The Reporter Population Connection
Volume 45, Issue 4 December 2013
President’s Note
E
arth’s climate is changing at a speed never before seen in history. The proposed Keystone XL pipeline will only make it worse. But consider this: A modest additional investment in voluntary family planning programs could reduce carbon emissions as much as preventing 377 Keystone pipelines. Climate change is a puzzle with many pieces, and stopping bad projects is crucial. But we can’t end there. We need to make good things happen, too. We need to invest in people. Specifically, we need to invest in ensuring that every woman and every couple on this planet has access to affordable and appropriate modern birth control. 222 million women around the world still have an unmet need for family planning. This appalling lack of basic care leads to 80 million unintended pregnancies every single year. Here in the United States, nearly every other pregnancy is unplanned. The good news on this front is multifold. First, when women, in particular, are able to choose their own futures, which includes if and when to have children, they generally choose smaller families. Second, women around the world want to use birth control. And finally, a relatively modest investment can address the unmet need and bring enormous returns in terms of public health, economic and political stability, and environmental and climate security. Some people point out that investments in family planning will spur economic development that could increase emissions. It’s true: When people have smaller families, their economic
status improves so they may be able to afford things like electricity in their homes and transportation via taxis rather than slow, overcrowded buses. But the answer to rising fossil fuel emissions isn’t to keep the poor mired in poverty. In order for the world’s poorest people to attain a decent quality of life, their energy use and emissions will have to increase to some degree. Instead, we need to reduce our own carbon gluttony here in the United States. According to a detailed analysis undertaken by a team of scientists in 2010, if our global population in 2050 were 8.3 billion rather than the more-likely 9.6 billion, some 3.1 billion tons of carbon emissions would be averted each year. The resulting annual reduction in carbon emissions is the same as avoiding 377 Keystone pipelines. Solving the climate puzzle isn’t a multiple-choice question. Rather it’s a question with a vast multitude of answers. Stopping harmful projects is a great place to start. But it’s not enough. Investments in people—especially women—help us meet the climate challenge. They also lead the way to healthier women, children, and economies.
John Seager john@popconnect.org
Help Make the Population College Connection
It’s going to take an extended, concentrated effort to achieve population stabilization. That’s why we need the next generation. We’re already active on nearly 200 college campuses, and we’re expanding our outreach. You can help. Just email Lee Polansky at lee@popconnect.org or call her at (202) 974-7702 if you know of opportunities for us to make presentations on any campus across the country. There is never any fee or other cost involved since reaching young people is central to our grassroots mission. The Reporter — December 2013
The Reporter Volume 45, Issue 4 December 2013
Board Chair
J. Joseph Speidel, MD, MPH President and CEO John Seager
Editor and Designer Marian Starkey Contributors
Amy Phillips Bursch, Rebecca Harrington,
10
Book Review: Countdown: Our Last, Best Hope for a Future on Earth? By Marian Starkey
12 Population and Development: One Traveler’s Observations from South Korea and Ethiopia
By Marian Starkey
2
Editor’s Note
3
Letters to the Editor
4
Pop Facts
6
In the News
8
The President’s Circle
24
Connecting Dots
26
Washington View
28
Field & Outreach
Stacie Murphy, John Seager, Marian Starkey, Pamela Wasserman
Population Connection is the national grassroots population organization that educates young people and advocates progressive action to stabilize world population at a level that can be sustained by earth’s resources. Annual membership includes a one-year subscription to The Reporter. Annual membership, $25. All contributions, bequests and gifts are fully tax-deductible in accordance with current laws. The Reporter (ISSN 0199-0071) Population Connection 2120 L Street, NW, Suite 500 Washington, DC 20037 (202) 332-2200 (800) 767-1956 info@popconnect.org www.PopulationConnection.org www.PopulationEducation.org http://twitter.com/popconnect www.facebook.com/PopulationConnection
30 PopEd
Cover Photo
33
In Ethiopia, a community-based distribution agent, who is also a local traditional birth attendant, visits a village where she is leading a discussion about family planning. Photo: Virginia Lamprecht, Courtesy of Photoshare
www.popconnect.org
32 Cartoon Editorial Excerpts
December 2013 — The Reporter
1
Editor’s Note
O
ne of the perks of my job at Population Connection is the international travel that comes with attending global conferences. This year I’ve been fortunate to add two more pins to my travel map: South Korea in August and Ethiopia in November. These two destinations really couldn’t be more different from each other but conveniently serve as an exemplary lesson in the benefits and outcomes of investing in family planning over as little as one generation. This is the topic I explore in my article beginning on page 12. The International Union for the Scientific Study of Population meets every four years in whichever country wins its bid to play host—the Olympics of demography, if you will. This time around, Busan, South Korea put forth the winning proposal. Nearly 2,400 researchers, delegates, and NGO workers attended from 110 countries around the world. With 272 sessions spanning five days, plus 484 posters to peruse during lunch breaks, a strong dose of caffeine from A Twosome Place—a ubiquitous chain of cafes—was often required to get me through the afternoon and evening sessions. The IUSSP doesn’t mess around—it makes the 24+ hours of travel each way well worth everyone’s while, with 12 straight hours of programming each day. The International Conference on Family Planning is a more applied conference, attracting practitioners, program staff, and advocates in addition to researchers. It’s hosted by the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health (where our board member Duff Gillespie is a professor). Only in its third iteration (prior conferences were held in 2009 in Uganda and in 2011 in Senegal), the conference has already become a must-attend event for those who work to promote health and development and halt environmental degradation by expanding access to voluntary family planning. This year, Ethiopia was chosen to host because of the great strides it has made in family planning in recent years, especially in the capital, Addis Ababa.
2
The Reporter — December 2013
Conferences are an efficient way of bringing people with a variety of backgrounds and research interests together for a common cause. It’s important to know who’s doing what as it relates to one’s own work. But the travel itself is at least as important as the sessions and the schmoozing. It’s impossible to overstate the benefits of getting to know the countries that receive our aid dollars. Whether it’s through a clinic visit, a hospital tour, or a conversation with a local woman, on-theground experiences provide rich context for the advocacy work we do from our headquarters in Washington, D.C. I never doubt whether funding international family planning is a worthy cause or a savvy investment, but I’m all the more enthusiastic about its impact after seeing programs in action. The same goes for seeing what communities and countries are like after receiving and making smart use of foreign aid. Case in point: South Korea was once a recipient of U.S. foreign aid. It now has a $1.13-trillion economy and is one of the most technologically advanced nations in the world. Life expectancy has shot up to 81 in 2013 (from 48 in 1950). Infant mortality has dropped from 138 newborn deaths per 1,000 live births in 1950 to 3.4 deaths per 1,000 live births in 2013. The role of family planning in those—and many more—health and development indicators cannot be denied. Our aim is to ensure that countries like Ethiopia can benefit as much in the coming decades from family planning’s influence as South Korea did over the past half-century.
Marian Starkey marian@popconnect.org
Send correspo
Letters to the Editor
ndence to marian@popc onnect.org. Letters are also accepted via postal mail. Le tters may be edited for clar ity and length .
