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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This newsletter is being made available by the Population Information
Network (POPIN) Gopher of the United Nations Population Division,
Department for Economic and Social Information and Policy Analysis, in
collaboration with Population Communications International. For further
information, please contact Patrice_Newman@together.org.
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INTERNATIONAL DATELINE
A Population and Development News and Information Service
JUNE WORLD POPULATION UPDATE: 5,687,000,000
(Population Reference Bureau)
June 1995
WORLDWIDE, HUMAN MIGRATION HAS BECOME AN EVER-PRESENT PHENOMENON IN
THE 1990s.
The Washington-based Worldwatch Institute notes that while our
public debate constantly focuses on "the refugee crises of the
moment," we have yet to take a step towards "real stability" by
finding "a clearer understanding of just what it is about the
world's politics, economics, or security that is causing so many
people to move." Hal Kane, writing for Worldwatch, says that new
pressures to move are joining the traditional forces of persecution
and war. And the new pressures reflect our times, says Kane,
including "the breakup of the Soviet Union, the desperation of
Africa, and many other developments." Population growth and
environmental degradation, Kane says, cast their steady shadows on
all these events.
HISTORICALLY, MIGRATION WAS A COLLECTIVE MOVEMENT OF GROUPS, NOT A
MASS MOVEMENT OF INDIVIDUALS, as it is today, says Kane. He notes
that beginning in 1500, the slave trade changed the nature and
volume of human migration, with roughly 14 million people thought
to have been forcibly moved in the next four centuries. Most
African slaves were brought to the Americas, especially South
America, says Kane. But in smaller numbers, they were also
transported to Europe and the Middle East. "Individual voluntary
migration" became a major trend in the early 1800s, according to
the Worldwatch article. Around 60 million Europeans went in search
of economic, religious, or political freedoms; about 12 million
Chinese and 6 million Japanese moved to other parts of southern and
eastern Asia; about 10 million left Russia and Central Asia; and a
million and a half people moved from India to Southeast Asia and
Africa. But, Kane points out, none of this foreshadowed today's
massive numbers of people moving around the globe. Now, as many
people migrate in one year as moved in entire previous centuries.
TODAY, EVERY WORLD REGION EITHER SENDS OR RECEIVES MIGRANTS, says
Kane, adding that the reasons people leave their homes and
countries are remarkably diverse. Land, water and food scarcity;
overcrowded squatter settlements; post-Cold War political changes;
and widening income disparities are some of the factors which Kane
says add up to an "unstable mixture of rapid economic change,
social disintegration, and unrelenting demographic pressure."
People generally move for a combination of reasons, says Kane,
noting that countries with high infant mortality, low literacy,
eroding farmland, and food shortages "often fill the world stage
with refugees," while countries with stable populations, high
levels of education and public health tend to resist shattering
social crises. In fact, Kane says, improving social stability is
the key to avoiding refugee and migration crises, including
spending money on sanitation systems, public health and preventive
medicine, maintaining stable soils and waters for farming, and
investing in literacy. Regarding the seeming disparity between
literacy and refugees, Kane points out that "no democracy that has
a relatively free press has ever suffered a major famine." And, he
adds, "if access by literate people to public debate seems too
detached from warfare to be relevant, consider the fact that no two
democracies have ever gone to war." (WorldWatch Magazine,
January/February 1995, Washington, DC)
* * * * *
IN BRIEF . . .
. . . A WALL CHART ON CURRENT HUMAN MIGRATION TRENDS has been
produced by Population Action International. The chart consists of
a world map with sweeping arrows indicating the numbers of people
migrating to and from different world regions. Accompanying text
sheds light on the forces that motivate people to move. To obtain
copies of the chart, contact: Population Action International, 1120
19th St., N.W., Suite 550, Washington, DC 20036, USA. The
Worldwatch article described on p.1 also contains a world map
showing human migratory patterns around the world.
