Except from a diary of (almost) 20 years ago

“How funny that we can’t bring ourselves to tell our children the most fundamental truth about sex, that most of the time we have sex, we have it for pleasure. ” – Alice Dreger

From the point of view of a 16 year old, sex is fascinating because it is forbidden. And it is forbidden  probably  because it feels good.

Hmmm … as good as what, I wonder? Even better than blueberry cheesecake? Or  Karen Carpenter songs? Is it  like waking up at 8 am and burrowing under your bedcovers when it’s raining outside and school is cancelled?

diary

 

I understand why grownups won’t talk about  the “S” word. My parents haven’t even said the “L” word. If they can’t bring themselves to talk about the “L” word  then S-word discussions must be like watching “The Exorcist”.

It’s like they do “it” and you are left wondering at all the fun they are having

I asked a teacher at Health Class  today why parents bother to have kids. What did I expect her to say? Because sex feels good and kids are a by-product of their parents having fun under their blankets? Of course that’s not what she said. Instead the answer was something about love and god wanting to spread love yada yada yada.

I hope  I can have the conviction to be an atheist like D. Oooops … one is not supposed to want to be an atheist. That kind of thinking can send you to hell.

***

If the Church had allowed them to grow up to be functioning adults in Irish society it would have ran the risk of demonstrating that the institution of marriage was not absolutely integral to the moral well-being of a person. – Stephanie Lord, on infanticide, unwanted pregnancies and the Catholic Church in Northern Ireland.

 

Interesting Stories

A poor patient with cervical cancer is writhing in  pain just outside the building of a big tertiary hospital. Her husband watches helplessly as she moans; all the while he was wondering when her (and his) suffering will end. They have 100 pesos with them and the wife needs at least 1500 pesos for her blood transfusion and a lot more than that for the chemotherapy.

The worst part about residency training is there came a point when the only way you can cope with all that suffering is to pretend you were a robot.

The worst part about residency training was there came a point when the only way you can cope with all that suffering is to pretend you were a robot.

 

Then comes the reporter. The reporter looks helpless and frustrated. She interviews the man and his wife. All the while, the woman was writhing in pain.

The reporter accompanies both to the heartless hospital that won’t admit them. The hospital, out of fear of negative media coverage, admits the patient and make her wait in the Admitting Section. They would still have to procure blood.

The secretary of health appears on the screen saying they are doing their best to achieve universal healthcare. A medical activist appears saying  that this is what happens when healthcare is privatized.

I haven’t heard from the doctor to whom the patient was decked.

But I imagine that this  must be his/her story:

Dr. Z has been on duty and without sleep for 48 hours. Technically, Dr. Z was on duty for 24 hours but the reality is Dr. Z has been staying in the hospital for three straight days because of complicated patients their team has to take care of. Dr. Z is  a resident-in-training and aside from taking care of the patients’s medical needs, Dr. Z has to take on the role of nurse, midwife, utility worker and social worker because the hospital lack the staff to provide adequate nursing, midwifery, janitorial and social work services to the patients. Now this cervical cancer patient comes in just as Dr.Z’s shift is about to end (the shift will end but the work will not). Dr. Z sighs and thinks, I will have to shell out the 1500 pesos for the blood, so that I can transfer her to the Oncology service, oh god 1500, I was planning to buy mommy her present, sorry mom, cervical cancer patient trumps your birthday any day, when I graduate, I am promptly going to another country, preferably first world where I don’t have to be a social worker and doctor at the same time, i am so sleepy, this day will never end .. lord please kill me now.

 

Janet’s Uterus

I have removed my share of uteruses in my career.  Hysterectomy is a pretty straightforward affair. Unlike having a brain or a heart, the presence or absence of a uterus will not be a deterrent to having a practicable human life. As readers with Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome know, it is entirely possible to have a rich, meaningful, lengthy, fulfilling existence without that organ whose primary function is nurturing a fetus.

So Janet Lim Napoles (whom I have written about here and here and here and here) has thought that telling her truth would  probably set her free, so on the eve of her surgery, she went on to spill her beans at Secretary De Lima.

The story gets murkier because Janet is now waving her own list (as opposed to Benhur Luy’s and other whistleblowers’s) of pork barrel scam players among  government officials. I can imagine people in the Executive Department and Legislative Houses craning their necks and going up on their toes, itching to know if (god forbid!) their names are on this List.

Oh Janet … were you thinking of doing a St. Paul-on-the-road-to-damascus stunt, or were you just biding your time playing everyone against each other with the goal of saving your skin (and/or your loot)?  By now, nobody in this country believes that anybody in politics is untainted by corruption. So much so that any person on your list, however seemingly unlikely, will probably elicit sighs of resignation instead of surprise.

