LOS ANGELES TIMES INTERVIEW : Nafis Sadik : Aiming for Consensus on the Roiling Issue of Population Control

More than 40 years ago, Nafis Sadik, a doctor, was required to ask her husband for his permission to go to work and practice medicine, as was the custom in Pakistan. This month, Sadik will lead the international community through a critical demographic crossroads. On the eve of the International Conference on Population and Development, to be held in Cairo this month, a 90% majority of U.N. members is poised to sign the proposed program of action to reduce the growth in human population that increases by 90 million annually.

As secretary general of the conference, Sadik has set a course different from those of previous conferences on population in Bucharest and Mexico City, each a decade apart. The cornerstone of the Cairo program is the empowerment of the individual--in particular, women.

A gynecologist and obstetrician who has practiced in rural areas, Sadik developed a five-year health and family-planning program as part of Pakistan’s overall development plan. “When the essential needs of the individual are addressed,” she explains, “those of larger groups--the family, the community, the nation and indeed the planet--are more likely to be kept in the right perspective.”

But this focus on empowerment has galvanized opposition to the Cairo meeting. Saudi Arabia has announced it will not attend, and the Vatican has maintained its strong opposition. In Egypt, Islamic fundamentalists have threatened violence to disrupt the conference, asserting the proposals violate their moral beliefs. Sadik’s leadership, however, has helped build a majority consensus. Abortion--the most emotional subject in the document--will remain under the jurisdiction of nation-states.

Nobel laureates and scientists have warned that current population-growth trends could lead to irreversible degradation of the environment and continued poverty for much of the world. Strong support for the Cairo program could change the nature of our stewardship of the Earth, and any decision will have far-reaching implications for future generations.

Sadik’s work to bring attention to the world population crisis has earned her numerous awards and honors. She is married to Azhar Sadik, a businessman, and has five children, two of whom are adopted.

Question: How will this International Conference on Population and Development be different from the previous U.N. meetings on population in Mexico City and Bucharest?

Answer: The outcome of Mexico City and Bucharest was a policy of population stabilization that targeted population goals at the national level, through governments that would try to create policy and pass laws. Goals were imposed on the individual through international and then through national institutions. What those efforts didn’t do was establish an enabling environment in which people could make the right decisions.

The 1994 Cairo conference plan of action focuses both on population and development. It broadens the scope of population policy from the narrow focus on family planning and fertility to other issues of sustainable development and empowerment of the individual--particularly women--to make decisions.

The keystone of the Cairo plan is gender equality, equity and empowerment of women. Women are half the population of the world, half the population of every country. Because women are the only ones who become pregnant and bear children, population policy must be dealt with by them. Women have always wanted to have some control over their fertility. Even if a woman wants four or five children, she should be allowed to space those children, so that she will be better able to care for them.

Q: How is the document, with this cornerstone for the empowerment of women, being received by the U.N. member nations?

A: In the preparatory meetings for the ICPD over the last two-and-a-half years, every single government spoke of the importance of empowering women, of having women in the decision-making process . . . . From the African countries to the Latin American countries, and Arab countries--all of them spoke of the importance of the role of women.

Ninety percent of the governments have also agreed to the text as is, except for a few of the brackets. It is only on abortion--the whole subject of reproductive health, women’s rights, and abortion is so fraught with emotional overtones--that there are different points of view, even though the document does not suggest legalization of abortion. The subject of control is what concerns religious leaders. Throughout history, anthropological, cultural, social and religious norms have supported fertility control. That has been used to subjugate women.

Disagreement, then, is not centered so much on the need for population stabilization, but on family planning and whether it should occur at the individual level or at the institutional level.

Our plan of action is only saying that the needs of women should be addressed in consultation with them, not as a prescription to them and imposed on them. Today, all women do not have the possibility to choose their roles. Their roles are assigned to them to be, in a sense, service providers. To enforce the reproductive role as the only role in this day and age is mind-boggling.

Q: There is opposition to these ideas coming from the Vatican and some Islamic leaders. Given their opposition, what is the best-case scenario coming out of Cairo?

A: The Catholic religion does not accept modern methods of contraception. In other religions, there is no one point of view. Some Islamic leaders do say that family planning is against Islam. But most statements from Islamic leaders have favored family planning.

Traditionally, religion plays more of a role when it is linked with politics--when religious leaders have influence with government. Look at the U.S., for example. During the Reagan Administration, religious groups were more vocal and influential than today. With President Clinton in office, it’s a different situation.