Attn: Marian St Population Co
arkey
nnection 2120 L St., NW , Ste. 500 Washington, D C 20037
Even though I haven’t yet had an opportunity to read it in detail, I already consider the June 2013 issue the best issue of The Reporter I’ve ever seen. Here’s why: Before today, I never could quite understand what Population Connection really does. It’s easy for me to quantify what the other groups I support do because of data indicating number of condoms distributed, etc. But today, for the first time since I began supporting Population Connection, I got a real appreciation for what you do by reading the “2012 U.S. College and University Tour” article on pages 24 and 25. Population Connection just moved way up the priority list of the dozen or so non-profit organizations I support. When I support a non-profit, I want to see what it does in specifics rather than generalities. I got that in the June issue. Thanks again. William Cundiff Menomonie, Wisconsin You have been doing so well with the college programs. We are changing our estate plan this month to include Population Connection. Steve Willey Rolling Thunder, Idaho I really believe in the goal of Population Connection. Having said that, I wish to request that you stress the “canary in the coal mine” principle as it relates to population. I’ve found it successful here in Texas that when I discuss the “problem,” I use the following analogy. If four people live in a four-bedroom/two-bathroom house (finite in size), each person has enough space and resources. If 40 people live in that same finite area, space and resources are much more scarce. I find that nobody can disagree with this and it’s just then a www.popconnect.org
matter of presenting the facts (relatively easy to do because the principal is what most don’t get, at least here in Texas). After all, the earth is finite with just a finite amount of natural resources. It’s important that they understand the problem first before we give solutions (like abortion, birth control, etc.). Bill Hurley San Antonio, Texas In the September issue of The Reporter, a graphic says that “By the end of the century, Nigeria could start to rival China as the second-most populous country in the world.” Given that Nigeria is a far, far smaller country in terms of physical size, I can’t help but say ‘how?’ In terms of food, water, living space/ conditions ... I don’t even really want to imagine a country of Nigeria’s size with many hundreds of millions. Yes, I realize food can be imported, but as populations increase, everyone wants and needs more. The people who instantly dismiss any concerns about population growth, who come up with all kinds of plausible and implausible ways to meet the needs of endless numbers of people, never seem to include quality of life in their discussion. DeWitt Henderson Las Cruces, New Mexico
Correction: The photo of Derrick and Lua Belgarde on page 29 of the September 2013 issue was taken by Bill Petros, not Jonathan Look. Sincere apologies to both photographers for the error.
December 2013 — The Reporter
3
South Korea & Ethiopia: Population Pyramids South Korea
1950
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
0
0
500
100
0
500
100
150
0
200
0
0
150
100
500
0
0
0
500
100
150
0
200
0
0
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
0
0
0
200
150
0
100
500
0
150
100
500
250
200
0
0
0
0
800
0
0
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
0
600
400
200
0
0
0
0
800
600
400
200
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
0
400
0
300
0
0
200
100
ia
Addis
0
0
200
0
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
250
2050
0
150
200
2010
Ethiopia
80+ 75-79 70-74 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4
A
Ethiop baba,
0
100
0
200
0
300
0
400
0
500
0
00
100
0
800
Female Male
0
600
0
400
0
200
0
200
0
400
0
600
0
800
0
100
00
Sources: UN Population Division, Population Reference Bureau Design by Rebecca Dodelin
250000
Population Estimates and Projections, 1950 to 2100
Ethiopia
(population in thousands)
200000
150000
100000
South Korea 50000
0 1950 Busan,
1960
1970
1980
1990
2000
2010
2020
2030
2040
2050
2060
2070
2080
2090
2100
South K orea
50
3
63 65 62
81 85 78
44%
14%
87,095,000
48,454,000
Total Fertility Rate, 2010-2015
4.59
1.32
Population Living Below US$2 per Day
78%
0%
29% 27%
80% 70%
$930
$27,240
Infant Mortality Rate, 2010-2015 (infant deaths per 1,000 live births) Life Expectancy, 2010-2015
Both Sexes Females Males
Population Age <15, 2010 Population, 2010
Contraceptive Use Among Married Women Ages 15-49, by Method Type GNI PPP Per Capita (US$) www.popconnect.org
All Methods Modern Methods
December 2013 â&#x20AC;&#x201D; The Reporter
5
In
the
News
Supreme Court to Rule on Contraceptive Mandate The ongoing disagreement over whether for-profit employers who are against birth control should have to provide contraceptive coverage to employees in their health care plans is about to be decided. The Supreme Court is being called on by both sides of the argument to rule on the mandate’s legality in light of the 1993 Religious Freedom Restoration Act, which supporters insist only applies to individuals. Sebelius v. Hobby Lobby Stores and Conestoga Wood Specialties v. Sebelius are the two cases under consideration. The Court agreed to hear the cases in late November after about 30 companies sued the federal government. The Green family, which owns Hobby Lobby, a chain of craft stores, is the ringleader in the fight against the mandate. The company employs more than 13,000 full-time workers. Hobby Lobby faces fines of $1.3 million a day if it does not win the case and still fails to comply.
American Indians to get Plan B on Reservations Until now, Plan B has been difficult for American Indians to obtain on reservations because Indian Health Services (IHS)—the agency that provides free primary health care services for American Indian and Alaska Native people—does not have any retail pharmacies. Women had to have consultations and then obtain and fill prescriptions for Plan B while women in the rest of the country bought it over-the-counter at pharmacies.
6
The Reporter — December 2013
IHS will now provide emergency contraception at its federally-operated facilities, mirroring the level of access that women across the United States now enjoy. According to the U.S. Department of Justice, American Indians are more than twice as likely to experience sexual assault compared to other groups. A third of American Indian women report having been raped during their lifetimes.
Texas Law Forces Clinics to Stop Providing Abortion A Texas law, approved by the state legislature in July, bans all abortions after 20 weeks; requires clinics to meet the building standards of ambulatory surgical centers; mandates that physicians have admitting privileges at hospitals within 30 miles of abortion clinics; and forces clinics that distribute medication abortion pills to follow a medicallyunnecessary protocol (requiring that patients visit clinics four times in person to complete the procedure). Reproductive rights groups in Texas filed Planned Parenthood, et al. v. Abbott to challenge the last two items, which were set to go into effect on October 29. A challenge to the first two provisions will be mounted at a later date. The day before the law was to go into effect, a trial judge issued a permanent injunction blocking the admitting privileges component, saying that it “does not bear a rational relationship to the legitimate right of the state in preserving and promoting fetal life or a woman’s
health.” He refused to block the medication abortion requirement, however, “except when a physician finds such an abortion necessary, in appropriate medical judgment, for the preservation of the life or health of the mother.” The Supreme Court refused in late November to reinstate the trial judge’s permanent injunction (they voted against it 5-4), so the law requiring admitting privileges is now in effect, and will remain so at least until January when the 5th U.S. Circuit Court of Appeals in New Orleans will hear arguments. At least 12 clinics that offered abortion services have stopped providing procedures.
Rick Perry Apparently Speaks for His Wife Anita Perry, wife of Texas Gov. Rick Perry, was asked whether her husband had “got it [abortion policy] right” during an interview in September. She responded, “Well, that’s really difficult for me … because I see it as a woman’s right. If they want to do that, that is their decision. They have to live with that decision.” Evan Smith of the Texas Tribune cautioned, “Mrs. Perry, I want to be sure that you didn’t just inadvertently make news. Are you saying that you believe that abortion is a woman’s right—to make that choice?” “It is not mine, it is not something that I would say for them,” Perry responded.
She added, “Yeah, that could be a woman’s right. Just like it’s a man right if he wants to have some kind of procedure. But I don’t agree with it and that’s not my view.” Days later, regarding his wife’s comments, Gov. Perry said, “From time to time we’ll stick the wrong word in the wrong place and you pounce upon it.” What a relief that Perry corrected his silly wife; clearly she can’t properly express her own opinions.
Plan B One-Step Doesn’t Work in Heavier Women A European drug that is identical to Plan B One-Step bears a new warning about weight and effectiveness: Norlevo loses its effectiveness in women who are more than 165 pounds and does not work in women over 176 pounds. Teva Pharmaceuticals, the company that produces the equivalent drug sold in the United States, is reviewing the information that came out of a 2011 study that led the European company to issue the warning. The study references Body Mass Index (BMI) rather than weight, so the drug warning and the media reports are confusing and perhaps even dangerously misleading.
12 Percent of Population Chronically Hungry The UN estimates that 842 million people were suffering from chronic hunger www.popconnect.org
in 2011-2013, or more than one in eight people worldwide. In the developing world, 14 percent of people are chronically hungry. In Africa, that figure is more than 20 percent.
Iowa Telemedicine Ban Goes to Court The Iowa Board of Medicine banned the use of telemedicine for early abortions in August. Iowa Judge Karen Romano issued a temporary stay one day before the ban was to go into effect that allows Planned Parenthood to continue providing the service to patients while they challenge the ban in court. The judge commented that the ban doesn’t protect women’s health and also that it’s odd that no other telemedicine procedures were targeted.
Albuquerque Votes Against 20-Week Abortion Ban Voters in New Mexico’s largest city rejected a ballot measure in November to ban abortion after 20 weeks of pregnancy. Only 1.5 percent of abortions occur after 20 weeks, often due to fetal abnormalities that are undetectable before 20 weeks gestation.
