[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]