Check population growth, but without coercion

Today, we have come full circle, for the one thing that has grown by leaps and bounds is our population. Steps have to be taken, and soon, so that we don’t displace China from the top position. As we have seen that decrees are counterproductive and force boomerangs, so how do we go about it without rubbing our people the wrong way? One of the measures that can be adopted is to give incentives to people with small families.

Swelling numbers: The country may be bursting at its seams, but the right way forward for population control is through education and awareness. PTI

Amrinder Bajaj

Senior Gynaecologist

India is bent on creating a world record — that of being the most populous country. This is one competition in which we might soon beat our traditional enemy China, but it will be a matter of shame, not pride. Quantity will replace quality. For how long can the education system and the healthcare system, bursting at the seams, be sustainable? The number of the hungry, the homeless and the jobless will escalate; the crime rate will rise too. The rapid deforestation to accommodate the exponential population growth will worsen our deteriorating environment. What a drain on our natural resources, what a strain on our growth potential.

I remember the time in the 1970s when the population issue was brought into sharp focus by Congress leader Sanjay Gandhi. Fresh after my post-graduation at AIIMS (All India Institute of Medical Sciences), I had joined as a senior resident in a government hospital. The Emergency that the then Prime Minister Indira Gandhi had imposed upon the country was still on. Of the various excesses that took place, one that affected doctors (especially gynaecologists and surgeons) the most was the mass sterilisation campaign, spearheaded by Sanjay Gandhi. One could not impose dictatorship on the largest democracy in the world (there is something to be said for numbers after all) or take such large-scale liberties with the human body. He ended up antagonising the very people for whose welfare he had ostensibly taken this drastic step. Such was the state of affairs that government teachers were not given promotion till they got at least five persons sterilised. Imagine, urging students to get their parents sterilised during a maths class! Ineligible women, be they in the menopausal age group, or those who were already sterilised, were also recruited in a desperate bid to increase the numbers. Sterilisation camps were set up in far-flung areas where asepsis was not up to the mark and, if something went wrong, the patient had to be taken to a hospital miles away.

The onus of ‘permanently’ preventing pregnancies fell upon the hapless doctors. Gynaecologists ligated the tubes that transported the egg from the ovaries to the uterus so that the ova and sperm could not meet, thus ending a woman’s reproductive life. Large-scale vasectomies were done by surgeons who tied the fine tube that connected the testicles to the rest of the male genital tract, blocking the passage of sperms. I had been looking forward to honing my surgical skills during my residency in a hospital with such a huge patient load by performing major surgeries like hysterectomies. Sadly, all I got to do, along with the others in my department, was female sterilisation from 8 in the morning to late in the evening; sometimes even far into the night, when complications occurred as case selection was hurried and poor.

We worked long and hard, for our hospital wanted to gain recognition by having the highest score. We did surge ahead of the others, but when the time for accolades came, there was a new government in power and the sterilisation campaign was now considered a major violation of human rights.

Today, we have come full circle, for the one thing that has grown by leaps and bounds is our population. Measures have to be taken, and soon, so that we do not displace China from the No. 1 position. As we have seen that decrees are counterproductive and force boomerangs, so how do we go about it without rubbing our people the wrong way?

Having worked both in general and corporate hospitals, I have seen that the affluent, who can afford to bring up any number of children, restrict their families, while the poor breed like flies. This could be due to lack of education, early marriage, poor medical facilities and high infant mortality rates in the slums and rural India. This induces people to procreate profusely, in the hope that some of their offspring would survive.

In order to curb our population growth, we could adopt the following measures: i) Improve the socio-economic status of people; it has been seen that in order to maintain a certain standard of living, people opt for small families; ii) Educate the girl child so that she can think for herself, and is not reduced to a baby-producing machine; iii) Ensure ample job opportunities, especially for women; iv) Raise the minimum age for marriage; v) Ensure that daughter after daughter is not produced by families desperate for a son. The girl child should be equally welcomed, loved and given equal opportunities. The Sukanya scheme is one such step in the right direction, the abolition of dowry is another; vi) Healthcare workers should offer contraceptive advice after childbirth or abortion; it should not be forced down their throats, or up their uteri, for that drives them away; vii) Don’t just take away privileges from those with more than two children; give incentives to those with small families, just as under-populated countries like Canada offer free education and other benefits to those who contribute to population control; viii) Use multimedia on a large scale to educate the masses.

And the time to act is now!