The best-case scenario, then, would be full approval of the plan of action minus the brackets. That would include an acceptance by all governments of the definition of sexual and reproductive health that comes from the World Health Organization. It addresses unsafe abortion as a public-health issue for women and should be an issue in every country where these deaths are occurring. We would also like a full agreement on family-planning services, adolescence and reproductive health.

It does not legalize or seek legalization of abortion. Rather, it seeks to make abortion less necessary through the provision of family planning and to make medical services available to women who resort to abortion in order to prevent health consequences, including death.

Reproductive health does not contain a hidden agenda to legalize abortion; that is up to every country to decide. Reproductive health means information and education about reproduction, pre- and post-natal care, assisted deliveries, family-planning services and HIV/AIDS and STD (sexually transmitted disease) control and prevention.

Indeed, if we are to be successful, three conditions must exist simultaneously, and globally, to help reduce population: First, education and empowerment of women-- the ability of women to participate in decisions about family size and in decisions about the shape and nature of society; second, the availability of family- planning services and information, and, third, the confidence by parents that their children will survive. These conditions must occur at the same time to be effective.

Q: Do you see the Cairo conference as a watershed for feminism on a global scale?

A: I think it is. We will be looking at major increases in women in the economic labor force--the national labor forces. Across the North and the South, women are increasingly working outside the home, admittedly at the lowest-paid jobs. In Asia, women are working outside the home; they are educated, they become “bread-winners” and thus gain more respect from their husbands and families. Gradually and grudgingly, there will be more and more recognition of women’s work, even within the household. Things are now changing.

Alongside women’s entry into the labor force, consideration should be taken that their work not simply be overloaded onto them. There should be a changing of roles--a balancing of women’s roles outside of the home with the man’s role inside of the home.

The Nordics are very good examples of this. The role of men and women in the parenting of children is quite equal there, especially in Sweden. In Sweden, it is not unusual for the father to take leave to look after children. Helping in the household is common. The division of responsibilities are such that sometimes the man cooks and the woman looks after the rest of the house. Sometimes, it is the other way around. Such role equality is not happening in the developing world to such a great extent. Men are pushed by what is expected of them, and they don’t want to be laughed at by their peers and their colleagues. The stereotyping there has to change.

Q: How, then, will gender equality and the changing of stereotypes be accepted on a global scale? Won’t such change take many years?

A: Changing gender roles is threatening. Men and women are afraid of how these changes are going to affect them. Will they really be able to cope with the new circumstances? Women are also worried about a new role expected of them, to be independent and fend for themselves. Change is always worrisome.

But things can happen rapidly. It might not take decades, and major change could occur in a decade. If we can identify and engage key people to make changes, then change starts to happen very quickly. Core interventions should include, for example, getting girls into school and literacy programs.

Q: Change occurs at different speeds. North and the South are not in sync; they exist in non-parallel historical time. Isn’t it worth listening to the concerns of those in the more advanced industrial societies who have gone through the breakdown of the family?

A: True, different societies live in different historical times . . . . (But) all I can say is it is impossible to legislate family. I do not disagree that there should be a father, mother and children, but how do you make them stay together?

Women, in fact, don’t leave their children and walk out; men do. Women keep their children. Most societies have condoned men having multiple sexual relationships. Societies don’t frown on a man having mistresses, regardless of upholding marriage as sacred. In my part of the world, it is considered a great achievement to have many women. It is power over women, and confirms the low status of women. You can have them, you can own them.

So it is the same all over the world. Fathers abandon their families and go off. In some cases, there is the extended family, but even the extended family is now under economic pressure and is gradually breaking down so that they, too, are unwilling to support additional family members.

The nuclear family, in the end, is abandoned when the father, the bread-winner, walks out. Restricting women from having children out of wedlock could preclude arranged marriages in order to avoid preventing them from fulfilling their biological roles.

Q: The Vatican and some Islamic scholars would argue that America’s key societal problem is the breakdown of the integrity of the family, in large part due to the rise of the feminist sensibility. Is this justified?

A: Feminism is not the cause of the breakdown of the family. The breakdown of the family is due to men having remained in their traditional roles. Men have not changed. Men must now take responsibility and change their roles. The roles of both genders must change.

The woman should not be expected to take on double, triple loads. She must not be induced to sacrifice her professional career in order to look after the family because, after all, it is her job alone. Fathering is also a job as much as mothering is a job. Both parents should share the responsibilities of parenting and the household work. If you have a proper relationship, that is what you will share.

If the status quo in fact was such that everybody was equal and women and men could select their own roles, there would be no feminist movement.