By Barbara Crossette
New York TimesOctober 2, 2000
When Nafis Sadik, an obstetrician from Pakistan, was hired by the United Nations Population Fund more than 20 years ago, family planning in the developing world was largely something bureaucrats foisted on poor women who were targets for meeting fertility-control quotas. "The world has come very far since then," said Dr. Sadik, who, by 1987, had become the fund's executive director. Quotas and targets are gone. So is some of the squeamishness about sex. And "population control" is no longer an acceptable description of what family planners do.
Dr. Sadik, who will retire at the end of the year, has presided over a social revolution. Working with independent family planning organizations, women's groups on every continent and many governments, she and other increasingly powerful women in the United Nations system have turned the debate over how to cut population growth into a campaign for women's rights. Other women involved in this process include Carol Bellamy, the executive director of Unicef, the children's fund; Noeleen Heyzer of Unifem, the United Nations' development organization for women; and lately Gro Harlem Brundtland, director general of the World Health Organization.
The United Nations itself is now in new territory, supporting the concept that women should have the right to make their own decisions about bearing children, and that they should have access to education and health services, a range of family planning tools and, as a last resort, safe abortions. "If women had the power to make decisions about sexual activity and its consequences," says the new annual report of the population fund, "they could avoid many of the 80 million unwanted pregnancies each year, 20 million unsafe abortions, some 750,000 maternal deaths and many times that number of infections and injuries."
"They could also avoid many of the 333 million sexually transmitted infections contracted each year," says the report, titled "Lives Together, Worlds Apart: Men and Women in a Time of Change." The report says that the needs of women are often "invisible to men" and that until discrimination against women ends, the world's poorest countries — where women are also often the most oppressed — cannot develop to their potential.
Here are some of the statistics from the report:
The message that women must be able to make more decisions about their lives is not welcomed by every government and culture, and not only in the developing world or among Islamic nations. As the United Nations began to move in the mid-1980's toward more unambiguous support for women's rights, in which it included the right to seek a safe abortion, the American Congress dealt the population fund — which now has an annual budget of $250 million — heavy financial blows. In an interview, Dr. Sadik said her successor will have work to do, but at least will be able to do it in a new atmosphere of frankness.
"The most difficult issues of behavior or practices like rape, incest, female genital mutilation, the idea of female reproductive rights — all these concepts we would never have been able to discuss just a few years ago," Dr. Sadik said. That sexual violence, the sex trade, AIDS and other issues like the need to provide adolescents with information and services to promote safe sex can be talked about openly in the United Nations and government offices "is an indication of massive, massive change in thinking," she said.
Many women's health experts say that the most significant shift of gears came at a 1994 conference in Cairo, which Dr. Sadik directed. "Cairo represented a fundamental paradigm shift in the way the population field perceives the problem and, most important, the solution," said Adrienne Germain, president of the International Women's Health Coalition in New York, which assists women's health groups in the third world. "It put women's health and rights at the center of the agenda, recognizing that in so doing, demographic ends would also be served."
Dr. Sadik said she came early to her view that it was often pointless and inhumane to curb population growth by government edict. "That came from my experience in Pakistan," she said. "When I worked in obstetrics, I found that when you told women, 'You must plan your next birth at least two years later,' they would say: 'Not for me. I must have a son.' They were so anemic, so ill — and yet they had no control over their lives. "I remember making speeches in 1975 saying unless women had rights to control their own fertility they would have no other rights."
Dr. Sadik, 71, said her Muslim upbringing and her background in the developing world have enhanced her credibility in dealing with reluctant or suspicious governments and societies. She was born in 1929 in the Indian state of Uttar Pradesh, before the partition of British India in 1947 into Muslim- and Hindu-majority nations. She was educated in medicine and public health in Calcutta, Karachi and at the Baltimore City Hospital and Johns Hopkins University. She still wears an Indian sari rather than a Pakistani shalwar-kamiz.
In her work, she has encouraged developing countries to look at population growth in connection with economic trends. Dr. Sadik also has tried to avoid emotional debates over cultural values by casting practices like female genital mutilation — the cutting of all or part of female genitals, often in very young girls — as a public health issue. "My view always is that culture and values are supposed to be helpful to societies," she said. "Not to discriminate. Not to subjugate. Not to perpetuate practices that are going to be harmful."
Among South Asians, the Pakistanis have been the least successful, she said, because a political commitment to family planning declined. And, she said, mullahs often swayed public opinion by speaking of using contraceptives as a sin or even by claiming that soap given to women to keep their bodies clean was laced with a sterilization agent. The country's present military ruler, Gen. Pervez Musharraf, has asked for her advice. "I gave him a lot," she said emphatically.
More Information on Gender and Inequality
FAIR USE NOTICE: This page contains copyrighted material the use of which has not been specifically authorized by the copyright owner. Global Policy Forum distributes this material without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. We believe this constitutes a fair use of any such copyrighted material as provided for in 17 U.S.C íŸ 107. If you wish to use copyrighted material from this site for purposes of your own that go beyond fair use, you must obtain permission from the copyright owner.
