Countless millions of people in developing countries have been robbed of their human rights and dignity by a movement still regarded as humanitarian.
“The great tragedy of population control, the fatal misconception, was to think that one could know other people’s interests better than they knew it themselves,” says Matthew Connelly, summing up one of the major global forces of the last 50 years. Although that assessment comes nowhere near my own sense of outrage at the movement that has filled the world with aborted fetuses and sterilized men and women, Connelly’s book as a whole is an unprecedented admission, from a supporter of what is now known as “reproductive rights”, that the movement, historically at least, has trampled wholesale on the rights of Third World people. As a citizen of a developing country I can breathe a sigh of relief: finally, the truth is coming out.
Connelly, an associate professor of history at Columbia University in the United States, set himself a task that has been avoided by mainstream academics; the result is what his publishers call “a withering critique [that] uncovers the cost inflicted by a humanitarian movement gone terribly awry”.
In spite of my familiarity with human rights violations committed in the name of population control in the Philippines, I am still appalled by what this movement has done in India, China, Bangladesh and other Third World countries.
Many people are probably unaware that India was the first Third World country to adopt a population control policy -- in 1952 -- with more than a little encouragement by the US and other world powers. In the 1960s US President Lyndon Johnson leveraged food aid for the family planning cause during crop failures in India, thus creating an incentive for the sterilization program. Incentives are subtly coercive even in the best of times; but when Indians were subsisting on less than 900 calories a day, and accepting IUDs or sterilization meant the difference between starving and not starving, they were blatantly so. India’s Ministry of Health and Family Planning would admit: “The large number of sterilizations and IUD insertions during 1967-68 was due to drought conditions.” Eventually more sophisticated incentives such as bicycles, transistor radios were used to bribe rural people to accept sterilization.
Under Indira Gandhi in the mid-1970s sterilization became a condition not just for land allotments, but for irrigation water, electricity, ration cards, rickshaw licenses, medical care, pay raises and promotions. Everyone, from government officials to train conductors and policemen, was given a sterilization quota. The oppressive nature of the program is described in one report: “Obviously, the stories ... on how young and unmarried men more or less are dragged to sterilization premises are true in far too many cases.” In the course of one year, eight million sterilizations were recorded: 6.2 million vasectomies and 2.05 million tubectomies.
In India the Dalits (untouchable caste) were ignominiously targeted for family planning. They were entitled to scholarships and other assistance as minorities who needed to integrate into Indian society, but Maharashtra and Uttar Pradesh states stripped Dalits with more than three children of these entitlements. At the grassroots level in Uttar Pradesh, where Dalits made up 29 per cent of the population, they constituted 41 per cent of those vasectomized. In some states in the US the eugenics movement successfully targeted “degenerative” segments of the population for sterilization, but never at the scale that the International Planned Parenthood Federation achieved in India.
Human rights violations in Bangladesh make another shameful chapter of coerced birth control. During a famine, field workers fearing loss of salary or dismissal would deny food to destitute women who did not help them meet sterilization targets. The Bangladesh army would round up hundreds of people for forcible sterilization. Emergency aid from the World Food Program meant to feed people made destitute from floods was denied to those who would not agree to sterilization.
The Dalkon Shield scandal
When the manufacturer of the Dalkon Shield (A H Robbins Corporation) was hit with lawsuits in the First World it sold its entire inventory to USAID at half price; 440,000 women in 42 countries had used them before the recall order was issued in 1975. The Dalkon IUD involved a painful insertion and high risk of scratching or piercing the interuterine walls; of pelvic inflammatory disease, of ectopic pregnancy and host of infections. In the Philippines there are countless stories of the suffering of women who had trouble with the IUDs and were refused any assistance by family planning workers who feared having to report them as drop-outs from their acceptor rates.
Just a few years ago, health authorities in the Philippines promoted an anti-tentanus vaccination drive that was curiously only for women from ages 15-45; the vaccine turned out to contain an anti-pregnancy vaccine. But in the broader context this is hardly anything compared to what the Indians and Chinese suffered through forceful and often violent sterilizations.
Poor women, especially vulnerable in the twilight of recovery from a painful delivery are often coerced to accepting tubal ligation. In the sorry saga of Third World “family planning”, non-medical personnel were often permitted to dispense pills without prescription; illiterate midwives were taught to insert IUDs; and doctors learned how to further simplify and speed up sterilization procedures. It was argued that considering the high rate of maternal mortality in most developing countries, even risky contraceptive methods imperfectly administered would save lives.
