UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
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The electronic preparation of this document has been done by the
Population Information Network(POPIN) of the United Nations Population
Division in collaboration with the United Nations Development Programme
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AS WRITTEN
Cairo Conference
September 1994
Dr. Nafis Sadik invited me to speak at this forum today and I am
honored to be here with you. Many of you in this room are population
professionals who were among the first to see that unwanted pregnancies
posed risks and problems for women, as well as for countries trying to
provide a better life for their people. Without your early efforts and
understanding, fewer countries would have articulated population
policies, family planning programs would be far less evolved,and many
more women would have suffered the consequences of unwanted pregnancies.
Others of you here today have longed been involved in women's
health and development issues. The fact that you have all joined
together here to forge a common agenda, each adding a new perspective,
shedding a new light from a different angle on the issues of population
and development is what makes this conference so significant and so
unique
We owe you all a debt of thanks for what you've done to prepare
for this conference and especially for your consensus building work; for
making your voices heard and then listening to each others voices. With
the perhaps inevitable but sad tendency the world has to focus on
discord and controversy, not enough has been said about the ground
breaking consensus that marks this conference.
In addition, I want to thank the Clinton Administration for
returning the United States to its historic leadership role on this
issue. It is fortunate for all of us that Secretary Tim Wirth has the
vision that allows him to see that non-governmental organizations bring
all kinds of new energies, skills and knowledge to the table;that
without the participation and input of women in the field whose lives
are most affected by this issue, international population policies could
never have moved beyond a narrow focus on quotas to address human
rights, women and child health and appreciate the breadth of cultural
differences. This new, inclusive approach to policy-setting is a long
time in coming, and I hope it will be a model for future initiatives of
all kinds.
In the relatively short period of time that I have been trying to
understand these issues, I have seen the landscape change dramatically.
In fact, it's hard to believe how differently people think about and
talk about population today as compared to even two or three years ago.
What are some of the things that have been learned: that providing
contraception is critical but not sufficient Why?
-Because women do not control their sexual or reproductive lives;
-Because women with no education, no legal status and no
financial independence are in no position to negotiate issues
like the planning and spacing of their children, and are often
at risk of violence from uncooperative spouses;
-Because in many countries where women have no secure social and
economic roles apart from motherhood, large families are
necessary to uphold their status and provide them with
assistance with work as well as old age security;
-Because too often there are limited forms of contraception
available which may not be medically appropriate or personally
acceptable to a particular woman;
-Because sometimes a family planning provider's interest in her
client does not extend beyond reducing fertility and neglects
other aspects of the woman's reproductive health needs as well as the
concern she has for her children's health. Under these circumstances, it
is unlikely that the woman will develop trust in the provider and become
a consistent contraceptive user.
Fortunately, today there are ample examples of well run,
successful family planning programs that exemplify the principles
espoused in the Cairo Plan of action. Many of these programs have
certain key features which are achievable by mainstream programs. I
think these features have been best and most charmingly described by Dr.
Mahmoud Fathalla, director of ob-gyn at Assiut University, Egypt who
presented them in February at the Population Council's Symposium on
"Family, Gender and Population Policy." He calls them "The Ten
Commandments of Reproductive Health Care: A Signpost For All Clinics."
"As a woman-friendly service:
1. We uphold the principle that family planning is a dignified and
voluntary informed choice.
2. We are open to serve you at times of your convenience, not
ours. Our outreach services will knock at your door. We need your
business.
3. We excel in counseling. We not only listen to you, we hear you.
4. We offer you a broad choice of the good "oldies" as well as the
very newest contraceptive technologies. we seek to meet your needs and
preferences.
5. We are not in the business of promoting contraceptive methods
for their demographic impact. We do not subscribe to demographic targets
or quotas. Your safety and convenience is our primary concern.
6. We only add to our inventory methods that our service can
deliver which insure your safety and with full respect for your
voluntary choice.
7. We encourage and promote men's participation and
responsibility.
8. In the event you are faced with the possibility of or are
burdened by an unwanted pregnancy, you will find us sympathetic and
caring.
9. We care as much about protecting you from sexually transmitted
diseases as we care about protecting you from unwanted pregnancy.
We will not miss an opportunity to help you with other reproductive
health needs or problems.
10. Our demographic competitors are running out of business.
We are in business. We are the future."
I would like to point out that programs offering these features
often do not cost more than other programs, and because they tend to
attract and keep a larger clientele, their fixed costs are spread over
larger numbers making them more cost effective than programs which
neglect these vital elements.
What else have we learned? We've learned that educating girls,
economic and legal empowerment of women, things which are important in
and of themselves, also have a provable effect on fertility decline.
When a woman is educated, when she is able to earn some money outside
her home, money over which she has control, when she has access to
credit and training, she gains status, wants and needs fewer children,
can negotiate family planning with her partner from a position of
strength and the children she does have will tend to be healthier and
better prepared for the emerging economy. In addition, the improved
health, education and earning capacity of women leads to better
management of natural resources.
