but on the right of
women to make their own decisions.
On the fringes of society
She says government’s neglect of women’s
rights to family planning has led to the unusual strength of groups
like Pro-Life Philippines. “In other countries, they are on the
fringes, here they are in the mainstream,” she says.
But Ramon San Pascual, executive director of the
Philippine Legislators’ Committee on Population and Development,
says HB 3773 will at least force Malacañang to abandon its
“escapist” stand of allowing local government officials to carry
out family planning as they see fit. While he concedes that the bill
has provoked strong reactions from anticontraception groups, he also
says that floor discussions on it at least present a good
“educational” opportunity for the whole population.
Indeed, with various sides and arguments
clashing on the issue, some cooler heads have seen the need for a
rational discussion. At the Bishops-Businessmen’s Conference for
Human Development in Makati in March, Fr. John J. Carroll, S.J.,
called on the Church, the government and other sectors to hold a
dialogue on the issue “from the points of view of women and the
poor.”
He observed that the Church had always flexed
its muscle on the political level when it came to contraception, but
lacked in efforts to educate its people in the advantages of family
planning. The Church was a member of the Population Commission until
it pulled out in 1970 due to its stand against artificial
contraception.
Carroll warned that 27 percent of women in the
poorest fifth of the population “want to limit their families, but
are not taking steps to do so.” He said the Church should be
“open about receiving government assistance for its program of
natural family planning,” and admit that “it lacks the resources
to meet the need by itself.”
The likes of Manila’s Atienza, however, may
not be willing to take part in any kind of dialogue on birth
control. Atienza has already made up his mind, and has gone to the
extent of arguing that the Constitution is pro-life and that it
contains no provision mandating government officials like him to
provide birth-control materials to couples.
In his view, the government is even violating
the law when it uses taxpayer’s money for birth control.
“Population control and the distribution of contraceptive
materials in government facilities is a continuing illegal act,”
argues Atienza.
Pro-quality of life
Pangasinan’s Agbayani disagrees with this
view. Still, he emphasizes that his government is not pro-abortion.
“We are pro-quality of life,” he says. “If we do not
manage our population, we negate our gains in economic
development.”
Like Muego, Agbayani, a civil engineer with a
Master’s degree in business administration, pays close attention
to numbers. “Our budgetary resources are not enough to provide the
basic services of our people,” he says. The province has built
some 400 schoolrooms the past years, but they are not enough to
accommodate the new entrants every year. While the province has
100,000 hectares of irrigated land, it cannot support runaway
population growth.
Agbayani says his provincial government’s
studies show that a family spends every year as much as P3,300 to
educate one child if there are two children. This amount dwindles to
P2,500 for a family with three to four children, and to P800 for a
family with nine.
The governor says Pangasinan’s target is to
reduce the population growth rate by .1 percent a year until it
reaches 1.5. He says the reduction will give the province enough
time to cope with the demands of the current population. But the
provincial office also aims to bring down the number of women with
unmet contraception needs by 1 percent a year.
Agbayani notes with amusement that although his
father pioneered population management in Pangasinan, the late
governor had 9 children. Victor Agbayani has only 3 children, aged
13, 8 and 5. He and his wife never used contraceptives, relying only
on natural family planning, an area he leaves up to his wife, a
doctor.
’97-percent effective’
Experts like Corazon Raymundo of the University
of the Philippines Population Institute have noted that although
natural family planning is “97-percent effective, it has a lot of
dropouts.” This is because the natural method calls for constant
monitoring of a woman’s fertility cycle and taking of
temperatures, which many couples may have neither the time nor
patience for.
Mayor Atienza himself admits that the number of
women actively using natural family planning in his city is dismal.
But he says this proves that the “contraceptive mentality has been
somehow effective in brainwashing the young generation to believe
that the solution to poverty is not having or avoiding children.”
According to the 2004 report of Manila’s city
health department, the most widely accepted form of natural family
planning is the Lactation Amenorrhea Method, or LAM, with 22,148
users. But LAM is effective only for a maximum period of six months,
and mothers have to breastfed constantly for it to work. The report
says that since 2004, 1,401 people have accepted the Billings
method, in which women chart their fertile and infertile periods.
National Statistics Office data show that in
2000, Manila had 471,307 women of childbearing age, or those aged
between 15 and 49.
The city of Manila, which had a total population
of more than 1.5 million in 2000, allocated a total of P470,920 for
natural family planning last year.
Here in Pangasinan, the capitol this year set
aside P14 million for the province’s population-control program.
In 2004 the province had 120,822 family-planning “acceptors,” or
those who are using means of birth control, natural or otherwise.
The province’s efforts at population
management have had major setbacks in the past. In 1987 with
fertility reduction missing from the agenda of the Aquino
administration, Pangasinan’s population program was abolished for
lack of funds.
Instead, family-planning campaigns were left
solely in the hands of the Department of Health. The result: the
province’s population growth rate of 1.8 percent jumped to 2.1
percent. It was pulled back to 1.9 percent beginning 1992, when the
program was revived under President Fidel Ramos.
Phaseout of USAID support
These days, among the problems Agbayani and
Muego are looking at is the US Agency for International
Development’s (USAID’s) scheduled phaseout of its materials
support for family planning in 2007. Already, the province is
reeling from the 20-percent reduction in contraceptive supplies from
USAID. By next month the drop will reach 40 percent.
As usual, Agbayani and Muego are solving the
problem by doing their math. The numbers have told them that close
to half of commodity users can afford to buy their supply. But only
14 percent buy their own, with the rest relying on government.
Realizing this, the capitol launched a
contraceptives self-reliance program to make individuals and town
mayors share the burden. Indigent clients will be given an ID
entitling them to free materials or a subsidy. The provincial
government has identified nine towns where the program will be
tested. Agbayani has also wooed pharmaceutical companies to provide
cheaper contraceptives to the province.
Although Pangasinan has tried to keep a low
profile when it comes to its population-control efforts, these have
been just too good to escape notice by various groups. In 2003
Agbayani received the Rafael Salas Population and Development Award.
Muego and her office, meanwhile, have won several awards from the
Population Commission and other agencies for their effective
population management program.
The Population Institute’s Raymundo remarks,
“Pangasinan’s program is ideal because it comes from the highest
policymaking body, the governor. There’s support, there are no
barriers, and the population units are very strong, with lots of
activities. Most important, the people are free to choose.”
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