[Panorama of a large cityin the Philippines]
[City traffic sounds]
[Motor engines]
[Narrator:] ThePhilippines shares
with other nations ofthe developing world
the visible pressureof population growth.
Industrialization and a toplayer of commercial modernism
have made its citieslike cities everywhere,
large, loud, crowded, withpeople and vehicles contending
for the same inadequateallocation of space
and natural resources.
There are, moreover,special characteristics
in this land to explain themagnitude of its recent growth.
It seems a landof the very young.
Almost 45% of all Filipinosare under 15 years of age.
Family ties areunusually strong.
And even in the worstof circumstances,
it is hard for a Filipino toavoid regarding a large family
as somehow betterthan a small one.
It is a nation of devoutlyreligious people, where
the Catholic Church in its mosttraditional, pro-natalist form
has broad influence.
[Quiapo Church, in Manila, Philippines]
Still, within thisunlikely atmosphere
have grown up a diversityof population efforts.
One of them, employing the verystrengths of the society, love
of family and home, infurtherance of population goals
is that of the indigenouschurch called Iglesia ni Cristo.
One of its ministersexplains the rationale
behind the program.
[Minister:] The Church ofChrist, or Iglesia ni Cristo,
is aware of the fact thatthere is a tremendous growth
of population.
As administratorsof the church, we're
most concerned andinterested in the welfare
of the poor elements of thechurch because our concern is
not simply to look intothe spiritual welfare
of the members but also afterthe material aspect of life.
Every family is responsiblefor the future welfare
of the children.
We have explained to them thebenefits of family planning.
And we really were satisfiedwith the tremendous response
among the members.
[The Island Way]
[Filipino language singing]
[A Church Experiment in Sterilization]
[Filipino singing continues]
[Men seated in pews]
[Narrator:] This is thechurch in Catanduanes,
an island off thecoast of Luzon, where
a population offarmers and fishermen
live the most modest of livesand offer an unusual laboratory
for the program of thisdistinctively Filipino church.
Founded in 1914, it has hadan almost phenomenal growth
not only in the Philippines butin other areas of Asia, Europe,
and North America.
It is notable principallyfor its strong concern
for social amelioration,its cohesiveness,
and the disciplineof its members.
[Filipino female choir singing]
[Minister's footsteps]
[Minister:] [Speaking Filipino]
[Separate seatingfor women and men]
[Minister delivers a sermon]
[Narrator:] The Iglesiani Cristo began
a forthright familyplanning campaign
in 1973 and withinthree years had
enlisted some 280,000 users.
Family planning became thetheme of sermons in churches
throughout the country.
Thus, the church madefamily planning in one step
not only acceptableto Christian doctrine
but the keystone of a broadprogram of social betterment.
The Iglesia ni Cristo is analready-existing delivery
system for familyplanning services.
There are such localstructures in every country.
They are ready to beimaginatively used
to expand the population effort.
[Filipino speech]
[Mobile team arranges supplies]
The newest and mostspectacularly successful
element of the familyplanning program
is the sterilization campaign,in which mobile teams fan out
from Manila through parishesall over the country.
It is a markedlyinformal project,
responding on short notice toappeals from whatever church
has assembled a largeenough number of candidates
who have made their voluntarydecision for sterilization.
[Metal clanking]
Informality aside, it is also athoroughly scientific program.
Instruments, gloves, drapes,and all other needed materials
are packed for field usewith sterilization procedures
as precise asthough the work were
to be done in theheadquarters clinic.
[Filipino speech]
[Indiscriminate chatter]
In this case, the mobile teamof doctors, nurses, and general
assistants travels by van tothe coast, thence by ferry
to the island from whichthis newest appeal has come.
[Indiscriminate chatter]
[Small engine sputtering]
[Car approaching]
[Horn sounds] [Beep-Beep]
[Traffic and car engines]
[Banner at the church]
Here, as in mostrural regions, they
will make their basein the church compound.
[Filipino speech][Indiscriminate chatter]
[Van door slams]
The arrival of themobile team van
is an occasion forcheerful interest
on the part of thewhole community,
not only the male candidatesfor vasectomy but their women
and children.
[Filipino speech][Indiscriminate chatter]
Here, they will use theadministrative office
of the church asan operating room.
Such arrangementslend themselves
to vasectomy procedures.
Tubal ligations, whichare growing in popularity
among women of thechurch community,
require a more medicallysophisticated setting.
Every effort ismade to bring women
who want mini-laparotomies,the most common sterilization
operation for women, to thenearest available
health center.
[Health worker:] Make sure youdon't contaminate the sterile
ones with the unsterile ones.
[Narrator:] A climateof acceptance
has already been established.
