In this talk I would first like to celebrate the tremendous history of efforts by Christian organizations to promote care and treatment of the poor and the diseased. Successful pioneering examples are found in every corner of the globe. In India, one need look no further than the heroic efforts of Mother Teresa in the slums of Calcutta and the difference she made to the lives of the lepers. One cannot fail to recognize the passion and humility shown in dealing with the most oppressed, ones whom most people abandoned and shunned. I believe what set these caring people apart was their genuine compassion for fellow beings and love for the human spirit, no matter how small or troubled. Today we have a challenge of a much greater magnitude, leading to similarly ostracized communities, and which will prove much more difficult to eradicate as it is much more hidden. It is the challenge of worldwide eradication of sexually transmitted diseases, of which HIV/AIDS is the most serious.
I believe that Christian organizations, having revolutionized health care in the past, need to step up and promote the use of condoms for stopping the spread of sexually Transmitted Diseases (STDs), and of HIV/AIDS and Hepatitis B in particular. I understand this is a very difficult and emotionally charged issue, but today we have no choice but to break the silence. The lives of tens (and possibly hundreds) of millions of people are at stake. We need to rise to the challenge, and act starting today.
I believe that religious organizations would have no qualms vigorously promoting the use of condoms to stop the spread of diseases if condoms did not also prevent conception. So the problem lies, in more ways than one, in their essential and non-separable dual role -- birth control and disease prevention. Promoting the use of condoms during risky sex serves both purposes and should, as I could not imagine wanting children out of such encounters. Today, the use and promotion of the use of condoms involves disease prevention, birth control and population stabilization. I would like to make the case that India, in fact the whole world, desperately needs all three, so we must act to break the silence immediately.
I will begin with a discussion of the need for population control and small planned families before addressing the three issues posed above. In all developed Christian countries -- US, Canada, Western Europe including Italy -- there is a negative population growth if one excludes immigration. Are we to believe that these people are not good Christians or that they have stopped having sex? No, in fact these people are enjoying better health and greater sexual freedom than ever known in recent history.
The difference is that they have access to, and have adopted, modern safe birth control methods. They have, as societies, made a separation between religion, sex, and birth control methods. For both men and women, the choice of with whom and when to have children has lead to small planned families.
The difference is that they have understood and believe that small families are healthier, more prosperous, and can provide better opportunities for themselves and for their children.
They have intellectually and emotionally learned to distinguish between sex for pleasure, and sex for reproduction. This has come with additional benefits: more and more couples have developed healthy communication between them and are reaching equality in their relationship.
This openness and the ability to distinguish between sex for pleasure and reproduction is leading the way towards making sex safe -- healthy and risk free, without exploitation, and without emotional trauma and/or guilt.
Birth control methods did lead to smaller families, but they did so by heightening the awareness of the sanctity and value of human life. One can no longer afford to loose any child; the cost -- emotional, physical, and monetary -- is too high.
In developed countries families do not rely, even for a very short limited term, on children for income. Each child is raised to maximize the child's and not the parent's future. The child is not a helping hand or to be used as a source of revenue.
Security in the old age has been assured by savings, insurance, and retirement benefits. This trust is possible in a stable economy. People have developed confidence in the system and in the continued value of their savings to assume a comfortable retired life. They have confidence in the health care system to provide care. They and their children can therefore develop a relationship of love and responsibility and not of burden.
The goal, and one within our power to implement, is to have children because we enjoy and cherish them, because they are a source of joy and inspiration, and because we are willing and able to nurture and develop them.
The developing world is a different story. Children are often viewed as extra hands that can provide income and help with family chores. Bare subsistence existence, small land holdings, no access to technology that reduces household labor (by this I mean a stable structure for a home, running water, toilets and drainage, and fuel for cooking and heat) make extra hands, no matter how small, very useful. Even the smallest hands can do some necessary chore with efficiency. This economic driver behind having many children is not unique to India, it has existed in all families, cultures and civilizations prior to the rapid industrialization that occurred in the twentieth century. Developed nations have moved ahead to confront the next challenge while the majority, in India, have yet to finish this transition to smaller planned families.
