Saturday, May 21, 2011

[Featured Article] Why I Would Like the Consolidated Reproductive Health Bill be Approved

Why I Would Like the Consolidated Reproductive Health Bill be Approved
By Carl Elexer Watt, RN

“Reproductive Health refers to the state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes

    It is very alarming that the debate on the approval of the HB 4244 or The Final Consolidated Reproductive Health Bill which will be known as The Responsible Parenthood, Reproductive Health and Population and Development Act of 2011” is trending and causing issues between the Church and the State. The Catholic Bishops’ Conference of the Philippines (CBCP) together with their supporters continuously oppose the approval of the said bill as they claim that the bill is immoral, pro-abortion, and is not the answer to eradicate poverty as they believe and proves that the population has nothing to do with poverty.

    On the other hand, Risa Hontiveros, Sen. Pia Cayetano, Lacson, Defensor – Santiago, Pres. Aquino, De Quiros, Ces Drilon, Randy David, Lea Salonga, Jim Paredes and Nurses groups to name a few are working their ways on supporting the approval of such bill, for they believe in such facts that poverty is a multi - factorial problem and population is one of the biggest contributing factor and also they clearly understood that the bill is not just particular on contraceptive use as what their opponents claim, rather more of values promotion, knowledge enhancement, holistic self development, sexuality awareness, promotion of responsible parenthood and a response to the alarming condition of maternal and fetal death in our country.

    I myself when I first encountered the bill I was against the enactment of this bill due to the belief that it will be legalizing abortion in the Philippines and being a strong advocate for life, I initially opposed the RH Bill. I was hearing then a lot of premise regarding the bill, some are against the bill, some are good things about the bill. That particular event pushed me to separate the biases and understand the bill well. After understanding the bill, I then came to a realization that the bill is not a pro- abortion rather it offers a lot of good things which will help us economically, socially, morally and personally. So, why should I go for the enactment of this bill? Here are some of my realizations about the bill.
    1. Law of Supply and Demand.
      > From the simplest analysis of the Law of Supply and Demand, it shows that when demand increases and the supply remains unchanged, then it leads to higher equilibrium price and quantity. Applying that to the trends in population, when the population is increasing continuously and the financial resources (supply) remains unchanged, the amount of expenses (equilibrium price) increases and the amount of financial resources (quantity) also increases to meet and satisfy the demand and maintain the amount of expenses in balance.
    2. Population is one of the strongest contributing factor of poverty.
      > Most of the anti RH people defend that the country is not “overpopulated”. They also claim that population has nothing to do with poverty. These premise are basically incorrect. With basic knowledge on demography, computing the country’s population density:
      94 million (projected population 2010) 300,000 km(estimated total land area)

