# data[].attributes.headline
India Tries Using Cash Bonuses to Slow Birthrate

# data[].attributes.subject
India Tries Using Cash Bonuses to Slow Birthrate

# data[].attributes.body
http://www.nytimes.com/2010/08/22/world/asia/22india.html?pagewanted=all

# data[].attributes.headline
Pope Francis opposes population control in speech praising UN climate agreement

# data[].attributes.subject
Pope Francis opposes population control in speech praising UN climate agreement

# data[].attributes.attachment_link.readable_text
Lisa Bourne

ROME, Italy, October 18, 2017 ( LifeSiteNews) - On the eve of an international symposium on the threat of population control, Pope Francis denounced the artificial altering of the human population as a counterfeit answer for addressing hunger.

Speaking about possible options to deal with a rise in world hunger, the pope called the case for population control a "false solution," the Catholic Herald reported.

Addressing the U.N. Food and Agriculture Organization on Monday for U.N. World Food Day, Francis said the answer to a UN-reported global increase in hunger was not to reduce the world's population but instead to better manage the Earth's resources and prevent waste. He called for a new model of international cooperation that integrates love, fraternity, and solidarity into responding to the needs of the poorest.

The pope's denunciation of population control came as the first of its kind online international population control conference was set to kick off, with a dozen experts poised to make presentations on the evils of population control and how some of its biggest proponents have gained access to the Vatican under the guise of poverty reduction and environmental protection.

The International Conference on Population Control opened Tuesday, running for three days through Thursday, October 19.

It was organized and is presented by the Lepanto Institute.
Find more coverage of the International Conference on Population Control here.
Symposium presenters are addressing population control basics, detailing various ways that population control is being pushed on developing countries via foreign aid programs, identifying major players behind the agenda and showing how some forces within the Catholic Church are cooperating with that agenda.

The problematic role that the U.S. government's foreign aid programs play in population control efforts overseas - and the ways in which the U.S. bishops benefit from those aid programs - is one of the issues covered by the population control conference.

Another matter addressed by the conference is the bewildering nature of the inexplicably close relationship between population control dogmatists and the Vatican - ironically underscored by the pope's condemnation of population control before the UN group on Monday.

In the same address where he was critical of population control, Pope Francis also gave the controversial Paris Climate Accord as an example of action that could be taken to fight so-called global warming based upon science.

Climate change - or global warming - remains the subject of contentious debate. Proponents allege consensus in the scientific community - even as some scientists dispute the theory - and with critics warning its real agenda advances abortion and population control and threatens the sovereignty of nations.

Pro-life and family advocates have denounced the Paris Climate Accord for its backdoor promotion of abortion and contraception.

On Monday before the UN group, the pope also appeared to take a veiled shot at the U.S. and President Donald Trump, who announced in June that the United States would withdraw from the Paris Agreement - by lamenting how "unfortunately some are distancing themselves from it."

Pope Francis has sent conflicting messages by regularly partnering with radical environmentalists and population control advocates within and outside the UN.

The Vatican has also hosted a number of conferences addressed by population control advocates, typically under the pretext of climate concerns. The latest is scheduled for early next month.

The Holy See, however, has clarified that it opposes any interpretation of the UN's Sustainable Development Goals ( SDG s) - to "end poverty, protect the planet and ensure prosperity for all" by 2030 - that could be used to support abortion, contraception, population control, or gender ideology.

The remaining live sessions of the International Conference on Population Control run from noon to 4 p.m. Eastern time on Wednesday and Thursday.

Conference attendees will have the ability to submit questions to presenters.

Registration is free and available online, with continued access to the presentations available for a limited time after the close of the conference and unlimited access with a subscription.
​

# data[].attributes.attachment_link.title
Pope Francis opposes population control in speech praising UN climate agreement

# data[].attributes.attachment_link.description
Lisa Bourne ROME, Italy, October 18, 2017 ( LifeSiteNews) - On the eve of an international symposium on the threat of population control, Pope Francis denounced the artificial altering of the human population as a counterfeit answer for addressing hunger.

# data[].attributes.body
Maldives government "Allow Migrants

# data[].attributes.attachment_link.readable_text
(July 2017) The name of Maldives usually generates images of pristine beaches, marine wonders, and luxurious resorts and, as such, the country epitomizes the ultimate touristic destination. Nowadays, however, the Maldives are also in the news because of climate change and rising sea levels and its fragile environment is threatened by ominous global trends.

Maldives, located in the Indian Ocean southwest of Sri Lanka, encompass a large sea area with an Exclusive Economic Zone of 859,000 square kilometers. In this vast expanse, the emerged land area represents about 300 square kilometers, one third of 1 percent of the total country's area. There are close to 1,200 islands, grouped in 20 Atoll-systems or Administrative Islands. Among these islands, 187 islands are inhabited and another 128 islands are resort-islands (50 more resort- islands are being developed). The capital city of Male', which is in the center of the country, is among the most densely populated urban areas in the world. In September 2014, 129,381 persons (38 percent of the total resident population in Maldives) were living in Male' on two square kilometers.

In the past 30 years, the Republic of Maldives has experienced rapid economic and social change. ¹ First, its economy has grown impressively. The multibillion U.S. dollars' tourism industry, which started in 1972, is the main engine of this economic prowess. Currently, the country attracts 1.2 million visitors per year (one third of them come from China), and plans have been laid out to increase the number of tourists in the future. However, the economy is also supported by fisheries and services, and to a lesser extent by the agricultural sector. The economic growth, which had built up during the past four decades, has accelerated during the last 15 years. Maldives enjoy one of the highest Gross National Income (GNI) per capita in the South Asia region, as expressed in Purchasing Power Parity (PPP). ²

Concomitantly, the population of Maldives has almost completed its demographic transition-the shift from high birth and death rates to low ones. ³ As a consequence, the age and sex structure of the country has changed significantly. Today, with half a young dependent below age 15 for each active adult (ages 15 to 64), the country has opened its demographic window of opportunity and could possibly capture the benefits of a first demographic dividend (an economic surplus generated by changes in the age structure).

The results of the 2014 Population and Housing Census confirm this demographic picture. ⁴ The 2014 Census adopted a de facto approach, which means that all people residing in the country were enumerated. The total population in Maldives at the time of the Census in September 2014 was 402,071 people. The Census enumerated 338,434 resident Maldivians and 63,637 resident Foreigners, about 16 percent of the total resident population in Maldives (according to administrative records, however, foreigners have been significantly undercounted). The 2014 Census findings highlight the issue of immigration to Maldives: Foreigners come mostly from India, Bangladesh, and Sri Lanka, and work essentially in the tourism industry and the construction sector. Last but not least, the 2014 Census also pointed to the weight of the youth-47.5 percent of all resident Maldivians are less than 25 years old.

The Government of Maldives last addressed population and development issues in its 2004 Population Policy of the Maldives, as well as in its national development plans (NDPs). ⁵ These documents are now in disuse. The 2007 Seventh National Development Plan (2006-2010), which was renamed the Strategic Action Plan 2009-2013, was the last NDP to be released. The Seventh NDP discussed in more details the population and development "consolidation policy," whereby the Government elicited voluntary migration in order to regroup scattered populations in larger and more economically viable entities. This is necessary to save costs on the delivery of services (education and health) and provide better job opportunities. In addition to population and development policies, the Government had also adopted sectoral policies, including a Health Master Plan (a new one is being prepared), two youth strategies, several reproductive health policies, and a national gender strategy.

Current Government policies, as spelled out in the Election Manifestos (documents outlining the programs of political candidates), call for the creation of 94,000 new jobs in Maldives between 2013 and 2018. These policies also favor the migration of a large portion of the population (up to 100,000 people) to the Greater Male' Area. These migrants would settle mostly in Hulhumale', an island adjacent to Male', where land has been reclaimed. The government is implementing infrastructure, housing schemes, new hospitals, and industrial development projects in Hulhumale´ and other nearby islands. The focus is to attract the youth population to Hulhumale', which has been labelled a 'Youth City'. The Government has also launched the construction of a bridge between Male' and Hulhule (where the international airport is located and will be expanded). In total, about two-thirds of the total population of Maldives could eventually be concentrated into six islands in the center of the archipelago. Foreigners will probably represent a significant proportion of this population.

There is no doubt that the country is entering a new, potentially promising phase of its socioeconomic development. Addressing Maldivian youth's human capital needs in education and health and managing internal as well as international migrations will help the country to take advantage of the new demographic trends and possibly capture a first demographic dividend. However, to achieve these goals, the Government will need to give the highest priority to the training of Maldivians in order to give them, and not the foreign workers, the benefits of a potential demographic dividend.

John F. May is a Visiting Scholar at PRB and Fathimath Riyaza is deputy statistician for the National Bureau of Statistics in Male', Republic of Maldives.

References

1. John F. May, 2. Toshiko Kaneda and Kristin Bietsch, 3. May, 4. Republic of Maldives 5. May, Maldives' Population Dynamics: Policy Prospects for Human Growth and Opportunity (Male': UNFPA Maldives Country Office and Ministry of Finance & Treasury, National Bureau of Statistics, 2016).
2016 World Population Data Sheet.
Maldives' Population Dynamics.
Population & Housing Census 2014. Statistical Release: 1 Population & Households (Male': Ministry of Finance & Treasury, National Bureau of Statistics, 2015).
Maldives' Population Dynamics.

# data[].attributes.attachment_link.description
(July 2017) The name of Maldives usually generates images of pristine beaches, marine wonders, and luxurious resorts and, as such, the country epitomizes the ultimate touristic destination. Nowadays, however, the Maldives are also in the news because of climate change and rising sea levels and its fragile environment is threatened by ominous global trends.

# data[].attributes.body
National and international development policies may also have an impact on human population dynamics.

# data[].attributes.attachment_link.title
Demographic Destiny: What Will the World Be Like in 2050?

# data[].attributes.attachment_link.description
The year 2050 is right around the corner, and yet it​ is hard to imagine the sweeping changes the world will confront by then. In a multimedia series, The Wall Street Journal helps readers ​envision how we will work, how we will age and how we will live.

# data[].attributes.attachment_link.title
Dubai's Kids Now Worth Their Weight (Loss) in Gold

# data[].attributes.attachment_link.description
The Dubai Municipality launched the "Your Child in Gold" initiative during Ramadan which will give kids gold to lose weight

# data[].attributes.headline
Policies to Address Population Growth Nationally and Internationally

# data[].attributes.subject
Policies to Address Population Growth Nationally and Internationally

# data[].attributes.attachment_link.readable_text
Populations: Policies to Address Population Growth Nationally and Internationally
Background
Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet. On the other hand, modern medical techniques are producing life extension but not healthy life extension, and we are seeing numbers of old and chronically sick or disabled elderly people in increasingly longer economically unproductive retirements, who need consequentially increasing numbers of younger people to support them.

The ability of the Earth to sustain the human population, posed by Malthus over 200 years ago, is a serious question. Dependence on finite resources for energy and water is already threatening international stability. Potentially exponential population growth can only make matters worse. Improving economic development in the most populous countries of the developing world (India, China) is leading to changing patterns of demand, as people seek more affluent lifestyles. Food and energy demands are increasing faster than had been predicted. Air quality resulting from over-rapid industrialisation is becoming a major problem that will have major public health effects. The likely determinants of climate change, usually attributed to the developed nations, are now spread throughout the developing world, making the ability of nations to achieve the targets signed-up to at Kyoto unlikely to be achieved. Religion is a significant factor in population growth: families in catholic families tend to be larger than protestant, and Muslim tend to be larger than others. In both class, the religion tends to relegate the role of women to the second class.
International Moves
In 1994 the United Nations Population Information Network (POPIN) organised an International Conference of Parliamentarians on Population and Development (ICPPD) and an International Conference of Parliamentarians on Population and Development (ICPD) in Cairo . There was a shift in thinking recognized at Cairo, towards viewing population from a more humane and equitable perspective. The consensus document that was produced recognizes that consumption in wealthy countries and rapid population growth in poor countries put pressure on the natural environment, both locally and globally. The OCPPD group issued an agreed statement that included the following items:
We therefore commit ourselves, as elected representatives of the people, to do our utmost to remove all remaining barriers in our countries that inhibit access to family planning services, information and education, as well as to help support the provision of reproductive health and family planning services as widely as possible. We acknowledge the fact that abortions constitute a major public health concern for women all over the world. Since the use of family planning methods may prevent the prevalence of unplanned pregnancies, we call upon all national Governments to reduce the need for abortion by providing universal access to family planning information and services. The empowerment of women and the improvement of their political social, economic and health status are highly important ends in themselves. We further believe that human development cannot be sustained unless women are guaranteed equal rights and equal status with men. In this process women should be seen not merely as the beneficiaries of change but as the agents of change as well. This entails an enhancement of their own gender awareness. We believe that education is the single most important element on the road to equality and empowerment of women.
Rather than simply equating population policy with family planning, the new thinking is that population growth should be stabilized - and development enhanced - by attacking some of the roots of the problem: by improving women's access to education, health care, and economic and political decisions.

Today, more than half of all developing countries have national population policies, and about 130 national governments subsidize family planning services. When polled by the UN in 1994, 91 percent of the countries that lacked national population policies stated that they intended to formulate them in the near future, reflecting a rising global commitment to population-related concerns. But national policy statements do not necessarily translate into program implementation.
Examples from various cultures
China has operated a one-child policy for a number of years, enforced though a system of fines, relaxed after mass bereavements such as Sichuan Earthquake; the focus of China on population control helps provide a better health service for women and a reduction in the risks of death and injury associated with pregnancy. At family planning offices, women receive free contraception and pre-natal classes. Help is provided for pregnant women to closely monitor their health. Culturally, traditional religious practice requires a son to perform the parents' funerals, leading to resistance to the policy in some rural areas when the first-born is as girl.

Growth has indeed slowed, yet during 1996 China added 13 million people to its numbers. Rural folk have been less cooperative; however, the one-child policy has achieved statistical wonders. In one generation, China's birth rates have plunged to 1.9 children per mother - a rate that, if sustained, will lead to depopulation.

According to a recent survey, ethnic minorities are currently growing about 7 times faster than Han Chinese.

The decline in population growth rate has exacerbated another problem familiar in the West: rapid aging. There will be 129 million Chinese over the age of 60 as of the year 2000. By 2020, one in four will be elderly (twice the total present population of the United States) - a rare burden for a low income country.

The sex ratio at birth (between male and female births) in mainland China reached 117:100 in the year 2000, substantially higher than the natural baseline, which ranges between 103:100 and 107:100. This suggests differential abortion if the sex is known antenatally?

India operates a two-child policy. During 1970s they used forced sterilisation of the poor. India has greatly increased food production per head over last 20 years, making it better placed to absorb higher numbers. The country's most recent approach to population issues focuses on the advancement of women economically, academically, and socially, as independent women are more likely to have small families.

Africa: birth rates in Africa are the highest in the world. By the year 2050, twenty percent of the world's population will live on the African continent. That will be almost two thousand million people, up from eight hundred fifty-five million people today. Especially large population growth is expected in Nigeria, Ethiopia and the Democratic Republic of Congo. Other countries likely to have major growth include Burkina Faso, Mali, Niger, Somalia and Uganda.

Kenya was the first country in sub-Saharan Africa to view runaway population growth as a serious impediment to economic prosperity, and it became the first, in the late 1960s, to begin developing a national family-planning campaign. The country's official population policy calls for matching population size with available resources, yet leaves decisions on family size up to individual families.

As recently as 1970, Africa was essentially self-sufficient in food. What fostered a breakdown in the continent's ability to feed itself has been a decline of nearly 1 percent per year in per capita grain production since 1968 - in part due to an annual population growth for the continent approaching 3 percent.

The root cause of Africa's crisis, according to Worldwatch Institute analyst Lester Brown, is population growth faster than on any continent in history, widespread soil erosion and desertification, and a failure by African governments to adequately support agriculture.

Europe: by contrast, France offers financial incentives for larger (3 child) families. The population of Europe is also aging faster than any other part of the world, except Japan. Birth rates are also down in many European countries. The number of people depending on workers will rise as the number of workers falls. Spending in European countries will have to increase for retirement, health care and long-term care for old people in the future.

Russia faces the most severe population decrease of any country. The population of Russia is now one hundred forty-three million. It is expected to drop twenty-two percent over the next forty-five years. If this happens, Russia could lose more than forty percent of its active workforce and have economic problems. Part of the problem is the short length of time that Russian men generally live. The average life expectancy for Russian men is just fifty-eight years. Russian women live fourteen years longer. Men in Western Europe live sixteen years longer. Drugs, tobacco smoking and alcohol are some of the main causes of death among Russian men. Russia also has low birth rates.
http://www.voanews.com/specialenglish/archive [accessed 20 June 2008]

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty.
References
US Global Change Research Information Office, www.gcrio.org, Consequences Vol. 2, No. 2
Dru C. Gladney, "China's National Insecurity: Old Challenges at the Dawn of the New Millennium", Papers from "Asian Perspectives on the Challenges of China", Institute for National Security Studies, National Defense University, March 2000
© M Goodyear 2008

# data[].attributes.attachment_link.title
Policies to Address Population Growth Nationally and Internationally

# data[].attributes.attachment_link.description
Background Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet.

# data[].attributes.body
The Big Indian Development Debate: Growth and / vs. Inclusion

# data[].attributes.attachment_link.readable_text
Once upon a time, many Indians, and many people in the rest of the world, believed that India was well on its way to become one of the next superpowers. In fact, this time was only a few years ago.

Since the era of liberalization in India began in earnest in 1991, the country has experienced consistent rates of growth of its gross domestic product (GDP) of around 6-7.5% p.a. and exceeded 9% in several years after 2005. For many years, India boomed. Well-known key drivers have been sectors such as information technology and services, for example the business process outsourcing (BPO) industry that established call centres for customers world-wide. India became a major destination for international investments, with German chemical companies, service (insurance) industries and car manufacturers prominent among them. Vice versa, Indian companies appeared seriously on the scene as international players, even in Europe: In an ironic twist to the old colonial relationship, the century-old Tata Industries bought British luxury car manufacturer Jaguar. Perhaps less fancy, but more sustainably, the Indian renewable energy multinational Suzlon (founded only in 1995, as a textile company with just 20 members of staff) bought REPower, a major German wind power turbine manufacturer.

