“Modern medicine in the rising West may have been a boon, but it could only be darkly ambiguous in Asia as populations expanded without corresponding economic growth, pushing many into destitution.”
PANKAJ MISHRA (REVIEWING NIALL FERGUSON’S “CIVILIZATION”)
I have been reading Niall Ferguson’s panegyric to European economic and social superiority Civilization and I was curious as to how non-western readers responded to such mighty praise of the “white man’s” mission to “civilize” the world. Indian author Pankaj Mishra had much to say in response that I could agree with, however when he came to reject the benefits of Western medicine I had to stop and think for a bit.
In this one-line retort against Niall Ferguson’s assertion that Western medicine improved the lot of the world in general, Mishra states that any such benefits could equally be cancelled out because the people in many (particularly non-Western) countries whose lives are extended are more likely to be poor as their under-developed national economies cannot support increased numbers of people in lifestyles considered to be essential for happiness. What he appears to be saying by corollary is that, if the people cannot be materially provided for, it is better not to medically intervene. Or to put it another (simpler) way, if the poor get sick, let them die.
Mishra’s argument that western medicine had darkly ambiguous results in the non-West also hints at a sense of regret that the populations of poor people have risen in the first place. The idea of elites looking upon the growing masses of underclasses with a sense of horror that people should have to suffer under such conditions is a two-sided coin. On the one side, no one wants to see people suffer under difficult conditions, however, on the other side, these “masses” have lives and families. They laugh and play and in most ways live the life human beings have always lived. The suggestion that, if these Asian poor get sick, they shouldn’t be treated with modern medicine is inhuman. I am sure Mishra would never state his ideas in this way, however these are the implications of his and the others who speak blithely of “overpopulation”. Contraception, promoted and advanced by Western medical science, is not mentioned. Before we in the more affluent societies stroke our chins wisely and speak of the tragedy of growing populations of poor people, lets remember that human life without modern affluence is not, by definition, worse than death.
The biblical character Job declares that, after having once being rich and prosperous he is horrendously afflicted with poverty and disease, he wishes he had never been born. However It is the fall from the heights that make’s Job’s story a tragedy, not the state of poverty itself. It is also a mistake to equate poverty as a single state without the same gradients of economic levels that we equate with those not poor. The world is not binary – the poor and the not poor. Lack of economic security does not necessarily mean a life not worth living.
I am not speaking about the earnest need to alleviate the plight of poor individuals. I am speaking about the way in which the growing numbers of people who are born into poverty are grouped together and assessed as a single negative economic statistic. Such language creates the impression that economists and sociologists look upon the birth of every child to a poor family as an intolerable burden to be born by children in affluent families. If medical improvements to extend the lives of the poor in fact worsen the global situation, is it not then a corollary to say that it is better for everyone if the poor just died young like they used to?
To assume that it was better that the poor not be born, is the height of and elitist worldview. “Poor” people do not regret their birth. Perhaps some affluent people, looking down at the masses whom they know will never achieve the standard of living they themselves have, might regret their growing numbers. While I was in Hout bay, South Africa, dining at the large and beautiful home of a British expat family, my hosts pointed out a dark smudge between two distant hills, an encroaching shantytown spreading out from Capetown to blight their serene landscape. To them it was a cancerous tumor signalling to them that their pretty little affluent seaside town was about to be visited by the post-apartheid reality. It was clear they were saddened, not for the plight of the occupants of the hovels, but for themselves as their increasing proximity to the poor dimmed their own happiness. My hosts looked at the shantytown perhaps like population control experts do, feeling modern medicine’s success has had darkly ambiguous results.
For any individual human being the choice to live longer is usually a no-brainer. Do we want to die early of disease? No. Does anyone want to see their children die in infancy or early childhood? Never! In that respect the poor are just like the rich. They want to live as long as they can, even if that means they are poor. The choice of being poor or dead is also a no-brainer, except perhaps to those who are currently affluent and can’t imagine a life in which survival is a struggle. “I’d rather be dead than poor!” sounds like something Paris Hilton would say. Most “normal” people, If they really had to face that choice, would “choose life”.
The rhetoric of “population control” has been in vogue since the 1960s when Paul Ehrlich, a biologist, argued that the Earth’s biosphere could not sustain any further human expansion due to limited agricultural potential. Ehrlich extrapolated his research on butterfly populations to create his vision of a human apocalypse of hunger and death. But he failed to understand that, with increased economic development, birth rates tend to fall. Ehrlich was essentially regurgitating Thomas Malthus’ 18th century argument that agricultural output was not sufficient to support large population expansions. In 1898 Malthus failed to see the advances in agriculture that could increase land productivity and boost agricultural output. Similarly Ehrlich, nearly two hundred years later, refused to believe that there were any further revolutions in food production to come. Time and human creative ingenuity have demonstrated again and again that he was wrong.
In the eyes of the Biblical God each person is a miraculous creation of great worth. Each child born is a joy to God and each loving parent an imperfect representation of the imago Dei. As Christian thinkers we must resist the rhetoric of “population bombs” and the “population control” as much as we would abortion or radical birth control. We must fight to make the existing human population less poor without demanding that there be less poor people.
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