The deadly mass sterilization in India has sparked outrage worldwide. In a surgery spree, more than 80 women were submitted to the procedure in less than 5 hours, all done by the same doctor. Dozens of women have become ill from which 14 have already died. Population growth control is a controversial topic, especially when it comes to the developing world, where population reduction seems to hold the key to ending poverty. But is it really that simple?
In 1798 Thomas Malthus warned the world about a possible catastrophe if the population was to exceed certain limits, namely Earth’s limits to provide. Fears of overpopulation have spiked again after World War II due to the mechanization of agriculture followed by a substantial population growth. Then, when scientists started to notice that along with the improvement of living standards came low fertility rates, the worries spanned from the developed West to the developing South, whose birth rate continued to rise. The economic sustainability paradigm was joined by environmental concerns, and with developing countries now making their transition to the developed world, population control has become a common practice. India and China have been on the spotlight for a while regarding this topic, not only because they represent the two most populous countries in the world, with a combined share of 36,9%, but also because of their fairly recent economic boom. Additionally, both countries have implemented controversial population growth control mechanisms – India known from its sterilization programmes, and China known by its one-child policy.
India – A Painful Choice
The country’s sterilization programme started in 1975 when then prime-minister Indira Gandhi suspended democratic rights by declaring a state of emergency. More than 8 million people, mostly men, were coerced to be sterilized in the name of population control. Although this is now considered history, sterilization continues to be India’s most used contraceptive method, now largely targeting women instead. After the mass sterilization in the 1970s vasectomies became a social and cultural taboo, with men thinking that it might affect their virility; the burden now rests on women, since despite having a smaller financial incentive – men receive an extra 10 dollars compensation – are still more likely than men to undergo the procedure, even if vasectomies are safer than the female operation. Last year alone, around 4.6 million women were sterilized, and 77 percent of them had never previously used any other form of contraception. Last week, 83 women were submitted to a supposedly voluntary procedure under poor sanitary conditions, in an abandoned hospital in rural Chhattisgarh. All the surgeries were done under 5 hours by the same doctor, now in jail. This situation raises two main questions: Was the sterilization really voluntary? What is the real cost of population control in developing countries?
The women who undergo these government-sponsored procedures are mostly poor women, who are given one-time money incentives, usually between 10 and 20 dollars, the equivalent to a week’s salary of a poor person in India. This is part of the country’s target-based approach to population control, now replaced with the term “expected level of achievement”. Poor women are an easy target because not only there is a bigger chance that they accept the money incentive, but often because of their lack of education they do not understand the inherent risks to the surgery, which are in many cases actually omitted from them in order to avoid unwanted decisions. These risks are further aggravated by the poor sanitary conditions, with patients’ stating that sometimes doctors do not wash their hands and do not sterilize the surgical instruments properly. In last week’s incident, according to a statement of the Population Foundation of India, the hospital allegedly did not possess even basic life-saving equipment. The statement also denounces this a common practice, with doctors often discarding the rules in order to meet the “expected level of achievement”, which is a purely numerical indicator, with no regards for quality, incentivized by monetary compensations to the health staff. There are additional worries about the sterilization of women and young girls, including forced prostitution and human-trafficking – without the burden and costs of a possible abortion or even for a kid, these women might become an easier target for traffickers and pimps.
China – The One and Only
China’s population growth history has different phases. Considering only the People’s Republic of China (from 1949 until now), the first stand was on stimulating population growth, with the government considering a large population as the basis for a prosperous nation. Women were encouraged to have children and abortions and sterilizations were restricted. During the 1950s the Party began to realize the problems inherent to over-population and made an abrupt U-turn on its policies, loosening abortion regulations and creating programs to improve education and health and to protect women and children. By the end of the Cultural Revolution in the 1970s the fertility rate was around 5,75 and the government took drastic measures to reduce it. In the next six years, more than thirty million men and women were sterilized, and abortion began to be frequently utilized. In 1978 the infamous one-child policy was implemented, along with a strict program of incentives and disincentives to enforce it. The only child received preferential treatment such as priority in school admission and employment and parents would be awarded extended paid maternity leave, a fixed monthly stipend, better access to housing and increased pensions upon retirement. By 1996 China’s birthrate fell below replacement‐level fertility. The policy is also based in the hukou system, which differentiates between rural and urban residents – while urban couples were strictly forbidden from having a second child, rural citizens were allowed a second child in case the first one was a girl, showing the country’s culturally engrained preference for sons. The United Nations estimates as many as 200 million girls are missing in the world because of this, as portrayed the documentary movie “It’s a Girl“.
