| 30
July 2002
Quiapo, Washington, Cytotec
THE HIDDEN camera takes a long shot of
the vendor in Manila's Quiapo district, then zooms in on her necklace
– "proof", as far as the TV show's host is concerned, that
she has made lots of money selling the abortifacient Cytotec.
The whole operation, including the hidden cameras, is part of a set-up,
organized by a television channel and the police to trap the vendor. An
"asset" buys the tablets and a few minutes later, the police
move in to arrest the vendors. The camera follows their interrogation in
a police vehicle. The policeman curses the women several times, the
invectives beeped out for the desired dramatic effect. At the end of the
segment, the commentator, in dark sunglasses and standing in front of an
Army-type vehicle, booms: "We'll keep coming back for you."
Every few weeks some "investigative journalist" has to pick up
on the Cytotec issue, as if it were something new. The police storm
Quiapo, make a few arrests, and disperse the vendors. Shortly
afterwards, sometimes within a few days, the stalls are back.
The mass media's coverage of Cytotec is hypocritical, pretending to be
part of a morality campaign but, like all of moralism, ends up
capitalizing on people's despair and misery. There are little or no
attempts to explain why abortion occurs in the first place, or what this
Cytotec is.
Cytotec's generic name is misoprostol, which is different from
mifepristone or RU-486, the "abortion pill" approved in the
United States in 2000. Cytotec was available, legally, for many years in
the Philippines as a drug to prevent gastrointestinal bleeding in people
taking certain arthritis drugs. But Cytotec's package inserts also
warned about an important side effect: it causes the uterus to contract
and therefore should not be taken by pregnant women.
That side effect eventually became Cytotec's main indication, for which
it has been sold for many years now, in front of the Quiapo church,
together with herbal preparations to "bring back the
menstruation". Cytotec's local distributor eventually withdrew the
drug but it's now smuggled in illegally from neighboring countries and
is sold underground in many of the Philippines' major cities.
In the United States, Cytotec is used in combination with other
abortifacients for pregnancies up to seven weeks. Women are first given
either RU486, or the drug methotrexate, which starts the abortion. A few
days later Cytotec is administered to complete the abortion. The
combination of the two drugs, administered under medical supervision, is
safe and effective.
The latest edition of "Managing Contraception," an American
publication giving updated information on family planning methods,
advises against using misoprostol alone because it does not always lead
to a complete abortion. The book notes that there are other "safe
alternative regimens".
But in the Philippines, women have to contend with misoprostol, bought
off Quiapo and administered at home without medical advice or
supervision. Vendors claim Cytotec will work in pregnancies of up to
three or four months. Each dose of several tablets can run up to several
hundred pesos, but this is still cheaper than the thousands of pesos
charged by clandestine clinics for surgical abortion. Only the herbal
concoctions are cheaper, but the vendors themselves will tell you
they're not very effective. Safety? Cytotec has its risks but it is
certainly much safer than using improvised catheters-a hanger, for
example.
The media people have a field day with their cameras, aware of the
ironies surrounding the Cytotec trade in Quiapo. This is the heart of
Manila, a city whose mayor has banned artificial contraception from all
government centers. Housing the Black Nazarene, the Quiapo church is
also a spiritual center of the city. Cytotec is actually sold together
with amulets, rosaries and other religious items.
I wouldn't be surprised if women did in fact buy a prayer book to go
with the Cytotec. They're not sure how the drug works, if it works. The
instructions, scribbled on pad paper, and varying according to the stage
of pregnancy and the vendor, are cold and cryptic: Drink X tablets. Lie
down. Put X tablets in your vagina. Do not stand until the next morning.
Do not eat anything sour.
The vendors don't always explain the possible side effects, which can
range from mild cramps to bleeding and infections. An incomplete
abortion, or heavy bleeding, can be serious enough to require
hospitalization. It can be a long, harrowing night of waiting, of
uncertainty, of praying.
But all these illegal abortions are going to continue as long as women
can't access information and services for family planning. The Catholic
Church says we should stick to natural family planning but there are few
parishes with such programs in place. The government's family planning
program is hobbled as well, with the President preferring to keep silent
about the population program. Elections are around the corner in 2004
and she's unwilling to antagonize conservative Roman Catholic leaders.
The US government has cut back its support for family planning, thanks
to a conservative Bush presidency. They're no longer supplying
contraceptives to the Philippines, hoping our government will cough up
its own funds for such purchases. This has not happened.
Not content with cutting back on American government programs, Bush last
week vetoed a congressional allocation of 34 million dollars for the UN
Population Fund (UNFPA), supposedly because it was supporting abortion
in China. Never mind that the US government's own fact-finding team
found no evidence to support that claim, filed by an American group
opposed to family planning. Bush, with his own 2004 elections coming up,
is also beholden to religious conservatives.
Decisions in Washington affect the lives of people everywhere. Expect
more abortions. Expect more raids and Rambo-style television coverage.
The Cytotec vendors just keep spreading out, creating a wider ring
around the church in Quiapo. Maybe they'll eventually move out of the
area, but word will spread and people will follow. There will be more
long nights with Cytotec.
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