A Sign that Family Planning is Desperately Needed

This is what happens when a school system can't keep pace with the vast numbers of students that must have an education: half of the classes come to school in the morning and then leave at noon, while other students come into the same classrooms in the afternoon and study for the rest of the day. Resources are strained to the breaking point, students are crowded together, and educators are forced to go above and beyond the call of duty on a daily basis.

This type of situation will feel like a familiar nightmare to anyone reading this that sends their child to one of America's financially strapped public schools. However, it's not a nightmare, but a terrible reality.

It is now Government of Rwanda Policy that students of all grades study in shifts in Primary School. The reason for this is compounded by historical underinvestment in the education sector. However, the driving force today -- a time when government is investing in the sector -- is Rwanda's rampant overpopulation crisis. Since as far back as the 1920s, Rwanda has had one of the highest population growth rates in the world. These days, an average Rwandan woman will give birth six times -- in large part due to a lack of adequate family planning options, including education and contraception.

That population burden is impacting schools on an increasing basis. Prior to this school year, this type of 'education in shifts' only occurred in classes up to grade three. With a new government push (which should be applauded) to increase enrollment levels, the floodgates have opened. However, the sheer numbers of students that come to primary schools are choking the Rwandan education system.

This problem is a perennial one for Rwanda, but it has been exacerbated by several years of tragically bad U.S. policies (not to mention those of other nations as well) which have led to the problem Rwanda faces now. Despite suffering a staggering 15 percent population loss during the 1994 genocide, Rwanda's traditionally high population growth has swiftly brought its overall population to levels far above 1994's. Today, Rwanda has one of the highest population densities in the world and an average per capita income of only $280 per year. Fewer than twenty percent of Rwandan women have access to family planning methods, and Rwanda's population of 10 million is scheduled to double by about 2032.

Rwandan President Paul Kagame has prepared a major initiative to address Rwandan's population problem and to reduce Rwanda's birth rate by at least half. This will be a challenge, and his efforts must be supported. Abortion is illegal in predominantly Catholic Rwanda, but even the Church has recognized that overpopulation threatens to derail much of the positive developments in this country. The Rwandan Church has taken a place at the table with Government of Rwanda and other stakeholders to develop a plan for engagement on population growth that includes family planning education and the promotion of contraception, including condoms. This last action has the ancillary effect of helping to prevent the spread of HIV/AIDS and other infections.

Until this past week, the United States had excluded funds to any group that offered abortion services or which lobbied for abortion rights, even if they were not engaged in abortion services abroad. The downstream result over the last decade has been lower availability of contraceptives (and of course, an increase in childbirth, which costs the world 500,000 women's lives every year). A 2005 survey of Rwandan women found that 59 percent wish to space or limit their births, even though they currently have no access to effective contraceptive methods.

The so-called gag rule has been a tragic mistake in the real world, especially in Rwanda. For example, 1/3 of PEPFAR funds have gone toward abstinence and fidelity programs which may have been ideologically desirable to the previous administration, but which have been deadly in their unintended-though-real promotion of new HIV/AIDS cases. The imposition of the gag rule has also meant that Rwanda's population, which is already prone to accelerated growth, did not receive the level of support for family planning that is warranted and essential.

That could now change. The most exciting development of the first week of the Barack Obama Administration when viewed from here in Rwanda is the removal of the gag rule. This means that in this country committed to women's health, there may be a major expansion in family planning services supported by the US, led by the government.

The willingness of the Government and the Catholic Church to work together on finding a solution to rampant overpopulation should be signal enough that the US should no longer be standing back, or obstructing progress on this issue. I've said before that health care cannot be addressed adequately without tackling the overall economic context in which it takes place, and population growth is a crucial component of that context.

America is experiencing the change made in campaign promises, and that change will thankfully extend beyond U.S. borders. Change of U.S. policy gives Rwandans the ability to enjoy the fruits of their labor. If we can halt overpopulation, we will have a partner in a healthier Rwanda with smaller families, higher per-capita income, and children who have access to the education and future they deserve.