by Sen, Amartya
The villagers of Tongmuchong did not need any convincing on that day when Mrs. Liao, the family-planning official, threatened to blow up their houses. Last year, in the neighboring village of Xiaoxi, a man named Huang Fuqu, along with his wife and three children, was ordered out of his house. To the horror of all those who watched, the house was then blasted into rubble. On a nearby wall, the government dynamiters painted a warning: “Those who do not obey the family planning police will be those who lose their fortunes.”27
Human rights groups and women’s organizations in particular have been especially concerned with the loss of freedom involved in this process.28
Second, aside from the fundamental issue of reproductive and other freedoms, there are other consequences to consider in evaluating compulsory birth control. The social consequences of such compulsion, including the ways in which an unwilling population tends to react when it is coerced, can often be quite terrible. For example, the demands for a “one-child family” can lead to the neglect—or worse—of infants, thereby increasing the infant mortality rate. Also, in a country with a strong preference for male children—a characteristic China shares with India and many other countries in Asia and North Africa—a policy of allowing only one child per family can be particularly detrimental for girls, for example, in the form of fatal neglect of female children. This, it appears, is exactly what has happened on a fairly large scale in China.
Third, any change in reproductive behavior that is brought about by compulsion need not be particularly stable. A spokesman for the State Family Planning Commission in China told some journalists earlier this year:
At present low birth rates are not steady in China. This is because the birth concept of the broad masses has not changed fundamentally.29
Fourth, it is not by any means clear how much additional reduction in the fertility rate has actually been achieved by China through these coercive methods. It is reasonable to accept that many of China’s longstanding social and economic programs have been valuable in reducing fertility, including those programs that have expanded education (for women as well as men), made health care more generally available, provided more job opportunities for women and—more recently—stimulated rapid economic growth. These factors would themselves have tended to help in the reduction in the birthrate, and it is not clear how much extra lowering of fertility rates has been achieved in China through compulsion. In fact, even in the absence of compulsion, we would expect the Chinese fertility rate to be much lower than the Indian average, given China’s significantly greater achievement in education, health care, female job opportunities and other ingredients of social development.
In order to “take out” the influence of these social variables, as opposed to coercion, we can note the much greater heterogeneity of India than China, and look specifically at those Indian states which are comparatively advanced in these social fields. In particular, the state of Kerala provides an interesting comparison with China, since it too enjoys high levels of basic education, health care and so on, somewhat ahead of the Chinese average.30 Kerala also has some other favorable features for women’s empowerment and agency, including a greater recognition, by legal tradition, of women’s property rights for a substantial and influential part of the community.31
Kerala’s birthrate of 18 per thousand is actually lower than China’s 19 per thousand, and this has been achieved without any compulsion by the state. Kerala’s fertility rate is 1.7, compared with China’s 1.9 for the mid-1990s. This is in line with what we could expect through progress in factors that help voluntary reduction in birthrates.32
SIDE EFFECTS AND SPEED OF FERTILITY REDUCTION
It is also worth noting that since Kerala’s low fertility has been achieved voluntarily, there is no sign of the adverse effects that were noted in the case of China—for example, heightened female infant mortality and widespread abortion of female fetuses. Kerala’s infant mortality rate per thousand live births (16 for girls, 17 for boys) is much lower than China’s (33 for girls and 28 for boys), even though both regions had similar infant mortality rates around the time, in 1979, when the one-child policy was initiated in China.33 There is also no tendency toward sex-selective abortion of female fetuses in Kerala, as there is in China.
It is also necessary to examine the claim in support of compulsory birth control programs that the speed with which fertility rates can be cut down through coercive means is very much higher than for voluntary reductions. But this piece of generalization is not supported by Kerala’s experience either. Its birthrate has fallen from 44 per thousand in the 1950s to 18 by 1991—a decline no less fast than that in China.
It could, however, be argued that looking at this very long period does not do justice to the effectiveness of the “one-child family” and other coercive policies that were introduced only in 1979, and that we ought really to compare what has happened between 1979 and now. So let us do just that. In 1979, when the one-child policy was introduced in China, Kerala had a higher fertility rate than China: 3.0 as opposed to China’s 2.8. By 1991 its fertility rate of 1.8 is as much below China’s 2.0 as it had been above it in 1979. Despite the added “advantage” of the one-child policy and other coercive measures, the fertility rate seems to have fallen much more slowly in China than in Kerala, even in this period.
Another Indian state, Tamil Nadu, has had no slower a fall of fertility rate, from 3.5 in 1979 to 2.2 in 1991. Tamil Nadu has had an active, but cooperative, family planning program, and it could use for this purpose a comparatively good position in terms of social achievements within India: one of the highest literacy rates among the major Indian states, high female participation in gainful employment, and relatively low infant mortality. Coercion of the type employed in China has not been used either in Tamil Nadu or in Kerala, and both have achieved much faster declines in fertility than China has achieved since it introduced the one-child policy and the related measures.
