About science; About current developments in family planning

This is about science produced by the California Institute of Technology and originally broadcast by station KPP C. Pasadena California. The programs are made available to the station by national educational radio. This program is about current developments in family planning with host Dr. Peter Letterman and his guest Mr. Robert Gillespie. Here now is Dr. listen. Most of us will recall the scriptural injunction go forth and multiply. Or the Arabic salutation from the poem Abu ban RDM May your tribe increase. In fact it has long been traditional that happy was the family or nation whose numbers were steadily growing. But as the world changes at an ever accelerating rate the old order changes to the new must replace it. Today we realize that man's headlong self multiplication. So picturesquely called the population explosion must be made head on and controlled. If we are to create a habitable

earth. There are just too many people being born. In fact not for the first time in history. There are actually more people alive than dead. In other words there are living on the earth at this very moment. More people then all of those who have lived and died in the Earth's history. A striking observation. We are fortunate to have with us Mr Robert W. Gillespie an expert on population control and family planning. Mr. Gillespie whose fields involve statistics economics and social sciences has worked in the foreign Middle East in many areas of family planning as staff representative for the Population Council which is sponsored by the ford and Rockefeller foundations. He had just returned from two years in Taiwan with consulting visits to Pakistan and Turkey. Bob let's start off by discussing some of the causes of the population problem.

Well the major cause Peter is that 50 years ago common killers such as malaria cholera the plague were controlling population in the last 50 years there's been medical developments which have controlled these diseases and death rates have gone down considerably. But there hasn't been a corresponding decrease in the birth rates. And for this reason the population has grown at a very rapid rate. It's really only two percent. But in the long period of time this is very fast. And I suppose this huge growth is going to lead us into all sorts of social and economic problems. Well it certainly is. The population grows in multiples where is agricultural and economic growth usually increases arithmetically. The economic burden is very severe. Developing nations need a population reduction in order

to have fewer consumers dividing the total production of the economy. This is a major problem particularly in places like. Asia where the population 50 percent of it may be below 15 years of age. This means that you have over 50 percent of the population in the consuming and unproductive age category. And they will not be productive until they have the educational and they technical skills to produce a surplus of capital or pursue a process of labor in their countries. And I suppose going along with this is their world wide problem. The urban people that's the people who live in cities are always being joined by the people who live on farms who seem to long to want to come into the cities. Yes there is a rapid migration from the rural areas into the urban areas mainly this is a migration into the slum areas these people coming off the farms are unskilled and

educated and the problem is that. These people who can't be used on the farms because they farm units of land are too small as they are come in and cannot also create to the economic development because of lack of skills. And this is caused a real problem. On the other end there is a problem with just the educated people not finding jobs because industry isn't carried to handling the type of scales that a lot of educated people have. So we see then Bob that there are just too many people and that some way must be created to stop this large rate of people being born. But I imagine there must be many religious. Groups which do not feel that it is a good thing to limit population in any way. Well really Peter most of the world does not have any religious restrictions only

in South America are there really dogmatic religious restrictions the Buddhists Confucius to the major religions in a theological sense do not oppose these programs of family planning. So actually this is not such a severe religious barrier as we tend to think of it in America. Well Bob what has been done about family planning in the past. Well in the developing countries the first generation of young leaders after the break up of colonial empires were mostly against family planning such as Gandhi and Dr. So you have sent him. China but the present leaders are recognizing the problem of family planning are trying to take steps to curb population growth particularly in the Far East. One of the problems was is that the methods of contraception

50 years ago and 20 years ago and the facilities for providing these methods just were not adequate. And so such countries as India which started family planning during their first five year program really failed quite miserably so. So in the past these methods have failed largely because medical science hadn't developed techniques which were effective and safe to use. But what about the current developments in for example. Well due to government planning commission the government leaders understanding of the economic and agricultural problems of their nations they are taking active steps now particularly in Asia to curb their population growth. This is done Prince of lay by appropriating large sums of money through the Ministry of Health to set up family planning programs. I see. And so we see right from the start that these things have such a large scale that they have to be done on a national basis by the

appropriate ministries I suppose that much of the contraception today takes place through the female side of the family. Yes and this is mainly due to a breakthrough in contraceptive technology a method called the interviewing device or loop. This is used in most of the major countries which have family planning programs today. The doctors are trained in the use of this device in just a matter of days. And so the doctors have to be there to insert the loop I expect. But obviously you don't have that number of doctors in the underdeveloped countries to do all the other jobs which must be associated with a plan like this Bob. Well in most of the government programs they use the government doctors plus they are private doctors and then pay them on a per case basis for each loop that they insert. But the major program is based around

home to home visits by field workers who are trained in home visit techniques sales techniques group meetings procedures and such things as this so that they can educate the women about the methods about family planning and explain where the doctors are located who are providing the contraceptives and then how do they know if this is doing any good at all. Well it's difficult to calculate the effect of the family planning programs that are on operation today on the what effect this will have on the birth rate. However we do know from a month to month basis how many loops are inserted Ghar how many other contraceptives are distributed who referred the cases and generally such characteristics as the age of the people coming in and their location and factors relevant to planning a program.

