It is sometimes surreal to visit countries with low populations. Russia and New Zealand are examples. For hour after hour, no person is visible and the landscape, with its scattered animal herds, is all that is visible out of the window of a train or a car.
This comes as a shock to us from Pakistan. We are accustomed to people everywhere, and we see them everywhere except in parts of Balochistan where red rock and sand gives away no sign of human life.
But are we prepared for a future in which there is literally no place to stand and stretch one’s arms? Are we prepared for a future where wars over a jar of water are a common occurrence in every community? Are we prepared for a future where there are simply no resources to feed, clothe, educate or medically care for these people? If our answer is no, then we should be looking more closely at our failures in controlling population growth and promoting reproductive healthcare.
According to the latest UNFPA report, Pakistan is now the fifth most populous country on Earth. Within a few years, it will climb to fourth place. The population growth rate of 2.4 percent is amongst the highest in the world, and the total fertility rate of 3.6 percent exceeds that of all countries in the region except Afghanistan. We argue, and often hear our political leaders arguing, that religious constraints bar them from openly promoting family planning. Certainly, whenever an advertisement appears on television screens for contraception, there is an immediate outcry.
But do we really have the option of listening to this? Should those who direct our future be thinking of what will happen to our nation rather than to the religious lobby that has taken it over through threat of violence and the sense of fear they generate? We dare not violate them, even when what they say has no connection with religion or with simple, common sense. The reality is that a population growing so rapidly will quickly swamp us. Experts have already warned this will be the biggest crisis the Pakistan of the future will face.
The results of our failure to manage or control our population have been devastating. Over the decades, the rate of poverty has climbed alongside the population, which stood at 33 million in 1950. People have less to eat, they are less well-nourished and there was a time when stunting and wasting on the scale we see now was simply not a feature of Pakistan. It is worth considering that since it broke away violently from Pakistan by 1971, Bangladesh, also a strictly religious Muslim country, has been able to bring down its population growth rate to just over one percent.
Somewhere there are lessons to be learnt in this. The success in that country of winning over the support of prayer leaders and clerics played a part in this. So did the will of private NGOs and the government, which recognised that with a population growth rate which was once among the highest in the world, the population could simply not survive. Of course, it is still trapped in poverty and deprivation. But just think what the situation may have been had the growth rate not been contained to less than half of that of Pakistan.
Our problem appears to lie in the reluctance to promote family planning and especially to give access to contraceptives directly to women. Studies by Unicef have shown that women and their families wish to control family size, whereas men choose not to. There are locations in Punjab where organisations have made the pill or contraceptive injections available to women without the consent of their husbands.
The right over reproduction and their bodies after all lies with women, who must carry a foetus for nine months, feed the child after birth and be the primary carers of the new child which comes into the family. Yet this right is stripped away from women, even in some cases among the relatively affluent, sometimes because of the desire for a male child. Just as was the case in pre-Islamic times, female feticide is common today through the use of ultrasounds which allow the gender of a foetus to be identified well before birth. Technically, informing parents on gender is forbidden – but naturally almost no ultrasound clinic follows this protocol.
With a large proportion of our population between 15 and 30 years in age, there is a particular need to educate schoolchildren about sex education at appropriate age levels. Yet whenever this has been attempted, there has been a violent backlash, from parents and from religious leaders. We should directly ask them what they want; an endless stream of hungry people unable to reach their potential or take their country forward? Mass destruction of environment and resources? These are questions that need to be answered. There is evidence from all parts of the world that when children and teenagers are aware of family planning, the impact of their learning reaches into larger households. This is especially true of girls, the mothers of the future.
The high fertility rate has an impact not only the collective whole of the nation but also on individuals. The acute malnourishment seen among the women of Sindh is, according to leading doctors who have worked in the field, a direct result of the multiple pregnancies with short intervals that they are forced into throughout their married lives. Early marriage contributes to this and to complications with birth which mean our infant mortality rate is again the highest in the region. Child mortality, for children up to five years old, is also the highest and is linked to the poor health of mothers and the simple inability to feed children.
We have not heard mention of a family planning policy from the new government. Surely this has to be made a priority. Pakistan already struggles to maintain the numbers who live on its soil. It simply cannot afford to place more on a territory which is after all limited. The uneven distribution of the population and the migration to urban centres makes things even worse.
The squeamishness about family planning and the methods available has to be overcome. The reproductive rights of women need to be restored. This means a massive media campaign coupled with education at schools, colleges and through mosques and medical centres. There has been almost no attempt to implement such efforts.
We hope that as it sets about its task of building a new Pakistan, the current government will realise that any nation worth living in is only feasible if the number of persons who populate it can be controlled. There is no reason at all why the issue should raise so many sensitivities. Other nations, in the Muslim world and elsewhere, have been able to move past these. It is essential that we do the same.
The UNFPA has already warned that Pakistan is headed towards disaster. It must be the mission of our government and private organisations working in the field to ward off this disaster, which in so many ways is already upon us and could rapidly worsen over the coming years. A barrier has to be placed to prevent this.
The writer is a freelance columnist and former newspaper editor.
Email: kamilahyathotmail.com