Words and photos by Shireen Durrani

Facebook: Forum for revolutions, nemesis of despots, and occasional friend of free speech. And now it is playing no small part in helping to subvert centuries-old religious codes that forbid the public discussion of S-E-X among young Filipinos. In one of the largest recent studies on sexual attitudes, around a quarter of young Filipinos reported having had sex before marriage. Given that a generation ago only a brave individual would have admitted fooling around outside of the conjugal bed, one thing is crystal clear: premarital sex is on the rise.  Conservative leaders may see social media as complicit in the relaxation of modern attitudes to sex, but a growing number of health activists are cleverly co-opting Facebook and Twitter in their efforts to improve sexual health.

Culturally, the Philippines has always been different from their Southeast Asian neighbours: colonized for nearly 400 years by the Spanish and then promptly handed over to the US for the neat sum of 20 million dollars. Without a doubt, it is the tenets of Catholic religious doctrines that so strongly flavor public life in the islands, although Americanization has brought conflicting liberal ideals to the mix. This conflict between social conservatism and liberalism is perfectly encapsulated in the debate on reproductive health.

In a country where 11 women die each day as a result of childbirth-related complications (a rate much higher than Thailand, a similar “medium-development” country), it seems clear that reproductive health should be addressed. The problem is that to do so means talking about sex and the myriad taboos this entails. The World Health Organisation has expressed concern that only around 15% of young Filipinos understand the basics of HIV transmission—a figure much lower than in some neighboring countries like Thailand or Vietnam, where governments are valiantly trying to open up debate about sexual health. In the Philippines, the result of the knowledge gap and social taboo around sex is that only around a fifth of young men are using condoms consistently—and the same proportion of women become mothers in their teens.

In the last decade or so, the growing independence of youth culture, combined with the eager adoption of technology by Filipinos—perhaps the world’s most avid consumers of social media—has met with a staunchly orthodox establishment. Fireworks have ensued.

Sex before marriage is still viewed in the same way it was in America in the 1950s: immoral, and a topic to be avoided at all costs in public. Cohabiting is rare even amongst liberal, educated Filipinos, and discussion of sexual health is stigmatized even within health settings. This conservatism carries through to reproductive health in general; it has taken decades to bring maternal health and family planning to the forefront of public consciousness, despite the evident need. Certain city councils within Manila notoriously ban contraceptives entirely within government clinics. In the rest of the city, unmet need for contraception leads to large family sizes, untreated STIs—including a growing HIV problem—and unsafe abortion. Advocates assert that lack of information and basic services means that women give birth to children they have no means to support, exacerbating the extreme poverty seen in many Philippine provinces. When given a choice, Filipino women with options—i.e. wealthy, educated women with access to healthcare—tend to have much smaller families. Coincidence? Reproductive health supporters don’t think so.

Activists, it seems, just see this melee of conflicting values as work to be done.  Deftly using the Internet as their key ally, they have created an arena to network and distribute sometimes explicit or subversive (by Philippine standards) ideas. Though much of their work involves basic health knowledge and lobbying, the ideas regularly whip up a storm by contradicting traditional Catholic doctrine. Their conservative opponents, although very vocal in the traditional media, have lagged behind in the race to define the debate.

Who is behind these dangerous ideas? The grassroots push to improve reproductive health takes in a lively civil-society mix of women’s organisations, freethinkers, and healthcare workers. Community mothers’ groups have joined voices with youth workers and sexual health advocates. Key to the whole movement has been the space for activists and young people to share stories and promote healthy sexual practices. Their enthusiasm and courage has been backed up by a key legal proposition: the nascent Reproductive Health (RH) Bill, which would ensure the provision of maternity care, family planning, and reproductive health for all Filipinos. The prospect of the bill is inflaming Philippine opinion like few issues before; a threat by the Catholic Bishops Congress of the Philippines (CBCP) to excommunicate President Noynoy Aquino if he decided to back the bill is often quoted as a measure of just how deep the divisions run. Recently Archbishop Jose Palma of the CBCP offered his opinion on supporters of the bill, accusing them of being “no different to terrorists” and using slippery-slope logic to back his stance. In the eyes of the Bishops, the introduction of sexual and reproductive health services will lead to a moral abyss of abortion and teenage pregnancy.

