Birth control will save the world

Despite the right's attacks, in many cases it's simply the difference between poverty and a comfortable life

Published September 22, 2013 4:30PM (EDT)

  (<a href='http://www.istockphoto.com/user_view.php?id=2384286'>plastic_buddha</a> via <a href='http://www.istockphoto.com/'>iStock</a>)
(plastic_buddha via iStock)

Excerpted from Countdown

Rubber

Thirty kilometers below Bangkok, where the Chao Phraya River meets the Gulf of Thailand, stands a remnant mangrove forest. In the early twentieth century, several monks retreated here from the city to practice the oldest form of Buddhism, known as Therava¯da, or the Forest Tradition. They named the temple they founded Wat Asokaram, the Monastery of No Sorrow.

In the twenty-first century, the estuary surrounding Wat Asokaram is no longer a forest wilderness. To one side are shrimp farms; on the other, a beach resort. The temple itself is now a Buddhist tourist attraction: a three-tiered, white wedding cake with thirteen spires. At one end of its ample parking lot, a path leads into what is left of the mangroves. Along raised walkways amid the trees are the monks’ kutis: clapboard cottages on pilings above tidal mud flats, shaded by curtains of hanging aerial roots.

The throb of urban Thailand fades here beneath the chitter of curlews and the splash of crabs and mud skippers. “In a city,” says Ajaan Boonku, a monk here for more than half a century, “you can study to control the mind. But it is difficult to achieve tranquility. In a forest, it is much easier to not think.”

At eighty-three, Ajaan Boonku is mostly sinew and bone. Wrapped in a brown muslin sanghati, he sits cross-legged atop a prayer rug on his covered porch. A bench against the wooden porch rail holds offerings from pilgrims who come seeking peace and guidance: shampoo, bars of soap, mouthwash, toothbrushes, Sensodyne toothpaste, and boxes of tissues.

To Buddhists, attachment to material things, even to the world itself, is a trap, because nothing is permanent. Is there no obligation, then, for a Buddhist to try to conserve the world, such as these mangroves and their fragile fauna?

“A humble Buddhist cannot strive to control the world,” he whispers in a voice like rustling leaves. “But balance cannot be achieved without nature. We monks of the forest try to preserve nature, as examples for others to follow.”

And if the entire human race falls out of balance because there are more of us than nature can accommodate, does Buddhism permit us to control our reproduction?

“If more people means more problems, they can adjust by any means. In Buddhism, we don’t prevent birth control. People with good morals know to have the right-size family.”

But to those who lack a monk’s discipline, the means to act on those morals were long unavailable, and human numbers grew overwhelming, undoing much of nature. Has an onrush of humanity possibly hastened its own demise? Ajaan Boonku shuts his eyes and leans on one thin forearm atop his thigh. Minutes pass. Then he straightens.

“We don’t know if the end for humans nears. We know it may come, so the mind must be ready. Overuse of this world by people brings disaster — floods, global warming. But it’s not the end of the Earth, even if it is our own. Nature will move onward, beyond us. But for now,” he says, “it is a good idea for us to save trees. It helps.”

*

Across the mouth of the Chao Phraya, another Buddhist temple, Wat Khun Samut Trawat, has been severed from the mainland by the rising Gulf of Thailand. Perched now atop a rocky islet, surrounded by half-drowned utility poles where there once was a village, the temple’s floor has been raised several feet, but the water keeps coming.

In 2011, a monsoon bearing 345 percent more rain than normal submerged much of Thailand, including half of Bangkok, a metropolitan area of 14 million people.

To the Western world, it would have been yet one more flood in a low-lying south Asian country, except that this one inundated Bangkok factories that assemble much of the world’s computer hard drives and semiconductor chips, as well as Japanese and American automobiles. The toll in Thailand approached $50 billion, and supply delays amplified those losses throughout the world. Damages would have been even higher, but a decision was made to open floodgates to divert the floodwaters into millions of hectares of rice paddies upstream of the city, to spare Bangkok’s downtown.

That included Sukhumvit Soi 12 — a narrow four-block spur off Sukhumvit Road, a Bangkok thoroughfare lined with Sheratons, Westins, and a high-rise fashion mall. Along Soi 12’s length, food stalls sell skewers of fried fish, pad Thai, oyster omelets, and sizzling chicken. Every few steps is a parlor offering variants of massage: herbal, oil, aroma, or soapy; facial, foot, head, or full-body — the last sometimes featuring Thailand’s euphemistic “happy ending.”

