Reproductive Health bill, dapat bang isabatas?

Ang talakayan nina Dr. Junice Melgar (pro-RH) at Atty. Dindo Garciano (anti-RH) tungkol sa kontrobersiyal na  Reproductive Health bill sa News To Go kasama si Howie Severino noong Mayo 11, 2011. Howie Severino (H): May isang issue ngayon na mainit na pinagtatalunan ng bansa. May mga nagsasabi na posible itong maging sagot sa lumalalang kahirapan — ang Responsible Parenthood bill o ang dating tinatawag na Reproductive Health bill. Kasama nating ngayon si Dr. Junice Melgar, executive director ng Likhaan Center for Women’s Health at isang organizer ng Day of the Purple Ribbon na gagawin ngayong araw. Siya ay pro-RH. Kara David (K): Syempre dito sa News to Go, balanse tayo Howie. Para naman sa kabilang panig, ito po ‘yong anti-RH. Narito naman si Atty. Dindo Garciano, director and immediate past president ng Alliance for the Family at nakasama rin sa RH panel ng Catholic Bishops Conference on the Philippines (CBCP). H: Unahin natin si Dr. Melgar. Sa dinami-dami ng argumento, ano ang pinakalamakas na basehan para ipasa ang RH o ‘yong tinatawag na Responsible Parenthood bill? Dr. June Melgar (JM): Medical doctor ako kaya 'yong health aspect. Una, nag-aattempt talaga ito na ilatag yung services that will l provide life-saving services for pregnant women and their babies. No. 2, it will also provide services that will prevent abortion and unintended pregnancies which are the root of abortion. So kasama do'n 'yong sexuality education. Tingin ko part 'yon ng prevention. No. 3 is that it will try to fix some of the weaknesses in the health system. Like making sure na meron kang enough midwives and health professionals attending birth, na meron kang enough facilities, meron kang emergency obstetric facilities that can attend not just to obstetric emergencies pero magagamit din 'yan pag napilayan, yung mga ganyang emergencies, medical emergencies. No. 3, it will make sure that Philhealth assists people in need, 'yong mga mahihirap through their benefits. K: Atty. Garciano, kayo naman. Ano sa tingin niyo ang pinakamatibay na basehan para hindi naman ipasa itong RH bill? Atty. Dindo Garciano (DG): Bilang nagtuturo naman ng Policy sa University of Asia and the Pacific, naniniwala ako na ang RH bill is a legislative initiative therefore, a policy initiative. Ang polisiya ay isang gamot. Kung gumawa ka ng policy, meron kang ginagamot. Ang sabi ng mga proponents ng RH bill ay ang gusto raw gamutin dito ay 'yong high incidence of pre-natal deaths and post-abortion cases. K: Oo, mataas ang maternal deaths natin. DG: So naniniwala ako, bilang na-train sa Policy Sciences, na hindi naaakmang gamot o hindi magiging responsive na gamot ang isang legislation para dito sa sinasabing sakit na ito. Sapagkat itong legislation na ito ay may apropriasyon na tatlong bilyong piso taun-taon na mag-iincrease ng an average of 15% a year. So on the part of the Policy Sciences, on the policy perspective, hindi sound policy na gumastos ka ng tatlong bilyong piso taun-taon para lang maipambili mo ng condom at artificial methods para gamutin itong sakit na ito. Sapagkat meron naman tayong mga tinatawag na executive remedies, bakit hindi gumawa ng mga administrative remedies? Bakit kinakailangan ng isang panukalang batas na kontrobersyal? K: So ang problema niyo po ay 'yong pondo? Masyadong malaki 'yong pondo na ilalaan para do'n sa ganitong klaseng services? DG: You know, ang ating pangulo ay nagcertify as urgent ng isang fiscal responsibility bill. Sinasabi niya na maraming unfunded mandates, na hindi mapondohan sapagkat kakarampot ang ating pananalapi. Kaya malaki ang ating fiscal deficit. Dapat daw i-certify as urgent. Kung magdadagdag ka pa ng tatlong bilyong gastusin para lamang pambili mo ng contraceptives, ng condom