Contraception is not a panacea

The UK Government/Gates Foundation summit on family planning is a good thing, but we can't be fooled into thinking it can solve all our problems.

Every day around the world 1,000 women die from complications related to pregnancy or childbirth. Think about it: that’s 365,000 women every year – almost as many as the total population of Bristol.

In many of the world’s poorest countries early marriage, overstretched healthcare services and low adoption of modern contraception methods together create a situation where pregnancy can be a cause for real concern as well as celebration.

So it is great news that the prime minister will tomorrow host a joint UK Government/Gates Foundation summit on family planning intended to provide 120 million women with access to contraception over the next eight years at a cost of £2.6bn.

David Cameron and International Development Secretary Andrew Mitchell certainly deserve real credit for putting the issue of family planning firmly on the development agenda. Giving millions more women the means to choose when and whether to start families will not only save lives, it will also help families who are struggling to feed their existing children avoid unwanted pregnancies. And it could play a role in helping younger brides delay pregnancy until they are ready to have children.

But the government needs to avoid the misconception that contraception is a panacea. Girls forced into early marriage, for example, often have less control over the choice about when to start a family. Handing out contraceptives is necessary but not enough. These efforts need to be backed up by education and support services that empower women to assert their rights. And women who choose to get pregnant will still die unnecessarily unless there are good quality health services to take care of them.

Alongside the provision of contraception we need more programmes like the one Oxfam runs in Hadrahmout Governate in Yemen where only a quarter of the population has access to primary healthcare.  There we are building health facilities, distributing home delivery kits and supporting health education and awareness raising programmes. We are also training midwives, a process which not only improves healthcare but can also raise the status of women in society.
These issues may not get much airtime at the summit, to be held on July 11, World Population Day, which is planned as the government’s latest effort to communicate to the British public the benefits our aid brings. In these tough economic times, ministers deserve a loud cheer for its unwavering commitment to keeping Britain’s promises to the poorest in the face of some significant opposition on their own backbenches and beyond.

There are potentially two reasons why ministers find family planning an attractive topic for such an event. Firstly, giving women a chance to gain control of their own reproductive health is something that can save lives, and that we can all understand.

Critics opposed to aid or who believe that our concern for the poorest should begin and end at home have two simple questions to answer: do you believe that it is right that women in Sierra Leone, for example, are more than 70 times more likely to die as a result of pregnancy or childbirth than those in the UK? If not, what would you do about it?

The second attraction of family planning is potentially more problematic. Population growth is the public’s number one concern about development– yes, higher than corruption. This goes beyond simple prejudice about growing numbers of Africans or Asians (although that doubtless does exist) - it is also fuelled by concerns that population growth is responsible for climate change and other environmental problems.

This is based on a fallacy. It is consumption in the rich rather than the poor world that is primarily responsible for the pressure on our planet. In the 25 years to 2005, for example, Sub-Saharan Africa accounted for almost a fifth of the growth in the world’s population but only 2.4 per cent of the increase in CO2 emissions. By contrast, North America was responsible for four per cent of population growth but a staggering 13.9 per cent of the rise in emissions.

These facts did not stop the Optimum Population Trust deciding a couple of years ago, ahead of the Copenhagen climate summit, to launch a carbon off-setting scheme where instead of planting forests your money was used to fund family planning in poor countries.

It is the government’s job to challenge public prejudice which is not based on fact. It needs to find ways to ensure that tomorrow’s summit avoids reinforcing such lazy and (for us high consumers) convenient thinking.

Barbara Stocking is Chief Executive of Oxfam

Indian programme officer G. Shilpa poses with a female condom at an awareness camp in Hyderabad. Photograph: Getty Images
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How Donald Trump is slouching towards the Republican nomination

There was supposed to be a ceiling above which Trump’s popular support could not climb.

In America, you can judge a crowd by its merchandise. Outside the Connecticut Convention Centre in Hartford, frail old men and brawny moms are selling “your Trump 45 football jerseys”, “your hats”, “your campaign buttons”. But the hottest item is a T-shirt bearing the slogan “Hillary sucks . . . but not like Monica!” and, on the back: “Trump that bitch!” Inside, beyond the checkpoint manned by the Transportation Security Administration and the secret service (“Good!” the man next to me says, when he sees the agents), is a family whose three kids, two of them girls, are wearing the Monica shirt.

Other people are content with the shirts they arrived in (“Waterboarding – baptising terrorists with freedom” and “If you don’t BLEED red, white and blue, take your bitch ass home!”). There are 80 chairs penned off for the elderly but everyone else is standing: guys in motorcycle and military gear, their arms folded; aspiring deal-makers, suited, on cellphones; giggling high-school fatsos, dressed fresh from the couch, grabbing M&M’s and Doritos from the movie-theatre-style concession stands. So many baseball hats; deep, bellicose chants of “Build the wall!” and “USA!”. (And, to the same rhythm, “Don-ald J!”)

