Field notes

Baby boom not quite a boon for Philippine youth

The population in the Philippines has grown five times to 100 million since 1950, while GDP has grown only 1.7 times. In this staunchly Catholic country, 12-year-olds can have consensual sex, but older teens need parental permission to get contraceptives.

Scattered around one of the oldest Catholic churches in the Quiapo district of Manila are hundreds of stalls selling a dizzying assortment of goods advertised as coming from God Himself.

There are ruby-red candles to hex a philandering husband, towels consecrated at the feet of a revered, 400-year-old statue of the Black Nazarene that devotees attest can drive away spirits that bring sickness and ruin, as well as a multitude of roots and leaves said to cure anything from diarrhoea to cancer.

Tucked among this cornucopia of superstition-inspired capitalism are used rum bottles with labels stating plainly what their gooey, acrid contents are for: "pamparegla", to induce menstruation. When taken with a banned anti-ulcer drug, the potent mix can induce miscarriages, even at three months.

That the "abortion capital of Manila" sits under the very nose of the Catholic church says a lot about the population conundrum in the Philippines.

Despite a law that allows the government to give away condoms and birth control pills for free, the population is still growing: 1.7 per cent, or 3.4 million babies, annually. By 2050, about 157 million people will call the Philippines home.

The Catholic church has had a hand in this boom.

Four in five Filipinos are Catholics. The church, using the pulpit and lobbyists, has been sideswiping all government efforts to check population growth through artificial birth control. For the church, the only acceptable way to manage population is by natural means, such as the rhythm method, or by abstaining from sex.

An anti-abortion sign on the wall of the Minor Basilica of the Black Nazarene in Quiapo, Manila. Vendors outside the church sell a dizzying range of goods, including the banned anti-ulcer drug Cytotec, known to induce miscarriage. That the "abortion
An anti-abortion sign on the wall of the Minor Basilica of the Black Nazarene in Quiapo, Manila. Vendors outside the church sell a dizzying range of goods, including the banned anti-ulcer drug Cytotec, known to induce miscarriage. That the "abortion capital of Manila" sits under the very nose of the Catholic church says a lot about the population conundrum in the Philippines. PHOTO: GETTY IMAGES

In 2012, after a 15-year slog through Congress, President Benigno Aquino signed the Reproductive Health Law allowing the government to distribute condoms and birth control pills, and provide vasectomy and ligation, for free. It also requires public schools to include sex education in their curricula.

But it took two more years before the law could be implemented. Pro-life groups affiliated with the church challenged it in court, claiming it promotes abortion.

In 2014, the Supreme Court ruled that the government can go ahead and implement the law. Yet, more than a year on, the law is still hopping on one leg.

Lawmakers have gutted it, slashing one billion pesos (S$30 million) off the 3.27 billion pesos requested by the health ministry for this year. That money was supposed to be for the purchase of condoms, birth control pills, intrauterine devices and injectable contraceptives for women who cannot afford them.

Then there are holdouts like the capital Manila, which has 1.6 million people and whose former mayor, Mr Lito Atienza, leads one of the nation's biggest pro-life groups. During his term, in 2000, he banned the city's health centres from distributing birth control pills and providing vasectomy.

His successors have refused to rescind that order, fearing reprisals from the church.

"Policymakers are scared to talk about sex. It's more sexy to talk about infrastructure," said Mr Klaus Beck, the Philippine representative of the United Nations Population Fund.

But it is not just the church telling its flock to "go forth and multiply".

Peer pressure, ignorance and other social factors that fuel risky behaviour among adolescents remain. Poverty continues to unravel family ties as both parents are often compelled to work, with one sometimes working abroad for years. In South-east Asia, the Philippines has the third-highest teen pregnancy rate, after Laos and Thailand, and is also the only nation where the rate is still rising.

The latest Young Adult Fertility and Sexuality study shows that about 14 per cent of girls aged 15 to 19 in the Philippines are either pregnant for the first time or already mothers. That is up from 6 per cent in 2002.

"We know from the data that teenage pregnancy has inter-generational effects… Children of teenage mothers are more likely to become teenage mothers themselves," said Asian Development Bank vice-president Deborah Stokes.

CAN HAVE SEX, CAN'T BUY CONTRACEPTIVES

Over the past 10 years, a new threat has emerged: mobile communication and the Internet.

Four in five Filipino teens have handphones, and some 90 per cent have access to the Internet.

Technology is allowing them to bypass traditional circuit breakers - their parents, adult supervision in schools and their social circles, and the stigma of getting caught.

