wolfson overpopulation.compressed (1)

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7 HUGE PROBLEMS. 7 BRILLIANT SOLUTIONS.KILLING A SNARLING pack of werewolves would be a stroll through Central Park compared to some of the challenges were tackling here. But fear not. Weve got answers. Brilliant ones. Silver bullets that could make the world a better, safer, cleaner and friendlier place. On the following pages, we lay out some smart, elegant solution to vexing problems like over-population, poverty, infectious disease, the energy crisis and more. Hows that for a Christ-mas wish list?

We understand your skepti-cism. Theres no such thing as a... is the phrase that usually precedes silver bullet. After all, the thinking goes, any huge problem that hasnt already been solved has regularly de ed the best e orts of even the best minds and must be bullet-proof, right? In many case, this is true; it would be insulting to argue that theres a quick- x for the geopolitical quagmire of the Middle East. And there is no panacea for the extreme weather patterns that have developed in recent years due to global climate change.

But history is replete with examples of immense, intimi-dating issues that only seemed insurmountable until some

iconoclast looked at an old problem in a new way. Scurvy killed millions of sailors and other travelers; all it took to end the epidemic was a daily ration of citrus juice, packed with vitamin C, to keep the disease at bay. Childbirth used to be a dicey proposition, but in the middle of the 19th century, an

observant Viennese physician noticed that when babies were delivered by midwives who washed their hands, both new-born and mother were much less likely to develop health complications. Big problems, simple solutions.

Bring on the werewolves. We are locked and loaded.

OVERPOPULATION

TOO MANY PEOPLEThe Earths too crowded, so better family planning may be humanitys last hope to save us from ourselves

WHEN NIGHT falls on Kibera, it is like a door slamming shut. When the sun is up, things are hectic and loud, rough and fetid, but always

safe and even welcoming: Bright colors abound and so do off ers of nyama cho-ma (roasted meat, usually goat) and bottles of Tusker, the local lager. Soon after the fi rst stars appear in the sky, the streets of Nairobi, Kenyas largestslum, go silent, emptying out but for dogs, cats and rats, thieves and rapists.

BY ZO SCHLANGER @zoeschlanger AND ELIJAH WOLFSON @elijahwolfson

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Life moves indoors, and because most people are too scared to leave their homes to use outhouses and public latrines, fl y-ing toilets (plastic bags holding human waste) are tossed out of doorways and over fences into the streets.

One night this past October, the sob-bing of a girl cut through the mu ed mu-sic reverberating behind the tin walls of makeshift homes and businesses. Track-ing the noise, a middle-aged man discov-ered a young woman slouched against the wall in an alley. Her face was contorted in pain, and blood had soaked her skirt and pooled around her body.

Acting quickly, the man ran through the streets until he found a wheelbarrow. He then lifted the womana girl, really

and placed her inside. More blood fl owed from her body as he wheeled her to the Marie Stopes Kibera clinic.

The next morning, Jimmy Ireri Njagi, manager of the clinic, found the girl on his doorstep, still in the wheelbarrow. Quick-ly, he diagnosed the problem: a botched, back-alley abortion. Within hours, he had her in a nearby hospital, where emergen-cy health care workers operated on and saved Florence Akinyis life.

The pregnancy was an accident, says Akinyi, a pretty 18-year-old with a buzzed hairstyle and shy smile. She is so grateful to Doctor Jimmy (as everyone calls him) that she has become a sort of de facto offi ce assistant, running small neighborhood errands and speaking with

+MISSION CONTROL: A billboard promot-ing family planning in Benin, a small, French-speaking country in West Africa. In Benin, the fertility rate is 4.93 births per woman, well over the world average of 2.5.

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prominentlythe problems created by a lack of reproductive rights are getting more dire. In 1650, there were about 500 million people on Earth. By 1804, the pop-ulation had doubled to 1 billion. In just 123 years, it doubled again, to 2 billion, and it doubled yet again, to 4 billion, by 1974. The worlds population passed 7 billion in 2011. The latest U.N. projections suggest well be up to 12.3 billion by 2100, with no stabilization in sight.

