The Philippines is one of the fastest growing populations in the world, driven by many sociocultural factors and a conservative culture that balks at providing women with responsible reproductive health services. One of the epicenters of that population growth is the Dr. Jose Fabella Memorial Hospital, the busiest maternal hospital in the country, and quite possibly the entire world. The hospital is called a "Baby Factory" because of the sheer volume of patients coming through its doors every day. I have colleagues and friends who have trained or had a tour of duty at Fabella, and nothing really prepares you for it. As a doctor, and having trained in a similar government tertiary institution myself, the birth rate statistics we see in pie charts and graphs aren't merely numbers to us. In the maternity wards and delivery rooms of the Philippines they're very tangible and real.
Ramona Diaz's documentary, Motherland, takes us on a tour through Fabella and the patients who stay there. The topic has been explored before in fictional narrative films like Eduardo Roy's 2011 film Bahay Bata, but few films have captured the hospital in such a comprehensive manner. The crew of Motherland spent several weeks in the hospital, documenting and following the lives of a number of patients. The film is immersive and lets us see the hospital as is, letting stories unfurl naturally. These patients are some of the poorest of the poor, with little to no money to cover the medical expenses of giving birth. To foreigners, especially Americans with their astronomical healthcare premiums, these prices may look like paltry sums, but to patients like these who barely make 50-150 pesos (1-3 USD) a day, the expenses incurred are crippling debts that may never be paid.
The film shows us the myriad problems that Filipinos face regarding health seeking behavior, cultural problems and lack of education regarding reproductive health. There are no incubators, so hospital staff has to improvise and provide alternatives for premature infants. A woman who has not had even one prenatal checkup for her pregnancy learns that she is giving birth to twins on the day of birth itself. A very young mother, the oldest of ten siblings, refuses to have an IUD installed because her mother disapproves of it. Mothers talk about their unemployed husbands who have trouble finding steady work and financial compensation for their children. These are mothers with four, five, even six or more children, far more than what they can sustain financially. These people share their voices and their stories to us to help us understand the problems they face whenever they bring a new life to the world.
The film shows that reproductive health options are readily available to these women. The bottom line is, they either don't know about their options or they refuse these options because of misguided beliefs or ignorance or societal pressure. The onus is up to medical professionals, educators and policymakers to help our fellow Filipinos know about reproductive rights and the implications of these rights on their lives. It's also a wake up call for men to get off their pedestal of privilege and actively help as a partner in their spouses' reproductive responsibilities.
One might expect that Motherland is grim and dark, but the film has a good deal of charm and humor. Despite the many hardships these women face on a day to day basis, they're very upbeat and humorous about it. The medical staff also helps these mothers by cheering them up every once in a while. That is, in my opinion, a very Filipino way of dealing with things.
Motherland is an essential documentary that I think everyone needs to see, especially lawmakers and people in positions that can make a difference. No cultural tenet, screed, scripture or belief can beat seeing a previously nebulous problem become palpable reality by giving these women a platform to help them speak for themselves.
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Motherland is part of the Active Vista festival that aims to discuss human rights and intersect them with film, visual art and other media. Find out more at their official website. Another public screening of the documentary will take place today at the Shang Cineplex.
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