My Take on the Reproductive Health Bill (Part 1)

For the first time in so many years and congresses, the debate on the Reproductive Health Bill has finally reached the Plenary. The debates are now raging, not just in the session hall but even in the media, with particular emphasis in print through the successive paid ads by the opposing groups.

In previous congresses, the bill did not make it beyond the committee hearings. On hindsight, it was a blessing in disguise, since it gave the bill time to be refined so as to become more palatable to a wider social spectrum. The bill in its present form is far from what the original bill used to be, which could be said to have been crude in present terms.
All the debates over the years have contributed to revisions and inputs that addressed the concerns from various sectors.

In all these discussions on the proposed measure, legislators are asked one basic and compelling question----“Where do you stand on Reproductive Health?”

I was in a forum with students of the Ateneo de Naga last month, and during the open forum, I was asked that question. Immediately, the thought that came to my mind was the fact that only a couple of weeks before, the university held a rally against Reproductive Health. Of course, that thought was quickly followed by a question to myself…How should I answer?

I answered the students’ question with a story. I related to them my grassroots experience, particularly with my constituents whom I deal with in the everyday performance of my job.

I told them the story of Grace, a constituent of mine who lives along the railroad tracks, one of thousands of informal settlers along the stretch of the right of way of the Philippine National Railways which cuts through 8 of the 9 barangays of Muntinlupa City.

Grace is 25 years old, and pregnant. I met Grace during one of my community visits and when I saw her bulging stomach, I asked her if it was her first baby, as is my habit whenever I see a pregnant woman during my rounds in the city. She said no, it is her fifth child, with the first one born when she was 18. Her husband is employed as a laborer, but only has work every now and then.

Asked if it was their desire to have that much children, she said if she had her way, she would have stopped having kids after the second. But they didn’t practice any family planning method since they didn’t know anything about it. She also said that when her husband comes home intoxicated with liquor, she has no way to turn down his advances. Lest he gets mad and violent. Obviously, Natural Family Planning will not work for her.

Other stories of my constituents include that of Marissa, a first time mother who was eight months pregnant when she availed of the free pre-natal medical mission that my office conducted. Marissa and her husband live with her mother in law in one of the urban poor communities in Muntinlupa. While she was waiting in line, one of the barangay health workers assisting us requested me to let Marissa go in front of the line, since she wasn’t feeling well and was bloated. I took a look at her and indeed, saw that her ankles were swollen, indicative of edema and pre-eclampsia.

I let her go in front of the line to see the OB-GYN and have an ultra-sound of her belly. The image revealed that Marissa’s baby was being compressed by an enlarged placenta and what appeared to be a myoma. The placenta also had dark blotches, indicative of an internal bleeding.

We immediately sent Marissa to the hospital, since it was determined that hers was an emergency medical condition. When we interviewed her, she admitted that it was the first time she had a pre-natal check up, since she did not have the money to go to a doctor, even in a government hospital. She said instead of spending for the fare going to the clinic, she just saves it up for their daily needs and saving for the baby’s needs when the baby is born.

Another story is that of Vilma, a utility worker in one of the Muntinlupa elementary schools. Aged 27, she has 3 children and her husband is a construction worker. Together, they earn around 10,000 pesos a month. After her third child, she decided to have a ligation because she felt that with three children to take care of, they wouldn’t be able to afford having an additional child without having to sacrifice some needs of the kids they already have. I asked her why she chose to have a ligation. Slightly embarrassed, she said she wanted to stop having children while at the same time fulfill her “marital obligations” to her husband. With a giggle, said it’s better than her husband find satisfaction elsewhere.

In a similar mindset is Rhodora, a school teacher who had a ligation after her second child, which was a special child. After her second kid, she wanted to have enough time and resources to attend to the needs of her special child, not to mention her first child as well. So she consulted her gynecologist and requested that the she undergo the procedure.

Her doctor refused, saying it is against his beliefs to do the procedure. Rhodora asked for a referral, and she was referred to a colleague of the doctor. But just like the first doctor, the second one also refused, trying to convince her not to proceed, citing that it is immoral. In the end, Rhodora had to look again for another doctor, since it she felt that the service she is looking for is being denied her on the grounds of personal beliefs of the doctors.