para sagutin itong sakit na sinasabing ito ay hindi magiging akma ito sa sinasabi ng pangulo na dapat nating i-manage 'yong fiscal deficit natin. Kaya nga pinapa-certify as urgent do'n sa state of the nation address niya 'yong fiscal responsibility bill. Because the RH bill o HB 4244, for us, for me, personally, for the advocacy, is a subsidy bill. Ginagawang libre ang distribution ng condom at contraceptives sa grass roots level. At alam ko po ito sapagkat ako'y dating punong-bayan. Mayor ako dati ng Baras, Rizal. At nakita ko, tinutulan ko noong ako ay mayor na gawin ito ng mga health centers sapagkat saganang akin, hindi dapat makialam ang estado sa kagustuhan ng mga mag-asawa kung ano'ng gusto nilang gawin. H: Dr. Melgar, tamang paggamit ba 'to ng taxes? JM: Tingin ko 'pag binilang natin 'yong maternal deaths, tapos 'yang maternal deaths may kaakibat na infant death, because infants whose mothers die actually do not (usually) survive beyond the first month after their delivery or even beyond the year. So ang bilang na 4,500, that's very conservative, ang sinasabing 2800, 2700. Actually, if you count that, that ranks among the top 9, top 10 causes of mortality of women, across all ages na 'yan. So talagang tingin ko, urgent siya and very preventable. Very preventable by the measures na nasa bill, yung maternal care but also family planning because family planning alone can reduce at least 35% of the deaths. No. 2, hindi lang 'yong mga namamatay na 'yan, malaki 'yan, pero 'yong nagko-complicate mula sa pregnancy and child birth, 400,000 'yan. That's the number 1 cause of morbidity. It's higher than tuberculosis, higher than hypertension. Definitely the highest form of morbidity for women. So kung hindi yan urgent, hindi ko na lang alam kung ano ang urgent. H: Attorney, naniniwala ba kayo na malaking problema talaga ang maternal mortality? DG: Well, kung sa statistics na sinasabi ng mga pro-RH na malaking problema ito, bakit kailangang legislative ang kailangang pag-usapan? Palagay ko po, ako'y naging mayor nga, 'yan po ay trabaho ng local chief executive. 'Yan po ay trabaho ng chief executive, ng administrative bodies, ng executive bodies, ng Department of Health. In fact, pag ginawa mong batas ito, nagiging contoversial sapagkat sa paggawa ng batas, sa paggawa ng polisiya, may mga tinatawag tayong mga iko-consider na policy players. And major policy players are always considered in the crafting of policy so that there will be no implementation problem. And one of the major policy players in the country, in the world, of course, is the Catholic Church. It's a policy player. K: Atty. Garciano, ang sinasabi niyo, in principle, naniniwala kayo sa RH bill? Ang ayaw niyo lang is to make it a legislative act? DG: No, no. Hindi ako naniniwala sa RH bill. K: Hindi rin talaga kayo naniniwala? Not just because it's a legislative act? DG: No, because the RH bill targets population and not poverty. It targets limiting our population by promoting and advertising the free distribution of condoms. K: So do'n kayo may problema, 'yong promotion ng artificial contraceptives? DG: Yes. And looking at the problem from the population perspective, there are a lot of economists and experts who say na walang kinalaman o walang correlation, walang causality ang populasyon at ang kahirapan. So the focus of this RH bill is not poverty. The focus of this RH bill is to lessen the population. That is why there is an initiative to promote. K: So ayaw niyo pong i-lessen ang population? DG: Well, there is no problem with respect to population. K: Ok, Dr. Melgar? JM: Tingin ko po merong problema sa population dahil malaki ang bilang ng unintended, unwanted pregnancies. For example, ang contrast niyan sa rich, gusto nila ng 1.7 children, they have 1.9. So talagang