SOME WILL argue that beggars can't be choosers, that we have no choice but to continue to encourage the exodus from rural to urban areas, from the Philippines to the world. But leaving the problem of poverty unsolved still ends up damaging the family with all its strains.

The deterioration of family planning services aggravates the problems. In the last five years, family planning usage has hovered at around 49 percent of women, about a third of them using unreliable methods such as withdrawal. The unmet need for family planning is highest among the poorest Filipinos: the 2003 National Demographic Survey found that on average, the poorest 20 percent want 3.8 children but end up with six. Compare that with the richest 20 percent, who have on average about two children, only slightly higher than a desired fertility rate of about 1.7.

Young marriages continue to be the norm for the poor, the median age of marriage for the poorest 20 percent being 19.7 years, compared to 24.6 for the richest 20 percent. By the age of 19, one out of every five Filipinas is already bearing children.

For all the declarations of large joyful Filipino families, there are larger and larger numbers of households where the male has absconded, or where one parent has had to work elsewhere, often in places thousands of miles away from home.

Then there are the exhortations to care for the young and the elderly; in fact, religious conservatives warn that family planning will result in a demographic winter, where we will have many elderly with no young to care for them. But Dr. Mercedes Concepcion, an expert demographer, refuted this in a recent conference showing that with current rates of family planning, we will not have a demographic winter until about 75 years from now.

The bigger question that looms, though, is this: even today, where the elderly constitute only about six percent of the population, we already see many of them neglected, fending for themselves. Where are their children? They're working overseas. The Filipino family, we try to comfort ourselves, is resilient, and will survive. I have no doubt about that, but we need to ask what the costs will be, into 2010 and beyond.

Michael L. Tan is a medical anthropologist with a growing family of his own. He is currently chair of the anthropology department at U.P. Diliman, Quezon City. He also writes an op-ed column, "Pinoy Kasi," for the Philippine Daily Inquirer.