This transition is proving hard to effect if the society is poor and illiterate. Unfortunately, for the poor, sex, alcohol, and drugs are the only inexpensive forms of pleasure available. We cannot hope to change this by repeatedly saying, with or without religious overtones, that sex is evil. We have to confront the real evils that can undermine any society -- corruption, exploitation, and darkness (illiteracy and lack of proper information).
A child is truly a gift of God, yet it is our responsibility that a child to whom we cannot provide sustenance, health, and future, should not be conceived. Proper use of birth control methods has provided us with the ability and control to avoid having children that are to become beasts of burden, and eventually a liability to the family, society, and the nation. Birth control methods have allowed us to have children when we want them and are ready to raise them as all religions prescribe: little precious angels allowed to grow in safety and not as beasts of burden. To my mind, methods that prevent conception, do not in any way violate the sanctity of human life. It is incomprehensible to me that any organization or society can continue to not provide information that prevents human suffering and a worldwide tragedy. How can the use of condoms to stop the spread of deadly diseases be bad?
Unfortunately, lots of people have risky sex and hence the rapid spread of diseases. We have two options: to stop people from having risky sex or to make sex safer. In my opinion the second option is the only one that has any chance of success. Religion has, throughout history, tried to limit sex to only for procreation, but it has not succeeded in practice. I don't see it happening today.
Sexual pleasure will continue to be a very major part of peoples lives no matter what shape future technologies take, unless of course people are replaced by robots. In fact, the history of "development" in the last century shows that a very large fraction of the technological innovations are driven by our need to improve the quality of life, and in particular our sexual lives -- witness the growth in cosmetic, health supplements, fitness programs, etc. industry. This growth does not simply reflect vanity, but underscores the fact that we are sexual creatures.
The goal, therefore, has to be to make sex safe, healthy, and free of trauma. This can be achieved only if people can choose when and with whom to have sex. This is not to say that we have no responsibility to make sure that the young understand when they are ready for sex and what the physical and emotional consequences are; that the joys (and dangers) of sex are both physical and mental; that mental, emotional, and physical maturity do not come at the same age. What I am advocating is that by empowering all individuals with information and understanding to have safe sexual lives, we can eradicate sexually transmitted diseases, at least those whose only hosts are humans, and which have the potential to become the nemesis of many civilizations.
Religion should and does play an important role in birth control. In the two largest communist countries, former USSR and China, the state sponsored and institutionalized abortion, and were not very active in spreading awareness about birth control methods. Consequently, in the absence of the moral authority of religion and the debate on sanctity of life, abortion has become the dominant method of birth control. The state removed the stigma on abortion in their effort to reduce population growth and not have unwanted children; unfortunately by doing so they created a new tragedy of colossal magnitude. To my mind, birth control methods have no relationship to abortion. Birth control methods are a safe way to prevent conception, whereas abortion is a last resort to terminate an unwanted pregnancy. That people, and even whole societies, have come to regard abortion as a form of birth control is a tragedy. There is ample evidence showing that repressing birth control methods, or even awareness about them, leads to growth in the number of abortions as the last resort to terminate unwanted pregnancies. Again we are faced with a difficult question and a choice between the lesser of the two "evils": providing awareness and means of birth control or facing growing number of abortions. We cannot postpone this decision as the number of abortions, and the suffering caused by them, are huge.
In India, the dominant form of birth control is sterilizations. Roughly eighty five percent of couples practicing birth control rely on sterilization and of these ninety percent are in women. There are no realistic estimates of the numbers of abortions, but it is believed that these numbers are very large already (in millions), increasing rapidly, and most are done under unregulated conditions.
So the question we have to confront is: with the very fast growth in the number of tragedies due to disease, abortion, and sterilizations, can we, or should we, live with silence rather than promote safer methods for sex and contraception?
Aside from moral and religious questions, both abortions and sterilizations are medically expensive and risky, especially in the developing world. By our silence we are denying reality, and de facto promoting unsafe methods which have disastrous long term consequences on health and the well-being of the people. In my opinion this silence has less to do with religion than it has to do with denial and not wanting to deal with hard, emotionally charged and important issues. Religion is being used, and in this case to the detriment of whole societies, especially those in the developing world.
