Sponsorship speech on the RH Bill

Sponsorship Speech

SB No. 2865, Committee Report No. 49
“The Reproductive Health Act”
June 7, 2011

By: SEN. PIA S. CAYETANO

[Note: View the video by clicking here]

A. INTRODUCTION

Mr. President, distinguished colleagues, on Wednesday last week, I sponsored Senate Bill No. 2849 which seeks to amend the PhilHealth law with the end in view of making quality and essential health care services affordable and accessible to all Filipinos, especially the underprivileged. As I said in my sponsorship speech, this bill is part of a whole package of reforms from your Health Committee.

It is again my honor to stand before you today to present on the floor an important addition to such package of health reforms.

Mr. President, as a woman and as a legislator, I am pleased to sponsor Senate Bill No. 2865 entitled, “AN ACT PROVIDING FOR A NATIONAL POLICY ON REPRODUCTIVE HEALTH AND POPULATION AND DEVELOPMENT”.

B. WHAT THE BILL IS NOT

Mr. President, because of all the misinformation regarding the contents and objectives of the bill, let me start by what this bill is NOT.

1. This is NOT a bill that promotes or legalizes abortion. On the contrary, it is for the protection of the unborn along with its mother.

2. This is NOT a bill that imposes one mode of family planning method on all. Every person will be allowed to choose the method suitable to his needs and based on his religious beliefs.

3. This is NOT a bill that imposes a certain family size.

4. This bill will NOT solve all the problems of our country. Like most of the bills filed in the Senate, it is just one measure that will address a particular problem. In this case, it is the reproductive health of all Filipinos, particularly the women and her child.

5. This is NOT a bill that will teach 9 year olds how to use a condom. Neither does it promote sexual activity among the youth or promote promiscuity among adults.

C. WHAT THIS BILL IS ABOUT

This bill aims to:

1. Save the lives of the mother and the unborn.
2. Provide Filipinos with information on their reproductive health so they can make informed and intelligent decisions.
3. Provide Filipinos with access to health care facilities and skilled health professionals.

Mr. President, this bill seeks to acknowledge that women have reproductive health care needs that are distinct to women and to provide measures to address such needs. In the same way that the PhilHealth bill seeks to provide affordable and accessible quality and essential health care services to all, this bill seeks to provide affordable and accessible quality and essential reproductive health care services to Filipinos, particularly the underprivileged women.

D. FEATURES OF THE BILL

1. Access to skilled health professionals before, during, and after delivery

Mr. President, the bill aspires to address the number of mothers who die while giving birth and the high incident of infant mortality which are also connected with maternal health.
At present, the data we have tell us that we have 162[1] mothers dying for every 100,000 live births. What does this mean? This tells us that in Southeast Asia, we have one of the highest maternal mortality rates. Our rate is 162, compare this to 110[2] in Thailand, 62[3] in Malaysia and 14[4] in Singapore.

We are not on track, Mr. President, in achieving our Millennium Development Goal No.5. Our goal, is in fact, to enable all pregnant women to have access to pre-natal care, to be attended to by a skilled health professional while giving birth, and to be given post-natal care for her and her newborn.

Mr. President, no mother should die while bringing forth new life into this world. However, the depressing reality is, as I said, 162 mothers die for every 100,000 births. These are the number of newborns robbed of a mother’s love and care just when they need it the most. And because of that special bond between mother and child which begins from pregnancy, a child who loses a mother at childbirth is ten times more likely to perish.

We al know that the mother is considered the light of every home. Who of us would wish upon a child that he would grow up without a mother?
Mr. President, aside from the death of the mother, the death of a child is no less devastating. However, another sad reality is that for every minute, three[5] babies are born, and for every 1000 babies born, thirty-three (33)[6] die before reaching age five (5).

2. Establishment and upgrading of facilities and training of skilled health professionals

Because the common causes of maternal mortality are highly preventable, Section 6 calls for the establishment and upgrading of facilities with adequate and qualified personnel, equipment and supplies in every province or city to be able to provide emergency obstetric and newborn care. Section 12 further necessitates each congressional district to acquire a mobile health care service in the form of a van or other means of transportation to ensure the provision of health care goods and services even to people living in remote areas.

To further address the dearth in medical personnel in certain localities, Sections 5 and 14 direct the hiring of an adequate number of skilled health professionals such as doctors, nurses and midwives and the training of barangay health workers (BHWs) in each respective local government unit (LGU).

