MOHAN RAO

I

This document, poorly substantiated by data, deeply contradictory and profoundly at variance with the NPP, was drafted in the ahistorical language of neo-Malthusian scare-mongering. It attributed all the failures of the Indian state in the provision of healthcare to population growth and called for a range of incentives and disincentives – such as are present in many of the state population policies. The piece de resistance was the argument that China’s remarkable economic performance could be attributed to its one-child norm. Comparisons between India and China are of course inapposite for a large number of reasons, including per capita incomes, achievements in health, equity and education. Indeed, as Sen has shown, these Chinese measures on the population front were not just unnecessary but counterproductive; for instance Kerala’s birth rate declines were much sharper than China’s, and without obvious coercive measures [Sen 1994]. Indeed what could have informed India’s population policies were the appalling consequences for gender balance that China’s population policies have wrought, since India seems to be following China in its sharply skewed sex ratios at birth and child sex ratios. Indians, like the Chinese before them, are achieving population stabilisation, but at the cost of millions of “missing girls”.

For those in thrall with China’s population policies here is a majestic book that traces the evolution and growth, the ups and downs, and the factors influencing them, in one of the largest public health initiatives in the world. Relying on an astonishing array of sources, both primary and secondary – from official records (including minutes of meetings seldom accessible to scholars) to a range of studies, personal interviews, observations and, of course, vast years of field studies by the authors themselves, this is a masterful study of a vast and complicated subject. The book is divided into two sections, each divided into several chapters; the first outlines the official discourse and programmes in what has been described as the “governmentalisation of population”, a view from the top; the second, the view from below, the consequences, sometimes grievous, of the project of the bio-politics of life.

In the decades since the 1970s, China has experienced one of the fastest fertility declines in recorded history. In the 1970s, the number of children per woman dropped from just under six to just under three – this was a period accompanied by rapid improvements in health, sharp improvements in infant and child mortality, and increases in life expectancy at birth. In the 1980s – the heyday of the one-child norm and harsh incentives and disincentives, fertility hovered somewhat above the “replacement level” of 2.1 children per woman. By 2000, fertility appears to have dropped further to around 1.6. Vast sections of China’s people have, in the globalised

Economic and Political Weekly May 6, 2006 world, become increasingly preoccupied with producing “world class people: good scientific mothers, exemplary single children, and globally competitive workers” (p 2). From a commitment to Maoist and Stalinist principles in the Mao years (the 1960s and 1970s), to the high tide of Stalinism in the Deng era (in the 1980s), to the neoliberal policies of the Jiang (the 1990s) and now in Hu’s era, the politics of population, the policies that emerged, the actors who guided these changes and the programmes that ensued have varied. What has occurred also is a transformation of the Chinese world and of the family and women within it.

In September 1980, the prime minister Hua Guofeng announced that “after much research” the government had adopted a one-child rule. This policy prescription had emerged when mathematicians “drawing on two closely related natural sciences borrowed from the west, population cybernetics and the population ecology of the Club or Rome” (p 214) projected an alarming trend of population growth. More significantly, it stemmed from the yearning of the political leadership to “modernise” and enter the new globalising universe as a major player: population growth was seen to hold China back, to keep it permanently backward and forever peasantised. Thus, dawned one of the most brutal periods in the history of family planning in the world, rivalled only by India and Peru: the forcible sterilisation of millions, the performance of late abortions, the implementation of a host of harsh disincentives, measures that “injured bodies, upended lives, and destroyed local government institutions” (p 225). By ignoring the vital role of children in the peasant economy, ignoring patriarchy, believing that “the nation was to be eugenically enhanced to promote fitness and competitiveness of the national organism in a social Darwinist world of inter-racial and international competition” (p 214), the people paid a huge cost, not least through the disappearance of girls.

For a growing number of Chinese couples, prenatal sex determination, followed by sex selective abortion, became a “modern high-tech way” of meeting population norms. The sex ratio at birth soared – to 126 boys per 100 girls. Like in India, there soon emerged a market of girls of marriageable age who were often kidnapped. Even more poignantly, there emerged a huge population of “black” children – unwanted, unregistered by the state, and thus unable to access citizenship claims to services. While the birth rate indeed came down, the question that has been asked is: were these measures necessary? The experience across the world

– including in contemporary times in countries such as Russia, where the birth rate refuses to go up despite a host of incentives – is that once there is an onset of a secular decline in fertility, it obtains a momentum. The irony too is that these terrible measures were initiated at a time when the state was loosening controls to initiate marketisation.

Given the resistance that surfaced to the one-child norm, the policy was selectively relaxed. At the same time, the emphasis shifted from quantity to “quality”. Over the 1990s, the state initiated a number of reforms towards providing quality reproductive and child health services, and the provision of old-age security and insurance. With the total fertility rate reaching below replacement levels, albeit with regional differences, efforts were also made to undo the damage: coming down heavily on sex-selective abortions, encouraging adoptions, allowing “black children” admission to schools and so on. The “quality project has become a major site for the creation of [a] self-regulating, ‘autonomous’, neoliberal subject necessary for both the marketising capitalist economy and the slimmed down neoliberal state” (p 217). The emergence of “quality” singleton urban children, the emperor and empress of consumerist arcadia, of selfish, market-crazed global citizens, of course brings in its wake its own social problems – of mothers striving desperately for new norms of “quality” femininity, of parental care and neglect. As Greehlagh and Winckler conclude “over the last quarter century, the state has both gained and given up power over Chinese lives” (p 286).

It is not possible in the space of a short review to do justice to the richness of the tapestry woven in this book. But if at least some lessons are learnt by policy-makers in India, anxious to emulate China in only its terrible lessons, the book would have accomplished more than any reviewer, or indeed author, could ask for. Other than students of public health, gender and area studies, the book is mandatory for policy-makers.

EPW

Email: mohanrao@bol.net.in

Reference

Sen, Amartya (1994): ‘Population and Reasoned Agency: Food, Fertility and Economic Development’ in K L Kiesling and H Landberg (eds), Population, Economic Development andEnvironment, OUP, Oxford.

Economic and Political Weekly May 6, 2006