Secretary Dayrit's mistaken views…
Letters to the Editor
E.O. 119 (1987) Mandates DOH to Provide RH/FP Services
It is unfortunate that the duty bearer in our country who is responsible for the "promotion, protection, preservation or restoration of the health of the people through the provision and delivery of health services" as provided
for in E.O. 119 (1987), issued from the Office of the President, thinks that it is not part of his job or that of the Department of Health to buy contraceptives! Perhaps if the good secretary will review carefully the
provisions of E.O. 119 alongside the Philippine Constitution, and the international covenants the Philippines is a signatory to, he will be clearly reminded of his obligations towards all citizens of this country to respect, protect and fulfill their right to health. And by international standards the right to health definitely includes women's right to access contraceptives and other reproductive health services. It would also help the people understand how the Secretary intends to fulfill his obligations if he could explain clearly what he means by "Our government is now intent on providing much more than the options available in the past." Operationally, what does he mean?
This brings me to the second point Secretary Dayrit asserts with respect to the Commission on Population's more enlightened role to address "migration, human development, population and environment, human settlements, etc., even as it continues to acknowledge the importance of contraceptive distribution." If PopCom is to make true their obligation of ensuring the well-being of the population, they must go beyond merely acknowledging "the importance of contraceptive distribution." As an agency focused on population development and management, PopCom must ensure that reproductive health services, including family planning, forms part of their policy and
program development advocacy in these different population and development areas. To ignore people's health and well-being is to violate their rights to development and health.
It is amazing that the key government official obliged to respond to reproductive health needs and concerns of Filipino women should say that there is "really no massive clamor among the Filipino people to have more
free contraceptives." Which segment of the population has he spoken to that he should make such a conclusion? As a citizen of this country, I would expect that the health secretary heed to the needs of all segments of our
population and respond from a pluralistic, objective, evidence-based, and rights-based perspective.
Further, I hope the Secretary is not ignoring the numerous research and survey results (NDHS 1993/1998; UPPI, DOH; NSO; etc.) that have been conducted in our country to better understand the RH/FP situation. These
studies point to the importance of meeting the unmet needs of our people (women, men and young people) to have better control over their fertility, their bodies, their lives, their destiny - their health and well-being. It
would be irresponsible for duty bearers to ignore this clamor.
Alexandrina B. Marcelo
Chairperson,
Reproductive Rights Resource Group - Philippines (3RG-Phils)
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Dr. Sylvia Estrada-Claudio's letter to the Editor:
Dear Editor,
Last August 30, Secretary of Health Dayrit asserted that it is not the work of the DOH to buy contraceptives, plan the size of Filipino families, control the population or espouse women's rights. Rather, the government's family planning program is to ensure the health of the family.
Apparently the Health Secretary does not consider it his job to implement international covenants to which the Philippines is signatory, such as the Convention of the Elimination of Discrimination Against Women (CEDAW), Program of Action of the International Conference on Population and Development (ICPD), the Beijing Platform
for Women (BPW), the Millenium Developmental Goals (MDG). Dr. Dayrit also seems to think that it is not his job to implement health standards set by the World Health Organization on reproductive health. As crazy as that may sound, it is apparent from his statement that he does not even consider it his job to implement a DOH Administrative
Order that reiterates the WHO standards on reproductive health.
Mr. Secretary, it is your job to buy and distribute contraceptives! Under your watch, the DOH has bought vaccines which are meant to prevent certain diseases. So why not buy contraceptives as well? As one doctor to another, let us not argue about the fact that the provision of safe and effective contraception is crucial to the prevention of maternal mortality and morbidity.
Under your own budget request for 2004, we see this provision which is also found in the General Appropriations Act: PROVIDED, FURTHER,
- That the drugs, medicines and medical and dental supplies and materials so purchased shall be equitably distributed by disease pattern.
- Our maternal death rates remain far too high. They reflect a leading cause of death for women. At the ICPD conference in 1994, our government promised that we would bring these rates down by half by 2000.
Instead, they have not budged significantly. Are your drug purchases equitably distributed by disease pattern when you refuse to buy contraceptives?
It is also your job, Mr. Secretary, to enlighten our people and our legislators about issues like family planning, contraception and population control. If you were doing your job, we would not be having these silly debates about population control. It is NOBODY'S job to institute population control. That strategy was repudiated by the
international conventions I have mentioned above as contrary to women's rights. It is, however, your job, as well as the job of all government officials, to ensure that all government efforts contribute to national development and the assertion of the rights of all people, including women.
A long time ago Mr. Secretary, we were comrades during the Marcos dictatorship. We employed community-based health care approaches that emphasized that health could not be attained without rights and development and vice versa. Why do you say these things now, when everyone else is beginning to accept ideas we have advocated for so
long?
Signed:
Sylvia Estrada-Claudio, MD, PhD
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Providing women with more options
Philippine Daily Inquirer Sept 7, 2004
Source: www.inq7.net
IN CONNECTION with Dr. Sylvia Estrada-Claudio's letter, "Secretary Dayrit's mistaken views," (PDI, 9/7/04) may I make the following clarification:
First of all, it has never been my job or the job of the Department of Health to buy contraceptives. All contraceptive supplies, distributed free of charge through the government health care system in the past, were donated to the Philippines by foreign governments or organizations. After many years of this, many Filipinos have come to equate the government's role in maternal and child health and responsible parenthood with the available approaches employed in only one of the many essential elements of maternal and child health and responsible parenthood. It does not spell out the totality of the DOH's work in this area.
Admittedly, the focus of the Commission on Population in the 1970s was the promotion and distribution of contraceptives. However, PopCom has since evolved into a more enlightened agency that addresses a myriad other
population issues within its mandate, such as migration, human development, population and environment, human settlements, etc., even as it continues to acknowledge the importance of contraceptive distribution. Rather than work
in a small box, the present-day PopCom now works as a coordinative agency within a broad matrix of capabilities and services available in various government agencies and units.
Statistics will show that the prevalence of contraceptive use has leveled off, and there is really no massive clamor among the Filipino people to have more and more free contraceptives. The observations that hormonal preparations were used for gardening, and that stocks of unwanted contraceptives just took up space in storerooms, are not just urban legends, but facts. Thus, financial resources, allotted by foreign donors to assist the government's programs, could actually be better spent in other pursuits than purchasing contraceptives.
We should also demystify our perceptions about the role of contraceptives in women's health, women's rights and healthy families. To equate access to contraceptives with the reduction in maternal morbidity and mortality is
simplistic. Equally flawed is the much-publicized argument that women are accorded the rights they deserve when they are made to use contraceptives.
The majority of women who use these products are not wholly aware of the many effects they have on their health and lives, and of the other approaches that are available to them. Our government is now intent on providing much more than the options available in the past. It will also ensure adequate and honest information on the various modalities or approaches families can choose to ensure their health and well-being.
It is our belief that women's rights, reproductive rights, and the right to health can only be realized within an environment of informed choice.
Manuel M. Dayrit, M.D.
Secretary
Department of Health, San Lazaro Compound
Rizal Avenue, Sta. Cruz, Manila
