Seke Tribal Trust Land, Zimbabwe, Africa — For a full year, Medina Mavi paid regular visits to the thatched huts of Thomas and Isothosodwa Chodokufa here on the edge of one of Zimbabwe's rural tribal settlements.
After pedaling a bicycle down the sandy back roads to their home, she would greet the Chodokufa family with the traditional Shona courtesies. She had, after all, been born and married in the area, and was expected to observe the customs.
At first, her visits were mainly social, the talk centering on local happenings and family matters, but gradually it shifted to a discussion of family planning.
Mrs. Mavi's message was a simple one: "There's no need to have more children than you can support."
At first Mrs. Chodokufa was suspicious. After all, Shona tradition held that many children were the sign of a successful marriage. Too, she had heard rumors that it was mainly whites who stressed family planning -- to keep down the number of black Africans. And what about the modern methods of avoiding more children -- weren't they somehow "foreign"?
Mrs. Mavi patiently sought to allay such fears, and on each visit kept returning to the central question: Why have more children than you can feed, clothe, and educate?
The Chodokufas found that a reasonable query. Overcoming her initial suspicions, Mrs. Chodokufa eventually visited a nearby health clinic, where an appropriate form of contraception was prescribed. She now says other women should do the same.
"Family planning is very good," she says. "My husband is not working. So it is good that we should have only the children we can afford to educate, to have food for them."
"And," she continues, sitting by a fire in the middle of her tidy hut, "to rest. I think family planning is good for the mother, because she has more time to rest."
Her husband adds, "There are some who don't care how many children they have. But it is difficult to do that in our day, because we want our children to be educated and have a better life in the future."
Mr. and Mrs. Chodokufa represent one of the success stories in family planning in Africa. Unfortunately, there are not enough. And even this one is not without qualification: Although the Chodokufas now advocate family planning, the conversion came only after their sixth child was born.
Yet, in that respect, Mrs. Chodokufa is more or less typical of African women. They have an average of 6.4 children during the child-bearing years of 18 to 49. That contributes to a continentwide growth rate of 2.9 percent per year, meaning a doubling of people every 24 years.
And that, according to a number of experts, shapes up as the single most serious problem facing the world's poorest continent.
Africa already has the highest growth rate of any of the world's continents. Even as the growth in most of the developing world starts to decline. Africa's population growth rate keeps climbing. When it becomes the last of the world's continents to achieve a stable population -- sometime around the end of the next century -- its present population of some 470 million will, by some projections, have soared to 2.7 billion -- nearly a fivefold increase.
The challenges that presents are only now starting to be realized. In fact, some experts see the famine now sweeping the sub-Sahara area and East Africa as a grim precursor of things to come -- if the continent does not bring its population growth under control.
Ironically, the continent's burgeoning population is, in one sense, a measure of its progress. The most important factors behind the upsurge are a decrease in infant mortality and improvements in maternal health.
The East African nation of Kenya offers a graphic example of the progress -- and the problem. For Kenya, 1962 (the year before it attained independence) was a watershed year. Infant mortality began to drop dramatically, and healthier mothers began having more children, from an average of around seven in 1960 to eight a decade and a half later.
The upshot: Kenya now has a population growth rate of 4 percent, the highest in the world. At that rate, the number of people doubles every 18 years.
"If your population doubles every 18 years, your gross national product has to double every 18 years just to stay even," one authority says. "And what country," she asks, "has an economy that can do that?"
The Kenyan government would probably like to know the answer, too.
Better health care has been a welcome development in Africa. But Peter Dodds , director of the Family Planning Association of Zimbabwe, notes that the same physicians who worked so diligently to improve African health standards and cut the infant mortality rate often gave little thought to the entirely predictable result of their efforts -- spiraling population growth.
"They had measles vaccine in one hand," he says, "while the other hand was empty."
Advances in health care were not accompanied by education on the ways to limit family size -- and on the reasons to do so.
Even now, with warnings of the dangers of unchecked population growth in Africa, some people don't concede that a problem exists.
For example, Christopher Mulei, writing in Nairobi's Sunday Nation newspaper, argues that "Africa is actually underpopulated." Without citing sources, Mr. Mulei states that the continent has 1,400 million hectares (a hectare is about 2 1/2 acres) of arable land south of the Sahara, yet only about 170 million is under cultivation. By bringing the underutilized land into production, he argues, Africa could support a much larger population.
He charges that much of the concern about population control comes from the "developed world," which fears "a radical challenge to the international order."
But Mr. Dodds warns that the apparent abundance of space in Africa "is the snare and the delusion. People see space and say there is room for other people. That's not so."
And why not?
