No. 224 FEBRUARY 1993.pdf

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COMMUNITY HEALTH CEU

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(pNo.224 February 1993

326- v Ma'n. I Block

ISSN 0911-0755

Korambngala

JOICFP NEWS
Humankind, Culture and the Earth
Tokyo symposium highlights impact of lifestyles and population pressure on environment
are threatening our life support systems
on this planet.”
The symposium was organized by
Population Forum 21 and the Interde­
pendent World Institute. Supported by
UNFPA and the Mainichi Shimbun
(Newspaper) in cooperation with
JOICFP, it was attended by 300 people.

Sustainable Development

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Rapid population growth and the environment: a favela in Sad Paulo, Brazil.

The theme of “Humankind, culture
and the earth” drew comments about the
impact of lifestyles in developed and
developing countries and population
pressure on the environment from
speakers and panelists at the Population
Forum 27 symposium, held in Tokyo on
December 22. Opened with speeches by
Saburo Okita,
chairman of
Population
Forum 21 and
former foreign
minister of
Japan, and Dr.
Nafis Sadik,
executive
SoshitsuSen

symposium included addresses by Dr.
Soshitsu Sen IX, grand tea master and
Prince Takamadonomiya,followed by a
panel discussion.
The Japanese tea ceremony, or chano-yu, is a traditionally ritualized way of
making tea. Originally from China, the
ceremony is greatly influenced by Zen
Buddhism and was raised to an art form

by Sen-no-Rikyu in the 16th century. The
ceremony, which emphasizes spiritual
tranquility and simplicity of taste, has in
turn influenced many aspects of Japanese
culture and lifestyles.
“The tea ceremony teaches us of our
most valuable possessions — naturalness,
simplicity and self-knowledge,” said Sadik
in her opening address. “Yet today, outside
the tea house, we are living in a world that
lacks those most precious of all qualities.
It is a world profoundly out of balance.
“In the industrialized countries, where
population growth has dramatically slowed
or stopped, we are using the globe’s
resources in a reckless and heedless
manner,” she said. “The prevalent ethic
causes great environmental damage
through its wasteful production techniques
and gratuitous consumption.” Sadikadded,
however, that most people suffer from a
lack of resources. “In the developing world
where four-fifths of the people live,
widespread poverty is exacerbated by high
population growth rates which erode or
destroy economic development and create
environmental havoc,” she said. “Together,
both the developed and developing worlds

For his keynote address, Sen touched
on the issues of consumption, sustainable
development and quality of life under the
theme of “Suggestions for a better way of
life.” Referring to the four elements of
the tea ceremony — peace, mutual
respect, purity and silence—Sen stressed
that lifestyle change is the key to a brighter
future for humankind and the earth. “The
themes of peace and mutual respect go
beyond national borders and skin color,”
he said. “We are all part of the same
human race. We must learn how to
coexist peacefully with one another and
nature if we are
to survive.”
“Environ­
mental issues
should be join­
tly discussed by
the people sharing the same
planet to ensure
that the future is
Nafis Sadik
brighter for the
next generations,” said Prince
Takamadonomiya. In his address, the
prince stressed shared global responsi­
bility for environmental issues.
The panel discussion was coordinated
by Takeshi Hara, chief, Science Depart­
ment, Mainichi Shimbun (Newspaper).
The panelists comprised Kazuo Ogura,
director general, Economics Bureau,
Ministry of Foreign Affairs; Gregory
Clark, professor, Japanese Literature,
Sophia University; Chieko Mulhern,
professor, Literature, Fukuoka Women’s
University; and Eiko Ohya, freelance
journalist.
[j]
1

In the News

Women,
Population Target for Africa
Population & Dakar conference calls for dramatic cuts in population growth rate
Development
During her stay in Japan, Dr, Nafis
Sadik, executive director, UNFPA, gave
a lecture at the Office of the Prime
Minister on December 16. Below are
highlights of her talk.
When we talk of increasing the use of
family planning (FP), we are talking about
a great deal more than providing
contraceptives. Family planning is part
of an environment in which everyone
has opportunities and choices. Building
on these opportunities begins at birth
and depends among other things on the
position ofgirls and women. Higher status
for women brings more ability to choose:
where the choice is available, women
will take advantage of it.
The International Conference on
Population and Development is part of
the wider vision. Beyond it lie the
Women’s Conference and the proposed
Social Development Summit in 1995.
Women’s interests will be central to all
these discussions and decisions.

