Tuesday, January 09, 2007

OPINION: VITAL THRESHOLD by Juan Mercado

“Life is the threshold at which all other hopes begin.” And Health Secretary Francisco Duque is talking of how this threshold is surging, seen in our lengthening life expectancies.

In the mid-40s, life was “nasty, brutish and short” with life expectancy at 47 years. Today, it is 70 years, “due to a shift to a healthier life style,” the secretary says. DDT spraying after World War II, in fact, stomped out malaria that helped to lengthen lives.

“We’ve surpassed Thailand’s life expectancy of below 70”, the secretary went on. Thus, more Filipinos will, in William Butler Yeats’ haunting image, “comb grey hair” “Human Development Report 2006”, in fact, reveals that Filipino life expectancy today is 70.2 years. And it is 69.7 years for Thais.

It's a pity that Secretary Duque’s comparison skips the international context. He also didn’t bring out the stark disparities between provinces.

Singaporeans can look forward to 79 years of life. And the Japanese golfer, who tees off here, will probably outlive his Filipino caddy by 12 years. That gap shows what is possible. “That a man’s reach should exceed his grasp/ Or what’s a heaven for?” Browning once asked.

Life expectancy for Pampangenos and Cebuanos is now 72 years, “Philippine Human Development Report” reveals. But people in Tawi-Tawi, Sulu and Maguindanao are handcuffed to life spans that at 52, are almost a generation In between these extremes are people in Kalinga, Apayao, Quirino and Antique : 62 years is within their reach.

These “fault lines” mirror the skewed distribution of wealth, power, and strange hold over resources, by miniscule elite. The richest 20 percent in Metro Manila, for example, consume 45 centavos out of every peso. Mostly huddled in the slums, the poorest 20 percent try to make do with eight centavos.

Poverty is a “state of powerlessness, and not merely the lack of assets and services to meet the most basic of needs.” And chronic hunger spawns lethargy, apathy and ill-health, so widespread, they're taken for granted. Also, horizons of the rich rarely extend beyond their “gated enclaves”. The rich man’s line of sight, the parable tells us, blotted out Lazarus scrounging for crumbs at his gate.

Affluence guarantees these elite aside from summer homes, second cars, trips abroad -food, medical care, shelter, education, clean water, sanitation, aside from summer homes, second cars, trips abroad. These add on years of life, prompting many to ask: Does wealth vest a franchise to life on the few?

We must learn to see these dry-as-dust figures for what they really are: sentences to early deaths for helpless men, women and children. Many never get to thresholds “at which all other hopes begin”.

“Differences in homes, clothing, schools or even diets, are galling enough,” the late National Scientist Dioscoro Umali told Asia Society in New York. “But denial of life and premature graves constitute an obscene injustice…and cuts into the depths of our common humanity. They vest the cries for justice with the pent force of suppressed anger. We will reap the whirlwind if we persist in sowing the wind this way.”

This denial of life probably is seen most vividly in what Secretary Duque frets about: “the increasing number of maternal deaths, especially in rural areas”. Out of every 100,000 deliveries here today, he reports, 270 Filipina mothers die. This is six times the maternal death rate of Thailand which is 44. Why this stark difference?

Far too many Filipina mothers resort to untrained "hilots", the secretary said. DOH is therefore introducing maternity packages. These could steer pregnant women to local health centers, which often are short of medicine, or government hospitals, which invariably are overcrowded.

You deliver a baby in Thailand today; nine out of ten you'll have skilled health personnel in attendance, UN human development indicators. That slumps to only six out of ten in the Philippines. Are we seeing here part of the bill for mass migration of our doctors, nurses or midwives?

Thailand’s smaller population has higher per capita income. Yet, Bangkok spent $260 per capita of its GDP for health. We penny-pinched at $170. No wonder, 99 percent of Thai kids are fully immunized against TB. Compare that to 58 percent for Filipinos. And will Thais, in the future, be taller than Filipinos? Out of every 100 Filipino school kids, 32 are stunted, compared to 13 percent for Thais.

Clean water and sanitation are the most cost-efficient means for whittling death rates, says the UNDP study: “Beyond Scarcity". Some 99 percent of Thais have access improved sanitation. But only 72 percent of Filipinos do In Cuba City, 38 out of every 100 households tap into water supplies of neighbors because of its obsolete municipal system and collapsing aquifers.

The litmus test for those seeking elections in May is what they can do about premature deaths now that will make a difference later. The operative word is now. “Tomorrow is a postdated check. But today is cash.”

As those deaths show, we are a country of great needs. We need models of limited wants. Surely, fewer deaths for Filipina mothers and children are within our reach. We have the resources, the technology, and the human skills to ensure that the “threshold where all other hopes begin” need not close. But who has the backbone?

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