Fateshpurberi, India — The doctor’s frustration was reflected in his face. He tried to convince Bhagwathi, a 30 year old mother of five girls, to be sterilized.
Instead she stared at the ground. “I will keep on having children until I have a son.”
India’s population bomb keeps ticking. Bhagwathi was one of only four women at the Fateshpurberi Primary Health Center, a three-room building in a dusty village 30 miles from New Delhi.Dr. C. Guptha is exasperated.
“How can I convince these people of family planning and sterilization?” he asked.
Already burdened with more than 750 million people, many desperately poor, India must produce food, schools and jobs for a nation that has 13 million births every year.
The World Bank predicts India will be the most populous country on earth by the year 2050, outstripping China, which has been pushing harsh population controls.
“We know we will have a billion people by year 2000,” said Rami Chhabra, public relations officer of the private Family Planning Foundation. “The only question is how much more.”
Indian family planning officials have tried everything from mass coerced sterilization to mass education. But the first nation in the world to have a state sponsored population program is still torn by doubts.
Prime Minister Rajiv Gandhi admits current methods are not working.
“Although programs are in place now, they are not yielding good results,” he said. “one of the major factors is the social and cultural block” against birth control.
The greatest failures are in the rural areas, where 70 percent of the country’s people live.
“T speak to 10 families a day,” said Thanga Mani, a village midwife and nurse, “I am lucky if I get one person a month to come forward to accept sterilization.”
Most women are illiterate and deeply immersed in tradition and religion.
At the Fateshpurberi health center, after listening to Guptha for nearly 45 minutes, Bhagwathi shrugged and said, “Children are a gift from God.”
Male children are preferred because a son and his wife by tradition stay in the parents’ home after marriage, while a daughter goes to her in-laws’ home. Many couples, even after five or six daughters, continue to try for a son.
“For rural people, family plays a greater role than urban people,” said Manjit Singh, a social worker for the government funded Family Planning Association.
They believe a large family is a sign of good fortune. More children mean more help in the home and field. Children also provide security for their parents in old age.
“Why should the oppressed stop at two children when the government does not provide them with any social security, or medical benefits?” said Dr. D. Banarjee, chairman of the center for social medicine at Jawaharlal Nehru University. “It just does not make sense for the poor to have fewer children.”
Education, higher income and cash payments of up to 150 rupees ($12) have led many of India’s urbanites to use birth control after two or three children, but resistance from India’s rural poor tempts many family planning officials to propose tougher methods.
“For these rural areas, coercion is the only way,” Guptha asserted. “Otherwise, they won’t come on their own.”
“But we tried coercion and it didn’t work,” countered Chhabra. “It denies families’ basic needs. So they revolted.”
From 197577, with India under emergency rule by late Prime Minister Indira Gandhi, officials threatened jobs, cut salaries and sometimes physically coerced sterilization.
Millions o. people — young and old, newly married and long widowed, those with children and those without — were rounded up and sterilized to meet quotas.
The number of sterilizations rose to more than 8 million during the 18 months of emergency rule, but the draconian mothods infuriated many. Public outrage contributed to Mrs. Gandhi’s defeat in the 1977 election. The next year the sterilization figure fell to 1 million.
“Because of the emergency, our program was set back 20 years,” said A. D. Cripathy, professor of communication at the National Institute of Health and Family Welfare.
Ten years later, “the objective remains the same as in the days of the emergency,” said Satish Chander of the Family Planning Association. “But our means of achieving the objective has changed. There is no room for coercion and compulsion as it was before.”
The government and the private foundations are trying cash incentives and goods such as clothing, kitchen appliances and farm implements to induce people to accept sterilization.
But the birth rate remains high. Average family size has dropped only marginally from 5.7 children in 1971 to 5.3 children in 1981.
Birth control experts say the government will have to provide social security and better health care for the aging to deal with the underlying reasons for having large families.
But India’s population growth has developed such momentum it will be difficult to bring it quickly under control, even if the government were able to implement the best possible policies.
“We won’t see any change before the year 2000,” Chhabra said. “But the 21st century will be determined by what we do or don’t do now.”