California Increases Access to Abortion While states around the country impose strict laws limiting access to abortion, California has gone the other way—the only state to increase access this year.
Gov. Jerry Brown signed a law in early October that permits nurse practitioners, certified nurse-midwives, and physicians’ assistants who complete training to perform first-trimester aspiration abortions. California Assembly member Toni Atkins authored the bill, stating that, “Increasing the number of trained healthcare providers who can perform abortions on a timely basis without requiring significant travel will improve the lives of women and their families in many ways.” More than 8,000 abortions were performed by non-physicians during a pilot program, which started in 2007. Complication rates were the same as for physicians.
Gates Foundation Condom Contest Attracts 812 Applications A contest to develop “a next-generation condom that significantly preserves or enhances pleasure” received 812 applications, 11 of which were chosen as winners. Each winner received $100,000 and could receive up to $1 million more after the ideas are developed. Problems that the new condoms attempt to address include difficulty of use in the dark, breakage, and discomfort. New materials are being explored as options, including fish skin, beef tendon, and polyurethane. To read the original articles from which these summaries were taken, see www.popconnect.org/news December 2013 — The Reporter
7
The Population Connection Presidentâ&#x20AC;&#x2122;s Circle
Recognizing Donors for Their Generous Contributions of $1,000 or More E. Curtis and Eva Lou B. Aanenson Nina Abrams Fund Dawn Abriel
Michael B. and Mary Barbara Alexander Mariette Allen
Janet Jeppson Asimov
Aspen Business Center Foundation Allan Atmore Donald Ayer
Arthur A. and Shirley A. Babad
Jerry and Lynn P. Babicka Kent P. Bach Julia Bailey Bill Baird
Jill Barnes
Ralph L. Bass
The Bay and Paul Foundations
Philip T. Bee Charitable Trust
Jeffrey Dennis
Jerry Glowniak
Trent Block
Elzbet Diaz De Leon and Joe Connett
Lisa and Douglas Goldman Fund
Amy Blitzer
Joseph Blum
Brad and Pirkko Borland Thomas and Marilyn Breckenridge
Stephen A. and Barbara Brooks
Stanley Eisenberg
Lester Brown
The Reporter â&#x20AC;&#x201D; December 2013
Herb Engel
Lois Bueler Blair Carty
Lee Fisher-Rosenberg
John Chamberlain
Nancy Florsheim
Paul S. and Jean W. Burtness
Dennis Ferguson
Ernest F. Chace
Mary Fleming Finlay
Wallace H. Champeny
Gunther Fonken and Agnes Hughes
Willi Cheney
Clifford and Carolyn Colwell
James Blankenship
Jim and Maggie Dunn
The Moses Feldman Family Foundation
Art and Barbara Bryant
Robert Berg and Carol Emerson
Alan Black
Richard and Theresa Gregg
Catherine D. Brown
Virginia Clarkson
Rex Bigler
Julian and Katharine Donahue
Thomas and Elizabeth Gratzek
William B. Guenther
Dr. David J. Benefiel
Douglas W. and Anita B. Bewick
Henry C. Doll and Mary McEwen Doll
Emily L. Grant
Marlene Y. Ebert
Christopher Brown
Hilary P. Clark
Jeanne Berwind
Sarah C. Doering
Crawford Gordon
The Ruth H. Brown Foundation
Raymond Bellamy
Eleanor Berry
Nancy Dodson
David and Alena Goeddel
Mr. and Mrs. Richard Griffith Jr.
Dave Chizek
Erik E. and Edith H. Bergstrom Foundation
Ranae DeSantis Foundation
Susan R. Donaldson
Fred Brown
Brett and Tanya BeGole
Bill Berg
8
David Blittersdorf
Matthew and Dawn Cooper Walter Crager
Charles R. Crisp
Andrew Crowley Carolyn Daily Nick Dale
Gene L. and Linda Daniels Edward E. and Julia DeMartini
Cameron and Diane Fowler Charlotte Fowler
Frankel Foundation Marie E. Fraser
Foundation for The Environment
Marjorie Grinnell Robert Haegele
Robert Harrison
David E. and Shirley F. Hartley Paul C. Haughey
Mark J. Hausknecht Bob and Rosie Heil Jane Henner
Theodore W. and Margie Henning Louis J. Herskowitz
William W. Hildreth Eric and Susan Hirst
Constance Hoguet Neel Joyce Homan
E. Marianne Gabel
John Houston and Katherine Read
Don C. Gentry
Mr. and Mrs. Jerry Jedlicka
The Garfield Foundation Anthony C. Gilbert and Laurel Wroten Gilbert
Sarah L. Gilbert and Carl E. Wieman Duff G. Gillespie
Francis J. Gilmore
David Husch
Pierce Johnson Jr.
K. Malcolm Jones
Barbara Kaneshige Sally B. Kaplan
Richard R. Kauffman
Joanne and Dennis Keith
Paul Reilly
Jerome and Betty Stone Charitable Trust
Arthur and Jane Riggs
Philippa Strahm
Carol Rudolph
David Strickland
Michael Scher
Lawrence Tarone
Carol Ann Kell
Russell Moffett
Judith E. Randal
Nancy Kennaway
Denny Mullen
Ann F. Rhoads
Chuck Stout
Paul W. Rosenberger
Lee J. Strauss
Milton H. and Jeanne Saier
John and Eloise C. Sutter
Henry S. Scherer Jr.
Thomas Tarpey and Carolyn King
Vicky and Grant Kemp Thomas F. King
Graydon C. Kingsland Jerry A. Kolar
Paul V. Konka Hunt Kooiker
Melodee Kornacker Hannah Kramer
George Krumme
Dr. Peter Kunstadter
Dr. and Mrs. George Kurz Jim Lampl
Barry Lauesen and Marilyn Altebach William C. and Emmy Lawrence
Gladys and Ralph Lazarus Foundation David Lehnherr
Dorothy and Andy Leong
Sandra J. Moss
Janet McKean and David Murphy Robert K. and Caryn McTighe Musil Jeffrey Nelson
Lyle E. Nelson
Alice Neuhauser and Thomas Conroy Linda Nicholes Heidi Nitze
Karen Nixon and Clark Searle
Martha and Austin Nobunaga Robert Z. and Nita Norman Robert L. Nutt Charitable Foundation William Oettmeier
Roman Oliynyk and Maureen Hackett
Robert and Beth Schlechter
Dr. Ray and Betty Schofield Serving The Spirit Foundation Richard Shanteau
R. V. Wakeland
Sidney Stern Memorial Trust
Silverman Charitable Group
Gilman Ordway
Ruth L. Siteman
Mary Pearlman
Emil Slowinski
Marvin Marcus
Frederic W. and Mary L. Pement
Christopher and Catherine Mathews
Frank A. and Judy C.M. Pezzanite
Louise E. McClain
Joseph G. Pittman
Gregory B. McKenna
Paul Popenoe Jr.
Friedrike Merck
The Louis and Harold Price Foundation
Lincoln C. and JoAnne P. Miller
Nina Purdon Charitable Foundation
George and Sheila Marshall
Dr. Bob Pettapiece
Richard McCabe
John G. Pitcairn
McCullough Foundation
C. Plantamura and F. Prael
The Janis and Alan Menken Foundation
Stuart E. Porteous
Katharine Merck
Cory Pulfrey
Jonathan Ungar
James M. Shultz
Shenandoah Foundation
Marion B. Smith
Perry J. Luke
Theodore A. Tyler
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Jeffery Sliter
Mr. and Mrs. James Lindsay
John and Anna Marie Thron
Jamie Shaw and Christopher Cope
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Lois J. Levine
David Thomas
Susan M. Sogard Zig Sondelski
George Sonnichsen
Fred and Alice Stanback Norton Starr
Peggy and David Starr
Bonnie Vitti
Ralph Wagner
William Warburton John Weeden
Kevin J. Whaley
Jo Lynne Whiting Searle Whitney Jeff Wilde
John B. Williams
Michael J. Williamson, M.D. Mr. and Mrs. Theodore Winsberg Tom and Elizabeth Wippman
