Rwanda tackles population growth

MT. KABUYE, Rwanda — Three thousand feet above the nearest village, and accessible only by foot, this prominent peak was once unspoiled African wilderness.

For millennia, like most of Rwanda, Mt. Kabuye was covered by tropical forest and inhabited by bands of Pygmy hunter-gatherers who lived off roots, berries, wild honey and meat from animals they hunted.

Today, 3,000 years after the first Bantu farmers arrived in central Africa, the mountain has been conquered by agriculture. Where lush foliage once stood, women toil in the midday sun, tilling plots of beans, potatoes and cassava as their children scamper in and out of scattered mud and thatched-roof huts.

Rwanda is Africa's most densely populated non-island nation with a population density of more than 1,000 people per square mile, according to the Population Reference Bureau. In a country where 90 percent of people depend on small-scale farming and with a GDP per capita of just $500, Rwanda's people are in competition for scarce land.

The slopes of Mt. Kabuye show how agriculture has crept up to every arable acre of this mountainous country — a sign of the severe population pressure that some consider the greatest challenge to Rwanda’s development.

Despite recent improvements in farming and aims to move toward a service economy, Rwanda is expected to remain mired in poverty unless population growth is abated.

With a fertility rate of 5.4 births per woman, and a population growth rate of 2.9 percent, Rwanda’s population of 10.4 million is on path to double in size in just 24 years, according to data from the Population Reference Bureau.

Though these statistics are only slightly higher than the sub-Saharan Africa averages, they are of particular concern in a country where the economy is agriculture-based and where agriculture has little physical space to expand.

“We are a small country,” said Jean-Damascene Ntawukuliryayo, former minister of health and runner-up to Paul Kagame in this August’s presidential election. “If population growth continues as it is we are going to have a bigger and bigger problem.”

Though particularly acute in present-day Africa, overpopulation fears have preoccupied social scientists for centuries. In the early 1800s, Thomas Malthus, an English demographer and economist, became renowned for a controversial, and rather miserable hypothesis: that global population would eventually outpace food production capacity and population size would thereafter be limited by war, disease and famine.

Since then, a six-fold increase in the world's population — hastened by revolutions in industry, agriculture, transportation and biotechnology — has largely left Malthus discredited. Yet some neo-Malthusians see echoes of their ideologue in Africa. On a continent where collective life expectancy is just 52 years, high fertility remains a common response to drought, disease and civil conflict.

In Rwanda, like most of Africa, a culture of high fertility developed long before the arrival of Western medicine, when parents sought many children because it was assumed most would not live to adulthood.

Rwanda's 1994 genocide, in which 800,000 people were killed, set back efforts at birth control, said Anicet Nzabonimpa, family planning and HIV integration coordinator at Rwanda’s ministry of health.

“It was very difficult to talk about family planning after the genocide,” he said. “People wanted to replace those who had died.”

Yet in recent years, Rwanda’s government has made family planning a top priority, aware that high fertility is driving poverty and hunger.

High population growth in a country holds down the growth of its per-capita economic output, according to economists. High fertility also leads to higher rates of maternal and child mortality, and leaves families with fewer resources for each child’s nutrition, health and education.

Access to modern family planning methods helps families escape poverty, said Scott Radloff, director of the Office of Population and Reproductive Health at the U.S. Agency for International Development. Society at large also benefits from lower population growth through what Radloff calls a “demographic dividend.”

“When population growth begins to slow, you get a larger share of your population in their productive ages and fewer dependent age populations,” Radloff said.

This period, Radloff added, is one in which investment in physical and human capital is particularly effective in spurring economic growth — a phenomenon experienced in the 1960s and 1970s by the high-growth East Asian Tiger economies, all of which experienced significant drops in population growth en route to rapid industrialization.

A drop in fertility, others argue, would also assuage Rwanda’s potentially destabilizing “youth bulge” — a term used by social scientists to describe national populations with a large proportion of young adults. Countries with more than 40 percent of adults aged 15 to 29 in the overall adult population were more than two times as likely to experience civil conflict during the 1990s as countries with smaller youth proportions, according to a 2003 study by Population Action International, an advocacy group.

While the “youth bulge” theory does not ascribe causal links between demography and conflict, its proponents argue that large pools of youths — often with few outlets for employment — tend to be susceptible to recruitment by actors bent on violence.

In post-genocide Rwanda, advocates said, this is all the more reason to support family planning — a message embraced by the government of President Paul Kagame.

Across the country, according to the ministry of health, authorities are committed to giving all women access to modern contraception — including short-term methods such as condoms, pills and injectables and long-term methods like implants and male vasectomy. Though clients are now served at hospitals and health centers, the government has recently trained a network of 3,000 community health workers who provide door-to-door counseling and services in the most remote areas — all free of charge.

In addition, the government publicity machine has joined the effort by putting up billboards that promote condom use. An official order from the president requires local authorities to mention reproductive health every time they address their constituencies.

Rwanda is a largely Catholic country and 40 percent of its health centers are managed by the Catholic Church, which do not provide modern methods of family planning. But the Catholic centers, Nzabonimpa said, have now agreed to refer clients to facilities that do.

Despite many remaining challenges, the national effort appears to be working. Family planning use has increased quickly from just 4 percent in 2000 to 51 percent in 2010, according to government data.

One beneficiary of Rwanda’s family planning efforts — and a sign the country might yet avoid a Malthusian plight — is Beatrice Uwimana, a 30-year-old mother of three.

“Three children for me is enough,” she said, awaiting a contraceptive implant at Kigali’s Muhima District Hospital. "Life here is expensive. I cannot afford more. The kids I have — I want them to be healthy, happy and well-educated.”