Education for Women
Sadik also spoke at the Meeting with
Japanese Women’s Groups in Fukuoka,
held on December 17 and 18. Below
are highlights of her lecture.
Education of girls is perhaps the key
intervention in releasing them from the
oppressive hold of tradition. It is also a
key to reducing fertility levels and infant
mortality rates and in improving the
overall well-being of the family. With
education comes increased confidence
and self-esteem. Educated women are
more likely to stand up for themselves,
join the labor force and seek healthcare
for themselves and their families.
Family planning program develop­
ment and service delivery should be
appropriate to the needs of individuals
and communities. Non-governmental
organizations have an important role as
they are usually in touch with the
aspirations and needs of the local
community. To be effective, programs
must provide client counseling, full
information regarding contraception and
a choice among safe and effective
methods. The availability of quality FP
makes it possible for women and men to
practice responsible parenthood.
|T]

2

An ambitious regional population implementation of population and deve­
growth rate of2.5% by the year 2000 was lopment programs difficult.
set as a targetfor Africa by participants of
The role of the NGO in promoting
the Third African Population Conference, population and development programs
held in Dakar, Senegal, from December 7 at the community level was also fully
- 12, 1992. Incorporated in the recom­ recognized in the resolutions which call­
mendations put forward in the Dakar ed for NGOs to promote community
Declaration, the call to dramatically slow participation and involve communities
population growth underscored the desire in program planning, implementation and
ofAfrican governments to solve population financing; enhance collaboration and
problems, promote sustained economic coordination with multilateral and
growth and achieve sustainable bilateral organizations and other organi­
zations and gov­
development. To
lower growth
ernment agencies.
Participants agreed
rates, participants
that NGOs should
called for the
be strengthened and
integration of
population poli­
considered full
partners by gov­
cies andprograms
ernments in the
in development
implementation of
strategies,
population pro­
focusing
on
grams and in
strengthening
contributing to the
social sectors with
formulation of re­
a view to influ­
lated policies.
encing human
“They should also
development and
J
be empowered to
urged the setting
act as a liaison
of quantified
between the com­
national objec­
munity and the
tives for reduc­
public sector pro­
tion ofpopulation
grams to facilitate
growth.
large-scale rep­
The confer­
lication of suc­
ence was organi­ Participants of the Dakar conference.
cessful innovative
zed under the joint
auspices of the Organization for African pilot programs,” state the resolutions.
Another feature of the recommend­
Unity (OAU), United Nations Economic
Commission for Africa (UNECA), African ations put forward at the conference was
Development Bank, UNFPA and Union the recognition of the effectiveness of
for African Population Studies. Attended integrating population factors with other
by officials of 48 countries and repre­ aspects of the development planning
sentatives of international agencies and process. In outlining the international
non-governmental organizations (NGOs), community’s role, participants called for
the conference took the theme of “Popu­ strengthening South-South cooperation
lation, Family and Sustainable with regard to training, exchange of
information, sharing of experiences,
Development.”
One of the main issues on the agenda know-how and technical expertise.
Participants agreed that priority
of the meeting was a review of the
Kilimanjaro Program of Action (KPA) should be put on Africa in population
adopted at the Second African Population activities. As a result, the resolutions
Conference, held in Kilimanjaro, Tanzania, appeal to donors to respond to requests
in 1984. An epoch-making set of for population assistance and activities
recommendations, the KPA marked the and improve their coordination of
first show of unanimous African support population assistance with other bilat­
for action on population. During the Dakar eral and multilateral donors to ensure
meeting, participants endorsed the KPA, that the population needs and
but noted that the worsening socioeconomic requirements of African countries are
[J]
situations of most African countries made properly addressed.
JOICFP NEWS, February 1993

Women

Meaningful FP Messages for Women
IWTC director urges greater access to information and education for women
“There was a period of time when
enormous amounts ofmoney were being
poured into international organizations
working in the populationfield. Because
of the amount of money available, these
organizations were entirely run by men.
The salaries were very high with
$500,000 salaries being paid to the
heads of some of these population
agencies. But there was not a single
woman in a decision-making position.
It is easy enough to say that it is natural
for women to be involved in family
planning (FP), but at that time the fact
was that they were not being involved in
any of the decisions being made — and
some terrible decisions were made,” said
Anne Walker, director, International
Women's Tribune Center (IWTC).
Walker made her comments to JOICFP
during a visit to exchange information
on Nbvember 30.
Walker provided an outline of her
organization and spoke about issues
related to FP communications and
women during the discussions.
Established in 1976, IWTC is a non­
profit, non-governmental international
women’s organization. Its main aims
are to serve as a communications link for
women in over 170 countries and source
of information and technical assistance

