By Dr. Ian Clarke
Generally speaking a young healthy population is an asset to a nation, which is why many Ugandan politicians have encouraged their constituents to have large families. In countries such as Japan, China and Russia there is an aging population, which will give rise to shortage of labour in the future. Uganda has the second highest rate of population growth in the world, so is this large population bulge of young people an asset or a liability?
As a generalization, a young population gives strength for a nation, and if we take the example of Ireland, where they traditionally had large families, their young people are an asset, which attracts foreign companies to invest in Ireland. This is especially so in the IT sector, because they know that in Ireland they will find the right workforce to fill the jobs. However, this is because most Irish young people have relevant university degrees or technical training which equips them for such employment.
I am writing on this subject because this week I felt constrained to a serious chat with my own workforce who are employed on my farm located in the west of Uganda. Some workers were transferred from projects in Kampala where they have families, while others are young single men. Free medical treatment is provided as part of their employment package and the clinic carrying out the treatment informed me that there were a number of cases of sexually transmitted diseases. I had also heard a rumour that some local girls were pregnant by my workers.
This set off alarm bells because although I had ensured that condoms were readily available, it was evident that the condoms were not being used. Condoms, when used correctly, will prevent the transmission of conditions such as gonorrhea and non-specific urethritis, as well as HIV. The use of condoms also prevents pregnancy.
I felt it was my duty, not to simply turn a blind eye to what I had learned, but to have a serious chat with the men. Hence I gathered them together and did some straight talking. At first there were sniggers and suppressed laughter, but as I went into detail of the risks they were taking, they sobered up.
‘You do realize that you are exposing yourself to the dangers of catching HIV,’ I said, ‘because if you are catching STIs then you are obviously not protecting yourselves or your partners, and unless you have gone for testing with your sexual partner and you are both negative, you are at risk. Also, some of you have families back in Kampala, but you seem happy to get these local girls pregnant. Do you want another family here?’ I asked.
‘You earn between 300,000 to 600,000 per month, you can barely support the family you already have and you are going to get another girl here pregnant?’ I asked.
‘How are you going to pay for these random children?’ By this time no one was laughing.
‘Or are you simply going to impregnate some village girl and then take no responsibility?’ I continued.
‘I am not giving you a lecture on morals’, I continued, ‘but I am telling you to plan if you want to father another child, but use a condom if you don’t so that you don’t have children as a by-product of casual sex or get gonorrhea or HIV’.
I had observed the same behavior when I was Mayor, from the residents of the slums of Namuwongo, who did not plan for children; unplanned pregnancy just happened as a result of unprotected sex, and the women were left to bring up the kids as best they could.
This is in stark contrast to my middle class Ugandan friends who usually limit their family size to two to three children. The reason is that the middle class couple are more educated and calculate the cost of bringing up children. They know it is expensive to buy clothes and feed a child and then send him/her to a good school and on to university.
It is the financial implications that deter the middle classes from having big families. On the other hand, the lower paid workers did not appear to sit down and calculate the cost. Despite this, they knew instinctively that having many children made huge demands on their resources. As I pointed out – they were breeding themselves into poverty.’
It is important to make the distinction between the number of children a man can sire, and the number of children he can afford. I read about a man who had fathered over a hundred children, but then appealed to government for support. Even though this man was biologically capable of having such a remarkable number of children, he could not provide for them, so he was bringing them into this world to live in poverty.
Family planning is not just about contraception, as most men seem to think, it is about planning for the future, for the number of children they want and that they can afford. As such, men should give planning a family a lot more thought than they do.
The writer is the Chairman at International Medical Group, Uganda and Board Member at ‎East Africa Healthcare Federation (EAHF)