These are just some of the stories that I commonly encounter among my constituents. Such situations are most common in the poorer communities, resulting in high incidence of malnutrition, school drop-outs, maternal and infant death, birth complications and scarcity of family resources.

Since I regularly hold medical missions in my district, I get first hand experience and information on the health conditions in the communities. Hygiene is often a problem, especially that families live in confined spaces in the urban poor communities, so the spread of disease is more likely. One of my regular activities is the conduct of prenatal medical missions, There is not a mission where we do not encounter pregnant teenagers, the youngest of which has been 14 years old.

For example, not many people know that cervical cancer may be spread through sexual contact. Cervical cancer is caused by the Human Papilloma Virus, the cause of the common wart, which may be passed from male to female. Not many people know that hygiene plays an important part in preventing the spread and cause of cervical cancer, as well as prudent sexual practices. More importantly, not many know that cervical cancer is easy to detect and cure if diagnosed early. This is because there is no policy on reproductive health.

The fact of the matter is that many of the health problems encountered in the grassroots may be attributed to the lack of reproductive health services available to the people. While some limit themselves to the issue of population and birth control in the discussions about RH, the bill is not only about population and sex. It is more about the delivery of services to the people who are in need of it. The absence of a policy opens people up to medical risks and leaves them nowhere to go but to unreliable, ineffective and sometimes life threatening remedies.

A case in point is the proliferation of vendors right beside the Quiapo church who openly sell concoctions labeled “Pang-pa Regla”. It is common knowledge that many of those who patronize those vendors do so with the intention of getting rid of unwanted pregnancies. Even if they weren’t pregnant and just wanted to have regular menstruation, it is still the wrong place to go for treatment or service.

This is not to say that having Reproductive Health services will enable the availability of abortion. The bill expressly maintains that abortion continues to be illegal in the country. To say that the bill legalizes abortion is an outright lie and deception. My point in citing the “pang-pa regla” vendors is the fact that the absence of reproductive health services and information leads to people’s ignorance about reproductive health issues and their body’s reproductive systems. If they had the right information and services available, they would know that availing of the products sold by those vendors would not only be ineffective, it may even be harmful.

The intentions of the bill’s authors and supporters are not to legalize abortion, spread a culture of promiscuity or destroy the family. It is the intention of the bill’s authors and supporters to meet the needs of a significant portion of the population for reproductive health services and information. There is absolutely no intention to impose on couples particular methods that they should employ in planning their families. It is the intention of the bill to provide information to people about responsible parenthood, family planning, avoiding unwanted pregnancies and an informed choice on which method best fits their beliefs, convictions and needs.

To continuously insist that there are other ulterior motives other than the welfare of Filipino couples and families is to deny the existence of the problems faced daily by the people. To stop the adoption of a public policy on reproductive health is a denial of service to those who seek reproductive health care.

Some make it seem that the bill if passed into law will force people to use contraceptives. Even without the bill, contraceptives are available in the commercial market. What is not available in the present regime is the correct information about contraceptives and reproductive health. What the bill will provide if passed into law, is reliable and uniform information and services which people may avail of if they so desired. Whether it is modern or natural family planning method, the couple is left to decide after being properly informed.

Why do I support the bill?

Because there are those who have signified the need to have the correct information and reliable reproductive health services .

Because I have seen first hand during my service to my constituents the consequences of the continued denial of information and service to the people.

Because there are women whose bodies have been ravaged by multiple consecutive pregnancies even if they had not planned it.

Because there are women who have been physically abused by their husbands because they refused to indulge their spouses because “it is not the right time”.

Because I have seen too many teenage pregnancies which could have been avoided had these young women been informed about their adolescent reproductive system.

Because I have seen too many complications in pregnancies and births from the poor constituents that come to my office for medical assistance.

Because I have seen too many infant and maternal deaths, orphaned children, bereaved husbands.

Because I have seen children dropping out of school because their parents cannot afford to send all their children to school at the same time.