For one thing, Dieter Erhardt, an official of the United Nations Fund for Population Activities (UNFPA) says, "most people have a wrong view of overpopulation, because they only calculate the number of people per square kilometer. The number should be the number of available work places compared to the available work force."
By that standard, virtually every sub-Saharan African nation can be said to be feeling the effects of overpopulation.
Those who justify a much larger African population by stressing the continent's untapped agricultural potential miss the point, according to some experts.
In some countries environmental factors -- such as lack of irrigation water -- limit agricultural production. And even countries with both land and water lack the resources to bring new lands into development.
Robert W. Kitchen Jr., an official of the United Nations Development Program, can easily rattle off a number of projects that theoretically could increase food production in Africa.
Sudan, according to Mr. Kitchen, could become a breadbasket rivaling the American Great Plains in grain production -- if ambitious irrigation projects were undertaken in that country. But a 1974 estimate for such projects pegged the cost at $800 million, he says, adding that inflation probably has pushed the figure closer to $2 billion now.
Where, asks Mr. Kitchen, can African nations come up with such sums?
"Those funds are not in sight," he states bluntly, "and therefore the option is clearly to approach zero population growth."
Mr. Erhardt raises an even more fundamental question: If jobs cannot be provided for the millions of Africans born each year, then how will they be able to purchase the food that is available?
Some critics argue that Africa can always fall back on the subsistence farming that has sustained the continent for generations.
But the prestigious Worldwatch Institute questions that pat assumption. According to the institute, the demand for protein in a hungry world has, in some areas, already led to overfishing. The search for firewood in some parts of Africa has caused denudation of the land, that, coupled with overgrazing, has contributed to the spread of deserts. As the institute warns, "Populations are, in effect, outgrowing the biological systems that sustain them."
Moreover, the facts suggest that many Africans will not be content with a life of peasant farming. In fact, urbanization is now occurring rapidly across Africa. Where there is now only one city on the continent with an official population of over 5 million (Cairo), demographers predict there will be five by the year 2000.
Of course, food production in Africa must rise as populations grow and people change from food producers in rural areas into food consumers in the cities.But the UN estimates that in Africa, during the period 1970-77 food production actually fell at an annual rate of 1.3 percent.
Given these stark figures and gloomy projections, it is no wonder that one Western analyst pronounces the outlook for Africa "very bleak indeed" -- unless population growth can be brought under control.
Yet there is another, even more sobering statistic often overlooked in the population discussion. According to the Population Reference Bureau, fully 45 percent of the current African population is under the age of 15. Members of this group have their child-bearing years still ahead of them.
"The real population explosion," says the UNFPA's Mr. Erhardt, "we still have ahead of us."
But Mr. Erhardt says many African governments are aware of the need for family planning programs. Nevertheless, he says, they are hampered by a lack of funds, a shortage of trained personnel, and myriad other problems.
The result, says Nancy Harris, an official of Family Planning International Assistance (FPIA), is "a great unmet need for family planning services."
"I'm convinced," she says, "that there is a tremendous number of women who would accept family planning if it were readily available."
Yet family planning services are unlikely to be more widely available in Africa unless attitudes among the medical profession change, says Dr. Marasha. Dr. Marasha is sub-Sahara Africa representative for the Pathfinder Fund, a private foundation that supports family planning activities in less-developed countries. The agency receives most of its money from the US government.
"The biggest problem that you face in [bringing more family planning services to] Africa is the physicians," he says. "They are a stumbling block. They are not willing to admit that nonphysicians have a role to play in family health."
In many countries, he says, physicians view family planning services as their exclusive province. In view of the chronic shortage of medical practitioners in Africa, he says, that attitude virtually guarantees that adequate family planning services will not be available in many areas.
Yet Mr. Dodds, of the Zimbabwe Family Planning Association, argues that physicians are not necessarily the best source of family planning information.
"A medical person, with professional qualifications, is no longer part of the community," he says, and is often viewed by African villagers as "someone in a smart white uniform who's distanced from them."
To counteract this, Zimbabwe relies on para-professionals drawn from local communities to educate lay women and distribute contraceptive devices to them. These women, clad in beige dresses and green sweaters, take the family planning message to the grass-roots level. Even during Zimbabwe's bitter seven-year guerrilla war, many of them kept pedaling down the country's back roads.
Their efforts are paying off, according to Mr. Dodds, each month some 50,000 women accept family planning.
Dr. Marasha terms the Zimbabwe family planning program "one of the best in Africa," and other experts tend to agree.
The new Zimbabwe government of Prime Minister Robert Mugabe has given its support to family planning efforts. But, unfortunately, the same cannot be said about some other African governments.
In a continent where ethnic balances can still determine political power, some leaders encourage the expansion of their own tribal groups.