. . . THE EARTH'S OZONE LAYER weathered a tough winter this year,
with concentrations of the protective gas well below normal over
much of the Northern Hemisphere. And while natural weather
patterns may have contributed to the Arctic ozone loss, chemical
pollutants are taking most of the blame. Using satellite
measurements, scientists determined that the greatest depletions
occurred over Siberia, where ozone concentrations dropped 35
percent below that observed in 1979, before substantial ozone
destruction had begun. But low ozone levels were also found over
the United States and Europe. Ozone in the Earth's stratosphere
(12 to 50 kilometers above the surface) protects life by blocking
out harmful ultraviolet radiation from the sun. In the late 1970s,
chlorine and bromine pollution began eating away at the ozone
layer. Each September, the chemicals destroy most of the ozone
above Antarctica, creating an ozone hole. They have also eroded
ozone in more middle range latitudes, lowering its concentration by
about 2 to 4 percent per decade. International agreements to
eliminate many ozone-destroying pollutants could help the shield
recover in the next century. But scientists expect the problem to
get worse over the next decade. (Science News, Vol. 147, 6 May
1995, Washington, DC)
. . . THE HUGE FURNACES used by steelmakers can be used to destroy
ozone-damaging chlorofluorocarbons (CFCs), according to a group of
Japanese researchers led by Professor Kohei Urano of Yokohama
National University. The group said their method can process 40g
of CFCs in one hour--the same amount found in 250 refrigerators.
The new method of getting rid of CFCs makes use of existing
"fluidized bed furnaces" without either damaging them or creating
any harmful by-products. By-products from heated CFCs usually
corrode plant equipment. But Urano said that these can be
neutralized by adding "special compounds" to the CFCs before they
go into the furnace. The university researchers developed the
process in cooperation with the Japan Industrial Conference for
Ozone Layer Protection, an association of CFC makers and other
interested parties. They expect to develop the system for
practical use. (The Nikkei Weekly, 17 April 1995, Tokyo)
. . . THE SUBJECT OF HIV INFECTION came up at a recent Islamic
Jurisprudence conference in Abu Dhabi, United Arab Emirates. The
newspaper Al-Sharq al-Awsat of Jidda, Saudi Arabia reports that
participants at the conference ruled that "it is permissible to
kill ... anyone who willfully infects another person with the virus
when the infection results in that person's death." They also
decided that: an infected spouse and an uninfected spouse should
abstain from sexual intercourse, but if they do not, they should
use a condom; a pregnant woman with AIDS may not abort the fetus
solely because of the infection; and a mother infected with HIV
should not breast-feed her child. (World Press Review, June 1995,
New York)
. . . SHANGHAI is the home of a new 16-kilometer underground metro
called Line One. The metro went into full operation on April 10
and is the first step in a long-term plan to alleviate congestion
on the city's limited and narrow roads. Line One took about five
years to complete and will have a daily passenger capacity of
370,000. Also projected in Shanghai's public transport plan are
six more underground lines and a six-line light rail system. And
the director of the City Comprehensive Transportation Planning
Institute is proposing a six-line network of trolley-buses, which
would require the construction of viaducts but would cost a
fraction of the alternative rail systems. (South China Morning
Post International Weekly, 15 April 1995, Hong Kong)
* * * * *
THE ROCKY ROAD TO SEPTEMBER'S UNITED NATIONS WOMEN'S CONFERENCE IN
BEIJING IS GETTING ROCKIER. Some negotiators for the Beijing
Platform for Action are trying to re-open language and principles
previously accepted at other U.N. conferences. And the Chinese
announced in April that they want to change the site of the NGO
Forum, the parallel conference of nongovernmental organizations
(NGOs) which is projected to attract around 30,000 participants.
Currently, 35 to 40 percent of the draft Platform of Action for the
Beijing U.N. conference is bracketed, which means that the language
has not been agreed on and will be finalized in Beijing. Critics
of the bracketing of previously accepted principles say that
re-opening such language defies the principle of consensus,
threatening the integrity of the entire process. The United
Nations conference begins September 4 and ends September 15, while
the NGO Forum will run from August 30 to September 8. Currently,
the venue for the NGO Forum is in dispute. The Chinese want to
move the event from the Workers Stadium in Beijing to the suburb of
Huairou, almost an hour outside the city. They say a gymnasium in
the Workers Stadium is structurally flawed. But the Steering
Committee for the NGO Forum has rejected the proposed move, saying
that they want the conference either at the original site or in the
Beijing Olympic facility. NGO leaders are pressing U.N.
