One of the World’s Busiest Maternity Hospitals
Manila’s Dr. Jose Fabella Memorial Hospital is reputed to have the world’s highest birth rate and in “Motherland”, we get a look at it. It is more than just a hospital in that it not only provides an expressively etched account of specialized medical care, but it is also a telling perspective on dominant social trends and health care policy issues in the Philippines.
Through conversations and interactions among medical staff, patients and family members at Manila’s Dr. Jose Fabella Memorial Hospital, Ramona S. Diaz’s documentary focuses on several major issues subjecting many disadvantaged women to a repetitive cycle of pregnancy and childbirth. Problems include endemic poverty, a pervasive cultural bias favoring large families and a lack of access to education, medical care and family planning services.
As the Philippines’s leading public maternity hospital, Fabella often serves as the destination for Manila’s most impoverished pregnant residents. Up to 150 patients at a time tolerate the overcrowded dormitory-style wards where two women and their newborns may share the same bed, sweltering in the tropical heat because the facility has no air conditioning.
Lea Lumanog is in her 20s and wasn’t even aware that she was pregnant with twins until she checked into the public hospital’s Neonatal Intensive Care Unit (NICU), that specializes in treating premature or underweight infants. When her baby girls are born, she’s so overwhelmed that she just calls the firstborn as “A” and her sister as “B”. She tries to understand the enormity of her new responsibilities and juggle the twins’ care. Once she’s out of the delivery room, the attentive but harried nurses on the NICU ward demonstrate breastfeeding methods and the hospital’s signature “Kangaroo Mother Care” procedures. Because the hospital cannot afford incubators for premature newborns, the staff provides mothers with garments resembling elongated tube tops so that they can snuggle their infants on their chests to keep them safe and warm.
Days pass before her husband arrives for a visit, because he’s too broke to afford transportation to the hospital. Facing a bill of over $1,000, he can only barely afford a $20 payment and that he borrowed from his sister. After he fills out some paperwork, a social worker tells him that a Christian charity associated with Fabella will cover the balance of his expenses.
Lerma is in her mid-30s and has even more to manage. She has just given birth to her seventh child, while her unemployed husband is caring for the others at home. She’s quite open with the new mothers about the challenges of parenthood and she talks about the expenses of a large family and warning them not to have too many kids. Although her child is still under the recommended weight for a healthy baby, she insists on leaving the hospital, coercing her husband into signing the required discharge forms against his better judgment.
Aira Joy Jubilo is just 17 and among the youngest mothers that we meet in the film. She seems to be off to sea and has trouble breastfeeding and her premature baby is slow to gain weight. Although her mother visits the hospital almost every day, her boyfriend continues making excuses about not showing up thus forcing Aira to rely solely on her family for financial and emotional support, even though her mom has several other kids at home.
There is something to be said for a communal approach to having children like the one we see portrayed in “Motherland.” Ramona S. Diaz directed this look at a Manila maternity ward where overcrowding and limited technological resources have forced some solutions that may not be ideal.
The patients are a microcosm of the Philippines in general— poor, Catholic, and already burdened with several children. (No doubt religion is a major factor in many women’s reluctance to use birth control.) Even in the delivery rooms themselves, mothers are often crammed two or more apiece onto beds. Before and after giving birth, they stay in a ward that at first glance seems noisy and cluttered.
What is there is a sense of community like the patients have at home. Hospital staff members (which include a flamboyant transgender doctor) try to encourage good habits for the babies’ sakes, though often their advice falls on deaf ears, as the women are accustomed to deprivation.