One of the main bones of contention within the bill is the clause endorsing state provision of contraception. Aside from their belief that birth-control pills and IUDs cause abortion of early pregnancies (a position which has been refuted by mainstream medical opinion), the bishops and their supporters are concerned about access to sex education “destroying the morals” of teens and leading to promiscuity. Again, this controversial claim is at odds with existing evidence but it appears that, as is often the case, the gloves are off when the morals of a nation’s youth are at stake. Apparently underlying the conflict are deep-seated fears about the direction of Philippine society and the culture clash between conservative religion and modernity.

Proponents of the bill and their allies in civil society say that they are not seeking to destroy strongly held moral codes. Abortion, for example, is not supported by the bill, though post-abortion care for women who illegally obtain terminations is outlined as a key right. Health advocates instead insist that they are trying to improve maternal health, destigmatize open debate about sex and address a growing need for sexual-health services for young people. Adding impetus to the movement is recognition of how far the Philippines have to go in order to fulfil the often-criticised but universally adopted Millennium Development Goals. Although population control (and in theory poverty alleviation) are often raised as a reason for expanding reproductive choices, the crux of the argument lies in the rights of individual women and men to control their sexual life and fertility.

Behind the public hand wringing and deep divisions, a youth counterculture is continuing to grow in support of the RH bill, although knowledge of condoms, relationships, and sexual health comes almost entirely from the Internet and peer groups. Facebook has played host to young activists attempting to generate buzz and mobilize support for the cause.  “Artists for RH,” a coalition of sympathetic public figures and entertainers, are risking public censure and their profile in the entertainment industry to make a stand. Backing up the agitators are progressive doctors, nurses associations, and NGOs, who stress the Philippines’ constitutional separation of church and state and tell heart-breaking stories of young people who have suffered injury and death for lack of reproductive-health knowledge or medical care.

Almost on a monthly basis, social media sees rallying calls to protest in support of the RH bill, and the Internet continuously acts as a free forum for impassioned debate and comment. Urban, educated young professionals maintain a strident voice on Facebook pages such as “I support the RH Bill!” (15,000 “likes” at last count), and “Excommunicate me, I support the RH Bill!” They are up against more than a few cultural walls: not only the conservative establishment’s views on the responsibilities of government and the role of women in society, but those of fellow teens and young mothers. Many teens themselves believe sex education will corrupt morals and that contraception is against God’s will. This school of thought is encouraged, and sentiments inflamed, by local bishops in their weekly mass. Services in neighborhood churches are co-opted as political opportunities; it is not uncommon to see huge banners on churches decrying the RH bill and its allies. To give an example of the strength of Christian ideals in young people, in recent polls 90% stated a belief that abortion is wrong under any circumstance—yet other research shows that over one third of (illegal) abortions are in women in the 15-24 demographic. This paradox perhaps underlines the contradictions between public expectations and private behavior.

reproductive health in the Philippines

Despite huge social hurdles and overt pressure from conservative ideologues, overall support for improving reproductive health appears to be snowballing. With many politicians fully on board, it may now be a matter of time before the bill jumps its final hurdles in the Senate. The Philippines is no doubt a conservative culture looking forward to many difficult years of social change. But although there is entrenched opposition to the openness of debate on sex that comes through youth activism and new media, many ordinary people still look forward to the opportunities that will be realized if the RH bill passes. With modernity, it seems, comes complexity and shades of gray. “RH Bill?” said a Manila taxi driver reflectively after happily showing me pictures of his eight children, crucifix dangling from the windshield. “It’s a good thing.”