3. Addressing HIV and other Sexually Transmitted Diseases

Mr. President, I beg the Body’s indulgence, but allow me to repeat. Imagine that out of 63 countries, the Philippines is one of seven countries where HIV is increasing[7]. This is also embarrassing because we are aligned with such countries that years ago were so much backward compared to us, not just in health care but in economic development.

Anyway, to address this problem, Section 11 provides that all serious and life threatening reproductive health conditions such as HIV and AIDS shall be given the maximum benefits under PhilHealth, such as the provision of Anti-Retroviral Medicines (ARVs).

4. Access to different family planning methods

The poor Filipino couples are the real beneficiaries of this bill, Mr. President. The privileged can either afford to have larger families or afford reproductive health services by specialized doctors. It is a sad fact that this is not the same for the poor. Studies have shown that many of them would prefer smaller families than what they have. In fact, every year, there are over half a million[8] clandestine abortions happening in our country primarily brought about by unplanned or unwanted pregnancies. Most of these women are the poorest of the poor who have no access to reproductive health care services, including family planning. Stories range from women jumping off coconut trees to dislodge babies from their bellies to teenagers inserting hook shaped wires inside their vaginas to scrape off fetuses to even married women bleeding on makeshift beds of “abortionists” — all forced to undergo the pain and perils of abortion because they do not want, and cannot afford to have, a baby. But surveys and my personal visits to the grassroots all over the country have shown that more women want the information and services available for them to plan their pregnancies. Indeed, this is the better way out than enduring the immense pain and possible bleeding to death from an abortion and the loss of a child.

Mr. President, I just want to make this clear. Senate Bill No. 2865 does not, in any way, compel any individual to choose one form of family planning method over the other, or even to use any family planning method at all. The guiding principles under Section 3 merely seeks to equip all Filipinos with accurate and sufficient information on family planning methods necessary for them to make an informed choice as to how many children they want, when they want it and what family planning method to use, if any. The end goal, Mr. President, is to provide all Filipinos with information and access, without bias, to quality reproductive health care services and supplies essential to the promotion of every person’s right to health.

5. Age- and Development- Appropriate Reproductive Health Education

All that I have discussed merely scratch the surface of the problem. To eradicate maternal and infant deaths, lessen unwanted pregnancies and prevent the infection and transmission of HIV and AIDS, we should address the root cause of the problem — lack of education and awareness.

Mr. President, knowledge is the best tool in our deadly battle against these evils. It is for this reason that Section 13 provides for reproductive health education to be taught by adequately trained teachers in formal and non-formal educational systems and integrated in age and development appropriate subjects. It is also important to note that the bill mandates that minors are taught the value of healthy relationships including how abstinence is still the best form of protection from pregnancy and diseases. Mr. President, it is not true that nine-year old children will be taught how to use contraceptives. This is not age appropriate and that will never be allowed.

Mr. President, allow me to give an example. Even a three-year-old has adequate intelligence to understand a certain amount of reproductive health education. When a three-year-old has a mother who is pregnant, the three-year-old will ask, “Why is your stomach big?” Do we tell the child that the mother swallowed a basketball? No. But then many families do say that to a three-year-old.

But the truth is, we are supposed to tell the child that mommy is about to have a baby; that she will have a baby brother or sister. And, if the child progresses to ask the next question- how did the baby get there-then there are age-appropriate answers unless we prefer that our youth grow up thinking that they came out of bamboo trees because they will learn this in, I think it is Kasaysayan, in one of their Filipino classes where they are taught Filipino mythology.

Do we want our children to think that they came out of bamboo trees until they are 21 years old? That is the choice that we face if we refuse to acknowledge that there are many ways of teaching age-appropriate reproductive health education.

And if I can just quickly point out some of the topics that should be included, these include values formation, knowledge and skill, and self-protection against discrimination and sexual abuse and violence. I need to point out that many children, especially those in single homes, especially in the squatter areas where we have multiple families living in one home are victims of child abuse.

Teen pregnancy as I mentioned earlier in my speech, abstinence will be taught as the primary mode of protecting one’s self from pregnancy and sexually transmitted infections.

And the list goes on including physical, social and emotional changes in adolescents. There are stories where adolescents commit suicide because they do not understand the changes happening in their bodies.

6. Women’s rights and children’s rights and responsible teenage behavior.

Time and again, we have seen news reports about a 14-year-old teenager raping a six-year-old. And this is why, it is important that these children are taught responsible behavior which, of course, includes not raping a six-year-old.

