CHILDREN in rich countries cost an average of $50,000 each—that’s by the time they have been fed, clothed and educated up to the age of eighteen. So ask a European or North American how many children they want and the thought that flashes through the mind may well be: How many can we afford?
But children in poor countries, particularly in rural areas, can actually be a source of income. From the age of five onwards they might be helping with the household chores or transplanting rice in the countryside — work that can add to the security of the family. So their parents might well ask themselves: How many children do we need?
These two different questions produce —not surprisingly — two different answers. Parents in rich countries nowadays want on average two children per family — while in the poor world the number of children wanted is on average between three and five - according to the 1983 State of World Population Report from the United Nations Fund for Population Activities.
At present there are four and a half billion people in the world: a number that will at least double in the future. The UNFPA Report says that world population could eventually stabilize at around 10.2 billion towards the end of the next century. But for population growth finally to come to a stop the number of children will have to be no more than needed for replacement. This will mean parents on average choosing to have only two children.
We are a long way from that. And the extent of the distance to go is indicated by the results of a survey by the East-West Population Institute in Hawaii. If parents everywhere are to have just two children they will have to see children in much the same light. This survey asked parents in many countries what they saw to be the advantages and disadvantages of having children. The differences revealed by the answers were striking.
In Ghana, for example, 64 per cent of women said that they had children chiefly for the economic and practical help they gave. In Peru this figure rose to 80 per cent.
But in the United States — as in other Western countries — the economic benefits paled to insignificance, only being given as the most important reason by five per cent of the women surveyed. Companionship and happiness was what most motivated nearly half of US mothers. The majority of the rest sought psychological benefits from rearing children including, for example, the satisfaction that many parents get by experiencing the world anew through their offspring.
A levelling off in world population is more than a hundred years away — but only if by then we can get to the point where Third World parents need, want — and can choose to have — two children on average. Without this the population plateau will remain an unattainable and distant feature on the horizon.
The main reasons for having children are shown below, along with the percentage of
Source: East-West Population Institute.
EVEN in Biblical times people were advised to ‘turn back and cover that which cometh from thee’ (Deuteron. 23:13). But this basic environmental duty is still not observed in many parts of the world — a negligence that produces dangerous health hazards.
The threat comes mainly from human waste infected with diseases, such as cholera and typhoid fever. These are then transmitted either by flies or other insects or a contaminated water supply.
Management of excreta is not a topic that generates much public interest. But according to the World Health Organization some 15 million children below the age of five die in developing countries every year partly due to the absence of sanitation. Diarrhoea alone kill six million children every year and contributes to the death of another 18 million. Parasitic worms infect nearly half the people in developing countries.
In Western countries excreta are flushed into sewers and the wastewater is purified at a treatment plant. But according to Dr Krisno Nimpuno, who recently chaired a seminar on human waste in Bangkok. Thailand, ‘flush and forget’, sewerage systems are too expensive for poor communities.
The best known cheap alternative is the pit latrine — basically a hole in the ground. But the pit has odours that attract flies and rodents and can sometimes pollute groundwater. So a new ‘VIP’ latrine. (‘Ventilated Improved Pit’) has now been designed which does not give off odours and is both clean and safe. Many African countries have satisfactorily adopted it and in Zimbabwe a locally made VIP costs only $8.
But there are many social factors as well as technical ones which determine a community’s toilet customs. In one Central American country, for instance, despite health education programmes, women did not use public latrines. Subsequent studies revealed that the women felt going to the latrine was a private function and since the walls of the toilet did not cover their feet, they refused to use it.
Waste disposal is a collective concern that requires the active co-operation of all. But sanitation is a taboo subject. The solutions are there, but their application requires a lot more than technical expertise.
Kamon Pensrinukan, IDRC
DEPRESSION by the Guatemalan military government has now forced a large part of the rural population to migrate. More than half a million peasants have been uprooted during the last three years, of whom about one hundred and fifty thousand have crossed the border to seek refuge in Mexico. Close to 40,000 are concentrated in 36 camps situated along the border. The majority, however, is scattered in groups of a few families or in the inaccessible jungle of Chiapas where they are out of reach of all types of aid. Some have been taken by Mexican families who share their already scarce provisions.
Three-quarters of the refugees are children, for whom malnutrition is the main problem. All children under the age of five years show some signs of nutritional deficiency. Estimates made by the Mexican Secretariat of Health and by other organisations show that 20 per cent of the children have third-degree malnutrition.
Another health problem is the gunshot wounds. The Guatemala army has adopted the practice of contaminating the bullets with fecal material in order to cause grave infections in those wounded. It is quite common to see people die with light wounds which have been complicated by terrible infections.
The help of the Mexican Government and the United Nations has increased since the visit of the High Commissioner for Refugees, Paul Hartling, who announced aid of$1,700.000 for 1983. However, this is only for the refugees concentrated in the 36 camps, leaving out the rest of the immigrants. For those in the camps it amounts to about 8 cents a day each.
