[Hammering and sawing]
[Narrator, Joseph Julian:] In a village inLatin America, a child is dead.
Two months old.
The youngest of eight children.
He was a casualty of poverty.
Another mouth to feed and afamily where already there
was too little to eat.
She died of proteindeficiency and malnutrition.
And her father whoworked in another town
did not come to her funeral.
He could not affordto make the trip.
[Low singing]
This infant's deathis not unique.
In countries throughoutthe developing world,
the death of littlechildren is one
of the daily tragedies of life.
[Singing, crying]
Though we usually think ofthe problem of an exploding
population in terms suchas economic development,
overcrowding, underemployment,ecology, education,
maternal health, andpersonal freedom,
it has come down forthese people, on this day,
to a matter of life and death.
[Sounds of singing, crying, wailing]
[Dr. Vernon Madrigal:] Childrendying from starvation
in underdeveloped countriesand children dying in the wars.
There is not much difference.
They are both murder.
I'm scared about thepopulation of the whole world.
But especially in El Salvador,which is a place where I live,
where my children are, mywife, my work, everything.
And it's scary.
Of course.
And that's why I'm working here.
[Interviewer:] Is it desperate?
[Dr. Madrigal:] Yes.
I think it's desperate,
the situation.
But somebody has to,
somebody has to do something.
We have to do something.
And when I say something,I am complaining,
because I want a verystrong and aggressive policy
in population.
If this country is going to bea country, a liberal country,
within 20 years.
[Music]
[Joseph Julian:] El Salvador hasthe highest population density
in Latin America.
and one of the highestpopulation growth rates
in the world.
There are three and a halfmillion people here now.
And if something is notdone, there will be seven million
in 20 years.
[Music]
Already, one can seewhat this might mean
in terms of human degradation.
[Music]
Although El Salvador does nothave an official population
policy, people likeDr. Madrigal are
working to meet the challenge.
But in the meantime,human tragedies occur.
[Speaker 1:] I can't tell you what my name is,
or show you my face,or tell you the name
of the hospital we are in.
But I really wantyou to see this.
It's terrible.
This girl is AnnMarie, and she's
been here for about six weeks.
Laying very close to deathfrom an illegal abortion.
This is not a unique case.
We have more than 60,000cases like this a year
in this small country alone.
As a doctor, I feel that iffamily planning services were
more widely available, tragedieslike this would never happen.
[Joseph Julian:] The greatnumber of illegal abortions
throughout LatinAmerica, and the risks
taken by women who seekthem, is powerful proof
of the desire by thesewomen for a way to control
the size of their families.
Dr. Vernon Madrigal wantsthem to have an alternative
to butchery.
Among his many interestsis female sterilization.
[Dr. Madrigal:] This ladyis a 32 years old lady.
She has had sixchildren, ages from 11
I think to five years old.
And she has been takingpills in the last five years.
But she's so nervous.
She's so anxious, too,about the problem
that she decided to askus to sterilize her.
And we're doing it witha new method called
laparoscopic tubal ligation.
I am the grantee ofPathfinder, so we
are working for the [?] and Pathfinder
will provide the funds todo 300 tubal ligations
in one year.
OK.
[Dr. Madrigal switches between Spanish and English:] She isunder local anesthesia.
She's not undergeneral anesthesia,
which representsa great advantage,
because the lady can beoperated with local anesthesia
and then go home in four hours.
[Joseph Julian:] Dr. Madrigalgot his laparoscope
from the Pathfinder fund, anAmerican foundation concerned
with population indeveloping countries.
Along with Pathfinderand other groups,
the Agency forInternational Development,
AID, the largestsource of assistance
in funding in thefield, is helping
in an international assaultupon the most pressing problem
of the 20th century.
[Dr. Madrigal:] OK.
[People walking and conversing in Spanish]
[People walking and conversing in Spanish]
[People walking and conversing in Spanish]
[Bill Flexner:] Someplaces in El Salvador
are very difficult to get to.
But getting there is partof winning the battle
in health and family planning.
The nurse that I camewith came because there's
a problem of healthin the family.
After she tries toresolve this problem,
she will talk to the familyabout preventive medicine
and family planning.
AID is supportingher in this effort.
[Nurse presents to a group of children, speaking Spanish]
[Nurse presents to a group of children, speaking Spanish]
[Joseph Julian:] Sex educationis an important part
of the populationprogram in El Salvador.
In a few years,these children will
be in the primereproductive age group.
And then will have the knowledgeto make intelligent decisions
about family size.
[Spanish conversation]
[Man speaking Tagalog]
[Joseph Julian:] On theother side of the world,
the governor of aPhilippine province
spends 30 percent of his timetalking about family planning.
Like Dr. Madrigal,Governor San Luis
is convinced thatunchecked population growth
is the greatestthreat to his country.
[Music]
In the Philippines,one finds the problems
of El Salvador reflectedon a huge scale.
In 1970, the governmentestablished
a population policy.
The result?
In the short time,the Philippines
has developed a diverse,far-reaching
family planning program,
potentially one of the mosteffective in Southeast Asia.
With help frominternational agencies,
a large input from AID,and the energetic efforts
of Philippine officialsand volunteers,
the challenge isfinally being faced.
Is it too late?
No one can say for sure.
A traditionalagricultural economy
is giving way toindustrialization.
The country is in thethroes of a vast migration
from farms to cities.
Manila is overcrowdedand mired in smog.
