Duo in demographic race

Published: 11th July 2013 07:32 AM  |   Last Updated: 11th July 2013 07:32 AM   |  A+A-

The cat is out of the bag! India’s population will overtake that of China around 2028. This was part of the first sentence of the UN press release on its report, World Population Prospects: The 2012 Revision, a month ago. As nearly headline material, it is obviously important, but as an Indian citizen I don’t know whether to be happy or worried.

Let us see it another way — for a second let us assume that the report was one from World Bank on World Economic Prospects and the sentence read India’s economy will overtake that of China by 2028. Some of the readers will immediately respond “wishful thinking”, others will say “impossible”, still others may say “I wish”. There is a tinge of wistfulness to this reaction on comparison of economies, while a sense of regret, frustration, and probably anger may be associated with the population-level comparisons with China. Clearly, we think differently about people by comparison with how we think about economies; people seem problematic but financially healthy economies desirable. So, should I be happy or worried about the UN predictions?

As a person dealing with population issues for some time, I would not be too alarmed by the fact that India’s population will overtake that of China. We knew this for a long time. What this report says is not new, but what it does is set the date forward. India had adopted a National Population Policy in 2000, making some programmatic promises and predictions. If those programmatic promises had been kept, then the predictions would have been met and the goal posts would not have shifted. Within any country development and population are related. They are related through the health status of the people, their educational capabilities as well as their access to family planning services. In large parts of India, the status of health and educational capacities continue to be comparable to sub-Saharan Africa, and it is the part we like to forget about when we make the BRICS-level economic comparisons. Unfortunately, we cannot forget about them for too long as the list of internally disturbed areas grows. Also, we cannot forget them because many of our natural resources are “trapped” in those very regions.

I have not seen the village in which my forefathers lived and probably tilled the land. Many of the readers of this piece may also have tenuous links with their ancestral land-based livelihoods. We and our previous generations have had the privilege of health care and educational opportunities, increased our capabilities and become less dependent on land for survival at an individual or family basis. Why can’t we evolve a similar solution for our fellow citizens in India’s heartland where population and development both appear to be an impossible problem?

Many of us are irked by the crowds we see in our urban centres, and immediately the population problem hits us at a primal level. All the lessons from our textbooks about shrinking resource bases and smaller size of the cake for each individual seem true, regrettably the textbooks have not been revised for years, and the problem we see is more related to lack of rural livelihood opportunities than to extra births anywhere — in villages, cities or slums. The urban crowds are also partly due to lack of urban planning. The middle class, whose needs often form the subtext of planning exercises, need cheap labour, and they are getting it as thousands pour into cities from the hinterland. Unfortunately, the cheap labour finds little designated infrastructure, and in the name of urban beautification and renewal they get physically pushed out of sight. But they remain as crowds every day as they stream into their poorly paid and insecure jobs.

The poor hardly consume any resources, while SUVs, completely air-conditioned homes and offices and neatly manicured lawns are the privileges that the rich enjoy and are loath to leave. So while one small set of people across the world increase their carbon footprint and direct and indirect use of natural resources, a much large number of marginalised people face the accusation of destroying the environment and also bear the brunt of calamities that are part of the climate change that is slowly but surely coming about.

So, development is related to people, but we often forget that population includes all people, even those we would like to forget about. While some choose to ignore the poor in their imagination of India, others would like to reduce their numbers through aggressive family planning programmes. Thus, we have lottery schemes gifting DVD players, washing machines and Nano cars to women coming in for tubectomy. In still other places, these women are operated in a great hurry and in sub-human conditions by surgeons who want to meet their targets. People need family planning services, want to use them, but don’t need to be forced to use methods that they either do not want or are not suited. We continue to have nearly 25 % of couples in many states still not getting the method that they want. We continue to emphasise the permanent sterilisation method even though we know that the largest reproductive age group in India is that of new and young couples. Sterilisation operations, especially in women, are as serious a surgery as say an appendix or gall bladder surgery. In all these operations, the “peritoneum” or abdominal cavity needs to be opened. Though tubectomy is technically simpler, the consequences of infection of the peritoneal cavity are the same in all the three operations mentioned. But we continue to conduct surgical “camps” in the most unhygienic, hurried manner on lakhs of women annually as part of a national programme. Clearly, Indian citizens deserve better.

How do I then feel now that the day India’s population overtakes China’s seems closer than before? I feel sad that we are still unable to harness the energy and creativity of our billion-plus people, making them economically productive through their good health and capabilities. I also feel happy and relieved because I know that our policy makers did not make the huge mistakes made in China. Today, China is not only faced with the prospects of an ageing population and depleting workforce, but a tremendously skewed sex ratio as well. In my mind the comparison is redundant. In India our challenge is to be able to meet the aspirations of our billion-plus people, not compete with China in a game of numbers.

The writer is a clinical assistant professor at the department of global health, University of Washington, Seattle.

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