in women and development areas, and to and that it was their fault that the country
provide support for women’s organizations, was going down the drain,” she said.
particularly with their efforts to promote “So, there had to be a revolution in FP
more women-oriented development plans, agencies—which is when women started
getting involved in the
policies and projects.
1980s. But this also
The areas in which
meant that women
IWTC is involved
started saying things
include publications,
about abortion rights
workshops, internships,
training, women organ­
and women in deve­
izing, science and
lopment — messages
that some agencies did
technology and com­
not like. Now that a
munity economic deve­
lot of the funds have
lopment.
been withdrawn and
According
to
salaries have come
Walker some of the past
down, suddenly there
“terrible mistakes” were
made in FP commu­
are more women.”
few
However, Walker
nications, a field in
said
that women are
which women were not
Anne Walker
still divided on the
actively involved. To
illustrate her point, Walker referred to issue of FP and that well-funded net­
communications that were aimed at works already established for FP around
“forcing women to stop having babies.” the world must be pulled together.
She said that such activities showed no Commenting that education, economic
respect for women and no understanding development and training opportunities
that childbearing was the main purpose in for women have gone backwards, Walker
many women’s lives and that without stressed that women must be considered
children “they were nothing.” “Millions as women — many of whom have
and millions of dollars were being spent on desperate needs—and notjust as mothers
communications across Latin America with and daughters. She said that women
posters telling women to stop having babies without children are not counted by
agencies such as UNICEF which
considers
women and
children as a
single unit. “A
WHO, a professor of public health from the
lot of women
Medical Department of S an Carlos Uni versity,
are
dying in
the director of the health center in the IP area
Somalia while
of San Lucas Tollman and
the men and
selected TBAs. To meet the
needs of the Mayan population
their guns are
in the area, it was agreed that
well-fed,” she
two booklets were needed: a
said. “Women
Spanish-language handbook to
are not dying
IWTC postcards
serve as a health record for the
because of a
mother and child and designed
lack of food, but because they lack status.”
to be filled in initially by TBAs
She said that many international agen­
and health personnel and at a
cies are close to losing the support of the
later stage by mothers; and an
women’s movement because of their
illustrated manual without text
failure to consider issues such as women ’ s
to be used by mothers as a
status. “This would be tragic,” she added.
visual guide to safe mother­
hood practices. Ahead of the
“I am not an FP specialist, but if we
distribution of the booklets,
regard women as human beings, the
TBAs were given training in how to use and
rest takes care of itself,” she said. I have
fill in the health records in October and
seen many cases where one woman
November last year. A total of 8,000 sets of
who got access to information and
the two booklets have been printed and are
education
caused a revolution in her
being distributed in IP areas in Guatemala.
community.”
g]

Support for Safe Motherhood
A maternal and child health (MCH)
handbook and manual produced with funds
from the Voluntary Deposit for International
Aid (VDIA) scheme of the
Japanese Ministry of Posts
and Telecommunications is
being used to promote safe
motherhood in areas in
Guatemala where the Inte­
grated Project (IP) is being
( l *Dt*'r*° V
implemented. Modeled
SAW”
after the Japanese MCH
rnovrno
Handbook, the Guatemalan
t ■«T««saK’
handbook and manual are
presently being distributed
to pregnant women and
mothers by traditional birth
attendants (TBAs) and
health workers and will be
given to all women in IP areas including
adolescents in the future. The contents of
the book and manual reflect the input of
health personnel from various levels
including the Guatemalan representative of
JOICFP NEWS, February 1993

COMMUNITY HEALTH CEL13
326, V Main, I Block
Korambngala
Bangalore-560034

Bangladesh

Low Status, Illiteracy and Early Marriage
Bangladeshi women face lives of little choice and many children, JOICFP mission finds
A JOICFP mission learned much
about the situation of women living in
rural areas of Bangladesh while in the
countryfromNovember22 - Decembers
to prepare for the implementation of the
newfour-year regional project. Entitled
“Sustainable Community-based Family
Planning (FP) and Maternal and Child
Health (MCH) Project with Special Focus
on Women,” the project is being
implemented in Bangladesh by the Fam­
ily Planning Association of Bangladesh
(FPAB) in cooperation with JOICFP and
IPPF and is supported by UNFPA.
To gain an understanding of the
situation of women in Bangladesh, the
mission held discussions with govern­
ment officials and representatives of non­
governmental organizations and inter­
national agencies and observed the