Secretary-General Boutros Boutros-Ghali to intervene.
(International Dateline reporting, May 1995, New York)
* * * * *
THE POPE LINKED ABORTION AND CAPITAL PUNISHMENT IN CONDEMNING WHAT
HE CALLED A " CULTURE OF DEATH" in his recent encyclical letter
titled "Evangelium Vitae" or, Gospel of Life. Calling on Catholics
to resist laws that violate what he calls the fundamental right to
human life, the Pope said that "there is a grave and clear
obligation to oppose...by conscientious objection" [laws that
permit abortion and euthanasia]. The encyclical upheld the
Vatican's ban on contraception and condemned experimentation with
human embryos, including experiments done for the purpose of
fertilization outside the body. "Christians, like all people of
good will, are called upon under grave obligation of conscience not
to cooperate formally in practices which even if permitted by civil
legislation, are contrary to God's law," the Pope said, adding that
resisting an injustice is "not only a moral duty--it is also a
basic human right."
THE POPE DEFENDED THE VATICAN'S POSITION AGAINST CONTRACEPTION,
asserting that increased contraceptive use does not necessarily
prevent abortions. The Pope says that while "many people use
contraception with a view to excluding the subsequent temptation of
abortion...the negative values inherent in the `contraceptive
mentality'...are such that they in fact strengthen this temptation
when an unwanted life is conceived." He says that "from a moral
point of view, contraception and abortion are specifically
different evils," one of which violates the spirit of conjugal love
and the other is opposed to life itself. While the Pope
acknowledges that "in many cases contraception and even abortion
are practiced under the press of real-life difficulties," he says
that these do not exonerate people from "striving to observe God's
law fully." And he adds that in many instances, contraception and
abortion are "rooted in a hedonistic mentality unwilling to accept
responsibility in matters of sexuality, and they imply a
self-centered concept of freedom which regards procreation as an
obstacle to personal fulfillment." Finally, the Pope says that
"the close connection which exists, in mentality, between the
practice of contraception and that of abortion is becoming
increasingly obvious. It is being demonstrated in an alarming way
by the development of chemical products, intrauterine devices and
vaccines which, distributed with the same ease as contraceptives,
really act as abortifacients in the very early stages of the
development of the life of the new human being..."
THE POPE'S ENCYCLICAL DENOUNCES ABORTION AS MURDER, categorizing it
as aggression against a "weak and defenseless" being who lacks
"even the poignant power of a newborn's cries and tears." The Pope
says that "among all crimes, abortion is the most deplorable,"
equating it with infanticide and reaffirming the Church's earlier
pronouncement that it is "an unspeakable crime." The Pope admits
that having an abortion may be a "tragic and painful" decision for
a woman, "if the decision is not made out of selfishness or
convenience, but out of a desire to protect certain important
values such as her own health or a decent standard of living for
other members of the family." And fathers, the Pope says, often
encourage women to have abortions, by leaving women alone to face
the problems of pregnancy. Doctors and nurses bear moral
responsibility in procured abortions, the Pope says, because they
place "at the service of death" skills that exist to preserve life.