About 50% of the world's food is grown by women. It is estimated
that two - third's of women in developing countries who work, work in
agriculture, mostly unpaid subsistence farming. They hoe, plant, weed,
harvest, store, process, cook and take care of livestock, including
cattle, sheep and goats. They are the ones who walk miles and spend
hours, sometimes days, collecting water, fire wood and fodder. All this
has provided women with profound knowledge about crop diversity, soil
conditions and water quality. They are the ones who are most impacted by
environmental degradation and have the most to gain by protecting the
local ecosystems. Sustainable development begins and ends with women.
To give this a real voice, I'd like to quote a Hill woman from Nepal. I
found this quote in a pamphlet called "Seeds," dealing with forest
conservation in Nepal.
"By law, we villagers are only allowed to collect what
has fallen on the ground in the forest. The trees are used for
timber for building for those lucky enough to be sold a permit
by the forest officers. Women are left with the leaves, branches
and twigs. Once, it too difficult to find wood on the ground,
but now there is not even enough leftover to fill one headland,
unless you walk for miles and miles, and no fodder unless you
cut the branches.
Even when I travel a long way into the forest, I still have
to cut branches illegally to get a large enough headland to cook
for my family. If I'm caught by a forest guard, he takes my
cutting tool, or tells me I have to pay a stiff fine, but what can
I do? As it is now, I must bring my daughter with me to help
collect fuel and fodder, so she often skips school to help me.
I would rather that she got a good education so she would have
a good chance in life, but I have no choice. There are too many
other chores to complete. I now go to the forest everyday that
I have no work in the fields or grain to thresh or grind, and one
headload (about 35 pounds) lasts only a few days. If fuel gets
even more scarce, I will have to take my daughter out of school
completely so she can help me with my other tasks."
In addition to the fact that women produce the food and fodder for
their families, evidence from numerous studies done in developing
countries show that when women are able to earn and control their money,
they spend it in ways that benefit their families' health and welfare.
Men, on the other hand, tend to spend their incomes on entertainment and
consumer goods. In addition, women in developing countries deliver basic
health care to their families and communities.
Given all this, why is it then that women in these countries are
discriminated against when it comes to education, inheritance, land
ownership, jobs, training and resources; girls receive less health care
and food than boys; women do not fully participate in or benefit from
development policies? Why is it that too often women are not consulted
and listened to when programs are being put in place? Over and over
again, experience shows that when women are involved from the
outset,programs stand a far better chance of succeeding, the lives and
status of women and children are improved. and often this is linked to
fertility decline.
Too often governments and lending institutions undermine women
with poorly defined economic programs on the one hand, while at the same
time actively trying to engage them in limiting fertility, thus wiping
out with one program what is being attempted with another. There are
numerous examples of development approaches in Africa and other parts of
the world which give priority to men even when women are the primary
producers. For example, when cooperatives are formed, only one member of
the family (which will turn out to be the male) isallowed to
participate, freezing the women out of new input, training and access to
land, making her subsistence work more difficult and increasing her need
for more helpinq hands.
Another example is the large-scale agricultural intensification
projects which put more demand on women's time and energy without
compensation, reducing her ability to farm sustainably. Just as natural
resources are not infinite, neither is women's energy. Both can only be
stretched so far. By increasing women's need for children to help with
the work, we also undermine women's desire to reduce child numbers. But
in some countries, Zimbabwe for example, there are active efforts to
improve women's access to land and credit, modernize their livelihoods,
and this is reflected not only in economic returns but in high
contraceptive use.
Disinvestment in women can be avoided, and our approach to aid and
development can be made more coherent, if development plans, social and
economic investment policies and national budgetary guidelines are
reviewed at a high government level by some coordinating body in light
of their fertility as well as their justice implications. Population
policy cannot solely be in the purview of Health Ministries. Likewise,
the policies of the international lending institutions should not
compartmentalize population concerns, separating them from
education,from promotion of livelihood, health and so forth. If
population is important, this concern should be spread throughout the
development portfolio.
We mustn't permit our development policies to be driven by
politics or special interests or even altruism for that matter. They
should be driven by enlightened self-interest. To quote Janice Jiggins
in her book changing the Borders, "Protecting and strengthening the
capacities of girls and women is the bottom line in the survival of
humankind as a species dependent on its environment. It is thus
essential for human survival that economic theory, policy and practice
in both rich and poor countries begin to measure, value and reward the
services provided by women and by the environment."
The good news is that there is a slow but steadily growing
appreciation that it makes economic, social and demographic sense to
invest in women. This new direction is being lead by innovative, smaller
institutions such as Women's World Banking, ACCION International, and
Grameen Bank in Bangladesh, who have fostered women's economic
entrepreneurship and independence. Following their lead, the larger
bilateral and multilateral donors are beginning to direct more and more
of their funds towards women. Why is this happening? Because the banks
always hard to impress ... are impressed. They've seen that women can
manage their finances better and that support for women's economic
activities is more likely to benefit the community at large and the
health and education of the next generation. These lending institutions
have begun to recognize that women in developing countries are agents of
change.
