World Population Day on July 11:

Meeting the 2014 population challenge

by Carol Aloysius

Bursting at the seams, the world's population is gaining ground at a terrifying speed. Think about it. Less than two centuries ago the count taken in 1830 was just one billion. It took barely 100 years to add another billion in the early 30s of this century and three decades later the figure swelled to three billion, soaring to four billion just 15 years later and reaching the five billion mark 12 years later. Today the world's population stands at its highest ever - at seven billion.

The irony is that populations are greatest in the poorest of nations and in developing nations. These less privileged countries are not only economically poor; they are land poor. Much of the land on which they live is either not arable, or are unending stretches of barren desert land where agriculture is impossible and safe water beyond the reach of the vast majority of people.

Surge

In other nations, such as Sri Lanka (now a middle income nation,) and the Maldives, sea erosion caused by illegal sand mining have robbed our tiny nations of our already limited land size placing immense strain on the state to provide enough food and other basic amenities for the people.

What has caused this frenzied upward surge of people living on our planet?

According to health experts one reason may be the vast strides in health care which has resulted in more people living longer life spans.

At the same time we also have a large youth population. In Sri Lanka adolescents comprise 1/5 of the population. The same is true in most nations especially in the developing countries.

Therein lies the heart of the problem.

Unless we address the needs of these young persons especially in the context of their reproductive health, populations everywhere will continue to grow - although perhaps more slowly due to concerted efforts at controlling this explosion, and despite the fact that maternal mortality rates and child mortality rates have taken a dramatic plunge in many countries including Sri Lanka adding more numbers to global population figures. Health sources say adolescent pregnancy now an emerging problem in many countries, both in the developed west and in Asia could also be a contributory factor.

Figures quoted by the State of the 'Word's Population 2013 by the United Nations Fund For Population Activities (UNFPA) are mind boggling: A total of 7.3 million girls under 18 give birth every year: Over 20,000 girls under 18 give birth every day and 90 percent occur within the context of marriage All this poses severe health risks and problems for the young mother.

Challenges

These risks are not confined to only the mother however.

They affect her unborn child, society, the state, and the world's population.

This was why, the Report emphasised, it is important to refocus on the challenge of adolescent pregnancy - of motherhood in childhood. It further states that adolescent pregnancies are intertwined with many other issues.

"It is not just a health issue. It affects the mother, her child, her family, her education and aspirations and the country as a whole", Director of Information and external Affairs at UNFPA Dianne Stewart says in the Report. "Pregnancy harms a girl in many ways: it impacts on her health, her child, her household, community, her country and the economy. It is also intertwined with her human rights".

So how does giving birth to a child in one's teens affect the health of a mother?

A senior gynaecologist from a state hospital said: "A teen mother is still a child. Her body is still developing and her bones are still not strong enough, and her immune system is also relatively low. Most teen mothers don't pay attention to their health and are anaemic.

They are prone to hypertension, renal disease and eclampsia as well as psychological problems such as depression.

Their babies are likely in most cases to be low weigh (under 2.5 kg) and are likely to suffer from low IQ and subject to frequent infections, they can end up stunted, and show poor performance at school".

While no national surveys have been made on teen pregnancies that occur outside state facilities, Professor Dissanayake in his 2008 report cites the HealthCare and Nutrition Ministry sources as saying, over 121,164 teen-aged pregnancies were reported from Sri Lanka during the past six months (of 2008).

The number of still births reported was 20,609 and infant deaths 3,097. A sample survey by the same researcher also found the age distribution of the mothers ranged from 14 - 28 years, with the majority being married while a significant minority were unmarried.

He further notes that, "while most teen pregnancies end with a live birth, there is still a substantial majority who tend to terminate their pregnancies with induced abortion".

Solutions

One reason for this may be the fact that while awareness raising efforts on contraceptives by the Sri Lanka Family Planning Association and other institutions, has resulted in a relatively high level of knowledge on the scientific methods of contraceptives in Sri Lanka, there was still a fairly low level of awareness in certain areas. e.g. Badulla and Ratnapura.

When addressing future population problems we must bear in mind two things, says a sociologist. "Firstly, that Sri Lanka's population is currently youth dominated.

Secondly, we are increasingly becoming a 'grey' nation with the number of people going into retirement spiralling each year.

Our challenge is to be able to cater to the needs of each of these two groups - teenagers and adolescents as well as those above 55 years of age".

To do that we need tools, resources and manpower, he noted. "To meet the requirements of our large youth population, we need projects that are directed to Youth Power and programs that will empower our young men and women in every aspect of their lives.

"These programs must include education on sexual and reproductive health", he says.

"They must teach young people living by themselves or in boarding rooms how to make themselves balanced nutritious meals to avoid anaemia, they must teach them how to protect themselves from physical, mental and emotional abuse and provide them with psychological counselling as many of them are traumatised by their problems. Young people also have the right to information that will help them make the right choices when planning to conceive, and the right over their own bodies."

Equally important is the attitude society adopts towards young persons who make the wrong choices, notes a female activist.

"On no account must they be stigmatised for an act committed impulsively at a time when their bodies undergoing hormonal changes made them sexually active. A young girl who becomes pregnant out of wedlock is not guilty of a criminal act. It is the society which judges her that is guilty", she points out. Researcher Prof. Dissanayake says in his 2008 report, "The social stigma that once attended out of wedlock pregnancies may have declined in the West but in developing countries like Sri Lanka it can be counted as a major factor."

'Adolescent Pregnancy Equals Powerlessness' a voluntary organisations underlines this view when it states, "Adolescent pregnancies should not be seen as the result of recklessness or a deliberate choice but rather that of an absence of choices and circumstances beyond the girl's control," it states.

Suggestions

Suggestions have been made to introduce sex education in schools. Those in favour of this say that awareness on sex issues starting at primary school levels can help young people to understand their bodies and have access to accurate knowledge about reproductive health without relying on their peers for such information.

Human right activists also advocate the need for society to change its attitudes towards teen pregnancy since it prevents young people from seeking help at a time they really need such help. In the case of our elderly population, Sri Lanka's challenge is to provide these vulnerable groups with geriatric services such as hospices, home nursing care, low cost nutritive food, elderly wards in hospitals, and funds for their medicines. They need psychiatrists, since depression and dementia are very common among the elders, and trained nurses and volunteers to spend time with them. That Sri Lanka already has a separate unit for Elders welfare at the Ministry of Healthcare and Nutrition is a step forward.

What is needed is however much more focus on youth and the elderly as they will be the most vulnerable groups in the future. "This will need a multi sectoral approach which brings together communities from grass-root level up, to doctors, youth activists, family planners, teachers, education authorities, and those at the curriculum development unit", says a sociologist.

So can this reverse our current population boom? An expert in the study of populations had this to say: "We may not be able to stop our populations from growing and expanding. But we can make our society capable of offering every child, woman and man a chance to enjoy a quality life apart from simply existing, by giving them tools of empowerment." This, surely is the biggest challenge nations across the planet will face as they grapple for solutions to meet the needs of seven billion people.