China: forced sterilisations and abortions by the million
Knowledge of how coercive China's population control program was did not prevent IPPF and the United Nations Population Fund (UNFPA) supporting it—after all, both had had previous involvement in coercive programs in India. Connelly states that as the two super-agencies stepped up support, China's program became ever more coercive. Vehicles transporting Cantonese women to hospitals for abortions were “filled with wailing noises”. Some pregnant women were reportedly handcuffed, tied with ropes or placed in pig's baskets. This type of news caused IPPF donors to be uneasy; but their worries were easily placated by repeated reassurance of Chinese officials.
In its most coercive phase the China program required all women with one child to have a stainless steel, tamper resistant IUD inserted; parents with more than two children were sterilized and all unauthorized pregnancies were aborted. In 1983, 16 million women and more than 4 million men were sterilized, 18 million women had IUDs inserted and over 14 million underwent abortion. Well aware of what was going on, UNFPA that year bestowed its Population Award gold medal on Qian Xinzhong, head of China’s military-style campaign.
Humanitarianism gone wrong -- or plain racism?
In the forefront of this movement were the most prominent industrialists of mid-twentieth century America: the likes of Rockefeller, Ford, Gamble, Packard and McCormick -- “well meaning people” who, decades before governments of affluent countries began giving development aid, gave huge amounts of money to “preserve the quality of life” that could be endangered by overpopulation. It was not the baby boom in America and other parts of the West that worried them but “the rising tide of colour” in the rest of the world. Despite avowals to the contrary, Connelly’s book provides proof beyond doubt of the racist roots of population control.
Connelly’s thorough documentation of these and other leading promoters of population control is particularly interesting, although it strains the evidence to claim that they were basically well-meaning. The book is replete with documentation of instances where major protagonists of the movement admitted to harboring one agenda while pretending to be dedicated to another. But in spite of this, the author concludes that unfettered access to archives (including both International Planned Parenthood and newly opened Vatican archives) belies accusations of conspiracy. Well, conspirators they may not have been, but there was a convenient convergence that united many forces—racists, eugenicists, feminists, colonial imperialists—in a common endeavour. Strange bedfellows considering how family planning victimized so many women in the Third World but ultimately the demographic implications of the feminist agenda made this coalition acceptable for the latter.
Surprisingly, Connelly does not make any mention of NSSM 200—the population policy paper authored by Henry Kissinger that marked the US government’s official debut on the population control front. Eventually countless millions of dollars was lost -- and continues to be lost -- to development aid, swallowed by birth control programmes.
And yet, says Connelly, family planning efforts explain “less than five per cent of fertility levels in developing countries” -- a reference to the 1994 analysis of World Bank economist Lant Pritchett. Pritchett argued that fertility levels are related to demand factors -- the fact that people in developing countries typically want many children -- and not to the supply of contraceptives. This realisation was behind the rebirth of the population control movement as the “holistic” reproductive health movement at the world population conference in Cairo in 1994. Where bullying could no longer be countenanced, persuasion in the form of educating and looking after women might succeed.
Thus the language of the movement changed but the goal remained, and remains, the same: to persuade entire nations -- and non-white nations at that -- to commit demographic suicide. Whether it is called eugenics, or birth control -- as Margaret Sanger first named it, or family planning, or maternal and child care, or, as now, Population, Health and Environment, an element of deceptive imperialism remains.
Connelly has done well to expose the failure of the population control movement to get the consent of its victims, but to see this alone as its “fatal misconception” is to fail to get to the heart of the matter. The historian does not see, or at least acknowledge, that the “reproductive rights” he champions involves the systematic violation of the rights of the unborn child through abortion, the unbreakable link between abortion and contraception, and the disastrous personal and demographic effects of the culture of birth control.
And all for what? The population control/reproductive rights movement has never produced one single piece of evidence showing the direct connection between family planning and economic development. But if Connelly is neither an economist nor a moral philosopher we must be grateful that at least he has used his historical skills to salutary effect. As the saying goes, those who do not acknowledge their history are condemned to repeat it.
Rosa Linda Valenzona is currently General Manager of the Ayala Multi-purpose Cooperative in Manila. She is a former lecturer in economics at the University of the Philippines and a former Assistant Secretary for Legislative Affairs, Department of Social Welfare and Development. She is also a consultant to Pontifical Council on the Family.