Because there are many malnourished children whose ability to learn has been impaired.

Because I have constituents who have acquired diseases that could have been prevented if only there was appropriate information and service available to them.

Some might say that instead of supporting the proposed measure, we should just allocate enough resources to other services such as education, housing and the eradication of corruption. There is no doubt to that. We should do those things. We are trying to do those things. But at the present situation, even if we are able to provide the right number of classrooms, the right number of teachers and all the books that the students need, the ability of poor families to send their children to school is hampered by their absolute lack of resources to provide for the cost of sending the kids to school ----- transportation, snack, uniforms, other miscellaneous requirements, etc.

Statistics show that of 10 children who enter elementary school, only 6 go on to high school, and only 2 finish high school. And based on actual experience in my district, it is not due to the lack of classrooms or teachers. It is the day to day difficulty of surviving through life with the severely limited resources of poor families. Bottomline is, how can a child who does not finish studies lead the ideal productive life?

The intention is not to prescribe a limit on the number of children but to enable couples to decide their family size based on correct information and according to their desired number of children and capability to provide support.

Those who oppose the bill cite various statistics and studies all done abroad. I’m taking a position that is based on what I see with my own eyes as I perform my duties. I see the living conditions of my constituents on a daily basis, especially many of them come to my office to seek assistance for various reasons---health, education, livelihood, etc. On the other hand, I also see what government is trying to do with the little it has to serve the needs of the people.

It is unfair to those who support the bill to be labeled “anti-life”, “anti-family”, “pro-abortion” and many other monickers on the basis of a pre-conceived notions. If there is anyone who desire the best for the Filipino family, that would be the one who is most familiar to the daily struggles of the poor families. The question should not only be whether you are pro-life or not (because there is absolutely no one who is anti-life), but also if the people deserve quality of life.

The Coming 2010 Elections--How should we vote?

Many have said that Philippine elections and politics are all about personalities. That we choose our leaders not on what they stand for but for their personal endearment to the electorate. Perhaps we have enough proof of that, without even going into examples of beneficiaries of that disposition of the average Filipino voter. But there is reason to say that the Filipino voters are showing signs of electoral adolescence, slowly maturing from the habit of voting for personalities to voting on issues.

The 2007 elections revealed that issues prevailed over money and machinery, two of the basic elements of traditional politics (the other sinister elements being guns and goons). With the opposition almost sweeping the senatorial elections, the administration candidates were humbled, if not humiliated, despite their massive political machinery and abundant campaign war chest. A senatorial candidate who did not have the physical freedom nor the financial flexibility to go on a nation wide campaign easily won a senate seat, faring much better than one administration stalwart who had the harrowing experience of dangling in the 12^th-13^th slot before finally being proclaimed part of the winning circle.

This recent experience in Philippine elections gives us hope that in the forthcoming elections, the voters will once again move farther way from traditional politics and take with them the politicians. I believe that the political maturity of this country is a joint effort of the politicians and the electorate. Each can drag the other either way.

I was in a group discussion where we tossed around the table ideas about the forthcoming elections. With the nation set to choose its leaders twenty months from now, it isn’t too early for people to already talk about the elections, particularly what issues should take center stage for the people to consider in selecting the next leaders of this country.

As each of those in the discussion group spoke, various issues were forwarded as issues that should take center stage in the 2010 elections. On top of the list was Education, since almost everyone agreed that the only way Filipinos can rise from the pit of poverty is arm themselves with a good education that would make them productive. Imagine, if all the 88 Million Filipinos had a good education, then those who are for and against the Reproductive Health Bill will have one good reason to stop going against each other!

Another important issue that was common in everyone’s mind was the need to address graft and corruption. Indeed, that issue was played out to extremes by those in all shades of the political spectrum. The opposition had a grand time pointing fingers at the administration as the ultimate culprit while the administration proudly boasted of its anti-graft programs such as lifestyle checks and officials charged with cases in the Ombudsman (although the sincerity and success of those programs are also being questioned).

With so many issues that may occupy the political stage come 2010, what exactly are the Filipino voters looking for? How will the electorate decide who to support in the elections?