Mary Wohlford Foundation
Theodore L. Steck and Yvonne Lange
Linda Wolcott
H. Paul Steiger Jr.
Frances Yuhas
Susan Steif
Patricia C. Stein
Frances W. Stevenson
S. Paul Wright Chris Wurtele John Zapp
The Mike and Corky Hale Stoller Foundation
This list represents donors who made gifts of $1,000 or more between October 2012 and October 2013. If you have questions or feedback, please contact Shauna Scherer, Director of Marketing and Development, at shauna@popconnect.org or (202) 974-7730. www.popconnect.org
December 2013 â&#x20AC;&#x201D; The Reporter
9
Book Review: Countdown: Our Last, Best Hope for a Future on Earth? By Marian Starkey
I
met Alan Weisman at a restaurant near my office in April 2010. It was a beautiful spring day in D.C. and we sat outside on the sidewalk to eat and converse. One hour turned into two, and before I knew it, we were the only ones left of the noisy, hurried, demanding lunch crowd. A perfect metaphor for his book, I thought, as we stood to leave. The World Without Us was published in the summer of 2007. It had received much acclaim and even inspired a documentary on the History Channel. I enjoyed Weisman’s ambitious thought experiment, exploring a hypothetical world in which humans had suddenly vanished (no apocalyptic explanation given—we were just gone without a trace). But I was startled to read in the last chapter his pronouncement on our species’ necessary next steps. In order to avert the collapse of humanity, Weisman declared, we needed to do something drastic to stabilize our numbers: “Worldwide, every four days human population rises by 1 million. Since we can’t really grasp such numbers, they’ll wax out of control until they crash, as has happened to every other species that got too big for this box. About the only thing that could change that, short of the species-wide sacrifice of voluntary human extinction, is to prove that intelligence really makes us special after all. The intelligent solution would require
10 The Reporter — December 2013
the courage and the wisdom to put our knowledge to the test. It would be poignant and distressing in ways, but not fatal. It would henceforth limit every human female on Earth capable of bearing children to one.” Whoa whoa whoa, I thought. Where did that come from?! How did we go from pipes bursting and flooding the New York City subway to calling for people to stop at one? Yes, if every woman beginning today had only one child, our global population in 2100 would be 1.6 billion—roughly what it was in 1900. But hypothetical scenarios are intended to be just that. Another example of a hypothetical scenario: the UN constant-fertility population projection. Nobody really expects the global population to be 27 billion in 2100—it’s just helpful to know how many people there would be at the end of the century if fertility rates remained unchanged from where they are today. I emailed Weisman to share my concern about how readers might interpret the conclusion of his book. He graciously emailed back and suggested that we meet to discuss his next project. That project became Countdown: Our Last, Best Hope for a Future on Earth? In it, Weisman explores “how might we continue to have a world with us?” A much more refreshing prospect to my mind.
Hardcover: 528 pages Publisher: Little, Brown and Company First Edition: September 24, 2013 www.littlebrown.com/countdown.html Video: www.popconnect.org/Countdown
During lunch, Weisman was eager to talk about countries that had reached replacement-level fertility (2.1 births per woman) or below without any sort of governmental coercion. Iran, being an intriguing example, became an entire chapter in Countdown. He was also interested to discuss the various barriers to contraceptive use that exist for women and couples in the developing world, and in our own country. I suppose it was that discussion that kept us at the table so long, as the list of barriers is practically endless. After that lunch, we spent three years corresponding, sharing travel stories, and swapping book and article recommendations. During that time, Alan visited over twenty countries, from Nepal to Niger.
scientists, economists, religious leaders, and ministers of health. Weisman shows time and again, with examples from every populated continent in the world, that conflict and strife often come down to simple resource scarcity. It’s the reason the U.S. has been willing to fight certain wars and not others (oil); the reason many immigrants flee the desertifying Sahel for Europe; and to quote an old ZPG mantra, the reason “we can’t grow on like this.” So, how to solve the problem of too many people requiring fast-disappearing resources?
The four fundamental questions that he contemplated during his travels were (excerpted directly): 1. How many people can our planet hold? 2. If, in order to have an ecosystem robust enough to insure human survival, we have to avoid growing past 10 billion—or even reduce our numbers from the 7 billion we’re already at—is there an acceptable, nonviolent way to convince people of all the cultures, religions, nationalities, tribes, and political systems of the world that it’s in their best interest to do so? Is there anything in their liturgies, histories, or belief systems—or any other reason—that potentially embraces the seemingly unnatural idea of limiting what comes most naturally to us, and to all other species: making copies of ourselves? 3. How much ecosystem is required to maintain human life? Or, what www.popconnect.org
species or ecological processes are essential to our survival? Or, at what point does our overwhelming presence displace so many other species that eventually we push something off the planet that we didn’t realize our own existence depended on, until it’s too late? What can’t we absolutely live without? 4. If a sustainable population for the Earth turns out to be less than the 10+ billion we’re headed to, or even less than the 7 billion we already number, how do we design an economy for a shrinking population, and then for a stable one—meaning, an economy that can prosper without depending on constant growth? Just like Joel Cohen before him, who wrote How Many People Can the Earth Support?, Weisman isn’t able to definitively answer the first question because the answer depends so heavily on people’s lifestyles and consumption patterns. He does a fine job of tackling the other three questions, though, with the help of
If every woman were able to have a child only when she wanted, our population would have a fighting chance of stabilizing peaceably. That’s a hypothetical situation that we should make a reality. In order to do so, according to Weisman and the experts he consulted, we need to double the global investment in voluntary family planning, to a total of $8 billion. The U.S. share of that is $1 billion, or about $400 million more than we now invest. That’s just an additional $1.25 per year per American—less than the price of the coffee I had at the end of our lunch date. I’d trade one cup of coffee a year for women’s health, and I suspect most other Americans would too.
Receive a complimentary copy of Countdown! Population Connection is pleased to offer copies of Alan Weisman’s book Countdown to members who make a gift of $100 or more by January 31. Just mail this coupon inside the enclosed envelope, along with your contribution, to receive your hard cover copy. December 2013 — The Reporter 11
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A sculpture along the waterfront in Busan, South Korea demonstrates the countryâ&#x20AC;&#x2122;s reverence for motherhood.
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Population and Development: One Traveler’s Observations from South Korea and Ethiopia Article and photos by Marian Starkey
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usan, South Korea’s secondlargest city, has the cleanest subways I’ve ever seen. It really struck me when I saw a woman dusting the underground station one morning. She was literally dusting the station, as if it were the lobby of a fine hotel— mahogany end tables instead of hulking ticket dispensers. She wiped down the fire extinguisher, the railings in front of the tracks, and even the frames that held the system maps. She cleaned quickly and efficiently and had the air of a professional, with her tidy uniform and kempt hair. A bar of classical music—different each time and all unidentifiable to my untrained ear—played over the station’s speakers, indicating that a train was arriving. Passengers calmly filed onboard. There was no pushing, no yelling, and no rushing to beat the pregnant lady to the empty seat before she could take a load off—something every D.C. commuter has witnessed far too many times on the Metro. South Korea—or at least what I saw of it in Busan—was orderly, respectful, and pleasant—but not in a creepy, oppressive way. There were still bad smells, crazy drivers, and street markets crammed www.popconnect.org
with people buying and selling cheap clothing—the signs of a large, booming city. Chili peppers dried on tarps on city roofs, and stray cats roamed the forest at Beomeosa Temple. I even stumbled upon a private moment between two homeless people in the park one night while I was out for a jog. But, overall, Busan felt safe, comfortable, and prosperous.
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realized early in the trip that I had seen very few children. And nearly all of the children I did see throughout my stay—mostly at the enormous shopping mall across the street from BEXCO, site of the conference I was attending—appeared to be “onlies.” Having one child allows couples to experience parenthood without completely breaking the bank. In East Asian societies where child rearing is a major investment, the decision to parent a single child makes financial sense.
