Basilan Province is an island 30 minutes away by sea from mainland Zamboanga City. It has a total land area of approximately 1,279 sq. kilometers and a total population of 332, 828 (NSO 2000). Despite its beauty and richness both in resources and in culture, Basilan is best known for only one thing: the extremist group Abu Sayyaf. Since the group first sowed terror in the early 90’s, the once underdeveloped but peaceful, tranquil island has become one of the poorest provinces in the country and battleground of the military and the Abu Sayyaf.

This tragic plight of the province is made even worst by the government’s response to the situation. Militarization alone is bad enough, couple this with a dwindling budgetary allocation, and you get a dying province. In 2001, Mindanao, of which Basilan is part of, was allocated a measly P100.7 Billion or 13.90% of the national budget. In 2002, it fell to P92.93 billion or 11.90%. In 2003, Mindanao’s share fell to a mere P84.86 Billion or a pitiful 10.55% of the national budget. This is further divided among the different cities and provinces in the region, many of which are the poorest in the country and are war-torn areas, with more or less half a million evacuees to be fed.

Welcome to Basilan. Welcome to Mindanao.

 MEH KARENDEHAN SI BASILAN (THE WOMEN OF BASILAN)

Based on the 2000 census, out of the total population of Basilan, 60% are women. Of these, 69,894 are women of reproductive age. Majority of these women are Muslims and as such, her struggle is tripled.

In a highly patriarchal Moro culture, she struggles in asserting her rights as a woman. In a province plagued by war, she struggles to keep her family alive. In a country where Muslims are second rate citizens, she struggles against discrimination while struggling to preserve her identity as a Muslim. Indeed, struggle is an all too familiar word to a Muslim woman in Basilan.

In the year 2000, there were at least 3,207 families displaced due to armed operations and encounters between the military and lawless elements in the province. In 2001, the number increased to a whopping 15, 650 families with 74, 630 dependents. Translate this to 15,650 mothers looking after 74, 630 children, making a home out of the

little space assigned to her family in evacuation areas, looking for whatever food she could serve her family, tending to her sick or perhaps injured children or husband, and the others, mourning over the tragic loss of a loved one. At the end of the day, it is she who suffers most, it is she who pays for the miserable cost of war.

 INE REPRODUCTIVE HEALTH? (WHAT REPRODUCTIVE HEALTH?)

Given the above picture of the Muslim woman in Basilan, it is highly expected that her overall health comes last in her priorities, if it is a priority at all. Much more ignored is her reproductive health, if she is aware of it at all.

A recent interview with health workers in the province however revealed a different perspective of how Muslim women there confront reproductive health issues. Although the presumption presented can not be totally ruled out, there is a significant deviation from what was expected. They are aware of the problems, and are calling for solutions.

Almost all health workers, who are either nurses or midwives in the local health offices and centers echoed the same report. The clamor for family planning methods is overwhelming. Everyday, an increasing number of women are going to the health centers, asking for condoms, pills, IUD insertions, Depo shots and others. Unfortunately, none of these are available in the said centers.

As stated lately by the Dep’t. of Health Secretary, family planning is not the business of the government. This is heard loud and clear to as far as Basilan province. So who’s business is it then? What options do these women have?

From January to June of this year, Basilan General Hospital reported 15 cases of abortion. Quite a shocking figure for a small, conservative, Muslim-dominated province. And we have not looked into the unreported cases yet. .

As one nurse from the Lamitan Health Office said, “women are more open to abortions these days.” She narrated that once, a Muslim woman wearing a hijab casually walked up to her and asked what she can take to abort her pregnancy. A Muslim herself, the nurse was beyond belief! When she refused, the woman insisted, telling her that she is not asking for the medicine, just a prescription. Or even without a prescription, just the name of the medicine.

In Isabela City, where there are 23,213 women of reproductive age, there is a one-woman FPOP Center. For the second quarter of 2004, she has a total of 568 regular acceptors, majority of whom are Muslims. Services include are family planning orientations and methods such as pills, condoms, DMPA, IUD insertions and spermicides. They also conduct breast examinations and pap smears. Being the only FPOP Center in the entire province, there are also acceptors from other municipalities. Usually, whenever they or their husbands go to Isabela for any other errands, they visit the FPOP Center. She also related an instance when a Muslim woman asked for cytotec
which she blatantly admitted she will use for abortion. The nurse refused. The woman went on to tell the nurse not to feel guilty, it will be her own sin anyway.

In the municipality of Maluso, the nurse there is more concerned with the possible incidence of sexually-transmitted diseases. What used to be a highly conservative, backward town, Maluso’s night life became more lively with the conduct of the Balikatan exercises. Night clubs opened and prostitution became rampant. Today, even after the Balikatan, the clubs continue to operate.

Though there are no reported cases yet, the health workers can not dismiss the possibility. No one agrees to medical examinations and even if there are, the center does not have the capability to conduct such.

As for Lantawan municipality, their biggest challenge is accessibility of the areas. Aside from being an Abu Sayyaf lair, the municipality includes 10 island-barangays. With no hazard pay or transportation allowance, the health workers hire fishing boats out of their own pockets, braving waves and storms to get to these barangays. Worst, upon reaching their areas, all they can do is, as what one midwife said, “nagtitinginan lang kami.” (We just look at each other). The last time they distributed medicines was more than a year ago, in a medical outreach conducted in the barangay of Lubukan after an armed conflict. But as to when the last time health centers were given medicines? They can no longer remember.

This predicament has also robbed Lantawan of the rare opportunity of having a Municipal doctor. After ten years without a doctor, Lantawan finally had one through the Doctor to the Barrio program. But he only lasted for a little more than a year. Dr. Omar gave up. He said there is nothing more demoralizing than being a doctor with no use.

