| SAPLER Population Trust | |
| Splendidly Alive People Within Limited Environmental Resources | |
Contraception is the Best Contraceptive
A sad thing happened at the first World population Conference in Bucharest in 1974. A slog an was coined:
"DEVELOPMENT IS THE BEST CONTRACEPTIVE"
This is not only sad - it is tragic. Because it has blocked the way to a direct solving of the overpopulation problem.
"Development" is too big a word. It can mean anything from the building of a Tokyo skyscraper with floors made from the indigenous wood of the Malaysian rainforest, to a nompilo bringing a farm labourer to a mobile clinic on the correct day for her Depo injection.
It is true that Soweto now has a fertility rate of two children per mother. And it is true that Gazankulu has a fertility rate of six children per mother. People who have come to Soweto and got jobs and been in touch with family planning services - or with the services of illegal abortionists - and been exposed to the advertisements of the urban commercial world - yes, they have limited their families.
We must also give some credit to the government-funded programme, "Crossover", which preached the two-child message, but on the whole they were preaching to a very receptive audience - people living in small houses with television sets who wanted to go up in the world.
DOES THIS MEAN THAT WE SHOULD NOT GO TO THE PEOPLE OF GAZANKULU WITH CONTRACEPTIVE SERVICES?
That is the problem with the "Development" message. It blocked initiatives that might have occurred.
What is the rigidity rate amongst developing countries? Who swallowed the development message whole?
It seems that all Africa did. All over Africa there are departments of "Development and Population" or "Population and Development".
But in South Africa we left out the "and". We have the "Population Development Programme". What does "Population Development', mean? (We would remind SAPLER readers that this department has nothing to do with the delivery of contraceptive services in this country.)
The following developing countries ignored the "Develop First" message and tackled the population problem head on. These countries have nothing in common except their ability to ignore nonsense. They have all got an overall fertility rate of 3 or fewer children per mother. They are:
COLOMBIA, JAMAICA, TRINIDAD AND TOBAGO, MAURITIUS, INDONESIA, SRI LANKA, THAILAND AND TURKEY.
When is a theory an hypothesis?
"Demographic Transition Theory" was never a proven theory - only an hypothesis. Now proved wrong. It stated - in a nutshell - that people start limiting their families only when they get richer.
Now it has been shown, a tragic number of years later, that education, occupation, wealth, location, religious belief, women's rights and social status are only indirect determinants of fertility. We might add 'electricity', since we have received a letter from someone who has heard that 'electricity' has brought down the fertility rate in Soweto.
The factors' vary from time to time and from place to place, from fashion to fashion and from culture to culture.
The only proven determinant of population limitation is universal, well distributed contraception.
Anyone who wants back up for all this is welcome to write to SAPLER for a free printout of an article in Scientific American December 1993.
Here is one quote: 'Bangladesh is a perfect example of how this concept has been disproved. It is one of the world's poorest and most traditional agrarian countries. Infant mortality is high, women have low social status and most families depend on children for economic security. Nevertheless, fertility rates there declined 21 percent between 1970 and 1991 ... During this period, the use of contraception among married women of reproductive age rose horn 3 to 40 percent.'
Why?
We are including a reprint of an article by Norman Myers with this newsletter. For those who lose it, or don't have time to read it, we will quote from the end:
"So what is working the birth-control chemistry? It seems to be the speedy spread of family-planning facilities ... TAKE NOTE, THOSE NATIONS THAT INSIST THAT FAMILY PLANNING HAS ONLY A MINOR ROLE TO PLAY IN POPULATION PLANNING." (our caps)
Population Limitation is an essential element in saving our environment. The best way to ensure that it happens is:
(1) To say so.
(2) To ensure that every South African is reached with the message and the means. Nothing else has to 'come first'. We can do it now.
Population Limitation is not:
(1) The only thing we have to do to save the environment.
(2) The only thing we have to do to improve the quality of individual lives and communities.
Before SAPLER was established I was talking one day to the wife of a farmer who employed many women packing avos in the Northern Transvaal.
'All these women will have babies this year,' she said.
Why?"
'The sister who used to come and give the injections was regular and reliable, but now there is one who is always ill - or her car isn’t working - or something.'
It was four months since the women had had their last Depo injections.
I didn't feel up to tracking down the right person in the right government department, but my son Julian was worried about all these women who would have unwanted babies. He phoned the Louis Trichardt health department. The day after that one phone call all the women on that farm, and on the neighbouring farms as well, had their injections.
The interesting thing is that ever since that time, two years ago, the women themselves remind the farmer's wife that it is time for their three-monthly injections.
In a deep rural very traditional village in Natal the women stayed home and had babies. Their men went to work in Johannesburg.
Someone from a Paris boutique discovered this village and the women started making beadwork for this shop. The men, who were all working in the same industry, were all laid off at the same time. When they got home they said to the women:
"You must go on doing this beadwork and we will work in the fields. What is more, you must go to the family planning and get fixed up there."
(Story told to me by Mary Rose, then of the lnstitute of Natural Resources.)
On TSS television, now NNTV (and probably what will save South Africa) some rural women sat around a table discussing women's empowerment.