It’s becoming a more popular option in the U.S. as well, where 18.5 percent of women ages 40-44 have only had one child, and an equal percentage (18.8) have had none. The total fertility rate in South Korea today is 1.32, after bottoming out at 1.22 a decade ago. According to the latest census figures, most married women ages 15-49 have two children. Only 11.5 percent have more than two, while 32.5 percent have one or none. Most married women under 35, however, have only one child, and that trend does not appear to be changing as each younger generation enters their reproductive years. But it hasn’t always been this way. South Korea’s fertility rate was over six children per woman in 1960, and the country was more desperately mired in poverty than two-thirds of sub-Saharan
Crude birth rate (abbreviated as birth rate): Number of births over a given period divided by the person-years lived by the population over that period. It is expressed as number of births per 1,000 population. Total fertility rate (abbreviated as fertility rate): The average number of children a hypothetical cohort of women would have at the end of their reproductive period if they were subject during their whole lives to the fertility rates of a given period and if they were not subject to mortality. It is expressed as children per woman. Source: UN Population Division December 2013 — The Reporter 13
Africa. Thousands of young men had been killed in the war, starkly illustrated in the first population pyramid on page four of this issue. The nation’s leaders realized that they needed to take proactive measures and accept help from other countries. USAID started working in South Korea in 1952, just before the Korean War ended. Family planning was added to the programs funded in 1964. Immediately, the birth rate began to drop, from 40 births per 1,000 people to 30 ten years later, and to 20 ten years after that. The birth rate is now just under 10 births per year for every 1,000 people. The country’s total fertility rate reached replacement level just a couple years after “graduating” from the USAID program in 1980. It didn’t stop declining there though—it continued to drop year after year for another two decades
14 The Reporter — December 2013
and is only now creeping upward, despite the government’s pleas for more children to balance its rapidly aging population. South Korea follows a pattern that has been repeated in industrialized countries across the globe: health, wealth, and education create a cycle of low fertility, each aspect reinforcing the others. Along with South Korea’s precipitous fertility decline came improved health indicators for women and children and incredible economic growth. In less than one generation, the country was unrecognizable from its previous wartime self. GDP per capita increased by 1,800 percent between 1960 and 2009, to $22,590, and life expectancy went from 50 to 80. That’s the power of family planning, especially when coupled with investments in other development initiatives.
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short time later, I was in Ethiopia, Africa’s second most populous country. No immaculate subways here, although a Chinese company is in the process of building a basic light rail system in the capital city of Addis Ababa. Ethiopia made it into global headlines in the mid-1980s when catastrophic famine caused by drought and civil war killed more than a million people. Even now, about 44 percent of the population under age five is stunted from malnutrition. As a result, they are physically and mentally less developed than their well-nourished peers and will likely never catch up— the physiological damage from stunting tends to be permanent. The damage to society is incalculable. Ethiopia sits 173rd on the Human Development Index (HDI)—a respected
Opposite: An only child watches two elderly men play a board game in a park in Busan. Above: Children in Addis Ababa, excited about that eveningâ&#x20AC;&#x2122;s football game against Nigeria. Below: Children leaving school on Entoto Mountain.
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16 The Reporter â&#x20AC;&#x201D; December 2013
Opposite: A nurse at Nifas Silk Lafto Health Center shows us the delivery recovery room. Above: The delivery room and front exterior of Nifas Silk Lafto Health Center.
ranking of health, educational attainment, and income by country—just 13 spots above last-place Niger. Life expectancy is around 60. The average adult has only 2.2 years of schooling. Per capita GDP is only $470 a year. Despite its disadvantages, Ethiopians are proud, friendly, and welcoming. I was even hand-fed (a gesture of hospitality called gursha) by a self-appointed tour guide my first day in Addis!
men stripped naked and bathed in the filthy, garbage-strewn water. Or to turn a blind eye to the child with half his face melted off, begging in the streets for change instead of attending school. Or the countless blind people shuffling around outside the eye hospital near my hotel—a daily reminder that health problems we easily tackle in the developed world often cause permanent damage or even death in the developing world. (Cataracts, which are treatable, almost always cause blindness in lowincome populations because sufferers cannot afford surgery. In fact, 87 percent of the world’s blind people live in the developing world.)
But there was no escaping the homelessness, physical deformities, and desperation that slapped me in the face every time I walked outside of the stateof-the-art African Union building. (That same tour guide said when he heard that my conference was being held at the AU, “It’s so nice, you won’t even know you’re in Africa!” He was right and that is exactly the problem.)
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It’s impossible to ignore scenes like the one at the creek near my hotel, where herds of shabby goats grazed and scores of men relieved themselves, while other
In an effort to create jobs and attract foreign investment, developers in Addis Ababa are clearing slums and building high-rise condominiums. The initiative
any projects are underway that aim to improve the quality of life for the people of Ethiopia, with mixed results and levels of support.
Contraceptive prevalence rate: The percentage of women married or in-union aged 15 to 49 who are currently using, or whose sexual partner is using, at least one method of contraception, regardless of the method used. Source: UN Statistics Division www.popconnect.org
does create jobs for some, but others lament that the poorest slum dwellers who are removed from their homes cannot afford even the heavily subsidized cost of securing a spot in one of the new condos. Instead, they are forced to relocate to different slums, often in areas where hyenas and other wild animals threaten their safety. Several high-profile energy projects aim to end the country’s frequent blackouts and create enough surplus energy to export to neighboring countries. (I experienced one of these blackouts at dinner one evening during an Ethiopia vs. Nigeria World Cup qualifier game, turning the TV we were all watching into a pictureless black box. I used a cell phone as a flashlight to eat my injera— a fermented flatbread that doubles as silverware—and waited with the rest of the crowd in the restaurant for the TV to continue broadcasting the game. Power was soon restored and the increasingly antsy football fans were appeased, much to my relief.) The controversial Grand Renaissance Dam is being built on the Blue Nile, to the consternation of Egyptians who claim that it will degrade their soil fertility and diminish their supply of drinking December 2013 — The Reporter 17
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A patient receives postpartum contraceptive counseling at Nifas Silk Lafto Health Center, after her child received a vaccination.
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Opposite: A pregnant woman at Nifas Silk Lafto Health Center listens as our group receives an overview from the clinic director. Above: Patients wait to be seen at Nifas Silk Lafto Health Center.
water. The dam is projected to be completed in 2017. An Icelandic company with U.S. backing is building a geothermal plant in Ethiopia’s volcanic Rift Valley; it will be the largest such plant in Africa. Africa’s largest wind farm is already operating in Ethiopia’s northern region, completed by a French company this past October. Small solar energy projects are also underway, and some villages have already begun benefitting from solar power. Belay Simane, professor of environment at Addis Ababa University, said of the projects, “Unless you have this kind of ambitious plan, the pace of population pressure will take over and you won’t see any change.” For the advancement of scientific research, the Ethiopian Space Science Society www.popconnect.org
plans to launch three of its own satellites. The mission began with the recent installation of two telescopes on Entoto Mountain overlooking Addis Ababa. The $3.4 million project is being funded by an Ethiopian-Saudi business tycoon, not the government, but many still disapprove of such spending when the country remains one of the poorest in the world. Indeed, the juxtaposition of the modern observatory dome and the goats, wild dogs, and women carrying enormous bundles of eucalyptus branches on their backs is jarring to see. But it serves as a rather eloquent reminder that private sector development in sub-Saharan Africa is often focused on those who are already living at a relative level of comfort.
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he kind of development that my colleagues and I are most excited to see involves public health investments that save and improve the lives of the poorest people. Family planning is at the top of that list and has been enthusiastically adopted by users across the capital. Addis Ababa now has the same fertility rate as the United States—1.9 children per woman. But 84 percent of the country’s population is rural, and the fertility rate as a whole is estimated at 4.59 children per woman. At the population growth rate such high fertility causes (2.55 percent a year), the population will double every 27 years.
December 2013 — The Reporter 21
While the contraceptive prevalence rate has increased from 15 to 29 percent over the past five years, it’s still a long way away from its target level of 66 percent in 2015. Getting there, however, might be easier than one would imagine. After all, 25 percent of women in Ethiopia have an unmet need for family planning; that is, they say they’d like to avoid pregnancy but are not using a modern method of contraception. They are the obvious group to target with new and expanded outreach programs if adequate funding can be provided. One example of existing community outreach is the Health Extension Program. Since 2003, it’s been delivering primary health care and a variety of family planning methods to rural women who previously had no options besides pills and injectables. So far, 35,000 Health Extension Workers (HEWs)—all women with at least a 10th grade education—have been trained to provide care and education related to disease prevention and control, family health, hygiene and sanitation, and health education and communication. They provide care as directly and accessibly as possible—right in people’s homes. One creative tactic employed by the HEWs is to train households to be role models for the rest of the community. By serving as positive examples for their neighbors, model households help more than their own members—they convince others in the community to take control of their own health and wellbeing.
