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JOURNAL OF COMMUNITY MEDICINE |
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INDIAN ASSOCIATION OF PREVENTIVE AND SOCIAL MEDICINE ORISSA CHAPTER |
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Secretary General, National Institute of Applied Human Research & Development Kalyan Nagar, Cuttack – 753 013 |
Dr. Saraswati Swain |
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Professor R.G.P. Panigrahi Oration From Population to People: Food for thought |
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Chairperson of this meeting and D.M.E.T. Orissa, Prof. S.C.Mohapatra, Chief Advisor of Organizing Committee and Director, S.I.H.F.W. Prof. B.C.Das, Prof. H.B.Mohapatra, Retd Prof. S.P.M. (who presented a brief account of Prof. R.G.Panigrahi) Reporter Dr. S.K.Sahoo, Organizers of the Silver Jubilee Conference, students, faculty, media, ladies and Gentlemen.
I am deeply touched and consider it a privilege as well as honor to have been requested by my junior colleague Dr. Bijayani Mohapatra, Prof and Head, Dep’t of S.P.M. to deliver Prof. R.G.Panigrahi memorial Oration.
Prof. Panigrahi was a great humanist, an excellent teacher and a forceful orator. He used to bring to the classroom the most recent advances on the topic, which took place even the day before. This indicates his thirst for knowledge and also earnestness to provide his students with new information. He was a great visionary and had the rare quality to see beyond his time. Under his leadership the “Hygiene” Department grew to the present prestigious discipline of Social and Preventive Medicine.
I take this opportunity to pay my humble homage to my professor.
With your permission Mr. Chairman, may I come to the topic of my oration, which was very dear to my professor.
According to the National Population Policy 2000, “India’s current annual increase in population of 15.5 million is large enough to neutralize efforts to conserve the resource endowment and the environment. On 11th May 2000 India has touched 1 Billion (100 crores) mark. India is the second most populous country in the world with 16.7% of global population on 2.4% of earth’s surface area.
As per Registrar General of India’s analysis, India will require 66,000 primary schools per year, raising food grain production from 40 lakhs tones to 50 lakhs tones per year, creating 30 lakh new non-agricultural jobs per year and accommodating 50 lakhs additional labourers in agro sectors. Some more frightening statistics were also put forth to prove:-
That the progress of the country would be adversely affected, unless the growth of population is checked. That the food production would not be able to keep pace with population growth rate and the people would die of starvation; That the number of people below poverty line will continue to increase and the resources of earth would not be able to sustain this huge population and that dooms day was knocking at our step, etc.
Both the government of India and different State Government have promulgated various eye catching populist measures/incentives to stabilize our country’s population. But behind all the alluring programme, the indication on curbing the growth rate and birth rate (though not directly) stands out loud and clear and we have the unfortunate incidents of forcible vasectomy effort in the past.
The tendency of “compulsory birth control” started from world population conference at Geneva sometime during 1927 continues even today though not directly. The “one child norm” of china and the “two child norm” in India could be cited as example of this mindset. I would like to quote Mr. A.R.Nanda executive director of PFI, “It is well realized by now that such tendency smacks of an alarmist, racialist and over-simplistic view of a complex personal and societal issue which needs to be perceived with utmost circumspection, care and empathy”.
Linking the two-child norm to contest in election in some states violates the spirit of 73rd Amendment to the Constitution. Besides its undesirable consequences if would lead to sex-selective abortions with its attendant, health, socio-economic and cultural disasters. Realizing this China has officially abandoned it’s one child norm!
During 1960-70 the developed and affluent nations started spreading the message that a “small family” was necessary for both national and personal upliftment, since according to them “over population was the cause of poverty”. This period could be considered as the “hey day of the international campaign” to control population in poor and developing countries. The concept got a boost from international organizations like World Bank, USAID, Ford Foundation etc. who came up with every generous support to spread this message of “small family norm”.
The “target approach” came handy to propagate this message until the paradigm shift of ICPD (1994) giving a new dimension to the issue of population problem.
Here I would like to quote from a book of Prof. Ashish Bose, the famous demographer of our country, “the demographers tend to get stuck in decimal points, while family planning administrators are obsessed with targets and achievements”. He has very aptly observed, “India’s family planning programme has become increasingly vertical, bureaucratic and dehumanized, were people do not count. Only the number of sterilization cases matter. And all this has happened in the face of the professed policy of making family planning a ‘peoples’ movement……” [From population to People, Vol. I, B.R.P.C., 1988].