napakalapit. Kung ikaw ay napaka-poor, 'yong poorest segment, they only want 3 children but they're having 5. So you multiply that across all the poor women, ang dami no'n. I call it parang "surfeit", 'yong sobra sa kaya at gusto nila na births and pregnancies. K: May sinabi si Attorney kanina na ang ayaw daw nila ay 'yong pinangungunahan ng estado kung anong family planning method ang gagamitin ng mga mag-asawa 'pag nagpamudmod daw ng mga artificial contraceptives. Hindi ho ba kayo naniniwala do'n? JM: Naniniwala kami sa ebidensiya ng survey. And when you study the surveys, actually, ang un-met need natin napakalaki. 'Yong women that would not have wanted to be pregnant but got pregnant, 20% yon. Ang estimate nila if you total women not using any contraceptives but don't want to have children and the women not using effective contraceptives, mga 50% 'yon. 'Yon tingin kong kailangang habulin kasi 'yon ang may gusto. K: Ng RH bill? JM: Oo, ng modern methods because the no. 1 choice of method by women is pills. No. 2 is ligation. So, actually, makikita mo do'n na gusto talaga nila 'yong effective. I think that speaks of the very stark need of women to control, kung marami sila, attorney, na pagbubuntis na hindi talaga nila kayang pakainin din. Kaya hindi ko alam kung ano'ng mas moral pa do'n? Di ba dapat tinutulungan sila ng gobyerno para they can have the children they would like to have, that they can feed, that they can send to school, na ma-assure din nilang 'yong kanilang quality of life? DG: Alam niyo binanggit niyo po ang pagkain, binanggit niyo ang kahirapan. Ang solusyon ay hindi condom, hindi contraceptives. Ang solusyon ay iukol sa pagkain, iukol sa kalusugan, iukol sa pabahay, iukol sa ikabubuhay 'yong tulong ng gobyerno. Hindi 'yong... 'yong tatlong bilyon. Marami ka nang mabibiling pagkain do'n. Maitutulong mo na 'yon sa conditional cash transfer ni (DSWD) Secretary Soliman. Bakit hindi mo ibigay 'yan kay Dinky at ipagpatuloy yung CCT dahil maganda ang CCT. Pero bakit ka gagawa ng isang legislation na maglalaaan ng tatlong bilyon taun-taon para lamang ipambili mo ng condom at contraceptives? Hindi po iyon akma sa tamang pamamahala ng ating pananalapi. 'Yan po, kaya sinabi ko kanina, 'yan po ay executive remedies. It may be the job of Secretary Soliman, it may be the job of Health Secretary Ona but definitely, it is not the job of the legislature. And if you will be targeting the population, you know, one of the factors of production is labor. Alam niyo sinasalba na po tayo ng ating mga OFW. Ang daming mga naka-deploy na mga OFW at karamihan po dito, if not 70 to 80%, ay nanggagaling po sa mga mahihirap na pamilya. Bakit po natin pipigilin ang pagdami ng ating mga kababayan na pwede nating pakinabangan in the future? There is an Indian economist by the name of Jagdish Bhagwati. Sinabi ni Jagdish Bhagwati that human resources pave the way for economic difference. Kasi kung wala kang tao, wala kang resource, di ba? So kung sinasabi na there is overpopulation... K: So you don't think we're over populated? DG: No we're not. Maybe we are overpopulated in the metropolis but definitely we are not overpopulated as a country. H: Pero sinasabi ni Dr. Melgar na dapat bigyan ng choice or options 'yong mga pamilya. DG: Ang sinasabi ay choice so dapat hindi makialam ang state. Because if there is legislation, there is compulsive authority. So compulsive authority is intrusion to the exercise of private initiatives. JM: Can I respond to that? Because I think if you read the RH bill closely, lahat po ay rights-based ang informed choice. Kung ikaw po ay isang babae na gusto mong sampung pregnancies, ang gagawin ay tutulungan ka talaga to achieve that, if that's your wish. Ang gagawin ng estado ay to make sure that each of those