One woman told a story: The Agricultural Extension Officer didn't come and didn't come to fix the village pump. Finally the women decided to do something about it. They went to his house and disconnected his water supply! The next day he came and fixed the pump.
While everyone else was laughing, one woman sat silent. Then she said: 'Why don’t you learn to fix the pump yourselves?'
Why am I making such a point of insisting that development is not the best contraceptive?
It is because it is a very well established myth, which gets passed from mouth to ear and ear to mouth without any critical analysis or definition. It is repeated by very high-powered spokespeople and decision-makers, like Van Zyl Slabbert and Mamphela Ramphele.
Even SAPLER's own Dr Motlana, now president of the Population Council, says - in a speech on population limitation - that we must have more houses. Of course we must have more houses, but not as a direct way of limiting population.
Nelson Mandela says we must have population education. Of course we must have population education, but in addition, at the same time, we must have birth control provision.
Have I got anything against development? Yes, if you mean unsustainable industrial development. No, if you mean developing people to the point where they can solve problems and not fall for myths.
It is because SAPLER is for "development" - in its best sense - a spiralling up to self-help, 40 million problem-solvers, access to land and/or jobs - that we exist at all.
SAPLER - in case anyone has forgotten or never known - stands for 'Splendidly Alive People etc." We are now emphasizing community-based, self-help contraceptive services because this seems the most worthwhile help we can point to at this moment.
Egypt may be considered a "developed" country. It has a 'low" fertility rate - only four children per mother!
Egypt has excellent education, excellent health care, very low teenage pregnancy and widespread family planning services.
Egypt also has a catastrophic environmental problem: very low rainfall. Nearly all its water comes from the Nile. The Nile is heavily polluted - and more and more of the upstream water is being used by Sudan and Ethiopia.
So why does Egypt still have a fertility rate of four children per mother?
Professor Maher Mahran, secretary-general of the Egyptian Population Council, visited South Africa last year. He told us that they have tried to promote small families by every means possible. But only by giving health reasons. "It is medically inadvisable to have babies before age 20 or after age 35. It is medically advisable to space your children three years apart."
Those who think that four children is fine should consider exponential growth. If one woman has four children and each of her children has four children that is 16. If each of those 16 children have four that is 64. If each of those four have four children that is 256. After ten generations that woman will have one million descendants.
Egypt is now, at last, starting to talk directly to its people about the population problem. They will host the third International Conference on Population in September this year. Hopefully no one will come home saying, "Development is the best contraceptive".
At a population conference last year a speaker said: "You can't tell black people who have suffered and been severely deprived that the environment is at risk."
A young black delegate from the Ciskei asked: 'Why not? We do.' In 1991 the Ciskei had a fertility rate of four children per mother. This was by far the lowest among the homelands and self-governing territories.
The main reason was probably that their contraception services are very well organized, but it's good that they don't muff the environmental message.
RESA (Reach Every South African)
RESA is a SAPLER project which aims to bring contraceptive services to all who wish for them.
It bypasses all the scruples of the guilty whites by making people active participants, not passive recipients.
It also bypasses negativities such as "the chiefs won't permit it". Peter Dodds says that, In every furthest corner of the Empire there was always one woman who needed no persuasion.' She saw the benefits of controlling her fertility without this needing to be spelt out. She then became the distributor/educator/injector of her friends who wanted to copy her. And that was twenty years ago.
Some chiefs won't like it. Then the women will either defy him or slip away next door. What about the costs? First of all there is nothing as cost effective to the country as a whole as limiting the population. All attempts to upgrade the poorest people will fail if we never 'catch the curve'.
Secondly we have not begun to consider using the most cost-effective means:
Gold Fields of SA, via the SA Nature Foundation, has given SAPLER a grant to do a survey of unmet family planning needs in the Transvaal, particularly in the rural areas.
We will work through organizations already in the field, such as church groups and environmental groups and also through farmers.
Is there an unmet need in their area?
Would a Peter Dodds/nompilo type of trainer be welcomed?
Is there a hospital not too Tar away where volunteers could take those who choose sterilization? (And where STD testing could be done to help those at risk of AIDS).
In areas where AIDS is high, are condoms readily available? In areas of high teenage pregnancy and high teenage STDs, would the available videos which show girls how to "say no" be appropriate?
My sister, Jane Stewart, who works for the Ontario Ministry of Health in Canada, reports that the teenage pregnancy rate in Canada dropped dramatically after AIDS awareness programmes were introduced, into the schools.
We don’t send renewal forms so please send your R30 now. All paid-up members were sent the Enviroteach magazine on "Population" as our second offering for 1993.
Enviroteach is still available for others who pay now for 1994. It has an excellent article by Peter Dodds with pictures. This tells the full story of the spectacular rural scheme which Peter Dodds ran in Zimbabwe in the 1970s.
This is a scheme for the people by the people. Non-coercive, non-prescriptive. And through it Zimbabwe became the first country in Africa to reduce its population growth rate. The scheme continued during the bush war. When communities were moved into protected villages, their family planners went with them.