"Incredible India" has remained not merely an advertising motto for the tourist industry, but seemed to suggest far larger perspectives. Expectations rose about India's international role and as a member of the BRICS group of leading emerging economies. Many believed that India appeared to be on China's heels; on a development path that was perhaps a bit slower than China, and certainly more chaotic, but nonetheless on the right path, and with India's democratic political system and its widespread use of the English language even having some strategic advantages over China.
India's Development Model in Crisis?
To be sure: All through the boom years, there have always been those in India - and this is by no means a small group - who did not subscribe to the beautiful narrative of "India Shining", the slogan with which the then governing Bharatiya Janata Party (BJP) went into the election campaign in 2004. Substantial groups of people have felt excluded from India's growth, or at least felt that they were unable to participate sufficiently. As a consequence, the electorate removed the BJP from power in 2004. The United Progressive Alliance (UPA) coalition, led by the Congress Party under Prime Minister Manmohan Singh, re-elected in 2009, has continued a liberalizing economic reform policy (though it is widely seen to have come close to standstill in more recent times), while adding important social security programs to it. The most prominent of these are the National Rural Employment Guarantee Scheme (NREGS) which has been implemented since 2006, and the recent passing of the Food Security Bill of 2013, which will provide heavily subsidised food grains to 67 percent of the entire population.

Today, however, with general elections expected for April or May 2014, the entire Indian development path suddenly appears to be in crisis.

There is an acute economic downturn: The GDP growth rate fell below 5%, the Indian Rupee lost 18% of its value against major foreign currencies since early 2013, and figures for manufacturing and foreign investment are going down.

There is a widespread perception of political stagnation: The UPA government is tainted by large-scale corruption scandals, and it appears to have lost the capacity to drive reforms - as shown most markedly by the furious conflicts resulting from a 2012 legislation that allowed international multi-brand retailers (such as Walmart and Metro) to enter India's retail trade.

And there is more fundamental questioning of the direction of the Indian development and growth path. Has India's economic growth been "inclusive"? Has it brought people out of poverty? And what type of development has growth - defined primarily as GDP growth - brought about?

The current economic downturn, brought about in part by international factors and affecting other BRICS economies as well, is likely to remain a temporary dent: Positive fundamentals of the Indian economy - such as its huge market size and the country's youthful demographic structure - remain valid, and a new government in power from mid-2014 is likely to have greater capacity to make strong economic policy decisions. Thus it is very probable that the economy will recover from its current slump, though it remains open (and will depend on economic and social policies undertaken) whether it will return to the high GDP growth rates of earlier years.
"Growth Matters" vs. "Uncertain Glory"
The third question, however, is far more difficult to answer, and it is extensively debated in India today. India is a country with a strong debating culture, and the vast number of print and electronic media contains much commentary on this every day. Four of India's leading economists recently published two books that are widely acknowledged to represent the two predominant positions in the ongoing big debate about development, growth and inequality in India.

Jagdish Bhagwati and Arvind Panagariya take a liberal (some may call it "neo-liberal") stance in arguing "Why Growth Matters". They maintain that economic growth - measured by GDP - constitutes the foundation for any meaningful development and the reduction of poverty. Only on the basis of fast growth, they say, redistributive reforms for poverty alleviation and human capital / capacity building become viable.

Bhagwati & Panagariya argue that India's economic growth since the 1990s has indeed substantially reduced poverty: The proportion of the poor population, according to Planning Commission figures, fell from 44.5 (1983) to 27.5 (2004-5) per cent; taking population growth during this period into account, they estimate that 187.5 million people have left the status of poverty (at least in its most extreme form) in the same period.[1] Bhagwati & Panagariya then identify persistent impediments to India's further growth: an inflexible labour legislation operating against the sizing-up of companies; the difficulties of land acquisition for public and private industries and housing; the poor state of public infrastructure, most dramatically so in the field of power supply.

While Bhagwati and Panagariya also argue for innovation and reform in the social sector, for example by favouring competition and privatization in the educational services, redistributive reforms constitute a clearly subordinate[2] rank in their list of reform priorities. Within India's current political spectrum, their position is broadly identified with (or seen to support) the BJP and its prime ministerial candidate for 2014, Narendra Modi, who as Chief Minister of Gujarat has overseen a rapid rise of industrial and export-oriented development in a state that many acknowledge to be well-governed and with low levels of corruption.

By contrast, Jean Drèze and Amartya Sen look at the Indian growth story of recent years as "An Uncertain Glory". Their overall perspective could perhaps best be called a "social-democratic" one.

For Drèze & Sen, India's main contradiction is the persistence of poverty combined with rising inequality, despite rapid economic growth. While the measurement of poverty figures in India remains notoriously difficult, it is clear that even using the same Planning Commission figures as Bhagwati & Panagariya (above), the absolute number of Indians in poverty has far less reduced than the high GDP growth may suggest, if at all. At least 270 million Indians remain in abject poverty, and many more millions are just beyond that threshold.

In its record of poverty reduction, India falls far behind China, while at the same time, inequality has rapidly grown. A significant new middle class has emerged, even though its consumption is still on a substantially smaller scale than that of Western middle classes, with the motorcycle or small car, and perhaps a modern flat as the family home, forming the core of aspirations. A growing number of super-rich Indians has fuelled the societal imagination - and the scorn and anger of intellectuals. And beyond the pattern of inequality which is common world-wide, in India, traditions of cast oppression are even reproduced in the modern society and economy, even though they are countered by affirmative action policies that India has given constitutional guarantees to.

Instead of mere economic growth, Drèze & Sen see the developmental process primarily as the need to grow human capacity, and on the systems that enable and help to provide it: education, health, and social support services. They point to the severe deficits that make India risk wasting the "demographic dividend" it currently has: poor education (except in a few top-level institutions) as well as severe health and nutrition issues that, besides the death toll, make substantial parts of the population less productive than they could be.

Drèze & Sen stress the need for systematic government health, educational and social sector policies. For example, they strongly argue in favour of social support programmes such as NREGS, the cash-for-work programme which has been criticized by liberals for, among other reasons, its cost implications, but which in many parts of India has indeed led to rising incomes for poor rural people, especially for women. Drèze & Sen look positively at Kerala, a state in South India which has achieved a high level of human development (by investing in education and health) despite rather low GDP growth rates. Within India's mainstream political spectrum, Drèze & Sen are seen as standing closer to the Congress Party positions, though they likely would not want to be seen as supporting the current government directly.
More Debates, Loose Ends
The debate between India's master economists currently receives much public and media attention. It has become a slugfest that, at times, wrongly tends to reduce both sides to stereotypes: While Drèze & Sen are sometimes criticized as being "against growth" (which they clearly are not), Bhagwati & Panagariya are viewed as representing a kind of market extremism (whereas they clearly support well-designed social support interventions). Personal animosities have entered newspaper contributions by the lead authors themselves. Overall, however, the differences are more a matter of priorities in public policy. None of the two sides is seriously considering a radical turning away from the basic policy of liberalization and economic opening, but also social support for disadvantaged groups, which India has been pursuing for some years now. Neither of them also questions India's democracy as a possible source of inefficiency, delay, conflict and outright barrier to development - an argument that one may come across in India from time to time, though few would dare to argue this way in public.

Sometimes, the fight is also about the pros and cons of certain very practical policy propositions, informed in part by social and economic philosophy, but in part also by an impressive number of empirical research studies that are conducted to evaluate often very specific aspects of the problem. One such case is the issue of cash transfers for social support, a system that is just about to be expanded (as against the more traditional Public Distribution System that sells subsidized food to the poor on the basis of "ration cards"): Bhagwati & Panagariya in general prefer direct cash transfers to recipients as a means to ensure efficient distribution and to reduce corruption, whereas Drèze & Sen maintain that cash payments should not be introduced just to relieve the state from its duty to provide quality services. There are many more such debates. While the basic economic philosophies behind them are, of course, of a global kind, and while experiences from abroad are brought in sometimes (such as the conditional cash transfer schemes introduced in Brazil), the debates overall retain a thoroughly Indian flavour, and arguments about particular policies being applied (or rejected) elsewhere in the world do not feature very prominently.

Of course, the four master economists discussed here do not cover the entire spectrum of Indian public opinion on economic and social policy. There is a considerable political spectrum beyond them, especially on the left of Drèze & Sen, which remains fundamentally critical of the policy of liberalization. It views the opening up to international trade and investment as dangerous for the poor, as well as for India's capacity to pursue a sovereign policy. Some of these voices come from the traditional left, represented by different political parties who claim the term "Communist" for themselves; others represent a more modern, independent criticism of globalization that finds quite some support among civil society organizations, farmers' associations and movements etc.

Especially the latter groups can rightly point to one fundamental weakness of the lines of argument presented by both Bhagwati & Panagariya and Drèze & Sen alike: All these master economists, in their thinking about "development" and economic policy, have rather little to say about the agricultural sector. This is somewhat surprising in - but perhaps also characteristic for - a country where 70% of the population still lives in villages, and half of it is employed in the agricultural sector. Thanks to an irrigation-based Green Revolution strategy pursued in the Punjab and some other parts of the country since the 1960s, India today is largely self-sufficient with regard to its basic food needs. But the input-intensive Green Revolution-style agriculture is reaching ecological limits, while large parts of India's rural world are in distress, as agriculture remains rain-dependent, is apparently ever more affected by drought, and lacks marketing and extension systems, as well as policy support.

Overall, developmental thinking in India seems to view the rural world - at least once basic foods needs are secured - primarily in terms of a labour reserve, also noting that urban development in India already today struggles to cope with rural-urban migration. Indeed, a common criticism (voiced prominently by economists such as Jayati Ghosh) of India's economic development is one of a "jobless growth". In China and other East Asian countries, a large number of migrants were absorbed by a booming low-wage export-oriented manufacturing sector. Apart from a few exceptions, such as the Tamil Nadu garment industry, the same is not happening in India. In order to solve this problem, Bhagwati & Panagariya advocate liberalization of the labour market and a more export-oriented policy, all of which should create more industrial jobs; Drèze & Sen favour securing the survival of the rural world and relieving distress migration by means of the NREGS cash-for-work program. However, neither of them systematically addresses the development needs of India's rural world, and neither of them seems to have a vision for the future of rural India.

Another loose end is the question of sustainability. Neither Bhagwati & Panagariya nor Drèze & Sen take much notice of the environmental consequences of India's GDP-focused model of economic growth - and of the limits to growth that exist in terms of the use of resources such as land, water, clean air, etc. India is getting closer to its ecological boundaries, and some of them have already been overstepped in parts of the country. While environmental and rural activists (farmers as well as members of indigenous communities who live in mining areas) are pointing to these problems since many years, a more comprehensive questioning of the very fundamentals of a GDP growth-based model of economic development is only emerging recently, for example by Ashish Khotari. A debate on the "limits of growth" has not yet found many contributors in an India that, despite impressive GDP growth figures, continues to be confronted with mass poverty and growing inequality. Even India's master economists dominating the public debates around development would be well advised to take greater note of these limitations.
References:
Bhagwati, Jagdish & Arvind Panagariya, 2013. Why Growth Matters: How Economic Growth in India Reduced Poverty and the Lessons for Other Developing Countries. New York: Public Affairs.

Drèze, Jean & Amartya Sen, 2013. An Uncertain Glory: India and its Contradictions. London: Allen Lane.

# data[].attributes.attachment_link.title
The Big Indian Development Debate: Growth and / vs. Inclusion | Heinrich Böll Foundation

# data[].attributes.attachment_link.description
For more than a decade, fast-growing India appeared to be well on the path to become another superpower. However, a considerable part of India's population has remained poor; India's growth lacks social inclusion. The debate is not new, but it is gaining increased attention in the current economic downturn, with elections pending for spring 2014.

# data[].attributes.headline
Nine Population Strategies to Stop Short of 9 Billion

# data[].attributes.subject
Nine Population Strategies to Stop Short of 9 Billion

# data[].attributes.attachment_link.readable_text
Populations: Policies to Address Population Growth Nationally and Internationally
Background
Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet. On the other hand, modern medical techniques are producing life extension but not healthy life extension, and we are seeing numbers of old and chronically sick or disabled elderly people in increasingly longer economically unproductive retirements, who need consequentially increasing numbers of younger people to support them.

The ability of the Earth to sustain the human population, posed by Malthus over 200 years ago, is a serious question. Dependence on finite resources for energy and water is already threatening international stability. Potentially exponential population growth can only make matters worse. Improving economic development in the most populous countries of the developing world (India, China) is leading to changing patterns of demand, as people seek more affluent lifestyles. Food and energy demands are increasing faster than had been predicted. Air quality resulting from over-rapid industrialisation is becoming a major problem that will have major public health effects. The likely determinants of climate change, usually attributed to the developed nations, are now spread throughout the developing world, making the ability of nations to achieve the targets signed-up to at Kyoto unlikely to be achieved. Religion is a significant factor in population growth: families in catholic families tend to be larger than protestant, and Muslim tend to be larger than others. In both class, the religion tends to relegate the role of women to the second class.
International Moves
In 1994 the United Nations Population Information Network (POPIN) organised an International Conference of Parliamentarians on Population and Development (ICPPD) and an International Conference of Parliamentarians on Population and Development (ICPD) in Cairo . There was a shift in thinking recognized at Cairo, towards viewing population from a more humane and equitable perspective. The consensus document that was produced recognizes that consumption in wealthy countries and rapid population growth in poor countries put pressure on the natural environment, both locally and globally. The OCPPD group issued an agreed statement that included the following items:
We therefore commit ourselves, as elected representatives of the people, to do our utmost to remove all remaining barriers in our countries that inhibit access to family planning services, information and education, as well as to help support the provision of reproductive health and family planning services as widely as possible. We acknowledge the fact that abortions constitute a major public health concern for women all over the world. Since the use of family planning methods may prevent the prevalence of unplanned pregnancies, we call upon all national Governments to reduce the need for abortion by providing universal access to family planning information and services. The empowerment of women and the improvement of their political social, economic and health status are highly important ends in themselves. We further believe that human development cannot be sustained unless women are guaranteed equal rights and equal status with men. In this process women should be seen not merely as the beneficiaries of change but as the agents of change as well. This entails an enhancement of their own gender awareness. We believe that education is the single most important element on the road to equality and empowerment of women.
Rather than simply equating population policy with family planning, the new thinking is that population growth should be stabilized - and development enhanced - by attacking some of the roots of the problem: by improving women's access to education, health care, and economic and political decisions.

Today, more than half of all developing countries have national population policies, and about 130 national governments subsidize family planning services. When polled by the UN in 1994, 91 percent of the countries that lacked national population policies stated that they intended to formulate them in the near future, reflecting a rising global commitment to population-related concerns. But national policy statements do not necessarily translate into program implementation.
Examples from various cultures
China has operated a one-child policy for a number of years, enforced though a system of fines, relaxed after mass bereavements such as Sichuan Earthquake; the focus of China on population control helps provide a better health service for women and a reduction in the risks of death and injury associated with pregnancy. At family planning offices, women receive free contraception and pre-natal classes. Help is provided for pregnant women to closely monitor their health. Culturally, traditional religious practice requires a son to perform the parents' funerals, leading to resistance to the policy in some rural areas when the first-born is as girl.

Growth has indeed slowed, yet during 1996 China added 13 million people to its numbers. Rural folk have been less cooperative; however, the one-child policy has achieved statistical wonders. In one generation, China's birth rates have plunged to 1.9 children per mother - a rate that, if sustained, will lead to depopulation.

According to a recent survey, ethnic minorities are currently growing about 7 times faster than Han Chinese.

The decline in population growth rate has exacerbated another problem familiar in the West: rapid aging. There will be 129 million Chinese over the age of 60 as of the year 2000. By 2020, one in four will be elderly (twice the total present population of the United States) - a rare burden for a low income country.

The sex ratio at birth (between male and female births) in mainland China reached 117:100 in the year 2000, substantially higher than the natural baseline, which ranges between 103:100 and 107:100. This suggests differential abortion if the sex is known antenatally?

India operates a two-child policy. During 1970s they used forced sterilisation of the poor. India has greatly increased food production per head over last 20 years, making it better placed to absorb higher numbers. The country's most recent approach to population issues focuses on the advancement of women economically, academically, and socially, as independent women are more likely to have small families.

Africa: birth rates in Africa are the highest in the world. By the year 2050, twenty percent of the world's population will live on the African continent. That will be almost two thousand million people, up from eight hundred fifty-five million people today. Especially large population growth is expected in Nigeria, Ethiopia and the Democratic Republic of Congo. Other countries likely to have major growth include Burkina Faso, Mali, Niger, Somalia and Uganda.

Kenya was the first country in sub-Saharan Africa to view runaway population growth as a serious impediment to economic prosperity, and it became the first, in the late 1960s, to begin developing a national family-planning campaign. The country's official population policy calls for matching population size with available resources, yet leaves decisions on family size up to individual families.

As recently as 1970, Africa was essentially self-sufficient in food. What fostered a breakdown in the continent's ability to feed itself has been a decline of nearly 1 percent per year in per capita grain production since 1968 - in part due to an annual population growth for the continent approaching 3 percent.

The root cause of Africa's crisis, according to Worldwatch Institute analyst Lester Brown, is population growth faster than on any continent in history, widespread soil erosion and desertification, and a failure by African governments to adequately support agriculture.

Europe: by contrast, France offers financial incentives for larger (3 child) families. The population of Europe is also aging faster than any other part of the world, except Japan. Birth rates are also down in many European countries. The number of people depending on workers will rise as the number of workers falls. Spending in European countries will have to increase for retirement, health care and long-term care for old people in the future.