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conditions of rural
women. Based on
its findings, the
mission outlined
three interrelated
issues that affect
the conditions of
women in Bang­
ladesh: lack of
access to edu­
cation; the prac­
tice of early
marriage; and the
traditional low
status of women.
While
the
overall literacy
rate is low for
B angladesh’s
entire population,
the rate for women Childbearing begins early for most women in Bangladesh.
is extremely low
with about 85% of rural women illiterate. effective way of improving the situation
Despite the government’s provision ofeight of women and raising the standard of
years of free elementary school education health of family members. The new
for girls and five years for boys, only 3% of project, which is targeted at promoting
girls receive a full elementary education. FP/MCH by gaining the participation of
Most drop out of school in their first year. the community, will also be geared toward
The traditional low status of women sustainability to ensure its continuity.[J]
contributes to restricting their access to
education. Women are expected to play an
active role in agriculture and take care of
Population to Surge
the home and family without taking part in
Tokyo
decision-making on matters such as
household economy. Under such circum­
The population in the greater Tokyo
stances, education is not considered
metropolitan area is expected to
important for women.
dramatically increase by the year 2010
Meanwhile, the tradition of early
absorbing over 90% of Japan’s total
marriage is widespread in much of rural
population growth, according to a recent
Bangladesh, where a girl is considered
report by the Institute of Population
ready for marriage at first menstruation,
Problems of the Japanese Ministry of
Health and Welfare (MOHW).
and too old for marriage and a burden on
The largest increases are predicted for
her family if single at the age of 20. Early
the Tokyo metropolitan area including
marriage in turn severely affects MCH.
Saitama, Chiba and Kanagawa prefectures.
By beginning childbearing at an earlier
Saitama Prefecture is expected to have the
age, a woman is more likely to have a
highest population growth rate at 38.7%,
larger number of less healthy children and
followed by Chiba with 31.2% and
experience more health problems herself.
Kanagawa with 26.1%.
With a population of 116 million and
The report estimates that the total popu­
population density of 800 persons per
lation of these prefectures will increase by
square kilometer, Bangladesh is already a
6.29 million people in 2010. If added to
the population of Tokyo, which is expected
densely populated nation. Despite succes­
to drop by 5.3%, the total numberof people
ses in reducing its total fertility rate from
living in the greater Tokyo metropolitan
a high level of 7 in the 1960s, the rate still
area will represent 29% of the national
remains high at 4.6 (1991). Meanwhile,
total in 2010, the report said.
the infant mortality rate is also high at 118
The institute also predicted Japan’s
per 1,000 live births (1991).
population will total 130.4 million in
Providing women with access to safe
2010, up 6.79 million from 1990.
FP/MCH services and information is one

Around

Malnourished children in a rural area.

Draper Fellowships
Four graduate students at the Johns
Hopkins School of Public Health were
recently named as the first recipients
of the newly-established William H.
Draper Jr. Fellowships. The awards
provide financial assistance to students
primarily from developing countries
who have the potential to become
leaders in family planning and related
health communication. The fellowships
are aimed at supporting advanced
training and field internships in the use
of modern communication techniques
including mass media and enter­
tainment to advance health education
and public health advocacy. Of the
four recipients, two are from India, one
from Egypt and one from the
Philippines. The fellowship is sup­
ported by a number of contributors
including JOICFP.

4

JOICFP NEWS, February 1993

Exchanges

A Call to Philippine People Mexico Takes
FP Further
Dr. Antonio Lopez, provincial health the quality of life of each and every Filipino
officer, Tarlac Province, the Philippines, and make everyone a productive person.
spoke withJOlCFP NEWS on December
Health workers should make people
11 aboutfamily planning (FP) promotion aware that problems such as malnutrition,
and the impact of the government's deprivation and communicable diseases
decentralization policy on healthcare. are the effects of big family size. If these
messages were brought to the grassroots,
Below is an outline of the interview.
Health has been made a
then people would be more
priority in the Philippines
understanding of the ill-effects
of big family size.
under President Fidel
Apart from FP, another
Ramos and our new secre­
tary of health, Juan Flavier,
major priority for the govern­
ment is the promotion of
emphasizes that FP, res­
primary health care through
ponsible parenthood, and
people’s empowerment. Dr.
the protection of children
Flavier has stressed that pre­
and mothers should be given
vention of diseases, especially
top priority as is stated in
communicable
diseases,
our constitution. It is true
should be emphasized more
that the Catholic church in
than medical care because of
my country opposes any
Antonio Lopez
our economic situation. It
method of FP outside of the
so-called “natural” methods, but the stand would save considerable costs if people
of the Department of Health is to give were to participate in identifying health
people complete and correct information problems and the decision-making on how
about different methods of contraception to address the problems, and if they were
and responsible parenthood to enable mobilized to work together to resolve them.
This approach jibes well with the
them to make their own decisions.
The success of FP promotion in the process of decentralization under which
Philippines depends on the motivation local government units are being challen­
and commitment of the health workers. ged to charter the course for their own
It is crucial that these workers are community, municipality or province and
committed to getting the message across are obliged to look for resources. As a
to the people that we will go down the provincial health officer, I think decen­
drain if we do not slow population tralization will initially be extremely
growth. Our resources are dwindling, difficult for us economically. It will be a
available land is shrinking and our per- test of our resourcefulness and manage­
capita income is not increasing as fast ment capabilities to see how well we can
as the population. Hence, we should at deliver services given the scarce resources
least slow population growth, improve available to us.
[5]