This is the third visitof the sterilization team,
and the satisfied customers havebeen the strongest motivators.
[Health worker:] Don't forget the--
[Narrator:] Thereis a high degree
of mutual support amongthe brothers and sisters,
as they are known to eachother, for the sterilization
procedure.
[Health worker:] [Filipino speech]
[Dr. Carolina Gabriel:][Filipino speech]
[Dr. Carolina Gabrieladdress a large crowd]
[Narrator:] DoctoraCarolina Gabriel,
who with her husband,Melanio, administers
the program for theIglesia ni Cristo,
will be the surgeon today.
Before the firstoperation, there
will be a talk explainingexactly what vasectomy
is and is not andwhat the patient may
expect in the course of theoperation and subsequent to it.
[Dr. Gabriel continues]
[Narrator:] The atmosphere isvisibly informal, even jocular.
In its way, the churchis an extended family.
Even such seriousconsiderations as a vasectomy
are treated in simple,familial terms.
The doctor knowsthat the men have
chosen to have thisoperation voluntarily.
But she is anxious thatthey not have any doubts
as to its nature,its permanence,
and its potential effectupon their future lives.
[Dr. Carolina Gabriel:][Speaking Filipino]
[Male anatomy display]
Bodega [Speaking Spanish]
OK, so you know.[Speaking English]
[Narrator:] In countryTagalog, with pepperings
of Spanish andEnglish, she explains
the male reproductivesystem in terms
her listeners will recognize.
She confronts themost common fear
that vasectomy is aform of emasculation
by assuring themthat it will not
interfere in any waywith their sex life
nor diminish their virility.
[Laughter]
[Dr. Carolina Gabriel:] Bodega [Speaking Spanish]
[Narrator:] Fishermen andfarmers respond comfortably
to her earthy explanations.
They are close to nature andaccustomed to calling things
by their natural names.
[Dr. Carolina Gabriel:][Speaking Filipino]
[Laughter]
[Dr. Carolina Gabriel continues]
[Laughter]
[Speaking Filipino]
[Narrator:] There is much serioustalk about the importance
of informed consent.
And the Iglesia ni Cristo hasbeen punctilious in its demand
that its peoplebe fully informed
and positively consenting.
They may be humanly apprehensiveabout it as about any surgery,
but the breeziness of thepresentation is reassuring.
This is no officialdemand upon them
with the weight ofgovernment orders behind it.
They have no reasonto fear authority.
The church is their familywhich brings them all together.
And they are convinced of itsconcern for their well-being.
[Dr. Carolina Gabriel:][Speaking Filipino]
[The mobile team prepares for a procedure]
[Dr. Carolina Gabriel:] One here,and one here.
[Narrator:] A vasectomy is arelatively simple
outpatient procedure.
[Preparation for the procedure]
Normally, the onlydiscomfort is related
to the injection whichnumbs the operating area,
and that is minor.
[Rustling]
[Dr. Carolina Gabriel:] [?]
[Rustling]
[Narrator:] The patient willhave a few days of soreness
and diminished activity.
Then, after an interval ofcontraceptive protection
to ensure that all remainingsperm have been expelled
and he is certain to besterile, he and his wife
are free to resume fullrelationship without any fear
of unwanted pregnancy.
[Man puts back on pants]
[Men snickering]
[Filipino cultural music]
The men of these islandsare wholly masculine
by nature and bycultural tradition.
They have workedhard since childhood.
And most of them expect towork hard as long as they live.
[Rice farming]
They are comparativelypoor people,
as rice farmers andfishermen and their families
are likely to be the world over.
The Iglesia ni Cristo hasgiven them something of value,
a perception of brotherhoodamong themselves and of kinship
with men and women on otherislands and other continents.
Armed with this sense ofsecurity and responsibility,
more than 14,000men and women have
chosen surgical contraception inthe three years of the program.
In a country wheresterilization was once
thought wholly unacceptable,this is a remarkable record.
Because they areislanders, they know
that they are already enjoyingthe fruits of all the land they
will ever have.
Their boundary onall sides is the sea.
But then, we all are dwellerson an island in a sea of space
whose resources are finiteand fast diminishing.
Indeed, we are all islanders.
[Upbeat music]
[An Airlie Production]
[Executive producer: Murdock Head, M.D.]
[Filmed in cooperation with Iglesia ni Cristoand Family Planning International Assistance]
[Producer: Douglas C. Larson; Director: Paul Noonan; Writer: Miriam Bucher]
[Camera: David Nash, James Reid; Editing: Gordon Heerman; Music: Excerpt from "Mahal"]
[Produced by the George Washington University, School of Medicine and]
Health Sciences. Department of Medical and Public Affairs. c1977]
[Fade to black]