Russia faces the most severe population decrease of any country. The population of Russia is now one hundred forty-three million. It is expected to drop twenty-two percent over the next forty-five years. If this happens, Russia could lose more than forty percent of its active workforce and have economic problems. Part of the problem is the short length of time that Russian men generally live. The average life expectancy for Russian men is just fifty-eight years. Russian women live fourteen years longer. Men in Western Europe live sixteen years longer. Drugs, tobacco smoking and alcohol are some of the main causes of death among Russian men. Russia also has low birth rates.
http://www.voanews.com/specialenglish/archive [accessed 20 June 2008]

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty.
References
US Global Change Research Information Office, www.gcrio.org, Consequences Vol. 2, No. 2
Dru C. Gladney, "China's National Insecurity: Old Challenges at the Dawn of the New Millennium", Papers from "Asian Perspectives on the Challenges of China", Institute for National Security Studies, National Defense University, March 2000
© M Goodyear 2008

# data[].attributes.attachment_link.title
Policies to Address Population Growth Nationally and Internationally

# data[].attributes.attachment_link.description
Background Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet.

# data[].attributes.headline
[Five recommendations for controlling population growth in China].

# data[].attributes.subject
[Five recommendations for controlling population growth in China].

# data[].attributes.headline
Permit to building "Rusun" [Rumah Susun] is Eased

# data[].attributes.subject
Permit to building "Rusun" [Rumah Susun] is Eased

# data[].attributes.attachment_link.readable_text
Izin Pembangunan Rumah Susun Dipermudah

Ilustrasi Rusunawa (Istimewa)

Jambi - Direktur Rumah Swadaya Kementerian Pekerjaan Umum dan Perumahan Rakyat (Kempupera), Raden Joni Subrata, mengatakan, pemerintah mempermudah proses izin pembangunan rumah susun (Rusun) sebagai salah satu upaya mempercepat penyediaan rumah layak huni bagi warga masyarakat berpenghasilan rendah (MBR) di seluruh Indonesia. Karenanya, pemerintah daerah (Pemda) diharapkan mendukung percepatan pembangunan rusun melalui penyediaan lahan dan kemudahan pengurusan izin pembangunan.

"Melalui paket ekonomi ke-13, pemerintah pusat mempercepat proses izin pembangunan rumah susun untuk MBR. Pembangunan rusun terutama ditujukan untuk buruh industri, PNS, TNI, Polri, santri, dan mahasiswa. Karenanya, seluruh daerah wajib mendukung program nasional pembangunan rusun ini," kata Joni, saat peletakan batu pertama pembangunan rusun RSUD Abdul Manap, Kota Jambi, Kamis (16/2).

Menurutnya, pembangunan rusun untuk pegawai RSUD Abdul Manap sangat penting karena masih banyak pegawai yang belum memiliki rumah.

"Masih banyak yang menumpang atau mengontrak karena penghasilan mereka belum mencukupi untuk membeli rumah melalui skema kredit kepemilikan rumah (KPR)," kata Joni.

Dana pembangunan rusun RSUD Abdul Manap Kota Jambi sebesar Rp 21 miliar bersumber dari APBN 2017. Rumah susun yang dibangun untuk PNS golongan II dan dokter tenaga kontrak tersebut sebanyak 70 unit dengan ukuran 36 meter persegi. Rumah susun tersebut dibangun berlantai lima.

"Pembangunan rumah susun ini ditargetan rampung Oktober 2017," tambahnya.

Sementara itu, Gubernur Jambi, Zumi Zola, mengatakan, pembangunan rusun ini mendukung peningkatan pelayanan kesehatan di RSUD Abdul Manap. Terlebih, lanjutnya, ketersediaan rumah bagi para pegawai rumah sakit dapat menambah semangat dalam bekerja.

"Masih banyak tenaga medis yang masih mengontrak rumah karena penghasilan yang masih rendah. Nah, melalui pembangunan rumah susun ini, mereka tidak terbeban lagi biaya mengontrak rumah. Dengan demikian, mereka bisa meningkatkan kesejahteraan. Peningkatan kesejahteraan tersebut mudah-mudahan membuat pelayanan mereka semakin baik," kata Zumi Zola.

Gubernur menjelaskan, pemerintah pusat melalui Kempupera akan membangun dua rusun di Provinsi Jambi pada tahun ini.

"Satu pembangunan rusun khusus pegawai RSUD Abdul Manap Kota Jambi dan pembangunan rusun khusus pegawai Dinas Kebersihan dan Pertamanan Kabupaten Merangin," tutupnya.

Sumber: Suara Pembaruan

# data[].attributes.attachment_link.description
Izin Pembangunan Rumah Susun Dipermudah Ilustrasi Rusunawa (Istimewa) Jambi - Direktur Rumah Swadaya Kementerian Pekerjaan Umum dan Perumahan Rakyat (Kempupera), Raden Joni Subrata, mengatakan, pemerintah mempermudah proses izin pembangunan rumah susun (Rusun) sebagai salah satu upaya mempercepat penyediaan rumah layak huni bagi warga masyarakat berpenghasilan rendah (MBR) di seluruh Indonesia.

# data[].attributes.headline
Countries attempted to encourage their citizen to have baby.

# data[].attributes.subject
Countries attempted to encourage their citizen to have baby.

# data[].attributes.attachment_link.readable_text
On November 16, 1990, what appeared to be a fun-filled little family yarn about a kid left to his own devices at Christmastime and forced to fend off a couple of bungling burglars, became an instant classic. Today, no holiday movie marathon is complete without a viewing of Home Alone, the movie that turned Macaulay Culkin into one of the biggest kid stars of all time. And while you may be able to recite its dialogue line for line, here are 25things you might not know about the John Hughes-penned picture. So settle in and enjoy, ya filthy animals.

1. WITHOUT UNCLE BUCK, THERE'D BE NO HOME ALONE.

The idea for Home Alone occurred to John Hughes during the making of , which also starred Macaulay Culkin. Always game to play the precocious one, there's a scene in which Culkin's character interrogates a potential babysitter through a mail slot. In Home Alone, Culkin has a similar confrontation with Daniel Stern, this time via a doggie door.

2. THE ROLE OF KEVIN WAS WRITTEN SPECIFICALLY FOR MACAULAY CULKIN.

But that didn't stop director Chris Columbus from auditioning more than 100 other rascally pre-teens for the part. Which really was all for naught, as Culkin nailed the role.

3. MACAULAY WASN'T THE ONLY CULKIN TO APPEAR IN THE FILM.

Macaulay;'s younger brother Kieran also landed a part as Kevin's bed-wetting cousin, Fuller. Though the film marked Kieran's acting debut, he has since gone on to build an impressive career for himself in movies like The Cider House Rules, Igby Goes Down, and Scott Pilgrim vs. the World.

4. CASTING CULKIN TAUGHT CHRIS COLUMBUS A VERY IMPORTANT LESSON.

Since Home Alone, Columbus (who also wrote the scripts for Gremlins and The Goonies) has gone on to become one of Hollywood's premier family-friendly moviemakers as the director of Home Alone 2, Mrs. Doubtfire, and two movies in the Harry Potter franchise. But one lesson he learned from Home Alone is that when you agree to work with a kid actor, you're also agreeing to work with his or her family.

"I was much younger and I was really too naive to think about the family environment as well," Columbus told The Guardian in 2013. "We didn't know that much about the family at the beginning; as we were shooting, we learned a little more. The stories are hair-raising. I was casting a kid who truly had a troubled family life." In 1995, Culkin's parents, who were never married, engaged in a very public-and nasty- legal battle over his fortune.

5. THE FILM IS A GUINNESS WORLD RECORD HOLDER.

In its opening weekend, Home Alone topped the box office, making $17,081,997 in 1202 theaters. The movie maintained its number one spot for a full 12 weeks and remained in the top 10 until June of the following year. It became the highest grossing film of 1990 and earned a Guinness World Record as the highest-grossing live-action comedy ever domestically.

6. THE MOVIE'S UNPRECEDENTED SUCCESS LED TO ITS TITLE BECOMING A VERB.

In his book The Big Picture: Who Killed Hollywood? And Other Essays, two-time Oscar-winning screenwriter William Goldman admitted that the unexpected success of Home Alone contributed a new phrase to the Hollywood lexicon: to be Home Aloned, meaning that other films suffered at the box office because of Home Alone's long and successful run. "More than one executive said to me, 'My picture did 40, but it would have done 50 if it hadn't been Home Aloned,'" wrote Goldman.

7. IT SPAWNED MORE THAN A SEQUEL.

While all of the main, original cast members reprised their roles for Home Alone 2: Lost In New York (with Columbus again directing a script by Hughes), the success of the original led to a full-on franchise, complete with four sequels, three video games, two board games, a novelization, and other kid-friendly merchandise (including the Talkboy).

8. POLAND LOVES THE MCCALLISTERS.

Showings of Home Alone have become a Christmas tradition in Poland, where the film has aired on national television since the early 1990s. And its popularity has only increased. In 2011 more than five million people tuned in to watch it, making it the most watched show to air during the season.

9. THE MCCALLISTER HOME HAS BECOME A MAJOR TOURIST ATTRACTION.

Located at 671 Lincoln Avenue in Winnetka, Illinois, the kitchen, main staircase, and ground-floor landing seen in the film were all shot in this five-bedroom residence. (The dining room and all other first-floor rooms, with the exception of the kitchen, were shot on a soundstage.) In 2012, John and Cynthia Abendshien, who owned the home when it was used as one of the film's locations, sold the property for $1.585 million.

10. KEVIN'S TREE HOUSE WAS NOT PART OF THE DEAL.

Kevin's backyard tree house was not originally part of the property. It was constructed specifically for the movie and demolished once filming ended.

11. ALL OF THE FILM WAS SHOT IN THE CHICAGO AREA.

Though the main plot point is that that McCallister family is in Paris while Kevin's back home in Illinois, the production was shot entirely within the Chicago area. The scenes supposedly set at Paris-Orly Airport were shot at O'Hare International Airport. And those luxurious business class seats they're taking to Paris? Those were built on the basketball court of a local high school-the same school where the scene in which Kevin is running through a flooded basement was filmed (the "basement" in question was actually the school's swimming pool).

12. ROBERT DE NIRO TURNED DOWN THE ROLE OF HARRY LIME.

As did Jon Lovitz. Then Joe Pesci swept in and made the part his own. Bonus fun fact: The character is a slight homage to Orson Welles. (It was the name of Welles' character in Carol Reed's The Third Man.)

13. JOE PESCI GOT ALL METHOD ON MACAULAY CULKIN.

In order to get the most authentic performance possible, Joe Pesci did his best to avoid Macaulay Culkin on the set so that the young actor would indeed be afraid of him. And no one would blame the young actor for being a bit petrified, as he still bears the physical scar from one accidental altercation. "In the first Home Alone, they hung me up on a coat hook, and Pesci says, 'I'm gonna bite all your fingers off, one at a time,'" Culkin recalled to Rule Forty Two. "And during one of the rehearsals, he bit me, and it broke the skin."

14. PESCI WASN'T USED TO THE WHOLE "FAMILY-FRIENDLY" THING.

Considering that Pesci's best known for playing the heavy in movies like Raging Bull, Goodfellas, and Casino, it's understandable that he wasn't quite used to the whole family-friendly atmosphere on the set of Home Alone-and dropped a few f-bombs as a result of that. Columbus tried to curb Pesci's four-letter-word tendency by suggesting he use the word "fridge" instead.

15. DANIEL STERN HAD A FOUR-LETTER WORD SLIP-UP, TOO.

And it wasn't cut out of the film. He utters the word "s***" when attempting to retrieve his shoe through the doggie door (look for it at the 55:27 mark on the DVD).

16. IN REAL LIFE, HARRY AND MARV MAY NOT HAVE SURVIVED KEVIN'S ATTACK.

BB gun shots to the forehead and groin? A steaming hot iron and can of paint to the face? A flaming blowtorch to the scalp? The Wet Bandits endure an awful lot of violence at the hands of a single eight-year-old. So much so that neither one of them should have been walking-let alone conscious-by the end of the night. In 2012, Dr. Ryan St. Clair diagnosed the likely outcome of their injuries at The Week. While a read-through of the entire article is well worth your time, here are a few of the highlights: That iron should have caused a "blowout fracture," leading to "serious disfigurement and debilitating double vision if not repaired properly." And the blowtorch? According to Dr. St. Clair, "The skin and bone tissue on Harry's skull will be so damaged and rotted that his skull bone is essentially dying and will likely require a transplant."

17. THE ORNAMENTS THAT MARV STEPS ON WOULD CAUSE THE LEAST AMOUNT OF DAMAGE.

"Walking on ornaments seems pretty insignificant compared to everything else we've seen so far," said Dr. St. Clair. "If I was Marv, I'd be more concerned about my facial fractures." Fortunately, the "glass" ornaments in question were actually made of candy. (But just to be on the safe side, Stern wore rubber feet for his barefoot scenes.)

18. THE TARANTULA ON STERN'S FACE? YEP, THAT WAS REAL.

At one point, Kevin places a tarantula on Marv's face. And it was indeed a real spider (Daniel Stern agreed to let it happen-but he'd only allow for one take). What wasn't real? That blood-curdling scream. In order to not frighten the spider, Stern had to mime the scream and have the sound dubbed in later.

19. JOHN CANDY WRAPPED IN ONE DAY.

But what a long day it was: Twenty-three hours to be exact. Candy was a regular in many of John Hughes' movies, and Gus Polinski-the polka-playing nice guy he plays in Home Alone-was inspired by his character in Planes, Trains & Automobiles.

20. KEVIN'S OLDER SISTER IS A JUDO CHAMP.

Two years after appearing in Home Alone, Hillary Wolf-who played Kevin's older sister Megan-landed the lead in Joan Micklin Silver's Big Girls Don't Cry... They Get Even. She also appeared in Home Alone 2, but hasn't been seen on the big screen since. But there's a good reason for her absence: In 1996 and 2000, she was a member of the Summer Olympic Judo team for the U.S.

21. DON'T BOTHER TRYING TO FIND ANGELS WITH FILTHY SOULS.

The Jimmy Cagney-like gangster movie that Kevin channels as his inspiration throughout Home Alone? Don't bother searching for it on eBay. It's not real. Nor is its sequel, Angels With Even Filthier Souls, which is featured in Home Alone 2.

22. OLD MAN MARLEY WASN'T IN THE ORIGINAL SCREENPLAY.

Kevin's allegedly scary neighbor, who eventually teaches him the importance of family, wasn't a character in the original script. He was added at the suggestion of Columbus, who thought the film could do with a stronger dose of sentimentality.

23. THE LYRIC OPERA OF CHICAGO BENEFITED FROM THE MOVIE'S SNOWFALL.

When filming of Home Alone wrapped, the production donated some of the artificial snow they had created (the stuff made from wax and plastic) to the Lyric Opera of Chicago. It has since been used in a number of their productions.

24. MARV WAS SUPPOSED TO HAVE GOTTEN A SPINOFF.

Greg Beeman's 1995 film Bushwhacked, which stars Daniel Stern as a delivery guy on the run after being framed for murder, was originally intended to be a spinoff of Home Alone. The storyline would have been essentially the same: after giving up a life of crime, Marv would have been framed for the same murder.

25. IF YOU BELIEVE THAT ELVIS IS STILL ALIVE, THEN YOU MIGHT BELIEVE THAT HE IS IN HOME ALONE.

No hit movie would be complete without a great little conspiracy theory. And in the case of Home Alone, it's that Elvis Presley -who (allegedly?) died in 1977-makes a cameo in the film. Yes, that's right. The King is alive and well. And making a living as a Hollywood extra.

# data[].attributes.attachment_link.title
6 Creative Ways Countries Have Tried to Up Their Birth Rates

# data[].attributes.attachment_link.description
On November 16, 1990, what appeared to be a fun-filled little family yarn about a kid left to his own devices at Christmastime and forced to fend off a couple of bungling burglars, became an instant classic.

# data[].attributes.headline
Population policies, programmes and the environment

# data[].attributes.subject
Population policies, programmes and the environment

# data[].attributes.headline
Surabaya improve clean environment through public commitment

# data[].attributes.subject
Surabaya improve clean environment through public commitment

# data[].attributes.attachment_link.readable_text
Abstract

Background

Some parts of northern Surabaya are slum areas with dense populations, and the majority of the inhabitants are from low-income families. The condition of these areas is seemingly different from the fact that Surabaya city has won awards for its cleanliness, healthy environment preservation, and maintenance.

Aim

This study aimed at turning the researched site into a clean and healthy environment.

Methods

The research was conducted using a quasi-experiment technique with a non-randomized design and pretest-posttest procedures. The research subjects were 121 inhabitants who actively participated in the public commitment and psychoeducation program initiated by the researchers to learn and practice clean and healthy living behaviors.

Results

The statistical data showed that there was a substantial increase in the aspects of public commitment ( t-value = 4.008, p = 0.001) and psychoeducation ( t-value = 4.038, p = 0.001) to begin and maintain a clean and healthy living behaviors.

Conclusion

A public commitment in the form of a collective declaration to keep learning and practicing a clean and healthy living behaviors were achieved. This commitment followed by psychoeducation aimed at introducing and exercising such behaviors was found to have effectively increased the research subjects' awareness to actively participate in preserving environmental hygiene. Developing communal behaviors toward clean and healthy living in inhabitants residing in an unhealthy slum area was a difficult task. Therefore, public commitment and psychoeducation must be aligned with the formulation of continuous habits demonstrating a clean and healthy living behaviors. These habits include the cessation of littering while putting trash in its place, optimizing the usage of public toilets, planting and maintaining vegetation around the area, joining and contributing to the "garbage bank" program, and participating in the Green and Clean Surabaya competition.

Keywords: urban clean and healthy environment, public commitment, clean and healthy living behavior learning

Background

Surabaya is one of the urban and metropolitan cities in Indonesia which is concerned with clean and green living. It has continuously shown a positive development in this field. Surabaya has won several awards related to environmental and hygienic issues. For instance, the Indonesian national award "Adipura" has been awarded to Surabaya by the President of Indonesia since 2006. Another achievement was the United Nations international award for Taman Bungkul being named the best urban park in 2014. Additionally, Surabaya was the recipient of the international award of the European Business Assembly as an Innovative City of the Future in 2014.