As Peter Dodds wrote in the Star correspondence of 1990, after which SAPLER was initiated: "Family planning from within a community, through the medium of a member of that community, becomes a natural part of the social fabric."
The scheme continued when Rhodesia became Zimbabwe. I have copies of letters to Peter Dodds from Dr Ushewokunze, Minister of Health, and from international organizations, attesting both to the efficiency and the humanity of the scheme.
What happened was that an evil, fanatic, superstitious wind blew in from America. The wish to use Depo Provero injections had come from the people. It was not imposed on the people. No one had ever died from Depo, and those who suffered side effects could change after three months.
But the voice from America said that Depo was carcinogenic, racist, anti-women and a weapon of the capitalist establishment to bring about global population control.
The entire medical establishment of Zimbabwe, black and white, and including the Medical School, supported Peter Dodds.
But the fanatics won. When the ban on Depo was made public, 100 000 regular Depo users demonstrated outside Mugabe's office. But this made no difference. Peter's office was closed down in 1982 and the scheme collapsed. The ban on Depo was lifted in 1992. But how much suffering had been caused in those years between?
Letters to the Editor (shortened)
While I respect your concern for the future of our country, I think your newsletter at times lets enthusiasm obscure reality.
You say, "The population continues to explode". This simply is not true. The population growth rate is declining and has been for some time.
I also think it is important that much of your rhetoric is against the view that development programmes are an essential part of population (for example your pieces on Mauritius and Thailand). Your description of the Nompilo scheme is an excellent example of a development programme which incorporates contraceptive provision.
Good luck in your endeavours,
Barbara Klugman Women's Health Project, Centre for Health Policy (Wits)
The population of the whole of South Africa (including Bop, KwaZulu etc.) is increasing by one million people per year. Ed.
We regret that in April 1993 in "Sensitivities?" (back page, Newsletter No.1) you refer to a Planned Parenthood meeting which was held late in 1991, and take exception to the tone in which the article was written.
The Association is presently developing its policy on population, and it is intended that this be ready for ratification at the National Council meeting at the end of August.
You mention a successful Nompilo scheme. May I point out that we run a similar scheme in Nhlangweni in Natal, in conjunction with the Institute of Natural Resources.
Tsietsi Maleho
National Coordinator
Planned Parenthood (PPASA)
GIVE ANOTHER ten pamphlets like this one. People like it.
Rufus T. Manaka
Bakone
The aim of the government's Population Development Programme - namely, "To ensure a balance between the size of the population (80 million by the year 2010) and the resources (natural resources and socioeconomic potential)" is clearly stated in all its policy documents.
The PDP has specific objectives aimed at reaching this aim:
The enhancement of the standard of living of all people of South Africa.
The acceleration of development, with specific emphasis on changing fertility perceptions in favour of a small family norm.
The integration of family planning in development programmes where possible.
The involvement of communities in actions of the PDP, with particular reference to the terrains of education, primary health care, family planning, the economy, manpower training and housing.
G. Snyman PDP
Your aims are vast and unfocused. The issue is whether the money spent by your department could be spent in a better way. The nompilos bring down the growth rate much more quickly than you do. So does Dr de Villiers Of Paarl. What if a combined nompilo/ sterilization scheme was introduced into the areas which still have an average fertility rate of six children per mother?
The South African environment is not "carrying" 40 million people. How can it be expected to cope with 80 million? Ed.
Research shows that for any family planning programme to be successful there are four necessary components:
accessibility of contraception
improved women's education
improved women's status
better maternal and child health care.
The Planned Parenthood Association of S.A. does believe that population is important, but approaches the issue from an integrated development viewpoint. Further, we believe that all the people in this country are capable of making their own decisions, and that our role is to provide them with information which assists them in making their own choices. Population is not about economics, population is about quality of life.
By tackling the four issues mentioned above, people's quality of life will improve, and the rate of population growth will be reduced. The Association does not support tackling population issues through coercive means. Regrettably in the past family planning has been politicised in this country, and thus needs to be handled with sensitivity. Population control has a stigma attached to it and is not in keeping with a human rights perspective.
SAPLER and PPASA are working in the same field, taking a different approach. I appeal to you to support efforts that are being made in the field of reproductive health and empowerment of women, which will be to our mutual benefit.
T. Maleho
PPASA
Ja well no fine. Ed.
Paul and Anne Ehrlich: "The race that wins inherits a dead planet. " The vast majority of people has been added to the ranks of the poor, not the rich."
'Why isn't everyone as scared as we are?"
'Why isn't everyone as scared as we are?"
Elise Ottesen-Jensen, Swedish family planner 1933: 'I dream of the day when every child that is born is welcome, when men and women are equal and sexuality is an expression of intimacy, pleasure and tenderness. "
A Johannesburg gardener: "I'm hearing that after April 27 it is only two or one children.
Printouts included on this newsletter are: 'The Biggies' from People and the Planet, and "Scientists" from the Daily Dispatch.
This newsletter was written and edited by Ann Cluver Weinberg and published by SAPLER. Cheques for membership (R30) and donations to: SAPLER POPULATION TRUST Please print name and state: 'For 1994'
SAPLER
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