While I believe that all the issues mentioned above are important, I think one issue which encompasses everything is the people’s desire for a decent, inspiring, and visionary government, one that responds to the people’s needs and provides direction and hope to the nation.

If there is anything that the 2010 elections offer, it is the opportunity for the restoration of faith in government and the fresh start for the country. After years of political strife, endless bickering, outrageous scandals and controversies, the chance to bring back dignity and honor in government service and politics, to stir the people’s hearts into a renewed sense of nationhood where patriotism is the norm and traditional values a way of life. It is time for the Filipinos to feel good once again, to bring out the best in each one and to maximize the most positive traits of the country and its citizens.

With the elections coming in around twenty one months, we can expect a lot of potential candidates to come out of the woodwork, with everyone trying to pull the others down in order to rise above the clutter. The people will be drowned in wave after wave of issues designed to attract support from the electorate.

But the Bible says, “Seek first the kingdom of God and its righteousness; then all good things will be added to you.” Therefore, if we desire righteousness in government, we should take steps to install a righteous government. The people must see through the smog of traditional politics and choose leaders who will not only represent positive change but will also exhibit renewed purpose, determined action and decent governance. Only then will the country’s needs be met, and the destiny of our nation fulfilled.

AFP BUDGET DOES NOT SUPPORT THE PRESIDENT’S TARGET TO DEFEAT COMMUNIST INSURGENTS BY 2010

While the President has given the Armed Forces of the Philippines until 2010 to eradicate the Communist Insurgency, the proposed 2009 Budget of the Armed Forces of the Philippines is not sufficient to support operations to meet the deadline.

It may be said then that the thrust to defeat the insurgents is doomed to fail, not because the AFP is not competent to win battles, but because they lack the resources to carry on the fight to meet the objectives in the prescribed time.

For example, the 2009 Budget fails to fund the required additional 600 marines. Across the different major Service Commands, namely the Army, Air Force and the Navy, funds are even not enough to supply the mandatory 2 basic loads of ammunition for soldiers.

The operational tempo of the AFP needs to be increased in order to meet the 2010 deadline. But with many unfunded requirements by the AFP, the operational tempo needed may not be achieved.

With the pronounced target seemingly out of reach by the Armed Forces, two actions may be done by the government:

1. Increase the appropriations for the Armed Forces of the Philippines in order to support their requirements to meet their targeted operational tempo.
2. Review and reset the deadline to defeat the insurgents.

In the first option, it would necessitate the reduction of appropriations for other programs or other agencies since the total ceiling of the General Appropriations submitted by Malacanang cannot be increased by Congress.

In the second option, it would simply mean that the government will admit that the deadline originally set is unrealistic given the available resources.

It will be unfair to the AFP to be set up for a failure by setting a deadline that is not supported with the appropriations needed to fulfill the mission. The AFP has the will, determination, skill and the manpower to fight, but regretfully, the financial strength is sorely lacking.

It is hoped that when Congress considers the budget of the Department of National Defense and the AFP, the requests for additional funding will be granted.

LUMP SUM ITEMS SOURCE OF CONGRESSIONAL INSERTIONS

The discussion on the "double entries" in the 2008 National Budget is predictably leading to the issue of congressional insertions, or the practice by privileged legislators of inserting in the proposed national budget appropriations for their pet projects. Note that I say "privileged legislators" because not all senators and congresmen have the know-how and influence to accomplish such a feat. Most especially insertions that reach hundreds of millions or even billions of pesos.

It is a practice that I assume has been in place even before I became congressman. At one point, talk about a "Leadership Fund" circulated, a fund which was supposedly tapped into by the political leadership to dispense patronage.

Technically, congressional insertions are within the mandate of the legislators, since the House of Representatives is the institution tasked by the Constitution to exercise the power of appropriations with the Senate concurring.

It is an ideal system, in that the House of Representatives are the direct representatives of the people. Ideally, they know the needs of the districts they represent, therefore, they can give inputs to the budget process which would ensure that their districts have a fair share of the national government coffers.

But the problem begins when the insertions take the nature of tools of politics instead of tools of development. Or when the insertions accrue to the personal interest of the one doing the insertion rather the interest of the nation.