1

Health Education for Egyptian Women
Dr. Mostafa Mohamed AU Kabier, I have little understanding of pregnancy
specialist, Obstetrics and Gynecology, I and issues related to safe motherhood such
as nutrition. By providing
Naga Hammadi General
advice to pregnant women, we
Hospital, Egypt, spoke to
can also prepare them to accept
JOICFP NEWS about the
FP because a large number of
bilateral FPIMCH project
rural women become pregnant
being conducted with the
soon after giving birth—often
Japan International Co­
while they are breast-feeding.
operation Agency (JICA ) in
I think the application of
Naga Hammadi. Below is
an outline of his interview
Japanese experiences has
conducted on December 11.
worked in this project because
Health education is an
we have seen improvements
important aim of the project.
in health conditions of the
In rural villages of Egypt,
people in many villages and
Mostafa Kabier
most women
do uvi
not even
even
uivoi
wuiuvii uv
.
nave
have see:
seen the number of
have basic knowledge of hygiene and I acceptors of FP grow.

a

JOICFP NEWS, February 1993

Dr. Fernando Amado, director, Super­
vision & Training, Family Planning Bureau,
Ministry ofHealth (SSA), Mexico, spoke with
JOICFP NEWS on December 16 about the
bilateral population and FP project being
conducted in Mexico with the Japan
International Cooperation Agency (JICA) and
activities of the Mexican Family Planning
Foundation (MEXFAM). Below is an outline
of his interview.
The bilateral project supported by JICA
is being conducted in two pilot areas and
focuses on improving the quality of FP/MCH
(maternal and child health) services to reduce
the infant mortality and maternal mortality
rates. The aims of this project include ex­
panding the coverage of FP usage, providing
prenatal care and the training of traditional
birth attendants
(TBAs). A pub­
lic health nurse
from Japan ar­
rived in Mexico
in July last year
and is living in
Tecpan, a small
village in one of
the pilot areas.
The project was
started in April
. /
1992 and will
be conducted
for a period of
five years.
Fernando Amado
The FP Bu­
reau works closely with non-governmental
organizations (NGOs) involved in FP and
adolescent health such as MEXFAM.
Through MEXFAM, our office receives
films in JOICFP’s animated health series
(Blue Pigeon, Music for Two and Best
Wishes') which we use to train personnel in
orientation and counseling on FP and sex
education. These IEC materials are high
quality, well produced and have good mes­
sages. I am also familiar with the Integrated
Project (IP) in Mexico and feel that its concept
is very suitable to the Mexican situation.
An innovative new clinic was established
last November in Mexico City with the
support of MEXFAM’s community doctor
system to provide services mainly to
adolescents and female industrial workers.
Initially, it is hoped that industries will pay
for monthly health and FP services provided
by the clinic for their female employees.
MEXFAM will stop supporting the clinic in
the second phase when it is expected to provide
IEC services in schools and to industries. By
the third phase, the clinic is expected to be
able to provide laboratory tests, which will
earn income to support other clinic activities
and recover costs. By doing this, it is hoped
that the clinic will be able to provide services
for adolescents free of charge.
[j]