For the year 2003, Lantawan has reported 4 cases of maternal mortality, due to placental retention and hemorrhage.

The interview made with the Muslim women and health workers in Basilan revealed the following:

A. PREFERRED FAMILY PLANNING METHODS:

1. Pills
2. DMPA
3. IUD insertion
4. Natural method
– symptothermal
– standard days method
– Basal body temperature
5. Condoms
6. Ligation
7. Spermicide

B. CAUSES/REASONS OF INDUCED ABORTION:

1. Poverty
2. unplanned pregnancies
3. work abroad
4. maintain figure

C. CAUSES OF SPONTANEOUS ABORTION:

1. Poverty
– malnutrition
– work labor
– incapacity to access medical assistance in cases of threatened abortions
2. Illness
3. Evacuations in times of armed conflict

D. CAUSES OF MATERNAL MORTALITY

1. Deliveries by untrained hilots
– placental retention
– hemorrhage
– eclamsia
– hypertension

2. No pre-natal care
– non detection of illness or positioning of the fetus
– malnutrition

3. Inaccessibility to hospitals or other facilities in case of emergencies
– no transportation
– distance
– rough, non-passable roads

E. FACTORS AFFECTING DELIVERY OF REPRODUCTIVE HEALTH SERVICES

1. Reproductive health is not a priority of local government units
– no medicines and other facilities
– lack of trainings

2. Muslim culture and traditions

3. Peace and order situation

Statistical analysis of reproductive health indicators may prove to be inadequate considering there are more unreported cases than those which are reported. Though it may still be used as baseline for future studies, it cannot be reflective of the real situation of the Muslim women in Basilan.

With the above limitation, it is hereby opted that stories of three different Muslim women be told in an effort to paint a vivid picture of the realities confronting the Muslim women in Basilan in general.

 SHE AND THE ABU SAYYAF

Elsa was already an elementary public school teacher in Basilan when she met Rashid, who was then a 3^rd year Engineering student at the Zamboanga A.E. College. He was a religious Muslim and was very much into Islamic fundamentalism. It was only after almost a year in their relationship that she learned of his involvement with the Harakatul Islaamiya or commonly known as the Abu Sayyaf. She only knew of this when she told Rashid of her pregnancy. Rashid was not ready for marriage. They decided not to have the baby, foremost out of fear of public humiliation, considering Rashid’s presumed spiritual ascendancy as an Abu Sayyaf, and pre-marital sex is highly immoral in Islam.

After 2 years they finally decided to get married. Rashid dropped out of school and went into the jungles of Basilan, answering the call to Jihad of the Abu Sayyaf. Elsa had 3 more abortions, without Rashid’s knowledge. She said it was not really because of economic reasons, though they were also factors. It was more of her fear of loosing her husband, of raising a child alone, without a father. Whenever there are reports of military operations or encounters with the Abu Sayyaf, she is tortured with thoughts of Rashid being dead. She can not imagine giving that kind of life to an innocent child.

When Abdurajak Janjalani died in 1999, Rashid decided to quit. They opened their own business and tried to start over again. Elsa couldn’t ask for more. All they lack are little ones to make their life complete. But to this time, they never came. Rashid married another woman and now have 2 children with this second wife. Though he did not divorce Elsa, he rarely visits her.

All Elsa could blame is herself. She thinks those successive induced abortions caused her sterility. She did not give in to Rashid’s demand that they consult a doctor. She was afraid Rashid might find out about those abortions, convinced that he will kill her. She chose to keep her secret and carry the grudges alone.

 SHE AND POLYGAMY

Orphaned at 19, Nisar was helpless when her relatives forced her to marry a distant uncle. They said marrying an older man will give her financial security and being her uncle, she is assured of being treated well. They all said it was best for her, even if she was the fourth wife.

In two months, she was pregnant. But her husband’s rice smuggling business was not doing well. He said he can not afford to raise another child. He had 4 children with his 1^st wife, 6 with his 2^nd wife and another 4 with his 3^rd wife. He then brought her to a “doctor” in Zamboanga City.

All Nisar could remember was the excruciating pain, but she did not resist. She did not have the strength to defy her husband’s will. Even if she decides to keep the baby, she believes she does not have the means to support it. She just kept crying, apologizing to the baby who was meant to be her first.

 SHE AND POVERTY

Nur-aina was the Barangay Health worker of Upper Manggas, Lantawan, Basilan. Being a BHW, she was aware of the risks of delivering the baby in the hands of a hilot. But much as she wanted a hospital delivery, they can not afford it. Her husband was a mere farmer and as a BHW, she only received an allowance of P500 per quarter.

Babuh was a trained hilot but was already in her mid 70s. The Municipal health nurse have already prohibited her from conducting deliveries knowing the high risk of doing such at her age. But when Nur-aina started to labor, her family called Babuh, being a relative.

The baby came out smoothly but the placenta remained inside longer that what babuh expected. She became impatient and started pulling what she thought was the placenta until it came out. She placed in a bag and brought it for a customary Tausug ritual. But after a while, Nur-aina started bleeding profusely and gasping for air. She was sweating and trembling, begging her husband to bring her to the hospital, 20 kilometers away. On the way to the hospital however, she died. Her husband related that her last words were instructions to him, telling him to bring their baby religiously to the health center for immunizations.

When they reached the hospital, it was found out that what babuh pulled out was not the placenta but the uterus.

These stories of the women of Basilan is a reflection of the totality of our condition in the province. Our struggle against religious and cultural chauvinism, against war, against poverty, leaves us with no choice but turn a blind eye to our personal health, more so our reproductive health.

This most sorry state of our women is indeed a violation of what Islam guarantees for women. A guarantee which is best perhaps described in the Hadith : “The best among you is he who is best in character. And the best in character is he who is best to women.”