When I heard about the seven billionth baby born somewhere in the world, I wondered if it might be Vishnu Maya's grandchild.
I met Vishnu Maya on my first week of public health work in Nepal. I had arrived in one of the many remote rural areas of the country to lead a small health team, and had been called to the home of a sick child. The little boy was about a year old, lying on a mat on the porch. He was pale, with his eyes rolled back, breathing in rapid, shallow grunts, unconscious. I was a nurse, and one thing that I'd learned in working with children is how to recognize when a child is seriously ill. This was a very sick child -- I realized that this baby could likely not be saved even if we had an ambulance waiting to whisk him away to a pediatric emergency room, lights and sirens announcing the importance of his little life. But there was none of that, not even a road in this rural area.
I looked him over and asked the basic questions about what had happened, but gleaned no hope that there was anything I could do to help. I took at deep breath and said gravely to the father, "He is very sick."
"Will he die?" was his response.
Before I could answer, I looked up to see the baby's mother, Vishnu Maya, coming towards me. She was a small woman in her late 30s and she was weeping, wiping her eyes with her sleeve. Her look of anguish was combined with despair and anger -- despair because she didn't have to be told that her child was dying. Anger because, as it turned out, this was the second child she had lost.
She began a litany of what she had suffered, and even though with my rudimentary Nepali I didn't understand the details, I was clear on the sense of them. She wailed that she could not go through this again. She had seven children still alive, and that was enough. Was there not something she could do to not have any more? "Pariwar neojan" was a national slogan then in Nepal -- plan your family. Could I help her do that? If I couldn't save her baby couldn't I help her with that one thing so she wouldn't have more children, just to see them die? I took the mother's hand, struggling in vain to find the words in Nepali for "I am so sorry," hoping that she could see that I understood her pain. She continued to cry, more softly now, and then went off to sit by her baby son.
I left her there, weeping. The next day we heard that her baby had died during the night.I will never forget Vishnu Maya. Meeting her was my first experience of the struggles women face when they are totally unable to plan or space their children. Childbearing is a blessing, but when the mother is too young or too old, or when the births are spaced too closely together or are too many in number, there are real risks for the health of both mother and baby. And when combined with deep poverty, the results are often disastrous. I knew that the poverty of families like hers in Nepal was very close to the worst in the world. But the cause of her pain was not just lacking the means to buy food, clothing, and other essentials. It was having no power over what she could and could not do. She was among the most powerless people I could imagine: low in status as a Nepali woman, uneducated, a member of the untouchable caste, in one of the poorest countries of the world. She had virtually no control over her life, her choice to reproduce, her ability to keep her children well.
And that is, to me, the lesson of the seven billion. Although birth rates have reduced substantially in Nepal since I was there, there are still millions of women like Vishnu Maya all over the world. If those women had genuine options in their childbearing and in their lives, we would not be facing the seven billionth birth this month. The Guttmacher Institute estimates that at least 225 million women globally don't want to become pregnant but have no access to contraception. Providing that access -- whether to modern methods or "natural" ones -- is an avenue to changing their lives. Other approaches are important too: for years we have known that the education of girls gives the women they become a voice in their household that surpasses any other single intervention. Another part of the solution is women's empowerment, promoting activities such as helping women develop economic independence or run for political office; a wide range of groups such as the United Nations Population Fund and the international nonprofit ActionAid are taking this approach.
We know what works. We also know that every new baby would grow up to have enough food if global resources were not so skewed. The real human disaster is lack of concern for the rights of women and the poverty that much of the world endures. On the Vishnu Mayas of the world lies the burden of those seven billion.