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[Vital Signs Column] My Final Stand on the RH Bill

Posted Sep 13 2012 10:54am

Vital Signs
NURSE'S NOTES
By: Alvin Cloyd Dakis, RN
August 16-31, 2012 Issue (Part I)
September 01-15, 2012 Issue (Part II) www.vitalsigns.ph/Articles  
Many things have been said and the debates just go circuitous and tiresome. They have called me by many names because I have, time and again, supported the Reproductive Health Bill which is still pending in the 15th Congress.
Long before I started my RH advocacy, I was advocating the issues of HIV & AIDS and the Deaf's access to information on health. I started to seriously advocate on the RH Bill during the last quarter of 2010 when I saw the need for nurses and young people to speak  up and inform the people about their reproductive & sexual health needs and the RH Bill as well. I went on to study its provisions and the issues that surround it. And since HIV & AIDS is one of the reproductive & sexual health concern under the RH Bill, I felt it was connected and my deeper knowledge of reproductive & sexual health (SRH) would lead me to become a better nurse educator to my patients.
Furthering into the RH advocacy I have noticed that:
    Nurses or its professional organization/s do not take a stand on the bill, not even in the issues that surround it;Nurses are silent in the issue and the bill whereas doctors and midwives have given their professional opinions and statements;Some nursing organizations and influential individuals are against the RH Bill; andThere is no nursing organization that is supporting the RH Bill in the open and is vocal about it.
With that in mind, I discussed the provision of the RH Bill in our nursing organization, the Alliance of Young Nurse Leaders & Advocates International (AYNLA) and ask them to read the bill as well. After some time, I have asked our national and local leaders of their stand on the bill and they were supportive of it. Therefore I wasted no time in involving them in the different discussions and activities of those who support the RH Bill. Our nurses saw how tirelessly the RH advocates and volunteers work and how we continuously educate people who were so misinformed of the bill.
Before anything else, I read the bill first, as would any thinking individual would do before I cast my judgment. I read all versions, the 6 ones in the House and the ones in Senate. Read the international commitments & treaties mentioned in the bill as well. I also did reviewed oral contraceptive pills, IUDs and other family planning methods as this will be necessary for me to cast my judgment.
Why then do I support the RH Bill?
Freedom of informed choice. I have always believed that every individual should have a choice of what kind of services they would to access and avail from the government. Under the RH Bill, the government shall offer all possible legal and medically-safe family planning methods and RH services including traditional (natural) and modern (artificial) methods. After a thorough education from a health provider, the client will then have the ability to choose of what services best suits them.
Not in any case, shall the government enforce its own decision for individuals or couples on what RH or FP methods they would want to employ. For me, an empowered & informed person can make the right choices for his/her own future.
Proscription of Abortion. Time and again, proponents of the RH Bill stressed that under the measure, abortion would still be and will remain illegal. It shall support the Penal Code and provided a line in the bill that education be added on the harms of abortion.
In the Philippines, there is an estimate of 500,000 to 800,000 unsafe abortions happening every year. The RH Bill authors believe that the high rate of unmet need for contraception once fulfilled would drastically decrease the number of unsafe abortions per annum. As the Philippine Obstetric & Gynecological Society would put it, contraception would prevent conception, therefore no conceptus to be aborted.
On the personal note however, I would opt for medical abortions, meaning the therapeutic abortions medical experts would do to prevent the mother from dying. Examples of these are ectopic pregnancies. Under the bill, women who have had unsafe abortions and developed complications should be given post-abortion medical care to save them from dying.
Essential RH services. What I loved in the RH Bill is that it addresses RH concerns of different people, in different areas. The RH Bill will provide services to women & young people in evacuation centers, provide information on sexuality that are PWD-friendly, provide mobile RH centers to reach constituents who are far from the health centers, requires health professionals to render pro-bono RH services to poor members of the community. Now who wouldn't want these services be given to them?
Essential services would also need a handful of healthcare providers that would be trained and be deployed in various parts of the country to facilitate these services. Apart from that, the RH Bill will also appropriate funds to enhance healthcare facilities like hospitals and community health centers so that these facilities would be ready to accept clients with RH needs.
