More Power to Women, Fewer Mouths to Feed

By EUGENE LINDEN/CAIRO

Sohad Ahmad, an impoverished Egyptian farmer's wife, knew nothing about the huge United Nations population conference going on 50 miles to the north, in Cairo. For her, family planning was not a global issue but a personal, practical matter. Getting a checkup last week at a health clinic in the rural town of Sinnuris, Ahmad laughed when a nurse asked if she was pregnant. "No," she replied, "we know pregnancy is an evil now." She and her husband, Sohad explained, had decided to stop after two children because of the expense of raising a large family. Ahmad's 20-year-old daughter Nadia also has two children, and she too says she wants no more. In fact, the only difference in their family-planning strategies is the method of contraception: injections of the drug Depo-Provera for the mother and an IUD for the daughter.

That poor Egyptian women in a farming community would take action to limit the number of children they bear illustrates how rapidly attitudes about family size are changing -- and not just in so-called developed countries but in every corner of the globe. Only a few years ago, the task of persuading % rural populations to lower their birthrates was considered impossible; farmers presumably wanted to have many children to help work the fields. But as land becomes scarce, even uneducated villagers begin to see that having more children in an effort to grow more food can become self-defeating. In rich and poor nations alike, people acknowledge that their world is getting too crowded.

Changing public attitudes help explain why the U.N. meeting in Cairo, formally known as the International Conference on Population and Development, ended in surprising peace and harmony, even though it had opened amid fierce disputes about abortion and threats of violence by Islamic fundamentalists. For once the U.N. was truly united: no country voted against the final draft of a 113-page plan calling on governments to commit $17 billion annually by the year 2000 to the cause of curbing population growth.

Much of the money would be headed for traditional programs designed to provide health-care and family-planning services for hundreds of millions of people who want to limit the number of their children but have no access to contraceptives. But more ambitious aspects of the plan call for efforts to give women equal participation in politics and public life and for initiatives to eliminate gender discrimination in the workplace and other forms of economic inequality, such as limits on a woman's ability to obtain credit, hold property or receive an inheritance. The premise of the strategy is that if women are "empowered" to control their own reproductive lives, they will choose to have fewer children.

Despite intense opposition from the Roman Catholic Church, the document also recognizes that unsafe abortions are a public-health problem that should be addressed. But the plan steered clear of encouraging abortion as a means of family planning, and, in a stunning reversal, the Vatican endorsed much of the program.

That conciliatory step may have been a response to the anger aroused by the Vatican's earlier attempts to rally nations against the meeting. The Holy See had courted fundamentalists in Iran, for example, but instead of bashing the West, the Islamic republic delighted delegates by working harmoniously to resolve differences over the language in the final document. Iran's Deputy Minister of Health, Malek Afzali, spoke proudly of his nation's aggressive family-planning program, which he claimed has cut Iran's population growth rate in half, from 3.6% a year in the early 1980s to 1.8% now.

"The world has changed since the Earth Summit," said a U.S. delegate, referring to the 1992 Rio conference on environment and development, which was marred by deep distrust and finger pointing among participating nations. "That was just two years ago, and you couldn't even talk about population." In contrast, the unexpected consensus in Cairo left delegates bubbling about a "watershed in world history." Timothy Wirth, the U.S. Undersecretary of State for global affairs, who earned high praise for helping guide the initially fractious group toward agreement, called the consensus a rare victory for the U.N. "It's hard enough to get 180 members of the U.S. Congress to agree on anything, much less 180 nations," Wirth pointed out.

That said, it is far from certain that the conference will have lasting impact. Most U.N. action programs seem to be the bureaucratic equivalent of Tibetan mandalas, those intricate designs of colored sand arduously crafted through years of work. Once completed, they are allowed to blow away into oblivion. Maher Mahran, Egypt's outspoken Population Minister, endorsed the conference for "energizing" governments to face a crucial issue but said he doubted that countries would pay attention to the specifics of the action plan.

Mahran knows that his own country, which crowds 62 million people into a narrow strip of arable land the size of the Netherlands, provides a sobering reality check for the idealistic premises of the Cairo accord. Egypt imports 70% of its food, yet each year it loses thousands of acres of farmland to urban sprawl and overuse. The nation will somehow have to find food, water and jobs for an additional 37 million people over the next 30 years.

Faced with these dire statistics, the Egyptian government began to explore family planning in the early 1980s, at first cautiously and then with increasing boldness. In fact, the U.N. gave President Hosni Mubarak its 1994 population award because Egypt cut its growth rate from more than 3% in 1985 to just over 2% last year.

It's useful, therefore, to see how the methods employed to slow growth in Egypt match up with the ones outlined in the new U.N. plan. In Sinnuris officials try to link family-planning services to health care for women and children -- a combination considered vital by the delegates to Cairo. But Mohammed Zakaria, undersecretary for health affairs in Sinnuris, says he must also meet birth-control targets set each year (an approach deemed ineffective in the Cairo plan) and that after a second child, families must pay steep fees for hospital delivery (a disincentive generally frowned on as coercive). In general, women like Sohad Ahmad are limiting the number of their children not because of any economic or political empowerment but because of economic hardship.

Whatever the practical benefits of the conference, few denied its symbolic importance. One delegate likened the event to an Alcoholics Anonymous meeting: countries drew comfort from the plight of other countries, and together they resolved to deal with the mutual problem. As this delegate saw it, "Muslim nations said to other Muslim nations, 'It's O.K. to support family planning,' as did Catholic nations to other Catholic nations." Thus, the consensus achieved in Cairo may allow the world community to move beyond divisive debates about abortion and contraception in dealing with the population juggernaut. The accord may signal a new, more mature approach to confronting a potential global disaster.

With reporting by Lara Marlowe/Cairo