Out of sight: The Philippine reproductive health crisis

There seems to be an unsaid discomfort when anything related to sex is brought to the table. From menstruation, contraceptive pills, pregnancy, to abortion, it is almost impossible to share details about these experiences casually, unremarkably, and with no holds barred.

“This image that we like to portray—that the Philippines is so conservative—stands in the way of people actually facing the problems that we have,” says Amina Swanepoel, the director of Roots of Health, a reproductive health organization based in Palawan. “As much as people like to make reproductive health seem taboo,” she says, “it’s the starting point of women’s health.”

Even before the pandemic, the Women’s Global Network for Reproductive Rights reported that thousands of women in the country die every year from preventable medical issues related to pregnancy and childbirth. Now that the world is fixated on curbing virus transmission, healthcare systems are forced into an overburdened position, pushing reproductive health services to the sidelines.

Understated struggle

“It’s an essential service. It should not be isolated with other health services,” Jona Turalde emphasizes. Turalde is one of the volunteers for SheDecides, an organization that provides reproductive care services mainly to the youth. As the COVID-19 crisis continues to bring multifaceted issues to light, it further affects women disproportionately as accessibility, affordability, even information per se regarding reproductive health services are now far from being considered a priority.

“Because of the fact that it’s harder to access services, a lot of people are having pregnancies that they didn’t want to have this year. In a lot of communities, barangay health centers that used to be the place that women and girls could access contraception are not giving it anymore because they’re focused on COVID,” Swanepoel details.

She also mentions that in Puerto Princesa alone, there are a lot of babies being born with low birth weight and other health complications due to the lack of prenatal care for pregnant women, who are unable to access such services; and even when pregnant women have the pass to go out, services remain severely limited.

It requires maximum effort for reproductive health organizations and movements to try and mitigate the concerns surrounding the issue. Aside from their usual clinic services, The Family Planning Organization of the Philippines (FPOP), Roots of Health, and SheDecides, for instance have begun offering home deliveries in communities for free. They have also expanded their online presence and local hotlines. SheDecides, in particular, has been promoting a chatbot called Kai. “It’s a chatbot that you can ask any questions about sex, even consent [in relationships]. It will answer you in Filipino or English,” Turalde explains.

However, Michael Himor, FPOP’s Metro Manila Chapter Manager, points out that even if NGOs do the best they can, “it is still more challenging resource-wise, kasi nga hindi ito priority program ng gobyerno.” He further adds, “Hindi na-anticipate ng ating government partners na sa susunod na taon, magko-cause ito ng mas malaking problem [since] you have the baby boom next year.”

(Our government partners did not anticipate that, because of the baby boom next year, this would cause a bigger problem.)

Piling up

Aside from lack of reproductive healthcare, women are also burdened during the pandemic in other ways. As COVID-19 ushers in a new “normal”, the scope of women’s responsibilities in the home widens significantly.

“Having everyone at home adds to the burden of work that most women and girls do,” Swanepoel explains. “For anyone who also has school-aged children, usually they’re now being expected to handle homeschooling in addition to whatever other work they might be trying to do.”

The gravity of women’s responsibilities in this context—coupled with the challenges faced by the RH sector—spark potential for unsustainable reproductive trends in the near future—particularly, a nationwide “baby boom”. When a woman overloaded with caregiving duties suddenly finds herself without the proper resources to sustain their own reproductive health, all parties dependent on her are left vulnerable.

It goes without saying that the effects these challenges can have on both the physical and emotional well-being of afflicted individuals are extensive. Thus, providing support to loved ones facing these challenges is imperative. In line with this, Turalde also adds, “The least we can do is to be understanding and to be there. And if we have contacts with services, we can connect them to those services. They will need it the most.”

A necessity for change

Ultimately, these problems are not something that have just suddenly surfaced during the pandemic. Indeed, the country’s reproductive health issues are rooted in long-held stigmas and are perpetuated by a flawed national discourse.

“The Philippines is conservative only theoretically. It’s not conservative in practice. All you have to do is look to see our very high teen pregnancy rates to see that people are having sex,” Swanepoel emphasizes. With discourse on reproductive health oftentimes linked to the encouragement of promiscuity, Riziel Castro, FPOP’s Humanitarian Focal Person, offers another perspective on the issue,  “Hindi dahil gusto mo ipasok sa utak nung mga bata na makipag-sex kaPero para mas maintindihan ng kabataan ‘yung karapatan nila sa katawan nila, at ano ‘yung pwedeng mangyari kung pumasok sila sa ganitong bagay.”

(It’s not that you want to encourage the youth to go have sex, but rather to let young people fully understand their rights over their own bodies and what can happen if they engage in these things.)

Unfortunately, this mindset does not exist merely on an individual level. Reflecting on her organization’s partnerships with local government units and stakeholder partners, Swanepoel notes that these sentiments still carry over in communities. “It’s really high time that people understand that what we say are values are not necessarily what’s actually happening in reality,” she asserts.

Fundamentally, the steps needed to remedy these issues all go back to the collective. “It’s a collaborative effort of the government, the civil society organizations, the private organizations, the church, and the religious sectors,” explains Himor. Swanepoel echoes the sentiment, insisting that solving our issues requires “taking an honest look at society and what actually our problems are, and trying to solve them, instead of pretending they don’t exist.”

ERRATUM: November 23, 2020

The article previously stated that the chatbot Kai was set up by SheDecides. In truth, it was initiated by Likhaan, another women’s health organization, while SheDecides promoted its use.

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