the Philippines, a case study

The Philippines, with per capita GDP (PPP) of about $5,000 (2006 estimate) and a land area smaller than California, has rapid population growth, low contraceptive use, high poverty, and a fast growing economy (5.4% annually). Of the 91 million Filipinos (July 2007 estimate), 40% live in poverty, 16% on less than a dollar a day, and 10% live and work in other countries. The remittances of the OFW’s (Overseas Filipino Workers also known as bagong bayani, “new heroes” in Tagalog) account for almost one tenth of GDP. (The government offers annual Bagong Bayani Awards given out by the president.)

In case you don’t remember where the Philippines is:

A few comparisons with California:

[Making the comparison more poignant, about 40% of new immigrants from the Philippines to the US choose to settle in California.]

Fast growing Asian economies are often touted as the answer to both poverty and population growth, yet a number of business leaders in the Philippines disagree. Senen Bacani, business owner and former Secretary of Agriculture, said in a speech to the Philippine Economic Society:

Amid all the hype about [the Philippines'] favorable economic indicators, the fact remains that its benefits have not trickled down to the poor, most especially the rural poor. In fact, a social weather survey conducted last Sept. 2-5, 2007 revealed that a new national hunger record was set, with 21.5 percent of households reported as suffering from hunger, without having anything to eat, at least once during the three months preceding the survey.

What is wrong with our development model? Isn’t it ironic that with increased GDP growth, reduced fiscal deficit and other favorable economic parameters, we are faced with the growing reality of undernourishment and hunger among our rural poor — our citizens who ironically enough, produce the bulk of our food?

…

A national population policy, at the core of which are well-funded family planning programs that provide accurate information and access to all methods of contraception, is pro-poor, pro-women, pro-people and pro-life.

A few facts from the Philipines’ National Statistics Office (NSO):

• In the period from 1990 to 2000 the Philippines had an average annual population growth rate of 2.34% (30-year doubling time), among the highest in the world.
• The projected growth rate for 2005 to 2010 under the “medium” scenario is 1.95% (37-year doubling time) — still high even compared to other developing countries in Asia.
• The proportion of currently married women in the reproductive ages of 15 to 49 years reporting current use of any contraceptive method was 49.3 percent in 2004.

According to the NSO, the population would continue to grow to 112 million by 2020, to 128 million by 2030, and to 142 million by 2040, even if the annual population growth rate eventually falls to 1 percent in the 2030-2040 period. [source]

In 2004 Population Reference Bureau senior editor Allison Tarmann wrote,

Continued ambivalence and resistance at the national level on the merits, the morals, and the means of birth control have prompted business executives in the Philippines to call for a national campaign on family planning. The business leaders cite the need to check rapid growth of the Philippine population to stimulate further economic growth, create more jobs, reduce poverty, and improve health. They say they must act because political leaders have vacillated under pressure from the Catholic Church to limit the availability of modern methods and because the United States has begun phasing out contraceptive commodity assistance to invest those funds in other family planning activities.

Donald Dee, past president of the Employers Confederation of the Philippines (ECOP), explained the private sector’s interest. “Business leaders used to equate a growing population with an expanding market. Now they see declining purchasing power,” he said.

The numbers bear him out. Although the economy is growing, poverty in the Philippines is high. While the gross domestic product grew by 4.6 percent in 2002, the Philippine poverty rate is 40 percent, affecting nearly 33 million people. And the Philippine labor force grows by more than 1 million workers per year due to an annual population growth rate of 2.4 percent. [See above for growth rate info.] The creation of new jobs lags, and unemployment grows.

This is the first time I’ve heard of business leaders anywhere advocating slower population growth. In light of a 40% poverty rate, perhaps that’s not so surprising. However, in this predominantly Catholic country with a Catholic president, slowing population growth is especially difficult:

President Arroyo announced in 2002 that her government would promote responsible parenthood by funding only natural family planning …, which the Catholic Church endorses.