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ublic clinics also provide Ethiopians with crucial medical care. I visited Nifas Silk Lafto Health Center through its partnership with EngenderHealth, an American NGO that works in over 20 countries.
22 The Reporter — December 2013
We toured the compound, which included consultation rooms, labor and delivery rooms, and recovery rooms. One staff member, wearing sneakers and a flannel shirt under his white lab coat, showed us the animated flip chart he uses to counsel patients on different family planning methods. The pictures gave a better explanation of how the methods work than most women receive from their doctors here in the U.S. A wooden model used for condom demonstrations sat on the desk next to him, alongside samples of all the available methods from which to choose. A worn-out medical reference book on drug interactions sat on the desk next to his kit of supplies. The health center provides contraception to thousands of women each year—51 percent of whom opt for injectables. A third choose pills and the remaining users go with implants, IUDs, and condoms. Patients preferring permanent surgical birth control methods are referred to the nearby hospital. The center also provides safe abortion—legal in Ethiopia—and post-abortion care. The clinic takes maternity patients too, with staff delivering babies whenever possible (women needing Cesarean sections are referred to the hospital). We peeked in on two women in the early stages of labor, both exhausted and in pain, but lying stoically on narrow beds across from each other. A different room held a crying baby receiving a vaccination while his mother was counseled on postpartum family planning options. The facilities at Nifas Silk Lafto Health Center were basic—even dingy by Western standards—but the staff members were competent and had access to all the medicines and supplies they needed to run a top-notch outpatient facility.
Clinics like these are located within walking distance of every household in Addis. Services are delivered at no cost to the patients. Women can choose methods that their partners will be unable to detect if they are not supportive of family planning, but based on the number of men present with their wives, it seems that acceptability isn’t nearly the problem it once was or is in other subSaharan African countries.
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hese health interventions have helped make the capital of Ethiopia one of the fastestdeveloping cities in Africa. It may not be developed to South Korea’s standards, and there may be many more problems to solve and people to help climb out of poverty, but nobody can deny that the first steps have been taken, by the Ethiopian government and NGOs, toward a healthy, educated population. What begins in the capital is bound to permeate rural areas eventually. For the millions mired in deep rural poverty, however, time is of the essence. Scaling up programs that reach people in the countryside will require additional donor funding. With a population growing as quickly as Ethiopia’s, stagnant funding just won’t cut it. South Korea once benefitted from our foreign aid. Now it is a trusted partner in diplomacy and trade. Ethiopia, too, has the potential to one day rise above its grinding poverty and join us on the global economic stage. But it can’t get there alone. History tells us that disadvantaged countries need a boost in order to begin to prosper. South Korea got one and is now paying it forward with overseas development aid of its own. Perhaps one day, Ethiopia will also be a donor country—the middle income “African Lion” that it seeks to become.
A woman on Entoto Mountain carries a huge bundle of eucalyptus branches to sell as cooking fuel in the markets of Addis Ababa. Two blind friends help each other navigate the chaotic streets outside the eye hospital.
www.popconnect.org
December 2013 â&#x20AC;&#x201D; The Reporter 23
Connecting Dots
These Boots Are Made for Regretting By Amy Phillips Bursch
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have something I need to confess. I regret buying boots. I thought these particular black leather boots were something I wanted. I had a desperate need—comfortable footwear—and I filled this need by visiting a shoe store and buying these boots. It was a terrible mistake. I’ve been thinking a lot about different choices I could have made. Should I have bought the more expensive boots instead? Not bought boots at all? Bought Uggs? Definitely not that. I would have regretted Uggs even more. Perhaps I should have been more responsible. I should have known what might happen when I walked into the mall. I knew what I was getting into. “You made your bed, now you lie on it,” you might be thinking. Maybe I should have consulted with my husband about buying boots. After all, we all know that men have a lot of useful opinions when it comes to women’s decisions. It’s too late for me, of course. But maybe we can protect other women. Maybe we can save other women from the regret of buying boots.
24 The Reporter — December 2013
I regret buying these boots, so maybe the state should step in. Maybe we need a waiting period. Women should have to wait 24—no, 72—hours from the time they find a pair of boots they want until they get to take the boots home. That will give women ample time to consider all of their options and ensure they’re making the best decision for themselves and their futures. Sure, it might be a pain for women who live hundreds of miles from a shoe store and will need to take time off from work to buy some boots. But if it prevents even one woman from regretting buying boots, it will be worth it, right? Women also deserve as much information as possible when making their boot decision. They should know EXACTLY how that boot was produced. They should know all of the components and be told about all of the possible dangers of wearing boots. After all, they might turn an ankle. They might catch a heel on an uneven sidewalk. They might even break a toe. And that doesn’t count the psychological dangers of buying boots. Regret. Sadness. Maybe even depression when women find that once again, what seemed like a simple solution to end their footwear problem was anything but. Maybe women should be required to
have their feet scanned by a podiatrist before buying boots. That would help uncover any physical problems—bunions, fallen arches, hammertoes—that could make wearing boots more dangerous. Or maybe more women could avoid boot regret if they learned from an early age to avoid shoe stores. If only I’d signed a boot virginity pledge, vowing to steer clear of shoe-shopping. What about women who might have been coerced into buying boots? Shoe salespeople make money off of selling their product. How are we to ensure that women aren’t being inappropriately pressured by some dude trying to meet his sales quota? Big Boot is only in it for the money, after all. I wish I could blame the salesperson, but he didn’t pressure me into it. I bought the boots, and I knew exactly what I was doing. I made the decision, and now I have to live with the consequences. I regret buying boots. Women regret buying boots. It’s time to protect women. ***
Obviously, the above commentary is pointing out absurdity by being absurd. Am I trying to equate having an abortion to buying boots? Absolutely not. Some decisions are trivial—such as choice of footwear. Others are vastly more important—such as deciding whether or not to have an abortion. (As for the boots, I actually did buy black leather boots that I later regretted purchasing. I returned them to the Clarks store and exchanged them for a different pair, which I love and wear all the time.) But this ridiculous line of argument is one anti-choice activists insist on using. Last month, Tennessee residents Jim Bob and Michelle Duggar spoke out in support of an anti-abortion initiative that would pave the way for a new wave of abortion restrictions in their state. If you’re not familiar with the Duggars, they’re the family whose reproductive prowess is highlighted on the TLC show, “19 Kids and Counting.” The Duggars are fundamentalist Christians who don’t believe in contraception and think married couples should let God make their family planning decisions.
“Tennessee is the only state in the Southeast that does not have a waiting period for a woman before she has an abortion, and it does not have informed consent,” Jim Bob Duggar told a crowd at a church in Madison, Tennessee, in November. “Many women are having a lifetime of regret.” But here’s the deal, Mr. Duggar: any decision—be it buying black leather boots, having an abortion, pursuing adoption, or raising 19 children—carries the risk that one will regret making that decision. The possibility of regret is one we all live with. It’s part of life. Trying to “protect” women from making a decision they might regret might be soft paternalism, but it’s still paternalism. It’s time to let women make their own decisions—about boots, and their bodies.
Amy Phillips Bursch is Population Connection’s Media Relations Manager. She can be reached at amy@popconnect.org.
Not surprisingly, the Duggars aren’t interested in letting women make other, different decisions. www.popconnect.org
December 2013 — The Reporter 25
Washington View
A Wild Ride Toward 2014 By Stacie Murphy
Government Shutdown and Access to Birth Control In my last Washington View column, I wrote that as the end of the fiscal year approached, the House and Senate held dramatically different opinions about what our spending levels on family planning (and everything else) should look like in FY 2014. I noted that prospects for a long-term agreement appeared dim. It turns out I understated the case. The fiscal year ended on September 30th without a new budget agreement in place, triggering a 16-day government shutdown—the first since 1995. By the time it ended, House leaders had issued a long list of demands to re-open the government—including the removal of the birth control benefit from the Affordable Care Act. Fortunately, the Senate and the Obama Administration held firm, and the benefit remains intact. The funding agreement that re-opened the government, however, only lasts until mid-January, so there’s every reason to believe we’ll be in for another rocky ride early in 2014.