Owing to the present budget practices of our government, congressional insertions will be difficult to avoid or prevent, especially because of the lump sum items in the budget. Lump sum items in the budget represent programs or projects in general terms, instead of being listed down specifically.

One example is the lump sum item in the budget of the Department of Public Works and Highways which simply says "Others" with an appropriation of P 100,000,000.00 (2008 General Appropriations Act-Department of Public Works and Highways, under their Locally Funded Projects). While other items in the budget specify the name and location of the road, this lump sum item will be spent purely at the discretion of the agency.

The lump sum items run into billions of pesos and is the source of the congressional insertions and discretionary spending of the executive department. At the pre-approval stage the lump sum budget is huge, but after approval, it shrinks . This is because the congressional insertions are taken from these lump sum items.

But focusing on the congressional insertions per se will not lead to budget transparency. We must look into the source of the insertions. Since the total budget proposed by the President cannot be increased by Congress, the insertions may only be achieved either by reducing or cutting from the budgets of the agencies or tapping into the lump sum items.

These lump sum items, if not tapped by Congress in the form of insertions, become billion-peso pork barrels of the Executive department particularly the department secretaries. Seen from a different perspective, the insertions may become tools of transparency if the funds are appropriated to specified projects instead of being placed in non-specific budget items such as lump sum appropriations.

But that is not to say that I am defending congressional insertions. What I believe in is that instead of submitting lump sum appropriations, the budget proposal should contain specified projects and programs which are aligned with the overall economic and development strategies of government.

Lump sum items are prone to political projects which are incongruent with development plans or geared towards personal interests.

Comments on the GRP-MILF MOA from Another Blog

Atty. Bong Montesa, the Liberal party Director General who went on leave due to differences with the LP leadership on the issue of the GRP-MILF Memorandum of Agreement, made a comment on a statement I made during an interview on UNTV. Since he mentioned me and quoted my statements, I had to post a reply.

The Ateneo de Manila Law School professor (on leave) is the Executive Director of Institute for Autonomy and Governance (IAG), a political think-tank based in Cotabato City, Southern Philippines. He is also the legal counsel of the GRP Peace Panel.

Below is a portion of his blog post which mentioned me, followed by my reply:

He wrote:

"We are dealing here with a social problem and our toolkit must be beyond what the present Constitution provides. This is about policy. Let us propose a policy and then work out the needed changes in law and the constitution to make such policy a reality. It cannot be the other way around. We cannot say that all solutions must follow the present Constitution for that limits our capacity to solve the Bangsamoro problem.

I was listening to Cong. Ruffy Biazon over UNTV this morning and one of his arguments against the MOA on AD is that the President has a sworn obligation to “defend and protect the Constitution” ergo any intent to change or amend the Constitution is a violation of that sworn oath. That seems to be stretching the limits of constitutionality too much. The President has sworn to “protect and defend the Constitution”, a constitution which includes provisions of its very amendment. Changing the Constitution is part of the Constitution that the President is sworn to protect and defend."

I wrote:

Thank you for your comment on my statements during that interview in UNTV.

It was such a short interview, there was not enough time to elaborate on points. So I hope I will be given the privilege to respond here.

Perhaps my comment on the President’s oath may be seen as “stretching the limits of constitutionality too much”, but actually, from my point of view, I am trying to confine the MOA within the limits of my understanding of the text of the Constitution.

I am not a lawyer and I am not trying to pose as a legal luminary. My educational background is in the medical field, but being a three term member of the HOuse of Representatives, I believe I have enough experience dealing with the law for me to have a grasp of what the legal framework of this country says. Besides, every citizen is supposed to be a student of the Constitution, since it is the tie that binds all citizens of a country and the Rule that they must live by.

Having said that, I must admit I do not have a conclusion as to the constitutionality of the agreement per se. But I do have questions based on my reading and understanding of the Constitution vis-a-vis the MOA. Being a member of the Legislature and representing a district comprised of close to half a million citizens, I have the right and duty to ask questions about a matter that will affect the COnstitution I am sworn to uphold, and the country to which my constituents belong to.