Halfway down Sukhumvit Soi 12, just past a miniature Buddhist shrine atop a white marble pedestal, a brick path lit by bamboo lanterns leads through a garden of banyans and palms, to a restaurant. According to guidebooks, it is one of Bangkok’s best. Inside, the lanterns give way to yellow, orange, green, and red fixtures shaped like globes, bouquets, and giant strawberries. On closer inspection, their designs turn out to be glowing collages — of multicolored condoms. A step farther, and condoms are covering everything, including several life-sized mannequins. Here’s Santa Condom, his suit, beard, and curly hair entirely confected of red and white rubbers. Same with the dress of the Thai princess at his side. A bride’s traditional white wedding gown and her tiara: all condoms. Ditto for bikini’d beachgoers, a bowing Chinese couple, assorted superheroes (including one named Captain Condom), and even Tiger Woods, the shaft of his putter a long stack of rolled condoms, next to a sign asking if he remembered to use them.

In addition to condoms, a gift shop sells coasters that read, “No Glove, No Love”; long-stem condom flowers; condom brooches; condom-shaped USB drives; 100 percent Thai silk neckties bearing a Gumby-like happy condom; condom key-chains that read, “In Rubber We Trust”; and T-shirts printed with ditties such as “Weapons of Mass Protection” — and:

“We took off our clothes, I got on top of you. How long before it starts feeling good?”
“I don’t know, but I’ve got a headache already.”

Above the bar, near a portrait of a sly Mona Lisa dangling a pair of rubbers, is a model of the Mayflower, its hull, sails, and riggings crafted of condoms. In the restaurant’s courtyard, where the haute prophylactic décor continues, menus reassure that “Our food is guaranteed not to cause pregnancy.” In lieu of after-dinner mints, the check arrives with flavored condoms.

The name of this discombobulating place is Cabbages & Condoms. Although its history is peripherally meshed with that of Thailand’s legendary sex industry, which crescendoed when fifty thousand U.S. troops were stationed here during the Vietnam War, the impetus behind Cabbages & Condoms goes far deeper. Quirky as it seems, it is part of what many call a miracle that changed all of Thailand — and continues to do so.

*

“Foreign assistance,” Mechai Viravaidya once told a visiting delegation of U.S. congressmen, “is like an erection. It’s nice while you have it, but it doesn’t last forever.”

That exchange took place in 1976. At the time, Mechai was in charge of something for which his economics and commerce degree from Melbourne University had absolutely not prepared him. Upon graduating, he had taken a post with Thailand’s economic development agency, traveling to evaluate infrastructure projects. Until then, he knew little of his country outside of Bangkok, where his parents were doctors.

The job was a chance to learn about transportation, energy, irrigation, schools, and telecommunications. But as Mechai’s biographer, Thomas D’Agnes, recounts in his book From Condoms to Cabbages, wherever he went, the same thing repeatedly grabbed his attention: astonishing numbers of children.

“In every village I asked women how many,” he recalls over coffee at the conference table he moved into the Cabbages & Condoms bar, which is much more fun than his office upstairs. “Seven to ten was typical.” He would look at the hordes of kids, then at mothers nursing one while pregnant with another, then at the prospectus for the project he was evaluating. Nothing added up.

“When I studied economics, they taught us not to worry about the number of people, because we can always expand food production. No problem.” Except there were plenty of problems. Mechai hadn’t studied demography, but he’d learned accounting. The numbers he ran told him that at a certain point there wouldn’t be any more places to put more rice paddies. And not just food. Every child ratcheted up demand for housing, clothing, schooling, and jobs. Add things like plumbing, water purification, and health services, then multiply them by the multiplying little bodies that surrounded his government jeep in every village he visited, and he concluded that his agency’s goals were futile.

There was no way that Thailand could go forward with so many people. On the contrary, they were doomed to fall farther back with each new, bigger generation. What were developmental economists possibly thinking?

With his agency reports vanishing into the bureaucratic maw, Mechai Viravaidya began moonlighting, writing folksy newspaper columns about economics under the pseudonym “GNP.” They earned him another extracurricular job as a radio commentator under yet another pseudonym, as he was still working for the government. But then radio led to television: A tall and handsome former national tennis champion, Mechai soon became a highly recognizable soap opera star and stage actor.

But he was still an economist, and he was thinking hard about how to leverage his media skills to that end. A column he wrote in 1968, extolling family-planning workers as unsung heroes of development, caught the eye of a Thai government advisor from a U.S.-based NGO, The Population Council. Their ensuing friendship led him to a position with the newly created Planned Parenthood Association of Thailand.

He didn’t stay long. His director proved to be squeamish when talking about sex: a bit of an occupational challenge under the circumstances. She was especially mortified by Mechai’s public presentations.