Since 2005, Surabaya has developed a program to maintain and preserve the environment, known as the Green and Clean program. The Green and Clean program has been aimed at transforming Surabaya into a beautiful, independent, and healthy city. The objective of this competition was to elect areas of the city that demonstrate a clean and healthy environment as award recipients. This competition is held annually, and every area in Surabaya is eligible to participate. However, Surabaya, like many big cities, still has some slum areas with highly populated and underprivileged residents who mostly come from low-income families. These areas, located in the northern part of Surabaya, are in need of greater attention and transformation. The condition of this region is considered unhealthy and detrimental to the residents' health. The community or public health is not optimal due to a number of factors, such as the environment, human behavior, health care services, and genetics. 1

Cuellar and Paniagua 2 suggest that community issues can be solved through a community-based intervention. In this study context, it means that a community-based intervention is necessary to change slums in the researched site into clean and healthy residential areas. The head of the North Surabaya regency stated that sanitation and health are two of the many priority programs happening in the region. In efforts to improve environmental hygiene and health in this area, some facilities have been built to support the regional government's goals on these issues. These facilities include the implementation of a public toilet program in some parts of this area targeting most of its inhabitants who do not own a toilet in their houses. The head of the North Surabaya regency and his team also suggested, and hoped for, a third party and/or university to participate and contribute in their community development, particularly in hygiene and health programs. A series of discussions that involved several parties were then established. These parties consist of local authorities of the northern Surabaya regency, its resident representatives, and the third parties, in this case represented by Wahana Visi Indonesia and Faculty of Psychology, Universitas Airlangga. All of these members of the discussion meetings agreed on implementing public commitment and on participation in psychoeducation aimed at practicing and maintaining a clean and healthy living behaviors. The efforts signify a form of community-based intervention to increase the environmental hygiene and promote a clean and healthy living.

In promoting a hygienic and healthy behaviors effectively, action is required from individuals and communities in order to gain strong public commitment, policy support, social acceptance, and systemic backing. This public commitment, motivated by local values and wisdom, aims to collectively build the community's awareness to be the main actors/partners in creating a clean and healthy urban environment. According to Inauen et al, 3 the true manifestation of a decision lies in the implementation of a commitment to act and maintain such action. A decision derives from an intention/perception, followed by plans on when, where, and how the intended behaviors should be implemented. In the context of hygienic and healthy living behaviors, Inauen et al 3 emphasize that a commitment to engage in such behavior is exhibited through individuals' rigorous reinforcement of their intention and action. For those who are committed, being able to perform in this way is urgency or a need. They would be satisfied when they display the healthy living behaviors and would be disappointed and irritated if they fail to do so. 3

In regard to the public commitment, a study by Munson et al 4 illustrated a substantially positive effect of public commitment on a physical activity program that indicates healthy behaviors. This study compared commitments available publicly and privately. They examined personal but publicly available statements of commitment posted on social media including the ones written through emails. Then, they compared these to the ones kept in private. The result showed that participants who posted their statements of commitment in social media participated in the physical activity program longer than those who made private commitment without any form of publication. In order to achieve a public commitment, clear and detailed objectives must be set. This is imperative because unclear prospectus and public reporting can reduce the motivation for healthy living behaviors. 4

The role of psychoeducation in this study is essential to stimulate and train one's behavior in order to increase knowledge, attitude, and behavior in terms of clean and healthy living behaviors. A study by Aldcroft et al 5 found that an intervention using psychoeducation was able to generate a significantly positive impact on the physical activity level, for instance, dietary habits or healthy diet choices, and the process of quitting smoking. Psychoeducation deals with planning management, problem-solving, self-monitoring, and the appearance of individual perception and attitude that can be looked upon as a role model. 5

A clean and healthy urban environment has become one of the priority programs for increasing the quality of human development and resources in Indonesia. 6 Cloninger 7 suggests that this type of environment is fundamental for children to learn behaviors in a way that supports a clean and healthy living at an early age. Children who live in unhealthy slums would not be able to visualize, manage, and practice clean and healthy living, even though they get an intensive lesson at school concerning the issue.

Methods

This research used a quasi-experiment method with a pretest-posttest design and non-randomized sampling technique. 8- 10 The residents of North Surabaya were made to implement a public commitment and given psychoeducation related to clean and healthy living behaviors. The public commitment was aimed at building trust and providing a pledge to motivate the community's involvement to adopt a clean and healthy lifestyle. This technique was expected to be effective because a public commitment is an element of a health promotion model that considers the socioecological aspects. 11, 12 Public commitment in this context means a collective declaration to pledge for a hygienic and healthy environment as part of daily living of the individuals and community. Psychoeducation in this study refers to a psychological education for the community to achieve the shared goal of a clean and healthy urban environment.

The research subjects were the residents of North Surabaya, consisting of children, elders, local authorities, and other figures in the community. In detail, the total participants were 122 inhabitants whose characteristics are described as follows.

shows the subjects included in this study. The subjects were divided into three categories: children (aged 4-18 years), female adults, and male adults. Those three subject categories were then divided based on their occupation. The children who participated in this study were classified as students. There were 18 students, and they made up 14.75% of the whole subjects. The female subjects were grouped under four types of occupations: housewife, teacher, government employee, and private employee. The housewife category formed the largest percentage (27.88%) of the whole participants. There were six teachers, and this made up 4.92% of the entire subjects. Only three were government employees in this research which equaled to 2.45% of the whole participants. There were seven private employees which made up 5.74%. From the table, it can be seen that housewives formed the biggest group among the female research subjects.

Table 1

The last subject category was the male participants. They were divided into five categories based on their occupation. There were three men whose occupation was listed as local figures of authority. They made up 2.45% of the group. The two government employees made up 1.64% of the whole group. There were three men working as private employees who made up 2.45% of the group. Additionally, there were 42 participants working as laborers who contributed to 34.43% of the group. The proportion of men working in other occupations was 3.29% of the total. From the table, it can be concluded that the informal/labor workers formed the biggest group of participants in the research.

The data were collected both prior and after the intervention using questionnaires. The public commitment questionnaire consisted of five items focusing on the evaluation of the level of the community's awareness to contribute in environmental hygiene. The psychoeducation questionnaire consisted of 25 items focusing on the assessment of individuals' understanding related to clean and healthy living. The questions on the topic of clean and healthy living in the questionnaire conducted prior to and after the psychoeducation included putting garbage in the proper places, optimizing the function of public toilets, planting and maintaining the vegetation area, contributing to the "garbage bank" program, and participating in the Surabaya Green and Clean competition. Both questionnaires used in this research had been reviewed by experts for their content validity.

Analysis

The obtained data were analyzed using a paired-sample t-test to examine behavioral differences prior to and after the intervention of public commitment and psychoeducation, particularly on clean and healthy urban living. The analysis was conducted using Statistical Package for the Social Sciences (SPSS) 16.0 for Windows.

Declaration

Ethics approval was obtained from The Board of Ethics, Faculty of Psychology, Universitas Airlangga, prior to the study. All participants were required to give their written consent before participating in this study.

Results

The results of the paired-sample t-test showed a substantial increase. The statistical results illustrated a significant increase in public commitment ( t-value = 4.008, p = 0.001) and psychoeducation ( t-value = 4.038, p = 0.001) to adopt and maintain clean and healthy living behaviors. Since the research, the public commitment has established a widely positive impact on northern Surabaya residents. This is indicated by the increasing phenomenon of the residents' awareness that individual and environmental hygiene was to be part of their daily behaviors. Thus, psychoeducation about clean and healthy living has indirectly shaped positive behaviors in the residents. For instance, residents conduct some voluntary work where they clean the surroundings together once a month. Mothers and their children demonstrated a firm attitude to restrict fathers from smoking inside the house. Further impact of this community-based intervention was the involvement of children aged 6-12 and 12-18 years who volunteered to water the vegetation in the afternoon to look after their environment. More positive effects can also be seen among the housewives. They plant vegetables and fruit in their houses and maintain the cleanliness of the water sewage system in their environment by regularly cleaning the gutter.

The involvement of every element of the community in clean and healthy living behaviors is expected to change these slum areas into a clean, beautiful, and green space. This significant change into clean and healthy behaviors in the community signifies a behavioral transformation. Further changes include throwing garbage in its proper place ( t-value = 2.236, p = 0.041), participating in the "garbage bank" program ( t-value = 0.565, p = 0.048), participating in the Surabaya Green and Clean competition ( t-value = 1.861, p = 0.033), optimizing the function of public toilets ( t-value = 1.464, p = 0.016), as well as planting and maintaining the vegetation in their surrounding areas ( t-value = 1.484, p = 0.006).

Discussion

Forming a clean and healthy living habit should start as early as the childhood period in order to familiarize and internalize certain behaviors that would support the love for the environment. The efficacy of character building, however, should not be entirely relied upon at the school alone to achieve the goals. In this sense, the learning process should begin and continue at home. Thus, it becomes a difficult task when children do not see and practice what they learn at school where they live. Developing the intended habit would be more challenging especially to those who reside in unhealthy slum areas. For instance, a child will find it hard to learn how to dispose of garbage properly if he/she lives in a cluttered and littered residential area. This is consistent with the finding of a study by Sholihah and Anwar 1 investigating the effect of home hygiene in Marabahan, Kalimantan. Their study showed that the impact would be more optimal when various parties, starting from the residents to the government, were all involved in the process.

Psychoeducation was part of the groundwork for providing a conduit to understand and exercise the intended behaviors to support the goals of this study. Psychoeducation includes a clinical-based and practical model consisting of training in ecology, behavior and cognition, learning theories, practice in group, stress management, social support, and narrative approach. 13 Through such ecological approaches, psychoeducation is expected to offer and stipulate a framework to specify and deliver the objectives and help people understand the importance of healthy living from their experience in the environment, within the family, or at school, or in the local government. Cognitive-behavioral approaches, such as problem-solving and role-playing, can enhance children's understanding to accept and make sense of new information about healthy living, as well as to implement this in the long term.

According to Klingman, 14 psychoeducation refers to psychologist's/counselor's capability to educate individual(s) with psychological knowledge and skills relevant to one's development and health. It is also expected that this training would equip individuals with competences to effectively act and adjust when a problem emerges. Based on this study result, psychoeducation evidently improved the behavior of clean and healthy living in the research subjects. This finding is in line with a study by Zikrillah et al who found that psychoeducation positively affected family's skills to overcome psychosocial problems. These skills were the result of the allocated psychoeducational intervention. 15

Klingman 14 elaborates that psychoeducation differs from traditional counseling. In this respect, psychoeducation is cognitively and psychologically oriented knowledge that purports to effectively solve problems at hand. It encompasses skills in designing the psychoeducational framework, capabilities to clearly communicate the knowledge, and competences to stimulate the emergence of intended behaviors. In addition, psychoeducation can be implemented for prevention, optimization, or curative goals. This is consistent with the current research finding in which psychoeducation optimized the research process and was able to accomplish the objectives of this study. In this case, it was to stimulate clean and healthy living behaviors.

This research also proved that the level of public commitment rose significantly, and this resulted in the increase of the community's awareness on clean and healthy living. Some prior studies also found that public commitment had effects on improving health behaviors, such as weight loss and diabetes-preventive behavior. 16, 17 There are additional explanations on how commitment can serve as a promoter of health behavior.

Cialdini 18 suggests that commitment may influence behavior through changes in self-image or self-concept. When individuals make a commitment to endorse a behavior, they will likely change their self-concept in line with the commitment. 19 This change in self-concept is what eventually drives individuals to behave in a consistent fashion with the commitment they make beforehand. Another explanation for the effect of commitment is that commitment results in an individual's attitude shift, which later shapes the behavior according to the commitment. 17 Particularly, writing down a commitment can make an individual change his/her attitude because a written statement is generally associated as the writer's true attitude. 18

In the current research, the type of commitment used was public commitment. Public commitment can increase one's motivation to behave in accordance with the commitment. 18 This is because individuals are inclined to try to look consistent in the eyes of others, and violating a commitment made in public may potentially cause social sanction for the individuals. 16, 19 Thus, publication of commitment to endorse health behaviors can heighten one's motivation to keep the commitment.

The government also sustainably attempts to support clean and healthy urban environments in North Surabaya. The findings of this research can be used by the government to heighten the effectiveness of their attempts. According to the research finding, which has been backed up by theoretical review, we suggest that psychoeducation should be used in conjunction with solving the existing problem, designed in a structure suitable for the target participants and in a communicative way. Through this approach, the design can be easily understood and implemented. With regard to commitment, Lokhorst et al 19 list some viable strategies to optimize the effectiveness of commitment in shaping behavior. First, commitment should be made public and voluntarily. 18 Written commitment has been proven to be the most effective. 19 Commitment also ought to be made specific and salient so that individuals know what behavior is expected and when they should do it. Using commitment along with other interventions, like in this research, is also a recommended procedure to bring about a long-term behavioral change. 19

Limitations

The limitation of the current study is the variation in research subjects' age, level of education, and socioeconomic status, which affect their level of comprehension concerning clean and healthy living behaviors. The community's comprehension about the indicators of a clean and healthy environment varied, and hence the variation in active contribution in public commitment and psychoeducation. Also, the measuring instruments, which were questionnaires, may have allowed the respondents to provide superficial answers or statements of what might be expected by their community.

Conclusion

Public commitment on a communal declaration to endorse clean and healthy living behaviors, followed by psycho-education on the clean and healthy living, was found to be effective in raising the residents' awareness to participate actively in improving environmental hygiene. Educating communities of unhealthy slums on how to develop clean and healthy living behaviors is not easy. Therefore, public commitment and psychoeducation shall be followed by the development of clean and healthy living habits in the community, such as disposing garbage properly, optimizing the function of public toilets, planting and keeping vegetation around the area, contributing in the "garbage bank" program, and participating in the Surabaya Green and Clean competition. The government's role in urban planning, particularly in building physical facilities, is one focal factor which will support the development of such clean and healthy environments in North Surabaya.

Footnotes
Disclosure
The authors report no conflicts of interest in this work.

References

1. Sholihah Q, Anwar S. Effect of household life behavior to clean and healthy life in district Marabahan, Barito Kuala. J Appl Environ Biol Sci. 2014;4(7):152-156.

2. Cuellar I, Paniagua AF. Handbook of Multicultural Mental Health. San Diego, CA: Academic Press; 2000.

3. Inauen J, Tobias R, Mosler HJ. The role of commitment strength in enhancing safe water consumption: mediation analysis of a cluster-randomized trial. Br J Health Psychol. 2014;19:701-719.

4. Munson SA, Krupka E, Richardson C, Resnick P. Effects of public commitments and accountability in a technology-supported physical activity intervention; Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems; New York, NY: ACM Publication; 2015.

5. Aldcroft SA, Taylor NF, Blackstock FC, O'Halloran PD. Psychoeducational rehabilitation for health behavior change in coronary artery disease: a systematic review of controlled trials. J Cardiopulm Rehabil Prev. 2011;31(5):273-281.

6. Danim D. Transformasi Sumber Daya Manusia [Transformation of Human Resources] Jakarta: Bumi Aksara; 1996. Indonesian.

7. Cloninger SC. Theories of Personality: Understanding Persons. 4th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2004.

8. Cohen S, Underwood LG, Gottlieb BH. Social Support Measurement and Intervention A Guide for Health and Social Scientists. New York, NY: Oxford University Press; 2000.

9. Singarimbun Effendi. Metode Penelitian Survey, Cetakan Kedua [Survey Research Methodology, 2nd ed] Jakarta: LP3ES; 2003. Indonesian.

10. Sugiyono . Metode Penelitian Kuantitatif Kualitatif dan R & D [Quantitative-Qualitative Research Methodology and R&D] Bandung: Alfabeta; 2010. Indonesian.

11. Bartholomew KL, Parcel GS, Kok G, Gottlieb NH. Intervention Mapping: Designing Theory- and Evidence-Based Health Promotion Programs. Mountain View, CA: Mayfield; 2001.

12. Green LW, Kreuter MW. Health Promotion Planning: An Educational and Ecological Approach. 4th ed. Mountain View, CA: Mayfield; 2005.

13. Lukens E, McFarlane W. Psychoeducation as evidence-based practice: considerations for practice, research, and policy. Brief Treat Crisis Interv. 2004;4(3):205-225.

14. Klingman A. Psychoeducation: applications in community health education settings. Int Q Community Health Educ. 1986;7(1):51-60.

15. Zikrillah, Lukman M, Setiawan R. Pengaruh Psikoedukasi terhadap Masalah Psikososial Keluarga yang Memiliki Anggota Keluarga dengan Masalah Kesehatan Kronis: Sebuah Literature Review [The Effect of Psychoeducation on Psychosocial Diffiuclties of Families that Have Member with Chronic Health Condition: A Literature Review] Medisains: Jurnal Ilmu-Ilmu Kesehatan. 2016;14(2):26-31.

16. Nyer PU, Dellande S. Public commitment as a motivator for weight loss. Psychol Mark. 2010;27(1):1-12.

17. DeBar LL, Schneider M, Drews KL, et al. HEALTHY Study Group Student public commitment in a school-based diabetes prevention project: impact on physical health and health behavior. BMC Public Health. 2011;11:711. [ PMC free article]

18. Cialdini RB. Influence: Science and Practice. Boston, MA: Allyn & Bacon; 2001.

19. Lokhorst AM, Werner C, Staats H, van Djik E, Gale JL. Commitment and behavior change: a meta-analysis and critical review of commitment-making strategies in environmental research. Environ Behav. 2013;45(1):3-34.

# data[].attributes.attachment_link.title
Improving urban environment through public commitment toward the implementation of clean and healthy living behaviors

# data[].attributes.attachment_link.description
Some parts of northern Surabaya are slum areas with dense populations, and the majority of the inhabitants are from low-income families. The condition of these areas is seemingly different from the fact that Surabaya city has won awards for its cleanliness, ...

# data[].attributes.attachment_link.readable_text
Country Listing Singapore Table of Contents
Singapore

Population Control Policies

Since the mid-1960s, Singapore's government has attempted to control the country's rate of population growth with a mixture of publicity, exhortation, and material incentives and disincentives. Falling death rates, continued high birth rates, and immigration from peninsular Malaya during the decade from 1947 to 1957 produced an annual growth rate of 4.4 percent, of which 3.4 percent represented natural increase and 1.0 percent immigration. The crude birth rate peaked in 1957 at 42.7 per thousand. Beginning in 1949, family planning services were offered by the private Singapore Family Planning Association, which by 1960 was receiving some government funds and assistance. By 1965 the crude birth rate was 29.5 per 1,000 and the annual rate of natural increase had been reduced to 2.5 percent. Singapore's government saw rapid population growth as a threat to living standards and political stability, as large numbers of children and young people threatened to overwhelm the schools, the medical services, and the ability of the economy to generate employment for them all. In the atmosphere of crisis after the 1965 separation from Malaysia, the government in 1966 established the Family Planning and Population Board, which was responsible for providing clinical services and public education on family planning.