Within India, contrasts between the records of the different states offer some further insights on this subject. While Kerala and Tamil Nadu have radically reduced fertility rates, other states in the so-called northern heartland (such as Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan) have much lower levels of education, especially female education, and of general health care. These states all have high fertility rates—between 4.4 and 5.134 This is in spite of a persistent tendency in those states to use heavy-handed methods of family planning, including some coercion (in contrast with the more voluntary and collaborative approach used in Kerala and Tamil Nadu).35 The regional contrasts within India strongly argue for voluntarism (based, inter alia, on the active and educated participation of women), as opposed to coercion.
TEMPTATIONS OF DURESS
While India has been much more cautious than China in considering the option of coercive birth control, there is much evidence that the possibility of coercive policies greatly attracts many activists in India. In the mid-1970s, the government of India, under Indira Gandhi’s leadership, tried a good deal of compulsion in this field using the legal opportunities that she opened up through her declaration of “emergency” and the collateral suspension of some standard protections of civil and personal rights. The northern states, as was mentioned earlier, have various regulations and conventions that force family control measures, particularly in the irreversible form of sterilization, often of women.36
Even when coercion is not part of official policy, the government’s firm insistence on “meeting the family-planning targets” often leads administrators and health care personnel at different levels to resort to all kinds of pressure tactics that come close to compulsion.37 Examples of such tactics, used sporadically in particular regions, include vague but chilling verbal threats, making sterilization a condition of eligibility for antipoverty programs, denying maternity benefits to mothers of more than two children, reserving certain kinds of health care services to persons who have been sterilized, and forbidding persons who have more than
two children from contesting elections for local governments (the panchayats).38
The last measure, introduced a few years ago in the northern states of Rajasthan and Haryana, has been widely praised in some circles, even though denial of the opportunity to contest elections involves a strong violation of a basic democratic right. Legislation was also proposed (though not passed) in the Indian parliament that would bar anyone from holding national or state office if he or she has more than two children.
It is sometimes argued that in a poor country it would be a mistake to worry too much about the unacceptability of coercion—a luxury that only the rich countries can “afford”—and that poor people are not really bothered by coercion. It is not at all clear on what evidence this argument is based. The people who suffer most from these coercive measures—who are brutally forced to do things they do not want to do—are often among the poorest and least privileged in the society. The regulations and the way they are applied are also particularly punitive with respect to women’s exercise of reproductive freedom. For example, even such barbarous practices as trying to assemble poorer women in sterilization camps, through various kinds of pressure, have been used in several rural regions in north India as the deadline for meeting “sterilization targets” approaches.
Indeed, the acceptability of coercion to a poor population cannot be tested except through democratic confrontation, precisely the opportunity that authoritarian governments withhold from their citizens. Such a testing has not occurred in China, but it was indeed attempted in India during the “emergency period” in the 1970s when compulsory birth control was tried by Mrs. Gandhi’s government, along with suspending various legal rights and civil liberties. As was mentioned earlier, the policy of coercion in general, including that in reproduction, was overwhelmingly defeated in the general elections that followed. The poverty-stricken electorate of India showed no less interest in voting against coercive violation of political, civil, and reproductive rights than it takes in protesting against economic and social inequality. Interest in liberty and basic rights can also be illustrated from the contemporary political movements in many other countries in Asia and Africa.
There is, in fact, another feature of people’s reaction to coercion—that of voting with their feet. As Indian family planning specialists have noted, voluntary birth control programs in India received a severe setback from that brief program of compulsory sterilization, since people had become deeply suspicious of the entire family-planning movement. Aside from having little immediate impact on fertility rates, the coercive measures of the emergency period introduced in some regions in India were, in fact, followed by a long period of stagnation in the birthrate, which ended only around 1985.39
A CONCLUDING REMARK
The magnitude of the population problem is often somewhat exaggerated, but nevertheless there are good grounds for looking for ways and means of reducing fertility rates in most developing countries. The approach that seems to deserve particular attention involves a close connection between public policies that enhance gender equity and the freedom of women (particularly education, health care and job opportunities for women) and individual responsibility of the family (though the decisional power of potential parents, particularly the mothers).40 The effectiveness of this route lies in the close linkage between young women’s well-being and their agency.
This general picture applies to developing countries as well, despite their poverty. There is no reason why it should not. While arguments are often presented to suggest that people who are very poor do not value freedom in general and reproductive freedom in particular, the evidence, insofar as it exists, is certainly to the contrary. People do, of course, value—and have reason to value—other things as well, including well-being and security, but that does not make them indifferent to their political, civil or reproductive rights.
