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Contraceptive Commotion

autumn 1995

From nucleus - autumn 1995 - Contraceptive Commotion [pp8-16]

More people share the planet today than have ever lived. The United Nations Conference on Population and Development took place on 6-13 October 1994 in Cairo and welcomed delegates from 182 nations.

Despite quadrupling in one century, world population growth has slowed, dropping from 2% a year in 1960 to 1.8% by 1989. However sub-Saharan Africa is swelling by 3.2% a year, the highest recorded growth rate of any continent in history. This dwarfs Latin America's peak at 2.8% and Asia's 2.5% in the 1960s. An average Kenyan woman will have 8 children, four times the number in the developed world. Population growth is certainly a phenomenon, but is it a problem?

A common analysis, exemplified by this comment from the British Medical Journal, runs as follows: 'If population growth is not controlled then poverty will never be reversed, rapidly increasing energy consumption and environmental degradation will continue, and leaders will still invest heavily in arms to fight for resources to defend their privileges.'

The treatment for this condition might appear obvious: a mass transfer of condoms, coils, pills and safe abortion services should rescue the poor from their predicament, and safeguard the interests of future generations.

A closer inspection casts serious doubts over this simplification, which has become dogma in developed countries. (Cairo interestingly saw a stubborn alliance between Catholics and Muslims against both abortion as a family planning option, and also the 'rights' of under-age childen to contraceptives).

  1. Family planning in the developing world
    High birth rates in developing countries (DCs) are generally not the result of chance or ignorance. Far more women know at least some forms of contraception than want to use them. In fact, the World Fertility Survey revealed that in 7 out of 9 African countries covered, the women's ideal family size was even bigger than than their actual size. The proportion of women who wanted no more children averaged 13%! However, it is worth noting that the average number of children born to these women, 6.7, is well below the physiological limit of about 11. Europe's own past echoed this pattern, when fertility was managed effectively decades before the advent of contraceptives, and declined as the standard of living rose.

    It seems that African women often want large families. A child is insurance against an uncertain future in circumstances of high infant mortality (see table), low and insecure income, and labour intensive farming. There is little disincentive in raising children deprived of costly education: 39% of DC inhabitants were illiterate in 1987. Survival is the bottom line. A missionary recently described to me how he buried the fifteenth consecutive child of an African woman. She had changed her name to 'I fill the graveyard'.

    Cultural factors complicate the African picture, where fertility is prized as a sign of virility and success. In addition, the need for a husband to recoup his bride-price, and the wife's need to compete with other wives is substantial. An African woman rarely has rights to land or income in the event of divorce or widowhood, except via sons. Furthermore, few tribes in post-colonial countries polarised by tribe loyalties want to risk becoming outnumbered.

    The traditional practice of sustained breast-feeding delays fertility and confers direct health benefits. Sadly Western habits have threatened its use. UNICEF reports a drop from 95% to 20% of mothers in Chile over just 30 years. They estimate that children in DCs can be 25 times more likely to die in childhood if they are not breast fed for 6 months. The popularity of bottle feeding is partly due to unscrupulous companies off-loading our milk surplus as baby feed.

  2. Poverty
    Poverty and trade
    The roots of poverty cannot be separated from their global economic context, although population growth can exacerbate poverty on a local scale. Despite claims that population growth cripples economic growth, the President of the World Bank remarked that 'the evidence is clear that economic growth rates in excess of population growth can be achieved and maintained by both developed countries and DCs'. That is, the economy is not inevitably hampered by population growth, witness the success in Asia. The distribution and flow of resources is critical. Clearly there is a huge inequality in the world's resources: the richest 20% are 150 times better off than the poorest 20%. This disparity is growing. The Global 2000 Report to the US President predicted that for every $1 increase in GNP per capita in Least Developed Countries, a $20 increase is expected for the industrialised nations. All too often 'them that's got, gets'.

    We in affluent countries carry much of the responsibility for this situation. Colonial powers encouraged DCs to produce raw materials for motherland industries, whilst actively quashing any competition, particularly industrial. Protectionist trade barriers remain to this day to extract maximum benefit from countries with weak economies and no bargaining power. The World Bank calculate that our slanted terms of trade cost them $50-100 bn in lost earnings. A dependency on rich nations and their banks has developed, enhanced by a vast debt burden. DCs are therefore at the mercy of markets in low-profit raw products, often relying on a handful of products (eg Zambia 88% copper). A slump in commodity prices of about 40% has rendered DCs weaker in international trade. Thus Tanzania had to export 10 times the amount of tobacco in 1981 as was needed only 5 years earlier to buy a tractor.