Last year, the government has loosened the one-child policy and contrary to expected there does not seem to be a baby boom any time soon. According to informal studies, Chinese couples are showing similar concerns and doubts to their counterparts in developed countries, such as worries about not being able to give the same to the second child, which is worsened by the poor social security support in the country. And some people show no desire whatsoever in having a second child and claim that there is nothing wrong with being the only one; a man interviewed for the mentioned study stated that “Our generation is all only children, and we’re doing just fine”. But are they really? Michael Gross has mentioned two demographic side-effects: the rapid inversion of the age pyramid and the prevalence of what he calls “little emperors”. In other words, on one hand we have an aging population in an early development phase, and on the hand a generation spoilt by the unchallenged attention of its parents and who because of that failed to acquire certain social and co-operative behaviors; according to the author they are “less altruistic, less trusting, less trustworthy, more risk-averse and less competitive than the generations born before 1979”. But this is far from being the biggest problem with China’s policy choice. Since the one-child policy was implemented there have been millions of forced abortions and infanticides, especially of girls, due to the cultural and social preference for sons. This has caused not only a huge gender imbalance, with a lot more men than women, but also an enormous trauma in women, who often experience feelings of guilt alongside possible medical complications. It is also estimated that the gender gap also allowed the human-trafficking and forced prostitution market to grow. According to the World Health Organization, suicide is the leading cause of death for young women in the country, with women in rural areas being twice as vulnerable. China is the only country in the world where women are more prone to suicide than men.
A War Against the Poor
In the Cairo Consensus of 1994, reproductive rights were clarified and endorsed internationally as human rights. These include “the right to decide the number, timing and spacing of children, the right to voluntarily marry and establish a family, and the right to the highest attainable standard of health, among others”.
The examples above are just two cases where women’s rights are not respected. Worse than that, governments and organizations often try to embellish population control under the veil of feminism, arguing that women’s lives are actually improved without the burden of having to have children. But are these women empowered? Feminist Betsy Hartman includes this false idea of empowerment in what she calls the “population doublespeak“. This consists in a series of misconceptions spread and enforced by governments, institutions and the media, which are also spilling into the third sector
“The ideology of population control is being refurbished, polished with a feminist and environmentalist gloss, and marketed with the latest in mass communication techniques.”
Improving women’s status is always seen as a plus, as long as it does not affect the status quo, and family planning is seen by agencies as a miraculous cure to lift up women without having to make meaningful social and economic change. And let us not forget that the institutions pushing population control in developing countries are often the ones which force systematic reductions of public spending on human welfare, being through loans or structural adjustment programs from the World Bank or the International Monetary Fund.
“Since the benefits of the free market rarely trickle down to the poor, then the only way of reducing poverty, the logic goes, is to reduce the number of poor people being born”
Population control programs have underlying economic interests tied to the neo-liberal West. And the so called balance between individual reproductive rights and collective reproductive responsibilities always falls on the same shoulders: poor women, with men being completely left out of the population growth discourse. The gendered discourse obscures the deeper social and economic forces at work and breeds racism. This distinction between “us” and “them” does not stay within borders, reinforcing racial stereotypes in the West, scapegoating immigrants, particularly women of color, since “dark-skinned babies are portrayed as ‘mouths to feed’, and rarely as potentially productive human beings”.
“Calling for a drastic reduction in world population growth is not just an academic exercise taking place in a political vacuum. It has profound ethical consequences, as do all attempts at final solutions.”
Historically, it is the West, and not the developing countries, that has been exploiting the environment and exhausting resources. Now, latecomers such as India and China – or even barely industrialized countries – are the ones who have to pay the price for our mistakes. Over-population can be a problem in the future, but there are countless ways to slow down population growth without having to resource to brutal solutions like forces abortions or sterilizations. They are a quick fix which ignores women’s rights, carving deep physical and psychological scars on both women and nations. It has been shown that improving life standards in general and women’s status in particular leads to a gradual decrease in the fertility rate, not the other way around. How can women feel empowered if their bodies are merely used a tool to control the world? There is no power in being in the end of the spectrum which disregards you as a human being and as we saw last week the consequences of being dehumanized can be fatal.