Birth rates fell from 1957 to 1970, but then began to rise as women of the postwar baby boom reached child-bearing years. The government responded with policies intended to further reduce the birth rate. Abortion and voluntary sterilization were legalized in 1970. Between 1969 and 1972, a set of policies known as "population disincentives" were instituted to raise the costs of bearing third, fourth, and subsequent children. Civil servants received no paid maternity leave for third and subsequent children; maternity hospitals charged progressively higher fees for each additional birth; and income tax deductions for all but the first two children were eliminated. Large families received no extra consideration in public housing assignments, and top priority in the competition for enrollment in the most desirable primary schools was given to only children and to children whose parents had been sterilized before the age of forty. Voluntary sterilization was rewarded by seven days of paid sick leave and by priority in the allocation of such public goods as housing and education. The policies were accompanied by publicity campaigns urging parents to "Stop at Two" and arguing that large families threatened parents' present livelihood and future security. The penalties weighed more heavily on the poor, and were justified by the authorities as a means of encouraging the poor to concentrate their limited resources on adequately nurturing a few children who would be equipped to rise from poverty and become productive citizens.

Fertility declined throughout the 1970s, reaching the replacement level of 1.006 in 1975, and thereafter declining below that level. With fertility below the replacement level, the population would after some fifty years begin to decline unless supplemented by immigration. In a manner familiar to demographers, Singapore's demographic transition to low levels of population growth accompanied increases in income, education, women's participation in paid employment, and control of infectious diseases. It was impossible to separate the effects of government policies from the broader socioeconomic forces promoting later marriage and smaller families, but it was clear that in Singapore all the factors affecting population growth worked in the same direction. The government's policies and publicity campaigns thus probably hastened or reinforced fertility trends that stemmed from changes in economic and educational structures. By the 1980s, Singapore's vital statistics resembled those of other countries with comparable income levels but without Singapore's publicity campaigns and elaborate array of administrative incentives.

By the 1980s, the government had become concerned with the low rate of population growth and with the relative failure of the most highly educated citizens to have children. The failure of female university graduates to marry and bear children, attributed in part to the apparent preference of male university graduates for less highly educated wives, was singled out by Prime Minister Lee Kuan Yew in 1983 as a serious social problem. In 1984 the government acted to give preferential school admission to children whose mothers were university graduates, while offering grants of S$10,000 (for value of the Singapore dollar--see Glossary) to less educated women who agreed to be sterilized after the birth of their second child. The government also established a Social Development Unit to act as matchmaker for unmarried university graduates. The policies, especially those affecting placement of children in the highly competitive Singapore schools, proved controversial and generally unpopular. In 1985 they were abandoned or modified on the grounds that they had not been effective at increasing the fecundity of educated women.

In 1986 the government also decided to revamp its family planning program to reflect its identification of the low birth rate as one of the country's most serious problems. The old family planning slogan of "Stop at Two" was replaced by "Have Three or More, if You Can Afford It." A new package of incentives for large families reversed the earlier incentives for small families. It included tax rebates for third children, subsidies for daycare, priority in school enrollment for children from large families, priority in assignment of large families to Housing and Development Board apartments, extended sick leave for civil servants to look after sick children and up to four years' unpaid maternity leave for civil servants. Pregnant women were to be offered increased counseling to discourage "abortions of convenience" or sterilization after the birth of one or two children. Despite these measures, the mid-1986 to mid-1987 total fertility rate reached a historic low of 1.44 children per woman, far short of the replacement level of 2.1. The government reacted in October 1987 by urging Singaporeans not to "passively watch ourselves going extinct." The low birth rates reflected late marriages, and the Social Development Unit extended its matchmaking activities to those holding Advanced level (A-level) secondary educational qualifications as well as to university graduates (see The School System , this ch.). The government announced a public relations campaign to promote the joys of marriage and parenthood. In March 1989, the government announced a S$20,000 tax rebate for fourth children born after January 1, 1988. The population policies demonstrated the government's assumption that its citizens were responsive to monetary incentives and to administrative allocation of the government's medical, educational, and housing services.
Data as of December 1989 Country Listing Singapore Table of Contents

# data[].attributes.attachment_link.description
Country Listing Singapore Table of Contents Since the mid-1960s, Singapore's government has attempted to control the country's rate of population growth with a mixture of publicity, exhortation, and material incentives and disincentives.

# data[].attributes.attachment_link.readable_text
(March 2014) In 2012, the government of Kenya passed a landmark policy to manage its rapid population growth. The new population policy aims to reduce the number of children a woman has over her lifetime from 5 in 2009 to 3 by 2030. ² The policy also includes targets for child mortality, maternal mortality, life expectancy, and other reproductive health measures.

Participatory Process a Formula for Success

Between 1999 and 2009, Kenya's population added 1 million people every year, growing to 41 million, and was expected to hit 77 million by 2030. ¹

Kenya's long-term development plan, known as Vision 2030, recognizes that rapid population growth could severely derail progress in reaching its primary goal: To achieve a high quality of life for all Kenyans that is sustainable with available resources. ³ The National Council for Population and Development (NCPD), under the Ministry of Planning, National Development, and Vision 2030, initiated a series of consultations to achieve a population policy that would bolster this vision. Although Kenya has made great strides in increasing contraceptive coverage, from 27 percent in 1989 to 46 percent in 2009, concerns over worsening unemployment, food shortages, and a large youth population threaten Kenya's economic future. ⁴

The Population Reference Bureau (PRB) has a long-standing relationship with NCPD, dating back more than 15 years. PRB assisted NCPD, at the request of and with support from USAID's mission in Kenya, to stimulate institutional reform to become a stronger and more effective policy advocacy organization in Kenya. Through this partnership, NCPD has developed multimedia presentations, videos, and a variety of publications, as well as conducted policy communication workshops, to more effectively consolidate strategies to influence population policy decisions. Key among these tools are the PRB ENGAGE presentation, " Kenya Leading the Way," and the Kenya Population Data Sheet 2011, developed through PRB's IDEA project. PRB also helped NCPD write policy briefs on national priority themes such as youth and reproductive health, family planning and religion, and other topics. NCPD was among the first to disseminate the results of the 2008-2009 Kenya Demographic and Health Survey. These materials have been shared at the national and county levels to raise awareness about the relevance of family planning.

Kenya's population policy proposes a multisectoral approach. ⁵ Key to passage of the policy, according to George Kichamu, NCPD deputy director of communication, advocacy, and public education, and Lucy Kimondo, NCPD senior program officer in the same department, was the patient, inclusive nature of the consultative process they employed that solicited input from stakeholders from the very beginning. ⁶ As part of the process, NCPD hosted a national conference for 1,300 public- and private-sector leaders; forums for members of Parliament; meetings with district and regional leaders of churches, civil society, and the government; and supported ongoing nationwide mobilization. In particular, engaging two key groups-religious leaders and parliamentarians-was key to crafting a policy in which all citizens felt ownership. ⁷ A major outcome of the national conference was an increase of more than 10 percent over the previous year in resources allocated to family planning.

NCPD translated the policy into accessible language and reviewed the policy thoroughly as they met with different groups, in order to achieve buy-in from as many people as possible. ⁸ For their efforts, in 2013, NCPD received the Resolve Award, granted by the Global Leaders Council for Reproductive Health, a group of 18 sitting and former heads of state, high-level policymakers, and other leaders who advocate for increased support of reproductive health.

Dissemination at the Top of Action Plan

According to Kimondo, the challenge is getting the word out about the policy. "The big task has now begun," says Kimondo, and NCPD must develop strategies to implement this policy while at the same time address the issue of access to services, "to make sure that every woman who wants services can access the services, [and] any man, because I believe family planning is for both men and women." ⁹

Kenya recently decentralized to a 47-county system of government. Since this system is relatively new, it is a good time, according to Kichamu, to make sure the leaders at the county level understand the population policy and their role in implementing the policy to support local communities. The ENGAGE presentation has already been shown in over 30 counties, which puts NCPD on the front lines of bringing national development goals to local policymakers.

Kichamu also notes that it is important to balance rights with development to create the environment for a successful transition to smaller families in Kenya. The new policy, he says, reaffirms that reproductive health is a human right, and that choosing the number and timing of their children is important for all couples. ¹⁰

Heidi Worley is a senior writer/editor at the Population Reference Bureau.

References

1. Kenya National Bureau of Statistics, Kenya Demographic and Health Survey 2008-09, Final Report (Calverton, MD: Kenya National Bureau of Statistics, Nairobi, Kenya, and MEASURE DHS, ICF Macro, 2010); and Population Reference Bureau, Kenya Population Data Sheet 2011 (Washington, DC: Population Reference Bureau, 2011).

2. "Minister Oparanya Launches Population Policy," Kenpop News 5, no. 1 (2012), accessed at http://ncpd-ke.org/ncpdweb/News-Letters%20, on Feb. 11, 2014; and National Council for Population and Development (NCPD), Ministry of State for Planning, National Development, and Vision 2030, "Sessional Paper No. 3 of 2012 on Population Policy for National Development, Popular Version" (Nairobi: NCPD, 2012), accessed at http://dataspace.princeton.edu/jspui/, on Feb. 11, 2014.

3. NCPD, "Sessional Paper No. 3 of 2012."

4. "Minister Oparanya Launches Population Policy"; and NCPD, "Sessional Paper No. 3 of 2012."

5. NCPD, "Sessional Paper No. 3 of 2012."

6. Video interview with George Kichamu, deputy director of communication, advocacy, and public education, and Lucy Kimondo, senior program officer, communication, advocacy, and public education, NCPD, Resolve Award recipients, The Aspen Institute, Dec. 5, 2013, accessed at www.youtube.com/watch?v=KBjA-iVvn9Y&feature=youtu.be, on Feb. 11, 2014.

7. Video interview with George Kichamu and Lucy Kimondo.

8. The Aspen Institute, "Global Leaders Honor Kenya for Visionary Population Policy for National Development: 2013 Resolve Award Recognizes Kenya's Rights-Based, Inclusive Policy," press release (Geneva: Global Leaders Council for Reproductive Health, 2013).

9. Video interview with George Kichamu and Lucy Kimondo.

10. The Aspen Institute, "Global Leaders Honor Kenya."

# data[].attributes.attachment_link.title
New Kenyan Population Policy a Model for Other Countries

# data[].attributes.attachment_link.description
(March 2014) In 2012, the government of Kenya passed a landmark policy to manage its rapid population growth. The new population policy aims to reduce the number of children a woman has over her lifetime from 5 in 2009 to 3 by 2030.

# data[].attributes.attachment_link.readable_text
Populations: Policies to Address Population Growth Nationally and Internationally
Background
Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet. On the other hand, modern medical techniques are producing life extension but not healthy life extension, and we are seeing numbers of old and chronically sick or disabled elderly people in increasingly longer economically unproductive retirements, who need consequentially increasing numbers of younger people to support them.

The ability of the Earth to sustain the human population, posed by Malthus over 200 years ago, is a serious question. Dependence on finite resources for energy and water is already threatening international stability. Potentially exponential population growth can only make matters worse. Improving economic development in the most populous countries of the developing world (India, China) is leading to changing patterns of demand, as people seek more affluent lifestyles. Food and energy demands are increasing faster than had been predicted. Air quality resulting from over-rapid industrialisation is becoming a major problem that will have major public health effects. The likely determinants of climate change, usually attributed to the developed nations, are now spread throughout the developing world, making the ability of nations to achieve the targets signed-up to at Kyoto unlikely to be achieved. Religion is a significant factor in population growth: families in catholic families tend to be larger than protestant, and Muslim tend to be larger than others. In both class, the religion tends to relegate the role of women to the second class.
International Moves
In 1994 the United Nations Population Information Network (POPIN) organised an International Conference of Parliamentarians on Population and Development (ICPPD) and an International Conference of Parliamentarians on Population and Development (ICPD) in Cairo . There was a shift in thinking recognized at Cairo, towards viewing population from a more humane and equitable perspective. The consensus document that was produced recognizes that consumption in wealthy countries and rapid population growth in poor countries put pressure on the natural environment, both locally and globally. The OCPPD group issued an agreed statement that included the following items:
We therefore commit ourselves, as elected representatives of the people, to do our utmost to remove all remaining barriers in our countries that inhibit access to family planning services, information and education, as well as to help support the provision of reproductive health and family planning services as widely as possible. We acknowledge the fact that abortions constitute a major public health concern for women all over the world. Since the use of family planning methods may prevent the prevalence of unplanned pregnancies, we call upon all national Governments to reduce the need for abortion by providing universal access to family planning information and services. The empowerment of women and the improvement of their political social, economic and health status are highly important ends in themselves. We further believe that human development cannot be sustained unless women are guaranteed equal rights and equal status with men. In this process women should be seen not merely as the beneficiaries of change but as the agents of change as well. This entails an enhancement of their own gender awareness. We believe that education is the single most important element on the road to equality and empowerment of women.
Rather than simply equating population policy with family planning, the new thinking is that population growth should be stabilized - and development enhanced - by attacking some of the roots of the problem: by improving women's access to education, health care, and economic and political decisions.

Today, more than half of all developing countries have national population policies, and about 130 national governments subsidize family planning services. When polled by the UN in 1994, 91 percent of the countries that lacked national population policies stated that they intended to formulate them in the near future, reflecting a rising global commitment to population-related concerns. But national policy statements do not necessarily translate into program implementation.
Examples from various cultures
China has operated a one-child policy for a number of years, enforced though a system of fines, relaxed after mass bereavements such as Sichuan Earthquake; the focus of China on population control helps provide a better health service for women and a reduction in the risks of death and injury associated with pregnancy. At family planning offices, women receive free contraception and pre-natal classes. Help is provided for pregnant women to closely monitor their health. Culturally, traditional religious practice requires a son to perform the parents' funerals, leading to resistance to the policy in some rural areas when the first-born is as girl.

Growth has indeed slowed, yet during 1996 China added 13 million people to its numbers. Rural folk have been less cooperative; however, the one-child policy has achieved statistical wonders. In one generation, China's birth rates have plunged to 1.9 children per mother - a rate that, if sustained, will lead to depopulation.

According to a recent survey, ethnic minorities are currently growing about 7 times faster than Han Chinese.

The decline in population growth rate has exacerbated another problem familiar in the West: rapid aging. There will be 129 million Chinese over the age of 60 as of the year 2000. By 2020, one in four will be elderly (twice the total present population of the United States) - a rare burden for a low income country.

The sex ratio at birth (between male and female births) in mainland China reached 117:100 in the year 2000, substantially higher than the natural baseline, which ranges between 103:100 and 107:100. This suggests differential abortion if the sex is known antenatally?

India operates a two-child policy. During 1970s they used forced sterilisation of the poor. India has greatly increased food production per head over last 20 years, making it better placed to absorb higher numbers. The country's most recent approach to population issues focuses on the advancement of women economically, academically, and socially, as independent women are more likely to have small families.

Africa: birth rates in Africa are the highest in the world. By the year 2050, twenty percent of the world's population will live on the African continent. That will be almost two thousand million people, up from eight hundred fifty-five million people today. Especially large population growth is expected in Nigeria, Ethiopia and the Democratic Republic of Congo. Other countries likely to have major growth include Burkina Faso, Mali, Niger, Somalia and Uganda.

Kenya was the first country in sub-Saharan Africa to view runaway population growth as a serious impediment to economic prosperity, and it became the first, in the late 1960s, to begin developing a national family-planning campaign. The country's official population policy calls for matching population size with available resources, yet leaves decisions on family size up to individual families.

As recently as 1970, Africa was essentially self-sufficient in food. What fostered a breakdown in the continent's ability to feed itself has been a decline of nearly 1 percent per year in per capita grain production since 1968 - in part due to an annual population growth for the continent approaching 3 percent.

The root cause of Africa's crisis, according to Worldwatch Institute analyst Lester Brown, is population growth faster than on any continent in history, widespread soil erosion and desertification, and a failure by African governments to adequately support agriculture.

Europe: by contrast, France offers financial incentives for larger (3 child) families. The population of Europe is also aging faster than any other part of the world, except Japan. Birth rates are also down in many European countries. The number of people depending on workers will rise as the number of workers falls. Spending in European countries will have to increase for retirement, health care and long-term care for old people in the future.

Russia faces the most severe population decrease of any country. The population of Russia is now one hundred forty-three million. It is expected to drop twenty-two percent over the next forty-five years. If this happens, Russia could lose more than forty percent of its active workforce and have economic problems. Part of the problem is the short length of time that Russian men generally live. The average life expectancy for Russian men is just fifty-eight years. Russian women live fourteen years longer. Men in Western Europe live sixteen years longer. Drugs, tobacco smoking and alcohol are some of the main causes of death among Russian men. Russia also has low birth rates.
http://www.voanews.com/specialenglish/archive [accessed 20 June 2008]

The Millennium Development Goals (MDGs), committed to by all 191 United Nations member states, are rooted in the concept of sustainable development. Although 2007 (midway) reports indicated that programs are under way, unfortunately many countries are unlikely to reach their goals by 2015 due to high levels of poverty.
References
US Global Change Research Information Office, www.gcrio.org, Consequences Vol. 2, No. 2
Dru C. Gladney, "China's National Insecurity: Old Challenges at the Dawn of the New Millennium", Papers from "Asian Perspectives on the Challenges of China", Institute for National Security Studies, National Defense University, March 2000
© M Goodyear 2008

# data[].attributes.attachment_link.title
Policies to Address Population Growth Nationally and Internationally

# data[].attributes.attachment_link.description
Background Global population is increasing by about 1.5 percent per year, a growth rate (should it persist) that in less than half a century will double the number of people who live on the planet.

# data[].attributes.attachment_link.title
Obamacare: Has Trump managed to kill off Affordable Care Act?

# data[].attributes.attachment_link.description
While America dissects the president latest tweets, he is dismantling Obamacare by inches.

