Some dismaying news reported this week was that Iran had gone into panic mode by deciding to abolish its state-sponsored birth control program (mentioned in my 4/2/2009 entry) due to a falling birth rate – its population is currently around 75 million. The usual fear of an aging and decreasing population is a reason given, but by any other definition the program has been successful, with women having access to family planning. Now it looks like that will be made much harder for them. The last thing the country wants is a surplus of young people – that factor is one reason for the revolutions in other Middle Eastern countries. A New York Times article from April, “The Other Arab Spring” notes:
Especially when you consider the other stresses. Nafeez Mosaddeq Ahmed, the executive director of the Institute for Policy Research and Development in London, writing in The Beirut Daily Star in February, pointed out that 12 of the world’s 15 most water-scarce countries – Algeria, Libya, Tunisia, Jordan, Qatar, Saudi Arabia, Yemen, Oman, the United Arab Emirates, Kuwait, Bahrain, Israel and Palestine – are in the Middle East, and after three decades of explosive population growth these countries are “set to dramatically worsen their predicament. Although birth rates are falling, one-third of the overall population is below 15 years old, and large numbers of young women are reaching reproductive age, or soon will be.” A British Defense Ministry study, he added, “has projected that by 2030 the population of the Middle East will increase by 132 percent – generating an unprecedented ‘youth bulge’.” […]
If you ask “what are the real threats to our security today,” said Brown, “at the top of the list would be climate change, population growth, water shortages, rising food prices and the number of failing states in the world. As that list grows, how many failed states before we have a failing global civilization, and everything begins to unravel?”
Another recent NYT article, “What Can Mississippi Learn From Iran?”, gives some details of Iran’s health care program, which a US state was looking to model for its own.
The Iranian reforms were relatively inexpensive to implement there. It was the early ’80s, just after the Ayatollah Khomeini’s return and the Iranian revolution, which had promised the country’s rural villagers the kind of social justice that had been lacking under the shah. At the time, more than half the population lived outside major cities, in or around more than 60,000 villages. The Iranians built “health houses” to minister to 1,500 people who lived within at most an hour’s walking distance. Each house is a 1,000-square-foot hut equipped with examination rooms and sleeping quarters and staffed by community health workers – one man and one or more women who have been given basic training in preventive health care. They advise on nutrition and family planning, take blood pressure, keep track of who needs prenatal care, provide immunization and monitor environmental conditions like water quality. Crucially, in order to gain trust, the health workers come from the villages they serve.
People who become very sick, or require surgical procedures, are referred up through a single, multitiered system: from health house to rural health center to district hospital. The integrated nature of the system is what makes it unique. Today, 17,000 health houses serve 23 million rural Iranians. Health disparities between rural and urban Iranians have narrowed; the Iranians have reduced rural infant mortality by 75 percent and lowered the birthrate. Iran’s reforms won praise from the World Health Organization, which has long advocated preventive, primary care.
And now they will abandon some or all of that? Utter madness.
