The cycle of poverty and pregnancy

October 2, 2012

By Erik de Castro

It was a few minutes before 6 a.m. when I arrived at the dwelling of Liza Cabiya-an, 39, and her 14 children. Liza was pouring coffee on a plate of rice as her five small children, including her youngest 11-month-old baby, huddled on the floor around her waiting to be served their breakfast. On a good day, Liza says breakfast would be pan de sal, or the classic Filipino salt bread, which they dip into hot instant coffee.

While the small children have their breakfast, Liza’s nine other children were still asleep, shoulder-to-shoulder, in a room of approximately 9-square meters.

The only appliances they have are the television and a DVD player. The glassless window provides natural ventilation to the space. Liza’s family lives on the third floor of a three-story tenement in a slum neighborhood in Paco, in the Philippines capital Manila. I had to go up a narrow wooden ladder to reach their dwelling. Residents of the tenement share the same toilet, which is on the second floor. Liza complains that there are nights when they have to endure the stink of the toilet, which is not regularly cleaned.

“Life is hard with so many children but we still try to have fun,” says Liza as she turns on the TV, inserts a music CD in the DVD player and, as if on cue, the little kids start to dance. The noise wakes up the rest of the brood. “I still remember the names and birthdays of each of them,” Liza boasts with a grin, revealing her decaying teeth. After a while, she turns off the music and half-jokingly says, “That’s it for now. Too much activity will make them hungry again.”

While I took snapshots of the family, Liza told her story. She works as a part-time house help and laundry woman. She can’t accept full time work because she still has very young children to take care of. Her husband, a construction worker, comes home only on weekends. Her grown up children – the eldest at 22 – help augment the family income by scavenging, selling rice cakes and working as part-time house helps as well. All children are physically small for their age, most likely because of lack of nourishment. Only five of her children are also in school, most of them in elementary education.

Liza’s situation is a common condition of most poor families in Metro Manila. A lot of them come from the provinces with the false hopes of finding better jobs in the capital. With no money to pay for rent, most of them settle in slum areas, including riverbanks and creek sides, which are often flooded during the rainy season.

Not far away from their neighborhood, at Baseco compound in Tondo, Manila, there is a small drug store that sells birth control pills and condoms. “Look, we have plenty of stocks because nobody buys them. Most people here don’t have the budget for these because they would rather spend on food,” says the drug store attendant. A village watchman who himself has 10 children said it is rare to find families in the area with few children.

Also located in Manila is the government maternity hospital, Jose Fabella Memorial Hospital, where you can find about 300 mothers and their newborns in the ward. As you walk through its halls, pregnant women lining up for prenatal check ups and mothers carrying their newborns are a common sight. Such scenes and the smell of breast milk makes me liken the place to a baby factory, which indeed, has become synonymous with this hospital.

As I was going down the wooden ladder from Liza’s home, a woman named Elsie called out to me from the porthole of her family’s room, asking me to also take pictures of her family. Elsie says she has 10 children but gave up four for adoption. “They have a good life now, they don’t get hungry anymore,” she said happily.

I am a Catholic but I don’t understand the opposition of the bishops to the reproductive health bill in the Philippine Congress, which would provide access to free contraceptives for poor women like Liza and Elsie.

In the years I have been working as a photojournalist, I have encountered stories of poverty even more heartbreaking than theirs. Most of the time, it is the big families who are in such situations, and they have the same stories about not being able to afford family planning. Just like how an umbilical cord connects the mother and baby, poverty and family size are also linked. Those who oppose the bill should visit these places so they can see for themselves how wanting in free family planning services these poor families are. The inhumane living condition of these people is more controversial than the issues they raise about the bill.

When I was a teenager, I remember a slogan on streamers posted on streets in northern Philippines, promoting family planning. It says, “Talo nga anak okey daytoyin” (Three kids in a family is very good). If most families were able to exercise that, perhaps women like Liza and Elsie and their families would have a better shot at quality life.


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Erik, you seem to equate their poverty to their giving birth to their children. Do you think if they have a job, an opportunity for work, free education and basic welfare and health services – would they still be impoverished? Rather than spending 13 Billion on contraceptives – these can be spent on job creation, free education and providing basic welfare services. The RH Bill is trying solve and economic problem thru a medical solution. If Liza and Elsie will have access to free contraceptives (worth 13 billion) – will that make them any less impoverished? We opposed the passing o the RH Bill because this is not the solution to help our impoverished brothers and sisters. The RH Bill is simply another vehicle for corruption and to pave the way for other vested interest of foreign interest like International Planned Parenthood who wants to promote abortion and commercial interest of foreign companies producing condom and contraceptive manufacturers. Your pictures are touching and moving -0 but the RH Bill will not help these brothers and sisters of ours. Instead they will further be sucked into more social problems in the future.

Posted by FARHB | Report as abusive

The father is construction worker whose daily wage may not be sufficient to meet the needs of the family of 13. How will condoms, pills, IUDs solve the insufficiency of his income? Hindi kaya kailangan ang dagdag na TESDA training ni mister para maging karpentero sya at nang tumaas ang kanyang sahod? Dahil 39 pa lang si misis, maaaring maka-5 pa silang dagdag na anak…pwede naman siyang turuan ng basal body temperature, lactational amenorrhea, and rhythm methods.

Ako my 3 na pero gusto ko makalima man lang…ang problema ko kahit every week hindi pa rin makabuo ng dagdag…which means that the Lord of Life is in control. Ako inggit sa 13 na yan…

Posted by Anonymous | Report as abusive

Great pictures, piercing story. Sadly I can just sympathize for Liza and hope that her story doesn’t happen to her children as well. Had I not get into contraceptives, I would have probably ended up like her, and dragged my children into such inhumane living condition. But it was my choice to limit the number of my children according to my means. Whatever the moralists say, at the end of the day, I am answerable only to my God. And I know that when it’s time to face Him, He would tell me that I did good raising my children well and giving them a decent life, not sending them to streets to scavenge for food and scraps. Unfortunately, there are women like Liza who do not have the means for the same choices I had. Hopefully, your work wakes up people who have the power to change the situation. As you said, being able to have a small family is the first step to quality life.

Posted by Isabel70 | Report as abusive

Nice pictures. You look at them and you know what’s happening. Big family can be fun, but obviously not in cases like this.

Posted by CesarDavid | Report as abusive

Church Fetal position:

Posted by hkrieger | Report as abusive