While the MOA and the talks are between the GRP panel and the MILF, the matter of a just and lasting peace in Mindanao is not just a concern of the MILF, the indigenous peoples of Mindanao and the other citizens living therein, but it is also a desire and concern of all other Filipino citizens. Whatever ails Mindanao, ails the Philippines.

Going back to my comments on the President;s oath, which says, ” I do solemnly swear/affirm that I will faithfully and conscientiously fulfill my duties as President of the Philippines, PRESERVE and DEFEND its Constitution, execute its laws, do justice to every man, and consecrate myself to the service of the Nation” ( not DEFEND and PROTECT, as stated in the post above), I used my literal understanding and avoided stretching the meaning of the text of the oath.

The dictionary defines PRESERVE as “To keep in perfect or unaltered condition; maintain unchanged”. DEFEND is defined as “To make or keep safe from danger, attack, or harm.” In interpreting this provision of the Constitution, I strictly confined myself within the meaning of the text, instead of stretching it, as commented above. To my understanding, the President is sworn to keep the Constitution in an unaltered condition, maintain it unchanged and keep it safe from attack until its very provision on amending it are availed of.

Indeed, the Constitution is a living document, allowing itself to be improved, through the appropriate procedure. My non-lawyer’s understanding of the Constitution’s provisions is that there are only three ways that amendments may be undertaken, that is, by a vote of three fourths of all the members of the Congress (a constituent assembly), a constitutional convention, and by an initiative of the People.

I noted that Article XVII, the Constitutional Provision on Amendments and Revision, also provided on who may propose or act on amendments or revisions of the Constitution. It said that the Congress, the members of a constitutional convention and the people are the ones who may propose changes in the Charter.

My non-lawyer’s unstretched interpretation of the text of the Constitutional provision on amendments is that the President does not propose changes to the Constitution, especially since the President’s oath is to PRESERVE and DEFEND it.

Other provisions in the Constitution which caught my attention in the diligent effort that I am undertaking to understand the whole issue are those that pertain to the rights of the indigenous people (which is the point of the MOA-AD). Two provisions come to mind:

Article XIV. Sec. 17, which says “The State shall recognize, respect, and protect the rights of indigenous cultural communities to preserve and develop their cultures, traditions, and institutions. It shall consider these rights in the formulation of national plans and policies.”

There is no doubt that government is obliged to provide for the protection of the rights of the indigenous people. I myself believe in that and consider it my Constitutional duty to work for that, because the Constitution says so.

The second provision is:

Article XII, Sec. 5, which says, “The State, subject to the provisions of this Constitution and national development policies and programs, shall protect the rights of indigenous cultural communities to their ancestral lands to ensure their economic, social and cultural well-being.”

Again, it is clear that the State should protect the rights of the indigenous people. But the text of the second provision sets parameters on how the State will deliver on its obligation. It says, “subject to the provisions of this Constitution”. My non-lawyer’s understanding of the text is that any act of the State to protect the rights of the indigenous people should be within the bounds of the provisions of the Charter.

Meaning to say, if the Constitution says that there shall only be one police force (which it says in Article XVI, Sec. 6, then the State shouldn’t allow, or even offer, the creation of another security force (which the MOA provides).

These are only the perspectives of a non-lawyer. It is not a stretch of the meanings of the provisions of the Constitution but a reading of the charter’s text in simple terms. Perhaps the learned men of the law can provide me with a better interpretation which would show that I am mistaken.

Or better yet, the Supreme Court, which is mandated to interpret the law for everyone, as embodied in the Constitution should be left to do the interpretation.

But if there will be an opportunity for proponents of the MOA to clarify the issues, I would rather that such clarifications be done within the proceedings of an official body. That is the reason why I filed a resolution in the House of Representatives calling for an inquiry into the basis, purpose and prospects of the provisions of the MOA. It is not because I am blindly opposing the peace efforts in general and the MOA in particular, but it is because I would like to be enlightened so that I may be able to do my part in fulfilling the mandate to achieve peace in Mindanao and protect the rights of indigenous people.