# data[].attributes.headline
Population policies in pacific island countries 

# data[].attributes.subject
Population policies in pacific island countries 

# data[].attributes.body
quite outdated (1999). To think about

# data[].attributes.attachment_link.title
HOW CAN POPULATION POLICIES HAVE A BENEFICIAL IMPACT IN THE PACIFIC ISLAND COUNTRIES

# data[].attributes.attachment_link.readable_text
World War 2 left no part of the world untouched - North America, South America, Europe, Asia, Africa and all oceans between were involved to one extent or the other. While the conflict gave rise to legends and led to the fall of others, the true cost of the war lay in the human commitment: scores of souls were affected by the events that led up to - and consisted of - the war between the Allies and the Axis. Before the end, individual stories (some surviving) were largely lost, the grand scope of the Second World War more simply summarized through numbers - such was the destructive force of the conflict that spanned half-a-decade. ©www.SecondWorldWarHistory.com

Total War Deaths by Nation:
(in some cases, numbers are averaged from multiple sources due to discrepancies).

Tank Production (includes SPGs, approximate):

Soviet Union: 105,250
United States: 88,410
Germany: 46,860
United Kingdom: 27,900
Canada: 5,680
Empire of Japan: 2,515
Kingdom of Italy: 2,475
Kingdom of Hungary: 500
Total: 279,590

Warship Strength (major types, includes submarines):

United States: 1,410
Germany: 1,379
United Kingdom: 871
Japan: 257
Canada: 191
Soviet Union: 79
Italy: 43
Total: 4,230

Military Truck Production (approximate):

United States: 2,400,000
Canada: 815,730
United Kingdom: 481,000
Germany: 346,000
Soviet Union: 197,100
Japan: 166,000
Italy: 83,000
Total: 4,488,830

Artillery Production (approximate):

Soviet Union: 517,000
United States: 257,400
Germany: 160,000
United Kingdom: 125,000
Japan: 13,350
Canada: 10,550
Italy: 7,200
Commonwealth: 5,215
Hungary: 450
Total: 1,096,165

U.S. Medal of Honor Recipients:

Army: 324
Navy: 57
Marine Corps: 82
Coast Guard: 1
Total: 464 (Posthumous: 266 (57.3%))

# data[].attributes.attachment_link.description
World War 2 left no part of the world untouched - North America, South America, Europe, Asia, Africa and all oceans between were involved to one extent or the other.

# data[].attributes.headline
Uzbekistan's policy of secretly sterilising women

# data[].attributes.subject
Uzbekistan's policy of secretly sterilising women

# data[].attributes.attachment_link.readable_text
The BBC has been told by doctors that Uzbekistan is running a secret programme to sterilise women - and has talked to women sterilised without their knowledge or consent.

Adolat has striking looks, a quiet voice and a secret that she finds deeply shameful.

She knows what happened is not her fault, but she cannot help feeling guilty about it.

Adolat comes from Uzbekistan, where life centres around children and a big family is the definition of personal success. Adolat thinks of herself as a failure.

"What am I after what happened to me?" she says as her hand strokes her daughter's hair - the girl whose birth changed Adolat's life.

"I always dreamed of having four - two daughters and two sons - but after my second daughter I couldn't get pregnant," she says.

Every doctor is told how many women are to be sterilised - there is a quota
Uzbek gynaecologist

She went to see a doctor and found out that she had been sterilised after giving birth to her daughter by Caesarean section.

"I was shocked. I cried and asked: 'But why? How could they do this?' The doctor said, 'That's the law in Uzbekistan.'"

Sterilisation is not, officially, the law in Uzbekistan.

But evidence gathered by the BBC suggests that the Uzbek authorities have run a programme over the last two years to sterilise women across the country, often without their knowledge.

Foreign journalists are not welcome in Uzbekistan, and in late February of this year the authorities deported me from the country. I met Adolat and many other Uzbek women in the relative safety of neighbouring Kazakhstan. I also gathered testimony by telephone and email, and in recordings brought out of the country by courier.

None of the women wanted to give their real names but they come from different parts of Uzbekistan and their stories are consistent with those of doctors and medical professionals inside the country.

"Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilised," says a gynaecologist from the Uzbek capital, Tashkent.

Like all doctors I interviewed, she spoke on a condition of anonymity. Talking to a foreign journalist could result in a prison term, in a country where torture in detention is the norm.

"There is a quota. My quota is four women a month," she says.

Two other medical sources suggest that there is especially strong pressure on doctors in rural areas of Uzbekistan, where some gynaecologists are expected to sterilise up to eight women per week.

Find out more

Listen to the full report on Crossing Continents on BBC Radio 4 on Thursday, 12 April at 11:00 BST and on Assignment on the BBC World Service
Listen to Assignment on the World Service Explore the World Service Assignment archive Download the Crossing Continents podcast
"Once or twice a month, sometimes more often, a nurse from the local clinic comes to my house trying to get me to the hospital to have the operation," says a mother of three in the Jizzakh region of Uzbekistan.

"Now it's free, but later you will have to pay for it, so do it now," the nurse tells the mother.

On paper, sterilisations should be voluntary, but women don't really get a choice
Uzbek doctor

Another mother says she experienced months of mysterious pain and heavy bleeding following the birth of her son. Then she had an ultrasound check and discovered that her uterus had been removed.

"They just said to me, 'What do you need more children for? You already have two,'" she says.

The BBC gathered similar testimony from the Ferghana Valley, the Bukhara region and two villages near the capital Tashkent.

According to a source at the Ministry of Health, the sterilisation programme is intended to control Uzbekistan's growing population, which is officially held to be about 28m people. Some demographers are sceptical, however, pointing to the large numbers of people who have emigrated since the last census in 1989, when the population stood at around 20m.

"We are talking about tens of thousands of women being sterilised throughout the country," says Sukhrob Ismailov, who runs the Expert Working Group, one of very few non-governmental organisations operating in Uzbekistan.

In 2010, the Expert Working Group conducted a seven-month-long survey of medical professionals, and gathered evidence of some 80,000 sterilisations over the period, but there is no way of verifying the number and some of the procedures were carried out with the patient's consent.

The first cases of forced sterilisation were reported in 2005, by Gulbakhor Turaeva - a pathologist working in the city of Andijan who noticed that uteruses of young, healthy women were being brought to a mortuary where she worked.

After gathering evidence of 200 forced sterilisations, by tracing women from whom the uteruses were removed, she went public with her findings and asked her bosses for an explanation. Instead they sacked her.

In 2007 Turaeva went to jail, accused of smuggling opposition literature into the country. Like many others, she refused to be interviewed for this report because of fears for her and her children's safety.

In 2007, the United Nations Committee Against Torture also reported forcible sterilisations and hysterectomies in Uzbekistan, and the number of cases of forced sterilisation appeared to fall.

But according to medical sources, in 2009 and 2010 the Uzbek government issued directives ordering clinics to be equipped to perform voluntary surgical contraception. In 2009, doctors from the capital were also despatched to rural areas to increase the availability of sterilisation services.

There is evidence that the number of sterilisations then began to rise again.

Uzbekistan: Infant and maternal deaths

Uzbekistan ranked 140th out of 194 countries in terms of infant mortality in 2005-2010, according to data from the UN Population Division

This put it just behind Laos, Madagascar and Bolivia, and just ahead of Bangladesh, Ghana and Papua New Guinea

Figures from the UN Population Fund indicate that Uzbekistan had a maternal mortality ratio of 30 deaths per 100,000 live births in 2008 - a 44% improvement on 1990

This ratio put it level with Iran, just ahead of Albania and Malaysia (31) and just behind Armenia (29), Romania and Uruguay (27)

"On paper, sterilisations should be voluntary, but women don't really get a choice," says a senior doctor from a provincial hospital, who wished to remain unnamed.

"It's very easy to manipulate a woman, especially if she is poor. You can say that her health will suffer if she has more children. You can tell her that sterilisation is best for her. Or you can just do the operation."

Several doctors I spoke to say that in the last two years there has been a dramatic increase in Caesarean sections, which provide surgeons with an easy opportunity to sterilise the mother. These doctors dispute official statements that only 6.8% of women give birth through C-sections.

"Rules on Caesareans used to be very strict, but now I believe 80% of women give birth through C-sections. This makes it very easy to perform a sterilisation and tie the fallopian tubes," says a chief surgeon at a hospital near the capital, Tashkent.

Several doctors and medical professionals said forced sterilisation is not only a means of population control but also a bizarre short-cut to lowering maternal and infant mortality rates.

"It's a simple formula - less women give birth, less of them die," said one surgeon.

Islam Karimov

Born 1938, became first secretary of the Uzbek Communist Party in 1989 and president of the Uzbek Socialist Republic in 1990

Elected president of independent Uzbekistan in 1991 with 86% of the vote, re-elected in 2000 with 92%, and again in 2007 with 88%

Mr Karimov has been accused of using the threat of Islamic militancy to justify authoritarianism

Uzbekistan country profile
The result is that this helps the country to improve its ranking in international league tables for maternal and infant mortality.

"Uzbekistan seems to be obsessed with numbers and international rankings," says Steve Swerdlow, Central Asia director at Human Rights Watch.

"I think it's typical of dictatorships that need to construct a narrative built on something other than the truth."

Swerdlow believes foreign governments could do more. Until recently Uzbek President Islam Karimov was a pariah in the West, but in recent years both the US and the EU have lifted sanctions, including a US ban on arms sales.

This is apparently related to America's worsening relationship with Pakistan and Nato's increased use of routes through Central Asia, including Uzbekistan, to get supplies and troops in and out of Afghanistan.

A number of Western dignitaries have visited Uzbekistan in recent months, but few have made any public comment on the country's human rights record.
Listen to the full report on Listen again via the World Service website or download the Crossing Continents podcast.Crossing Continents on BBC Radio 4 on Thursday, 12 April at 11:00 BST and Monday, 16 April at 20:30 BST. You can also hear the report on Assignment on the BBC World Service.
"Karimov has managed to get to the point in his relationship with the West when there are no consequences for his actions and human rights abuses," says Swerdlow.

"There is a deafening silence when it comes to human rights. Reports of forced sterilisation add urgency to breaking this silence."

In a written reply to the BBC's request for comment, the Uzbek government said the allegations of a forced sterilisation programme were slanderous and bore no relation to reality.

The government also said that surgical contraception was not widespread and was carried out only on a voluntary basis, after consultation with a specialist and with the written consent of both parents.

The Uzbek government stressed that Uzbekistan's record in protecting mothers and babies is excellent and could be considered a model for countries around the world.

However, Nigora is among many for whom forced sterilisation is a reality. She had an emergency C-section. A day later she was told she had been sterilised. On the same day, her newborn died.

Nigora is 24 and will never have children.

# data[].attributes.attachment_link.description
The BBC has been told by doctors that Uzbekistan is running a secret programme to sterilise women - and has talked to women sterilised without their knowledge or consent. Adolat has striking looks, a quiet voice and a secret that she finds deeply shameful.

# data[].attributes.headline
Vladimir Putin hires Boyz II Men to boost the Russian birth rate

# data[].attributes.subject
Vladimir Putin hires Boyz II Men to boost the Russian birth rate

# data[].attributes.attachment_link.readable_text
Putin has organised a gig in Moscow with the American boyband

Russian president Vladimir Putin has long been at war with his country's plummetting birth rate, with a concert of measures designed to boost his compatriots' ailing sex drive.

But it seems he has added a new secret weapon to his arsenal: a weapon known as Boyz II Men.

Putin apparently hopes to harness the all-American boyband's raw romantic charm through a gig in Moscow to encourage their legions of Russian fans to reproduce ahead of Valentine's Day to songs such as I'll Make Love To You and On Bended Knee.

As Russia's population continues to fall to record lows, Putin's continuing PR campaign to persuade the population to have more children appears to have stalled. Until now.

Band members Wanya Morris, Shawn Stockman and Nathan Morris will take a break from their Las Vegas hotel residency and rehearsals for their upcoming tour with New Kids on the Block and 98 Degrees to perform in Moscow on February 6.

The band told the Moscow Times 'Russian audiences have always shown us a lot of love. It's amazing for us to see fans across the world who know every lyric to our songs. We really appreciate all the support they have given us over the years.'

Boyz II Men are one of America's most successful and long-standing R&B groups, known for their emotional ballads reflecting the vicissitudes of love, romance and heartbreak.

They burst onto the international music scene in the early 1990s with the 1992 smash hit End Of The Road which stayed Number One on the Billboard Hot 100 for 13 weeks, breaking a decades-old record held by Elvis Presley.

They subsequently broke that record with One Sweet Day, which stayed at the top of the Hot 100 for 16 weeks, consolidating their reputation as international sex symbols and garnering a worldwide following of adoring female fans.

In 2011 Putin announced plans to invest $53billion (£46.9billion) to help raise reproduction rates in the country by 2015.

At the time he warned that Russia's population will plummet by 30 per cent in the next four decades due to a falling birth rate.

Despite being the worlds largest country at over 6.5million square miles, high rates of smoking, alcoholism, pollution and poverty, together with falling rates, mean Russia's population will shrink to 116 million by 2050 from 142million last year.

Russia also has the world's third-largest heroin abuse rate and accounts for a third of all heroin deaths worldwide.

President Putin wants to boost the nation's birth rate by 25 per cent in the next three years to counteract the predicted decline.

Experts believe the country's impending demography disaster will drain one million people from its workforce every year until 2017.

Russia's population peaked at over 146 million in 1991, shortly after the break-up of the Soviet Union, but declined by nearly 800,000 a year until the mid 2000s.

# data[].attributes.attachment_link.title
Vladimir Putin hires Boyz II Men to boost the Russian birth rate

# data[].attributes.attachment_link.description
Putin has organised a gig in Moscow with the American boyband Russian president Vladimir Putin has long been at war with his country's plummetting birth rate, with a concert of measures designed to boost his compatriots' ailing sex drive. But it seems he has added a new secret weapon to his arsenal: a weapon known as Boyz II Men.

# data[].attributes.headline
Italy Implemented mandatory Vaccines for Children in 2017

# data[].attributes.subject
Italy Implemented mandatory Vaccines for Children in 2017

# data[].attributes.attachment_link.readable_text
(June 13, 2017) On May 19, 2017, the Italian Parliament approved the Decree-Law Containing Urgent Measures on the Compulsory Vaccination of Children, which makes vaccinations mandatory for children as a condition of school registration. (Italy Makes Childhood Vaccinations Compulsory, FRANCE24 (May 19, 2007); Decree-Law No. 73 of June 7, 2017, Urgent Provisions on Vaccine Prevention, GAZZETTA UFFICIALE (June 7, 2017), NORMATTIVA (in Italian).) The legislation seeks to counteract the rise in contraction of measles among children throughout the country; during the last epidemic, 18,000 cases and 15 deaths were reported. ( Italy Makes Childhood Vaccinations Compulsory, supra.)

The Decree-Law takes effect for the new school year that begins in September 2017. (Emilia Piccolo, Le Vaccinazioni Obbligatorie Secondo il Decreto Legge 19.05.2017 [ Compulsory Vaccinations According to the Decree-Law of May 19, 2017], SALVIS JURIBUS (last visited June 1, 2017).) The Italian Ministry of Health published a press release with details on the new legislation. (Press Release, Ministry of Health, Le Novità del Decreto Legge sui Vaccini [News of the Decree-Law on Vaccinations] (May 19, 2017).)
Specific Requirements
Vaccinations are compulsory for children from birth to 16 years of age, according to the National Plan of Vaccination Prevention. ( Id.) The vaccinations are designed to protect children from 12 diseases: chickenpox, diphtheria, haemophilus B (Hib), hepatitis B, meningitis B and C, measles, mumps, polio, rubella, tetanus, and whooping cough. ( Italy Makes Childhood Vaccinations Compulsory, supra.)
Exceptions
The compulsory vaccinations may only be omitted or deferred in cases of proven danger to the health of the child, when specific clinical conditions, duly documented, are present. (Le Novità del Decreto Legge sui Vaccini , supra.) Children who have not been vaccinated must be kept only in classrooms with other non-immunized children. ( Id.) School authorities must report the presence of non-vaccinated students to health authorities. ( Id.)

Violation of mandatory vaccination obligations may result in several adverse consequences for non-compliant parents and guardians, including:

administrative fines from €500 to €7,500 (about US$559-$8,380);

suspension of parental rights by the local juvenile court; and/or

prohibition from registration of the children in day-care centers or elementary schools, whether public or private. (Id.)

Education Campaign
Starting on June 1, 2017, the Ministry of Health is to begin a campaign for the education of the population about the importance of vaccinations. ( Id.) During the 2017-2018 academic year, the Health Ministry, together with the Ministry of Education, Universities, and Research, will promote initiatives for the training of teachers and students on the subject of vaccinations; parents' associations will also be involved in the campaign. ( Id.)

# data[].attributes.attachment_link.title
Italy: Vaccinations for Children Made Mandatory

# data[].attributes.attachment_link.description
(June 13, 2017) On May 19, 2017, the Italian Parliament approved the Decree-Law Containing Urgent Measures on the Compulsory Vaccination of Children, which makes vaccinations mandatory for children as a condition of school registration. (Italy Makes Childhood Vaccinations Compulsory , FRANCE24 (May 19, 2007); Decree-Law No.

# data[].attributes.headline
Law change allows Online Pharmacy access

# data[].attributes.subject
Law change allows Online Pharmacy access

# data[].attributes.attachment_link.readable_text
Consumers will shortly be able to buy common medicines online for the first time as the laws on internet pharmacy are liberalised.

However, the change will apply only to drugs currently purchased over the counter and will not apply to prescription medicines.

Online pharmacy will operate only within the Republic and patients will not be able to legally purchase drugs on the internet from overseas suppliers.

The move is likely to lead to greater price competition on over the counter drugs. Currently, the price of these drugs is not controlled, whereas ex-factory prices apply in the case of prescription medicines.

Increasing numbers of Irish consumers have responded to high medicine prices here by sourcing their needs overseas. It is legal to move medicines across borders in the EU when they are required for personal use but a ban applies to internet purchases.

Illegal medicines
New figures show illegal medicines, including sedatives, weight-loss products, erectile dysfunction drugs and anabolic steroids, are still being imported into Ireland in massive quantities.

Last year, more than 758,000 dosage units of counterfeit and illegal medicines were seized by the IMB, roughly the same as in 2011.

The board said it was particularly concerned by the high level of illegal weight-loss products found. Many when tested were found to contain sibutramine, a banned product that has caused severe reactions in some users and increase the risk of heart attack and stroke.

There was a big rise in seizure of sedatives, from 153,000 units to 247,000 units, which often end up being resold in smaller quantities on the black market.