And its Tondo slums areamong the worst in the world.
[Estefenia Aldaba-Lim:]Our statistics
show today that morethan 70 percent of our people
belong to the poverty line,
live within the poverty line.
I know for a fact that thereare 1.5 million families
in the Philippines who livebelow the subsistence level.
And with the presentgrowth rate of 3.1
of Philippinepopulation, you can just
imagine howdisastrous this would
be for the future of our socialand economic development.
[Doug Larson:] As a PeaceCorps volunteer here in
the Philippines, you seemany different developmental
projects.
And there are projects inagriculture, education,
infrastructure.
And yet all ofthese projects are
diminished because ofthe vast population
problem in this country.
So I feel as avolunteer working here,
it's been very rewarding to bein this kind of program that's
at the crux of the matter.
[Children singing]
[Joseph Julian:] Children tooare at the crux of the matter.
In a class onpopulation awareness
in elementary schoolin Cabanatuan City,
second-gradestudents play a game.
How many of them canfit into a limited space
before the overcrowdingbecomes unbearable?
How far can they be pressedbefore the game suddenly
becomes unfunny?
[Teacher speaking]
[Governor San Luis:] God created man andall the beings in this Earth.
And by nature,we're all selfish.
God has created us.
And it is one ofthe things that God
has given us in order thatwe should be able to survive.
So every man, bynature is selfish.
And in our familyplanning program,
we are exploiting theselfishness of man in order
that we can push throughour family planning program.
Why?
Because we know verywell that over and above,
the laws of God, thelaws of a society,
is they love the stomach.
Which is one of the expressionsof selfishness of man.
They love the stomach.
So if you go to the barriosand tell the people there
in the barriosabout, oh, you can
help the world, your countryby embracing family planning,
they would not listen to you.
But you tell them you help,if you embrace this family
planning program, you'dbe helping your children,
in order that they willnot be undernourished.
In order that they willbe able to go to school
so that you can give them ahigher degree of education.
It would be a veryeffective way.
Much more effective.
And that is whatwe are learning.
[People walking and calling out to others]
[Joseph Julian:] When Governor SanLuis began his family planning
programs in Laguna,he met resistance
from the Catholic Church.
Now the ResponsibleParenthood Council,
a Catholic organization,is working on population.
Volunteer couples visitpeople in their homes
to discuss the rhythm method.
In Kavita province,Commander Borgia and his wife
have made more than50 such visits.
How are they doing?
Pretty good, says the commander.
So far, nobody's pregnant.
[Woman speaking Tagalog]
[Background conversation]
[Joseph Julian:] The home visitapproach to family planning
has no national boundaries.
[Background conversation]
In the mining town ofBomi Hills in Liberia,
Phillip Quoiquoi has beena professional visitor
for four years.
In that time, he'scalled at house
after house on behalf of theFamily Planning Association
of Liberia,explaining to parents
how they can restrict thesize of their families.
Later, many of thesepeople have shown up
at the Bomi Hills Clinic, whichdispenses a large assortment
of birth prevention devices.
[Music]
Liberia has a relativelysmall population
and is not yet embroiledin a population crisis.
But the infantmortality rate here
is high, and mother-child health care is
below an acceptable standard.
[Music]
Though the government has noofficial population policy,
the Family PlanningAssociation of Liberia,
a private group supportedby the International Planned
Parenthood Federation, suppliesfamily planning services
for those who wish them,emphasizes the health
and welfare ofmothers and babies,
and instructs women on theproper spacing of children.
[Music]
[Health worker at desk speaks to a mother about infant formula]
[Health worker:] Three scoopsof [?] in here.
You fill it up.
Water up to six ounces.
That's how much ababy's supposed to have.
Now make sure thewater is boiled.
And before you come to feedthe baby, you wash your hands.
[...]
[Joseph Julian:] Mr WilliamHill, Administrative Secretary
of the Family PlanningAssociation of Liberia,
came to theUniversity of Chicago
to study advanced techniquesin population communications.
Mr. Hill's trainingin Chicago is
part of a huge effortin manpower development
essential to the worldwidepopulation movement.
Over the next 10years, the movement
needs more than 50,000physicians, 150,000 nurses,
100,000 health and familyplanning home visitors,
thousands more medicaland social workers,
health and family lifeeducators, demographers,
behavioral scientists,
and communications and training experts.
[Man holding camera: If it's a face,if it is a front-face,
you should have theeyes in the middle.
[...]
[Joseph Julian:] India.
After mainland China, the mostpopulous country on Earth.
Over half a billion people.
If the growth rateis not checked,
there will be morethan a billion people
by the year 2000.
The effort herehas been enormous.
The oldest and one of thelargest official
family planning programs in the world.
20 years of labor by hundredsof thousands of people.
The goal?
Lower the birthrate by 40 percentover the next 10 years.
In India, they use thecafeteria approach,
making a wide range ofbirth prevention methods
easily available.
Sterilization, intrauterinedevices, condoms,
and other conventionalcontraceptives,
including pills in selected projects.
However, sterilization isthe mainstay of the program.
In the city of Cannanorein Kerala state,
one of the great innovationsof the Indian effort:
a vasectomy camp, anintensive campaign
to perform more than 15,000operations in 30 days.
[Bernard Coehlo:] This iswhere all the people come
for the vasectomy operation.
[People talking]
[Coehlo:] Now wego to the control room.