Meanwhile the rest of Earths fl ora and fauna are being pushed aside. We are in the midst of the biggest mass-extinction event since the dinosaurs were obliterat-ed 65 million years ago. A recent paper in Science found that plant and animal spe-cies are now going extinct at least 1,000 times faster than they did before human-itys arrival, due mostly to human-caused

habitat destruction and climate change. Some scientists have taken to describing our current epoch as the Anthropocene, to highlight the fact that humans have ir-reversibly changed the ecological make-up of the planet.

In the 1970s, with the global popula-tion hovering around 4 billion, humani-ty began using more resources than the Earth could replenish each year, and was producing more waste than it could ab-sorb, pushing us all deeper and deeper

the young patients at the clinic. Akinyi is one of the lucky ones. Too many

more like her do not survive bad abortions, or suff er long-lasting health problems be-cause of them. And then theres the even greater number of young women who, be-cause they lack resources, keep unplanned children and end up trapped in a cycle of poverty and poor health.

Its an ancient problem, with a very obvi-ous solution: give women full reproductive rights, including easy access to contracep-tion and other family-planning options. Family planning and reproductive health are some of the most crucial tools for re-ducing human suff ering in a changing and increasingly crowded world.

NO FOOD, NO WATERLIKE MANY Kibera residents, Akinyi moved to the city only recentlyshe ar-rived a year ago from the upcountry. Its not clear how many people live in Kibera, but the Kenyan census says that at least 200,000 are crammed into this makeshift, two-square-mile shantytown. The impact of this massing of humans is like a physical blow: The land and city in-frastructure cant keep up with the peo-ple. Step between the houses of Kibera and into a back alley and you are likely to come across gulches carved into the dirt by streams of wastewater, the ad hoc sewage system here, and garbage and waste piled high.

Kenya is in the midst of a population explosion. With a high fertility ratethe average Kenyan woman has 4.5 children, compared with 2.3 worldwideKenyas population of 44 million is projected to more than double to 97 million by 2050. Meanwhile, more than a quarter of Ken-yan women are still unable to access the contraceptives they want. Despite over a century of family-planning aid work, it re-mains one of the most misunderstood as-pects of international development. This is in large part because of Western eff orts to apply a coercive form of population control under the guise of family planning.

Globally, birth rates are lower today than ever, and more women than ever be-fore are masters of their own bodies. But global populations are still on the rise, and in many parts of the worldAfrica most

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WE ARE IN THE MIDST OF THE BIGGEST MASS EXTINCTION SINCE THE DINOSAURS WERE OBLITERATED.


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into ecological overshoot, according to California think tank Global Footprint Network. It estimates that in 2014 humans used the resources of 1.5 Earths.

Most of the population growth is oc-curring in African nations. The continent hosts 15 percent of the worlds people; by 2050, the U.N. projects, that number will be closer to 25 percent. This is particularly problematic, because much of the conti-nent is also where people are less able to adapt to the eff ects of overpopulation, says John Wilmoth, director of the U.N. Popu-lation Division. If the world cant meet Af-ricas need for family planning, the result will be more and more poor, and poorly educated, people, he says. Kenya, Ethi-opia and Malawi, for example, are three nations where large numbers of women cant get the contraception they need and are at high risk for climate change eff ects like fl ooding and drought.

As climate change turns more coasts into fl ood zones and more farmland to desert, the damage will be inextricably linked to population growththe more of us there are, the more water, food and energy well need to survive. In the past three years, Australia, Canada, China, Russia and the U.S. have all suff ered dev-astating fl oods and droughts that severely impaired food harvests. Earlier this year, the Food and Agriculture Organization said that to feed a population of 9 billion in 2050, the world must increase its food production by an average of 60 percent or else risk serious food shortages that could bring social unrest and civil wars. By com-parison, wheat and rice production have grown at a rate of less than 1 percent for the past 20 years.

Mark Montgomery, a scholar at the Population Council, studies how the ur-ban population boom will cause dramatic

freshwater shortages. By 2050, the U.N. projects that 70 percent of the worlds population will live in cities. Already, 150 million people in cities around the world suff er from freshwater shortages. In a recent paper, Montgomery and his col-leagues found the number of urbanites with inadequate water will rise by more than 1 billion by 2050, and cities in certain regions will struggle to fi nd enough wa-ter for the needs of their residents.

