After So Many Deaths, Too Many Births
BABIES, NOT GHOSTS A crowd at a health campaign rally in northern Rwanda. Population control has been controversial because survivors of the genocide have felt it was a family’s right to replenish what was lost.
MAYANGE, Rwanda
CONVINCING women in the deeply impoverished Rwandan countryside that they should have fewer children is a daunting task. “They say we’re not Christian,” said Jeannette Mukabalisa, a local health advocate, of the predominantly Catholic population. “They say, ‘You’re town people, we’re traditional.’ Children bring these families prestige. For them, children come from God. So it’s difficult, very difficult.”
After the 1994 genocide, in which more than 800,000 Rwandans were slaughtered, it seemed difficult to believe that overpopulation would ever be a problem. Yet Rwanda has long had more people than its meager resources and small area can support.
In a recent interview, President Paul Kagame said he was preparing a sweeping population control program, to be unveiled in the coming months, that would aim to cut Rwanda’s birth rate by at least half.
“We recognize we are late on this,” Mr. Kagame said.
After the genocide, officials were reluctant to promote population control because they feared it would offend the survivors, who believed they had a right to replenish what they had lost.
“Because of the genocide, many people didn’t want to hear about birth control,” said Odette Nyiramilimo, a legislator who proposed a bill last year that would have given incentives and detailed disincentives for families to limit themselves to three children. Previous efforts had been opposed by officials who told Ms. Nyiramilimo that education, not population, was the problem.
But nearly half of Rwanda’s legislators are female, and Ms. Nyiramilimo is among several who have spent years pushing for a serious population control effort.
The country’s population has quadrupled over the last half-century. Today Rwanda has 8.8 million people; most are subsistence farmers. If current fertility rates are not curbed — Rwandan women bear an average of 6.1 children — the population will double by 2030. That would almost certainly doom Mr. Kagame’s ambitious plan to raise Rwanda from poverty over that same period.
“The last government’s philosophy was that the country was too small for all Rwandans,” said Dr. Richard Sezibera, a close adviser to Mr. Kagame, referring to the rulers who oversaw the genocide. “We insisted that the country was big enough to accommodate everybody. But many people took that to apply to the unborn as well, and we’re having to face that mind-set.”
Dr. Sezibera and President Kagame, like many members of the minority Tutsi group that suffered the brunt of the genocide, were forced out of Rwanda decades ago and grew up as refugees.
Officials who are designing the new population control program said it would include a requirement that everyone who visits a hospital or health center for any reason be counseled on family planning. Women of child-bearing age will be offered free contraceptive devices including Norplant II, a small silicone pin that is inserted beneath the skin and is effective for up to five years. All schools will offer comprehensive sex education courses.
“The basis for this new campaign is already in place,” said Laura Hoemeke, director of the Twubakane Decentralization and Health Project, a community initiative that includes family planning. Though the Bush administration has often discouraged birth control, the United States government is financing this program.
Political opposition to population control measures has melted away as it has become clear that President Kagame now strongly favors them.
In a sign of the changing climate, a government-sponsored newspaper, New Times, recently published a supplement with a front-page headline, “Rapid Population Growth: A Constraint on Resources.” Below was a photo of an idyllic landscape with the caption, “This beautiful scenery will diminish if population is not controlled.” An accompanying editorial said that Rwanda’s population “is already big enough” and that “drastic measures” were needed to keep it from growing.
Officials designing the population control campaign say they hope to produce a plan that could become a model for other African countries, and perhaps persuade a foreign philanthropy to pay its entire cost. They have already begun consulting specialists from the United States and other countries.
Though Rwanda is predominantly Catholic, the church’s leaders here are not expected to oppose a campaign for population control. A number of priests, nuns and lay workers participated in the 1994 genocide, which weakened the church’s moral authority, and has led it to avoid politics.
President Kagame said he thought the church might present a problem, but noted that it had already showed a flexibility that might not have been expected on issues like AIDS education and condom distribution. “They do not come out and preach, as we do, but they do not actively oppose what we are doing,” he said.
According to Josh Ruxin, an American public health administrator based in Rwanda, the rate of Rwandans living in extreme poverty declined from 60.4 percent to 56.6 percent from 2001 to 2006. Mr. Ruxin is helping to design the new population control project. “If Rwanda wants to be an Asian tiger,” he said, “this is where it all starts.”
