Ramona Vijeyarasa on October 2, 2008 – 8:00am
Ramona Vijeyarasa’s blog
East Timor, the world’s newest nation, is currently threatened with a soaring population, expected to double by 2020. UNFPA reports that Timor-Leste has the highest fertility rate in the world, averaging 7.8 children per woman. It is additionally alarming that countries with high birth rates tends to have high maternal and infant mortality. Reliable child and maternal mortality rates are hard to obtain for East Timor, but it is unquestionable that the poor quality and accessibility of family planning has directly impacted the health of Timorese women and children. According to WHO, East Timor has a maternal mortality rate of 380 deaths per 100,000 live births. UNICEF report correspondingly shocking rates of death exist for infants and children under the age of five, with an under-five mortality rate of 55 per 1,000 live births in 2006, and an infant mortality rate of 47 in 2006.
It is promising that the former-President, turned Prime Minister, Xanana Gusmao, recently noted that “fertility is a matter of education”. Improved access to family planning education and services together are vital not only as a matter of reproductive choice but to ensure that East Timor achieves some level of sustainable development. Yet, this “new approach” may have to face the notable influence of the Catholic Church. If the state of family planning in the Philippines, the other predominantly Catholic country in Asia, is a reflection of what is to come in East Timor, we should be alarmed. Millions of Filipino women of reproductive age have limited or no access to modern contraceptives. National figures suggest almost half of all pregnancies in the Philippines are unwanted, especially in rural areas and amongst low-income families. The entrenchment of fundamentalist religious beliefs in laws and policies and the promotion of “natural family planning” have undermined women’s choice and posed grave threats to their health and lives.
Low rates of contraceptive prevalence in East Timor are equally alarming, though, in this case, the Catholic Church has taken a more reasonable stance and has been more receptive to the promotion of contraceptives. According to WHO, only around 22% of the Timorese use modern contraceptives. Lack of awareness about contraceptives amongst the population is potent, with the former first lady and Prime Minister’s wife, Kirsty Gusmao affirming that the combination of poor education, poverty and the influence of the Catholic Church means that contraception is rarely discussed. According to a survey conducted in 2003 by the Ministry of Health, over 94% of currently married female adolescents and 87% of 20-24-year-old currently married young women were not using any contraception. The survey also reported that more than 90% of youth did not receive any information on family planning.
When it comes to abortion, the Catholic Church in the Philippines and East Timor are much more in sinc. The Philippines has one of the most restrictive abortion laws in the world, with no express exception to save a woman’s life, and penalizing both the woman and her provider. Criminalization of abortion has resulted in a overwhelming number of illegal and unsafe abortions. In 2000, approximately 473,000 women had abortions and an estimated 79,000 women were hospitalized for complications arising from the abortion. Similarly, the Timorese Government and Catholic Church do not endorse abortion and the Timorese law severely punishes abortion, even when the mother’s life is in danger.
Despite the sensitivity of discussing sexual health and family planning, the health needs of Timorese cannot be ignored. Achieving high standards of reproductive health is not only a question of reproductive choice. It is in fact essential to the achievement of sustainable development for East Timor, a country that is evidently still very much undergoing transition.