Breaches
More than 3,900 enforcement investigations for breaches of the legislation on medicinal products were carried out, a decrease of 16 per cent on the previous year. Nine cases were successfully prosecuted.

Most of the unauthorised substances being imported into Ireland have come from the UK, which is used as a transit point, China, the US and India.

Mr O'Mahony emphasised the dangers of buying medicines online and urged consumers not to risk their health by using unapproved or unauthorised medicines.

"We strongly recommend that members of the public never to purchase prescription medicines online as there are no guarantees as to the safety, quality or effectiveness of these products. There is absolutely no way for people to establish whether medicines available on the internet contain what they claim to or if they are in any way effective in treating the illness or condition in question."

Other products that were detained in significant quantities last year included diazepam, melanotan, zopiclone, flurazepam and testosterone.

# data[].attributes.attachment_link.title
Law change will enable consumers to buy common drugs through internet pharmacy

# data[].attributes.attachment_link.description
Consumers will shortly be able to buy common medicines online for the first time as the laws on internet pharmacy are liberalised. However, the change will apply only to drugs currently purchased over the counter and will not apply to prescription medicines.

# data[].attributes.attachment_link.readable_text
JULIAN ASSANGE, the founder of WikiLeaks and apparently an amateur demographer, is worried about Europe's declining birth rate. In a recent tweet he posited that "Capitalism + atheism + feminism = sterility = migration", and noted that the leaders of Britain, France, Germany and Italy are all childless.

Never mind that Mr Assange needs a dictionary. "Sterility" means the inability to play a part in conception (often for medical reasons, or because a man has had a vasectomy or a woman has had her Fallopian tubes tied). What he presumably meant was childlessness, or perhaps a preference for fewer children-a preference, moreover, that until the advent of modern contraception women might hold but could not act on. Mr Assange's tweet echoed sentiments expressed by RT (formerly Russia Today), a Kremlin-backed news organisation. Russian propagandists have long argued that the West's declining fertility rate is evidence of its decline. A recent RT editorial claimed that "Europe has been committing protracted demographic suicide for several decades." (Russia's own fertility rate stands at 1.8 births per woman, not much above the western European average of 1.6.)

Critics responded sharply to Mr Assange's tweet, countering that a country's birth rate depends largely on how rich it is. But is there any germ of truth in what he said?

Birth rates are indeed highly correlated with national income. But the fertility rates of many European countries are lower than would be expected if GDP per person were the only factor that mattered. Romania, for instance, has 1.5 births per adult woman. Based purely on its level of economic development, that figure would be expected to be around 2.1.

What about the factors Mr Assange mentioned? Prosperity, capitalism, secularism and feminism all tend to be found in the same places. To try to distinguish the impact of each, The Economist tested their relationships with fertility rates across different countries. To measure religious observance, we used survey data from the Pew Research Centre, a think-tank. Levels of capitalism or feminism are harder to quantify, but an economic-liberty index produced by the Heritage Foundation, another think-tank, and a gender-equality index from the UN Development Programme may serve as proxies.

Once GDP per person was taken into account levels of capitalism, thus measured, did nothing extra to explain variations in birth rates. Both gender equality and the share of population that is irreligious did seem to play a part. But while the two traits may help explain why eastern European countries have far lower birth rates than Middle Eastern and Latin American ones with similar levels of income, neither was a meaningful predictor of fertility rates within Europe. Birth rates in egalitarian and irreligious Scandinavia are comparable to those in Catholic Italy, where women are expected to care for both babies and older relatives.

Countries in eastern Europe and East Asia, however, tend to have both low birth rates and negligible numbers of immigrants. The last step in Mr Assange's equation makes no sense at all.

# data[].attributes.attachment_link.title
Wealth alone cannot account for Europe's low birth rates

# data[].attributes.attachment_link.description
JULIAN ASSANGE, the founder of WikiLeaks and apparently an amateur demographer, is worried about Europe's declining birth rate. In a recent tweet he posited that "Capitalism + atheism + feminism = sterility = migration", and noted that the leaders of Britain, France, Germany and Italy are all childless.

# data[].attributes.attachment_link.readable_text
The disastrous mortal disease known as the Black Death spread across Europe in the years 1346-53. The frightening name, however, only came several centuries after its visitation (and was probably a mistranslation of the Latin word 'atra' meaning both 'terrible' and 'black)'. Chronicles and letters from the time describe the terror wrought by the illness. In Florence, the great Renaissance poet Petrarch was sure that they would not be believed: 'O happy posterity, who will not experience such abysmal woe and will look upon our testimony as a fable.' A Florentine chronicler relates that,

All the citizens did little else except to carry dead bodies to be buried [...] At every church they dug deep pits down to the water-table; and thus those who were poor who died during the night were bundled up quickly and thrown into the pit. In the morning when a large number of bodies were found in the pit, they took some earth and shovelled it down on top of them; and later others were placed on top of them and then another layer of earth, just as one makes lasagne with layers of pasta and cheese.

The accounts are remarkably similar. The chronicler Agnolo di Tura 'the Fat' relates from his Tuscan home town that

... in many places in Siena great pits were dug and piled deep with the multitude of dead [...] And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city.

The tragedy was extraordinary. In the course of just a few months, 60 per cent of Florence's population died from the plague, and probably the same proportion in Siena. In addition to the bald statistics, we come across profound personal tragedies: Petrarch lost to the Black Death his beloved Laura to whom he wrote his famous love poems; Di Tura tells us that 'I [...] buried my five children with my own hands'.

The Black Death was an epidemic of bubonic plague, a disease caused by the bacterium Yersinia pestis that circulates among wild rodents where they live in great numbers and density. Such an area is called a 'plague focus' or a 'plague reservoir'. Plague among humans arises when rodents in human habitation, normally black rats, become infected. The black rat, also called the 'house rat' and the 'ship rat', likes to live close to people, the very quality that makes it dangerous (in contrast, the brown or grey rat prefers to keep its distance in sewers and cellars). Normally, it takes ten to fourteen days before plague has killed off most of a contaminated rat colony, making it difficult for great numbers of fleas gathered on the remaining, but soon- dying, rats to find new hosts. After three days of fasting, hungry rat fleas turn on humans. From the bite site, the contagion drains to a lymph node that consequently swells to form a painful bubo, most often in the groin, on the thigh, in an armpit or on the neck. Hence the name bubonic plague. The infection takes three-five days to incubate in people before they fall ill, and another three-five days before, in 80 per cent of the cases, the victims die. Thus, from the introduction of plague contagion among rats in a human community it takes, on average, twenty-three days before the first person dies.

When, for instance, a stranger called Andrew Hogson died from plague on his arrival in Penrith in 1597, and the next plague case followed twenty-two days later, this corresponded to the first phase of the development of an epidemic of bubonic plague. And Hobson was, of course, not the only fugitive from a plague-stricken town or area arriving in various communities in the region with infective rat fleas in their clothing or luggage. This pattern of spread is called 'spread by leaps' or 'metastatic spread'. Thus, plague soon broke out in other urban and rural centres, from where the disease spread into the villages and townships of the surrounding districts by a similar process of leaps.

In order to become an epidemic the disease must be spread to other rat colonies in the locality and transmitted to inhabitants in the same way. It took some time for people to recognize that a terrible epidemic was breaking out among them and for chroniclers to note this. The timescale varies: in the countryside it took about forty days for realisation to dawn; in most towns with a few thousand inhabitants, six to seven weeks; in the cities with over 10,000 inhabitants, about seven weeks, and in the few metropolises with over 100,000 inhabitants, as much as eight weeks.

Plague bacteria can break out of the buboes and be carried by the blood stream to the lungs and cause a variant of plague that is spread by contaminated droplets from the cough of patients (pneumonic plague). However, contrary to what is sometimes believed, this form is not contracted easily, spreads normally only episodically or incidentally and constitutes therefore normally only a small fraction of plague cases. It now appears clear that human fleas and lice did not contribute to the spread, at least not significantly. The bloodstream of humans is not invaded by plague bacteria from the buboes, or people die with so few bacteria in the blood that bloodsucking human parasites become insufficiently infected to become infective and spread the disease: the blood of plague-infected rats contains 500-1,000 times more bacteria per unit of measurement than the blood of plague-infected humans.

Importantly, plague was spread considerable distances by rat fleas on ships. Infected ship rats would die, but their fleas would often survive and find new rat hosts wherever they landed. Unlike human fleas, rat fleas are adapted to riding with their hosts; they readily also infest clothing of people entering affected houses and ride with them to other houses or localities. This gives plague epidemics a peculiar rhythm and pace of development and a characteristic pattern of dissemination. The fact that plague is transmitted by rat fleas means plague is a disease of the warmer seasons, disappearing during the winter, or at least lose most of their powers of spread. The peculiar seasonal pattern of plague has been observed everywhere and is a systematic feature also of the spread of the Black Death. In the plague history of Norway from the Black Death 1348-49 to the last outbreaks in 1654, comprising over thirty waves of plague, there was never a winter epidemic of plague. Plague is very different from airborne contagious diseases, which are spread directly between people by droplets: these thrive in cold weather.

This conspicuous feature constitutes proof that the Black Death and plague in general is an insect-borne disease. Cambridge historian John Hatcher has noted that there is 'a remarkable transformation in the seasonal pattern of mortality in England after 1348': whilst before the Black Death the heaviest mortality was in the winter months, in the following century it was heaviest in the period from late July to late September. He points out that this strongly indicates that the 'transformation was caused by the virulence of bubonic plague'.

***

Another very characteristic feature of the Black Death and plague epidemics in general, both in the past and in the great outbreaks in the early twentieth century, reflects their basis in rats and rat fleas: much higher proportions of inhabitants contract plague and die from it in the countryside than in urban centres. In the case of English plague history, this feature has been underlined by Oxford historian Paul Slack. When around 90 per cent of the population lived in the countryside, only a disease with this property combined with extreme lethal powers could cause the exceptional mortality of the Black Death and of many later plague epidemics. All diseases spread by cross-infection between humans, on the contrary, gain increasing powers of spread with increasing density of population and cause highest mortality rates in urban centres.

Lastly it could be mentioned that scholars have succeeded in extracting genetic evidence of the causal agent of bubonic plague, the DNA-code of Yersinia pestis, from several plague burials in French cemeteries from the period 1348-1590.

It used to be thought that the Black Death originated in China, but new research shows that it began in the spring of 1346 in the steppe region, where a plague reservoir stretches from the north-western shores of the Caspian Sea into southern Russia. People occasionally contract plague there even today. Two contemporary chroniclers identify the estuary of the river Don where it flows into the Sea of Azov as the area of the original outbreak, but this could be mere hearsay, and it is possible that it started elsewhere, perhaps in the area of the estuary of the river Volga on the Caspian Sea. At the time, this area was under the rule of the Mongol khanate of the Golden Horde. Some decades earlier the Mongol khanate had converted to Islam and the presence of Christians, or trade with them, was no longer tolerated. As a result the Silk Road caravan routes between China and Europe were cut off. For the same reason the Black Death did not spread from the east through Russia towards western Europe, but stopped abruptly on the Mongol border with the Russian principalities. As a result, Russia which might have become the Black Death's first European conquest, in fact was its last, and was invaded by the disease not from the east but from the west.

The epidemic in fact began with an attack that the Mongols launched on the Italian merchants' last trading station in the region, Kaffa (today Feodosiya) in the Crimea. In the autumn of 1346, plague broke out among the besiegers and from them penetrated into the town. When spring arrived, the Italians fled on their ships. And the Black Death slipped unnoticed on board and sailed with them.

***

The extent of the contagious power of the Black Death has been almost mystifying. The central explanation lies within characteristic features of medieval society in a dynamic phase of modernisation heralding the transformation from a medieval to early modern European society. Early industrial market-economic and capitalistic developments had advanced more than is often assumed, especially in northern Italy and Flanders. New, larger types of ship carried great quantities of goods over extensive trade networks that linked Venice and Genoa with Constantinople and the Crimea, Alexandria and Tunis, London and Bruges. In London and Bruges the Italian trading system was linked to the busy shipping lines of the German Hanseatic League in the Nordic countries and the Baltic area, with large broad-bellied ships called cogs. This system for long-distance trade was supplemented by a web of lively short and medium-distance trade that bound together populations all over the Old World.

The strong increase in population in Europe in the High Middle Ages (1050-1300) meant that the prevailing agricultural technology was inadequate for further expansion. To accommodate the growth, forests were cleared and mountain villages settled wherever it was possible for people to eke out a living. People had to opt for a more one-sided husbandry, particularly in animals, to create a surplus that could be traded for staples such as salt and iron, grain or flour. These settlements operated within a busy trading network running from coasts to mountain villages. And with tradesmen and goods, contagious diseases reached even the most remote and isolated hamlets.

In this early phase of modernisation, Europe was also on the way to 'the golden age of bacteria', when there was a great increase in epidemic diseases caused by increases in population density and in trade and transport while knowledge of the nature of epidemics, and therefore the ability to organise efficient countermeasures to them, was still minimal. Most people believed plague and mass illness to be a punishment from God for their sins. They responded with religious penitential acts aimed at tempering the Lord's wrath, or with passivity and fatalism: it was a sin to try to avoid God's will.

Much new can be said on the Black Death's patterns of territorial spread. Of particular importance was the sudden appearance of the plague over vast distances, due to its rapid transportation by ship. Ships travelled at an average speed of around 40km a day which today seems quite slow. However, this speed meant that the Black Death easily moved 600km in a fortnight by ship: spreading, in contemporary terms, with astonishing speed and unpredictability. By land, the average spread was much slower: up to 2km per day along the busiest highways or roads and about 0.6km per day along secondary lines of communication.

As already noted, the pace of spread slowed strongly during the winter and stopped completely in mountain areas such as the Alps and the northerly parts of Europe. Yet, the Black Death often rapidly established two or more fronts and conquered countries by advancing from various quarters.

Italian ships from Kaffa arrived in Constantinople in May 1347 with the Black Death on board. The epidemic broke loose in early July. In North Africa and the Middle East, it started around September 1st, having arrived in Alexandria with ship transport from Constantinople. Its spread from Constantinople to European Mediterranean commercial hubs also started in the autumn of 1347. It reached Marseilles by about the second week of September, probably with a ship from the city. Then the Italian merchants appear to have left Constantinople several months later and arrived in their home towns of Genoa and Venice with plague on board, some time in November. On their way home, ships from Genoa also contaminated Florence's seaport city of Pisa. The spread out of Pisa is characterized by a number of metastatic leaps. These great commercial cities also functioned as bridgeheads from where the disease conquered Europe.

In Mediterranean Europe, Marseilles functioned as the first great centre of spread. The relatively rapid advance both northwards up the Rhône valley to Lyons and south-westwards along the coasts towards Spain - in chilly months with relatively little shipping activity - is striking. As early as March 1348, both Lyon's and Spain's Mediterranean coasts were under attack.

En route to Spain, the Black Death also struck out from the city of Narbonne north-westwards along the main road to the commercial centre of Bordeaux on the Atlantic coast, which by the end of March had become a critical new centre of spread. Around April 20th, a ship from Bordeaux must have arrived in La Coruña in northwestern Spain; a couple of weeks later another ship from there let loose the plague in Navarre in northeastern Spain. Thus, two northern plague fronts were opened less than two months after the disease had invaded southern Spain.

Another plague ship sailed from Bordeaux, northwards to Rouen in Normandy where it arrived at the end of April. There, in June, a further plague front moved westwards towards Brittany, south-eastwards towards Paris and northwards in the direction of the Low Countries.

Yet another ship bearing plague left Bordeaux a few weeks later and arrived around May 8th, in the southern English town of Melcombe Regis, part of present-day Weymouth in Dorset: the epidemic broke out shortly before June 24th. The significance of ships in the rapid transmission of contagion is underscored by the fact that at the time the Black Death landed in Weymouth it was still in an early phase in Italy. From Weymouth, the Black Death spread not only inland, but also in new metastatic leaps by ships, which in some cases must have travelled earlier than the recognized outbreaks of the epidemic: Bristol was contaminated in June, as were the coastal towns of the Pale in Ireland; London was contaminated in early August since the epidemic outbreak drew comment at the end of September. Commercial seaport towns like Colchester and Harwich must have been contaminated at about the same time. From these the Black Death spread inland. It is now also clear that the whole of England was conquered in the course of 1349 because, in the late autumn of 1348, ship transport opened a northern front in England for the Black Death, apparently in Grimsby.

***

The early arrival of the Black Death in England and the rapid spread to its southeastern regions shaped much of the pattern of spread in Northern Europe. The plague must have arrived in Oslo in the autumn of 1348, and must have come with a ship from south-eastern England, which had lively commercial contacts with Norway. The outbreak of the Black Death in Norway took place before the disease had managed to penetrate southern Germany, again illustrating the great importance of transportation by ship and the relative slowness of spread by land. The outbreak in Oslo was soon stopped by the advent of winter weather, but it broke out again in the early spring. Soon it spread out of Oslo along the main roads inland and on both sides of the Oslofjord. Another independent introduction of contagion occurred in early July 1349 in the town of Bergen; it arrived in a ship from England, probably from King's Lynn. The opening of the second plague front was the reason that all Norway could be conquered in the course of 1349. It disappeared completely with the advent of winter, the last victims died at the turn of the year.

The early dissemination of the Black Death to Oslo, which prepared the ground for a full outbreak in early spring, had great significance for the pace and pattern of the Black Death's further conquest of Northern Europe. Again ship transport played a crucial role, this time primarily by Hanseatic ships fleeing homewards from their trading station in Oslo with goods acquired during the winter. On their way the seaport of Halmstad close to the Sound was apparently contaminated in early July. This was the starting point for the plague's conquest of Denmark and Sweden, which was followed by several other independent introductions of plague contagion later; by the end of 1350 most of these territories had been ravaged.

However, the voyage homewards to the Hanseatic cities on the Baltic Sea had started significantly earlier. The outbreak of the Black Death in the Prussian town of Elbing (today the Polish town of Elblag) on August 24th, 1349, was a new milestone in the history of the Black Death. A ship that left Oslo at the beginning of June would probably sail through the Sound around June 20th and reach Elbing in the second half of July, in time to unleash an epidemic outbreak around August 24th. Other ships that returned at the end of the shipping season in the autumn from the trading stations in Oslo or Bergen, brought the Black Death to a number of other Hanseatic cities both on the Baltic Sea and the North Sea. The advent of winter stopped the outbreaks initially as had happened elsewhere, but contagion was spread with goods to commercial towns and cities deep into northern Germany. In the spring of 1350, a northern German plague front was formed that spread southwards and met the plague front which in the summer of 1349 had formed in southern Germany with importation of contagion from Austria and Switzerland.

