Let the people control population

The last time Dalit Ezhilmalai made news, it was when he refused to sign the shut-up-or-get-out' ultimatum issued to Ramakrishna Hegde by t...

The last time Dalit Ezhilmalai made news, it was when he refused to sign the shut-up-or-get-out8217; ultimatum issued to Ramakrishna Hegde by the AIADMK law-makers in a show of stage managed bellicosity. For the BJP, Dalit Ezhilmalai may have been the proverbial St George taking on the dragon of dissent within a creaky coalition, but that hasn8217;t made much difference to the population clock ticking away relentlessly at the AIIMS crossing in New Delhi. If Dalit Ezhilmalai must play St George, he has got to do it as Minister of State for Health and Family Welfare. And if he finds time to tear his mind away from the political theatre of the absurd being enacted alternately in Chennai and New Delhi, he may find it edifying to read a copy if it can be retrieved from the layers of cobwebs it must have acquired by now of the Draft National Population Policy submitted to his ministry by a committee of experts headed by M. S. Swaminathan on May 21, 1994.

The committee, like all such groups of well-intentioned people,made some important points. One, in fact, was revolutionary. It suggested in polite language that the Department of Family Welfare be scrapped, that people, acting through panchayati raj and nagarpalika institutions, be encouraged to set their own reproductive health agenda, and, more importantly, that the seats in Parliament and legislatures be frozen till the year 2011, to deny politicians the privilege of using population growth as a bargaining chip. The committee, in other words, wanted New Delhi to move out of the business of determining the country8217;s population control strategy, which it has been doing since 1951, reducing what could have been a national movement to an exercise in number-crunching. A beginning was made in 1996, when New Delhi officially declared the end of the targets raj, but much remains to be done.

Look at the challenge Dalit Ezhilmalai has taken on unwittingly. It8217;s all there in official statistics. Female sterilisation, for instance, accounts for almost 80 percent of moderncontraceptive practice in the country, but the truth is that most women who opt for this terminal birth-control method have already had their share of three or more children. The other bad news is that an estimated 10-15 percent of all births take place when women are in their teens, yet there8217;s no contraception strategy directed at adolescent girls. But the really bad news is that even as most women continue to be denied their right to take the two most important decisions of their lives 8212; the timing of marriage and childbirth 8212; nothing tangible has been done to make reproductive health the responsibility of men as well. So, women are left bearing the double burden of childbirth and contraception choice in a society where men take the decisions. Is it surprising then that condoms account for just 2 percent of contraceptive use in the country? Or that 22 percent of the children born each year are products of what demographers call unwanted fertility8217;? In other words, if mothers had their way, one in fivechildren born every year wouldn8217;t have been conceived.

Some time back, there was much jubilation about the population growth rate slipping below 2 percent 1.98 percent, to be precise for the first time in decades, but the seemingly innocuous percentage figure translates into a population gain of 18 million 8212; India, to put it dramatically, adds an Australia each year. But maybe we could have lived with that distinction had our age pyramid not been inverted 8212; 36.3 percent of our population belongs to the 0-14 age bracket. It has three implications. One, even if by some stroke of luck India reaches overnight the stage where each birth offsets a death, the population will keep growing for another 40 years, until today8217;s children complete their prime reproductive years. Two, the number of new children needing education will keep growing, even before the backlog of children denied by their circumstances access to education is cleared. Three, when today8217;s children join the ranks of the economically activepopulation, more and more jobs will have to be found 8212; by one estimate, 100 million new jobs must be created by the end of this century, when the population crosses the 1,000 million mark.

It8217;s a daunting prospect. And it will remain so as long as New Delhi decides the nation8217;s population control and reproductive health agenda. Hence the need to harness the power of the new political elite created by the 73rd and 74th amendments, to enable the one million or so women who are to be elected to the new panchayats, zilla parishads and nagarpalikas take the lead in setting the demographic and reproductive health goals of their communities. For starters, the elected panchayats must be empowered to take over the levers of control of the basis of all health care in the country, the sub-centre. So, for every auxiliary nurse midwife who doesn8217;t show up at the sub-centre, for every batch of essential medicines that exists only in the registers but not on the shelves, for every obstetric emergency that goesunattended, there8217;ll be someone accountable locally.

The panchayats must also take the initiative to introduce some homespun realism into development strategies that complement population control exercises. Take, for instance, the girl child8217;s education, the much-touted antidote to big families. It is well-known that the preponderance of male teachers in primary and middle schools inhibits many parents from sending their girls to school. Now, if the panchayats were given the task of finding local solutions to the problem, they would do a much better job than the eggheads of New Delhi. Dalit Ezhilmalai cannot be expected to do so much in the limited time he has, but he can at least start making the right noises.