The Means of Reproduction: Sex, Power, and the Future of the World (14 page)

She later found out that she almost didn’t get the job because her bleached hair was considered too brassy. Nevertheless, once she was hired she was treated with deep respect. Her first week on the job, Rockefeller’s wife visited her in her new office. “ ‘I’m very glad to see you here,’ ” Dunlop recalled her saying. “ ‘I’ve wanted him to have a woman on his staff for many, many years, for a long time. But I want to say to you that you must tell him the truth. He’s not being told the truth. And in order for you to tell him the truth, you must consider yourself to be his equal.’ ”
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For her first assignment Rockefeller asked Dunlop to spend a year immersing herself in the population milieu in order to figure out what was wrong with it. She was to talk to everyone, go to all the meetings she could, read the literature. Once women in the field realized what Dunlop was doing, they started sending her anonymous notes telling her about the sexism they encountered at work. “It just reconfirmed for me that the personal was political,” she said. Meanwhile, when Dunlop listened to Population Council technocrats talk, she was aghast at the way women were reduced to their wombs. Women’s lives, she said, “why women have children, or what the rationale for it [may be], or what they felt, or were their concerns, never came into it at all, ever.”
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Soon Dunlop heard about a young woman at the Ford Foundation with similar interests, and she invited Adrienne Germain out for Chinese food. Germain impressed her deeply. “She had her finger right on it, as far as I was concerned,” said Dunlop. “And then I went back to Mr. Rockefeller, and I said, ‘There’s a problem. This is the problem. The [population] field was shot through with unintended sexism and racism, and there was a stranglehold on money and ideas, and it’s held by six people.’ ” Chief among the culprits was Rei Ravenholt, who controlled more money than anyone else.
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Part of Dunlop’s problem with Ravenholt was personal. His lascivious sense of humor alternately exasperated and enraged many of his female colleagues. “I mean, I found Rei Ravenholt totally unacceptable, as an American, as somebody who was representing the United States in the international arena,” Dunlop said several decades later. “In villages, I mean, forget it. This was the Ugly American, as far as I was concerned. And to me it seemed so defeating. Here we were trying to help—we were trying to do something about development. And we had this man who was in such a powerful position who was such an embarrassment.... These guys had no respect for women. None. At least, that’s how I felt at the time.... In retrospect, I’m sure that wasn’t fair.”
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The dispute went deeper than Ravenholt’s personal style, though. Dunlop and Germain objected to what they saw as his agency’s single-minded focus on preventing births. At the time one focus of USAID’s programs was offering IUDs to women who had just delivered babies in hospitals. That might sound reasonable: Such women are obviously sexually active, probably didn’t want to get pregnant again right away, and may have no other contact with the health system.

But imagining herself in the women’s place, Germain was disturbed. Most women in poor countries don’t go to public health facilities when they’re in labor unless something has gone horribly wrong. After going through a hellish experience, these women needed attention to their immediate health and that of their newborn, if he or she had survived. Inserting an IUD immediately after a difficult labor seemed unthinkable. “Anybody with any common sense, knowing what birth is about, would think, you know, the IUD probably isn’t appropriate,” Germaine said. “What maybe they should try to do would be to ensure that she came back for one-month and three-month checkups, and at the three-month checkup, or maybe even one month, you could talk to her and say, ‘Look, if you don’t want to conceive again soon, then don’t count on amenorrhea to protect you. We can give you condoms. We can give you whatever if you’re still breastfeeding.’ ”
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There were other general problems with IUD programs. Women suffering side effects, including heavy bleeding and cramps, sometimes had trouble getting their IUDs removed, either because of the resistance of target-obsessed family planning workers or because they simply didn’t have access to professional health care after the initial insertion. Others left them in past the five-year expiration mark for similar reasons.

In the early 1970s USAID distributed Dalkon Shield IUDs, devices that were later shown to slice through the uterine wall and conduct dangerous bacteria into the uterus, to dozens of countries. A
Mother Jones
investigation documented how in 1972 Dalkon Shield manufacturer A. H. Robins Company arranged to sell bulk, unsterilized packages of the IUDs to USAID just as the company was learning how hazardous they were. Eventually, after contentious FDA hearings—and the deaths of seventeen American women—domestic sales of the Dalkon Shield were suspended, and USAID issued an international recall.

There was, of course, no way to get the word out to remote villages. “When the recall order was issued in 1975, AID could hope to recover stocks of unused devices from the warehouses and storage rooms of major international agencies, like the International Planned Parenthood Federation,” wrote
Mother Jones
reporters Barbara Ehrenreich, Mark Dowie, and Stephen Minkin. “But it could not, despite any number of memos, recall the AID-supplied Shields from the approximately 440,000 women already using the device. Nor could it hope to recover the thousands of Shields lying in the drawers of countless private practitioners and tiny rural family planning clinics.”

In 1979, when the
Mother Jones
article came out, Ravenholt was still defending A. H. Robins Company. “Robins didn’t know there was any problem with it in 1972,” he told the magazine, dismissing early reports of adverse reactions. “You don’t really know anything until you have a very, very large number of people who have used it. You might have one kind of impression from 10,000 people, another from 100,000. You might need a million—10 million—before you really know.”

Ehrenreich, Dowie, and Minkin noted acidly, “You might, in other words, need a few medium-size nations to experiment on.”
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Ravenholt and his allies weren’t entirely callous, but to them the macro-scale specter of overpopulation obscured concern about individuals. As they understood it, family planning had the potential to save millions of lives—more lives than any other intervention they could imagine. It had to be done as economically and on as wide a scale as possible. People in the field, said Malcolm Potts, fall into two groups: “There’s one group which is sincerely regulated by human beings’ sufferings, and talks about rights and individuals’ stories, and another group, to which Rei Ravenholt and I and other people belong, . . . that has a sense of scale, that says a million people suffering is worse than a thousand people suffering.”

