Saturday, November 22, 2008


Just received this letter from a Mr. Dave from Florida, a man who used to work as a consultant in the PopCom of the Philippines back in 1972.  Dave offers a very interesting insight into how population management affects economic development.  He also presents an interesting analysis on why it didn't work in the Philippine setting.  Now remember, his experience is from more than 30 years ago.  I am pleased to know though that a few things have changed for the better since he was here in the early 70's.  Most interesting of all is that the Iglesia Ni Kristo is Pro-Reproductive Health nowadays, a huge shift from their position back then.  Photo above (Crowded Maternity Ward in Manila - Reuters).

Dear Carlos,
Why are South Korea, Taiwan, Japan and now China rich, and why is the Philippines poor? Demography is destiny. The dependency burden is the killer and the Philippines has one of the worst dependency burdens in the world.

Following is my story as a public health practitioner. When I was 36 I had lived in the Third World for half my life, in post-war Japan and Guam and the Philippines in the 1940s and 1950s, in Korea and Taiwan in the 1960s when they were impoverished, and in the Philippines, Indonesia, Thailand, Nepal and Turkey in the early 1970s. I speak from experience. Nothing I say is theoretical or academic.

I am truly saddened that the Philippines has opted to be poor due not to "foreign oppression" but to lack of demographic understanding. I have to start out by telling you that I am old, but that will become apparent as you read through the narrative. My degrees are in Sociology and Anthropology from Cornell, and a Masters in Public Health from Berkeley. My story starts in post-war Japan. I was born before the Second World War. I visited the Philippines and Japan first in 1948 as a US military dependent. In the Philippines I saw a country climbing out of the ashes of the war, at about the same economic level as Japan where I saw first hand the destructive power of the carpet bombing of Tokyo. My guess then would have been that the Philippines would be a rich country in 60 years and that Japan would still be poor. Boy was I wrong!

I was in Asia again in 1954 and 1955, during and after the Korean War, when I was in high school. I noticed then that the Japanese were very intent on exactly reproducing themselves, not overdoing it in the reproduction department. The average family at that time had two kids and they invested heavily in their children. They put all their money in making sure that their children never went through what they had suffered, and they saw that the path to success was to have two children, invest in their kids' education, get them into good jobs and that would be their path to family, community and national economic security. From my first visits to Japan in 1948 to my last visit there in 2007 I have seen a country go from flat on its back to one of the very strongest economies in the world.

From 1967 to 1972, I was fortunate to work as a consultant in two countries where the governments used voluntary programs and succeeded in drastically reducing population growth with some measure of assistance from the international community. These were South Korea and Taiwan (although Taiwan is not literally a country, but a province of China). Their achievement is best measured by the Total Fertility Rate or Live births per average woman in her reproductive lifetime. In South Korea and Taiwan we took the TFR from above 5, which implies doubling every 20 years, to 2, which is replacement level, in a generation. In each country it is now well below replacement level. We did this through massive intervention as I will explain below. I then worked in one country where we failed miserably to achieve the desired fertility reductions, the Philippines, and I can tell you why we failed.

In each country I served formally as the Information, Education and Communication Consultant to the Ministry of Health, Family Planning Division. In each country I also served informally as a consultant to the Ministry of Education, where I helped with curriculum design. I was supported by foundation money.

We succeeded in Korea and Taiwan because there was a strong government push for reduced fertility and we were able to communicate this mind-set to every citizen, including school children and young adults, grown-ups of child-bearing age, and elders. Everyone could look around their peninsula or island and say, "This is enough."

In Korea and Taiwan there was first a trust in centralized government and in the top down process of distributing government largesse. This is an artifact of the Confucian system of respect for the hierarchy. The central government, the provincial government, the county and township and village governments were all saying the same thing. There was no organized opposition from any religious organization and there was no ethnic minority saying, "we are being outbred." Children were surviving at an unprecedented rate, and economies were in transition as people left the countryside where child labor was a plus, for the city where children were a financial burden. Education was free through middle school and everyone stayed in school as long as the family could afford.

The message was clear and repeated in road signs, in pamphlets, in curriculum and on radio and TV - "Girls and Boys are Equal, Two is Enough!" This was a really powerful and shocking statement, putting the word "Girls" in front of "Boys" and saying something so patently unsupported by historical observation, that two children would be enough. The shocking statements were explained by government officials and university professors and other respected leaders telling the media that in the new era you did not need 3 or 4 boys to continue the family name, and to bring the family into the modern era, that improvements in health care and opportunities for education made the two child family viable, and that the land and the economy could support those two children, but not three or more. There were no restrictions against birth control or abortion in either country.

After my success in Korea and Taiwan I was identified as a person who could help other countries through the demographic transition, and I was invited by the Philippine government to serve in a similar advisory capacity, from January 1972. Upon arrival in the Philippines I was asked by Dr. Conrado Lorenzo, Director of the Population Commission (PopCom) of the Government of the Republic of the Philippines to report on how the experience of Korea and Taiwan might help the Philippines. Unstated in this request was the implicit understanding that there was about $50,000,000 in immediately available foreign aid that could be gotten to support a plan that would have the same effect in the Philippines as we had in Korea and Taiwan. 