5

Laos

Lao Women
Make Do
with Less

representatives of
non- go ver n mental organi­
zations
and
i n ternati on al
agencies and visi­
ted six districts
and three prov­
inces to gain an
understanding of
Women in Laos motivated
the country’s
but lack FP/MCH services
population situ­
and accurate information on
ation, particularly
the conditions of
reproductive health
women, and the
A JOICFP mission laid much of the availability and
groundwork for the implementation of quality of FP/ Representatives of UNFPA, UNDP, IMCH and JOICFP gather
information fromthedeputy provincial health director during
the new four-year regional UNFPA- MCH services. a field visit to Luang Prabang Province.
supported project in Laos while in the The JOICFP team
country from December 14-23. The worked closely with Sabiha Syed, country pressing problems in FP at present are a
project, entitled “Sustainable Commu­ director, UNFPA; Dr. Kotsaythoune lack of supplies and shortage of trained
nity-based Family Planning (FP) and Phimmasone, chief, Planning, National staff. However, it also found a high level
Maternal and Child Health (MCH) MCH Institute (IMCH) of the MOH; and of awareness of FP due to information
Project with Special Focus on Women,” Pheyphanome Nhouyvanisvong, national coming across the borders from Thailand
is to be implemented through the Mini­ program officer, UNDP, while in the field. and China, and a strong demand for
stry of Health (MOH) in cooperation The mission also held a planning meeting services in the areas it visited. The team
with JOICFP and the support ofUNFPA. with officials of the Lao Women’s Union was told that it is common for women to
During its stay in Laos, the team held (LWU), UNICEF and IMCH on the buy injectable contraceptives themselves
at pharmacies and take them to health
discussions with government officials and location of possible project sites.
facilities to be administered. Despite
this motivation, the mission found that
Health System
women in Laos lack correct information
UNFPA Greeting Cards
Based on its findings, the mission about reproductive health.
Based on the mission findings, one of
constructed
a profile of the country’s health
A series of 14 greeting cards
system which is organized into four basic the major strategies of the new JOICFP
produced by UNFPA are to be put on
levels: central (MOH), provincial, district project will be to strengthen district-level
sale to raise funds for activities of the
organization. The cards feature colorful
and village. It was noted, however, that the healthcare to improve trust in the health
illustrations designed by children and
four-tier system is not functioning system at the local level. The project,
young people around the world for
smoothly, that it lacks a criteria for refer­ which is anticipated to be implemented
UNFPA’s first international poster
rals and that the roles of each level are not in two or three districts, will incorporate
competition, held in 1992. A total of
clearly defined. The team found much of a fee-charging system to ensure project
134 submissions from entrants of 36
the cause to be a severe shortage of sustainability. Since the concept of
countries
equipment
and supplies and well-trained paying for contraceptives and drugs is
were made in
personnel, particularly at the district level already established in Laos, it is expect­
the
comand below, which drove patients to seek ed that people will not hesitate to pay
pet i t i o n ,
services at higher levels. Moreover, due to for project services if quality and con­
which was
aimed
at
the system’s weaknesses and difficulties stant supplies are assured. At present,
creating
of travel within Laos, people tend to rely contraceptives are provided free of
awareness
on traditional healers and private charge by the government, but are in
and under­
short supply and not readily available
pharmacies for services and supplies.
standing of
[T|
With a total population of 4.2 million outside the main urban areas.
population
(UNFPA/1991) and an annual growth rate
issues ahead
of about 2.6%, Laos has placed priority on
of the Inter­
FP as a means of birth spacing to improve
national Conference on Population and
MCH, rather than to reduce fertility.
Development in Cairo, Egypt, in 1994.
However, the total fertility rate is estimated
Meanwhile, the second international
to be high at around 6 with a crude birthrate
poster competition, open to children
and youths from the ages of 6 -18, has
of 41 per 1,000 live births. Meanwhile,
taken the theme of “Population and
MCH is being emphasized by the
Our World”to highlight rapid population
government which is allocating 70% of the
growth, urbanization, destruction of the
public health budget to MCH activities.
environment and related issues.
According to UNICEF figures, the infant
Announcementof winners will be made
mortality rate was 148 in 1991.
on World Population Day on July 11.
The mission noted that the most LWU officials suggest project sites.
6

PF

JOICFP NEWS, February 1993

Japan

AIDS and Adolescents
JFPA AIDS hotline highlights misconceptions andfears of teens
The Japan Family Planning second and third most common calls. The
Association (JFPA)found deep concern highest number of calls were received from
and widespread misconceptions about teenagers aged between 18 and 19 years.
HIV/AIDS among adolescents when it Counselors also found that many callers
ran an AIDS hotlinefor adolescents and considered AIDS to be a “foreign” disease
children during Child Welfare Week last and that safe sex (use of condoms) was
year. Actively involved in the field of not well-practiced among the adolescents.
In its analysis of the results, JFPA
adolescent health and sexuality, JFPA
took the initiative to operate an AIDS noted widespread misconceptions about
AIDS among adoles­
counseling service in
cents and mothers of
theface ofan increas- e]
ing number of HIV! !]
children indicating that
AIDS cases in Japan. I
correct information was
not being passed on to
The hotline, which was J
them through education
operatedfor six hours
channels and the mass
a day from May 11 media. Citing the ex­
16, received a total of
ample of one youth who
433 calls ofwhich 301
was concerned that he
specifically concerned
would contract AIDS
AIDS. Ofthis number,
through his nocturnal
287 calls were made
emissions, Dr. Kunio
by teenagers.
Kitamura, director, FP
The idea to target
Center, JFPA, called for
adolescents in an
an overhaul of Japan’s
AIDS hotline was
JFPA’s condom with a message.
sex education system to
developed by JFPA
following the poor response from young adequately inform youth about AIDS.
people to a 36-hour AIDS hotline run by “Fortunately, Japan still has a relatively
the Information Center for HIV and low number of HIV/AIDS cases which
Human Rights on World AIDS Day in means we can learn much from the experi­
1991. Only 2.4% of the callers to the ences of other countries,” Kitamura said.
“If we fail to prevent an epidemic, Japan
hotline were adolescents.
The most common calls received by will be the laughing stock of the world.”
To head off a rapid increase in HIV/
counselors of the JFPA hotline were from
adolescents engaged in high-risk behavior AIDS cases, Kitamuracalled for adramatic
and concerned about HIV infection. increase in education activities including
Questions about the routes of infection AIDS-awareness campaigns to enable
and requests for information on where to young people to fully understand the issue
[j]
receive a blood test for HIV were the and take preventive action.