It was precisely this kind of cold demographic utilitarianism that would come under increasing attack in the years to come. Rockefeller, erstwhile stalwart of the population control movement, fired one of the first salvos.

Launching a drive to raise awareness of overpopulation worldwide, the United Nations declared 1974 World Population Year. The highlight was to be a world conference on population, to be held in Bucharest, Romania, that August.
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As U.S. representative at the UN, George H. W. Bush encouraged both initiatives. The United States hoped the Bucharest meeting, the largest UN gathering ever convened, would convince recalcitrant nations of the urgency of population control. Diplomats were unprepared for the fierce skepticism of developing countries, though perhaps they shouldn’t have been—this was, after all, a period of powerful third world solidarity, in many ways the first iteration of the antiglobalization movement. Led by Algeria and Argentina, poor countries banded together and argued that if there was a looming demographic problem, its root cause was an unjust global economic order. China called the idea of a population explosion a “false alarm” designed to foster imperial exploitation.
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Brazil insisted that rapid population growth was necessary to transform itself into a world power.
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Other countries rallied around the slogan “development is the best contraceptive,” and tried to use the meeting to press for economic concessions from the United States and Europe. Even India, a country long concerned about its own population growth, sided with the developing nations. The
New York Times
characterized the struggle as one of “Marx vs. Malthus.”
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In addition to the main conference, a parallel “Population Tribune” gathered nine hundred activists, students, academics, feminists, NGO representatives, and miscellaneous gadflies in a sweltering university building nearby. (Such parallel meetings would become the norm at future UN conferences, turning them, in the words of one diplomat, into latter-day medieval trade fairs.) Betty Friedan showed up, as did Margaret Mead and Germaine Greer, who would eventually become one of the fiercest feminist critics of population programs. (The World Plan of Action, Greer announced, regarded women as baby factories, the only difference from other factories being that they were being asked to cease production.
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Rockefeller spoke to the tribune on the conference’s seventh day. Many were expecting him to affirm the Malthusian American position. Instead, invoking his onetime belief in population control, he announced, “I have changed my mind.

“The evidence has been mounting, particularly in the last decade, that family planning alone is not adequate,” he said. The old population establishment was shocked. He continued with a call for greater attention to social and economic development, especially for women.

As long as the social status and economic security of women throughout the world depend largely on the number of children they have, as long as development programs that do reach women deal with them largely or solely in their roles as mothers, they will have good reason to continue having many children. . . . In my opinion, if we are to make genuine progress in economic and social development, if we are to make progress in achieving population goals, women increasingly must have greater freedom of choice in determining their roles in society.
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The speech, said Germain, was “world-shaking” in the population field. She was proud; she had written most of it. Charged with crafting Rockefeller’s remarks, Dunlop had invited Germain and Germain’s future husband, Steve Salyer, to collaborate. They’d penned draft and after draft and had countless meetings with Rockefeller, often over lunch at his Rainbow Room restaurant. During those meetings Germain spoke about the women she’d known in Peru and told Rockefeller about the problems she’d faced at the Population Council. All this made its way, indirectly, into the speech.

Ravenholt was in Bucharest, and he was livid. “The essence of that speech was that family planning had failed,” he said. “Dunlop must have been quite persuasive for him to say that, because he really had much better sense than that. It was really sad, because his going along with Joan Dunlop and saying that was counter to everything he’d been doing for years.”

But Ravenholt’s time in the field would soon come to an end. A promiscuous maker of enemies, he’d managed the neat trick of enraging both the Catholic right and the feminist left, and when the Carter administration took over in 1976, he soon found himself isolated. His strategy of contraceptive inundation, while showing success in some parts of the world, had already been judged a spectacular failure in Pakistan. “Small children here have discovered that condoms paid for by the U.S. government make wonderful holiday balloons,” began a 1978
Washington Post
story. “It’s about the only use they’re put to.” Despite millions of dollars and a flood of contraceptives, the story reported, Pakistan’s birthrate had
increased
since 1960. A USAID official quoted in the piece said, “There’s never been a failure in population as large as this one.”
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So Ravenholt was vulnerable. When Carter came in, he made Sander Levin the assistant administrator at USAID. Those who worked with Levin sensed that he had orders to get rid of Ravenholt, who had no intention of going meekly.
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Levin asked for his resignation, Ravenholt refused, and several years of bureaucratic warfare ensued. Eventually Ravenholt was demoted. He fought hard against losing control of his program, spending upward of fifty thousand dollars on a legal challenge before the government’s Merit System Protection Board before finally giving up and taking a job in the Centers for Disease Control. Soon he went to the National Institute on Drug Abuse to pursue his early interest in the dangers of smoking.

A
n even greater blow to the population control orthodoxy came from reports of terrible abuses in India and China. First was the revelation of widespread compulsory sterilization during the Indian “emergency” that began in 1975, when civil liberties were suspended and Prime Minister Indira Gandhi ruled by decree. The horrors of the mass vasectomy campaign organized by Gandhi’s younger son, Sanjay Gandhi, are well known, their trauma immortalized in novels such as Salman Rushdie’s
Midnight’s Children
and Rohinton Mistry’s
A Fine Balance
. Obsessed with overpopulation and modernization, thirty-year-old Sanjay Gandhi mobilized all levels of government to meet ever-escalating sterilization targets. Uttar Pradesh’s chief secretary telegraphed his subordinates: “Inform everybody that failure to achieve monthly targets will not only result in the stoppage of salaries but also suspension and severest penalties. Galvanise entire administrative machinery forthwith repeat forthwith and continue to report daily progress by crash wireless to me and secretary to Chief Minister.”
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