International Development CommitteeWritten evidence submitted by Michael King O.B.E. F.R.C.S. Chief Government Surgeon in Malawi 1976–95, Volunteer surgeon in North Malawi 1995–2008 and Mrs. Elspeth King Ph.D. University of Malawi lecturer 1980–94

World population—7 billion in 2011—current world population increase—78 million per year, 1.5 million per week, 214,000 per day, 8,900 per hour.

POST-2015 Development Goals

(1) Millennium Development Goals failed because of high birthrates and increasing populations in poor countries. This has led to food shortages, deforestation, land degradation, and sinking water tables. It was wrong for the UN Agencies to give free food to the starving without also offering contraceptive services, and wrong for UNICEF to provide immunizations without birth control programmes. UN “Human Rights” become “Human Wrongs” if they produce environmental deterioration. Malawi’s population has increased by 50% since 1995 with consequent increases in poverty, malnutrition, diseases, and mortality rates. Similar problems present in many countries including Niger and Mali.

(2) MDGs funded by UN have often prevented Africans politicking the real problems in their own countries—caused by the rapidly increasing human population. For instance, in 1997 a leading politician, Chakufwa Chihana announced to cheering crowds in Malawi—“As long as our birthrate grossly exceeds our death-rate, then poverty alleviation is a non-starter”.

(3) The Rio Summit of 2012—sadly stated—Accept population growth as a given to be accommodated, not a variable to be tackled; and emphasize the illusory opportunities.

(By contrast, at the 1992 Rio Summit, Secretary General Maurice Strong spoke truthfully—Either we reduce our population voluntarily, or nature will do it for us, brutally.)

(4) Sustainable Development Goals Rio +20. We emphasize the need for the provision of universal access to family planning.

Comments from Elspeth and Michael King—“Humanitarian Family Planning Services”

Donors assume that education is a necessary precondition for birth control. That is not so. If men and women can make personal decisions about sex, marriage and parenthood, many benefits of modern life may become available to their families. Millions of poor, uneducated Africans and Asian could now benefit from access to birth control—To beget children By Choice and not By Chance.

Rural Malawians go to their free Government Hospitals and Rural Health Centres in very large numbers, and Banja La Mtosogola clinics (Marie Stopes International) are popular—we saw how patients are helped to accept contraception. Donors should pay for extra Family Planning Nurses to visit all the hundreds of patients daily in African wards and outpatient clinics—to advise and serve the parents of sick and starving children (big crowds in Malawi). Families lacking food need help to avoid another pregnancy. All ante- and post-natal mothers, and maternity ward patients should also be helped with birth control. This would be normal in UK. Often a Malawian nurse lectures a crowd of outpatient mothers and the tuition may include songs and dances. Male nurses and doctors have extra authority.

In addition and, birth control should be offered to all adult hospital in-patients and outpatients (usually with malnutrition, TB, HIV, malaria, pneumonia, other infectious diseases and surgical conditions including cancer and trauma)—these people are not in a good situation to bring another child into this overcrowded world. The ADVICE given by both female and male family planning nurses may allow thousands of people to understand birth control—both men and women. This is the way to reduce birthrates and maternal and child mortality rates in Poor Africa.

Melinda Gates is financing the contraceptives which are the most popular in Africa—injectable Depo provera which protects for three months, and the Norplant Implant which protects for five years. Both drugs promote breast feeding and so protect the baby. What is now needed is an implant to protect against pregnancy for perhaps one or two years—could research for this please be internationally financed?

Abortion. Support is needed for all levels of family planning, including the Morning After Pill and abortion facilities to reduce the high maternal mortality caused by unsafe abortions in African countries. For instance in Malawi in 2009 there were 70,000 unsafe abortions, causing 17% of maternal deaths.

(5) Countries which have successfully reduced birthrates (China and Iran) have both provided widespread basic health facilities for villagers at Rural Health Centres.

(6) Education. Please avoid the feminist notions of Rich women with visions of Poor African families worthy of Marie Antoinette. “Female empowerment” and “gender” are irrelevant red herrings in family planning. Poor, ragged, barefoot ladies, struggling to survive in the African Bush, do not need to become literate to manage birth control. Family Planning must be the priority international Humanitarian Service—for all women and men. Sexual decisions are a male preogative; contraceptive options always include condoms and vasectomy.

In schools across the world today, boys and girls should be taught about the human and environmental problems caused by the rapidly increasing human population. Could the UN Agencies, the EU, and Donor Governments fund the supply and distribution of Primary and Secondary school books, which describe and explaining these global problems?

David Attenborough’s 2011 Speech to The Royal Society in London would be marvellously interesting for all school pupils—www.populationmatters.org/davidattenborough

Postscript

In Karonga Hospital Maternity ward (48 beds for over 100 in-patients), the male paramedic Clinical Officer was called by the nurses to discipline the 30+ ladies with high risk pregnancies who slept on the floor at the far end of the ward by night—and often ran out to the witch doctors in town by day to get dangerous potions. He spoke very sternly—“Ladies, I am your doctor and I am in charge of you all, and you must do as I order—you must stay within the hospital and NOT go out to the witches around here”. Then he said to me—“Because I am an Nkhonde man, they will accept what I say.”

At Nkhota Kota Hospital I saw a male Malawian doctor talk very loudly to a couple who had brought their three severely malnourished children aged three, two and nine months to his clinic. “You must have NO MORE pregnancies. Already you cannot grow enough maize to feed three children for longer than four months after the April harvest. At this hospital we are now short of therapeutic food for babies and the problems of families around here are steadily getting much worse. You MUST tell your wife to have a tubal ligation her now.” This young man’s male authority with his own people was vital in persuading this couple.

Perhaps MPs should envisage the fears of people with vanishing water supplies—at Thundawike in Rumphi District we saw villagers walking along a path buzzing with tsetse flies to dig down into a dried up river bed—to find even a bucket of muddy water. In the 1950s (population two million) British colonial staff prevented Sleeping Sickness by moving villages out of the tsetse fly belts. Today (population 15 million) poor villagers have to move into the tsetse belts and game parks in order to survive.

This is typical of the worsening problems of an over-populated planet.

September 2012