      This will yield a result of 313 individual/kmif this value does not sound populated enough, think again. Remember that this is roughly an individual and the land mass per se, think of the land usage for agriculture, infrastructures, uninhabitable terrains and the archipelagic situation of the country leaving some of the small islands in our country as uninhabitable too.
      Focusing on the published population of the Philippines,2007 by the National Statistics Office (NSO). It shows that the population is dominated by the Children aged 0 to 4 years and 5 to 9 years, each making up 12.0 percent of the total household population, followed by age groups 10 to 14 years (11.6 percent) and 15 to 19 years (10.5 percent). NSO also claimed that the dependency ratio in our country is 66 per 100 individual and this fact is actually computed based on the working age group which is 15 – 64 y/o. And this is very alarming already since 66% of the population is dependent.
      But what if, observing the employment trend, most of the company and employers will employ applicants which are at least 20 y/o and with the prescribed retirement age of 60 – 65 y/o. Therefore analyzing the population again using the parameter of the dependent age as the ages 0-19 y/o and 65 and above, it will show that the total number of dependents is: 44,334.104 and the total number of individual under the working age is: 43,970,511 base on that information, dependents obviously is outnumbering the population under the working age, that is 101% dependency! 
      In 2009 poverty report, according to National Statistical Coordination Board (NSCB) an average family of five will need at least P7,107 monthly income to stay out of poverty.(READ HERE) Basically, with the given figure from NSCB it shows that an individual needs at least P46 - 47 daily to satisfy his basic daily needs, in which I think considering the prices in the market, this is far from reality. Analyzing the poverty threshold set by NSCB an individual needs P1421.40/ month, therefore accepting this premise, as the family size increases the minimum income required to stay out of poverty increases too!
       3. The RH Bill is not a Contraceptive promoting bill.
       The RH Bill is not into the promotion of Contraceptive use as what most of the Anti RH supporters claim. The bill is more of making sure that contraceptive will be readily available (which also explains why contraceptives will be considered as “essential medicines”) to those families who chose to use the modern methods of family planning. Anti RH supporters should understand that contraceptives have been part of the Family Planning program here in the Philippines since it was launched. The premise of obliging the Filipinos to use contraceptives because of the widespread distribution is a misunderstanding, the antagonists of the bill must understand that the decision on choosing which family planning method will be used is still left for the the couples. Sarcastically antagonists will react saying “then what is the use of the RH bill if there is a family planning program already?” and this will lead to the premise I have which is:
       4. The RH Bill is in promotion of Reproductive Health.
       The RH bill aims to promote and ameliorate the Reproductive Health situation per se and not just a part of the entire scope of Reproductive Health. This is even actually evident on the title of HB 4244 “The Final Consolidated Reproductive Health Bill”, from the word “consolidated”which means “joined together” which implies that programs concerning reproductive health are joined as one. This is further justified by the bill’s specification of the elements of Reproductive Health Care:
      • Family planning information and services;
      • maternal, infant and child health and nutrition, including breastfeeding;
      • proscription of abortion and management of abortion complications;
      • adolescent and youth reproductive health;
      • prevention and management of reproductive tract infections (RTIs), HIV and AIDS and other sexually transmittable infections (STIs);
      • elimination of violence against women;
      • education and counseling on sexuality and reproductive health;
      • treatment of breast and reproductive tract cancers and other gynecological conditions and disorders;
      • male responsibility and participation in reproductive health;
      • prevention and treatment of infertility and sexual dysfunction;
      • reproductive health education for the adolescents; and
      • mental health aspect of reproductive health care
    1. The RH bill is not Anti Life and Pro Abortion
      The RH bill is not setting any limits on how many child a family would like to have, however through family planning sessions, families will be taught on how they can suffice their family needs and decrease their vulnerability to poverty, however the bill is not claiming that this will be the ultimate solution to the problem of poverty, as aforementioned poverty is multi-factorial therefore programs of the government will work hand in hand to alleviate the problem.
      The bill is not legalizing abortion, the state still believes in the sanctity of life. It is a wrong assumption that because of the premise in providing humane post-abortive care tantamount to legalization of abortion. We need to understand that abortion is a general term, there are different types of abortion and even the accidental miscarriage is termed as spontaneous abortion. In case punitive abortion cases, not because they will be given humane post abortive care they will not be help liable to their criminal acts, still whoever engage themselves to such acts will still be penalized under the law governing such.
      The premise of contraceptives as abortifacients is also a wrong assumption. The contraceptives available for the family planning program includes combined pills, IUD, DMPA and condoms. “Emergency pills” or the “morning after pills” are not legally used. It is wrong to assume that these methods are abortifacients primarily because the mechanism of actions of such methods works on the ovulation part of the menstrual cycle, the release of a mature egg cell, and the entrance of sperms cells to the uterus. Therefore no abortion is committed. Now with the assumption of sperm cells are being killed is abortion, therefore it is apt for me to assume that when a man masturbates he is committing abortion, when a man practices withdrawal method he is committing abortion on that case men engaging on such acts must be penalized for committing abortion. Right?
    2. Contraceptive pills are threats to health as it promotes Cancer.
      Contraceptives specifically the combined pills reduces the risk of endometrial and ovarian cancer. And through the family planning sessions, safety, proper usage are being taught to those who would like to use a particular artificial method. Women are also being assessed first if they are safe to use such methods. The premise of contraceptives are not 100% effective, there are no methods on the family planning program are 100% effective except from vasectomy and tubal ligation. But with the artificial methods compared against the natural methods, artificial methods are more effective which yield 95 to 99% effectiveness upon proper usage. Natural methods are less effective as this may have interference with the body’s natural processes.
    3. RH bill will not promote promiscuity, pre – marital sex and extra – marital sex.
      It is a wrong assumption that the RH bill will promote promiscuity and engagement in pre – marital sex since the bill is aimed to promote values formation, gender equality, in depth understanding of sexuality, self – worth development through the RH education. Rh bill will not promote extra marital sex since it aims to promote inculcate the value of responsible parenthood among couples. Sex education is not tantamount to Kamasutra class, rather anatomical and physiological understanding of reproduction.
    4. RH bill aims to protect and ameliorate the lives of mothers.
      Being on the medical field, my eyes are very much open to the reality of the health condition in our country. It is very alarming that complications and deaths related to pregnancy and birthing is high in our country. Where in this is a very preventable event through early detection.
      Some antagonists of the bill actually claims that deaths from Tuberculosis and cardiovascular deaths are more prevalent than the maternal deaths without even thinking that these are actually lifestyle – related diseases and medicines to such cases are also being distributed by the government and prevention of such diseases is actually dependent on the compliance and behavioral changes on the individual involve. Wherein, maternal deaths, pregnancy complications, and birthing complications are brought about by inadequate facilities for safe birthing, prenatal check ups, and manpower to attend to such needs. RH bill is addressing this problem.
    5. RH bill will utilize the manpower resources of health care professionals which are mostly unemployed.
      Through the enactment of the bill and launch of the programs under the RH bill, job opportunities for nurses, doctors and midwives will increase.

    These are just some of my realizations about what the RH bill offers. RH bill is offering a chance to have a better life, understanding one self, and a strong gender equality. These are the reason why I support the RH bill. To the concerned groups and individuals, please avoid furious reactions through your impulses, it is better to separate the biases, be open – minded and understand the bill well. Opposing the whole bill is not the answer if you do not like something on the bill, that is why it is open for a debate so that amendments will be furnished. Do not waste the benefits of the entire bill just because of a small conflict that you think is not correct. 

    *** Just another lackadaisical thoughts from Carl.

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