Taking AIDS Prevention in Hand
Renowned for its innovative EEC materials, JFPA recently produced a unique educational
material to create awareness of AIDS in Japan. Featuring a flat, match-box folder containing
one condom, the material includes information on the transmission of HIV, ways to prevent
the disease and encouragements for blood tests. The material, which went on sale on
November 1,1992, is being sold in bulk to local governments for use in prefectural and health
center AIDS-awareness campaigns, coming-of-age ceremonies and health festivals as well
as in educational activities for youth organizations and companies.
The production of the material was well-timed to coincide with an AIDS-awareness
initiative of the Ministry of Education involving distribution of pamphlets to high schools
students and a large-scale TV and poster campaign. Rather than using a simple audio-visual
format, JFPA decided to design a more appealing material that could be handled, blown up,
filled with water, tested for strength and fully understood by recipients.
In developing the material, JFPA called on its experiences in the postwar years when FP
promoters working to prevent abortions counteracted the embarrassment and ignorance of
women concerning condom use by launching a system to deliver condoms to the doorstep
so as to enable women to leam about the contraceptive firsthand. In the future, JFPA hopes
to extend distribution of its new AIDS-awareness material to high schools.

JOICFP NEWS, February 1993

Insights into
Self-reliance
The six members of a study team from
China were impressed with the self-reliance
ofprivate Japanese organizations promoting
heath services in cooperation with govern­
mental agencies and community organi­
zations. The team noted that by providing
better services than the government, the
private organizations had gained the
support of the government as well as the
community people.
Headed by Li Baozhong, deputy secretary­
general, China Family Planning Association
(CFPA), the team was in Japan from December
6 - 13 to study IEC activities related to the
field of family planning (FP) and maternal
and child health (MCH). The tour was
organized by the Family Planning Federation
of Japan (FPFJ) in cooperation with Japan
Family Planning Association (JFPA) and
JOICFP at the request of IPPF-ESEAOR as
part of its China program. Team members
comprised personnel from CFPA and
representatives of the FPAs of Yunnan and
Gansu provinces.

NGO Activities
In presentations, the Chinese team was
given an overview of FP/MCH activities in
Japan and the work of non-governmental
organizations (NGOs) such as the Tokyo
Health Service Association and JFPA.
During the presentations, the team was
introduced to JFPA activities such as IEC and
training, development of commodities, sales
of contraceptives and the operation and
management system of the association.
The team also visited Oyama City, Tochigi
Prefecture, where it observed classes for
mothers and spoke with health administrators,
public health nurses, midwives and volunteers
about community-based FP/MCH activities.
The team members said that the tour had
taught them that community people will work
to develop the activities of a private organi­
zation if they feel that the organization is
answering their needs. It also noted the close
relationship that public health nurses have
with communities and that the IEC materials
provided by these nurses were appropriate
and welcomed by the people.
[J]

The team examines JFPA IEC materials.
7

Voice of Voices
By Chojiro Kunii

It All Started from Worms
In 1990,1 gave a step-by-step account
of my life work on the Jinsei Dokuhon
(Reader of Life) radio program of the
Japan Broadcasting Corporation (NHK).
During the program I recalled the various
movements I started after the war
including the production cooperative
movement, which expanded domestically
into the parasite control movement, and
the family planning (FP) movement. In
a simple documentary format I also
described the process with which these
movements spread to Asia and Africa.
Later, the contents of the program were
published as a book, and recently, with
the cooperation of the Hoken Kaikan,
an English version was also produced.
The production cooperative move­
ment, which I began after the war, turned
into a parasite control initiative and
then expanded into the FP movement.
Accepted by ordinary Japanese citizens
who shared a desire to rebuild Japan into
a healthy nation, these initiatives later
developed into the preventive health
movement. Korea and Taiwan soon
followed Japan’s example in preventive
health as did other Asian countries.

wishes exist in Asia, Africa and Latin
America. My book, “It All Started from
Worms — the 45-Year Record of Japan’s
Post-World War II National Health and
Family Planning Movement,” embodies
my hopes for the human race. I whole­
heartedly welcome whatever criticisms
there may be about this publication. [J]

DIARY

*

Margaret Dodd Britton, deputy director,
Technology Management, Program for
Appropriate Technology in Health (PATH),
visited JOICFP on Nov. 17 to exchange
information.
*
*
*
JOICFP Program Officer Aiko lijima was in
Nepal from Oct. 25 - Nov. 17 to monitor the
VDIA project and join an IPtechnical assistance
team consisting of Takaaki Hara, director,
Research and Study Department, JAPC, and
Fumiko Mukaigawara, public health nurse.
*
*
*
Dr. Fred Sai, president, and Mark Laskin,

