NEW SCIENTIST -- June 1999

SIN'S CITY

Family planning in the Philippines has been driven underground: Fread Pearce Investigates

Nellie put on her platform shoes, tottered past the display of multicoloured condoms with animal heads, thanked me for one of the better tricks of the week and headed out again to sell her body in the Manila night. 
I went home to bed.

Our encounter was only an interview, held in the offices of ReachOut, a clinic for prostitutes in the Philippine capital. But it revealed much about why the country is turning into a demographic nightmare. Nellie told of a city where the mayor, has banned contraceptives from clinics. Of a country where the half-a-million abortions each year are all illegal- and where even the Muslim clergy are more liberal on family planning than the Catholics led by the aptly named Cardinal Sin, Archbishop of Manila.

'Women were encouraged to adopt family planning 
under the guise of helping them set up piggeries, 
onion fields and fish farms'

In October this year, the world's population hits 6 billion. With birth rates falling faster than ever in many countries, there is no need to panic. Except that in others: such as the Philippines, the traditional demographic model of birth rates declining as prosperity and female literacy grow is not working. The Philippines has a fertility rate of 3.8 children per woman. That is higher than Bangladesh, even though its average earnings are three times as high and its female illiteracy levels twelve times lower.

What went wrong? The Catholic Church for one thing. From the pulpits and the nation's tabloid press, church leaders inveigh against contraceptives. They inspire real fear among politicians. The church under Cardinal Sin helped push out Ferdinand Marcos 13 years ago, and has flexed its muscles ever since. The current president, Joseph Estrada, once a supporter of family planning, courts church support by extolling large families on the grounds that he was an eighth child. The UN Population Fund has spent more than half a billion dollars on contraception in the Philippines in the past two decades. But such is the church's hostility that it is now planning to pull out of more than half of the 21 provinces.

Family planning is an underground movement here. Its practitioners adopt many disguises. "Reproductive health" clinics are the most obvious. Then there are lunchtime staff training programmes, adolescent clubs and discussion groups for rickshaw riders. Last month, I visited an agricultural development programme that encouraged women to adopt family planning under the guise of helping them set up piggeries, onion fields and fish farms.

The national government spends not a cent on contraceptives. And local officials often harass those who do-the foreign aid agencies and local activists. People such as Junice Melgar. She supplies the Manila shanty town of Apelo from a tiny clinic on a former garbage dump, sandwiched between a sewage-filled canal, a rusting store for liquefied gas and a big new fundamentalist pro-life church. In this world of dank alleyways and garbage scavengers, monogamy is a myth, marriage is rare and abortion is rife. Here sterilisation and injectables are the contraceptives of choice for women, because their men will never know.

Aurora Silayan-Go runs the Foundation for Adolescent Development, a euphemism for providing youngsters with contraceptives and advice on sex and health. At a teen club in the town of Cavite, she told me: "Because this is a club- you can play chess here- it is easy for kids to come without being seen by their parents going to a clinic."

The need for such centres is urgent. A fifth of 15 to 24-year-old girls in the Philippines have had an abortion. Every health worker I spoke to agreed that back- street abortions were killing thousands of women every year. They all wanted it legalised. But none of them would speak up for it for fear of the attacks on their organisation that would follow.

But times may change. I met Benjamin Martinez, mayor of Balayan, a poor church-dominated market town south of Manila. He is a classic product of macho, nepotistic Philippines politics. He was shoe-horned into the job at the age of 27 when his father, the incumbent, dropped dead six weeks before polling. His brother is the town's head priest and opposes all "artificial" family planning. So does the provincial governor, his father-in-law.

Yet Martinez chose to spend his mayor's development fund- a big slab of municipal revenue normally earmarked for highly visible infrastructure projects contracted to the mayor's favourite companies- on "reproductive health" clinics and a cadre of some 500 health volunteers.

The services are in such demand that many women health volunteers are themselves now winning elections to neighbourhood councils. "Reproductive health is a political gold mine," says Martinez. "I may run for Congress next." President one day? He smiles a politician's smile. First he will have to get past Cardinal Sin.

Meanwhile back at the ReachOut centre in Manila, they are restocking their shelves with bizarrely shaped condoms in a city where neither prostitutes such as Nellie nor abortions officially exist. Where 12-year-old boys and girls down the street sell themselves at a flower stall under the eyes of a police-run protection racket. And where the clinic's latest client is a 19-year-old girl in her fifth pregnancy. This really is Sin's City.


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