THE BIG TABOOROGER-MARK DE SOUZA is fed up. The director of the population, environmental security and resilience arm of the Wilson Center, a government think tank in Wash-ington, D.C., he says most of the discus-sion about adapting to climate change ignores the population explosion. If you have all of these initiatives being put in place, and you have ongoing population growth, to what end? he asks. If we only invest in programs that do not take into account these broader social interven-tions, there is a missed opportunity.

The Green Climate Fund, perhaps the most high-profi le one helping developing

BAD FINANCE: Its in our best interest to invest in family planning abroad; USAID says that every dollar not spent on family planning will cost the U.S. up to six dollars more in the long run. +

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EUROPEANS CAME TO AFRICA LOOKING FOR BODIES.


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countries adapt to climate change, does not say anything about population on its website. The United Nations Framework Convention on Climate Change, which manages climate-focused national ad-aptation programmes of action for the least-developed countries, devotes a sec-tion of its website to the role gender plays in climate change. Women, it explains, are more vulnerable to its ravages and must be included in adaptation efforts. But family planning and contraception arent on the official list of adaptation projects.

This failure has been exacerbated by the long and ugly history of wealthy, pre-dominantly white powers manipulating family planning on the continent for sev-eral centuries. Europeans came to Africa looking for bodies, says Nwando Ache-be, a professor of history at Michigan State University. First was the slave trade. Then came the colonist era, when Euro-peans settled in Africa, establishing mas-sive farms and plantations requiring local labor. Both groups of invaders needed

a population of able-bodied Africans, says Achebe. They were enacting laws to make sure the population grew.

Columbia University history professor Matthew Connelly argues that the 20th century was filled with wrong-minded approaches to family planning that have ranged from using risky contraceptives on unwitting clientsin 1967 a Ford Founda-tion report praised a proposal for a new technology involving an annual applica-tion of a contraceptive aerial mist (from a single airplane over India)to offering cash incentives to poor people who agreed to be sterilized. Policies like these made family planning seem like an imposition, rather than something that served clients own interests, writes Connelly, and the backlash was ferocious. Revolutionary leaders worldwide (including Daniel Or-tega in Nicaragua and Zulfikar Ali Bhut-to in Pakistan) attacked family planning as a symbol of American imperialism, and the Vatican jumped on board, help-ing organize a global campaign against

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family-planning eff orts, which just happened to line up with the Catholic Churchs offi cial stance on procreation, particularly in developing countries.

In 1984, President Ronald Reagan in-stituted what has become known as the global gag rule (offi cially the Mexico City Policy), which stopped U.S. dollars from fl owing to any international family-planning groups that provided abortions. The rule also stipulated that any organiza-tion receiving U.S. funding could not ed-ucate patients on abortion or take a stand against unsafe abortion. President Bill Clinton repealed the policy in 1993, George W. Bush reinstated it in 2001, and Barack Obama repealed it again in 2009. If a Re-publican takes the presidency in 2016, the gag rule will likely come back.

When the gag rule was in eff ect, United States Agency for International Develop-ment (USAID) funding to family-planning

organizations plummeted. Clinics provid-ing everything from condom distribution to HIV/AIDS treatment to neonatal care cut back their staff and services, and in some cases shuttered their doors entirely. In some cases, the rule backfi red: Kelly Jones, a senior researcher at the Inter-national Food Policy Research Institute, found that in Ghana during gag rule peri-ods, rural pregnancies increased by 12 per-cent and the rural abortion rate increased right along with it, going up by 2.3 percent.

Meanwhile, U.S. funding for family planning abroad has fl atlined for several years, at about $530 million, although it would take relatively little money to make an enormous diff erence. For every dollar spent on family planning, USAIDs web-site boasts, up to $6 is saved on health care, immunization, education and other services. Put another way, every dollar not spent on family planning will cost the

A SIMPLE CHOICE: Jimmy Njagi, a health care worker at the Marie Stopes clinic in Kibera, Nairobi, Kenya, implants a 5-year contracep-tive into the arm of 40-year-old Susan Osinde in 2014.+

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U.S. up to $6 more in the long run. Its not diffi cult to understand that contraceptive devices are relatively cheap compared to the cost of building roads and schools and hospitals, Wilmoth, the head of the U.N. Population Division, says. So its not for lack of money that it isnt accomplished.

