As the country continues to face challenges brought about by the COVID-19 pandemic, it’s important to recognize that responses to the virus differ based on sex and gender. From a primary impact point of view, studies have shown that men are most likely to have a severe form of the virus or to die from it. Meanwhile, the pandemic has also posed serious consequences for women on the societal level—including the higher risks they face as a result of their traditional roles as caregivers, the rise in domestic violence, and the lack of respect for their own bodily autonomy and integrity. While we celebrated International Day for Action for Women’s Health on May 28, it’s important to note that sexual and reproductive health and rights (SRHR) is still essential and SRHR of women shouldn’t be dismissed especially in the vulnerable sectors in countries like the Philippines.
Risk of domestic violence
Due to the lockdowns enforced by governments worldwide to flatten the curve, sexual abuse perpetrators and survivors are trapped in the same confined space resulting in severe psycho-social trauma and even physical violence. Countries from all over the world have reported an increase of domestic violence cases and hotlines lighting up with abuse reports ever since cities went into lockdown to contain the virus. According to Marianne Hester, a Bristol University sociologist who studies abusive relationships, cases of domestic violence increase whenever families spend more time together, such as the Christmas, summer vacations and, for the current cases, mandatory quarantine.
On Apr. 15, Senator Risa Hontiveros warned the government of an increase of cases of domestic violence against women and children in the Philippines. She urged the Philippine National Police and the Philippine Commission on Women to coordinate with local government units to take measures into protecting women and children from domestic abuse. She also suggested setting up a new domestic violence hotline and safehouses for vulnerable women and children. Aside from this, the senator has taken action against the spike of online child sex trafficking in the Philippines on May 22 due to the lockdown imposed by the pandemic.
The need for reproductive and sexual health services
Women from low and middle income countries like the Philippines were reported to have low access to maternal and reproductive health needs as overwhelmed health care systems decide to close facilities or limit family planning services due to staff shortages. The United Nations Population Fund estimates that seven million unintended pregnancies could occur if lockdown measures due to the pandemic continue for another six months.
Katherine Bulatao from Caloocan city was reported to have died due to blood loss after giving birth because six hospitals refused to accept her. The expectant mother chose to give birth at their house, on April 27, with a midwife instead of going to the hospital to avoid contracting the virus. However, the midwife urged her relatives to bring her to a hospital because she wouldn’t stop bleeding. The hospitals that turned Bulatao away were reported to have reasons ranging from inadequate supplies, unavailability of obstetrician-gynecologists in their facilities and a requirement of a P30,000 down payment for admission. Another woman, Mary Jane Alpide, was also reported to have died in labor after being turned away from four hospitals.
According to Asia Legal Adviser of the Center for Reproductive Rights Jihan Jacob, “the refusal to administer emergency reproductive health care to women (…) violates their fundamental rights guaranteed under our Constitution and a myriad of our laws including the Anti-Hospital Deposit Law, Magna Carta of Women and the Responsible Parenthood and Reproductive Health Act.”
“It also violates the government’s international human rights obligations to guarantee women’s rights to life, health, and equality and nondiscrimination. The current pandemic and resource constraints do not justify these refusals,” she told Inquirer on May 14.
Access to contraceptives and family planning services is vital amid the pandemic because an unwanted pregnancy can cause financial problems among families. Dimples Ortiz, told Deutsche Welle (DW) that she has been struggling to feed her two children – one 18-month-old and one 6-month-old – since her husband lost his construction job in March due to suspended operations.
“My eldest child has a disability. We don’t know when my husband can find work again. I cannot get pregnant,” Ortiz said.
She reached out to the Likhaan Center for Women’s Health since she was unable to get another dose of her contraceptive injection and she fears that an untimely pregnancy would add to her financial worries. Likhaan then offered to pick Ortiz up from her home to give her a free contraceptive implant.
