Hi elmatador,
Looks like demographics are at work in Brazil, too...
online.wsj.com
In Paying for Votes, Politicians In Brazil Reduce Future Rolls
Free Sterilization for Poor Is Common Bargaining Chip
By MIRIAM JORDAN
Staff Reporter of THE WALL STREET JOURNAL
CABO DE SANTO AGOSTINHO, Brazil -- During the last local election in this northeastern Brazilian town, Sarah da Silva and her sister accepted a curious favor in exchange for their votes. Instead of offering cash or medicine, a candidate paid for the two mothers to be sterilized.
In parts of Brazil, arranging for operations to tie women's fallopian tubes is a proven vote getter. "This is a perverse market in which sterilization has become just another commodity to trade," says Ana Paula Portella, head of SOS Corpo, a nongovernmental organization here in the northeastern state of Pernambuco. In some cases, politicians make it known that they will finance tubal ligations in exchange for votes; in others, women who want to be sterilized approach candidates.
In the slums of this town of 160,000 in a sugar-cane region, many women in their late twenties report nonchalantly that they are sterilized -- and most say they got a politician to pay. Mrs. da Silva's family of four lives on about $100 a month; she couldn't afford to pay $90 for a tubal ligation at a private clinic. Nor did the 27-year-old want to deal with the long wait and red tape at a municipal hospital that performs the surgery free of charge. Like most Brazilian men, her husband wouldn't countenance a vasectomy, a simple outpatient procedure.
Cabo's town council has 21 members, who each earn nearly $3,000 a month, a lot by local standards. Isaias Jose, an affable councilman in his fourth term, was an ambulance driver before he entered politics. He doesn't hide the fact that he uses his connections in the medical establishment to help voters get urine tests, blood work and surgery. Mr. Jose evades the question of how many sterilizations he has facilitated. "It's a financial issue," he says. "These women can't afford to have their tubes tied, so they go looking for politicians to pay for it."
According to Brazil's latest official figures, as of 1996, 40% of all married women of reproductive age in this Roman Catholic country were sterilized. Demographers believe the figure is now close to 50%. The procedure is a big reason for the plunge in Brazil's fertility rate over the past 20 years. In 1980, Brazilian women had an average of 4.3 children each. Today, women in Brazil have just 2.2, and the birthrate is projected to decrease further.
Academics point to several factors behind the trend: widely viewed soap operas, where small families are the norm; the rise of consumerism; and a high level of urbanization and women's education. In one generation, communities such as Cabo have seen a marked change in family size. Mrs. da Silva's mother gave birth to 11 children. But Mrs. da Silva, who shares a tiny shack with another family, says two kids are enough. "I want to give them a better future."
Contrary to 20th-century predictions, population growth is slowing in many parts of the developing world. In some countries, such as Mexico and Iran, government initiatives have induced couples to have fewer children. In the absence of government family-planning policies in Brazil, private doctors have responded to the high demand for contraception by encouraging women to tie their tubes, a procedure that became the preferred method of birth control.
Some feminist and human-rights activists decry the phenomenon, saying that poor, uneducated women are duped into surgery without being informed about the full range of contraceptive options. The Catholic Church, too, is officially against the procedure, but it is more focused on wiping out abortion than sterilization. For millions of Brazilian women, already inured to invasive medical procedures, including Caesarean sections and cosmetic surgery, tubal ligations are the most practical solution to unwanted pregnancies.
This mentality has bred a mutually beneficial relationship between women and local politicians used to doling out petty bribes in the northeast, an impoverished region that is home to 25% of Brazil's 170 million people.
Rosilene Maia, 25, knew where to go in the 2000 election. Saddled with three young mouths to feed and an unemployed husband, she contacted a councilwoman named Maria de Zequinha who was seeking re-election. Mrs. Maia says that she showed up at a local clinic on the time and day designated by Ms. Zequinha's aide. At first, an obstetrician on duty told her that he didn't have any knowledge of her case. But after a phone call, he declared, "We're all set" and operated, Mrs. Maia recalls.
Sitting in a rocking chair on her porch, Ms. Zequinha says that she sponsors sterilizations "because there is so much deprivation out there. I don't do it for political reasons." Asked whether she might benefit at the polls, the portly woman with a warm smile replies: "Voters see my deeds and they decide how to reciprocate." Carlos Fonseca, an obstetrician who performs sterilizations for Ms. Zequinha at a private clinic, won't disclose how much he earns from the procedures. But in election years, he concedes, "it rains tubal ligations."
In Brazil, voting is obligatory for anyone 18 or older. Politicians who exchange favors for votes have no way of checking whether someone actually voted for them, although sometimes they ask for a voter's identification number as a form of intimidation. Some women get the best of the candidates. "I got my tubes tied, and then I didn't vote for him," says Angelica Erica of one candidate.
In recent years, the Brazilian government has improved family-planning services. Birth-control pills, intrauterine devices and condoms are distributed free at public clinics. But often demand outstrips supply. One day recently, Cabo's main clinic didn't have a single pack of contraceptive pills, and the pharmacist said she didn't expect a new stock for two weeks.
The government has also taken steps to regulate tubal ligations. In 1997, it began paying for the procedure at public hospitals for women with at least two children. But applicants must wait no less than 60 days to have the operation to ensure they receive professional counseling and information about other forms of birth control. The bureaucracy, coupled with high demand, means that most applicants fail to get sterilized at public hospitals, says Elza Berquo, a leading Brazilian demographer. That opens the door for politicians to pay for private procedures.
Since she was sterilized in September 2000, Mrs. Maia has divorced and remarried -- and now regrets having had the difficult-to-reverse procedure. "My current husband is dying to have a child," laments the mother of three. "I made a big mistake."
Still, other women are just waiting for next year's municipal election to end their reproductive life. "I've already done my part for Brazil," says Rosilene Santana, who has two children. "Next election, I'm going to find a politician who will get my tubes tied."
Write to Miriam Jordan at miriam.jordan@wsj.com
Updated June 13, 2003
KJC |