Also in 2004 USAID which had been supplying 75% of contraceptives to the Philippines announced that “in consonance with the Philippine government’s goal of eventual contraceptive self-reliance,” it would end its donations by 2008 and instead be encouraging private sector provision of contraceptives. However, the federal government of the Philippines actually wanted nothing to do with contraceptives. Romulo Neri, director general of the National Economic and Development Authority, said that it had been a policy of the national government to entrust population control programs to the local government units.

The withdrawal of USAID contraceptives in the Philippines is likely related to anti-family-planning stance taken by the US government under George W. Bush:

In January 2001, the U.S. government imposed restrictions on nongovernmental organizations (NGOs) overseas receiving international family planning assistance. The restrictions, officially called the Mexico City Policy, are also known as the Global Gag Rule by those who oppose it.

Desperately needed USAID-supplied contraceptives are no longer being shipped to 16 developing countries in Africa, Asia and the Middle East. These family planning organizations were the only recipients of USAID contraceptives in their countries. The leading providers of family planning in 13 other developing nations are also no longer receiving USAID contraceptives.

In 2004 and again 2005 one legislator, Edcel Lagman, introduced the Reproductive Health Act (HB 3773) also known as the two-child policy to slow population growth by, among other things, providing tax incentives to families which had no more than two children. However,

The Philippines’ Catholic Church has come out against the two-child law arguing that it is a “veiled attempt at coercion” against families’ freedom of conscience. Archbishop Cruz and the entire Filipino Church maintain that the country’s poverty does not lie in the increase of its population as the two-child policy implies; poverty is the result of mismanagement of the national economy. [source]

The Alliance for the Family Foundation Philippines, Inc., lists 13 reasons for opposing HB3773. The first three are

• It is anti-life. … “reproductive rights” is universally agreed to include “abortion rights.”
• Poverty is not caused nor aggravated by overpopulation. … Numerous economic studies have shown there is no correlation between population and poverty.
• If we spend our scarce resources towards birth control, we would merely be promoting the undesirable outcome of de-population.

Today the Philippines spends $600,000 (USD) on birth control measures. There is now another bill in the legislature to increase that to $22 million.

It will be a “political statement,” said Rep. Edcel Lagman, chairman of the Lower House appropriations committee, considering it will be the first time that Congress will set aside funds for “reproductive health, responsible parenthood and population development.”

“Because President Arroyo is afraid of the [Catholic] bishops and partly because of her religious beliefs,” Lagman told the Philippine Star, the administration has failed to deal with the population problem.

“We cannot achieve genuine and sustainable human development if we continue to default in addressing the population problem,” he said….

From the same article:

Condoms and contraceptive pills could be unaffordable to the majority who are poor. And that is dire news for a population that is estimated at about 89 million today – and fast moving forward to 142 million by 2040. … “The reality is that we cannot educate, provide health services and feed 130 million Filipinos by 2025,” says Senator Rodolfo Biazon.

The quote at the top of this post is from a speech given by Senen C. Bacani, the 2006 Ernst & Young Entrepreneur Of The Year winner from the Philippines. (Guy Laliberte, founder and CEO of Cirque du Soleil, was named the World Entrepreneur Of The Year — go figure). In that same speech, Broad-based development: A perspective, Bacani also said,

From a net agricultural exporter, we are now a net importer. From being self-sufficient in rice and corn, we now import substantial quantities of these grains.

Our rural poor, instead of declining in number has now increased. Indeed, broad-based development would be a far fetched ideal unless we address the urgent needs of our rural poor.

We are worse off today than in the past decade or two because we have severely underinvested in agriculture, where most of our rural poor are engaged in. I don’t have to convince you that output is very much related to input. You have to plant first before you can harvest. What we are spending today in real terms per capita is even less than in the past.

How is it a sign of healthy economic growth for a developing country, or any country, to go from being self-sufficient in rice and corn to being an importer? And, as is the case Bangladesh, the Philippines has reduced the portion of people living in poverty while increasing their absolute number. Is that progress?

With not enough investments, it is not surprising that growth of Philippine agriculture has not kept pace with our growing population. Food production must be accelerated if it is to keep pace with population growth. This becomes all the more urgent when we consider that a fertility gap exists between rich and poor, and urban and rural families thereby exacerbating inequity in society.