My report to the Population Commission was not well received. Population Commission was broadly representative of the Philippine society with representatives from all the major government departments, including health, education, labor, social welfare, housing, etc. They wanted to achieve the replacement levels that they saw coming in both Korea and Taiwan and had brought me in to tell them how to obtain that result. They wanted to reduce the dependency ratio, the number of children that had to be supported by each working family. However, in the Philippines I was able to find 13 factors that mitigated against any such success. The government of Ferdinand Marcos was not universally trusted at every level. There were over 100 separate languages that were coded by the Census Bureau and many of these linguistic subgoups were afraid of being "outbred" by the others, particularly the politically dominant Tagalogs, who were not the numerical majority. 

The Catholic Church was against the program, as was the most vociferous non-Catholic sect, the Iglesia ni Cristo, which was afraid of being outbred by the Catholics. Child mortality was high, health care was poor in the rural areas and the city slums, the gap between the rich and the poor was growing, there were few alternative roles for women besides wife and mother, and everyone had a relative in the US or knew someone who had a relative in the US, so they felt there was a place to send their excess children. 

There was little access to any birth control except the rhythm method, and abortion was absolutely illegal. The PopCom clinics did prescribe pills and insert IUDs but the Church fought this movement through their Responsible Parenthood Council. Free education stopped before 6th grade for most, illiteracy was rampant, rural development was underfunded meaning no lights in the village, there was no adequate social welfare system to help those who did not have large families to support destitute citizens, basically life was a lottery and the more tickets you bought (children) the more likely you were to succeed.

Most telling were the responses in Knowledge, Attitude and Practice surveys in the three countries. In Korea and Taiwan most people automatically listed the keys to success in the following order:

1. Hard work
2. Education
3. Contacts (mostly school alumni)
4. Family
5. Luck

Filipinos usually ranked the steps to success in the following order:

1. Luck
2. Family
3. Contacts (mostly under the table or overseas)
4. Education
5. Hard work

My report concluded that until the society changed in every way, money sunk into family planning programs would be entirely wasted. That was not what the Popcom wanted to hear, and I was marginalized after that report came out.

Here is the crux of the matter.

In the mid 1960s South Korea and the Philippines had about the same population, about 30,000,000 and had about the same per capita income, around $1,200 per year.

According to the Population Reference Bureau South Korea in mid 2006 had a population of 48,500,000 and a per capita GDP of $21,800, and a TFR of 1.1, implying a population that will eventually fall by 2050 to 42,000,000, a population size which we may assume can be sustained at a high level of economic and social development indefinitely. South Korea has become a Developed Country.

The Philippines in mid 2006 had a population of 86,000,000 and a per capita GDP of $5,000, which is very poorly distributed, a TFR of 3.8, implying a population that will rise by 2050 to 142,000,000. The Philippines has become, in my estimation, a "Never to be Developed Country," not a "Developing Country."

Do you get the difference? Korea went from 30 million to 48 million, increasing by half, and the Philippines went from 30 million to 90 million, tripling in size. The experiment is OVER. High fertility over a long period of time CAUSES stagnation and poverty. Low fertility over a long period of time CAUSES economic growth. Having 3 or more children per woman is suicide.

China's economic success today is due to the lowering burden of a reduced dependency ratio. China has succeeded brilliantly in reducing fertility in a single generation through the One Child policy. China's TFR is now 1.6. Their population is now 1,300,000,000 and will not go much over 1,400,000,000 by mid-century. They are riding the boom of decreased dependency ratio. In the long term it is the dependency ratio that will determine a country's fate, since every added dependent above one or two is a drain on the family and on society. China is already importing Filipinos and Vietnamese to work in their factories.

With this information as a basis, can we begin to talk about effective means for solving the ongoing world population crisis? Countries like the Philippines, Bangladesh, Mexico and sub-saharan African nations still have 5 or 6 kids per woman during her reproductive lifetime. According to Population Reference Bureau the Less Developed World (without China) has a 2006 population of 4,028,000,000, growing at a TFR of 3.4, with a projection in 2050 of 6,545,000,000. That is 2,507,000,000 added mouths to feed in a world that is growing less food, catching less fish, increasing the size of deserts, losing entire fresh water sources, depleting ground water, becoming far more polluted and on the brink of swift ecological decline through global warming. That means we need to somehow accommodate an additional population of young people whose numbers will equal the entire world population in 1955. There is a limit to the carrying capacity of the planet. Are we rats? Who wants to live at the level of quality of life of the Philippine village when you could live like a South Korean or a Chinese?

Population is still the number one problem on Earth, since all other problems stem from the fact that there are just too many of us humans, and everyone wants the American lifestyle. We have pumped up everybody's expectations to an unsupportable level and now we need to face that fact. As Thomas Malthus said, "Nature will take care of the population problem in time, either through adjustments to the birth rate or to adjustments to the death rate."

So, Carlos, how do we proceed? Can the Philippines really afford not to take aggressive action to legalize and actively promote contraceptive use? I am so sorry to have seen this 60 year descent into population abyss for the Philippines when the surrounding countries went to the mountaintop in the same era.


So guys, remember, STAY VIGILANT. The bill still has not passed.  The Catholic Church is still using their bullying ways to influence some spineless congressmen. READ HERE:  If we let the bishops derail this bill one more time, it will only prove that the Philippines has no place in the developed world and truly deserves to be an overpopulated, underdeveloped, unhealthy, and uneducated nation forever. Oh, and for more on the hypocrisy and homophobia of the Catholic Church hierarchy. Click here.  

And I'll start posting lighter stuff soon...  But it's hard to do so with the debates on the RH bill coming up so soon in Congress. Really, it's the only thing on my mind nowadays.