While the West wa es on providing aid for family planning, Africans are asking for [it], says Faustina Fynn-Nyame, Ma-rie Stopess country director for Kenya, who is from Ghana. Africans see the im-portance of this. Its not the West telling us to do something.

LEAVING HALF THE POPULATION BEHINDIN 2012, the estimated number of unintend-ed pregnancies was 80 million (63 million in the developing world). World population growth? Also 80 million. In other words, if women all over the world had the ability to prevent the pregnancies they dont want, the worlds population would stabilize.

That would immediately improve both maternal and infant health. In most parts of the global south, access to abortion is either extremely limited or prohibited. In Kenya, a nurse was sentenced to death for providing abortions this past September. Any pregnancy terminations in Nairobi have to be done on the backstreets, often using DIY drugs made by chemists more concerned with sales than effi cacy, says Njagi, the Marie Stopes clinic manag-er. Thats how Florence Akinyi ended up nearly bleeding to death in a wheelbarrow.

Worldwide, its estimated that 20 mil-lion women have unsafe abortions every year because they lack better options. Over 5 million of them end up needing ur-gent medical attention, and 47,000 die in the process. In addition, in the developing world pregnancies are often dangerous. Every year, an estimated 358,000 women die during childbirth, and many more suf-fer debilitating pregnancy-related health problems. In sub-Saharan Africa, the life-time risk of dying from pregnancy-related problems is 1 in 22. Lower pregnancy rates and you lower those risksfewer preg-nancies means resources dont have to be spread dangerously thin.

Since 2011, the United Nations Popula-tion Fund (working to ensure universal

access to reproductive health, including family planning) has been led by Dr. Babatunde Osotimehin, a Nigerian nation-al. At the U.N. General Assembly meeting in September, Osotimehin urged the group to focus on gender equality. We cannot advance by leaving half of the populationour women and girlsbehind, he said. At the same meeting, Bathabile Dlamini, a representative of South Africa, said her country had recently implemented policies allowing access to safe abortion services and had seen an increase in life expectancy from 54 in 2005 to 60 in 2011.

Of course, abortion is the last resort; its far better to help women before concep-tion. According to research from the Gutt-macher Institute, 39 percent of all pregnan-cies in sub-Saharan Africaan estimated

19 millionwere unintended in 2012. Of those 19 million, the institute estimates 10 million resulted in unplanned births, 3 mil-lion in miscarriages and 6 million in abor-tions, most performed in unsafe condi-tions. Providing access to contraception for every woman in sub-Saharan Africa who wanted it might prevent 5 million abor-tions and save the lives of 48,000 women. Whats more, 555,000 fewer newborns and infants would die, cutting infant mortality in the region by 22 percent.

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REVOLUTIONARY LEADERS WORLDWIDE ATTACKED FAMILY PLANNING AS A SYMBOL OF AMERICAN IMPERIALISM.


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Many Kenyan women would like to have power over how many children they have, and when. We have a high unmet need, says Fynn-Nyame, adding that 20.9 percent of married women say they want to control their fertility some-how but dont have the access, money or awareness of where to go.

In the developing world, 222 million women want contraceptives but cant get them. (That is more than the popula-tion of Germany, France, Belgium, Spain and the Netherlands combined.) Meet-ing their needs would have prevented 54 million unwanted pregnancies, 26 million abortions, 79,000 deaths of mothers in pregnancy or childbirth and 1.1 million in-fant deaths in 2012 alone.

Plus, contraceptives let women space out births, leading to far healthier chil-dren. If all families in the developing world put a three-year gap between preg-nancies, almost 2 million fewer children under 5 would die each year, according to research from the USAID.

The problem is that too many of these important decisions are taken out of womens hands. Over 10 percent of Ken-yan women report being raped by their partners. Women have very little pow-er when they are having sex within their marriage, says Fynn-Nyame. A woman might know that shes at a fertile point in her menstrual cycle, but she wont be able to negotiate with her husband. If he wants sex, she has to give in.