E. CONSTITUTIONAL BASIS

Mr. President, this bill is grounded on the following Constitutional provisions:

1. Article II Section 15. The State shall protect and promote the right to health of the people and instill health consciousness among them.

2. Article II Section 12. The State … shall equally protect the life of the mother and the life of the unborn from conception….

3. Article II Section 6. The separation of Church and State shall be inviolable. Article III, Section 5. No law shall be made respecting an establishment of religion, or prohibiting the free exercise thereof. The free exercise and enjoyment of religious profession and worship, without discrimination or preference, shall forever be allowed…

4. Articles VI, VII and VIII all establish the three independent branches of government with their specific mandates.

E.1. On the right to health

Mr. President, I believe the Constitutional right to health needs no more further explanation.

E.2. On the protection of the life of the mother and her child

Mr. President, the health of the mother is intrinsically related to that of her child. Her health before and during pregnancy directly affects her child’s health. Numerous studies have shown that malnourished mothers and those who do not undergo pre-natal care give birth to malnourished and underweight children many of whom die before reaching five.

E.3&4. On the separation of Church and State and the freedom of religion.

Mr. President, we, as Senators have our own personal views and relationship with God. This is a part of who we are. Thus, I do not ask that we separate our moral values from our scrutiny of the bill. I simply ask that we remember that our religious views may be different from our neighbors and we cannot use our legislative seat to deprive a fellow Filipino of his legal and constitutional rights to exercise his religion, to make choices within the legal boundaries, but based on his own religion and NOT ours.

Time and again, the position of the Church has been discussed as a basis for not supporting this bill, but as Senators, we are tasked to separate our religious beliefs when they interfere with matters that belong to the State. I simply ask that we recognize the right of every citizen to make choices regarding one’s reproductive health based on one’s own conscience, moral and religious views.

Just because we are a predominantly Catholic country doesn’t mean we can impose Catholic dogma on every Filipino. This is the job of the clergy and they can do as they please in the Church and its activities with their flock. But, in the halls of Congress, the Constitution is clear, – - there must be a separation of Church and State. If for the sake of argument, 99.9% of Filipinos were Catholic and every single one express a certain view, I would still be standing here today to fight for the rights of that 1 Filipino who is entitled to choices based on his religion and not the religion of the majority because that is the mandate of our Constitution — that we make laws respecting the freedom of religion of all without the Church interfering with matters that should be left with the State.

Following the same argument, if 99.9 % of the population belonged to a different religion, I would still stand up for that 1 Catholic to ensure that his rights were protected and that services and facilities were available to allow him to make choices based on his beliefs. Those are the principles of separation of Church and State and the freedom of religion.

Does this now mean that we have no boundaries? That because we all have different views, the free flow of drugs and devices that may in fact be harmful to both mother and her unborn, are now to be allowed?

Of course not, Mr. President. We are still guided by our Constitution. And clearly we are to protect the life of the mother and the unborn from conception. Thus, knowingly taking a drug or performing an act after conception with the intention of aborting the fetus would be a violation of the Constitution and existing laws. And that brings me to my next point.

E.5. On the role of the executive, specifically the Department of Health through the Food and Drug Administration (FDA)

Mr. President, some groups would have the Senate arrogate upon itself the power to define, classify, allow or ban contraceptives. But this is clearly the jurisdiction of the FDA, a government agency that falls under the DOH which is part of the Executive branch. It is the FDA that has been tasked by law, among others to determine the efficacy of all drugs and medical devices, define what are abortifacients are and how their use is to be regulated. It is the entity with the scientific and technical ability to do that job.

So why not simply put a statement in the bill banning all abortifacients? Would that not simplify this debate? It sounds tempting, Mr. President. But I humbly submit it will not simplify this debate. Why? Because medicine is a technical field. And without the appropriate scientific background, we, as legislators who are not medical experts, could easily make mistakes and kill mothers and their babies instead of saving their lives.

Allow me to explain. A careless phrase like “no drug known to be an abortifacient will be made available in the Philippines” sounds like a statement we could all support. But what most of us do not understand is the fact that many life-saving drugs are made available to an ailing mother to address her medical condition although there is a possibility that they may be harmful to a pregnant mother and her fetus. Thus, we have for instance, drugs for diseases of the heart, hypertension, seizures, ulcers and even acne, all of which are to be taken only under doctors’ prescription and supervision precisely because of their harmful effects.

