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Emelita Borromeo, 28, breastfed her three-week-old baby as she watched videos about family planning at the waiting area of the Family Planning Fair venue in Tondo, Manila last July 11, World Population Day. She was not waiting for her turn to be served. She was waiting for her husband, then undergoing no-scalpel vasectomy procedure at a nearby referral hospital.

Vasectomy is a family planning method for men that is difficult to advocate because of the many misconceptions about it. However, Emelita said she and her husband, Kenjay, 30, did not have any fear because the procedure was thoroughly discussed with them by a community health worker.

“After the discussion with the health worker, my husband and I also talked about it for three days before coming to this family planning fair today for the procedure. We have already decided that he will have vasectomy,” Emelita said.

The story about how the couple’s family grew is not unique, but it’s their choice of family planning method that makes them different from most. They wanted only three children but the first three – now aged 9, 7 and 6 – were all girls. They wanted a boy so they went for a fourth and finally got one, who is now four years old. The fifth was unplanned.

Emelita said they tried other family planning methods before – pills, condoms, withdrawal – but not on a regular basis. As soon as they experienced how difficult it was to raise five children, that’s when they started to take family planning seriously.

Kenjay works as a fruit store helper in Divisoria market and is paid only P250 a day. Emelita stays home to take care of the family.

“We already have five children and we do not want any more. It is a challenge to make ends meet with my husband’s meager earning. We already spend P200 a day on food alone. There are other daily expenses such as transportation for my husband going to work and daughters who are going to school; plus the utility bills, and when a family member gets sick,” Emelita complained.

Upon learning that a family planning fair will be conducted at the Barangay Baseco, which is adjacent to the Parola village where they live, the couple immediately enlisted Kenjay for vasectomy. Emelita said they opted for a permanent method so that they need not worry about an unplanned pregnancy any more.

“Aside from going for a permanent method, my husband also chose vasectomy because he wanted to do his share in family planning. I have been on the pills before and now I am taking care of five children, he has to do his part as well,” Emelita explained.

Kenjay was the only client who successfully availed of the method at the fair. There were others who enlisted but were not served after going through a counselling, most of them needing more time to decide. Surprisingly, according to service providers, there were two men who wanted to have NSV although they did not have children yet. They were not qualified for the procedure.

Nearly 1,000 women availed of free family planning methods and reproductive health services during the World Population Day event. Family planning methods made available included pills, injectable (DMPA), implants, ligation, IUD, condoms, vasectomy and even natural family planning.

The fair was the second of its kind to be conducted in the city of Manila, where family planning services, especially modern methods, were banned in 2000 and continues to be difficult to obtain even now. Baseco is the biggest barangay in Manila with a population of over 50,000, and adjacent to Parola and San Nicolas. All three belong to the poorest communities in the city.

The fair was organized by Likhaan Center for Women’s Health, in partnership with the European Union, the United Nations Population Fund and 18 other local organizations.