However there is no denying the face that India’s population is high and needs to be stabilized. But it is hard to accept that in the Indian context, development is adversely affected due to the so called “population explosion”. It has become an usual practice with our planner and politicians to put the blame on “uncontrolled population growth”, which is only meant to divert the attention from real developmental issues. The numbers have been looked upon with horror and the urgent need to bring it down by any means available at hand, including forcibly sterilizing people (who sometimes were treated worse than the animals) in the name of development. Thus the question of development fro whom and how needs serious instrospection.
Mr. Nanda, the Executive Director of PFI, has rightly stated, “To allay the fears of these ‘population control’ exponents of the loss of the CPR, it can be said that the rates of contraception ‘acceptors’ have continued to rise in a target free environment, since many women ‘have begun to voluntarily opt for family planning’, particularly in South India State”.
Reasons for present population growthTo understand our present population growth, one has to go back to pre-Independence period, when the health status of the people of colonial India was dismal. The cite only one example, nearly 100 million people suffered from Malaria with one million annual deaths. Cholera, Small pox, Plague were some of the other major killers. India witnessed the worst ever famine’s, devastating cyclones and floods, bloody riots and a host of other natural calamities, which broke the backbone of this beautiful country.
During this period, the death rates, infant mortality rates, disease prevalence rates were unacceptably high, taking a heavy toll of human life. Lack of education, low level of awareness, poor socio-economic-factors coupled with cultural milieu of a tradition bound society did not allow the people to take recourse to measures to reduce the birth which continued to be high. Besides they were also not sure of the survival of their children who were considered the insurance for them. In an agricultural economy people needed more hands for help.
The situation then was so horrifying that the then colonial Government of India was almost pressurized to institute a Committee in 1943 named “Health Survey and Development Committee” under the Chairmanship of Sir Joseph Bhore. The findings of the committee were the eye openers for every one and the recommendations are still being quoted as ideal.
After Independence, the Government of India did undertake certain promotional measures, which though not very adequate still favourably influenced the health status of the people. As a result,
The Infant Mortality Rate (IMR) which is a very sensitive indicator of general health status of the community and of the environment (social milieu) came down. From 146 in 1951 to 74 by 1995, resulting in a reduction of almost 50%. The life expectancy, which was 32 years at the time of Independence, increased to 62 years. The death rates during the same period came down from 27.4 to 9.1000.
Some other stated reasons for population explosion:
Large size of the population in reproductive age group. Past TFR has resulted in current huge population in reproductive age group. It would continue to increase for something due to population momentum even when TFR has come down. The unmet need for contraception. High IMR resulting in high wanted fertility. Girls marrying before legal age of marriage (<18yrs.) resulting in too soon, too frequent and too many pregnancies. Socio-cultural factors of son preference. According to Ministry of Health and Family Welfare, if the NPP is fully implemented the projection for 2010 are that the CBR – 21.0, IMR – 30/1000LB and TFR – 2.1 would be achieved. The demographic cycle amply indicates the downward trend.
Resulting the Allegation The allegation that our country’s food production has not kept pace with population growth is not true.
During 1951 – 2001
Our population increasing from 36 crores to 102 crores. Food production saw a phenomenal surge from 50 million to 200+ million tons.
In fact, while our population grew less than 3 times, the food production increased by more than four times. India, which was an importer of food grains, became a net exporter of foodstuff.
Again, our “population over-growth” has been blamed for starvation deaths. But is not based on facts. Reports are plenty to indicate that while the various godowns in the country were/are overflowing with food materials, the country’s people were/are dying of starvation. The government had amassed food stack totaling about 27 million tons during 1996, when hapless farmers were committing suicide, knee deep in loans and in abject poverty. Unfortunately this is true even today. The reasons clearly are lack of proper distribution and not want of food materials.
The poor have been made sacrificial goats or held responsible for population growth since it is said that they did not limit their family size. This is also not true because the Total Fertility Rate (TFRs) among all segments of population are showing a declining trend, though more in urban areas.
India’s current TFR of 3.2 is much lower than many a developing countries in the world. It has reduced from 6 in 1951 to 2.85 in 1998 – 99. [Average annual population growth rate reduced from 2.22 in 1981 to 1.93 in 2001].
Our poverty has been attributed to be one of the major factors for population growth, since poor people need more children to raise the family income and this is more so in a predominantly agrarian society. Though poverty is one of the major contributing variables for lack of development, it can not be the cause of over population. In our own country we have examples of states like Kerala and Haryana. Kerala has amply demonstrated as to what can be achieved in spite of low socio-economic condition.