Ordinary People
Looking back, I can see that the
postwar efforts made to support the
demands of the ordinary people and the
perseverance and innovation displayed
by the citizens as they worked towards
development resulted in a miraculous
recovery. However, there is a darker
side to Japan’s rapid development which
has also caused environmental degra­
dation and various social problems.
Today, I am deeply concerned about how
Japan will overcome the crises and
difficulties that are now threatening the
nation and how it will determine a stable
direction for the future in harmony with
the rest of the world.
I also ask myself how much people of
other countries understand the concerns
of the Japanese about their country’s
history and its future. Can people from
other parts of the world with different
languages and religions understand the
sentiments of the Japanese?
Most of my movements were launch­
ed in response to the wishes of the ordin­
ary people, in particular, the wishes of
mothers and children to be healthy and
the desire of people to improve their
lives. I believe that these exact same

8

assistant secretary general, IPPF, were in
Japan from Nov. 11 - 18 to join lecture
meetings in Tokyo and Nagano Prefecture,
exchange information with Japanese
parliamentarians, officials of the ministries
of Foreign Affairs and Health and Welfare
and officers of FPFJ and JOICFP.
*
*
*
A 10-member mission from IP areas of China
headed by Dr. Zhang Youming, deputy
director, FP Commission of Hunan Province,
was in Japan from Nov. 5 - 18 to study FP/
MCH.

Dr. Nafis Sadik, executive director,
UNFPA (right) is handed a donation by
Reverend Yasusaburo Tazawa from the
Japanese Committee, World Con­
ference on Religion and Peace (WCRPZ
Japan), in Tokyo on December 22. The
¥10 million (US$82,000 at an exchange
rate of ¥122 to US$1) donation was the
second such contributionto UNFPA from
the organization of religious groups
which has members in 60 countries and
works to promote peace around the
world. The first donation, madein1986,
was used by UNFPA to establish the
Rafael M. Salas Memorial Trust Fund
which awards scholarships to students
from developing countries to study
population and development at
international training institutes and
organizes special lectures at the UN.
At the hand-over ceremony in Tokyo,
Sadik praised the commitment of the
group’s followers who raised funds for
the donation by fasting and organizing
bazaars. “Your contributions will be
used most effectively in accordance
with the spirit in which they were made;
namely to promote global peace through
the assistance for students from
developing countries," she said.

*

*

Dr. Phyllis Piotrow, director, Center for
Communication Programs, the Johns
Hopkins School of Hygiene and Public
Health, and secretary, Population Action
International, was in Japan from Nov. 14-19
to take part in a series of lecture meetings and
a symposium organized by the Japan Family
Planning Association (JFPA), Council on
Population Education and JOICFP. She also
paid courtesy calls to officials of the Japanese
government and exchanged information with
officials of concerned agencies.
*
*
*
Ten participants from five countries of the
JICA Training on Population and FP for
Counterpart Countries attended a one-day
seminar at JOICFP on the IP on Nov. 25.
*
*
*
Hari Prasad Khanal, director, Program
Development and Operation, Family
Planning Association of Nepal, visited
JOICFP on Nov. 24 and 30 to exchange
information.
*
*
*
Anne S. Walker, director, International
Women’s Tribune Center, visited JOICFP
on Nov. 30 to exchange information.
*
*
*
JOICFP Program Officer Ryoichi Suzuki
was in Bangladesh from Nov. 22 - Dec. 5 to
prepare for the initiation of the new UNFPAsupported regional project.
*
*
*
JOICFP Deputy Executive Director Yasuo
Kon and program officers Hideyuki
Takahashi and Kiyoko Ikegami were in
Ethiopia to attend the First African
Regional Workshop on the IP from Nov. 23
- 27. Takahashi also traveled to Tanzania
and Zambia to monitor IP and VDIA
activities and attended the Third African
Population Conference, held in Senegal
from Dec. 7-12.

JOICFP NEWS is a monthly newsletter
published by the Japanese Organization for
International Cooperation in Family Planning,

Inc. (JOICFP).
JOICFP NEWS welcomes your comments,
suggestions and contributions. Please mail to:
JOICFP NEWS
Hoken Kaikan Bekkan
1 -1, Sadohara-cho, Ichigaya
Shinjuku-ku, Tokyo 162 Japan
Phono: 81-3-3268-5875
Telex: 2324584 JOICFP J
Cable Address: JOICFP Tokyo
Facsimile: 81-3-3235-7090

JOICFP NEWS, February 1993

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