Sexuality Education. Now I've heard this argument many times, that teaching children about Sexuality Education will make them promiscuous. Let me tell you something, whether Sexuality Education is there or not, if young people would want to have sex, they will have sex. And studies showed that more than 50% of young people have sex in their own houses, when their parents are not around. Teaching them about sexuality can prevent unintended pregnancies and prevents them from contracting sexually transmissible infections such as HIV.
I can still remember when I was at the Senate Committee Hearing, Senator Pia Cayetano asked me this question "do you like sex?" saying further that "since you are the youngest member of the [expert] panel. I'd like to grab this opportunity of asking you". I candidly responded "yes!" and said that naturally, young people would experiment about their sexuality and their bodies, most of the times engaging in unprotected sexual intercourse. 
When I became a registered nurse, I was the one who started talking about sex and sexuality openly in the family. We don't talk about it before. No one has the guts to do so anyway. But after my nursing education and being exposed in the HIV advocacy, I was thinking that it is time for me to bring it in the open and talk about it without much hesitation. But how many are in my situation? Still millions of Filipino families would not talk about this, neither they want to talk about this to each other.  
In the RH Bill, parents will be trained on how to openly discuss such topic to their children (not necessarily in the dining table, they may lose their appetite of course). As you may know many parents are not ready to talk to their children about sexuality for they themselves think they lack the correct information and the approach to the topic. 
Children in Grade 5 will now be introduced to an integrated sexuality education found in different subjects. Though personally, I would like this to be a separate subject. Teaching children on sexuality makes them understand more of their bodies, the opposite gender, and how to take care of their bodies. They would know when a touch is malicious and needs reporting - preventing them to being raped.
As children grows, sexuality education also goes with their level of understanding. When they reach their pre-teens, they should have already an idea about positive sexuality, respect for differences, basic rights of children and women, and responsible relationships. And when they are in their teens, trained teachers can now discuss responsible relationships in a deeper context. By now they should know about changes in their bodies, hormonal imbalances, HIV, STIs and teen-age women should have already the knowledge about fertility, menstrual cycles, and that they can now be impregnated even by one penetrative vaginal sexual intercourse. Many of the teenage girls I met, this is one of their most common misconception, that one sexual encounter will not impregnate them.
The UNICEF in cooperation with UNFPA and WHO made a study in 2009 and according to the study, countries who have successfully implemented sexuality education among young people will not have increased sexual partners, increased frequency of sexual activities and increases sexual debut. This would mean that in many countries, a proper sexuality education have lessened early sexual debut and did not make young people promiscuous.
Opportunities for Nurses. Let me really honest here, I think the RH Bill can also help decrease the ballooning unemployment of nurses once it is passed. Just imagine the number of mobile health centers which will be deployed and the nurses who will man them? There will be increased number of nurses who will have to lead the Maternity Teams in the hospitals, evacuation centers and health facilities. Nurses can also be employed as health instructors to teach sexuality education in schools. Nurses are excellent health educators plus they have clinical skills that accompany that.
And yes since the time I have supported the RH Bill openly, I have been receiving hate mails, tweets and had been called names. Those who opposes the bill even resorted to doubting my RN license and is threatening to "expose" me and accused me of receiving funds from RH Bill supporters. 
I dared them to back their claims with proofs, but until now everything is purely a bluff. It is fine with me if you do not share my views or we have a contrasting one as long as you do not call me names, or attack me below the belt. Because that would be the lowest form of attack you can ever do in an intellectual discourse. 
My last stand for the RH Bill? Never back down. Never give up. Until the time comes we give justice to countless of women's lives lost due to deaths we can prevent.
My last stand is for all those young people who are deprived of the proper sexuality education they deserve. Never I will let them do to those children what I was deprived of. 
My last stand is for all women dying needlessly because their reproductive & sexual health concerns were not addressed. Worse, neglected by legislators, who, time and again, shuts their eyes and ears to what seemingly glaring fact. 
My last stand will be to end ignorance in this country. I started it with my advocacy for every Filipinos to have medically-safe, legal, accessible and affordable reproductive health services, information and education.
For comments please email  alvin.dakis@aynla.org
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