Organizations have laid out action plans
The Sexual Health and Empowerment (SHE) network wrote a list of steps for local authorities to take action against the worsening effects of the virus on women’s reproductive health. They wrote for the Oxfam Philippines website on May 4:
“To stop the worsening effects of COVID-19 on women and girl’s reproductive health, the SHE network is urgently calling on both national and local health decision makers and policymakers, including the COVID-19 National Task Force; local chief executives; emergency managers in health and other sectors, and other actors to urgently implement the following actions:
- Include reproductive health commodities, such as menstrual health items, oral contraceptives, condoms, spermicide and lubrication, in relief packages and dignity kits distributed during and immediately after the ECQ.
- Ensure the availability of comprehensive sexual and reproductive health services during the ECQ, such as emergency contraception and continuity of post and pre-natal care, which should be easily accessed by women and girls in a timely manner.
- Ensure that reproductive health clinics are able to operate and continue to offer services; and that communities are fully informed where to go for their needs.
- Strengthen gender-based violence referral pathways, including hotlines, social protection, and community care services, to enable the timely reporting of gender-based violence and the availability of safe houses.
- Empower young people to access sexual and reproductive health services in times of crisis through continuous flow of SRHR information to reduce unsafe and unhealthy sexual practices.
- Ensure psychosocial support is provided to all affected individuals, including women who represent 70 percent of the health and social workforce combatting COVID-19.
- Incorporate a gender perspective into plans and strategies to enable response operations reach underserved and at-risk individuals. Where plans and strategies have already been developed, ensure that information and interventions do not reinforce discrimination. Rather, these should respond adequately to the different needs of women and girls, LGBTIQ+ persons, homeless and displaced, refugees, migrants, asylum seekers, indigenous peoples, persons with disabilities and other groups who are most marginalized and excluded.
SHE shall work with our local government unit and rural health unit partners to ensure the continuous flow and prioritization of reproductive health services that will keep our communities, especially women and girls, safe and healthy amidst these difficult times.”
Meanwhile, the Women’s Global Network for Reproductive Rights (WGNRR) recognized the death of Bulatao due to the hospitals refusing her treatment as a violation of her fundamental rights to life, health, equality and non-discrimination, and to be free from torture and ill-treatment.
The WGNRR acknowledged that healthcare systems have been overwhelmed by the pandemic, however, this shouldn’t be an excuse for the government to neglect providing essential reproductive health services for those who are already in vulnerable situations. On May 4, the WGNRR released a petition to urge the Philippine government to ensure the availability and equitable access of essential sexual and reproductive health services during the pandemic on their website that contains these action steps for the government:
“Clear mechanisms to ensure the availability, accessibility, acceptability and quality of reproductive health information and services must be put in place. In particular, we urge the government to:
- Comply with the Minimum Initial Services Package for Reproductive Health which should include obstetric, prenatal and postnatal care; contraceptive information and services, including emergency contraception; and post abortion care and post-rape care
- Appropriate adequate funding for the continuation of essential reproductive health services to ensure that these services remain affordable for all particularly among socially disadvantaged groups
- Ensure that reproductive health facilities are able to operate and continue provision of essential services
- Widely disseminate up to date information on the continued availability of reproductive health services i.e. type of services available, and where to avail them, to ensure that women and girls are able to make informed decisions about their health and well-being;
- Ensure the supply of and access to essential and life-saving medicines as provided under the World Health Organization’s List of Essential Medicine
- Guarantee access to quality, respectful maternal health care to ensure freedom from abuse, discrimination, coercion or violence
- Monitor provision and utilization of essential reproductive health services including documentation of cases of delays or outright denials on the provision of these services for improved accountability
- Develop task-shifting and -sharing strategies to ensure the efficient use of health care providers currently available
- Adopt alternative approaches on the provision of essential reproductive health information and services including the mental health aspect through the use of telehealth and virtual or electronic platforms for screening, consultations and follow-up.”
While the shortcomings of the country’s healthcare system have long been apparent, we fear that abuse on women’s rights to SRHR will only get worse amid the pandemic and if the government won’t take action against this sooner. As stated by the Commission on Human Rights on May 28, women have long faced several threats to their health, including physical, sexual, and emotional violence. Therefore, they recommend appropriate information and education on this issue together with implementing social protection policies and enhancing health financing schemes and benefit packages to provide better healthcare services for women.
Photo courtesy of Unsplash
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