May 6, 2013

Melinda Gates is Throwing Away Billions and Calling it Charity

  Late last week Queen Jennifer sent me an article about Melinda Gates. The article is quite positive about how Melinda Gates is going to spend billions and thereby save millions of lives. Other articles are more measured, but warn that there will be 'push back'.
  Now, why would there be push back against a plan that, we are told, will save 'millions of lives'? What will these billions be spent on?
  Those billions are going to be spent giving birth control to women in the developing world. That's right, birth control.
  Please keep in mind that the United Nations Population Fund is already currently spending $1.7 billion a year on birth control and other population control measures. And that the United States spends about $750 million a year on the same goal. As well, every member of the OECD spends tens to hundreds of millions on population control measures (largely by providing birth control) for the developing world. Finally the IMF and World Bank both have their own budget to provide birth control to the developing world and typically make their economic assistance and loans contingent upon the countries receiving aid implementing internal birth control programs.
  In other words, the major governments and NGO's of the world are already spending billions on this very project, just as they have been for 40+ years. Why? well, until the 1990's the stated rationale was that the world was facing the spectre of catastrophic overpopulation. In additions to the tens of billions spent on birth control the period between the 1960's and the 1990's also saw mass sterilization campaigns (often forced on women against their will) and programs with stiff fines, prison, and more targeted at reducing birth rates. Since the demographic research of the 1990's proved that demographers of the 1970's were correct and that there never was a risk of catastrophic overpopulation the rationale has been changed to be that contraceptive use is 'good for women'.
  As mentioned in one of the articles linked above, some studies claim that 'contraceptive use is good for women's health'. Considering that the Gates Foundation wants to promote the use of depo-provera (which has side effects ranging from rash to hemorrhage and is known to cause increased risk of hypertension, stroke, heart attack, and cancer, is known as a direct cause of bone loss, may cause infertility and that children born of depo-provera users are low weight and twice as likely to die in their first year of life - and it may cause withdrawal symptoms similar to an opiate) and Sino-implant (II), a system that hasn't finished clinical trials and is not cleared for use by the World Health Organization, it is hard to defend the argument that providing these drugs to women is going to improve their health. This may be why the Gates Foundation also plans to spend billions developing new birth control implants, including, possibly, what is in effect a life-long cybernetic implant. Again, it is unclear how the expenditure of vast sums on the possibility of a birth control solution that requires surgical implantation and is then a life-long accessory is 'improving women's health'.
  The Gates Foundation, and many others, also argue that contraception 'improves the lives of women' and point to a handful of studies that purport to prove that women who use contraception are healthier, better educated,  and wealthier than their neighbors who do not use contraception. The article linked above from Business Insider lists one of the most often cited study that makes these claims, Joshi and Schultz' study 'Family Planning as an Investment in Development' which is an analysis of data collected in Matlab, Bangladesh over a period of 35 years. The Joshi-Schultz study is a favorite amongst groups like the Population Reference Bureau and other NGOs that advocate for increased birth control aid for developing nations. This should be obvious since the study claims that women in the Matlab district who use birth control have an average of 1 less child (5 instead of 6) and also have a higher (healthier) BMI, their homes are worth more, they have more land, are better educated, have daughters with a healthier (higher) BMI, and her children are much more likely to be vaccinated.
  That sounds pretty amazing, doesn't it? As you may well imagine, this study is a powerful tool in the hands of people who want to promote giving birth control to the developing world. After all, if giving women depo-provera can make them wealthier, healthier, and get their kids vaccinated why would you oppose it?
  Unfortunately, the data the study is based on, the so-called Matlab Study, shows nothing of the kind, in the end.
  What occurred in Matlab was fairly straightforward; between 1976 and 1996 about half of the 150 or so villages in the district were part of an outreach program where advocates went door-to-door offering birth control: the other half of the villages did not receive visits. At the end the women were compared, one group to another, and the women receiving birth control advocacy were wealthier and healthier. Thus says the abstract.
  But once you dive into the actual study itself (downloadable at the link provided) you learn a very different story. The 'Community Health Workers' that traveled door-to-door were "...women from... ...influential families in the villages, married, with 8 or more years of education, and who used contraception themselves." In other words, the women walking door to door urging the other women to use birth control were the wives of the village chiefs, etc., wealthier, and more educated. This is a fair amount of social pressure to conform and was obviously an attempt to influence women to emulate the wealthy  women of influential families.
  The study also very clearly states that offering birth control was not all that these Community Health Workers and their peers did. The study tells us that the outreach program included the following programs - pre- and post-natal healthcare for the mother and babies; inoculations of the mother and all children she had; oral rehydration therapy for children suffering from diarrhea; training of midwives; and training for the men about the creation and use of ponds for aquaculture, improved farming techniques, and other methods of improving crop yields and generating additional cash from the sale of produce.
  Now, some of these programs were extended to all of the villages of the region, but only well after more than half of the study was done. In other words, Joshi and Schultz are claiming that when you offer 1/2 of a region vaccinations, health care, training, education, and birth control and do not offer them to the other half the reason that the women and children from the first half are healthier and wealthier is because they had access to birth control!
  It is obvious from the actual studies that what made the women from the first half of Matlab healthier was health care, which should surprise no one. Also, training farmers how to improve their farms made them more successful - also not a surprise. Further, vaccinating children means that children are vaccinated. It actually doesn't tell us much about birth control other than if women use birth control they tend to have fewer children.
  This is also not a surprise.
  Another obvious fact that can be gleaned from Matlab and the rest of the world is that if Melinda Gates really wanted to help women she wouldn't be spending billions of dollars duplicating the efforts of the largest governments and NGOs in the world, she should be spending it on oral rehydration, training farmers, and other things we can actually prove make women and children healthier and wealthier.
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