***

Napoleon did not succeed in conquering Russia. Hitler did not succeed. But the Black Death did. It entered the territory of the city state of Novgorod in the late autumn of 1351 and reached the town of Pskov just before the winter set in and temporarily suppressed the epidemic; thus the full outbreak did not start until the early spring of 1352. In Novgorod itself, the Black Death broke out in mid-August. In 1353, Moscow was ravaged, and the disease also reached the border with the Golden Horde, this time from the west, where it petered out. Poland was invaded by epidemic forces coming both from Elbing and from the northern German plague front and, apparently, from the south by contagion coming across the border from Slovakia via Hungary.

Iceland and Finland are the only regions that, we know with certainty, avoided the Black Death because they had tiny populations with minimal contact abroad. It seems unlikely that any other region was so lucky.

How many people were affected? Knowledge of general mortality is crucial to all discussions of the social and historical impact of the plague. Studies of mortality among ordinary populations are far more useful, therefore, than studies of special social groups, whether monastic communities, parish priests or social elites. Because around 90 per cent of Europe's population lived in the countryside, rural studies of mortality are much more important than urban ones.

Researchers generally used to agree that the Black Death swept away 20-30 per cent of Europe's population. However, up to 1960 there were only a few studies of mortality among ordinary people, so the basis for this assessment was weak. From 1960, a great number of mortality studies from various parts of Europe were published. These have been collated and it is now clear that the earlier estimates of mortality need to be doubled. No suitable sources for the study of mortality have been found in the Muslim countries that were ravaged.

The mortality data available reflects the special nature of medieval registrations of populations. In a couple of cases, the sources are real censuses recording all members of the population, including women and children. However, most of the sources are tax registers and manorial registers recording households in the form of the names of the householders. Some registers aimed at recording all households, also the poor and destitute classes who did not pay taxes or rents, but the majority recorded only householders who paid tax to the town or land rent to the lord of the manor. This means that they overwhelmingly registered the better-off adult men of the population, who for reasons of age, gender and economic status had lower mortality rates in plague epidemics than the general population. According to the extant complete registers of all households, the rent or tax-paying classes constituted about half the population both in the towns and in the countryside, the other half were too poor. Registers that yield information on both halves of the populations indicate that mortality among the poor was 5-6 per cent higher. This means that in the majority of cases when registers only record the better-off half of the adult male population, mortality among the adult male population as a whole can be deduced by adding 2.5-3 per cent.

Another fact to consider is that in households where the householder survived, other members often died. For various reasons women and children suffer higher incidence of mortality from plague than adult men. A couple of censuses produced by city states in Tuscany in order to establish the need for grain or salt are still extant. They show that the households were, on average, reduced in the countryside from 4.5 to 4 persons and in urban centres from 4 to 3.5 persons. All medieval sources that permit the study of the size and composition of households among the ordinary population produce similar data, from Italy in southern Europe to England in the west and Norway in northern Europe. This means that the mortality among the registered households as a whole was 11-12.5 per cent higher than among the registered householders.

Detailed study of the mortality data available points to two conspicuous features in relation to the mortality caused by the Black Death: namely the extreme level of mortality caused by the Black Death, and the remarkable similarity or consistency of the level of mortality, from Spain in southern Europe to England in north-western Europe. The data is sufficiently widespread and numerous to make it likely that the Black Death swept away around 60 per cent of Europe's population. It is generally assumed that the size of Europe's population at the time was around 80 million. This implies that that around 50 million people died in the Black Death. This is a truly mind-boggling statistic. It overshadows the horrors of the Second World War, and is twice the number murdered by Stalin's regime in the Soviet Union. As a proportion of the population that lost their lives, the Black Death caused unrivalled mortality.

This dramatic fall in Europe's population became a lasting and characteristic feature of late medieval society, as subsequent plague epidemics swept away all tendencies of population growth. Inevitably it had an enormous impact on European society and greatly affected the dynamics of change and development from the medieval to Early Modern period. A historical turning point, as well as a vast human tragedy, the Black Death of 1346-53 is unparalleled in human history.

Ole J. Benedictow is Emeritus Professor of History at the Universtiy of Oslo, Norway.

Further Reading:

The Black Death, 1346-1353. The Complete History (Boydell & Brewer, 2004)

Ole J. Benedictow, 'Plague in the Late Medieval Nordic Countries', Epidemiological Studies (1996)

M.W. Dols,The Black Death in the Middle East (Princeton, 1970)

J. Hatcher,Plague, Population and the English Economy 1348-1530 (Basingstoke, 1977)

J. Hatcher 'England in the Aftermath of the Black Death' (Past & Present, 1994)

L.F. Hirst, The Conquest of Plague (Oxford, 1953).

# data[].attributes.attachment_link.title
The Black Death: The Greatest Catastrophe Ever

# data[].attributes.attachment_link.description
Ole J Benedictow calculated that the Black Death, or bubonic plague, killed 50 million people in the 14th century - or 60 per cent of Europe's entire population.

# data[].attributes.attachment_link.readable_text
The Influenza Pandemic of 1918
The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history. More people died of influenza in a single year than in four-years of the Black Death Bubonic Plague from 1347 to 1351. Known as "Spanish Flu" or "La Grippe" the influenza of 1918-1919 was a global disaster.

The Grim Reaper by Louis Raemaekers

In the fall of 1918 the Great War in Europe was winding down and peace was on the horizon. The Americans had joined in the fight, bringing the Allies closer to victory against the Germans. Deep within the trenches these men lived through some of the most brutal conditions of life, which it seemed could not be any worse. Then, in pockets across the globe, something erupted that seemed as benign as the common cold. The influenza of that season, however, was far more than a cold. In the two years that this scourge ravaged the earth, a fifth of the world's population was infected. The flu was most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually a killer of the elderly and young children. It infected 28% of all Americans (Tice). An estimated 675,000 Americans died of influenza during the pandemic, ten times as many as in the world war. Of the U.S. soldiers who died in Europe, half of them fell to the influenza virus and not to the enemy (Deseret News). An estimated 43,000 servicemen mobilized for WWI died of influenza (Crosby). 1918 would go down as unforgettable year of suffering and death and yet of peace. As noted in the Journal of the American Medical Association final edition of 1918: "The 1918 has gone: a year momentous as the termination of the most cruel war in the annals of the human race; a year which marked, the end at least for a time, of man's destruction of man; unfortunately a year in which developed a most fatal infectious disease causing the death of hundreds of thousands of human beings. Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there. Now it must turn with its whole might to combating the greatest enemy of all--infectious disease," (12/28/1918).

An Emergency Hospital for Influenza Patients

The effect of the influenza epidemic was so severe that the average life span in the US was depressed by 10 years. The influenza virus had a profound virulence, with a mortality rate at 2.5% compared to the previous influenza epidemics, which were less than 0.1%. The death rate for 15 to 34-year-olds of influenza and pneumonia were 20 times higher in 1918 than in previous years (Taubenberger). People were struck with illness on the street and died rapid deaths. One anectode shared of 1918 was of four women playing bridge together late into the night. Overnight, three of the women died from influenza (Hoagg). Others told stories of people on their way to work suddenly developing the flu and dying within hours (Henig). One physician writes that patients with seemingly ordinary influenza would rapidly "develop the most viscous type of pneumonia that has ever been seen" and later when cyanosis appeared in the patients, "it is simply a struggle for air until they suffocate," (Grist, 1979). Another physician recalls that the influenza patients "died struggling to clear their airways of a blood-tinged froth that sometimes gushed from their nose and mouth," (Starr, 1976). The physicians of the time were helpless against this powerful agent of influenza. In 1918 children would skip rope to the rhyme (Crawford):

I had a little bird,
Its name was Enza.
I opened the window,
And in-flu-enza.

The influenza pandemic circled the globe. Most of humanity felt the effects of this strain of the influenza virus. It spread following the path of its human carriers, along trade routes and shipping lines. Outbreaks swept through North America, Europe, Asia, Africa, Brazil and the South Pacific (Taubenberger). In India the mortality rate was extremely high at around 50 deaths from influenza per 1,000 people (Brown). The Great War, with its mass movements of men in armies and aboard ships, probably aided in its rapid diffusion and attack. The origins of the deadly flu disease were unknown but widely speculated upon. Some of the allies thought of the epidemic as a biological warfare tool of the Germans. Many thought it was a result of the trench warfare, the use of mustard gases and the generated "smoke and fumes" of the war. A national campaign began using the ready rhetoric of war to fight the new enemy of microscopic proportions. A study attempted to reason why the disease had been so devastating in certain localized regions, looking at the climate, the weather and the racial composition of cities. They found humidity to be linked with more severe epidemics as it "fosters the dissemination of the bacteria," (Committee on Atmosphere and Man, 1923). Meanwhile the new sciences of the infectious agents and immunology were racing to come up with a vaccine or therapy to stop the epidemics.

The experiences of people in military camps encountering the influenza pandemic:

An excerpt for the memoirs of a survivor at Camp Funston of the pandemic Survivor

A letter to a fellow physician describing conditions during the influenza epidemic at Camp Devens

A collection of letters of a soldier stationed in Camp Funston Soldier

The origins of this influenza variant is not precisely known. It is thought to have originated in China in a rare genetic shift of the influenza virus. The recombination of its surface proteins created a virus novel to almost everyone and a loss of herd immunity. Recently the virus has been reconstructed from the tissue of a dead soldier and is now being genetically characterized. The name of Spanish Flu came from the early affliction and large mortalities in Spain (BMJ,10/19/1918) where it allegedly killed 8 million in May (BMJ, 7/13/1918). However, a first wave of influenza appeared early in the spring of 1918 in Kansas and in military camps throughout the US. Few noticed the epidemic in the midst of the war. Wilson had just given his 14 point address. There was virtually no response or acknowledgment to the epidemics in March and April in the military camps. It was unfortunate that no steps were taken to prepare for the usual recrudescence of the virulent influenza strain in the winter. The lack of action was later criticized when the epidemic could not be ignored in the winter of 1918 (BMJ, 1918). These first epidemics at training camps were a sign of what was coming in greater magnitude in the fall and winter of 1918 to the entire world.

The war brought the virus back into the US for the second wave of the epidemic. It first arrived in Boston in September of 1918 through the port busy with war shipments of machinery and supplies. The war also enabled the virus to spread and diffuse. Men across the nation were mobilizing to join the military and the cause. As they came together, they brought the virus with them and to those they contacted. The virus killed almost 200,00 in October of 1918 alone. In November 11 of 1918 the end of the war enabled a resurgence. As people celebrated Armistice Day with parades and large partiess, a complete disaster from the public health standpoint, a rebirth of the epidemic occurred in some cities. The flu that winter was beyond imagination as millions were infected and thousands died. Just as the war had effected the course of influenza, influenza affected the war. Entire fleets were ill with the disease and men on the front were too sick to fight. The flu was devastating to both sides, killing more men than their own weapons could.

With the military patients coming home from the war with battle wounds and mustard gas burns, hospital facilities and staff were taxed to the limit. This created a shortage of physicians, especially in the civilian sector as many had been lost for service with the military. Since the medical practitioners were away with the troops, only the medical students were left to care for the sick. Third and forth year classes were closed and the students assigned jobs as interns or nurses (Starr,1976). One article noted that "depletion has been carried to such an extent that the practitioners are brought very near the breaking point," (BMJ, 11/2/1918). The shortage was further confounded by the added loss of physicians to the epidemic. In the U.S., the Red Cross had to recruit more volunteers to contribute to the new cause at home of fighting the influenza epidemic. To respond with the fullest utilization of nurses, volunteers and medical supplies, the Red Cross created a National Committee on Influenza. It was involved in both military and civilian sectors to mobilize all forces to fight Spanish influenza (Crosby, 1989). In some areas of the US, the nursing shortage was so acute that the Red Cross had to ask local businesses to allow workers to have the day off if they volunteer in the hospitals at night (Deseret News). Emergency hospitals were created to take in the patients from the US and those arriving sick from overseas.

The pandemic affected everyone. With one-quarter of the US and one-fifth of the world infected with the influenza, it was impossible to escape from the illness. Even President Woodrow Wilson suffered from the flu in early 1919 while negotiating the crucial treaty of Versailles to end the World War (Tice). Those who were lucky enough to avoid infection had to deal with the public health ordinances to restrain the spread of the disease. The public health departments distributed gauze masks to be worn in public. Stores could not hold sales, funerals were limited to 15 minutes. Some towns required a signed certificate to enter and railroads would not accept passengers without them. Those who ignored the flu ordinances had to pay steep fines enforced by extra officers (Deseret News). Bodies pilled up as the massive deaths of the epidemic ensued. Besides the lack of health care workers and medical supplies, there was a shortage of coffins, morticians and gravediggers (Knox). The conditions in 1918 were not so far removed from the Black Death in the era of the bubonic plague of the Middle Ages.

In 1918-19 this deadly influenza pandemic erupted during the final stages of World War I. Nations were already attempting to deal with the effects and costs of the war. Propaganda campaigns and war restrictions and rations had been implemented by governments. Nationalism pervaded as people accepted government authority. This allowed the public health departments to easily step in and implement their restrictive measures. The war also gave science greater importance as governments relied on scientists, now armed with the new germ theory and the development of antiseptic surgery, to design vaccines and reduce mortalities of disease and battle wounds. Their new technologies could preserve the men on the front and ultimately save the world. These conditions created by World War I, together with the current social attitudes and ideas, led to the relatively calm response of the public and application of scientific ideas. People allowed for strict measures and loss of freedom during the war as they submitted to the needs of the nation ahead of their personal needs. They had accepted the limitations placed with rationing and drafting. The responses of the public health officials reflected the new allegiance to science and the wartime society. The medical and scientific communities had developed new theories and applied them to prevention, diagnostics and treatment of the influenza patients.

Return to the Top

Graphs of the Influenza Epidemic Impact

The Public Health Response

Authoritative Measures
Preventative Measures
Prophylaxis
The Scientific and Medical Response

Clinical Descriptions
Treatment and Therapy
The Etiology of Influenza
Bibliography

by Molly Billings, June, 1997 modified RDS February, 2005

# data[].attributes.attachment_link.description
The Influenza Pandemic of 1918 The influenza pandemic of 1918-1919 killed more people than the Great War, known today as World War I (WWI), at somewhere between 20 and 40 million people. It has been cited as the most devastating epidemic in recorded world history.

# data[].attributes.headline
France to Implement Vaccine Policy in 2018

# data[].attributes.subject
France to Implement Vaccine Policy in 2018

# data[].attributes.attachment_link.readable_text
Parents in France will be legally obliged to vaccinate their children from 2018, the government has announced.

French Prime Minister Édouard Philippe said it was "unacceptable" that children are "still dying of measles" in the country where some of the earliest vaccines were pioneered.

Three childhood vaccines, for diphtheria, tetanus and polio, are currently mandatory in France. Others, including those against hepatitis and whooping cough, are simply recommended.

Announcing the policy, Mr Philippe evoked the name of Louis Pasteur, the French biologist who made breakthroughs in disease research and developed the first vaccines for rabies and anthrax in the 19th century.

He said all the vaccines which are universally recommended by health authorities - 11 in total - would be compulsory.

The move follows a similar initiative in Italy, which recently banned non-vaccinated children from attending state schools.

The World Health Organisation has warned of major measles outbreaks spreading across Europe despite the availability of a safe, effective vaccine.

Anti-vaccine movements, whose followers are known as anti-vaxxers, are believed to have contributed to low rates of immunisation against the highly contagious disease in a number of countries.

A recent survey found more than three out of 10 French people don't trust vaccines, with just 52 per cent of participants saying the benefits of vaccination outweigh the risks.

There were 79 cases of measles reported in France in the first two months of 2017, mostly due to an outbreak of 50 cases in the north-eastern Lorraine region, according to the European Centre for Disease Prevention and Control.

Between the beginning of 2008 and the end of 2016, more than 24,000 cases of measles were declared in France, official figures show. Of these, around 1,500 had serious complications and there were 10 deaths.

Vaccination is not mandatory in Britain, and around 24,000 children a year in England are not immunised against measles, mumps and rubella.

Fear surrounding the combined inoculation for the three infectious diseases, known as the MMR vaccine, stems in part from a discredited study claiming to show a link between the jab and autism.

The paper, published in medical journal The Lancet nearly 20 years ago by disgraced former doctor Andrew Wakefield, led to a heavy fall in uptake among parents at the time, but exhaustive scientific research has now disproved the theory.

Two children in the UK have died of measles since 2006, and in 2013 a young man from Wales died of the disease - all a "waste of life," Dr Farah Jameel told doctors at the British Medical Association (BMA) annual meeting last month.

The BMA is calling for evidence to be submitted to the UK Government on "the potential advantages and disadvantages of childhood immunisation made mandatory under the law".

Beatrice Lorenzin, the Italian health minister, has said falling vaccination rates in the country was "an emergency generated by fake news" and 12 vaccines would be compulsory for schoolchildren aged up to 16.

Cases of measles rose more than fivefold across Italy in April compared to the same month last year, according to National Health Institute figures.

This alarming resurgence of the disease has been blamed on the anti-vaccination stance of the populist Five Star Movement (M5S), which took a quarter of the vote in the country's 2013 general election.

The price of a packet of cigarettes in France will also rise from seven to 10 euros (around £6.10 to £8.70) in another public health measure announced by Mr Philippe.

Reuse content

# data[].attributes.attachment_link.title
France will make all vaccinations compulsory by law

# data[].attributes.attachment_link.description
Parents in France will be legally obliged to vaccinate their children from 2018, the government has announced. French Prime Minister Édouard Philippe said it was "unacceptable" that children are "still dying of measles" in the country where some of the earliest vaccines were pioneered.

# data[].attributes.attachment_link.title
Baby Boomers - Facts & Summary - HISTORY.com

# data[].attributes.attachment_link.description
Find out more about the history of Baby Boomers, including videos, interesting articles, pictures, historical features and more. Get all the facts on HISTORY.com