I found in the news that the reason for your profuse vaginal bleeding was myoma, adenomyosis and endometrial hyperplasia. Close call, but thank god it’s not cancer, right? Now if only prosecuting you and everyone involved in your scam is as straightforward as removing your uterus.

 

 

 

 

 

Comments on the RH Law

alternate title: The Constitutionality/Unconstitutionality of the RH Law from the Perspective of a Medical Practitioner Who Had Seen the Consequences of the Lack of One for Years

I am not sure whether the recent decision of the Philippine Supreme Court (SC) regarding the Reproductive Health Law is something I can be hopeful about; or something that I should tear my hair at in frustration.

I have always thought that the idea of having a Supreme Court is to have someone clear things up when laws have become so convoluted and confusing.

Now I am even more confused. But then I am just a lowly health worker and not a lawyer.

 

When I was a little girl, I have wanted to be a lawyer. That was before my mother nagged me to take up medicine.

When I was a little girl, I have wanted to be a lawyer. That was before my mother nagged me to take up medicine.

 

The most supreme magistrates of this country said that House Bill 10354 is not unconstitutional. (I have always thought that there is something fishy going on when people  say things with a double negative.)

However (and this is where things become confusing), the SC maintained that 8 provisions of the law are unconstitutional; and here they are:

 

Section 7, Paragraph 2.  No person shall be denied information and access to family planning services, whether natural or artificial: provided, that minors will not be allowed access to modern methods of family planning without written consent from their parents or guardian/s except when the minor is already a parent or has had a miscarriage. 

Section 23 (a)(2)(ii), penalizes a health worker who requires parental consent from a minor in non-emergency cases;

In striking down these parts, is the SC saying that I  will be defying the Constitution of the Republic of the Philippines when I provide a 16 year old who had an abortion and is pregnant with baby number 2 with information on family planning without telling her parents? Holy shit! I just did that last week! Please Supreme Court, have mercy on me — the darned teenager has been living with her boyfriend for the past 2 years and is estranged from her parents. I mean she would really benefit from knowing that she can prevent future pregnancies by using the Pill. Really!

As to Section 23(a)(2)(ii), I really think that if a teenager is mature enough to ask for contraception, then she is mature enough to have one. There are some things called “the evolving capacities of a child” and “emancipated teenager.” Apparently, the SC justices have not fully digested those ideas.

 

Section 17 —  provides the grant of 48 hours free services to indigent women as a prerequisite for health care providers in securing accreditation from the Philippine Health Insurance Corp. or PhilHealth;

Last month, I went to Philhealth to have my healthcare provider accreditation renewed. It was fairly smooth sailing except for the long lines at the cashier, but it’s ok because they were quite organized. Now I wouldn’t mind granting free services to indigent women, and having that a prerequisite to securing my Philhealth accreditation. Which reminds me, I put in over 48 hours of unpaid overtime pay for my public health job last year. Would that suffice, I wonder?

 

Section 23 (a)(1). Prohibits health care service workers from withholding or disseminating information on reproductive health programs;

Section 23 (a)(3). Punishes health care providers who refuse to refer non-emergency patients to another facility regardless of religious beliefs

My sister is an Opus Dei member. For those who have read the “The Da Vinci Code,” yes they are a very conservative Catholic Church believers. I know she would hate me when I say that yes, I agree that medical workers should never withhold RH information and services. If they are uncomfortable doing so because of their religious convictions, then they should refer. The idea of referring cases we don’t want to handle to our colleagues is part of medical ethics. Which reminds me of an incident when I was in medical training. An OB Gyn Consultant was supposedly opposed to doing bilateral tubal ligation (a family planning method where a woman’s tubes are tied and cut to prevent further pregnancies) because of religious reasons. After performing the cesarean section on her patient, she told the OB Gyn resident who was assisting to carry on. The Consultant turned her back on the patient while the resident did the ligation. Of course the professional fees for the ligation went to the Consultant. Hmmm … I have been known to be guilty of hypocrisy a number of times, but at least I admit it…

 

Section 23 (a)(2)(i), Spousal consent in case of married persons: provided, that in case of disagreement, the decision of the one undergoing the procedure shall prevail;

Okay, so I am again guilty of this. With a lot of women that I have lost count. Look, Supreme Court, the thing is, when a woman comes for family planning consultation, the fact that she is married should take a back seat to the fact that she needs family planning. Last week, this 34 year old gravida 5 delivered in the clinic. After being counselled on family planning methods, she decided that she would like to have an IUD inserted. However, the partner (the baby’s father) was not around. She and her husband (the one she was married to and the father of her first 2 children) have long been separated. The dear old 34 year old lady had her IUD and may I say, dear magistrates, that her case is the norm and not the exception in the public health facility where I work.

 

Section 23 (b), which punishes a public official who refuses to support reproductive health programs regardless of religion.

