Action Hope

BOGO (Buy One, Give One)

“My town has no light,” writes my friend from Ghana. “The high school has no computer. All of us have to travel to Tamale on a rough road for 5 hours to have internet or better education. My parents have never touched a computer.”We all have images of young Abe Lincoln studying by firelight. The reality is that most kids who lack electricity just go to bed after dark. Too few parents can afford to light a lantern so their kids can do their lessons.It is difficult to study and to be productive after dark without artificial light. A recent medical article pointed out that “…1.6 billion people are exposed to adverse health risks because of lack of access to electricity.” Even if there were medicines and the best of doctors living in their towns, they would be useless without electricity for medical instruments and refrigerators to cool medication.Yet two billion people live without a reliable source of electricity. Kerosene is the alternative for many of these people. Kerosene lanterns always present the risk of fire, and they generate air pollution. Their smoke adds to the burden of respiratory disease that afflicts millions.The World Health Organization estimates that indoor air pollution kills 1.6 million people annually in developing countries. That means that one person dies every twenty seconds from smoke from kerosene lights and from cooking and heating fires. Those who do not die from the fumes may suffer permanent damage to their heath. Many of the affected are children, who cannot escape the pollution.Many of the poorest people—the billion who live on the equivalent of just one dollar a day—cannot even afford kerosene. They are doomed to a life of darkness between sunset and dawn.Burning coal and biomass fuels is responsible for much ill health in the poorest countries. When we visited India last winter we watched a woman harvest manure from the sacred cattle. After drying, this biomass was used to cook and heat.Sometimes help comes from unexpected places. An ex-Marine recognized the importance of a safe source of light for people in poor countries and has developed a solar flashlight. How could he get them where they are needed, without a huge grant or government support?BOGO! This stands for “Buy One, Give One.” We’ve had our BogoLight for several months now, and use it frequently. It sits recharging in a sunny window and is ready to go when we are. We take it camping, where it hangs from the top of our tent when we bed down at night and read a bit before sleep. Part of it glows in the dark to help find it for late night pit stops.In bright orange or pink, BogoLights are waterproof, dazzlingly bright and rugged. To order these lights, go to I plan to do some holiday shopping there! You pay $25, which buys your light and the one that goes to a dark country. On the website you can choose what organization gets the gift. My current favorite is Saboba’s Hope, a medical clinic in northern Ghana near where my friend grew up. I recently saw a similar (but inferior) light in a store for more money.Perhaps you have heard of the One Laptop per Child program. It is an educational program to supply robust little computers designed for children in developing countries. They draw so little electricity that the child herself can generate it with a crank. The plan is for each child to have her/his own computer! The specifics are available at Although the manufacturer has contracts from the governments of several countries, they are using BOGO to kick-start the program.Hurry if you want one of these gems! They are only available in this country until November 26th—that’s tomorrow. Each order costs $399. Of that, $200 is a tax-deductible donation that pays for the unit that goes to a child in a poor country.These two products, the solar light and simple computer, are both high tech and, at the same time, simple. Each is designed to help people in the developing world, but can fulfill a need in our country. Neither is bankrolled by big money. In each case, the generosity of individuals can help our friends in poorer areas. Remember, two of the most important factors leading to lower birth rates in developing countries are education (especially of girls) and promoting health.© Richard Grossman MD, 2007[The article above may be copied or published but must remain intact, with attribution to the author. I also request that the words “First published in the Durango Herald” accompany any publication. For more information, please write the author at:]

Durango Herald Hope Population

Don’t Lose Hope

“What a terrible mess we are in!” I hear people say. “The only way overpopulation will be controlled is by the horror of war, famine, or a terrible epidemic.” Do you feel despair about the world’s population? Believe it or not, there is reason to be optimistic.

“The size of the family is shrinking all over the world because women in most countries want fewer children….” reports the Alan Guttmacher Institute. This desire for smaller families is because people have realized their advantages.

Let’s look at the facts. Thirty-five years ago only one in seven women worldwide used contraception. The number of children borne by the average woman (the total fertility rate or TFR) then was 6.1 in developing countries.

The good news is that growth has slowed. The TFR has dropped to 3.0 in developing countries, and worldwide the average is just 2.7. More than half of women in developing countries use contraception now. Many developed countries, especially in Europe, are actually shrinking in population.

Remember that a TFR of about 2.1 leads to a stable population. This is one child to replace each parent, and a fraction more to make up for kids who die in childhood. Unfortunately, a small difference in TFR can make a huge difference in population over a number of years. For instance, if we establish an average TFR of 1.96 now, in 50 years the world’s population will decrease to 5 billion. If the TFR is only slightly higher, at 2.18, the earth will have to support over 20 billion people by the year 2050.

Why are people choosing to have smaller families? The reasons vary from culture to culture. Three essential factors are the availability of contraception, reduction of child mortality and empowerment of women.

More and more people have access to family planning. A third of a century ago in many countries birth control clinics were found only in large cities. Modern contraception was unavailable in most parts of the world. Now, thanks to the media as well as to extensive family planning programs, most people have access to basic information on child spacing.

It is paradoxical that improving child survival can decrease the population growth rate. Historically, the population explosion was caused by decreased mortality. When the child mortality rate is high, parents have more children to assure that some will survive. Studies show that if more than 11% of children die before age five, parents choose to have large families. Not only does lowering child mortality result in a lower TFR and lower growth rate—it is the compassionate thing to do.

The status of women has improved thanks to the work of many. This improvement has been most impressive in developing countries. Overall, school enrollment of girls has more than doubled over the last three decades, as has female literacy. Education and literacy are important in part because they raise women’s aspirations and their ability to find employment outside the home. Education also helps mothers learn about contraception and mothering healthy children.
There are other reasons the population growth rate is slowing. Because they don’t need to have many kids to work the fields, people choose to have fewer children as they shift from rural to urban economies.

Older age at marriage is another important factor in slowing growth. Even though teens reach puberty earlier than in the past, people are starting their families later. Moreover, better-educated and more mature mothers are likely to have healthier and smaller families.

More and more couples are relying on surgical contraception when they have completed their families. Surgical contraception is permanent, so there is little chance for an unplanned pregnancy. One in four couples in developing countries have chosen surgery.

A TFR of 2.1 or less is the goal to stop the runaway increase in our population. Just thirty-five years ago that number averaged 6.1 in the developing world, and it has dropped to 3.0. This means that we are more than half way to the objective! It is unlikely that we will reach that goal soon, however. Even if we did, many millions of people would result from the momentum of the huge number of children growing up and having their own children.

Although we have not solved the problem of population, we have made great strides. There is good reason to be optimistic that excess population growth can be restrained if we make it a top priority and devote sufficient resources to the problem.

© Richard Grossman MD, 2006