Cabral fears no bishops

The Likhaan organization’s policy forum “Changing Course to Achieve the MDG5” held at a five-star hotel last week gravely noted the decline of contraceptive use among women who have more children than they want. A Guttmacher Institute study showed that the proportion of modern method users who obtain their supplies from the public sector declined, from 67 percent in 2003 to 46 percent in 2008.

The decline is due largely to the United States Agency for International Development’s ending its provision of free family planning supplies. That, plus the government’s reluctance to come out with a national population policy, has resulted in the high cost of contraceptives that the poorest women cannot afford to buy.

Reproductive health advocates are hopeful that the Aquino administration will respond to the Millennium Development Goal of slowing down population growth by Year 2015. According to Likhaan’s executive director, Junice Melgar, “Family planning services should be a major public health priority for the incoming administration. The government must ensure that the rapid fall in access to contraception, especially among poor women, is halted. Family planning services must be restored as a key strategy to help reduce maternal deaths and pregnancy complications.”

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The next president’s choice for health secretary is eagerly awaited. If former Health Secretary Jaime Galvez-Tan is chosen, meeting the MDG5 is likely to take place. Galvez-Tan, like his predecessor, former Sen. Juan Flavier, was a staunch supporter of reproductive health rights.

A good number of people are asking president-elect Noynoy Aquino to retain the current health secretary Esperanza Cabral. Cabral is willing to stay on, but will not go out of her way to get appointed. She goes where the president tells her to go, if he wants her.

She had not known why President Macapagal-Arroyo asked her to head the Department of Social Welfare and Development after the post was vacated by Dinky Soliman, who joined the oust-Gloria Hyatt 10 group.

She earned her medical degree at the University of the Philippines and completed her training in internal medicine at the Philippine General Hospital, and cardiology and clinical pharmacology at the Harvard Medical School in Massachusetts. She practiced medicine at the Massachusetts General Hospital and the Joslin Clinic in Boston, Mass.

Upon her return to the Philippines with her husband, ophthalmologist Bienvenido V. Cabral, father of her three children who are all medical doctors. She became director of the Philippine Heart Center and chief of cardiology at Asian Hospital and Medical Center.

Social welfare secretaryship was no easy job, but she was a tireless worker, rushing to give aid to victims of calamities, looking for ways to give assistance to the throngs of destitutes, and supporting legislative moves to lower the cost of medicines. Some criticism was raised against her. Charges filed against her for corruption were dropped by the courts, and surveys gave her top performance ratings.

Working with the poor, she saw the link between poverty and lack of access to family planning services, leading her to openly support family planning methods outside of the church-approved natural family method. To the President’s credit, Dr. Cabral told me at one meeting, “She never asked me to tone down, even if our positions are different on the family planning issue.”

In October 2009, President Macapagal-Arroyo appointed her Health Secretary, in place of Frank Duque. One of her first acts for which church prelates flogged her unceasingly was her endorsing of condoms on Valentine’s Day not for contraceptive purposes, but to stop the spread of HIV/AIDS. She said no government money was used for the condoms which were donated by a private organization.

Again, she was the target of attack when she approved introducing sex education in schools. She was quoted as saying that the government must take the initiative and teach sex education. “The Department of Education knows what is the appropriate type of sex education that they will teach our children. Should we wait for teenagers to get pregnant before we teach them sex education that is appropriate for them?”

Here is a Cabinet member who fears neither president nor bishops. At the Likhaan forum, she expressed her view on the need for reproductive health services.

“We cannot overemphasize the importance of addressing the issue of sexual and reproductive health in our national development plans. Our core problems of poverty and hunger, overpopulation and underdevelopment, maternal and child mortality, as well as gender inequality, are intimately linked with our lack of attention to adequate sexual and reproductive services for our people.

“Sadly, the Guttmacher Institute has reported that over the past decade, contraceptive use has hardly increased in the country, even as the number of unwanted pregnancies and deaths from clandestine abortions skyrocketed, reflecting the restrictive atmosphere of sexual and reproductive health here in the Philippines.

“That has been largely because of the State’s failure to provide easier access to such. Yet free access to all forms of reproductive health services, including artificial contraception, have proven to be crucial factors in improving the health outcomes.”

Her short time in the health department, she said, “has really given me a hands-on experience on how limited our options are, as far as pursuing reproductive health is concerned. While there is no codified law that bans the use of artificial contraception in the country, religious and political considerations virtually have the same effect. Our continuing laissez faire attitude towards sexual and reproductive health has made it even harder for advocates to bring down entrenched social and cultural barriers.”

As it stands, the provision of these services are left to the discretion of local government units. Most LGUs, however, she said, do not provide these services “either for fear of a backlash from the religious establishment or simply because they don’t realize the importance of providing them.”

Secretary Cabral said the department is not asking for the total abolition of the State policy exclusively promoting natural reproductive health services. “What we merely ask for is an equal chance, a level playing field where Filipinos choose freely. I believe that it is about time we gave credit to the ability of people to make an intelligent choice, instead of expecting them to act like animals when given access to modern reproductive health methods.

“I hope that the cramped space we are moving in now will expand into wider opportunities for better public health outcomes, especially for the next administration.” –Domini M. Torrevillas (The Philippine Star)