Legislators and health care center administrators are also
responsible, he says. But the most serious responsibility,
according to the Pope, falls on those who promote "sexual
permissiveness and lack of esteem for motherhood." Finally, the
Pope points to a "network of complicity" that includes
"international institutions, foundations, and associations that
systematically campaign for legalization and the spread of
abortion."(New York Times, 31 March 1995, Rome)
* * * * *
A TAX ON THE TRANSACTIONS OF GLOBAL FINANCIAL MARKETS HAS BEEN
PROPOSED by the Independent Commission for Population and Quality
of Life at a New Delhi meeting. The income from the levy would be
dedicated to improving the lives of the world's destitute. As
conference chairman Maria de Lourdes Pintasilgo, a former
Portuguese prime minister, explained: "A very small tax of 0.1
percent or less on the estimated daily turnover of a trillion
[U.S.] dollars can bring money for the real poor." On the linkage
between poverty and runaway population growth, she said they
reinforce each other, affecting the quality of life of millions of
people. The 20 members comprising the Paris-based independent
commission include representatives of nongovernmental
organizations, politicians, demographers and family planning
experts. There are no government representatives on the
commission. (Population Headliners, June 1994, Economic
Commission for Asia and the Pacific, Bangkok)
* * * * *
ELEVEN NATIONS HAVE BEEN SINGLED OUT AS HIGH ACHIEVERS IN SOCIAL
DEVELOPMENT in a forthcoming book commissioned by the United
Nations Children's Fund (UNICEF). The publication is a collection
of success stories about how, despite modest and even negative
national economic growth rates, enlightened government policies
have been able to break cycles of poverty and bring new hope to
communities. All 11 governments scored high for giving priority to
fundamental social factors: emphasizing mother-and-child health
care, providing educational opportunities, and closing the gap in
the availability of social services between males and females and
between urban and rural populations. Most of the country programs
focused on building health delivery systems, with particular
emphasis on reducing mortality rates, especially among children and
pregnant women. The collected data on the programs show a
significant correlation between education, especially female
education, and both life expectancy and under-5 death rates. The
study also shows that the reduction in child mortality rates in
most of the countries helped to reduce population growth rates in
the long run, contributing to population stabilization.
IN THE 11 NATIONS, SPECIAL ATTENTION IS GIVEN TO PROVIDING THE
SERVICES OF DOCTORS and other health workers. In Barbados and
Costa Rica, community health workers monitor the growth of
children, thus detecting nutritional deficiencies early on.
Malaysia and Sri Lanka insist that all physicians trained at public
expense serve a stint in the public health system. Under a similar
program in South Korea, young doctors are given the choice between
practicing health care in rural areas or going into military
service. The 11 countries surveyed are Botswana, Mauritius and
Zimbabwe in sub-Saharan Africa; Sri Lanka and India's Kerala state
in South Asia; Malaysia and South Korea in eastern Asia; and
Barbados, Costa Rica, Cuba and Mexico in Latin America and the
Caribbean. In all, the level of key social development indicators
in these areas are well above regional averages. And in none, the
study says, did the governments depend exclusively on the trickle-
down benefits of economic growth or on market forces as such.
THE FORTHCOMING BOOK--PROFILES IN SUCCESS--WAS ORIGINALLY LAUNCHED
as a UNICEF report to the recent World Social Summit in Copenhagen.
The book's publication is scheduled for later this year. Further
information is available from: Madeline Eisner, Information
Officer, UNICEF House, New York, NY 10017, USA. Phone:
212-326-7261.
* * * * *
THE LINK BETWEEN FAMILY PLANNING AND THE DISEASE BURDEN BORNE BY
WOMEN IS HIGHLIGHTED in a report by the U.S.-based Program for
Appropriate Technology in Health (PATH). The study cites World
Bank statistics asserting that in the 15- to 44-year-old age
bracket, one-third of developing country women's disease burden can
be attributed to health problems related to pregnancy, childbirth,
abortion, HIV and reproductive-tract infection. And the risk
continues well past middle age. Cervical cancer, for example, is
linked to early and frequent childbearing and annually strikes over
400,000 Third World women between the ages of 45 and 59.
Similarly, unsafe abortion is responsible for 30 to 40 percent of
the half-million deaths each year related to pregnancy. And in
Africa, an estimated 50 to 80 percent of infertility cases--a
common affliction with devastating social consequences--can be
traced to pelvic infection. Studies indicate that if women had
access to protection against sexually transmitted diseases, there
would be a significant decline in rates of infection. Yet male
condoms are the only readily accessible contraceptives and women
often have little control over their use. Even where STD clinics
exist, they are largely off-limits to women because of the social
stigma attached to such diseases. The ratio of men to women
attending STD clinics runs as high as 9 to 1.
