Maternity death road

I’ve been running a crap game since I was a juvenile delinquent,” boasts thischap in “Guys and Dolls,” the 1950 Tony Award-winning Broadway play. And Miss Adelaide snaps back: “Speaking of chronic conditions, happy anniversary.” This exchange came to mind as Senate debates on the Reproductive Health bill zigzagged from a chronic “war of words into a battle of figures.”

Today’s “crapshoot” pivots around a critical issue: On average, how many mothers die daily during childbirth?

“Eleven,” say Senators Miriam Defensor-Santiago and Pia Cayetano, who co-sponsor the RH bill. That’s almost triple Vietnam’s maternal deaths, UN Human Development Report 2010 shows. “No,” counters Sen. Vicento Sotto III, who bucks the RH bill. “Probably four or five.” He cites a Lancet article and a UN study. That implies that deaths of Filipina mothers has been whittled in little over a decade to China’s maternal mortality levels. That’s one for demographic record books—if true.

At the 2000 Millennium Summit, the Philippines pledged to slash maternal deaths down to 52 out of every 100,000 live births.  Fatalities towered at 209 in 1990, then slowly slipped to 162 last year. “That’s too far from (Millennium Development Goal No. 5) of 52 deaths,” National Economic Development Authority said. “Goal 5 is least likely to be achieved by 2015.”

In it’s latest “MDG Watch,” the National Statistical Coordination Board agreed with Neda. So does the United Nations Children Fund’s “Report Card on Maternal Mortality.” “In the Philippines, an estimated 4,500 women die every year because of complications from pregnancy and child birth.” Australian Aid agency also stresses the same point.

Come 2013, European Union will top up it’s P2.7-billion ongoing programs by P4.7 billion, Ambassador Alistair MacDonald pledged. This would buttress efforts to meet MDG goals. “Some 42 children are orphaned daily,” the EU envoy said. “Yet 90 percent of all maternal deaths could have been averted with proper care and services.”

Is everyone else tilting at windmills, given Sotto’s claims? “Statistics are people with the tears wiped from their eyes.” Look at what went before—and what occurs beyond RH debates.

“Based on present trends, most poor countries will miss almost all MDG goals, in some cases by “epic margins,” World Bank stated five years after the MDG summit.“Less than one-fifth of all countries are currently on target to reduce child and maternal mortality and provide access to water and sanitation.”

Two years later, the unusually frank “2007 MDG Midterm Progress Report” noted: Here, “the funding gap to achieve MD Goals by 2015 is estimated at around 15 billion…” (But) “expenditures for social and economic services, as a percentage of the total budget, had been declining for the past seven years.”

Thus, only six out of 10 Filipino mothers deliver babies with properly trained birth attendants. All births in Malaysia, in contrast, have medical personnel present. Why?

Well, out of every 100 Filipino doctors, 68 practice abroad. Over 164,000 nurses left over the past four decades. “The proportion of Filipinos dying without medical attention has risen to 70 percent, a figure not seen since the mid-1970s,” the Washington Post reports. “A health care brain drain is strangling (public) hospitals…”

Four out of 10 Filipinas “deliver either in a public or private health facility.” That’s a sliver lower than that of Mali in Africa. Worse, under ground abortionists account for nearly 12 percent of maternal deaths. UP Population Institute estimates 560,000 abortions are induced yearly. Some 90,000 mothers are lucky. Few seek post-abortion care. About half of 3.4 million pregnancies in 2008 were unintended.

On “Maternity Death Road,” most victims are poor and clustered in remote barangays. Often ill-fed school dropouts, these women lack access to what is, at best, patchy health services. “Giving midwives access to further training in life-saving skills could prevent up to 80 percent of maternal deaths.” These mothers have “no escape routes,” i.e. options that give them “quality information that would enable her to avoid unwanted or space pregnancies, and plan families.”

“We don’t realize the economic distortions and human pain that stem from corrupt and bad government,” Harvard professor John Kenneth Gailbraith once said. Is that why the present House of Representatives named, as chair of its Committee on Millennium Development Goals, the honorable representative from Ilocos Norte, Imelda Marcos?

Four years from now, President Benigno Aquino III and 188 other heads of state will convene and report on how each country delivered on the MDGs. “We should have achieved MDGs under the (Arroyo) regime,” says the study Winning the Numbers, Losing the War. We flunked. Don’t ask Mike Arroyo why.

At the start of P-Noy’s only term, the prevalence of underweight children under five was “comparable to sub-Saharan Africa,” the last national nutrition survey notes. Only three out of 10 drink potable water in the Autonomous Region of Muslim Mindanao. Gloria Macapagal-Arroyo’s decade in office, by happenstance, straddled the first decade of MDGs. It s uandered opportunities to achieve the  human ends of the MDGs.

That leaves Aquino little elbow room to buttress programs like “One Midwife per Barangay Policy” and upgrading health facilities, specially in Mindanao. Now, all much pitch in, whether we meet 2015 targets or not. This is not just a “Guys and Dolls” crap shoot. “No woman should die giving life.” Even Senator Sotto will agree with that.