Bob we've been speaking right from the start about planning planning planning. This makes me think immediately about wondering what people in the communist countries are doing we always think of the communist countries as essentially planned economies and so we would. I would expect that family planning would be developed to a rather high level there. What is the case. Well officially the communist countries do not have what we would call population policies. However China with one fourth of the world's population more people in China than Africa and South America combined. They have tried to increase the age of marriage for the male and female they are providing rings these metal rings are in her uterine devices through the hospitals and also they have a relatively liberal policy on providing both sterilization and abortion so they actually are doing something in family planning but they

don't do it for economic reasons or at least that's not what they state. They state that they're doing it for our maternal and child health. And the reason for this is that in a Marxist in a logical sense they do not believe that an individual in a communist state can produce a can be a burden. He was always producing a surplus and for this reason they have never come out in support of population policies and I've talked about their population problem. So that in spite of the fact that that communist ideology suggests that one should have very large families in practice they do much the same things that we do about family planning. Well in the Eastern European communist controlled areas they have a large number of abortions and in a place such as Budapest in large greater part of Budapest they have twice as many abortions as they

do have births and so their liberalized policy in abortions is very similar to what's happening in Japan. And this is stabilize the population to a great extent and in fact it's not growing very much faster than 1 percent a year. On the subject of Japan Bob you carry us from the island into the Far East and I think that I'd like to ask you to speak in possibly a bit more detail about what is actually happening on Taiwan from which you have so recently returned. Well to give you a bit of background on Taiwan the population there on the island is about twelve point six million people. And the growth rate for almost 20 years had been about four percent. And as a result a population on Taiwan is the second most dense in the world and they have a real severe population problem. However the birth rate had been declining just slightly since 1948 and the reasons

for this are that women with three to five children who are over 30 they want to stop having more children. They realize that the public health benefits are making and providing them with the opportunity to have children grow up till they are 45 60 years old and that they're not dying at birth I suppose they realize Bob that the less children they have the better they can provide for them. That's right they can provide more for each child the fewer they have. And so in Taiwan people have been doing this to a certain extent I would say voluntarily since 1948. But what about your programs there. Well our program actually began on a relatively extensive scale in 1962. They prevent child health department funded about two cents per capita for the family planning program. And we started by training mostly the private obstetrician and

gynaecologist in the insertion of the lope and paying each doctor 75 cents for the insertion of the lope and the woman paying another 75 cents giving the Doctor a total of a dollar fifty for each one of the contraceptives and then I suppose you'd have a very large field stuff that you also had to train and control. That's right there we train the workers most of them being nurse midwives and we found the best workers were just about 30 years old married and or very personable. Our training course lasted about two weeks in which we included home visits and group meeting techniques. How exactly do these ladies on your field staff go about their actual job. Well we know that the women who are going to be most interested already have three or more children and want to stop from having. Children and so the workers go and see them first. Furthermore they say they go to one in every five homes

rather than every home. This saves time because we know a lot of the information about family planning will travel by word of mouth communication. Women just talking to each other and I guess workers have been very favorably received. Yes they have. They've been received very favorably on Taiwan and we've fortunately had the support of such organizations as the Farmers Association and women's clubs and the leaders of these organizations have helped our workers spread the word in the communities where they're working. And of course once again we always have to ask you that old question how do you know. What sort of effect these workers are having. Well they they certainly are referring a large number of women to the clinics right now after two and a half years. One out of every eight married women have excepted they enter uterine device. But because of certain expulsions

removals we figure that about maybe one in 12 married women on the island have they interviewed her and device. We have evaluated these this program by using fertility surveys of follow up of accept. And every month we get reports on how the program is progressing in the field. I see. And I guess the program like all successful programs is going to be expanded. Yes it will cover the complete island in fact the target for they complete five years that we have set out from 1962 to 1967 is a loop for one out of every three women this is 600000 Lopes. Well if we need this kind of a target we can be pretty sure ours that the birth rate will decline from its present time

high of 30 to 33 to maybe as low as 27 and 28 per thousand population. What about some other countries close by. With the vast population problems countries like India Pakistan. Well both India and Pakistan combined comprise one fifth of the world's population but both of them also have a very strong population policies the governments are very actively trying to curb population growth. India with over 200 million dollars appropriated for this current five year program has very actively started a family planning program. The figures just recently show that 700 50000 enter uterine devices have been inserted. Pakistan has about 40000 women coming in every month. For these devices and so the programs are succeeding in terms of response or at least they're keeping up with the targets. But in order to