Still, the colonial powers must bear part of the blame for the tardiness with which some African states have come to grips with the population problem. Often , their slowness in granting independence kept the African people from acquiring the skills of governing."One day [African leaders] were made the head of state," says Mr. Dodds, "the next day they were faced with a computer. The next day they were told, 'Do you realize you're sitting on a population bomb?'"
The result is that some governments are frankly ill-prepared to formulate effective population planning programs. "There are no population policies in Africa," says Mr. Dodds.
"I think there are nine [plans] that have been published, but they're not quantified. There's no statement of what is the desired size of the community."
But there is a danger of too rigidly defining solutions for Africa.
Dr. Marasha says too many aid donors -- be they governments, international organizations, or private agencies -- place too much reliance on cleverlyworded grant proposals, and not enough on actually getting family planning services to the grass-roots level. The problem is often compounded, he says, by "population consultants" who are more interested in junketing than finding practical solutions to Africa's population problems.
When such people come to Africa, Dr. Marasha wryly observes, "they want to see as many animals as possible, and spend a little time talking to government officials."
Some experts argue that family planning programs can hardly expect to succeed in isolation while other social service and development programs languish. They view family planning as only part of a country's health care program.
But others complain that, given Africa's pressing needs for all sorts of medical and social services, family planning is often low on the priority list of many governments.
Mrs. Harris says there is a trend toward moving family planning services out of traditional health clinic settings, since "you can't possibly cover all those rural areas [in Africa] with clinics."
Meanwhile, some African leaders complain of the "faddish" nature of Western aid efforts. Too often, they argue, Western governments are willing to underwrite new, splashy, and headline-generating aid projects, but unwilling to fund the recurrent expenses associated with running a successful family planning program.
In the end, some aid donors are unsure of what approach to take to the African population problem. The United States, for example, gives money to a number of private agencies, as well as the United Nations; in addition, it sponsors family planning programs through the Agency for International Development (AID).
That may be more helpful than the Soviet Union, however, which contributes nothing to the UN Fund for Population Activities. And Dr. Marasha says that even though the Soviet Union has an impressive family planning program within its own borders, it does not share its knowledge and expertise with Africa.
The Soviet Union largely escapes criticism for its indifference. Western countries, on the other hand, are often questioned about their motives in trying to keep down Africa's population growth.
The once widespread belief that Western concern over African population growth had racialistic overtones is fading, according to some experts. Nevertheless, some suspicions linger, particularly the issue of alleged "dumping" of unsafe contraceptives in African nations.
A number of experts argue that new forms of contraception need to be developed. These should be appropriate, they say, for a largely rural continent such as Africa, combining ease of use with safety.
And some people think advances in contraception could help eradicate the widespread view in Africa that family planning is only a woman's concern.
"Perhaps if we had a contraceptive for men, they would see it [family planning] as part and parcel of their own responsibility," says one Kenyan woman. "But at the moment, they see it primarily as something for women."
In fact, the unequal status of women in African society is a major obstacle to effective family planning, she says. "Because of our tradition, the way we were brought up," she continues, "African women were taught that their main job is to have children."
In many areas of Africa, children were traditionally viewed as a form of insurance in old age, or as a source of dowry at marriage. Consequently, there were strong economic incentives to have large families. Although these reasons are slowly falling away as the continent develops economically, the traditionally subservient role assigned to women remains.
For that reason, more and more family planning programs are establishing ties with women's organizations. They reason that such organizations need to be supported in pushing for equal legal status and educational and job opportunities for African women. Historically, the realization of such goals has usually coincided with a falling birth rate.
Churches, too, have a role to play in solving Africa's population problem. In many areas of the continent, church mission stations are the only centers for health care and education for miles around. Many missionaries are, according to Dr. Marasha, incorporating family planning programs as part of their outreach work, with encouraging results.
The All-Africa Council of Churches is also grappling with the problem of how to reinforce traditional morality among younger Africans, as tribal mores fall away and Western influences become more pervasive.
Indeed, one mission hospital in rural Kenya reported that 20 percent of the children born there in 1979 were unmarried mothers.
Experts stress that there are no quick and easy solutions to Africa's population problems, and that solutions require patience and, above all, a caring respect for the human dignity of Africans. Programs involving coercion simply won't work, they say.
"The African is a very sensitive person," observes Dr. Marasha, "and he goes on the defensive before you even open your mouth."
Yet this need for sensitivity should not be used as an excuse for ignoring the serious consequences if Africa does not bring its population growth under control.
Says Mr. Dodds, "However you'd like to see Africa [in the future], you're confronted with the fact that as long as birthrates are left as they are, you are pushing Africans farther away from basic jobs, basic food needs."
"Whatever you'd like to see Africa become," he concludes, "it's unattainable so long as this situation persists."