Fynn-Nyame says a lot of the work her team does is with men. It works, she says, particularly among young men. The prob-lem is that misinformation about contra-ceptives is so endemic that even men who want to participate in family planning ei-ther dont know how or dont have the ac-cess. For example, recent research shows

that young Kenyan men in universities will often have a glass of water and the morn-ing-after pill ready for their date to take be-fore sex. Its eff ectivethough not exactly healthy for the woman who takes it. But what else are you going to do? asks Fynn-Nyame. You want to fi nish your education and have a diff erent lifeyou have all these dreams and aspirations.

GOD WILL PROVIDEACHEBES FIRST name, Nwando, is a shortened version of Nwabundo, an Igbo word that translates roughly to a child is the shade. She says, It means as the youngest daughter, Im expected to stay with my parents as they grow old and shade them as a tree. Let my lineage not end. Let my path not close. These are names that Africans give their kids.

In much of the developing world, there remains a deep-seated imperative to have as many children as possible. In part, this is due to the pernicious infl uence of colo-nialists and missionaries, but it also stems from many decades ago, when child mor-tality was so high that if you wanted to have a few kids, you had no choice but to follow one pregnancy with the next. This is particularly the case among people who live off of subsistence farming in the rural

areas, who feel that the more hands we have, the more work we can do, and the more money we can take in, says Fynn-Nyame. Children are also considered an investment for a parents old age. After all, if you have eight children, theres a chance at least one will have the wherewithal to care of you when you grow too old to care for yourself. And it doesnt matter if you cant aff ord eight children right now. If you ask people whether they can aff ord

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REAGANS GLOBAL GAG RULE STOPPED U.S. DOLLARS FROM FLOWING TO ANY INTERNATIONAL GROUPS THAT PROVIDED ABORTIONS.


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these children, says Achebe, the answer is always, God will provide.

Meanwhile, too many children lack information about sex and procreation. Many of the women in the Marie Stopes Kibera clinic come alone, with no real knowledge of their options. Often they will have been told by their husband what contraceptive to ask forusually they are told to avoid intrauterine devices (IUDs) because it makes sex less fun, says Njagi. I try to teach them about their options so they can make a more informed decision.

And that might just be IUDs, which are one of the best forms of birth controlthey have a failure rate of less than 1 percent, while birth control pills have a failure rate of between 8 and 9 percent. Plus, in re-gions where the health care infrastructure is shoddy, relying on a daily supply only drives up failure rates. As Elaine Lissner, director of the Male Contraception Infor-

mation Project, puts it, If youre some-where on the pill and the pill truck doesnt show up one month, youre pregnant.

THE GREAT GIRL BOUNCEWHAT WOULD happen if contraception suddenly became a universal right?

It did, in Bangladesh, which is season-ally flooded from Himalayan ice melt and is regularly bombarded by cyclones. The rising sea level, driven by climate change, is projected to wipe out 17 per-cent of its landmass by 2050 and displace 18 million people.

In the 1970s, Bangladesh, which had just become independent, concluded it was growing too quicklyit was on pace to nearly triple its size in four decades. Wom-en on average gave birth to more than six children. So the government made con-traception free and distributed it widely.

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+NO MORE LEFT-OVERS: If urban centers like Mexico City (shown here) and consumption patterns continue to grow as project-ed, by 2050 hu-mans will require the resources of three Earths a year just to survive.


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+HEAD IN THE SAND: A recent U.N. IPCC report names population growth as the one of the biggest drivers of CO2 emissions. But the report omits population con-siderations from its list of possible remedies.

In 1975, 8 percent of Bangladeshi wom-en used contraception. By 2010, the num-ber was over 60 percent. At the same time, educational opportunities increased: More than 90 percent of girls enrolled in prima-ry school in 2005. Just fi ve years earlier, female enrollment was half that number, according to The Economist. Womens liter-acy hit 78 percent in 2010, compared with just 27 percent in 1981. Women who had an average of six children in the 1970s have roughly 2.2 children today. That fertility rate is well below Indias and far lower than Pakistans. Bangladesh is now the only de-veloping country on track to meet the Mil-lennium Development Goals for child and maternal health.

