Catch a Glimpse of Kenya

Image from The Hunter Legacy Film, courtesy of Hunter Sykes

            Years ago I met Dr. Rhodes Moicombo in the little African country, Swaziland (now “Eswatini”). When he learned about my interests, he told me how he had promoted family planning in Kenya.

            Right after medical school, Moicombo worked in a rural area of Kenya that had never had modern healthcare. He understood that he needed to win the respect of his future patients so came up with an idea. Knowing how much Kenyans prize children, he planned a demonstration of his medical skill using the kids. He set up shop under a large tree in the center of town and gave kids candy-flavored worm medicine. Parents were amazed and delighted the next day to find worms in their children’s poop!

            After Moicombo had established trust with his worm medicine, he started talking with the mothers about the advantages of family planning. I don’t know what methods were available to women then, but overall Kenya has been successful in lowering its fertility rate in the past half century.

            Back in the 1960s Kenya was one of the fastest growing countries in the world, with a Total Fertility Rate (the number of children that a woman bore) of about 8. Although much lower now, the TFR is still high at just over 3 children.

            Kenya had their census last year and we are just starting ours. A subscriber to Population Matters!, David Zarembka, has lived in Kenya for many years and his wife is Kenyan. Some of his recent blogs treat the results of the 2019 census.

            There are problems in getting accurate census data in any country, so it’s not surprising that the Kenyan 2009 census was marked by some “irregularities”. One of the purposes of a census is to allocate government funds. Knowing this, some enumerators (census workers) in the 2009 Kenyan census “padded” the numbers, so their region would get more money. There may have been a million “ghost” people who didn’t really exist! The Kenyan government made changes to prevent this sort of fraud in 2019. Enumerators came from outside the community, and a local “elder” accompanied each. The result of last year’s census was significantly lower than expected. There were 47.5 million Kenyans on the night of August 24, 2019.

            Zarembka is optimistic that Kenya’s growth rate is slowing. He writes: “As I look around Kenya… I notice that very few teenagers are now giving birth – one of the prerequisites for a fall in the birth rate.”

           It will be interesting to see what the USA 2020 census will bring. We know that our country’s TFR is less than replacement, but our population will continue to grow due to population momentum and immigration. Even in the USA there are difficulties in getting an accurate count, since there are some groups who want to go under the radar—undocumented migrants are an example.

            Kenya is an example of what can be done to slow population growth. Moicombo was a pioneer in introducing family planning in one area, and recently I met another innovator. Dr. Charles Ochieng is a general physician in Nairobi whose passion is providing vasectomy care. He even offered to do his father’s vasectomy for free, but was turned down. His father already has 7 children with his new wife!

            Because I’m limiting my travel due to concern about climate change, I’ll probably never visit Kenya. However, I just watched a wonderful movie, The Hunter Legacy; perhaps some of you saw it at the Durango Independent Film Festival. In addition to world-class pictures of the beautiful people, scenery and wildlife, it tells important stories. Because of rapidly increasing population, especially in the past, humans have destroyed much of the wildlife. Hundreds of animals were killed in the past to make room for settlements. We have plowed much of the wildlife habitat into agricultural fields and ­­­­­­­poachers continue to the slaughter the animals.

            The Hunter Legacy demonstrates ways of protecting wildlife using armed guards, aerial surveillance and fences to keep animals away from settlements. It also stresses the importance of slowing population growth with family planning and education.

            The movie is about J.A. Hunter, a Scot who lived up to his name as a professional hunter, cleared the land of wildlife for human settlement. The film says this about Mr. Hunter: “J.A. Hunter lived for more than 50 years in East Africa. During that time, he shifted from a focus on hunting towards a belief in conservation as concerns about wildlife populations intensified.”

            The film was made by Hunter Sykes, who lives in Durango. You can view the film at:

© Richard Grossman MD, 2020



Look Out for the Sahel

Field in Niger, Africa

To Deal with Environmental Problems

“Our common goal is the improvement of the quality of life for all, both now and for succeeding generations…. To deal with the social, economic and environmental problems, we must achieve zero population growth within the lifetime of our children.” 

Joint statement signed by 58 of the World’s Scientific Academies                                (1994, before ICPD)

Last month I wrote about the International Conference on Population and Development that took place in Cairo, Egypt, 25 years ago. That experience inspired me to increase my activism on population and to start writing these essays.

            The primary thrust of ICPD was to turn the global focus away from population and to bend it toward reproductive health. This change was in reaction to the dark side of some past population programs: coercive tactics to get people to accept family planning—especially sterilization. Although the goal was to be more humanitarian, it may backfire.

            After reading my November column on ICPD, a doctor whom I respect highly chided me. Dr. Malcolm Potts wrote “Richard, I was also at the ICPD, which I thought at the time – and continue to think – was a step backwards.”


             I appreciate the many comments I receive on my population essays. They help to inform and inspire me as well as keep me honest. Although I gave a positive slant to ICPD last month, I have to agree with Dr. Potts—that conference seemed to ignore that the world was already overpopulated 25 years ago.

            Another friend who was also there wrote: “I gave a paper on population issues and the unsustainability of current levels of population growth. …the attendance was light and nobody really cared.” Although the rate of growth has decreased in the intervening quarter century, we have gained over 2 billion more people. The climate crisis is evidence that our planet is even more overpopulated

             No place reflects the failure of ICPD more than sub-Saharan Africa, and especially the Sahel. It is a band across the center of Africa that has barely enough precipitation to support life. The land is overgrazed already and people are degrading the environment even more. Despite this, some of the world’s highest population growth rates are in the Sahel. The average woman in Niger (one of the Sahelian countries) will bear 7 children during her lifetime!

            Combine the area’s aridity and fast population growth with climate change and you have a recipe for a potential disaster. Add military conflicts and hundreds of thousands of refugees and things look even worse. Already many countries in the Sahel depend heavily on foreign aid for food, but that is not sustainable.

            Developments in the Sahel reminds me of what happened in a country a bit to the south. People in Rwanda had killed each other shortly before ICPD. Although ethnic and political causes are usually cited as the reasons of this genocide, another theory makes sense to me. James Gasana’s “Remember Rwanda” in World Watch magazine paints a different picture. As a former Rwandan Minister of Agriculture and Environment, Gasana felt hunger due to overuse of resources fueled that violence.

            I am alarmed by an article published November 2019 in the journal Nature, “Avert catastrophe now in Africa’s Sahel”. Already there are thousands of people escaping Africa to Europe. We may see another genocide if crowding and conditions worsen in the Sahel.

4 suggestions to Prevent Catastrophe:

Invest in girls’ education and reconsider marriage laws. We all know that educating girls and women is one of the best ways to slow population growth—plus education is good in itself. What is less well known is that the norm in many places is for girls to be subjected to an arranged marriage when they are teens or younger.

Expand access to family planning. I spent time in Northern Ghana where large families are common. A program to increase access to family planning did little to slow growth. Why? Apparently the people there are loath to discard traditions and benefit from small family size. Organizations such as the Population Media Center could help change old practices.

Increase agricultural production. No till farming, mulching and techniques of water harvesting can increase production markedly.

Act now. The best chance to slow emigration from the Sahel and prevent disaster needs international aid to act quickly. However, the Sahel would be less likely to explode if ICPD had focused more on population 25 years ago.

© Richard Grossman MD, 2019