EXPANDED FAMILY PLANNING SERVICES CAN GO A LONG WAY toward
lightening women's disease burden, the PATH report says. The
incidence of abortion can be reduced markedly by providing access
to safe, acceptable, effective contraception. And PATH adds that
responsible answers should be available to common questions about
pregnancy, abortion, postpartum care and breastfeeding. Finally,
they say that women who are at risk of HIV infection should be
advised to use latex condoms as a barrier to both the AIDS virus
and unwanted pregnancy. (Outlook, August 1994, Program for
Appropriate Technology in Health (PATH), Seattle, Washington)
* * * * *
A 64-PAGE BOOK DESIGNED TO PROVIDE UP-TO-DATE INFORMATION ON
BARRIER-METHOD CONTRACEPTION has come off the presses. Published
under the self-explanatory title, Modern Barrier Methods: Effective
Contraception and Disease Prevention, the book promotes barrier
methods as "the only contraceptives that provide significant
protection against unwanted pregnancy and disease." The book is an
easy- to-read, comprehensive guide for health providers, planners
and users. Contents include instructions for providers on the
proper use of diaphragms, the contraceptive sponge, male condoms,
cervical caps and spermicides, and on the advantages and
disadvantages of each method. Charts and graphs show who should
use barrier methods, how to use them, the costs of production, and
new methods for women.
MODERN BARRIER METHODS is priced for U.S. and European orders at
US$13.95 per copy, including postage and handling. Copies are
available without cost to developing-country institutions and
individuals on written request, with a brief explanation of need.
Communications should be addressed to: Publications Coordinator,
Family Health International, P.O. Box 13950, Research Triangle
Park, North Carolina 27709, USA. Fax: 9l9-544-7261.
* * * * *
INDIA HAS ENLISTED THE PRIVATE SECTOR IN AN EFFORT TO SAVE ITS
FAST-VANISHING FORESTS--a challenge the government has been unable
to meet. Under the experiment, wood-based industries will be
permitted to plant trees on India's 40 million hectares of degraded
forest land. Scarcely 12 percent of the nation's land is forested,
with much of it having been denuded by the demand for fuelwood and
the illegal felling of trees. The government's National Wastelands
Development Board had targeted 5 million hectares per year for tree
planting but they could barely reforest 2 million hectares annually
due to a lack of funds. Under the new plan, the wood-products
industry will be permitted to take 30-year leases on land to grow
and harvest a mix of long- and short-term-maturing trees and to
grow cash crops among them. In addition to reforesting the barren
landscape, the program is expected to create jobs-- optimistically
projected as high as 120 million--for Indian villagers.
(Financial Times, 23 June 1994, London)
* * * * *
THE NORTH AMERICAN FREE TRADE AGREEMENT (NAFTA) HAS BROUGHT A NEW
SOURCE OF HOUSING TO MEXICO, but it doesn't answer the needs of
Mexico's poor. Prefabricated homes are being offered as a possible
solution to the nation's housing problems. But because the
American and Canadian prefab companies that have stepped in to
Mexico's housing market are aiming their products at upper- and
middle-income groups, housing for the poor is still wanting. In
1993, the shortage of low-cost housing was estimated at a million
units. Some 300,000 new homes are required annually to meet the
demands of those able to afford the cost as well as those who
can't. And while 326,000 units were built in 1993 and an estimated
350,000 last year, 70 percent of Mexico's 80 million people don't
earn enough to be eligible for home finance loans. That means the
affluent and middle-income dwellers have access to new housing and
even second homes while 56 million Mexicans remain crammed into
closet-size accommodations, living in cardboard shelters or living
in Mexico City's polluted open air.
THE COST OF PREFABS IS WAY OUT OF THE REACH OF MEXICO'S LOW-INCOME
GROUPS. Even though a prefabricated 1,700-square foot,
three-bedroom home with a water purification system and all
electrical amenities sells for less than half the US$250,000 price
of a conventionally built house, the cost still runs to $100,000,
not including land. Also, Mexican lending institutions are
skeptical and won't give mortgages for prefabricated homes.
Moreover, many imported prefabs do not meet Mexico's building
standards. Thus, despite the critical need, the growth of the
prefabricated housing market in Mexico appears to headed for a long
and uphill haul. In 18 months, a Canadian company's Mexico
franchise made only limited sales: two homes in Guadalajara and two
housing complexes--one of 32 units and the other of 50 units. A
few more have been sold since. Most of the buyers have been
middle-income and wealthy executives who already own homes.