But in fact it is uncertainty and fear that continue to be the major problems for the refugees. In spite of the latest official declarations of help and protection, they still fear being expelled from the country.
THE chances of victims of a nuclear attack receiving any medical attention at all are ‘next to nil’. This is the grim assessment of a ten-member expert committee in a report presented to the World Health Assembly in April.
There is no health service on earth, they pointedly say, that is geared to, or capable of, providing care for the injured or the dying during nuclear warfare, Even tending to those injured by blast, heat, or radiation from a one-megaton bomb would overwhelm a country’s medical resources. Although such a bomb is small by thermonuclear standards, it represents about an 80-fold increase over the 12.5 kilotons dropped on Hiroshima. ‘With facilities and supplies reduced, the capacity of the surviving medical personnel to provide adequate care, or even to provide first aid to keep the victims alive, would be next to nil,’ the experts state.
The view is corroborated by a US case study cited in the report which assumes a half of Boston’s population are casualties of a one-megaton bomb, with 700,000 estimated as dead and an equal number injured.
Even on the assumption that the rest of the country were spared devastation, and thus could divert all medical resources to the stricken city, this ‘would not suffice’.
The experts calculated in their report the consequences of three hypothetical situations:
1. A single megaton bomb dropped on a city the size of London. This, they say. would kill than 1.5 million people and injure as many more.
2. A war with small tactical weapons, totalling 20 megatons, and limited to military targets in central Europe. This would exact a toll of about nine million dead and seriously injured, plus about the same number of people with less severe injuries —a total of 18 million casualties.
3. A full-scale war, with 10,000 megatons of nuclear power unleashed — 90 per cent in Europe, Asia and North America, ten per cent in Africa, Latin America and Oceania. This ‘would result in about 1,150 million dead and 1,100 million people injured’. Or , put another way: ‘Altogether about half of the world’s population would be the immediate victims of war’.
Rescue work would be ‘scarcely other than makeshift’ with the death rate of health workers ‘greater than that of the general population because of their exposure to radiation, disease and other hazards’. As a result, ‘the majority of casualties would probably be left without medical attention of any kind’.
Peter Ozorio, WHO
Smashing the iron rice bowl
CHINESE shop assistants, notoriously offhand with customers in the past, are now vying with each other to offer good service. They have not only corrected their lax timekeeping, which often meant a 50-minute lunch break instead of the specified 30 minutes, but opening hours in many shops have now been extended.
China’s biggest iron and steel works has achieved a 20 per cent annual profit increase since 1979. A collectively-owned construction company has proved to be more efficient than a more technically advanced publicly-owned one. And once-bankrupt stores now take huge sums of money daily from their customers.
Under the old system, the state assigned every worker a job for life, with low but guaranteed wages — an ‘iron rice bowl’, the Chinese called it. No matter how hard or little the employee worked, the reward was the same or, as another Chinese saying put it, ‘everybody ate out of the same big pot’.
If an enterprise lost money, the state baled it out. Managements, accountable to no-one in particular, were bureaucratic and inefficient and since they handed over all profits to the State, there was no motive to raise production.
But under the new system the iron rice bowl is smashed. Workers are guaranteed only 70 or 80 per cent of their former pay; what they earn above that depends on their diligence.
The job-for-life principle is on the way out too. Workers are now hired on fixed-term contracts (usually renewable) which specify the circumstances under which they might lose their jobs.
Management reform is also under way. Managers have more personal responsibility for fulfilling state quotas, but also have greater flexibility — including the right to award bonuses and to hire and fire middle-level office workers. They themselves face the sack if they do not come up to scratch. Instead of handing over all their profits to the state, enterprises now pay taxes and keep some of what they make. Unproductive ones face closure.
The days when the state was the sole provider of work have also ended. Much of the responsibility has now been handed to local neighbourhoods, which are creating thousands of small businesses, especially in the service sector with shops, cafes, hairdressers, electricians and shoe repairers. Individuals are now encouraged to start their own small trades and may themselves hire a limited number of workers.
The success of the responsibility system was first proved in agriculture, where farmers were allowed to sell surplus produce on the open market once they had fulfilled their state quota and also to run profitable sidelines such as raising animals or growing vegetables. The annual average peasant income per head as a result increased from $67 to $112 over three years.
The Shoudu Iron and Steel Works just outside Beijing was the first individual plant to try the new system. And such was the success that the responsibility system is being encouraged throughout industry. By the middle of 1982 the changeover should have been completed in a quarter of China’s 42,000 state-owned industrial enterprises.
But there remains doubt in some minds whether certain transactions are ‘legitimate business’ or ‘illegal economic dealings’. Followers of the late Chairman Mao frown upon the responsibility system, which is one of the innovations inspired by senior politican Deng Xiao-ping.
To appease all views, the Chinese leadership will have to draw a careful line between bureaucratic control and free-for-all chaos.
But China’s biggest resource — its workforce — has entered the new system enthusiastically to judge by results so far.
Jane Marshall, Gemini
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