O puhleeaze! For several years, the regime of former Manila Mayor Lito Atienza of Manila would not give RH services to the indigent women of Manila. That was violence against women!

 

The eighth provision which the SC said was unconstitutional had something to do with the definition of contraceptives and abortifacients. 

And  had something to do with the word “primarily”.  By the way, a friend told me that the best pre-law course should be AB English.

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Whew … this was my longest post. Which just goes to show how emotionally invested I am in the RH Law. My mom, bless her soul, had an unwanted pregnancy and an induced abortion when she was young and stupid. I hope I would have learned from her mistakes.

****

This is one article critiquing the SC decision which is thought-provoking and well-argued. Of course it is biased towards RH but what the heck, so am I!

Sex Ed and Other Matters

I was about to attend a Policy Forum on Teen Pregnancy. It’s supposed to be today, but I just found that it has been postponed.

I expect it to be rich on informative, insightful lectures and speeches; and poor on workable solutions.

There is a culture of hypocrisy in this country as far as pregnancy is concerned. As far as sex is concerned, actually.

We are a people who tell our children, “do as I say, not as I do.”

For example, a grandmother of 35 brought her 16 year old pregnant daughter to the clinic yesterday. The grandmother is also pregnant with her 5th child with husband number 2. She tells me, referring to her pregnant daughter, “Ewan ko ba kung bakit nagpabuntis yan ng ang aga aga.” (I don’t know how she got herself pregnant at such a young age..”) What did they say about the pot and the kettle?

Congressman Manny Pacquaio is adamantly opposed to artificial contraception. His wife Jinkee has been using oral contraceptive pills to space her pregnancies. Good for you Jinkee … now please tell your husband to be consistent in his convictions.

Health workers are supposed to advise our clients about family planning. A week ago, a patient was willing and able to undergo tubal ligation (a procedure to tie her fallopian tubes that will permanently prevent her from getting pregnant). So I was ready to perform the procedure when my midwife reminded me that we have no anesthesia supplies.

Uhhh … I’m sorry Ms. Family Planning Client, I will have to refer you to another government facility because we lack supplies. And no, we weren’t given supplies for IUD or DMPA either. I can advise you about Lactational Amenorrhea Method (LAM) and Calendar-Based Methods. Oh I see, LAM didn’t work for you because you had to work in a factory that doesn’t have breastfeeding facilities;  and Calendar Based Method is so difficult to do because, really it feels sooo good to have sex when you’re ovulating … I can agree with the great sex during ovulation part :)

During Women’s Month (which is, incidentally, this month!), the mayor proudly announces that the health facilities in the local government provide complete and comprehensive family planning services.

The truth is: most funding for Family Planning come from foreign aid agencies.

Another truth is: the Department of Health (DOH), like a lot of government agencies, is wishy washy about reproductive health because of the Catholic lobby.  When they ask for funding for family planning supplies from Congress, god-fearing congressmen shoot them down.

Yeah, yeah, Undersecretary Garin is now at the helm of the Family Health Office and she was a proponent of the RH Law. Well good luck to her. I hope she doesn’t use her DOH post as just another stepping stone to higher political office.

In countries that have curbed teen pregnancy and have decreased unplanned pregnancy, education played a big role. And so in the Philippines, sex education is  being espoused as a solution to prevent pregnancy among adolescents. So okay, fine, but where and how will we conduct this so-called sex education if we lack classrooms; we lack teachers; the teachers are uninspired and underpaid; the school books are crap;  and the students are hungry?

And was I the only one who has noticed that the agencies who are very active in the Sex Ed/Teen Pregnancy advocacy are DSWD and DOH? Where does the DepEd come in all this? Are they, or are they not, the ones who are primarily in charge of education? Ah but my dear, Education is quite different from sex education

Do the people advocating sex education even know how  it is supposed to be conducted?

I can hear my 16-year old self: If sex feels soooo good, how can you keep us from it? If being a parent is so stress inducing, why did you go through with it?

The thing is, people become parents even if they don’t know how to answer such questions from a 16-year old.

Cynicism has its place and I don’t know if mine is warranted.

The virgin mary and me. I'm sure even she and Joseph had sex.

The Virgin Mary and me. I’m sure even she and Joseph had sex.

 

 

 

Hospitality

According to Wikipedia, hospitality is defined as “the relationship between guest and host which includes the reception and entertainment of guests, visitors, or stranger.”

Sometimes I wonder about this so-called “Filipino hospitality”, this tendency of my people to give the best part of what they have to their guests. The best place in the house to sleep in, the best blanket, the best food, the best type of treatment.

Or maybe, that was the case a long time ago. Like 400 years ago maybe.

I can remember a high school teacher saying something like, “if we Filipinos have not been so hospitable, we wouldn’t have been colonized by white-skinned foreigners. And then we wouldn’t be this fucked up.”  That  second sentence, she didn’t say that exactly … I just implied it from her expression and the kind of teacher she was (a member of the LFS who had probably joined the NPA — I think).