    Poverty and debts
    In addition many DCs are crippled by long-standing debts, consuming 35% of GNP in some countries. In 1989 the net flow of money (debt repayments minus new lending or aid) was $50 bn out of the Third World. Thus in 1990 every man, woman and child in the developing world subsidised our lifestyle in the industrialised North by £17.50 year.

    Poverty and food production

    Despite the fact that overall per capita grain production has increased by 30% since 1951, 750 million people will go to bed malnourished tonight. Population growth cannot explain why there is a net flow of $15 bn worth of food from poor to rich countries. Can it be true that DCs are demanding too much food? In 1987-9 the 816 million in Northern nations consumed 44m tons of grain, almost as much as the 551m eaten by the 2.8 billion people in the South. This feat is accomplished by eating livestock, which eat as much grain as all the people of India and China. Indeed, if we include livestock as 'population equivalents', and calculate the number of people that their protein intake would feed, the US feeding burden was 1.6 billion, despite a human population 3 times the size! Whilst the South exports protein Northward, we in the North are replete enough to pay farmers to produce less! It has been calculated that a mere 2% of the world's grain harvest would suffice, in the short term, to rectify the global problem of malnutrition. In summary, there would be plenty to go round if it was shared more equitably.

  3. Poor health:
    Once again, the issue of health cannot be tackled without considering wider economic issues. Life expectancy was only 48 years in low-income Africa in 1983. But Africa can only afford to spend 25% of what she spends on servicing debt on health care. NHS cutbacks appear laughable compared with some DCs. Austerity measures enforced by creditors ensure public spending is cut: governments lose the power to provide basic levels of food, clean water, sanitation, education and health care. Ghana had to slash its health expenditure per person by 90% between '74 and '83. UNICEF blames the burden of debt for 500,000 infant deaths each year. The WHO propose that an extra donation of 45p per person in DCs for simple preventative measures would save 5m lives per year, at a total cost of £2 bn /yr. Incidentally, dieters in the US alone spend £3 bn /yr on trying to lower their calorific intake.
  4. Energy consumption and
  5. Environmental damage
    The affluent are responsible for the lion's share of consumption and are implicated in much of the global spoilage. People in the developing world use 0.28kW/yr, compared with 3.2kW/yr in the industrialised North, and 9kW/yr in the US. One quarter of the world's population produces 70% of carbon emissions from fossil fuels, boosting global warming. Both in absolute numbers and per capita, the US is the worst offender, spewing 165 times the average citizen of Zaire. The poor will suffer the most from whatever convulsive changes global warming brings. They are most likely to be exposed to toxic waste: it was no co-incidence that the Bhopal disaster preferentially affected the poor. Even within rich countries, the poorer the neighbourhood, and the darker the skin of its residents, the more likely it is to be near a toxic waste dump.

    The poor are also most likely to be farming marginal land, at a time when huge tracts of good land are supporting cash crops. Cattle ranchers destroy 2.5m hectares of forest in Latin America for cheap beef export to the developed world. Another drain on forests is our demand for tropical hardwoods. When politicians scold DCs for attempting to emerge from conditions we left behind decades ago, they miss the point. The problem passengers on Spaceship Earth today are the ones travelling First Class. Professor Myers at the Science Academies' Summit on Population admitted: 'we can reduce population more readily than we can reduce affluence, lifestyles and wastefulness.' Just so. Reducing population growth in DCs is a painless substitute for mending our greedy ways.

  6. Military De-stabilisation

    'The most potentially explosive force in the world today is the frustrated desire of the poor to attain a decent standard of living.... promoting economic development and overcoming hunger in particular are tasks far more critical to US national security than most policy makers acknowledge.'

    This comment by the US Presidential Commission on World Hunger highlights the fact that the lack of opportunity in DCs needs to be directly addressed as a major cause of conflict globally.

Beyond contraception: towards a Christian response

'All a man's ways seem innocent to him, but motives are weighed by the Lord' (Pr 16:2)

'The heart is deceitful above all things' (Je 17:9)

Faced with a choice of responses to global suffering, our motives are key: are we worried for our future, or moved by compassion for the poor's present? In particular, a common factor in much of the 'population bomb' analysis seems to be fear; fear of limitless demands on our charity, fear of commercial competition, fear of dwindling resources, fear of a polluted planet, fear of war, fear of massive immigration.