It should be abundantly clear, looking at world demographics, that Christians in the developed countries, as individuals, have adopted and have practiced safe birth control methods. Why then, are Christian organizations continuing to maintain such a strong stand, and especially so in the developing countries, where the need for promoting safe sex and safe birth control methods is crucial and urgent? Access to good health care is one area in which India needs to emulate the many developed Christian nations.
There are many birth control methods (pills, inserts, implants, shots, and barriers like condoms), and some of these can have unwanted side-effects on individuals. In developed societies, where people exercise choice, the individual (couple) chooses what method of birth control is best for them in consultation with their doctor. Unfortunately, to prevent sexually transmitted diseases there is only one method -- the condom (microbicides provide additional protection but are not be sufficient by themselves for all the STDs). Even though condoms have a dual role, it is the role of disease prevention and the preservation of life and health that anyone need support if contraception is too difficult an issue in general. In fact, the experience of the last fifty years shows that condoms are the least preferred way of birth control -- people prefer pills or shots or implants as these require almost no behavior change. So, while condoms play a dual role, current emphasis on their use is predominately for the purpose of disease prevention during risky sex. I presume the silence persists because of the fear that if one advocates using condoms for risky sex one is either advocating it for all sex, and/or by advocating the use of condoms one is giving license to sex. Neither fears are justified, yet there is silence and this silence is leading to unnecessary misery and death for millions of our fellow beings.
Consistent and proper use of condoms is in many ways the simplest and in other ways the hardest behavior to adopt. It is simple if it becomes a habit, a reflex action best exemplified by the seat belt that one needs to put on as soon as one gets into the car, and every time. Such behavior is easiest to develop prior to a person's first sexual experience. It becomes increasingly harder with time once people get used to sexual activity without condoms. Awareness and social perceptions play a very important role in the success of such behavior changes. People have to have faith that using a condom does not decrease sensitivity (and thus pleasure), and its use is not a sign of weakness or timidity, or puts doubt on the other person's character. These are not easy perceptions to change as they are deeply rooted in society. Adding a feeling of guilt to these difficult mental hurdles does not help. We, therefore, have little choice but to provide information on, and an understanding of, how a condom prevents STDs, and how to use it properly prior to the first sexual experiment. Simultaneously we must negate the existing social prejudices and the perceptions that condoms are cumbersome and decrease pleasure.
I consider it our duty to teach our children about sexuality, safe sex, and protected sex using a condom before they begin sexual activity. Today, unfortunately, the rapid spread of Hepatitis B and HIV/AIDS has made the need for dissemination of correct information on sex time critical. There is no second chance with HIV/AIDS and prevention is our only hope. It is the wish of every parent that sexual activities begin at marriage or when the young adults are mature enough to form a stable lasting relationship. I am no different. All I am asking is that we provide children with the information and the tools by which they can lead healthy, happy, and fun lives.
Awareness and information on birth control methods, condoms and sexuality, should not be confused with promoting sexual activity. When a person chooses to have sex, and how thoughtful they are in general, has a lot to do with how they are raised and what values they have developed. Correct information and knowledge only helps to strengthen their values and provides a rational basis for withstanding the contradictory, confusing, and misleading influences they confront every day. It gives them the freedom to remain safe by making the right, informed decisions.
Every great society rose to meet their challenges or collapsed. We are fast becoming one big family -- physical borders are vanishing and cooperation between nations is increasing. Our challenge, therefore, is to ensure the health of all people. We have the knowledge and the means to do this, what has been missing is the courage, sacrifice, and will to implement it equitably. We can, and must, accept this challenge, and succeed.
I present these views before you not in anger or with ill-intent. I present them with the hope that Christian organizations that have, throughout history, shown humanity the way to provide health care and how to take care of the poor, the afflicted, and the marginalized, rise to today's challenge -- the urgent need to eradicate sexually transmitted diseases. The method is known and implementable. What is needed is for people of all faiths to break the silence and spread awareness. If the use of condoms can prevent transmission then we have to advocate their use. By making sex safe we will beat the diseases, whereas by not wanting to talk about safe methods of birth control and sex, these diseases will eat the very fabric of society that we think we are trying to protect. In short, this is a plea to all thoughtful and caring people, and a call to immediate action. It should not be confused with any intention to deny or to vilify religion.
Rajan Gupta