A friend of mine asked me to comment on a bill in the Philippine Congress that would have planned to implement a “two child per family” plan that mimics the policy in China.

The Responsible Parenthood and Popu­lation Management Act of 2005 (HB 3773) would officially enshrine two chil­dren as the proper family size in the Phil­ippines, where women have 2.8 children over the course of their lifetimes on av­erage. The current total fertility rate of 2.8 children per woman is a huge drop from 6 in 1970, 5 in 1980, and 4 in 1990. Even the pro-population control United Nations Population Division projects that the Filipino fertility rate will continue its long decline, dropping to under 2 by 2030 (replacement rate is 2.1).

That hasn’t stopped Arroyo and oth­ers from trying to get the national gov­ernment involved in telling Filipino families how many children they should have. They claim the bill is not coer­cive, yet it contains a discriminatory pro­vision right off the bat: Children from families that have more than two kids will be disfavored for college scholar­ships.

Hmmm…I wonder who is funding that bit of nonsense. The bill has been sitting there since at least 1985…

But actually, funding for family planning was included in the recently passed budget, over some Catholic opposition that wanted to limit family planning to promote only natural methods consistant with Catholic teachings.

The bill will fund for giving out contraception in public clinics, but mainly to replace the funding stopped by the USAID which previously had funded free condoms etc. but cut back the funding, ironically not for religious reasons but because they have a limited budget, and they judged an increasingly prosperous Philippines could do their own funding.

I mean, you can buy condoms at the grocery stores, right next to the “San Miguel 3 in one coffee” packets, the gum, and batteries for your radio and MP3 player.
What is not clear is what the present budget funds for government sponsored family planning: I don’t have a copy of the bill, and not being a lawyer, would probably have trouble figuring out what it says.
So who gets the funds? Will government funding lead to pressuring poor people to limit families? Will women be sterilized or have IUD’s inserted without understanding what is being done to them? Will condoms be diverted to other uses? Will a lot of the funding supposed to go for birth contol be diverted into some politician’s pocket before it reaches the small rural clinics? (This is the Philippines, after all).

Too often western NGO’s and their friends in the Manila elite frame the need for limiting children as a human rights issue, a lot of them really see it as too many poor people. I mean, when the article bemoans the lack of family planning but the cartoon implies overpopulation, you know the real worry is that there will be too many poor people, not that Mrs. Sanchez just got pregnant again because her husband spent all his pesos on San Mig (beer) and didn’t have any money left to buy a condom during the fiesta.

A lot of people, and not only Catholics, worry about poor people being sterilized because politicians (and outside NGO’s funded by rich westerners) will pressure local clinics to fill their quotas.
That is why some Filipinos are angry about the original bill:

At a meeting in Washington DC last week, the Filipino Family Fund warned that the legislative proposals, which are being spearheaded by the United Nations Population Fund (UNFPA) and International Planned Parenthood and its affiliates, would result in human rights abuses.

Human rights abuses (i.e. forced sterilizations) funded by the US and/or the UN have occurred in several countries, not just in China.. In Peru, President Fujimora’s campaign forcibly sterilized thousands. And one reason for Indira Ghandi’s election loss in 1977 was resentment for a similar program of forced sterilizations in that country.

But there is another problem with the philosophy behind some of the NGO’s that push birth control: because they also sponsor an agenda that sees sexual freedom as a good thing:

family planning, maternal care and prevention of STIs and HIV/AIDS — are being provided in the majority of health posts, clinics and hospitals in the nine provinces where UNFPA is active. However, more efforts are needed to meet the reproductive and family planning needs of adolescents…

But the real problem is that line about “The needs of adolescents” and “prevention of StIs and HIV/HIV”.

In plain English, this means teaching and promoting a “value free” idea of sexuality to be promoted in high schools, television, billboards, and clinics. A lot of people worry that this could, in time, lead to the breakdown of chastity in young girls and widespread promiscuity, similar to the breakdown we saw in US high schools in the 1960’s and 1970’s.

If you think the Jerry Falwell type fundamentalists get mad at their daughters being given the pill, you should talk to a Muslim father confronted with his daughter being encouraged to be promiscuous by a western organization…there are reasons they call us the “Great Satan”, and the sexual ethic of Hollywood and Planned parenthood are part of that reason.

And whereas in the US, if your 16 year old daughter gets pregnant, she can have an abortion, go on welfare, or have you raise the kid.

In poor countries, another mouth to feed, and having a ruined (unmarriageable) daughter on one’s hands can be a major financial disaster. You see, in most of these countries, it is the strong families that give the financial, nursing, emotional, and physical support of the young, the old, the sick, and the pregnant. No welfare system that rewards teen moms with welfare checks and scholarships.

So one’s life is not one’s own: there is a Confuscian/Muslim/Catholic ethic of responsibility: the idea that one is a member of that family and one needs to sacrifice many things for the good of the family is part of culture.

Giving a kid a condom and say, have fun, disobey your parents, the fuddy duddy traditions they teach, and the stodgy church/mosque teachings… (oh by the way: there is a 30% chance you’ll get pregnant) …. well, such programs aren’t really going to be welcomed by the grassroots.
Alas, these Western programs have a lot of money and can pressure governments to allow them to impose their entire agenda into the country, via advertisements, via astroturfing fake NGO’s to pressure the government, via “training” of locals, and ridicule of anyone who opposes their viewpoint. What they don’t always have is a sensitivity to the conservative cultures in which they work.
A better way to minimize unhealthy (and what local religions consider sinful) behavior is to have private clinics run and funded by NGO’s to supply needed treatment, allowing the government to continue to promote Asian/Confuscian/Catholic/Muslim ethics in their family planning clinics. That way, family planning will be viewed as a good and moral action for married couples, not as a ticket toward immoral behavior.
And linking of legalized abortion, which is highly disapproved by the public, with birth control actually leads to fewer women using birth control in the long run. (I have seen women refuse to get cheap birth control pills at planned parenthood because of it’s abortion connection. How much more will conservative Asians avoid such clinics).
What is needed is a sensitive “multicultural” approach that recognizes the value system of one’s patients, and encourages the families to make decisions that are compatible with their own values.
You see, in conservative Catholic and Muslim countries, women do use family planning: The Mullahs of Iran encouraged it (for married couples), with the result that their population is now at sustainale levels. And here in the Philippines, despite moans of population growth, the average fertility of women has gone down from 6 to 3 over the last twenty years, with only a ten percent rate of “birth control”.

But this is being done by using the vocabulary of family responsibility, reminding people that spacing children is needed for the health of mother and child.

Yes, Virginia, there is a reason for multiculturalism.

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Nancy Reyes is a retired physician living in the rural Philippines. She sometimes writes medical essays to HeyDoc Xanga Blog.

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