A grizzled man in camouflage pants and combat boots, whose T-shirt – “Connecticut Militia III%” – confirms him as a member of the “patriot” movement, is talking to a zealous young girl in a short skirt, who came in dancing to “Uptown Girl”.

“Yeah, we were there for Operation American Spring,” he says. “Louis Farrakhan’s rally of hate . . .”

“And you’re a veteran?” she asks. “Thank you so much!”

Three hours will pass. A retired US marine will take the rostrum to growl, “God bless America – hoo-rah!”; “Uptown Girl” will play many more times (much like his speeches, Donald J’s playlist consists of a few items, repeated endlessly), before Trump finally looms in and asks the crowd: “Is this the greatest place on Earth?”

There was supposed to be a ceiling above which Trump’s popular support could not climb. Only a minority within a minority of Americans, it was assumed, could possibly be stupid enough to think a Trump presidency was a good idea. He won New Hampshire and South Carolina with over 30 per cent of the Republican vote, then took almost 46 per cent in Nevada. When he cleaned up on Super Tuesday in March, he was just shy of 50 per cent in Massachusetts; a week later, he took 47 per cent of the votes in Mississippi.

His rivals, who are useless individually, were meant to co-operate with each other and the national party to deny him the nomination. But Trump won four out of the five key states being contested on “Super-Duper Tuesday” on 15 March. Then, as talk turned to persuading and co-opting his delegates behind the scenes, Trump won New York with 60 per cent.

Now, the campaign is trying to present Trump as more “presidential”. According to his new manager, Paul Manafort, this requires him to appear in “more formal settings” – without, of course, diluting “the unique magic of Trump”. But whether or not he can resist denouncing the GOP and the “corrupt” primary system, and alluding to violence if he is baulked at at the convention, the new Trump will be much the same as the old.

Back in Hartford: “The Republicans wanna play cute with us, right? If I don’t make it, you’re gonna have millions of people that don’t vote for a Republican. They’re not gonna vote at all,” says Trump. “Hopefully that’s all, OK? Hopefully that’s all, but they’re very, very angry.”

This anger, which can supposedly be turned on anyone who gets in the way, has mainly been vented, so far, on the protesters who disrupt Trump’s rallies. “We’re not gonna be the dummies that lose all of our jobs now. We’re gonna be the smart ones. Oh, do you have one over there? There’s one of the dummies . . .”

There is a frenzied fluttering of Trump placards, off to his right. “Get ’em out! . . . Don’t hurt ’em – see how nice I am? . . . They really impede freedom of speech and it’s a disgrace. But the good news is, folks, it won’t be long. We’re just not taking it and it won’t be long.”

It is their removal by police, at Trump’s ostentatious behest, that causes the disruption, rather than the scarcely audible protesters. He seems to realise this, suddenly: “We should just let ’em . . . I’ll talk right over them, there’s no problem!” But it’s impossible to leave the protesters where they are, because it would not be safe. His crowd is too vicious.

Exit Trump, after exactly half an hour, inclusive of the many interruptions. His people seem uplifted but, out on the street, they are ambushed by a large counter-demonstration, with a booming drum and warlike banners and standards (“Black Lives Matter”; an image of the Virgin of Guadalupe, holding aloft Trump’s severed head). Here is the rest of the world, the real American world: young people, beautiful people, more female than male, every shade of skin colour. “F*** Donald Trump!” they chant.

After a horrified split-second, the Trump crowd, massively more numerous, rallies with “USA!” and – perplexingly, since one of the main themes of the speech it has just heard was the lack of jobs in Connecticut – “Get a job!” The two sides then mingle, unobstructed by police. Slanging matches break out that seem in every instance to humiliate the Trump supporter. “Go to college!” one demands. “Man, I am in college, I’m doin’ lovely!”

There is no violence, only this: some black boys are dancing, with liquid moves, to the sound of the drum. Four young Trump guys counter by stripping to their waists and jouncing around madly, their skin greenish-yellow under the street lights, screaming about the building of the wall. There was no alcohol inside; they’re drunk on whatever it is – the elixir of fascism, the unique magic of Trump. It’s a hyper but not at all happy drunk.

As with every other moment of the Trump campaign so far, it would have been merely some grade of the cringeworthy – the embarrassing, the revolting, the pitiful – were Trump not slouching closer and closer, with each of these moments, to his nomination. 

This article first appeared in the 28 April 2016 issue of the New Statesman, The new fascism