A Humanitarian Worker’s Practical Reflections on the Coursework

In my last blog entitled “A Busy Professional’s Guide to Learning” I ended it with a quote by Alfred Mercier, who said that “What we learn with pleasure, we never forget.” After using this quote, I thought that it could be a cliché. After all, learning is hard work and how can it be pleasurable too? Isn’t this an oxymoron? Perhaps, Mr. Mercier was speaking of some other forms of learning, one which does not involve my Demography and Health coursework, with its formulas and a lengthy glossary of terms, and so on. For a first-year MSc student, this coursework has been everything but a pleasure.

However, my narrow view of learning as a pleasure changed when I read an article—part of a reading for my Introduction to Demographic Analysis course—by McDonald Peter. Sustaining Fertility through Public Policy: The range of Options. In: Populations (English Version), No.3, 2002. pp.417-446. This paper presents a range of policies that can be used to support fertility rate at a moderate level, that is, around an average of 1.7-1.9 births per woman. After reading this article, I posed to reflect on its practical meaning for a country that has been mired in what appears to be an unending civil war.

I recall reading in a previous course document that “A population with a growth rate of 3% per annum will double in size every 23 years.” This led me to check on the population growth of South Sudan, which as recent data suggest has an annual growth of 2.88%. Hence, by 2040 the population of South Sudan will double. This led me to reflect about the implications of a high fertility rate and McDonald’s policy options for sustaining fertility at a moderate level in the context of South Sudan.

I recognize that I do not have in-depth knowledge of the Malthusian Theory to speak about its merits, but I do know from first account how difficult it is for parents to feed their children without even mentioning their ability to provide them with quality healthcare and education. As a humanitarian worker, I have seen how dependent many households have become on food aid, healthcare, and education provided by non-governmental organizations, both local and international. Reading about the demography transition in Europe, Latin America, and some countries in Asia and Africa, I wondered when South Sudan, which has have been plagued by years of conflict, will start its demographic transition. Or has it started?

A search on the web led to the World Bank’s website where I found several charts on demographic trends on South Sudan. When I looked at the fertility rate chart,

Graph: Fertility Rate is going down

Graph: Fertility Rate is going down

it shows that South Sudan’s fertility rate has gone down, from 6.7 in 1960 to around 4.9 children per women in 2015. Although, this rate is still high by global comparison, it is, nonetheless, a surprising finding. My guess is that this decrease in the fertility rate could be explained by, but not limited to, a reduction in child mortality due to immunizations, aggressive campaigns against malaria and other childhood diseases, provision of ante-natal care, availability of modern contraception, robust family planning interventions, targeted programs to address moderate and severe acute malnutrition, etc., by various actors.

Graph: Infant Mortality Rate is going down

Graph: Infant Mortality Rate is going down

These interventions, many demographers have argued, contributed to the demographic transition in other corners of the world. While I do not know whether South Sudan is in the Pre-transitional, Transitional, or Post-transitional phase of the demographic transition (please come back to me with this query in a year or two after I have grasped this process a bit more), I do know that a decline in the fertility rate and mortality rate—number of deaths per 1,000 live births went from 177.1 in 1979 to 60.3 in 2015—coupled with an increased in life expectancy at birth, from 31.7 in 1960 to 56.3 in 2015, paint a positive demography transition. Whether demographers would agree or disagree with me is a moot point. My main concern, as a humanitarian worker with an avid interest in demography and health is to reason, although I could be wrong, that some of the interventions that I have implemented and supported have resulted in an improvement of some basic population-level indicators.

Graph: Life expectancy is going up

Graph: Life expectancy is going up

Could the above analysis be considered too simplistic or lacking a scientific reasoning? Perhaps yes, but the point I am making is that prior to starting my MSc in Demography and Health, It would have never occurred to me to think about the impacts of programs I have implemented or supported on the demographic patterns of a country. The knowledge I am acquiring through my coursework is enabling me to look at health interventions with a different lens, and more importantly to review project proposals focusing on health with a question in the back of my mind: “How is this project addressing issues in demography and health in this country?” As a result, I have also wondered if the interlinkages between demography and health could set South Sudan on the path to reach a full-fledged demographic transition. Or perhaps allow it to arrive at a place whereby by the Government, with the support of the international community, could use the range of policies options outlined by McDonald to sustain a fertility rate at a moderate level.

Let me acknowledge that the current civil war in South Sudan, coupled with recurrent attacks on humanitarian aid workers, volatile economy, and heavy reliance on foreign aid, do not make it easier to implement interventions to help South Sudanese to escape the “humanitarian trap” they are in. But, as a new international humanitarian operation gets underway to save the starving, it is worth looking at some progress that has been achieved in the past couple of years. As I depart from South Sudan after a short but highly fulfilling two-month-long assignment, I leave with the hope that it will experience a demographic transition, whatever shape it might take. When I look at the modest increase in life expectancy from 55.2 in 2013 (when the conflict began) to 56.3 in 2015, it reminds me that there is hope in a country where the news is full of heart-wrenching stories of starvation and killings.Quote: What you do makes a difference

Perhaps, Alfred Mercier was right after all when he said that “What we learn with pleasure, we never forget.” The pleasure for me comes when I am able to relate my coursework to my work. And as Jane Goodall said “What you do makes a difference and you have to decide what kind of difference you want to make.” The difference I want to make is to use my knowledge of demography and health for a greater good.

Issa studies Demography and Health by distance learning.

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