Amid a lockdown, staffing shortages and overcrowded hospitals, women are losing access to family planning services and essential lifesaving care. Ana P. Santos reports from Manila.
As already scarce medical resources are being redirected to respond to COVID-19, women in need of maternal and reproductive health services are paying the price.
According to government data, family planning services were reduced by over 50% in March, when a lockdown was declared to curb the spread of coronavirus.
"The suspension of public transportation, limited clinic staff and reduced clinic hours have made it difficult for women to access family planning services," said Juan Antonio Perez, executive director of the Commission on Population and Development.
According to Perez, a number of government-run reproductive health clinics are operating with only two-thirds of their regular staff, as many health care workers have been unable to get to the clinics due to lockdown measures.
To fill in the gap, government health workers have started going door-to-door to deliver birth control that will last for up to three months. Additionally, telephone hotlines have been set up for remote medical consultations, in place of face-to-face doctor visits.
"It's too early to tell what the full impact of this pandemic on reproductive health will be, but we are trying to stay ahead of the curve," Perez told DW.
As of May 15, the Southeast Asian island nation, which has the third highest number of cases in the region, had recorded 11,876 COVID-19 cases and 790 deaths, according to Johns Hopkins University.
Millions cut off from services
The United Nations Population Fund (UNFPA) estimates that 47 million women in low and middle income countries like the Philippines may not be able to access modern contraceptives, as overwhelmed health care systems close facilities or limit family planning services due to staff shortages.
If lockdown measures continue for another six months, such a health care shortage could cause 7 million unintended pregnancies, according to UNFPA estimates.
Earlier this week, authorities extended lockdown measures in the capital of Manila and neighboring cities until the end of May, while allowing certain industries to resume operations in order to jumpstart the economy.
But some women, like 26-year-old Dimples Ortiz, are suffering. Ortiz 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. She wasn't able to get another dose of her contraceptive injection, and fears an untimely pregnancy that would add to her financial worries.
"My eldest child has a disability. We don’t know when my husband can find work again. I cannot get pregnant," Ortiz told DW.
In her desperation, she reached out to the Likhaan Center for Women’s Health – an organization that runs community clinics. Likhaan then arranged to pick Ortiz up from her home, and take her to get a free contraceptive implant.
"In some areas under lockdown, you can only go out on certain days and only at specific times," said Diane Vere, who works for the Likhaan Center.
"Women now have to choose how to spend their limited time. Do they go to the market, go to get their social assistance from the government or go to the clinic for their family planning needs? Each activity could entail hours of waiting in long lines. How do you choose?" she said.
An overwhelmed system
Meanwhile, reproductive health advocates are demanding urgent action to address the increasing number of pregnant women who are being rejected by hospitals.
Last month, a 26-year-old woman died after six hospitals refused to admit her because they were either full or understaffed. The woman, Katherine Bulatao, had given birth at home but died of blood loss afterwards.
Another woman, Mary Jane Alpide, died in labor after being turned away from four hospitals, and finally being admitted to the fifth, according to the Center for Reproductive Rights. The center says it has received at least three reports of pregnant women being refused treatment by hospitals.
"Obstetric emergencies cannot be scheduled. The current pandemic and resource constraints do not justify the refusal of lifesaving medical attention," Jihan Jacob, the Asia Legal Adviser of the Center for Reproductive Rights told DW.
The shortcomings in the Philippines' health care system have long been apparent, but Jacob fears that conditions are becoming even worse due to the pandemic.
"Deaths of women like Bulatao and Alpide are preventable. The fact that it happened is a failure of our health care system," she said.