Higher rural fertility explains why, although poverty incidence in the countryside has dropped, the absolute number of rural poor has increased. The inability of agriculture production to outstrip population growth, coupled with inequities in distribution, confront us with the growing reality of undernourishment and hunger among our rural people.

That is why we must review our existing policies and programs regarding population planning. Our people, especially those in the rural areas, have to be aggressively informed of their various options regarding family size and make available to them what their needs are.

The Philippines might look at what Iran did to drastically reduce its high population growth rate — but Iran was able to get its religion leaders to back its policies, something that’s not going to happen in a country that’s predominantly Catholic.

A policy paper of the UP school of economics of December 2004 on Population and poverty: The real score [here for PDF] concluded as follows: “Rapid population growth is a critical national concern. It impedes economic growth, worsens inequality and exacerbates poverty. A sound population policy must be part of good governance to promote faster economic growth, lower inequality and hasten poverty reduction. A national population policy, at the core of which are well-funded family planning programs that provide accurate information and access to all methods of contraception, is pro-poor, pro-women, pro-people and pro-life.”

The paper Bacani cites also says,

Time and again, Filipino women across all socioeconomic classes have expressed their desire for fewer children. But many, particularly the poor and the less educated among them, have more children than they want and are unable to achieve their desired number of children. Moreover, an overwhelming majority of Filipinos have affirmed the importance of the ability to plan one’s family or control one’s fertility, and believe that rapid population growth impedes the country’s development.

Bacani concludes,

Today, there are 30 million Filipinos who continue to feel neglected, growing resentful of being marginalized and mired in poverty. Surely, we cannot continue to turn a blind eye to the ordinary Filipino. We must continue to seek ways and means of how to help him get out of his distressed condition.

too many people? export them

One way a developing country can increase its GDP is to export workers to developed countries.

In 2002, David Diamond wrote in Wired:

…the Philippines has discovered the future of work. At any given time, about 10 percent of the country’s 76.5 million population is hard at work — outside the country. During 2001, more than 800,000 people headed out on a commute that makes Rye-Grand Central [a NYC commuter railroad line] seem like a milk run to the corner store. They went to Italy, Saudi Arabia, Canada, Singapore, and Uzbekistan. They went to Mongolia and Equatorial Guinea. Unlike Mexicans, who flock primarily to the United States, Filipinos traveled to 162 nations in all. Unlike Indians, who fill mostly tech and medical positions, Filipinos toil as domestic helpers, engineers, nurses, bricklayers, teachers, farmers, seafarers, stenographers, hairdressers, crane operators, cooks, and entertainers.

… the money they electronically send back to their families, account for 8.2 percent of the nation’s gross national product, stabilizing its peso, improving foreign currency reserves, shoring up consumption, and making more than a dent in the unemployment rate … .

In 2004, Filipinos working abroad sent $11.6 billion in remittances back home, and just over half of that came from Filipinos working in the United States.

In the Philippines this is seen as a boon, and the government has an agency within the Department of Labor and Employment to support it, the Philippine Overseas Employment Administration, which other developing countries are trying to emulate.

…this thriving “trade” has already made the Philippines the envy of the developing world. Officials from such poverty-plagued countries as Sri Lanka, Malaysia, Indonesia, Nepal, and Vietnam have come to Manila to find out how they too can be prime producers of labor. The market for contract migrant work, they know, is growing: According to the International Monetary Fund, worldwide remittances totaled $2 billion in 1970; by 2000, the International Labor Organization set that figure at $73 billion. After a visit to the Philippine Overseas Employment Administration, Indonesia’s labor minister, Jacob Nuwa Wea, said, “We learned some things we can adopt at home — like mechanisms to protect overseas workers, how to prepare candidates to meet skill requirements, and how to license private employment agencies.” Pakistan has patterned its overseas workers welfare fund after the one established by the Philippine government.

