By Amina Evangelista Swanepoel
Palawan consistently tops international lists of best paradise islands in the world or lists of top 10 places to go before you die. We Palaweños are very proud of these distinctions. However, there are other lists that Palawan also tops that people know less about. Palawan has three major health problems that are gaining recognition, but not in a positive way.
Palawan’s three major health problems are: a high rate of teenage pregnancy, a high maternal mortality rate and a rapidly increasing rate of HIV. These issues affect us all.
We have one of the highest teen pregnancy rates in the Philippines. In our country, 20% of births are to teenage mothers. Palawan’s overall teen pregnancy rate is 25%, which is up from 21% in 2012. In some municipalities such as Roxas and El Nido the rate is even higher. Young people in Palawan are having sex, and they are not using contraceptives. This result is the phenomenon of the “batang ina” or teen mother. When young girls get pregnant, their pregnancies are very high risk, as their bodies are not yet ready for a baby. Aside from health risks to the girl and her baby, there are also other long-term implications. Teen pregnancy is one of the biggest reasons that girls drop out of high school. When a girl doesn’t complete high school, her opportunities for future employment are severely limited. Young mothers and young parents also put a lot of pressure on their families to help support the new baby. Families already living in poverty really struggle when they have to take care of more children.
Maternal mortality describes the number of women and girls who die of preventable complications during pregnancy or childbirth. Our country’s UN Millennium Development Goal was to decrease the maternal mortality rate to 52 deaths per 100,000 live births by 2015 but sadly our rate is increasing. Palawan had a maternal mortality rate of 138 per 100,000 live births in 2014 and 2015’s expected rate is even higher. Many women in Palawan really believe the old adage, “Ang isang paa ng buntis ay laging nasa hukay” (A pregnant woman has a foot in the grave).
Finally, the Philippines is one of only seven countries in the world where the rate of infection from the Human Immunodeficiency Virus (HIV) is still increasing. Palawan has one of the fastest growing rates of infection within the Philippines and the highest rate of infection in MIMAROPA. It has become such a big problem here that the Department of Health has opened an HIV treatment center in Puerto Princesa so that people living with HIV can get treatment here instead of going to Manila. Since 1984 Palawan has had 55 cases of HIV. This is not the highest number, and our rate was low for many years, but 28 of these 55 cases were registered just this year, which shows how fast it is increasing.
Some like to think that HIV only affects the gay population, and men who have sex with men (MSM). Others like to blame tourism as the reason our HIV rate is increasing. But doctors in Palawan say that they are seeing HIV among young people and women. The Philippines has a low rate of condom use and this is one of the reasons for HIV’s rapid spread. People are having sex and they aren’t using protection. The Puerto Princesa City Health Office also reports that many pregnant women who get tested for sexually transmitted infections (STI) are positive for gonorrhea, chlamydia and syphilis. These infections make one more at risk for HIV infection.
So, what can be done to combat these problems? The City and Provincial Health Departments are making efforts to tackle these huge problems, with support from civil society organizations like Ugat ng Kalusugan and Project H4. Ugat ng Kalusugan provides reproductive health education and clinical services to underserved women and girls in communities and high schools. Project H4 provides counseling and testing services so people can know their HIV status. They also provide clinical services and support to people living with HIV. Barangay Health Centers provide free prenatal care to pregnant women and girls. The Population Commission’s Social Hygiene Clinic at City Hall and the City Health Office Laboratory in Mendoza Park both provide free STI (including HIV) screening.
What can we as Palaweños do? A first step is to acknowledge the issues and to talk about possible solutions. So many people have no idea we have these problems, and awareness is an important step. We must talk to young people about relationships, sexuality and health. It is crucial that women have proper birth spacing, receive prenatal care and give birth with a skilled birth attendant like a midwife, nurse or doctor. We must also take precautions with sexual activity, including using condoms, especially when one has multiple sex partners.