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Population: children, burden or blessing?

AT CURRENT RATES of population growth it will take Denmark 753 years to double its population of just over five million people. Meanwhile, Egypt can expect to double its 55m population in just 28 years. To anyone who has experienced the turmoil of Cairo in the rush hour the prospect is inconceivable. The city's resources are already stretched to breaking point and beyond. With little cash and almost endless commitments there is little the government of Hosni Mubarak, or any that succeed it, can do to cater for in excess of 100m Egyptians.

In its efforts to make people aware of this pending population explosion the government has tried a number of approaches. Yet there remains enormous resistance to pressure to restrict the size of families. The reasons are threefold: tradition, religion and ignorance. A 1980 survey among women of child-bearing age found that 53% did not want any more children, yet only 24% of those polled were actually practicing birth control.

Traditionally, a large family was regarded as something of a status symbol in the Arab world. Sons and daughters were regarded as insurance for old age, a means of support and a guarantee that the status quo, or something close to it, would be maintained, even in the event of the death of one parent. Sons would be left to tend the fields and the flock, should a father die, daughters would remain to keep the house and home ticking over in the event of a maternal death. Only a matter of a couple of decades ago, infant mortality rates were high. Families frequently suffered the deaths of numerous children. With the introduction of better health care including vaccinations and neighborhood clinics where parents are able to consult trained medical staff about the prevention and cure of illness and disease, the death rate has been dramatically reduced. In Egypt, for example, figures show that infant mortality is down to 61 per 1,000 live births, almost a third of the figure recorded 20 years ago. The need to produce large numbers of sons and daughters as "insurance" no longer exists yet the habit continues.

Although family planning has gained the support of the mufti, Egypt's highest religious authority, which agreed that it did not contradict Koranic teachings, some hardliners still regard contraception as a sin against Islam. There have, over the last two years, even been incidents of murder against people involved in the promotion of family planning.

IPPF, the International Planned Parenthood Federation, has been active in the area of family planning for more than 40 years. The organisation's approach is a low key one. The concentration is not on limiting the number of children born into any household but rather on careful planning, the spacing of births to allow for full recovery of the mother and the maximum benefits for the new born child, is advocated by this non-governmental office which is active in over 130 countries.

Dr Hammouda Hanafi, IPPF's director for the Middle Eastern region, explained that his organisation's policy is to promote and support family planning services internationally and to educate people and governments about the benefits for the whole family, particularly mothers and children, of spacing and planning births. IPPF actively campaigns for policy and legal changes which will encourage the provision and voluntary use of family planning services. IPPF believes it is the right of every individual to control their fertility and to have the knowledge and means of doing so. The organisation is totally opposed to any form of coercion, direct or indirect, in the provision, acceptance or practise of family planning.

Dr Hanafi noted that when the means are available to enable couples to plan their families properly, the health and survival of the whole family improves. Firm scientific evidence demonstrates that the risk to the health of both women and their children increases when pregnancies come too early, too often or too late in a woman's life. When births are well spaced mothers have time to recover their health and strength after each pregnancy and their babies have the best chance of growing into strong and healthy children. "This way everyone benefits," Dr Hanafi stresses.

The experts seem to agree that the education of women is the key to successful planned parenthood. It cannot be a coincidence that the Arab states with the highest female literacy rates frequently have the lowest average number of children per family. For this reason IPPF has allocated a substantial amount of money for the training and education of women in the Arab region. In Algeria, for example, where women's groups are currently fighting for their rights in a variety of areas, access to family planning is being demanded as a right rather than a privilege.

"Times have changed, in the Arab world as everywhere else," a United Nations official told The Middle East. "The need to produce large numbers of children no longer exists and men and women are realising that they can have a better quality of life with smaller families. It is largely ignorance that is responsible for increasing populations. Huge inroads have been made in making family planning methods available throughout the Arab world but of course it is impossible to make people use contraception, they have to want to. Regrettably, there has been something of a backlash against contraception in some of the Arab countries recently, largely due to fundamentalist hardliners who say contraception is haram, forbidden by the Quran. Of course this is nonsense, the Quran does not forbid the use of contraception but here again the uneducated are not really in a position to dispute fundamentalist teachings, since they know no better they have to go along with it."

It seems clear that any successful family planning campaign must target the poor and uneducated for whom the benefits of smaller families are frequently less obvious. IPPF has embarked on an extensive programme to take its message of birth spacing to the younger generation who will be the parents of upcoming generations. As the UN official noted: "It's too late, for example, for family planning organisations to target the 40-year-old mother of ten children in Jordan. It is each of those ten children we should be concentrating on. If each child follows the example of their parents we have a further 100 Jordanians. If they do likewise we have, in two generations, a further 1,000 people dependent on an already stretched system and a swiftly deteriorating environment."

Nowhere in the developing world have family planning needs been fully met. Many women continue to face a greatly increased risk of illness or death, due to inadequate family planning services. Half a million women die each year as a result of pregnancy or childbirth. These high risk pregnancies also increase the danger of stillbirths and infant illness and death: 40,000 children under the age of five die very day, most of them in developing countries. It is estimated that in the developing world alone there are still some 300m women who want contraceptive help but have no access to family planning services and advice. Surely, in an already overcrowded world where hundreds of children are dying daily of starvation and preventable disease, it is in all our interests to ensure that all women are able to get it.
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Title Annotation:population growth in Egypt
Publication:The Middle East
Date:Jun 1, 1993
Previous Article:Intriguing changes of fortune.
Next Article:Islam and birth control: not a moral conflict.

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