There is little evidence that coercion works faster than what can be achieved through voluntary social change and development. Coercive family planning can also have seriously unfavorable consequences other than the violation of reproductive freedom, in particular an adverse impact on infant mortality (especially female infant mortality in countries with an entrenched antifemale bias). There is nothing here that gives definite ground for transgressing the basic importance of reproductive rights for the sake of achieving other good consequences.
In terms of policy analysis, there is much evidence now, based on intercountry comparisons as well as interregional contrasts within a large country, that women’s empowerment (including female education, female employment opportunities and female property rights) and other social changes (such as mortality reduction) have a very strong effect in reducing fertility rate. Indeed, it is difficult to ignore the policy lessons implicit in these developments. The fact that these developments are highly desired for other reasons as well (including the reduction of gender inequity) makes them central concerns in development analysis. Also, social mores—what is taken to be “standard behavior”—are not independent of the understanding and appreciation of the nature of the problem. Public discussion can make a big difference.
Reducing fertility is important not only because of its consequences for economic prosperity, but also because of the impact of high fertility in diminishing the freedom of people—particularly of young women—to live the kind of lives they have reason to value. In fact, the lives that are most battered by the frequent bearing and rearing of children are those of young women who are reduced to being progeny-generating machines in many countries in the contemporary world. That “equilibrium” persists partly because of the low decisional power of young women in the family and also because of unexamined traditions that make frequent childbearing the uncritically accepted practice (as was the case even in Europe until the last century)—no injustice being seen there. The promotion of female literacy, of female work opportunities and of free, open and informed public discussion can bring about radical changes in the understanding of justice and injustice.
The view of “development as freedom” gets reinforced by these empirical connections, since—it turns out—the solution of the problem of population growth (like the solution of many other social and economic problems) can lie in expanding the freedom of the people whose interests are most directly affected by overfrequent childbearing and child rearing, viz., young women. The solution of the population problem calls for more freedom, not less.
CHAPTER 10
CULTURE AND HUMAN RIGHTS
The idea of human rights has gained a great deal of ground in recent years, and it has acquired something of an official status in international discourse. Weighty committees meet regularly to talk about the fulfillment and violation of human rights in different countries in the. world. Certainly the rhetoric of human rights is much more widely accepted today—indeed much more frequently invoked—than it has ever been in the past. At least the language of national and international communication seems to reflect a shift in priorities and emphasis, compared with the prevailing dialectical style even a few decades ago. Human rights have also become an important part of the literature on development.
And yet this apparent victory of the idea and use of human rights coexists with some real skepticism, in critically demanding circles, about the depth and coherence of this approach. The suspicion is that there is something a little simple-minded about the entire conceptual structure that underlies the oratory on human rights.
THREE CRITIQUES
What, then, appears to be the problem? I think there are three rather distinct concerns that critics tend to have about the intellectual edifice of human rights. There is, first, the worry that human rights confound consequences of legal systems, which give people certain well-defined rights, with pre-legal principles that cannot really give one a justiciable right. This is the issue of the legitimacy of the demands of human rights: How can human rights have any real status except through entitlements that are sanctioned by the state, as the ultimate le
gal authority? Human beings in nature are, in this view, no more born with human rights than they are born fully clothed; rights would have to be acquired through legislation, just as clothes are acquired through tailoring. There are no pre-tailoring clothes; nor any pre-legislation rights. I shall call this line of attack the legitimacy critique.
The second line of attack concerns the form that the ethics and politics of human rights takes. Rights are entitlements that require, in this view, correlated duties. If person A has a right to some x, then there has to be some agency, say B, that has a duty to provide A with x. If no such duty is recognized, then the alleged rights, in this view, cannot but be hollow. This is seen as posing a tremendous problem for taking human rights to be rights at all. It may be all very nice, so the argument runs, to say that every human being has a right to food or to medicine, but so long as no agency-specific duties have been characterized, these rights cannot really “mean” very much. Human rights, in this understanding, are heartwarming sentiments, but they are also, strictly speaking, incoherent. Thus viewed, these claims are best seen not so much as rights, but as lumps in the throat. I shall call this the coherence critique.
The third line of skepticism does not take quite such a legal and institutional form, but views human rights as being in the domain of social ethics. The moral authority of human rights, in this view, is conditional on the nature of acceptable ethics. But are such ethics really universal? What if some cultures do not regard rights as particularly valuable, compared to other prepossessing virtues or qualities? The disputation of the reach of human rights has often come from such cultural critiques; perhaps the most prominent of these is based on the idea of the alleged skepticism of Asian values toward human rights. Human rights, to justify that name, demand universality, but there are no such universal values, the critics claim. I shall call this the cultural critique.