This is not just a medical issue; it is a social issue as well, the United Nationss Wilmoth says. The Bangladesh program did that community by community, with these women who would talk to people. Its amazing that [the fertility rate] has fallen that low in a country so poor. Its an example of whats possible.

The Iranian miracle is another ex-ample. It was the steepest population drop ever recordedfaster even than Chinas one-child policy. And it came without coercion.

In the late 1980s, Irans Ayatollah Ruhollah Khomeini reversed a pro-natal policy meant to produce soldiers for the war against Iraq. Persuaded that the Iranian economy could not handle the bloated population, he issued fatwasmaking contraception available for free at government clinics. State-run TV broad-cast information about birth control, and health workers educated patients on fami-ly planning as a means to leave more time between births. The fertility rate fell from seven births per woman in 1966 to fewer than two today. The plunging birth rate, coupled with increasing public education for girls, shifted the role of women in Iran. More women postponed childbirth to at-tend college, and now the countrys uni-versities are 60 percent female.

But in 2006, then-President Mahmoud

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+HEAD IN THE SAND: A recent U.N. IPCC report names population growth as the one of the biggest drivers of CO2 emissions. But the report omits population con-siderations from its list of possible remedies.

Ahmadinejad attempted to halt the de-cline, calling the family-planning pro-grams a prescription for extinction, ac-cording to the Los Angeles Times. He urged Iranian girls to marry young, off ered cash incentives per child, and most recently the government outlawed permanent sur-gical contraception. But it hasnt worked. Iranian women are not going back, Sussan Tahmasebi, an Iranian womens rights leader, told the Times.

When women can have fewer children further apart, the eff ect on their lives is dramatic and immediate. They have more time to pursue education and get jobs, earning money that they are more likely to invest back into their family and community than their male counterparts do. They lead healthier lives and have healthier children. The power dynam-ic between men and women can change too: Women with more access to resourc-es are less frequently victims of domestic violence, according to USAID.

The Aspen Institute estimates that if all women globally had access to the contra-ceptives they want, the reduction in un-wanted pregnancies would translate into an 8 to 15 percent reduction in global car-bon emissions. Fewer people would be in harms way as sea levels rise and farmland dries out, and less pressure on resources already stretched thin would mean less vi-olent confl ict over those resources.

OUT OF CONTROLNOT ALL experts agree that better family planning will save the planet. Connelly ar-gues that the environmentalist argument for population control is at best wrong, and at worst disingenuous. An individ-ual human who is a subsistence farmer consumes about as many calories as a dol-phin, he says. You and me are consum-ing calories equivalent to a blue whale. One American blue whale is worth dozens of Bangladeshi dolphins. To say if only there were fewer dolphins, the rest of us whales would be OK I think is crazy. And its a cop-out. And its unfair.

The point he is making is that the real problem for the planet is overall consump-tion. In some family-planning clinics, he says, there are posters on the wall depict-ing two families: the unhappy, unplanned

family, living in abject poverty and vio-lence, and the happy, planned family, with a suburban home and two cars parked in the driveway. The idea it promotes is the miracle of family planning: If you get rid of the kids, you can have more stuff .

But, he adds, you cant have it both ways. Either were going to lift hundreds of millions and eventually billions of people out of poverty and make them consumers of cars and everything else, or were going to reduce numbers of people so they will consume less. How do you reconcile these two things?

Nevertheless, even if family planning wont solve our resource challenges, Con-nelly says, there is no doubt the world would be a better place if women and fam-ilies everywhere had access to their full re-productive rights. And the demand for con-traception is there. In Kenya, Fynn-Nyame sees it. When you speak to these women, they are very angry, but at the same time, if they had diff erent choices in life, if they knew earlier, they wouldnt [have] wanted to have so many children, because theyre worried about the future of their children. Theyre worried about food security,

theyre worried about education. If they get pregnant again and they die, whats go-ing to happen to their children? she asks. Her survival is so crucial, but her ability to survive is all based on whether she can get some sort of fertility control.

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IN KENYA, A NURSE WAS SENTENCED TO DEATH FOR PROVIDING ABORTIONS.


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