“I would start out with a box of pills, and people would just look at it. Then I’d show an IUD and get blank stares.” One day, while showing a condom at a training session for schoolteachers, without thinking he unwrapped its foil pouch.

Immediately, people started giggling. “Aha, I thought.”

So he unfurled it. Women shrieked. Now he definitely had their attention. Improvising, he explained that condoms were all-purpose tools that could be used as tourniquets, hair bands, wineskins (“or,” he adds today, “as waterproof protectors for mobile phones”). Then he did what boys everywhere have done, but not before an auditorium filled with two thousand teachers: He blew it up. Now even the shriekers were laughing. Condoms were distributed, and Mechai enlisted the whole room in an inflating contest, with a year’s free supply for the biggest balloon.

Soon thereafter, he persuaded some key people at the International Planned Parenthood Foundation to fund an experiment in family planning, separate from Thailand’s staid Planned Parenthood affiliate. It was an idea he’d gotten from women with big families in tiny villages.

“You have seven?” he’d ask. “You must be really smart. My mother is smart, but she never could have handled that many.”

Almost invariably, that provoked a sighing admission that they’d never wanted all those kids. There was a way to control such things, he’d explain, handing them a box of pills. “These are family-welfare vitamins.

You take them for the welfare of your family. They make you stronger, by giving your body a rest. If you decide you want to get pregnant again, you just stop.”

Letting women choose proved far more effective than making them feel stupid or guilty for having so many children. Everyone wanted the pills — which led to the next problem: Until then, only medical clinics dispensed them, but just 20 percent of the population lived in easy reach of one. Even if they did, many found medical centers intimidating.

“In business school, we’re taught to get to know our customers. So we’d ask local women who they trusted the most. Often, it was the local shopkeeper.” That was perfect. He’d put up a sign reading, “Contraceptives Available Here” right next to the Coca-Cola sign.

“We had the same customer base as Coke, so we used the same vendor. And our product was far less bulky.”

Letting communities distribute their own contraceptives was the idea he’d pitched to International Planned Parenthood, and he used his showmanship to leverage a $250,000 grant, far beyond expectations. It soon seemed like Mechai Viravaidya was everywhere in Thailand, passing out T-shirts that read, “A Condom a Day Keeps the Doctor Away,” getting taxi drivers and traffic cops — his “Cops and Rubbers” brigade — to hand out condoms, and passing them out himself at state dinners to foreign dignitaries. Along Thailand’s rivers and coasts, where shopkeepers were usually fisherfolk plying their catch, floating markets sold fish and contraceptives. Throughout the country, condoms became known as “Mechais.” When the inevitable question arose about whether birth control might be sinful, he consulted Buddhist scholars for scriptural guidance. The closest anyone could find was a reference in Therava¯da Buddhism’s Pa¯li Canon, stating that birth causes suffering.

“From your own teachings,” Mechai wrote to every temple in Thailand, “we can conclude that to prevent birth prevents suffering.” He enclosed a photograph of an abbot from a Bangkok temple sprinkling holy water on pills and condoms. It was soon published by newspapers throughout the country.

“No wonder there’s no side effects from the pills,” women told him. “They’ve been blessed.”

Within five years, Mechai Viravaidya’s organization — known today as PDA, the Population and Community Development Association — trained three hundred twenty thousand teachers to educate students about family planning. “We have to win over kids,” Mechai told his staff, “because the most important thing to customers is their children.” Besides the ever-popular condom balloon contests, he had Thai kids playing his version of Chutes and Ladders: Mother takes a pill or Uncle buys a condom: move one square ahead. Uncle gets drunk and doesn’t use condom: fall back five squares, etc.

One day a village woman told him, “It’s true that many children make you poor. But fewer children don’t make you rich, either.”

“You’re right,” he agreed. So he raised more money to fund an idea that began to pay back almost immediately: nonpregnancy agriculture credits. Villagers would elect a group of trusted women to stake other women with starter loans. “If you’re not pregnant for a year,” they’d explain, “you can borrow money to raise two pigs. If you’re not pregnant for two years, you can get money for four pigs. Not pregnant for three years, you get six pigs.”

Women soon realized that when they weren’t pregnant, they were making money. The nonpregnancy credits soon led from pigs to mushrooms, crabs, vegetables, edible crickets, and fruit trees. Finally, Mechai was fulfilling his real goal: making his country viable. His training was in economics, not family planning. Contraception, he argued, was a means for people to have a chance at prosperity, and for Thailand to have a future.