Virginia Women Vote for Reproductive Rights The shutdown wasn’t the end of 2013’s 26 The Reporter — December 2013
political fights over reproductive rights. On November 5th, Democrat Terry McAuliffe won the governor’s race in Virginia, largely due to a 9-point advantage with female voters. McAuliffe’s opponent was current Virginia Attorney General Ken Cuccinelli, who is notorious in the state for using his position to further the conservative social agenda. He is perhaps best known for his role in implementing strict new regulations for abortion clinics in Virginia. The new regulations were signed into law by the current governor, Republican Bob McDonnell (the same Bob McDonnell who found himself in the national spotlight for supporting a law that would have required women seeking abortions to undergo invasive transvaginal ultrasounds). But the implementation of the new measure was up to Cuccinelli, and he took full advantage. When the Virginia Board of Health met to consider the new rules, they voted to grandfather existing clinics under the new law, exempting them from the new regulations. In response, Cuccinelli threatened to force Board members to pay for their own legal defense against any lawsuits filed by anti-abortion groups. The Board met again a few days later, and this time
voted to impose the stricter regulations on all clinics in the state. The law is currently being challenged in court. The new rules in Virginia were part of a classic TRAP (Targeted Regulation of Abortion Providers) law. Such laws require abortion providers (but not other comparable medical facilities) to meet exacting building standards—standards that often require expensive renovations—that are ultimately intended to drive clinics out of business. Similar laws have been enacted around the country. The outcome of the Virginia election is, perhaps, one sign that such tactics have sparked a backlash among women. Exit polls showed that among voters who said that reproductive rights were their top concern, McAuliffe won by 25 points.
John Kerry Speaks Up on Family Planning In November, family planning advocates from around the world met for a conference in Addis Ababa, Ethiopia (discussed in greater detail in Marian Starkey’s article beginning on page 12). On the first day of the program, participants heard a recorded welcome message from U.S. Secretary of State John Kerry, thanking them for their work and promising a renewed commitment from the
United States in the fight for universal access to voluntary family planning. He told the attendees that as both Secretary of State and the father of two daughters, he was grateful for their work on this issue. He referenced the 1994 International Conference on Population and Development in Cairo and said, “What was clear back then is still clear today: that challenges like reproductive health care and family planning are bigger than the political boxes that some try to force them into. These are basic human necessities that hundreds of millions of women are forced to go without … That’s why the United States and our partners must continue our lifesaving work to advocate for sexual health and reproductive rights. That includes universal access to voluntary family planning … And we’ll need to find new ways to remind people that when women and girls are better able to stay healthy and pursue new opportunities, they are also better able to contribute to the success of their families, their communities, their countries, and the world. The fact is, when women and girls thrive, so do the people around them.” www.popconnect.org
“[C]hallenges like reproductive health care and family planning are bigger than the political boxes that some try to force them into. These are basic human necessities that hundreds of millions of women are forced to go without … That’s why the United States and our partners must continue our lifesaving work to advocate for sexual health and reproductive rights.” —Secretary John Kerry There may never be a Secretary of State more dedicated to women’s health than former Secretary Hillary Clinton, but it is clear from his remarks in Addis Ababa that John Kerry is looking to live up to the mark she set during her term.
Supreme Court to Rule on Birth Control Benefit On November 26th, the Supreme Court announced that it would hear arguments on the constitutionality of the Affordable Care Act requirement for employers to offer insurance coverage of birth control to their employees. This decision was expected, both because the lower court rulings have been split, and because the Obama Administration had asked the court to accept the case and issue a final ruling. Several employers, notably craft giant Hobby Lobby, had sued to be exempt from the measure, arguing that for-profit companies should not have to provide insurance coverage to their employees when that coverage includes things which conflict with the owners’ religious beliefs. The Obama Administration contends that for-profit, secular businesses are not entitled to claim religious privilege, and that access to affordable birth control is an essential part of women’s health care. The Court will hear arguments in March, and is expected to deliver a judgment sometime in June. We will keep you informed as the case progresses.
December 2013 — The Reporter 27
Field & Outreach
Staff and Volunteers Reach Out By Rebecca Harrington
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rassroots organizing is about building relationships, expanding networks, and engaging more and more people in pushing for real change. That’s the kind of work our field staff does with volunteers every day. This fall, for example, a student volunteer at Seattle University and a Population Connection member (a retired Boeing employee with experience meeting with legislators as a representative from the Society of Professional Engineering Employees in Aerospace and the Engineering Retirees Society) organized and attended a meeting with Rep. Suzan DelBene, a freshman member of Congress for Washington’s 1st district. The purpose of the meeting was simply to thank her for her consistent support. A dedicated friend to the family planning and reproductive choice community, Rep. DelBene encouraged our volunteers to meet with her office regularly and to urge other activists to ask their members of Congress to support progressive policies and funding increases. Rep. DelBene expressed skepticism about the likelihood of securing additional U.S. investment in international family planning, given the current makeup of
28 The Reporter — December 2013
the House of Representatives. Despite this skepticism, she showed her support this year by cosponsoring the Global Democracy Promotion Act (to permanently end the Global Gag Rule), and by standing with us on the two House floor votes that we scored in the fall issue of The Reporter (against Rep. Ryan’s Budget Blueprint to dramatically cut foreign aid, and against Rep. Franks’ 20-week abortion ban). We can use all the friends we can get in this fight, and we are grateful that Rep. DelBene has already become such an important ally. Capitol Hill Days, our annual D.C. advocacy weekend, will be held April 4-8, 2014 at The Fairfax at Embassy Row in Dupont Circle. Please contact Jessica Anderson at (202) 974-7739 to register, or download the form online at www.popconnect.org/CHD. While we rely heavily on the dedication of our volunteers, our staff also stays busy with outreach activities year-round. Early in the semester, I spoke to 50 students at Ohio State University who were in a class called “The Anthropology of Food: Culture, Society, and Eating.” The course focuses on the cultural, economic, and development issues related to the consumption and sale of food, and the traditions associated with eating.
The day I presented, the class received a “field work” assignment to collect data about food sources available to them where they live. The discussion and assignment were meant to get students thinking about the challenges facing those who live in “food deserts” (areas with limited access to affordable and nutritious food—particularly areas composed of predominantly lower‐income neighborhoods and communities). One student questioned the effectiveness of investing in family planning regarding food security and wondered whether the focus should instead be on increasing levels of food aid and reducing inequality. The student even suggested that family planning was simply a “band-aid.” Certainly, poverty creates challenges to food security, but so too does population growth. In fact, Alexander Müller, FAO Assistant Director-General for Natural Resources and the Environment, says, “Feeding a growing world population will require a 60 percent increase in food production by 2050 …” That’s a tall order given that we’ve already exploited the most fertile soil. This was the second time that Dr. Jeffrey Cohen, the dynamic professor who teaches the course, has invited me to speak to one of his classes. An expert
on migration, development, and nutrition, the specific focus of Dr. Cohen’s current research is the migration to the United States of indigenous people from Oaxaca, Mexico. Later in the semester, I was invited to give a presentation to another Ohio State anthropology class, this one with a focus on women, development, and culture. We had a lively debate about access to reproductive healthcare abroad, in the U.S., and in Ohio, where provisions in the recent two-year state budget have led to the closure of four abortion clinics. The new provisions defund Planned Parenthood and redirect funding to anti-choice crisis pregnancy centers; restrict grants to rape crisis centers that give abortion referrals; and require abortion clinics to have admitting privileges at nearby hospitals. The only way to reverse these egregious policies—and to promote positive policies in their place—is to mobilize people to demand change. That’s why we and our members and volunteers are engaging people all across the United States in raising awareness about population, family planning, and basic rights and opportunities in reproductive health decision making. www.popconnect.org
Testimonials “Rebecca’s visit to my course on the Anthropology of Food emphasized the importance of understanding food’s cultural, social, and nutritional meaning, and affirmed the role population planning can and must play in managing food security and wellbeing.” —Dr. Jeffrey Cohen Ohio State University “Collaboration with Population Connection was a natural fit for me, a self-described political activist. I was thrilled to attend Capitol Hill Days in 2013 and feed my passion for both politics and social justice for women. As an executive member of Unplugging Society, I am able to continue the partnership by raising awareness for Population Connection and women’s reproductive rights in Columbus.” —Brooke Walters Unplugging Society: Women of Color Think Tank Ohio State University “Rebecca’s presentation concerning reproductive rights and legislation in Ohio was especially eye-opening for many of my students, and increased
their awareness about how they can help influence law-making decisions. Her presentation covered women’s reproductive rights at the international, national, and local level, helping put into context some of the topics covered in class. She really gave my class a nice overview of the international and national laws that affect women’s reproductive rights, and how students can become more politically involved.” —Michaela Huffman PhD candidate and teaching assistant Ohio State University “We were privileged to host Rebecca Harrington for two events during International Education Week at Clark College. Her exhibit at the International Student Exhibition was well received. Her presentation later that day was engaging and empowering. The Population Connection message is a vital one for all to hear. It was especially meaningful as we devoted a week to consider the importance of educating future generations of global citizens.” —Lorraine Leedy Clark College Vancouver, Washington December 2013 — The Reporter 29
PopEd Launches New Website and Student Video Contest PopEd
By Pamela Wasserman
T
his fall, PopEd launched a new, redesigned website in order to attract more educators to our curriculum and professional development workshops. The new site includes much more content to help teachers prepare lessons for the elementary, middle, or high school classroom. Some of the new features include: •
A “Find a Lesson” search module to locate relevant activities and student readings by grade, subject, and specific topic. Want background on the Demographic Transition Model or an activity on ecological footprints? Yeah—we got that!