For instance, the threat that the weight of numbers might pose to Western business interests has not passed unnoticed. In a document only recently declassified, the US National Security Council advised the President that population factors in developing countries (DCs) contain the seeds of 'revolutionary actions'. Efforts to restrain birth rates might be seen as imperialism, so it recommended that all such efforts be couched in terms of 'the right of the individual to determine freely and responsibly the number and spacing of children'. What a tangle of vested interests!

Some leaders openly argue from mutual economic interest to coax us into taking action. Others prophesy of doom and fear to coerce us to change. In contrast, the primary Christian concern must be for justice, for positive policies that affirm each man's equal worth before our creator and our judge, rather than purely expedient ones.

Family planning combined with reasonable economic circumstances is compatible with such a notion of justice. It allows couples in the light of their own circumstances and beliefs, to decide the number and spacing of their children. Family planning extends personal choice, and is a good thing.

In contrast, population control is inherently coercive. Governments and other agencies make and enforce decisions concerning the number of children couples ought to have in line with prevailing economic and social policy. (For example economic disincentives and forced abortion (China), access to schools (Singapore), limited maternity leave (Tanzania), conditional health care and bribes (Indo)). There is good evidence from fairly poor countries such as Cuba, South Korea, Taiwan, Barbados, Uruguay, the Punjab and Sri Lanka that a modest improvement in general welfare can stabilise population growth. With the basic provision of a secure food supply, access to basic health services and education, the poor can be enabled to take control of their own lives. In short, the greatest need is for development.

Biblical principles

The God of the Bible intended each Israelite family to make a stable living:

Economic slavery through interest loans was forbidden in the Law, the Wisdom Literature, and the Prophets.[1] Commodities were to be sold at a fair price and exploitation was forbidden,[2] provision for the needy was obligatory,[3] debts were to be periodically forgiven[4] and property was not to be accumulated at the expense of others.[5] Extremes of wealth were to be periodically corrected by returning each family's means of production rather than by charity.[6]

Jesus taught his followers habitually to forgive debts[7], and give generously.[8] He warned that indifference to poverty is as evil as outright oppression.[9]

How can we implement these principles, without being overwhelmed by the need? Perhaps that demands another Nucleus article from someone. But I would like to suggest some starters.

  1. Prayer. Prayer recognises that only the power and goodness of God can restore right relationships to sinful communities.
  2. Knowledge. No-one can know everything about complex problems. But everyone can explore one area, for example, which multinational corporations are morally allergenic and deserve boycotts.
  3. Lifestyle choices. Knowledge is dangerous. If it is not converted into change, it may harden our hearts. Choices range from cycling instead of driving, to working with the poor in Nicaragua.
  4. Politics. Our love of neighbour must include opposition to oppressive structural evils, wherever they are found. Voting, writing, lobbying and demonstrating are all vital to effecting change.
What are you called to do?

Bibliography

The Greening of Africa. Paul Harrison 1987.
Rich Christians in an age of hunger. Ronald J Sider 1991.
Issues facing Christians today. John Stott 1990.
National Security Study Memorandum 200 'Implications of Worldwide Population Growth for US Security and Overseas Interests'
Smith R, Leaning J. Medicine and global survival. BMJ 1993; 307:693
Nandan G, BMJ 1993; 307:1161

Bible References

  1. Ex 22:25; Lv 25:35; Dt 23:19; Ps 15:5; Pr 28:8; Je 15:10; Ezk 22:12
  2. Am 5:11, 8:6; Lk 25:37
  3. Dt 15; Ps 37:26, 112:5; Pr 19:17; Dt 14:28-29, 26:12-15; Nu 18:21-32
  4. Dt 15; Ex 21:2-6
  5. Is 5:8; Mi 2:2; Ezk 16:49; 1 Jn 3:17
  6. Lv 25:10-24
  7. Mt 6:12
  8. Lk 6:38
  9. Lk 16:19-26; Mt 25:41-46

Article written by Alex Bunn

More from nucleus: autumn 1995

  • Editorial
  • Problems in Psychiatry
  • Contraceptive Commotion
  • Discrimination
  • Be Prepared!
  • Dilemmas
  • Differential Diagnosis 13
  • Dionysius Dialogues - Theft
  • Know Your Bible 15
  • Rediscovering God
  • Lemuel's Limericks
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