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Population Policy: Will Coercion Come Back in Vogue?


Betsy Hartmann

In

February of this year the Indian government announced a new population policy

based on a two-child norm. While social activists have welcomed certain elements

of the policy, such as free and compulsory elementary education and improvements

in health infrastructure, other proposals are raising serious alarm.

After

the 1994 UN Population Conference in Cairo, India started to experiment with

dismantling its oppressive sterilization program which targets poor women. Under

this program women are not only offered cash incentives to be sterilized, but

family planning workers’ salaries are tied to how many "acceptors"

they recruit. The Indian government claimed it was abandoning this strategy in

favor of a more voluntary, reproductive health approach toward family planning.

Now it appears the pendulum may be swinging backwards.

Among

the new measures proposed by the government are incentive schemes which would

give health insurance to those below the poverty line who agree to be sterilized

after two children and special rewards to local government units which achieve

an ‘exemplary performance’ in universalizing the small family norm. Prominent

Indian feminists such as Kalpana Sharma and Gita Sen warn that such policies

could have a harmful effect on women. According to Sen, rewards to local

government bodies "should not translate into ground-level coercion of

(especially) poor women towards unwanted and unsafe sterilizations or IUD

insertions."

Furthermore,

she writes, "The ethics of rewarding those ‘below the poverty line,’

whether through health insurance or anything else provided they accept

sterilization, is highly questionable. Poor people and especially poor women and

girls need access to safe and good quality health services on a priority basis.

Placing conditionalities on this reinforces a mindset among providers and

politicians that poor people deserve nothing better. Such measures should be

dropped from policy."

The

international women’s health movement has long fought against such incentive

schemes because they undermine the health and human rights of poor women, making

a mockery of the idea of reproductive choice. They also set the stage for even

worse coercion.

For

example, in Bangladesh in the mid 1980s certain local governments withheld food

aid from poor women unless they agreed to be sterilized in order to meet or

exceed their population targets. Emboldened by India’s new population policy,

the Chief Minister of Uttar Pradesh, a supporter of the fundamentalist Hindu BJP

party, recently announced a state population policy which will target

"specific groups and communities," read Muslims, with higher rates of

population growth. Those with more than two children will be barred from

contesting local elections so "the menace could be controlled."

The

Plan of Action adopted by the Cairo population conference came out firmly

against family planning incentive and disincentive schemes. Why then do they

remain in place, or worse yet, are being reintroduced in a country like India?

Part

of the reason lies in the uneven development between international, national and

local population policies. Change at the top does not translate easily into

change at the bottom; top-down, demographically-driven programs are firmly

embedded in institutional culture in a number of countries, not to mention

international agencies. Furthermore, while the Cairo Plan of Action endorsed

important family planning reforms, it did not challenge traditional

neo-Malthusian thinking. The pressure is still on countries like India to reduce

birth rates as fast as possible. Improving the health and status of women takes

time and resources and is politically risky for elites; sterilization incentives

seem the ‘easier’ option.

And

then there is the phenomenon of Chinese exceptionalism. While some members of

the international population community have spoken out against China’s coercive

population control policies, many others have remained silent. The Chinese

population problem is so big, the logic goes, that maybe just in this one case

coercion is a lesser evil. And look, many urban Chinese accept the one-child

policy as necessary (never mind what the rural people think).

There

is too much silence about the Chinese policy on the left too. China is a

socialist country, some progressives argue, it puts collective interests before

individual interests, you can’t judge China by the same standards, and besides

we don’t want to play into the hands of red-baiting, anti-abortion politicians

like Jesse Helms…

True,

we don’t want to play into their hands, but there is an alternative perspective.

The work of feminist scholars such as Kay Johnson and Susan Greenhalgh points to

the devastating effects the policy has had on the health and rights of women and

girls — its gendered consequences belie the image of an ideal collective.

Moreover, there are plenty of reasons to challenge the necessity of the program.

Not only doesn’t China face an imminent Malthusian crisis (on the contrary the

economy is booming and people are better nourished than ever), but a number of

other Asian countries, including Taiwan, Thailand, Sri Lanka and South Korea,

accomplished the transition from high to low birth rates without recourse to

coercion. Chinese exceptionalism is in fact the flip side of the yellow peril,

the ‘othering’ of the world’s biggest country, especially its women.

Family

planning incentive and disincentive schemes need to be soundly criticized

wherever they may be — India, China or the United States. Yes, we have our own

versions here, in public welfare ‘reform’ child exclusion policies and private

efforts like the organization CRACK’s payments to poor drug users to be

sterilized. These schemes are no substitute for investments in health, education

and improvements in the status of women. They set back the clock of social and

gender justice.

Betsy

Hartmann is the Director of the Population and Development Program at

Hampshire College.