IUD removals in Bukidnon

The removals of IUDs (intrauterine devices) by a medical practitioner from Misamis Oriental have created quite a commotion among family planning advocates, members of the Serve Life Ministry of the Archdiocese of Cagayan de Oro City, and local government unit officials of Bukidnon as well as the provincial governor of Bukidnon.

Two questions are involved here. One is whether a medical practitioner can remove the IUDs on the basis of her religious belief, and the other, as the officers of the Commission on Population claim, whether her doing so is a breach in the constitutional provision on the separation of Church and State.

The story began on March 10 last year when the Serve Life Ministry of the Archdiocese of Cagayan de Oro conducted a symposium on family planning at Barangay Poblacion in Malaybalay, Bukidnon, with emphasis against artificial family planning (pills, condoms, and IUD, among government-approved artificial family planning devices). According to Dr. Ronnie P. Bongcogan, MD, Malitbog Municipal Health Officer, the symposium was followed by a call for IUD users to come forward and have their IUDs removed; 16 IUD users had their IUDs removed by Dr. Marites Echaves, who had claimed during the symposium that the IUD insertions were not aseptic, and that during the insertions, the municipal health office was introducing bacterial or microbiologic contamination to the uterus. The removals were repeated on April 21, at Barangay San Luis with 12 family planning acceptors having their IUDs removed.

The removals by Dr. Echaves of Laguindingan, Misamis Oriental reached Provincial Governor Jose Ma. R. Zubiri Jr., who wrote Dr. Echaves in a letter dated April 23, 2002, that what she had done was in "total disregard of professionalism", and that the IUD "is one of the accepted methods in the National Family Planning Program of the government. Attacking a government program is tantamount to economic sabotage, which is punishable by law."

The reports on the IUD removals were actually divulged by Mayor Socorro O. Acosta of Manolo Fortich, province of Bukidnon, during a program of the Local Advocacy Project Phase 3 (LAP 3) in Manolo Fortich. Mayor Osmundo dela Rosa of Malitbog confirmed the removals in Malitbog. Subsequently, POPCOM Regional Director Psyche Paler formed a team to look into the reports, secured documents related to the case, and interviewed some of the women.

In defense of Dr. Echaves, officers of non-government institutions (Educhild Foundation, Inc., Kahayag sa Dios Community, Christian Family Movement, Higala Foundation, Christian Family & Life Apostolate, and Religious Studies Department of Xavier University, among others), wrote Governor Zubiri, saying that no government facilities were used in the removal. They said that that the Ministry’s criticism and rejection of the IUD and the pill were done "with utmost regard to the sanctity of life. Many of the women patients who have had IDs and or pills have various ailments which were shown to be directly related to their use of contraceptives such as cervical erosions and infections." In fact, one patient was found to have breast mass and when interviewed, she said she had a history of Depo Provera injections for one year; later she underwent surgery to have the mass removed. The letter said that the said ailments were detected earlier because of the timely services given by the Ministry, and that Depo Provera is banned in other countries "for its carcinogenic effects . . . but is injected to our Filipino women."

Serve Life Ministry officers said that the facility of the Malitbog Provincial Hospital was not used, and the local residents and the general public were the recipients of the doctor-specialist‚s operations. They cited the ruling of the Supreme Court in P.P. vs. Fernandez, CA GR. No. L-1128 which "does not inhibit the use of public property for religious purposes when the character of such use is merely incidental to a temporary use which is available indiscriminately to the public in general." A case in point is the public street which is used for a religious procession or a public plaza for a religious rally and political assembly, they said.

Dr. Echaves wrote Governor Zubiri, saying that under her oath as a doctor, she could not refuse patients "who come to me for treatment or to have their IUDs removed when they are already suffering from complications". The use of the provincial hospital was not her decision as an invited guest but was offered to her only and she used instruments provided by the Ministry. "I believe in the Church teachings to uphold and protect life for which I am safeguarded by constitutional guarantees." My own observation was that the Ministry intended to have the procedures made, thus it provided the instruments used by Dr. Echaves. Incidentally, documents reaching me say that the doctor had previously performed similar procedures in other places.

As of May 23, 2003, Tom Osias, POPCOM executive director, wrote Psyche Paler of the POPCOM board of directors‚ recommending that concerned institutions should allow family planning users to shift to the Natural Family Planning methods advocated by the Catholic Church and other parties before IUD removals are undertaken. This approach will entail a conduct of dialogue with the Diocese of Bukidnon as well as with the agency promoting NFP in the area.

The decision had been made upon the clarification of Dr. Jondie Flavier that it was Natural Family Planning advocates who brought the matter of IUD removals to the attention of the media, and that it was all right for IUDs to be removed but "the Church should have taken advantage of the opportunity to allow the women to shift to natural family planning methods before removals are undertaken". It was ironic, Dr. Flavier said, that the removals were made in Bukidnon, which has been very receptive to natural family planning methods, including the newly-introduced Standard Days Method.

Dr. Flavier recommended "a softer response to this kind of situation – that instead of condemning, maybe there is a need to request concerned institutions to allow NFP promoters in the area to inform/train users on other natural family planning methods before removals are undertaken".

So, then, Dr. Echaves and other doctors of similar religious persuasion may have to promote other family planing methods before extracting IUDs from women’s bodies.

* * * E-mail: [email protected]