The allegation that the poorer people in developing countries are consuming larger share of the resources, adversely affecting the developmental process is also patently false. In face,
The upper crust of rich people (20%) in the highest-income countries account for 86% of total private consumption expenditure. While the poorer sections (20%), comparing similarly consume only 1.3%. A child born in the developed country utilizes 30 to 50 times more of the food, water and natural resources in lifetime than that of a child in the developing country.
Therefore, the oft-repeated allegation that development of India is not possible because of population over growth is unwarranted.
Further I would like to draw the attention of this august gathering to the UN’s World Population Aging report of 2003.
It is estimated that until 2040 India will remain one of the youngest countries in the world. Its current population of children below 14 (33 million) is more than the US (28 million). Its working age population (15-59 years) (i.e. our workforce potential) is almost four times that of the US. Its proportion of older people (60 plus) at 7.6 percent is far below the global proportion of 10 percent.
By 2025
India’s working age population will grow to 87 million, against 19 million in US. The proportion of older people in India will be only 12.5% against 25% in US. The report estimates that this demographic dividend for India will peak around 2040 and start declining only after 2050. The big picture is that the total dependency ration <15 and >60 people per 100 would be in India’s favour. The key fiscal problem of the developed countries would be – rapid rise in the total dependency ratio from about 48 percent from now to 57 percent in 2025.
As the rich nations age, more workers will continue to enter India’s work force. A Goldman Sachs reports estimates that by 2020 as far as people of working age are concerned.
The US will fall short of 17 million people China 10 million Japan 9 million and Russia 6 million
For a total shortfall of 42 million for all these countries, India will have a surplus of 47 million working age people. A German Institute of Economic Research Study for 2001 says that the country would need 1.2 million immigrants annually to offset labour shortage.
India’s advantage is not restricted to supplying immigrants. With its competitive labour cost, it can also provide a host of business and back office services. (Hindustan times, October 3, 2005, New Delhi).
Poverty, illiteracy specially, female illiteracy, inadequate woman empowerment, domestic violence, lack of health service, corruption in high places, conspicuous consumption, faulty technological developments – all contributed to the stunted developmental process. An abnormal rise in female feticide reflected a dangerous mindset to eliminate the girl child. The two – child norm enunciated by some State Governments only facilitated or rather encouraged the crime while the unholy alliance between tradition and technology paved the way for this.
There is close link between health, socio-economic development and population stabilization. Curbing growth rate cannot be an end in itself. The actual population stabilization will result when the society in question reaches an acceptable level of socio-economic development, instead of limiting itself to mere head counting to reducing the numbers as of now.
India’s population, which was in the high stationary stage, has started coming down. Presently, India is in late expanding phase which though not very satisfactory is definitely not bad. According to UNFPA India’s population growth rate was down to 1.8 percent a year but because of large population base this relatively low growth rate still translate into a net population gain of about 18 million a year. Because of high fertility in the past, close to 36% of the earlier population are under 14. This means that even if fertility fell to replacement level now, the population would continue to rise for another 40 years until children already born have passed through their reproductive period. Population momentum is equated with a fast moving train which would take sometime to slow down even if brakes are applied.
Orissa’s situation needs special consideration. The state has the dubious distinction of have very high IMR and M.M.R. Here –
1/3 of children are malnourished. Diarrhea and other diseases affect nearly 60% of the total population. Prevalence of Tuberculosis, Malaria and Leprosy are unacceptably high. Official figures for unemployment at the end of 1999-2000 stood at 7.84 lakhs, though it is expected to be much higher. Orissa stands at low ebb in all the developmental programmes and is one of the EAG (Empowered Action Group) States.
In spite of this, fortunately Orissa has a low growth rate. The TFR is 2.46, which is much less that of the all India figures of 3.2.
What the leaders say? To quote Mr. K.C.Panth, Deputy Chair Person of Planning commission, “1/3rd of the children in India are under-nourished. The main course of population growth in India therefore is lack of social-economic development. So far the targets of development have been the “people” and not “population”, thereby leading to this mass”.
