Categories
Global Conflict Greenhouse gases Population

Question the “People and Planet” Report

Graph from the Club of Rome, People and Planet report, showing the result of business as usual.

            Over 50 years ago the Club of Rome (CoR) made big news with the report “The Limits to Growth”. Last month another report came out that seems more optimistic than “Limits”.

            The CoR is an international think-tank of high-level people who tackle the world’s problems, including poverty, environmental deterioration and human population. “Limits” was based on an early computer simulation that looked at 5 variables: population, food production, industrialization, pollution and consumption of nonrenewable natural resources. The first of these were assumed to be increasing exponentially, while production was thought to be linear. Two of 3 scenarios in the program predicted “overshoot and collapse” of civilization before 2100. This is about as pessimistic as you can get!

            In contradistinction to “Limits”, the CoR has published another report which I fear is overly optimistic. “People and Planet” predicts that global population will stop its growth around 2050, with a maximum of 8.8 billion people. This is very different for the United Nations prediction, which projects continued growth until the end of this century, with a population over 11 billion.

            I first read about this report in The Guardian. The title of that article is: “World ‘population bomb’ may never go off….” This title did what a title is supposed to do—it grabbed my attention. However, it is wrong! The population bomb has already exploded. We are facing problems caused by overpopulation: climate chaos, and the extinction crisis both clearly have as their root cause our high population density. The increase in global aggression may also be related to overpopulation.

            People and Planet has a different way of predicting population. It is based on an observation that increased education (especially of girls and women) is associated with decreased family size. This has been observed many times in many different societies. It makes sense! Girls who are in school are better able to access and use family planning. Women who are in school or college are less likely to get married and start their families. Later, when they join the workforce, they are more likely to want to put more energy into their careers and less into childcare. Perhaps most important, educated women are less likely to be bossed by pronatalist, misogynistic men.

            The hope is that increased attention to education, especially in African countries, will speed up fertility decline. My observations, however, suggest that is difficult to achieve.

People and Planet gives two projections for the future; one of them is hopeful. The current scenario is called “Too Little Too Late” (TLTL), but the CoR advocates for “Giant Leap”. This would entail 5 steps: ending poverty, addressing gross inequality, empowering women, making our food system healthy for people and ecosystems, and transitioning to clean energy.

            “Giant Leap” would not be perfect, although it would get us closer to sustainability. It is also projected to reach peak global population a decade earlier than TLTL. I can see us transitioning to clean energy (it’s cheaper!), and women are already doing a great job of empowering themselves. Unfortunately, the current legal system and capitalism are designed to maintain the status quo; they make it problematic to address gross inequality and to end poverty. Furthermore, it is difficult for me to imagine what it would take to revolutionize the global food production system; again, there are too many vested interests in maintaining the status quo.  I fear that there is too much greed in our species for us to take the giant leap that is needed for us to live sustainably.

© Richard Grossman MD, 2023

Categories
Family Planning Population Sterilization

Check out Vasectomy

Dr. Charles Ochieng at the International Conference on Family Planning

            Sixteen years ago the Durango Herald published my column “Do your Partner’s Vasectomy”; it got lots of laughs on April Fool’s Day! Unfortunately, the latest news on male sterilization is not so funny.

            There is some recent good news, fortunately. In some states, men are rushing to get permanently sterilized because of the recent Supreme Court decision about abortion. My experience, however, is that they will be moving a little more slowly after this minor procedure. I was sore for a couple days after my vasectomy, many years ago.

            Remember that vasectomy is much safer and easier than a tubal ligation, the female sterilization procedure. Male sterilization is done with local anesthesia and is finished in just 10 or 15 minutes. There are only two drawbacks to vasectomy. While female sterilization is effective immediately, it takes a couple of months after the procedure before a man starts shooting blanks. The other drawback is that many men are frightened to have it done.

            It is interesting to note the countries where vasectomy is most popular. The top five are: South Korea, Australia, Bhutan, the USA and New Zealand. Bhutan? Yes! Perhaps it is because that little country’s government has promoted this simple surgery. Bhutan has had mobile vasectomy camps which bring the service to villagers. Furthermore, men tend to take responsibility for family planning in this enlightened country.

            The bad news is that we seem to have reached “peak vasectomy”. Worldwide, the maximum number of couples who use vasectomy for protection from unintended pregnancy was reached in 2001. That year, 44 million couples worldwide were safeguarded by this simple procedure. The latest figures show a sad decline to just 17 million couples who are dependent on vasectomy.

            What can be done to bring back vasectomy? One group is doing its best to spread the good word all over the world. World Vasectomy Day, www.wvd.org, has worked in several countries to introduce people—especially men—to this simple surgery. They claim: “World Vasectomy Day is the largest male focused family planning movement ever”. WVD was started by a New York film producer, Jonathan Stack, and urologist Doug Stein. Together, they have built an amazing crusade to not only to do the surgery, but also to train doctors to perform the procedure.

            Stein is a master of the No Scalpel Vasectomy technique. It uses a couple of special instruments that make it possible to perform this delicate procedure with tiny incisions. Because it involves less cutting, NSV has fewer complications than older methods.

            Vasectomy would be ideal for couples in developing countries who want to stop childbearing, since it doesn’t require a fancy facility. Dr. Charles Ochieng of Nairobi, Kenya    has become an evangelist for vasectomy. He had his own vasectomy years ago, and has done hundreds since then. An award-winning family practice doctor, he is devoted to providing vasectomies and teaching other physicians the NSV technique. He learned the NSV technique while spending time in Florida with Dr. Stein.

I met Ochieng at an international family planning convention in Kigali, Rwanda. He told me that he even offered to do his father’s vasectomy! His dad has 3 wives (polygamy is legal in Kenya) and many children. He was sad that his father turned down the gift. For some cultures, a large family is a status symbol, especially for men.

Now, as restrictions on women’s reproductive health increase in the USA, I hope more men will take this small, but important, step to prevent unintended pregnancies.

© Richard Grossman MD, 2023