pregnancies will not put the woman in jeopardy. Hindi siya mamamatay. Walang gano'n po na kapag gusto mo ng sampu ay babawalan ka. Ngayon, kung ikaw ay isa lang ang gusto mo o ayaw mong magkaanak, dapat tinutulungan ka whatever your wish is. K: So kunyari, kung pumunta ka sa health center at sabi mo "gusto ko natural family planning," tuturuan ka? Halimbawa gusto ko IUD, ganyan? JM: Oo. How to do it properly. It will be method-based. DG: Sinasabi nga po, I've been there. Naging mayor po ako. H: So sinasabi niyong may coercion involved dito? K: Na 'pag sinabi mo natural, sasabihin sa'yo, "hindi, mag-pills ka na lang?" DG: Mag-pills ka, bibigyan ka ng condom libre. Batas e, that's why it's coercive. JM: Hindi. Kasi kaya nga gusto natin i-legislate 'yong tamang standard ng family planning kasi kami sa NGOs, we've been doing that. 'Yong respectful ka, you respect, you facilitate their decision and enable them to implement their decision. Kaya gusto nating ipalaganap 'yong ganon, walang judgment, whatever. You need a law because attorney, 'yong local governments tsaka DOH natin, hindi nagkakatugma. So you just need to have uniform standards applied to all. K: Kasi I understand na meron ding mga local governments na kahit gusto mo ng pills, hindi ka pwedeng makakuha. DG: Pag meron kang batas, kasi wala pang batas e, may litigation. Pag may violation ng batas may litigation, may aawayin sigurado. Magkakaroon ng set ng kanya-kanyang interpretasyon. Why put a law that is (1) controversial and offends a major policy player, (2) will pave the way for litigation, (3) will appropriate P3 billion a year which is not a sound policy, (4) will have a coercive effect? Sa sinasabi ni Doctor na problema, why not intensify the campaign administratively on the executive levels? That is the job of the local chief executives. Ang sinasabi ni doktora kailangan ng batas, ngayon ang provisions ng RH bill o 'yong HB 4244 na 'yon are already covered by respective legislations. The rights of women, for example, are covered by the Magna Carta for Women. The other provisions of the RH bill right now are covered by international commitments we have signed. There is only one provision in that RH bill na hindi covered. 'Yon ang provision on appropriation. H: Attorney, can I just bring up a final point? Nabanggit kasi kanina 'yong maternal health, 'yong public health. Di ba sinabi ni Pope Benedict na justifiable na ang paggamit ng condoms to prevent the spread of HIV o AIDS. Sumasang-ayon ba kayo dito na pwedeng gamitin 'yong condoms para sa public health? DG: Both of us are not churchmen, so both of us are not competent to discuss that. I think you should ask somebody who is knowledgeable on the interpretation on what the Pope says. H: Pero 'yong posisyon niyo dito ay bilang CBCP panel having dialogues with the government. Lumambot ba 'yong posisyon niyo when it comes to condoms? DG: Hindi. The Pope declaration as I have said is not my competence to interpret. But ang sinasabi ko nga, the CBCP's position, I was in the panel up to now, has never softened. Matibay ang sinasabi ng mga obispo ngayon, lalong-lalo na na pinatibay ng pag-alis sa dialogue. There are non-negotiable stands na hindi pwede talagang pag-usapan. Asinasabi natin, the state should not spend precious resources just to target the population and just to buy condoms and contraceptives. That's P3 billion a year. It's a subsidy bill. K: Ok. Maraming-maraming salamat. Marami pang pag-uusapan ang RH bill na ito at may debate nga dito sa News TV about that. Maraming salamat Dr. Melgar and Atty. Garciano. Para mas maging maalam sa usapin ng Reproductive Health, abangan po ang RH Bill: The Grand Debate dito lamang po sa GMA News TV. H: Sa May 22 na po 'yan, Linggo, mula 8:45 hanggang 10:45 ng gabi - GMA News