Professor of Surgery
The world population is increasing gradually over the years. Century after century, or even year after year the number of people inhabiting the earth is getting greater.
Politically and demographically the world is made of separate countries,more than 190 sovereign nations,each has well defined borders and a known recognized population. The government of each country is responsible to look after its population within its borders with the available resources therein.
The population of each country is increasing all the time, except perhaps for a few temporary exceptions. Population reductions happens only as a result of fatal pandemics or wide scale wars. But this reduction is quickly reversed by a boom increase in fertility once the pandemic or war is over.
Although population over growth is an international problem, it is left to each country to deal with it within its borders and nationals. Once the number of people in a country exceeds the available or conceived resources,the government though working to increase the resources find it necessary , or easier , to work on curbing the increase in population i.e population control.
Pragmatically the easiest way for population control is by birth control i.e. asking, or coercing people to have small families. The usual figure for a small family is 2 children for each couple, not more.
In fact this magic figure will end by marked reduction of the population since not every woman will or can conceive and not every child will survive to adulthood. This actually happened in more than one European country and they are regretting it now,having to rely on immigrants for the work force. It is estimated that a female fertility figure of 2.6 is needed to keep the number of people stable.
The disadvantages of enforced birth control are many :
To start, it looks as if the people of the country considered that the country is their property for ever, or that it is their elite club that is closed for new members.
Also with advances in medical care and living conditions,the life expectancy has increased markedly, that birth control will end with a community of more retired elderly than productive youth. This happened in China after the one child policy, which they are now regretting and asking married couples to produce three children or more.
In Egypt where population growth is faster than economic growth, trying to convince the people to have small families and making contraception services and devices free of charge did not work. The suggestion to control birth by denying the third child the subsidized education and health care, is obviously unethical. It is punishing the child not only the parents, when in fact the child did nothing wrong to be born.
Also there is the human rights issue, how can you prevent a married couple from having a child if they so want?
The recent idea of rewarding every woman that complies with producing only 2 children by one 1000 Egyptian pound for every year to be cashed as lump sum when she reaches the age of menopause, I consider such an idea as only a joke.
In Egypt population control is needed to try to match the number of people to the resources, available, potential and anticipated. It is obvious to all of us that the upper and middle socioeconomic classes people adhere voluntarily to the small family of only 2 children. It is the lower socioeconomic class,that produce three or more children, most of them are encouraged,or forced, to drop education and do menial jobs to earn money for the family.
If we concentrate on raising the standard of living and education of people in this lower class they will automatically and naturally join the culture of a higher class and will produce, voluntarily, only two children. After all coerced birth control did not work.
To avoid the negative effect of 2 child policy on the work force, this policy should be combined with a malleable age of retirement, so that only the person who cannot work should retire. Mandatory age of retirement should be canceled. People now live longer and most of them keep their fitness to work longer. A person does not become unfit to work over night. A clinical medical examination can determine if a person has reached the production retirement age or not, we all know it is different from the chronological age.
Learning from our experience and the experience of other countries we can say that any national population control system should observe the following :
= It should be voluntary, no penalties,no rewards .
= Respect the age pyramid of the population.
= Employ who ever is capable of working, including the elderly and the adolescent.
= Consider the resources, available, potential and the anticipated resources that may be created by the new generation
= Consider possible massive loss of population by epidemics, wars and natural disasters.
= Remember population is power, over populated countries are stronger than less populated countries of the same socioeconomic standard.Population is power.
= Every person has only one mouth to eat, but has two arms to produce. The family, the community and the prevailing system can make of any person an asset rather than a liability.
Raouf Sallam F.R.C.S.