May
2, 2013 - CAIRO — More than two years after the Egyptian uprising, the
country’s new Islamist government has struggled to confront a drop in tourism and the faltering economy. But the leadership has remained silent
about another crucial indicator that has surged to a 20-year high: the
country’s birthrate.
In fact, officials have avoided public discussion about
population and dropped the awareness campaigns of the past, in an early indication
of how the Islamist leadership is approaching social policy in the most
populous Arab state.
After two decades of steady declines and modest
increases, the birthrate in 2012 reached about 32 for every 1,000 people —
surpassing a level last seen in 1991, shortly before the government of the
longtime president, Hosni Mubarak, expanded family
planning programs and publicity campaigns to curtail population growth that he
blamed for crippling Egypt’s development. Last
year, there were 2.6 million births, bringing the population to about 84
million, according to preliminary government figures.
The new government of President Mohamed Morsi has continued
financing for family planning programs. But health officials have taken a
starkly different view of climbing birthrates, presenting the problem as one of
economic management — not the size of the population. Population experts are
increasingly alarmed by the government’s silence and its lack of focus on the
issue.
“The birthrate is important. It is not right to ignore
the population problem,” said Hassan Zaky, a demographer who teaches at Cairo
University and the American University in Cairo. “Before, there was a clear
policy. Now, we don’t know where we are going. We don’t know the view of the
state.”
Government officials blame Egypt’s chaotic transition
for the lack of public discourse. But the shift in priorities also reflects a
longstanding critique by Islamists of Mr. Mubarak’s population policies. For
decades, the Muslim Brotherhood
and ultraconservatives chafed at Mr. Mubarak’s almost single-minded focus on contraception
and two-child families as a core component of public policy. Mr. Mubarak used
family planning — a foreign imposition — to mask the government’s failed
strategies, some Islamists said.
“The real problem is with us, as an administration,”
said Hamid al-Daly, a representative of the ultraconservative Nour Party and a
member of the health committee in Egypt’s upper house of Parliament. “The
population in China is over a billion, but there is good management and good
utilization of resources. The population is a blessing if we use it well, and a
curse if we mismanage the crisis.”
Many public health workers agree that Mr. Mubarak’s
approach, which was backed by international aid donors, was never a solution on
its own. But they said the current government’s silence on the population
threatens only to make the situation worse.
“No one is saying we should concentrate only on family
planning, or only on development,” Mr. Zaky said. “We need a mix. We don’t want
the new regime to focus on one thing.”
Over decades, Egypt’s climbing birthrates have helped
choke its cities. Fertile land along the Nile disappeared under new buildings,
as Egyptians crowded ever more tightly together on the tiny percentage of the
country that the government bothered to develop. Egyptians chastised their
leaders with taunts that illustrated the crisis: While presidents dressed in
the latest fashions, “we live seven to a room,” a chant went.
The state’s formal role in family planning began in the
1960s under President Gamal Abdel Nasser. In the late 1970s, the United States
Agency for International Development became the main supporter of family
planning programs in Egypt, spending about $1.5 billion on population and other
health programs over several decades. Efforts to rein in the birthrate
intensified after 1994, when Egypt hosted an international conference on
population and development.
Thousands of primary clinics were built around the
country, providing family planning and other health services that were credited
with decreasing the fertility rate as well as maternal and infant mortality
rates. The outreach efforts of that period included advertisements on state television
and banners on Cairo streets — with slogans like, “Before you have another
baby, secure its needs.”
Dr. Nahla Abdel-Tawab, the Egypt director of the
nonprofit Population Council, said of the Mubarak years: “The president himself
used to talk about population increases. It was in the newspapers, in the prime
minister’s speeches.”
Now, population has seemed to vanish from public
discussion. Health workers said they were stunned when Dr. Abeer Barakat, an
assistant minister for health who is responsible for family planning, made no
explicit mention at a United Nations conference in December of population or
family planning in describing the Health Ministry’s priorities.
In an interview on Thursday, Dr. Barakat said she had
simply been trying to inject balance into the debate about population and
planning, to reflect the new government’s priorities. “What was shocking for
them was that I talked about family health, and family planning as part of
family health,” she said.
Dr. Barakat, a former official in the Muslim
Brotherhood’s political wing before joining the Health Ministry, said she was
seeking to redress imbalances in the previous government’s approach to health
care. Mr. Mubarak, she said, “was biased” toward family planning and ignored
urgent concerns like cancer and hepatitis C.
And while she said that family planning programs would
continue to be a part of health policy, she also said the government should
play no role in encouraging families to limit the number of children they have.
“Assigning a number is against reproductive freedoms, and against human
rights,” she said.
“They are not rabbits, to stop giving birth,” she said.
“Manpower is a treasure.”
Among the members of a large family in Greater Cairo,
the new government’s approach is more popular than Mr. Mubarak’s.
Mohamed Rabia Ali, 62, a construction worker who lives
with seven members of his family in a cramped apartment, said that Mr. Morsi
could establish new communities in the desert to alleviate the housing crisis,
and focus on providing more jobs for young people. The government does not need
to tell Egyptians how many children to have. “The creator takes care of the
created,” he said.
But for the moment, grand development plans that could
alleviate overpopulation have taken a back seat as the beleaguered government
focuses on keeping the lights on and feeding its citizens. “The primary issues
are food and security,” said Dr. Atef El Shitany of the state-run National
Population Council. As a result, he said, the political commitment to
population issues “is decreasing.”
In the meantime, experts are trying to determine
whether the latest birthrate spikes represent a reversal of Egypt’s long-term
trends, including declining fertility rates. They are working in the dark
because the uprising delayed Egypt’s most comprehensive demographic survey. The
birthrate had started to creep up during the last five years of Mr. Mubarak’s
rule, as fertility rates held steady.
The latest population spikes could represent behavioral
shifts resulting from the revolution, “because people are under pressure,” said
Hisham Makhlouf, who teaches demography at Cairo University.
“That’s one theory,” he said. “The other is that it’s because no one talks about the population problem like before.”