The result has been more and more boys and girls, some as young as 10, engaging in risky behaviour - binge drinking, casual sex, prostitution, substance abuse - leading to unwanted pregnancies.

A study by the UN Population Fund shows that between 9 and 12 per cent of 15- to 19-year-olds have experienced binge drinking. Female sex workers aged 14 to 17, meanwhile, are more than three times less likely to ask clients to use condoms than adult sex workers, and more likely to use drugs.

It does seem ironic that with all the information they have at their fingertips, today's young people are still largely ignorant about safe sex. Misconceptions remain, like a belief that having sex while standing, or urinating after having sex, will not lead to pregnancy, or that condom use shows insincerity.

Yet, even those who do know safe-sex practices have to jump through hoops to get access. Teens cannot, on their own, buy pills from a drugstore. While they can engage in consensual sex at 12, they will still need parental consent before they can purchase contraceptives.

So, to get rid of an unwanted pregnancy, they go instead to Quiapo or to clandestine abortion clinics where they are as likely to die as they are to have a successful abortion. The maternal mortality rate continues to rise at 221 deaths per 100,000 live births.

Ms Alissa Mae Hernandez, who lives in Victoria town, Laguna province, a two-hour drive from Manila, is 18 and expecting her first child next month.

"I saw the pills that my big sister was using inside the fridge. I wanted to use them, but I didn't know how to. There were numbers on the bottle I didn't understand," she said.

She said she had lessons about reproduction at school, "but there were no details".

Her 17-year-old partner had suggested an abortion, but they had no money and no idea where to go.

"Besides, we'll just be committing a sin to wash away another sin," said Ms Hernandez. "I have regrets, especially when I see girls my age going to school."

She and her partner have stopped going to school and plan to find a job after their baby is born.

"It's going to be difficult, but I see my child as a blessing," she said.

In case studies compiled by Bulacan State University last year, the same narrative is told over and over: teenagers drifting towards each other to escape family problems, dropping out of school, picking up vices, getting pregnant, and now saddled with sometimes three children, without a steady job or decent roof over their heads.

"I went with the wrong crowd. I stopped going to school... Then, I had a boyfriend, and now I have two children," said Erika, 19.

Bel, 17, said she did not want to get pregnant, but her partner wanted a child, "so I gave him one".

Hannah, 17, wanted to be a nurse. But with two children already, she said "that dream is gone".

Said Ailyn, just 16 and already with a child: "We now survive on debts. We pay debts with debts. That's how my life is right now."

WHEN POPULATION GROWS FASTER THAN THE ECONOMY

There is an advantage in having a large, young population: the so-called demographic sweet spot.

"The demographic dividend is real… but the Philippines unfortunately missed it because of the very slow decline of [its] fertility rate," said the UN Population Fund's Mr Beck.

To illustrate his point, he said the Philippines, Thailand and South Korea had the same population size - 20 million - and the same level of growth back in 1950. Today, the Philippine population has ballooned to 100 million, while GDP has grown by 170 per cent. By comparison, Thailand now has 70 million people, but its GDP growth has been at 970 per cent since 1950. South Korea? Population, 50 million; GDP growth, 2,200 per cent.

Large families aggravate poverty. Among families with one child, only 2.9 per cent are poor. The figure leaps to 46.4 per cent for households with nine or more children.

Simply put, the Philippine economy is not keeping up with population growth.

For reproductive health rights activists, the Reproductive Health Law is not a silver bullet. But locking in a multi-year budget for it to avoid annual, highly political haggling will go a long way in slowing population growth.

Politicians will have to overcome their "irrational fears of the Catholic hierarchy", said Mr Benjamin de Leon, president of the Forum for Family Planning and Development.

Mr Juan Antonio Perez, executive director of the Commission on Population, said it is too soon to ascertain how effective the law will be.

However, anecdotal evidence on the ground is promising, he said.

Mr Perez pointed out that the Supreme Court did not restrain all aspects of the Reproductive Health Law. Since 2012, the health ministry has been able to provide sex education classes taught by peer educators in public schools.

Mr Perez said that in one school in Camiguin province, 728km south of Manila, the number of teenagers getting pregnant fell to just two from as many as 10 in just a year.

"There was a drop just by disseminating information to young people, through their peers who know the issue and can give support. Imagine how much more we can do."

A version of this article appeared in the print edition of The Straits Times on April 02, 2016, with the headline 'Baby boom not quite a boon for Philippine youth'. Print Edition | Subscribe