actually slow population in these areas it's going to take massive efforts 20 million lives and India to just begin to curb the population and hundreds of thousands opes and Pakistan. And yet the governments of these countries of course support you every inch of the way I imagine. Yes they have been very cooperative have very strong policy say in India and Pakistan. The not only the Ministry of Health but the Ministry of Economics the Ministry of Agriculture the Ministry of Education have all been cooperating in this program but they have an immense problem very low literacy rates in India alone there is over six hundred fifty thousand small villages and so transportation is very difficult providing doctors in these areas to insert the loop is very difficult. And so you have enormous problems. And as a result the programs are hampered tremendously

by just logistics and these are the major problems faced by the development of the development of these programs now. But how about these other great underdeveloped countries of the world the great sleeping arising giant of Africa or Latin America. How have they progressing or planning in family birth control. Well in tropical Africa Ghana Kenya and other nations there is some interest. But for the most part the African leaders today believe they need larger population growth. So there hasn't been very active participation in these areas although there has been certain voluntary groups who are working in family planning in Northern Africa. There have been very encouraging developments in the United Arab Republic and particularly Tunisia. They both of these countries have strong government policies and are providing extensive family planning services. Morocco now is

beginning with a family planning program. So we see that in parts of Africa the tropical Africa as you say the latest Field they do need more people but in the older more developed products they are anticipating their problems the problems which we are already fully aware of and beginning to take active steps. How about south of Latin America. Well generally there is a religious restriction there on the official family planning programs but because there is a large number of illegal abortions they private medical practice has become aware of the this acute problem and in some countries they are beginning to have a real interest in family planning. The PRAST president of Colombia has publicly stated that family planning is very important for the future of Latin America and in such countries such jellied are our active Lay

family planning programs. In a fact Bob you mentioned about your problems the problems of course that any innovator always has for religious to Buddhist illiteracy of ignorance. What sort of techniques do you use possibly to try to combat that ignorance. Well the easier the method you provide the less problem you have with ignorance. If a person for example has to use a method continuously then you have a real problem in education and the discipline to use of that method. However our foundation now is currently working on a method which if it is successful will be put like a capsule under the skin of a female and can remain in there indefinitely. This is mainly due to a very sensitive triggering mechanism or a sort of time capsule which releases a compound

which prevents this woman from becoming pregnant. I see. And what about what about the moral aspects of simply persuading people to do these things. What about your propaganda. Shall I say. Well we haven't had any real problem with the churches opposing this and in fact in a very minor way certain even Catholic priests are providing contraceptives to a small group of people where they have the women are having numerous abortions and their life is going to be severely hampered by additional births. We are though making a film to appeal to these people. We're working with the Walt Disney Studios and this film is divided up into three parts first we're explaining the population problem as it affects the villager himself. Then we're going to try to get all for the

benefits. Spacing and limiting childbirth to the individual family and the last part of this film well explain some of the methods and certain concepts of family planning which are important for illiterate people to understand what family planning programs and family planning itself is all about. In other words this will be an animated cartoon relic which will be shown in all the little primitive villages throughout the world. That's that's correct Peter. We're hoping to have this film finished within the next year. And it will be shown through all the little villages that we can distribute it to. Well I think there could be anything more effective than the visual media. And what what are we going to see in the future in family planning. Well this method which I just described which if it goes according to schedule with current developments may be available

for testing within two years. But. It's going to be very important for our governments to take a more active participation. There is going to be need of the use of more ministries. There's going to be legal requirements such as increasingly aged marriage. In addition the private sector is going to be needed for more active participation in this field and generally it's going to there is going to be a need for greater participation both in public and private sectors. National. In these nations in the developing countries. So we're going to have to see both the government and the people actively working in these areas and if they do work where will it get us where will they be able to hold back the tide. Even with ideal methods total support from governments increased age at marriage and all of the voluntary efforts to lower population

all the countries in the world will undoubtedly double for example take Japan and most of the European countries which are increasing at a rate of 1 percent. They will double but it will just take 60 years where it is in the countries such as India Taiwan will double in 30 or 40 years. So we have a real problem our hand. And you might say we are fighting for the rights of the couple to have children when they are wanted because you know hundred years this right to have children may not be a matter of choice. So we see then that plan a family planning for underdeveloped countries and indeed for ever developed countries like US is not a luxury or even merely a desirable object but a vital and stock necessity. Our economic survival and the only chance in these underdeveloped countries for them to permit their own

people to live in decency and dignity is to exercise some extensive form of family planning. Medical Sciences have made great progress. They've given us the means by which it can be done with reliability of planning methods as high as about 90 percent already. And as Bob said the ideal contraceptive device may not be too far distance but in spite of these we can still only hope to slow the great swell of the population growth and attempt to try to keep it at a manageable level in line with our own development of our resources. And one thing however that we may always be certain of is that the world of the 20th century will be a very crowded place. Thank you Bob. This was about science with host Dr. Peter Letterman and his guest Mr. Robert

Gillespie. Join us again for our next program when Dr. Albert Hibbs will lead a discussion about the Earth's mantle about science is produced by the California Institute of Technology and is originally broadcast by station KPCC Pasadena California. The programs are made available to the station by national educational radio. This is the national educational radio network.