Sometimes, I also wonder if this so-called “hospitality” is a concept devised by my country’s elites; foisted on me so I that I will not feel enraged when they screw me over and over. (But then I should also remember that I got screwed  because I smilingly I laid on my back and spread my legs. Well, boo hoo on me …)

I haven’t been bothered by a blog for a long time. But this one had. And I can’t really say why. The writer seem to be well-meaning and very honest. Honesty should be prized more than hospitality I think.

This is how she related an experience travelling to the Ilocos:

“A big disappointment here. For some reasons, Filipinos (especially older people) got really angry when they saw us taking photos of them, the food in the street or even ourselves in front of their shops or houses. It’s totally understandable, but once we asked them for permission, they quoted the price of the photo or said “Any money is ok. It’s up to you.” This attitude shocked us on the first day, but it continued for the rest of our stay. We still can’t understand that. Is it because some Filipino are materialistic people or they are just poor people trying to earn some extra money? Don’t know the answer.”

Hmmm …  are we a materialistic people? But then, we (a majority of us, anyway) are a people who have so little as far as material stuff are concerned. Even the lands under our feet are not ours.

We gave them to the white-skinned foreigners and their local cronies a long time ago. Shame on us …

And then she tried our foods and was disappointed as well.  Yup, me too … sometimes I’d rather starve than try the food she ate. But then, I can afford to starve like for a day or even two. The people who patronize the “poor quality food” she mentioned are, well,  poor.  If they starve, they really starve — as in, to death.

I feel sad for this tourist. For her horrible diarrhea and her bad experience in my third world home.

But I feel sadder for myself.

sunset

We are supposedly known for (and are proud of) our sunsets …

burot beach

… and beaches ….

tree

It’s just that I think, there is a dishonesty in being proud of stuff that one did not create in the first place.

Creative Endeavors

There was a 34-year old woman, let’s call her Y, who gave birth to a dead baby with Trisomy 13 yesterday. It is a congenital anomaly affecting 1/10,000 births and has a morbid prognosis since most end as stillbirths or die within the first year of life.

This is Y’s fourth  pregnancy. Her first 2 children are ok, but the pregnancy before this one was  also a Trisomy 13 stillbirth. I think she told me that she and her husband will still keep on trying because they want to have a girl. She is a vendor and  her husband teaches Arabic. I don’t think pre-implantation genetic diagnosis is a practical option for them.

Hmmm …

 

Patauhand

Trisomy 13 or Patau syndrome. The overlapping of fingers over thumb is a common feature. Picture from Wikipedia.

 

***

I was reading Book 3 of “50 Shades of Grey”,  that scene where Anastasia tells Christian that she’s (ehem) pregnant; and he goes ballistic, saying, “Shit! I don’t fucking believe it. How could you be so stupid?”

The thing is, I completely sympathize with Christian Grey. How could she fucking do it indeed? She was on a reliable form of contraception (Depo-Provera) and she forgot to take her shot. May I just add that Anastasia Steele is not one of my favorite heroines.

In fiction, the conception (or birth) of a new human being is considered a hopeful event.  In real life, though, things are more ambiguous.

Kids do get messed up even when their parents did want them. Even in circumstances where the conception was hoped for and planned, a thousand and one things could go wrong — from pregnancy to delivery, to the raising of the child, and the way it grows to be an adult.

I read somewhere that parenting can be one of the most creative things a person (or two persons) can do. Maybe it’s right up there with writing a book or composing a song. However, books and songs don’t end up (even the worst of them) as messed up adults who are full of resentments against their progenitors. Also, books and songs (in general) don’t end up disrupting the lives of their creators.

One grapples with the question whether parenthood should be deemed as a right or  privilege. And one is still stumped. Feminists, NGOs, government agencies, international aid organizations and the church have their opinions. The way they say it, you’d think that those opinions were carved in stone.

Contraceptives were invented so that people who do not want, or who are not ready, to be parents will not be so. However, humans being humans, do not take their contraceptives perfectly. And these devices do fail — a 0.05 failure rate may be nothing unless you become one of the 0.05.  I don’t know if there were studies that show children grow up just as well whether they were a wanted/un-wanted or a planned/unplanned pregnancy.

Would people/parents be so honest to admit when their children are born that, really, they had the same expression as Christian Grey when they found that that kid was conceived? Would they admit that they didn’t want a child when the kid is already there? They (whoever they are) say that when one sees the cute baby gurgling and looking so innocent and cuddy, one can’t help but love it. Is that true, I wonder?

Maybe, as with all acts of creations, a great deal of narcissism comes with wanting to be a parent. Or choosing to be a parent, wanted or not. And a great deal of hopefulness too. Trisomy 13 or not.