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Our View from the Ground: Family Planning and the “God Gulf”

Photo of Dr. Isaiah Ndong

Dr. Isaiah Ndong is Vice President for Programs at EngenderHealth.

I grew up in a small village in Cameroon, the second of 11 children. My father, a school teacher, wanted all of us to be educated, including my sisters—which was unusual at the time. School was not free, and it was very difficult to watch him work so hard, trying to take care of so many children and do the best for us with very limited resources. In addition, my mother suffered from a severe asthmatic condition that was debilitating, and we were always fearful that she would have an asthmatic attack and not survive.

Life in such a big family was challenging, but everyone else’s family was just as large. It seemed inevitable, until later when I left my village to go to secondary school. There I discovered that there were others who came from much smaller families: I realized that the situation in my village was not inevitable. Later, I heard about contraception, but by that time it was too late, as my mother had passed childbearing age.

While the rest of my siblings and I went to university, two of my sisters dropped out of high school. They were no less intelligent or hardworking than the rest of us, but they had unintended pregnancies and had to drop out of school to take care of their children. They got married soon after and missed out on a higher education and the chance for a better life. Today, compared to the rest of us, they are disadvantaged and have not had the same opportunities as the rest of their siblings—getting pregnant before they were ready had a lifelong negative impact on these two sisters.

I think of this every day, because more than two decades later, I see young girls around the world go through the same hardship my sisters went through. There are 201 million women out there, the majority of them in Africa, who do not want to get pregnant right now but who also don’t have information about and access to contraception. No woman should have to endure a pregnancy she’s not ready for—especially when you consider that the places where birth control is hardest to get are the places where pregnancy is also riskiest. There simply aren’t enough trained health professionals or clinics to make it safe.

These problems are due in large part to lagging support of family planning as a priority, inadequate funding, and in some cases, bad policies. As Nick Kristof and Sheryl WuDunn point out, the Global Gag Rule had disastrous effects on developing countries. U.S. support for international family planning programs stagnated while the need has grown almost exponentially—and this will continue as the largest cohort of young people in the world’s history comes of reproductive age.

For me, expanding access to family planning in every village around the globe is a personal crusade, because I don’t want other young women to find themselves in the situation my sisters faced. I don’t want other fathers to struggle like mine did. I don’t want mothers to be always worried that they will be pregnant again if they aren’t ready. I do want women to have the education and opportunities that can enable them to make informed decisions about their own bodies and health and to take care of their families. Safe and effective family planning is absolutely crucial to making this happen, to creating a better future—and a more equitable world. This is what motivates me to do the work I am doing.