Making a blanket statement banning all medicines classified as abortifacients would put all these mothers and their children’s lives in greater danger. For decades, these mothers have relied on these medicines to keep them alive. I would like to give another example. A known abortifacient, misoprostol commonly known as cytotec, is one of the drugs that can save a mother’s life. I am talking about a mother who just gave birth but has internal hemorrhage and in danger of bleeding to death. Her child has been born. Her child will live but she will die without this drug to stop her bleeding. Are we now to ban the use of this drug? Are we now to say that because it could possibly be used as an abortifacient, it could possibly be abused, this mother must now die despite giving birth to a healthy baby?

Mr. President, we clearly need to make distinctions. These life saving drugs SHOULD NOT BE USED on any circumstances for purposes of carrying out an abortion. But under strict guidelines by the FDA, they can be used by a health practitioner to save a mother’s life.

F. CONCLUSION

Mr. President, I appeal to my colleagues for patience and understanding and above all, an open mind. Because although reproductive health affects both men and women, it is primarily a women’s issue.

1. Men do not die from childbirth, but women and their newborn do.

2. Men are not affected by the deadly hpv virus – I am not talking about HIV, I am talking about hpv, which leads to cervical cancer – women do. Men merely pass along this virus to women through unsafe and unprotected sex.

3. Men infected with HIV likewise pass it on to women (although this virus can be passed both ways), but when a man transmits it to a woman, it can then be passed on to the unborn child as well.

4. And finally, no man can claim that he has experienced the pain of choosing to end the life of the unborn baby in his womb. But half a million mothers in this country do that every year.

Mr. President, I believe the options are simple. Do we provide the facilities and the professional services that women need? Do we want to equip our women with the means to plan their family using natural or modern family planning methods, as they so choose within the boundaries provided by our Constitution and laws, all of which, I repeat, are subject to the scrutiny by our FDA? Or do we want our women to live in the dark ages, unable to make informed and intelligent choices about planning their family? And worse, resorting to abortions when they find themselves carrying an unplanned child.

Mr. President, if one woman is given the ability to make informed choices and access to services and facilities, that changes her life and that of her family. Why is this privilege limited to the rich? Every woman deserves this as a matter of right…

The statistics I mentioned earlier are not just mere numbers; these are real people with families orphaned by the loss of a loved one, a mother or a child. The ball is now in our hands, Mr. President, and we cannot stand idly by as these deaths continue in our country. We have the power to end this. We have the power to provide poor Filipinos sufficient information for the exercise of their reproductive rights. We have the power to put an end to these problems. Let us show the Filipino people that we have not only the compassion but also the moral commitment and the political will to do something to prevent these tragedies from befalling upon families.

Mr. President, the bill is a work in progress. It is not carved in stone. And I welcome the inputs of my colleagues and look forward to the debates where issues and concerns can be threshed out. I only ask once more for compassion as each of you to study this bill.

Thank you very much.

[1] National Statistics Office (2007). Maternal Mortality Slightly Declined, MDG Target May Not Be Achievable. [ONLINE] Available at: http://www.census.gov.ph/data/pressrelease/2007/pr0718tx.html. [Last Accessed May 2011].

[2] United Nations Children’s Fund (UNICEF) (2009). The State of the World’s Children 2009. [ONLINE] Available at: http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf. [Last Accessed May 2011].

[3] United Nations Children’s Fund (UNICEF) (2009). The State of the World’s Children 2009. [ONLINE] Available at: http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf. [Last Accessed May 2011].

[4] United Nations Children’s Fund (UNICEF) (2009). The State of the World’s Children 2009. [ONLINE] Available at: http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf. [Last Accessed May 2011].

[5] National Statistics Office (NSO) (2008). Live Birth Statistics: 2004. [ONLINE] Available at: http://www.census.gov.ph/data/sectordata/sr08321tx.html. [Last Accessed May 2011].

[6] United Nations Children’s Fund (UNICEF) (2011). State of the World’s Children. [ONLINE] Available at: http://www.unicef.org/sowc2011/pdfs/SOWC-2011-Main-Report_EN_02092011.pdf. [Last Accessed May 2011].

[7] UNAIDS (2010). UNAIDS Report on the Global AIDS Epidemic. [ONLINE] Available at: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf. [Last Accessed May 2011].

[8] Fatima Juarez, Josefina Cabigon, Susheela Singh and Rubina Hussain (2005). The Incidence of Induced Abortion in the Philippines: Current Level and Recent Trends. [ONLINE] Available at: http://www.guttmacher.org/pubs/journals/3114005.html. [Last Accessed May 2011].

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