Acceptance of foreign-made prefabricated housing also runs into
cultural prejudice and unsympathetic Mexican builders. Mexicans
scoff at the idea of living in a house constructed of anything but
concrete block or brick. They fear anything less would not be
durable. Said one official: "You can't convince people that in the
United States, wooden homes have been used during the last 500
years and nothing has happened to them." (El Financiero
International, 20 June 1994, Mexico City)
* * * * *
A RURAL RADIO PROGRAM IN CENTRAL GUINEA IS CARRYING
PEOPLE-TO-PEOPLE ADVICE aimed at bettering the lives of villagers
within reach of the broadcasts. Guinea Rural Radio, which carries
beyond Guinea into Mali and Senegal, has a clear program policy: to
maximize community participation by using local people as
communicators. The program was developed as a collaborative effort
by several United Nations agencies with European technical and
financial assistance. Pilimini Diallo, a broadcaster from Guinea
Rural Radio, travels from village to village holding communication
contests keyed to health, agriculture, education and other issues
basic to people's lives. A jury of the most esteemed members of
the community narrows down the village contestants to six
finalists, all of whom must speak about the importance of a subject
in the form of a song or a poem. Rewards range from a first prize
of a transistor radio to such items as an oil lamp, sugar and soap.
The quiz is recorded for later broadcast. In one quiz, Diallo
posed a question this way: "A terrible gale is blowing, threatening
to carry away all the children of the village. Fortunately, big
brother has something that can tame the gale. What is it?" In
this case, the correct answer is: "The injection needle." Diallo
explains that immunization will protect the village children
against lethal diseases. Some 10 villagers knew the right answer,
and all got up to speak about illness, malnourishment, epidemic
diseases, and parental concerns. Guinea Rural Radio Director
Cheik Sylla points out the benefits of such communication: "If I
talk about family planning or ways to stop onions from spoiling,
who will listen to me? But if the imam talks, or the onion farmer,
their advice will be taken." And sponsoring organizations are able
to reach villagers within listening range for grassroots,
people-to-people advice about their programs. As Diallo explains:
"If the Food and Agriculture Organization wants to campaign against
termites or another organization against AIDS or UNICEF in favor of
breastfeeding, all will seek cooperation with Rural Radio."
(First Call for Children, July/September 1994, UNICEF, New York)
* * * * *
NONGOVERNMENTAL ORGANIZATION EXTRA May 1995
A HUSBAND'S ATTITUDE TOWARD FAMILY PLANNING AFFECTS HIS WIFE'S USE
of the reversible, three- month injectable contraceptive Depo
Provera, according to a survey in Bangladesh. According to a
recent issue of Studies in Family Planning, women whose husbands
approve of family planning are the most consistent users of Depo
Provera-- also known as Depo Medrox Progesterone Acetete (DMPA).
The duration of use is shorter when a husband opposes family
planning. Those findings indicated the importance of encouraging
husbands to support family planning. The study specifically
recommended that husbands be present during contraceptive
counseling sessions so they can help their wives manage any side
effects of Depo Provera. The interviews, conducted among 200
first-time DMPA users, also found that women with many children
used DMPA longer than those with smaller families. Side
effects--including weight gain, dizziness and changes in menstrual
bleeding--also discouraged the use of DMPA. Recommending further
study and improved counseling, the study concluded: "Researchers
and policymakers must recognize that cultural and social factors
determine how contraceptive side effects influence women's lives,
and that women's fears and problems should be addressed within
their particular context." (News Release, 29 November 1994,
The Population Council, New York)
* * * * *
NOW THAT THE CAIRO POPULATION CONFERENCE IS OVER, the people who
were supposed to benefit are waiting for the promised good to
trickle down. They're not overoptimistic that it will happen.