“The only way out of poverty is through business and enterprise. Access to credit must be a human right.” Years later, when his PDA won the Bill and Melinda Gates Foundation’s 2007 Award for Global Health, he used part of the $1 million prize to take his “barefoot entrepreneurs” model even further, by establishing Thailand’s Global Warming Foundation. The idea was to give poor people a way to help themselves and to help meet a global emergency. Over the years, their lending had expanded to small businesses ranging from embroidered silks to ice cream to raising off-season organic limes and cantaloupes that earned several times their normal price. Now, partnering with sponsoring Thai companies, they could finance these microloans by planting trees. Under the plan, companies pay elderly villagers to sprout seedlings that younger villagers plant. Each is valued at US$1.25, so a village that plants twenty-five thousand trees earns $30,000 for its development fund.

“This way,” says Mechai, “they feel ownership of their lending banks, and of their planet’s future.”

*

In 1970, the United States invaded Cambodia, a country it was already bombing in hapless pursuit of North Vietnamese forces. The invasion had the unintended consequence of unleashing Cambodia’s Khmer Rouge, a communist force previously under the disciplined rule of North Vietnam. Its genocidal leader, Pol Pot, soon launched his own equally disastrous version of China’s Cultural Revolution. After U.S. troops left, the Vietnamese finally routed the Khmer Rouge in 1979. Under its reign, entire harvests had been destroyed, a fifth of Cambodians had perished, and famine had struck. Nearly a million Cambodian refugees, many starving, were either in Thailand or packed into refugee camps along its border.

They needed to eat, even as Thailand was trying to feed its own exploding numbers. By then, Mechai Viravaidya’s PDA, working with the Ministry of Public Health, had helped to cut Thailand’s stratospheric fertility rates by nearly half in just six years. The toll of women dying from illegal abortions that commonly involved bamboo slivers had slowed after PDA established a clinic for legal terminations to protect the health of the mother, which became the model for clinics throughout the country. It was no surprise to Mechai when they were asked to help with the Cambodian crisis.

His prescription for the refugee camps was what PDA was already doing in Thai villages: First, empower families that could ill afford more hungry children with the means to control pregnancies if they chose. Second, give them a chance to provide their own relief, rather than depend indefinitely on donations. They organized family-planning clinics in the camps, run by the refugees themselves. Other refugees were soon in charge of sanitation and waste removal. To counter animosity from locals, they channeled relief funds to purchase food directly from a network of small farmers that they started, cutting out middlemen.

That program worked so well that surplus cabbages, garlic, squash, and other produce began to accumulate at PDA headquarters in Bangkok, so Mechai opened a vegetable stand with profits going toward the refugee fund. As he still reflexively disbursed condoms — Thailand today is the world’s biggest producer — its sign read, “Cabbages & Condoms.” The vegetable stand prospered, and became a restaurant. Then six restaurants.

In the 1980s, Mechai was tapped more for public service, as head of Thailand’s public water authority and as Deputy Minister of Industry. Then came another national crisis. When AIDS first appeared, he tried to convince the prime minister how serious it was. The prime minister feared that declaring a national emergency over a sexually transmitted disease would be disastrous for Thai tourism, of which the sex industry had become a pillar. Not waiting for things to deteriorate enough to change his mind, Mechai approached the military, which happened to own 326 Thai radio stations. The generals, understanding the threat of their troops becoming infected, gave him carte blanche access to their airwaves.

Having the world’s foremost condom expert running a national AIDS program, as eventually occurred, proved fortuitous. Presently, Captain Condom was dispensing samples in the nation’s schools and reminding business leaders that “dead customers don’t buy.” After Mechai was named Minister of Tourism, resorts held Miss Condom pageants and hotel mini-bars were stocked with prophylactics. It became mandatory to use a condom in a Thai brothel. Because prostitution is not just a tourist attraction but considered routine recreation by Thai men, the United Nations calculated that 7.7 million Thais were prevented from getting infected with HIV.

By the new millennium, HIV infection rates in the country were down by 90 percent. And Thailand’s fertility rate, 7.5 children per woman in 1975, had fallen to 1.5, where it remains today.

Excerpted from "Countdown: Our Last Best Hope for a Future on Earth?" by Alan Weisman. Copyright 2013. Little, Brown and Co. All rights reserved.


By Alan Weisman

Alan Weisman is the author of several books, including "The World Without Us," a National Book Critics Circle Award finalist, winner of the Wenjin Book Prize of the National Library of China, and an international bestseller translated in 34 languages. The 15th-anniversary edition was just published by Picador. Weisman's reporting has appeared in Harper's, New York Times Magazine, Atlantic Monthly, Discover, Vanity Fair and Mother Jones. He lives in Massachusetts.

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