According to Sri Sonnath Chatterjee, the Honourable Speaker of Liksabha “we should not take an alarmist view of our population growth. We should rather try to transform our human potential into an asset. Family planning measures though extremely important they alone are not sufficient to contain the growth of population in a country. What is more important is economic and social transformation. We have examples of several countries like Japan where the impact of their human resource development is reflected not only in their economic growth but also in population control measures”.
x x x x “The number of factors have to be addressed when we talk of population stabilization in our country. These include, besides the size of our population, various political social and economic consequences of such unbridled growth. India is pluralistic in more ways than one – political, climatic, linguistic, religious and many more”. x x x x
“Our strategies for human development must aim at generating economic growth, productive employment, social integration and environmental regeneration as also should ensure extensive public participation and empowerment of the vulnerable groups”.
“It is essential that the gap between the rich and the poor should be narrowed down, leaving balanced development our human wealth”.
I would also like to quote the Nobel laureate Amartya Sen. “Concern about population growth must not be simply dismissed as groundless….. And yet the population situation is not as terrifying as it is made to look based on the citation of selectively chosen statistics (or non statistics). First, food supply has not be falling behind population – quite firmly to the contrary. The possibility of accommodating considerably increases in food consumption per head – both quantitative and qualitative – is still quite favourable. Second, the fertility is falling quite rapidly and may decline faster still with sensible policies, especially, related to child health and women’s empowerment. Third, the fertility rate varies widely between regions in India, and there is much to learn from those that have already achieved low fertility rate and also much evidence that these achievement are indeed spreading to other regions as well”.
To further emphasize the issue I would lie to quote Dr. Manmohan Singh, the then leader of Rajya Sabha and presently Prime Minister of India.
“Population stabilization policy cannot be designed in isolation and that they have to be integrated into the frame work of social and economic development strategies and programmes as a whole is widely strategies and programmes as a whole is widely accepted”. He has emphasized on education and specially women’s education and their empowerment in stabilization process.
Addressing JRD Tata Memorial lecture Januar 1999 Shri I.K.Gujral former Prime Minister of India emphasized that “wealth of the nation lies in its people”.
Dr. Nafis Sadik executive director UNFPA and Under Secretary General, United Nations has always been a strong votary of women’s empowerment, gender justice, reproductive rights of women and had an integrated approach to population issue. She was very categorical on men’s participations and insisted on their full responsibility in this battle.
I would not do justice to this important topic without quoting Mahatma Gandhi whose approach to birth control was not only ethical but culturally and technically sound. His discussion with Margaret Sanger is an eye opener even today. He advocated for smaller and healthier family and was fully aware of the social dimension of uncontrolled population growth. His approach was on women education, their empowerment, gender justice and negotiating with their husbands for observing abstinence.
Finally, my dear friends I would like to conclude with a positive note that people are the most valuable assets of our country and for that matter of any country. Healthy people can create a healthy society and future of the mankind. I have purposely tried to quote from the speeches and writings of our leaders and scientists both in India and abroad, because they are at the helm of affairs and are responsible for framing the policies and giving it a direction. Therefore, it is extremely important to understand their views.
While emphasizing population stabilization, which is extremely important for our country, I would hasten to state that we should consider it from a holistic point of view. Our leaders have already gone on record corroborating this. We have some of the best planners, economists and committed people among us. We have the technical know how, the skills and the tools to tackle the situation in our own socio-economic-education cultural base. We do not have to be guided by the donor agencies and succumb to their pressure to fulfill their hidden agenda. Our target should be the development of our people, by our people and for our people. The focus should be on the people and not on population alone. Let us take care of ‘our people’ and ‘population’ will take care of itself.
Reference Bose, Ashish, (1988), “From Population to People”. Vol. 1, B.R.Publishing Corporation. Chatterjee Somnath, JRD Memorial Oration, Ninth 30th March 2005. Gujral K.K. JRD Tata Memorial Oration, fourth, 15th January 1999. Govt. of India (2000), “National Population Policy – 2000”. Department of Family Welfare, Minister of Health and Family Welfare. Government of India National Population Policy, 2000. ICPD-POA (1994) Programme of Action adopted at the International Conference on Population and Development, Cairo, Sept. 1994, UNFPA. K.Park, Park’s Text Book of Preventive and Social Medicine, 17th Edition, 2002. Nanda A.R., Obsolescene and Anachronism of Population Control: From Demography to Demology George B. Simmons Memorial Oration, 2004. Nanda A.R. Not just The Member Game, Seminar 511 – March 2002. Sidik Nafis, JRD Tata Memorial Oration, fifth, 13th December 1999. UNFPA Population Stabilisation and Sustainable Development, 2003. UNFPA, Population Myths and Misconceptions, 2003. Visaria, Leela and Vimla Ramachandran (2002), “The Problem in Beyond Numbers”, SEMINAR, No. 511. |