This was indeed a very interesting programme, both realistic about the present and optimistic for the future !


Anita Rani told us that 1/5 mums from central Manila come to the Dr Jose Fabella Memorial Hospital ; 200 had registered by 10 am that day ; and it’s a “ 24 hour operation “ resulting in around 24,000 deliveries each year.


She told us about the “ hands on approach, with no sense of panic or chaos “ suggesting it was “ something in the psyche of Filipinas.


We were introduced to Rosalie, who already had 6 children, and no period since her LAST pregnancy. Because of increased risk of haemorrhage, and a shortage of blood for donation, relatives are encouraged to be present in case of the need for transfusion. Rosalie came from Tondo, the “ biggest slum “, home to half a million, which has developed around a rubbish dump. Rosalie earns 250 pesos for each gown she makes ; her husband ( a carpenter and mason ) earns around 380 pesos /day. The points were made that the poorest people – in Tondo, as elsewhere – tend to have the most children, and Manila is expected to grow in population by half in the next 40 years.


Even so, Anita told us, “ things are changing ; the economy has grown “.


We were then “ taken “ to Makati, and told that there are many thousands of businesses there now. The Maternity Unit of the private Makati Medical Center is “ state of the art “. A Caesarean Section “ might cost 140 – 150 thousand pesos “. Our second expectant Mum, Rose, typical of the increasing number of “ upper middle classes “ who can now afford it, was due to have her second ( and last ) baby by “ scheduled Caesarian Section “ ( we weren’t told the clinical reason ). Her husband is a banker. Their home for the past two years has been in the “ new Manila “. “ Most wealthier Filipinos “ limit themselves to 2 children.


We were told that there could potentially be an end to the “ population explosion “ if more suitable jobs could be available in the Philippines, further increasing the numbers of “ middle classes “ and perhaps decreasing the need for so many OFW’s. “ The Philippines is the Call Center capital of the world “ ( it’s overtaken India ), with “ half a million employed in this work “. Such Filipinos are “ patient; polite; well educated ( a priority according to a respected local businessman ); most having degrees; willing to work long hours; for lower pay than in the UK ( £ 300 – 400 / month ) “. Medical tourism and financial services also got a mention.


“ Population growth has slowed around the world, even in Tondo “ we were told. We were reminded that the Philippines is predominantly Catholic, contraception is not readily available, and expensive if it is.


The third lady, Jenalyn, was also from Tondo. She has 10 sibs and wants to “ break the lifestyle her mother has “. She was doing work experience / an “ internship “ for City Bank, and was desperate to find a job to fund studying and a better lifestyle before having a family. Thankfully she did get a permanent job with the bank, after very careful preparation !


By complete contrast, we were then “ taken “ to meet a female Plastic Surgeon, in one of her 9 private clinics. Anita chatted to an 18 year old Filipina who was to have laser treatment for “ under-arm whitening “. She was typical of an “ increasing number of younger Filipinos “ able to afford such treatment.


Apparently the “ average number “ of babies for each Filipina has fallen from 5 to 3 in the past 30 years. This reflects a trend elsewhere in the world.



Rosalie ( already with 6 kids ) was desperate to be delivered naturally, and not by Caesarian Section, because the cost of that would “ bankrupt the family “ … money being their “ biggest worry “. Thankfully it WAS a natural childbirth ! The boy did however have “ an uncertain future; born into poverty in a tough city; with no safety net “, although Anita added that “ there is hope now there WILL be a better life “. Indeed the programme ended on the optimistic note that “ after decades of stagnation and poverty, children born today COULD be as wealthy as Westerners ! “


There were omissions in the programme ( no mention of Reproductive Health Act ; or statistics such as the Philippines birth rate, at around 25/1000 population, twice that of the UK; infant mortality rate, around 18/1000 live births, over four times that of the UK; maternal mortality rate, at between 100 and over 200/100,000 live births, at least eight times that of the UK ; more than half of Philippine pregnancies are unintended; see also http://filipinaroses.com/showthread....ductive+health
).


But these are minor points – there was a limit to how much could be shown in the available time. I only hope as many members as possible can see this programme .


In the UK, over a quarter of deliveries are by Caesarian Section ( 15% emergency, 10% “ elective “ ). It’s based on clinical need / safety ( and mother’s wishes ). Cost doesn’t directly come into the equation ! I for one find it very hard to accept that necessary treatment for ANY condition ( free at the point of need in the UK ) may be unaffordable in the Philippines - with serious consequences .


Having a notebook by the hospital bedside to write down complaints – as recently recommended in England – is an unfortunate sign of the times here.


How I also wish that others here in the UK appreciate their own NHS compared to the situation in countries such as the Philippines. This programme might have helped !