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“How To” videos (11 so far) of our staff demonstrating some of our most popular teaching activities.
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Fact sheets on how PopEd curricula can be used to meet the latest teaching requirements including Common Core State Standards and Environmental Literacy Plans. Or how to integrate our lessons into a STEM (science, technology, engineering, and mathematics) Program or ESOL (English for Speakers of Other Languages) class.
30 The Reporter — December 2013
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A “Request a Workshop” feature to bring one of our presenters to your area.
Visit our online store to purchase a CD, DVD, poster, or a downloadable unit on a specific topic.
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Read our blog, updated every few days. A recent staff post described presenting workshops to Utah teachers; another was on why we teach about the “global gender gap.”
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Pore over world and U.S. population counters, infographics and charts on population and resource consumption trends, recommended children’s books, and lots more.
Highlights from our recent evaluation—Measuring Our Impact—of workshops. Learn what recent participants have to say! Profiles of some of our talented volunteer trainers and how other educators can join this esteemed network.
And that’s not all … •
“World Population.” There are links to it from every page, so you can’t miss it.
A map that allows users to click on a state or territory to find upcoming workshops and lists of where we’ve presented in recent years (Canada, too!).
Watch our ever-popular “dot” video,
In short, the new website is awesome. But don’t take my word for it. See for yourself at www.PopulationEducation.org!
Announcing Our Next Student Contest … Back by popular demand—it’s the “World of 7 Billion” High School Video contest. We’ve so enjoyed challenging students to come up with “moving” messages in the past, that we’re doing it again—this time with new topics. Here’s the challenge: There are over 7 billion people sharing the planet and we live in an increasingly connected world. In our global society, population pressures can affect our ability to sustainably use the earth’s resources and improve living conditions for all of the world’s people. Considering the interdependence of people and the planet, create a short video (60 seconds or less) that illustrates the connection between population growth and one of the following global challenges: climate change, global poverty, or water sustainability. And here’s an overview of the three theme choices: Climate change: Over the past century, the earth’s average temperature has risen by 1.4°F, causing climate changes www.popconnect.org
that affect our health, environment, and economy. And although 1.4°F may not seem like a substantial increase, it causes shifts in the earth’s long-term climate patterns. Currently, our planet is experiencing more flooding, stronger heat waves, more frequent droughts, and more intense hurricanes—as well as glacier melting and sea level rising—than it has in the past. Because climate change is linked to many human activities, population growth will likely only exacerbate these problems. Global poverty: Roughly 1.2 billion members of our global family live in poverty, or on less than $1.25 per day. Poverty is linked to many global issues, including undernourishment, poor public health, and even issues relating to climate change. The causes of poverty are complex, and many poor communities across the world find themselves stuck in the “poverty trap”—a reinforcing cycle that enables poverty to persist across generations.
developed countries using much larger quantities of water per capita than people in the developing world. But across the board, this growing demand for water means that by 2025, the number of people without access to safe water may increase to 1.8 billion, and two-thirds of the global population could be living in water-stressed areas. Cash prizes will be awarded next spring in each topic area: $1,000 for 1st place, $500 for 2nd, and $250 for honorable mentions. The submission deadline is February 21, 2014. More background on topics is available at www.Worldof7Billion.org, along with a judging rubric and past winning videos.
Water sustainability: Currently, 1.1 billion people around the world lack access to safe drinking water, and 2.6 billion do not have access to basic sanitation. At the same time, water consumption increased at twice the rate of population growth over the past century, and we see December 2013 — The Reporter 31
Cartoon
32 The Reporter â&#x20AC;&#x201D; December 2013
Editorial Excerpts
New York, New York
Los Angeles, California
More than a year after it upheld the constitutionality of the Affordable Care Act, the Supreme Court has set the stage for a showdown over the law’s requirement that employer health plans cover birth control.
It’s disappointing that the Supreme Court denied a request to temporarily block an onerous new abortion law in Texas from taking effect while a federal appellate court determines whether the law is constitutional.
The thoughtfully balanced law exempts houses of worship and accommodates nonprofit religious and church-affiliated organizations, like hospitals and universities. At the same time, it preserves an employee’s right to make her own decisions regarding birth control and not to conform to the religious beliefs of her employer.
The law, signed by Gov. Rick Perry in July, requires doctors who perform abortions to have admitting privileges at a hospital within 30 miles of where they work. But some doctors don’t have privileges and would have to go through a difficult, lengthy process to get them, if they could get them at all. Without those doctors working, about a dozen abortion clinics in Texas will be forced to close and about 20,000 women a year will be unable to get abortions, according to abortion rights advocates.
While the Supreme Court has upheld the free speech rights of corporations, it has never recognized that a secular corporation is an entity capable of engaging in religion or that the religious beliefs of owners excuse noncompliance with the law. The Supreme Court’s challenge now is to recognize the real assault on religious freedom here—namely the assertion by private businesses and their owners of an unprecedented right to impose the owners’ religious views on workers who do not share them. — November 26, 2013
U.S. District Judge Lee Yeakel first ruled the law unconstitutional and issued an injunction against it. Within days of his ruling, a three-judge panel of the U.S. 5th Circuit Court of Appeals issued a stay of his injunction, thereby letting the law go into effect. As this matter makes its way up the judicial ladder, the courts should consider that there is no valid medical reason for doctors performing abortions in clinics to have hospital privileges. The Texas law is not, as state legislators have argued, an attempt to keep women safe. It is an attempt to curtail their access to abortion. — November 21, 2013
www.popconnect.org
December 2013 — The Reporter 33
Population Connection 2120 L Street, NW, Suite 500 Washington, DC 20037
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Your legacy...people and the planet in balance Have you considered leaving a legacy gift ensuring that your commitment to zero population growth continues well into the future? By remembering Population Connection in your will or estate plan, you can make a meaningful contribution to stabilizing population and improving the quality of life for everyone, everywhere. We also offer charitable gift annuities, which provide guaranteed life income and significant tax advantages. We are proud to honor our legacy donors as members of The ZPG Society. For more information, please contact Shauna Scherer, Director of Development, at shauna@popconnect.org or (202) 974-7730.
Population Connection members Katharine and Julian Donahue, visiting Iguazu Falls in Brazil.
If youâ&#x20AC;&#x2122;ve already included Zero Population Growth (ZPG) in your estate plans, there is no need to change any language. We proudly maintain the name and the mission. 34 The Reporter â&#x20AC;&#x201D; December 2013