The Philippines is famous not only for its overseas nannies, seamen, and cruiseline workers but also for exporting trained professionals like teachers, doctors, and nurses:

The Philippines is the leading primary source country for nurses internationally by design and with the support of the government. The 2001-2004 Medium Term Philippines Development plan views overseas employment as a key source of economic growth. Filipino nurses are in great demand because they are primarily educated in college-degree programs and communicate well in English, and because governments have deemed the Philippines to be an ethical source of nurses. A motivator for the Philippines to produce nurses for export is remittance income sent home by nurses working in other countries. In 1993 Bruce Lindquist reported that Filipinos working abroad sent home more than $800 million in remittance income. No other country produces many more nurses than are needed in their own health care systems at a level of education that meets the requirements of developed countries.

However, the Philippines may be reaching a natural limit in its ability to provide enough nurses for escalating worldwide demand. An estimated 85 percent of employed Filipino nurses (more than 150,000) are working internationally. About one-fourth of the total number of nurses employed in Philippine hospitals (some 13,500) reportedly left for work elsewhere in 2001. There has been recent debate that the growing global demand for Filipino nurses is so great that emigration of nurses could be threatening the country’s health care quality. It is estimated there are more than 30,000 unfilled nursing positions in the Philippines. In 2001 the United Kingdom, Saudi Arabia, Ireland, Singapore, and United States were the most common destinations for Filipino nurses.

There’s an important and tear-jerking side to overseas work:

Some of the saddest stories are of the many Filipino women who leave their own children behind to become nannies in other countries. There’s one on my street in Washington, D.C. She is unfailingly cheerful. But when I mentioned my trip to her home country, she confided for the first time how many nights she’s spent crying. She’s been in the United States nearly 10 years, leaving her two children in the care of her husband. He’s a rice farmer, and the price he is paid for his crop simply cannot support a family. But she has trouble conveying this to her teenage son. He recently lashed out over the phone, telling her how hard it’s been without a mother in the house.

And this one:

… the woman next to me asked where I lived and where I was going. But when I asked the same, she dissolved into tears. She’d just said goodbye to her 2-year-old son and would not see him for the next eight months. She and her husband both work for a holiday cruise ship based out of Puerto Rico. The job is eight months on, two off, then back on again. Her mother is raising their child.

One last note: before you decide these overseas workers are mostly young, look at the ages of the most recent Bagong Bayani award winners.

my thoughts

It’s difficult to distill the information in this post. There is no disgrace in Filipinos leaving their country to obtain better paying jobs abroad. The problem lies with their employers. There’s no innate requirement for the United States or any other country to be a nation of lawyers, stockbrokers, and hedge fund managers. We can and should change our economic, social, and political ways so American workers satisfy our need for nurses, teachers, engineers, and doctors as well as gardeners, meatpackers, janitors, and crop pickers. That is, like every nation, we can and should be self-sufficient in the long run. Right now, our economy is dependent on immigration which requires an unsustainable supply of foreign workers. If and when China, India, Mexico, and the Philippines achieve a standard of living like that of the United States, how will the US take care of itself?

Why should a country like the Philippines be sending us teachers, doctors, and nurses? If they have the educational capacity to train these professionals, they can and should be addressing their own needs given that 40% of Filipinos live in poverty and 40% of those on less than a dollar a day. The last thing their country needs is to be exporting the very people they most need — the talented and motivated — to other countries. It’s one thing to exploit the natural resources of a poorer country, like taking Nigeria’s oil, but to take their intellectual capital is simply egregious.

The other subject of this post is population policy, especially providing family planning services and contraception to the poor. As noted above most Filipino women wish to have fewer children and the main impediment to that is the Catholic church and its leaders. The Catholic church is enormous and influential world-wide, particularly in third world countries. It’s time Catholics in developed countries insist in the most forceful way their church enter the 21st century and embrace modern methods of contraception. Modern methods of contraception and the programs to make them available are pro-poor, pro-women, pro-people and pro-life. If the church doesn’t stand for those values, what good is it?

update: the BBC News reports today in an article headlined Africa ‘being drained of doctors’:

Many African countries now have more doctors and nurses working in richer countries abroad than they have at home… . 17,620 African doctors and nurses joined the [UK's] NHS last year [even though the UK did not actively recruit them].

another update (March 8, 2008): UN sees more people going hungry in Philippines as rice prices soar