We've begun to learn that, just as we can foster economic growth
and fertility decline by investing in women, we can promote a more
humane and equitable relationship between men and women which, as a
byproduct, encourages voluntary fertility decline. When a father shares
the rearing of and support for his children, he may be more prone to
share the mother's desire to limit family size. But there are countries
which will agree to the Cairo Plan of Action where children still only
have effective claims to their father's resources if the father wishes,
or where the father's name appears on the birth certificate. There are
countries in which the father's name only appears on the birth
certificate if the parents are married. Even countries with "good laws"
do not implement their ideal of shared parental responsibility. There is
much default in enforcing child maintenance policy. We must encourage
men to be emotionally and financially responsible for their children.
Laws, norms of behavior and media images all have vital roles to play.
Let us hope that the young men of today grow up with a sense of
responsibility about their sexuality, about their fertility and about
parenting.
Can we afford to properly expand and improve our family planning
programs world-wide? Can we afford to reproduce economic empowerment
programs and education for women? You bet! In fact, we can't afford not
to. It's a question of priorities and of developing a new understanding
of national and global security. If the United States and the former
Soviet Union could spend over 10 trillion dollars during the Cold War to
prepare for a possible threat, we can surely find enough money and
resources to deal with dangers that are actually occurring.
Cairo will soon be over. The Plan of Action will have to be put
into action. We need to walk our talk," and we particularly need the
help of the world's media to do this. It is true that changing our laws
and institutions can alter human behavior, but to alter people's
consciousness and do it fast, the media will need to play its role.
We've all experienced the media's power to change things, whether
its through the use of popular soap operas in Mexico, India and the
Philippines which have helped make family planning acceptable to a wide
audience or in the United States with the acceptance of seat belts,
recycling and other life style changes. You don't see movie characters
showing their cool by heading straight for the bar and lighting up at
the beginning of a scene anymore. Like it or not, television and movies
in particular have become powerful sources of education about how to
live and behave and raise families for people who have no formal
education. In addition, people will need to understand what has been
decided here in Cairo, the importance of these problems and the need to
be involved in their solutions.
All of us In whatever way we can have to help create a critical
mass for family planning and reducing consumption so that if a boy or
girl is asked, "What will you do to help heal the world?", they would
start by saying, "I will live more simply and only have the number of
children I feel I can support and care for." We need to communicate to
people the value that life is sacred, that children have the right to be
wanted and that it's irresponsible to have more children than you can
support. But parents here in the developing countries or in the north
for that matter cannot do this alone, individually. We must have
commitments from our national governments to also invest in women and
children and make them the center of our economic planning.
In a sense, we're asking ourselves to start doing what comes
unnaturally. Throughout human history, we've been exhorted to go forth
and multiply. All the western religious doctrines have encouraged this.
In part, it's because countries and churches needed bodies to fill the
ranks of their armies as they went forth to fight the infidel. But it
goes back even farther, hundreds of thousands of years to our ancestors,
Homo Erectus, when the human brain evolved to what it is today. At that
time, evolutionary advantage went to those who were most adept at seeing
and reacting to the most immediate danger and screening out the rest. to
those who spread their sperm wide and fast and early. The Homo Erectus,
who sat there pondering the implication of slaughtering all the Woolly
Mammoths, most likely had his head bit off before he could reproduce. As
the biologist E. O. Wilson said, "Prophets never enjoyed a Darwinian
edge."
Our brains may not have evolved since those days, but reality has
changed, and so must our thinking. We are not prisoners of our biology.
We must reconceputualize the way we live in light of limited resources
and a limited capacity to invest in the next generation. Quality, not
quantity, is the path to the future.
All of us have important and difficult things to do. Change is
always difficult and entails some discomfort and inconvenience.
Population numbers is only part of the equation. The other part is what
kind of consumers we are in the industrialized world and what kind of
consumers we will become in the developing world. We in the highly
consuming countries must change our patterns of consumption, invest in
the forgiving, energy efficient, low waste producing technologies and
share these technologies with the developing countries. We need to learn
that enough is enough, that "more" doesn't necessarily translate
into"happier."
People in the developing countries, with bilateral and
multilateral support from aid-giving nations, must change their social
investment patterns to support their women and children.
This is essentially what the Cairo Plan of Action is all about. It
will require a shifting of gears, making some tough adjustments, but if
we make them now, they can be humane and good, not especially jarring.
If we don't, adjustments will be made for us by nature and they will be
brutal and pitiless. If that occurs, we will not be the first species to
have weakened and disappeared, nor the first civilization. History is
littered with civilizations who fell victim to short-term definitions of
self-interests. Let us learn from history.