Chandaben Jagaria of India puts the question this way: "Will the
resources pledged at Cairo ever really reach us to improve our
lives and the lives of our children?" At the age of 50, Jagaria is
the mother of six, is illiterate and poor and lives in a leaky hut
in the bleak industrial city of Ahmedabad in India's western state
of Gujarat. One of five children, she was born in Badosan, a
village of 2000 people. Much of her first 13 years was spent
helping the family scrabble for a bare existence. At 14, her
parents married her off to a husband who was scarcely able to earn
an income sufficient to support them and their six children. Says
Jagaria: "If only I had had a choice, I would have had only two."
When her last child was born, she says, she took a bus to a
hospital and had herself sterilized. She explains that she didn't
want any more children and couldn't afford family planning.
DESPITE HER UNPROMISING BASE OF OPERATION, CHANDABEN HAS LABORED
for the past 25 years to raise the opportunities and living
standards of Indian women through the Self-Employed Women's
Association, a nongovernmental organization (NGO). She has helped
the association--which has assisted 60,000 poor women in India--to
set up village health clinics and form cooperatives that generate
income. She spent four years training in women and child health
care and now spends 12 hours a day going to villages to establish
health facilities and talk to women about family planning,
nutrition and hygiene. From her grass-roots perspective, Chandaben
had this to say about Cairo: "Few of the people at the conference
have ever had to feel the desperation or the pain that goes with
poverty." (Earth Times, Sept. 26, 1994, New York)
* * * * *
TWO PUBLICATIONS DESIGNED TO UPGRADE THE SKILLS OF HEALTH WORKERS
have been issued by the World Health Organization (WHO). One is a
60-page manual containing the most relevant documents currently
available on the work of WHO. It is called An Annotated
Bibliography of Documents Produced by the Division of Family
Health. Over half of the documents listed relate to safe
motherhood, and almost half of those emphasize maternal health.
Another major category in the bibliography focuses on adolescent
health and includes discussions of alcohol, drugs, sexually
transmitted diseases and AIDS, with new strategies on how to cope
with these problems. The manual also contains listings on family
planning and contraceptives, including injectables, implants,
intrauterine devices (IUDs) and vasectomy.
THE SECOND PUBLICATION IS OF A MORE SPECIFIC CONTENT, as described
by its title: Clinical Management of Abortion Complications: A
Practical Guide. The 77-page manual, says WHO, "is intended to
assist health workers in preventing death and serious injury" from
abortion complications. Supplemented by charts, the text is
presented to help clinicians identify and treat the most urgent
conditions first. A wall chart that accompanies the manual
provides a quick reference to abortion complications that require
early treatment. Both WHO publications are available from the
Division of Family Health, World Health Organization, 1211 Geneva
27, Switzerland.
* * * * *
A PAIR OF MANUALS ON PERMANENT CONTRACEPTION FOR WOMEN AND MEN has
been published by the World Health Organization (WHO). One is
titled Female Sterilization and the other, Vasectomy. Both are
subtitled: What Health Workers Need to Know. In its introduction,
the first manual points out that female sterilization is the most
widely used family planning method in the world and one of the most
effective. Of the 202 million married men and women who have been
sterilized worldwide, 75 percent are women--all but 2 million of
them in developing countries. WHO cautions that the procedure is
suitable only for women "who are certain that they want no more
children," adding that family planning programs must provide
careful advance counselling, highlighting the permanence of female
sterilization. The booklet contains answers to common questions.
Among the answers that health workers will be expected to know to
help women make well-considered choices are what female
sterilization is and how it works, its advantages and
disadvantages, and its risks and benefits.
THE STERILIZATION MANUAL FOR MEN IS SIMILAR IN PRESENTATION AND
PURPOSE. It concedes that vasectomy has taken hold in only a few
countries, but adds that the practice is a popular choice for
couples seeking permanent contraception in the United States,
Europe and Asia. An improved "no-scalpel" vasectomy developed in
China is being used increasingly worldwide; the technique is
believed to reduce men's anxiety about vasectomy. WHO says
vasectomy is simpler and safer than female sterilization.
BOTH MANUALS, each about 30 pages, come in a question-and-answer
format with tables, illustrations and diagrams of the procedures.
Both also list local organizations where health workers can get
more information. The manuals are available from: World Health
Organization, Family Planning and Population, Division of Family
Health, Avenue Appian, 1121 Geneva 27, Switzerland.
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