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A doctor’s ‘jihad’ to popularize birth control among Assam’s Muslims

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By NewsGram staff writer

Talks about birth control were once a taboo for Muslims, particularly the uneducated Muslims living in remote areas of Assam. This has changed largely due to Ilias Ali, a professor of surgery at the Gauhati Medical College and Hospital, who had launched a kind of ‘jihad’ (holy war) against the misconceptions about birth control and has thus far carried out a staggering 48,000 vasectomies on Muslim males.

Now, Muslim males with two or more children are voluntarily coming out in large numbers to get sterilized and help control the population.

“Muslims, particularly the uneducated ones, are opposed to birth control. It is not only in Assam but in many other parts of India as well. They believe children are the blessings of Allah and all births take place as per his wish. They consider it a sin to go against the wishes of Allah,” Ali, who conducted his first No Scalpel Vasectomy (NSV) also known as ‘keyhole vasectomy’ in Assam in 2008, told IANS.

NSV is one of the most popular techniques to conduct vasectomy through a single puncture in the scrotum which requires no suturing or stitches. It causes less pain and fewer post operative complications.

Ali went to China for being trained in NSV by Li Shunqiang, who had invented the procedure in the mid-1970s. However, it was introduced in India only in the mid-1990s.

“I have realized that there is ignorance among the people, particularly among the uneducated Muslims over this. The Holy Quran has been misinterpreted by some and the people have taken it to be true due to their being illiterate,” he said while explaining that, in fact, Islam is perhaps the only religion which talks of family limitation methods.

“There is a mention about ‘azol’ in the Holy Book, which means coitus interruptus (ejaculation outside vagina). During the time of Prophet, some of his companions tried to reduce the chances of conception and pregnancy by practising azol. The Prophet was aware of this,” Ali said adding that this method became widespread during the Prophet’s lifetime.

“I have been using this and other references from the Holy Book to explain to the people that birth control is not against Islam,” he said.

One of Assam’s best-known surgeons, Ali further added that he often refers to Chapter 46, Verse 15 of the Quran which says “Wa hamluhu wa fisaluhu salasuna sahran”, which means there should be a gap of 30 months between a child’s birth and his or her weaning.

“Since lactation is understood to act as a natural contraceptive for a mother, this implies that there should be a gap of two-and-a-half years between two children,” said Ali.

“It is incumbent upon fellow Muslims to arrest the spiralling population and preserve the environment. The population growth rate among the Muslims, particularly among the non-indigenous Muslims living in the riverine sandbars, is comparatively higher than other communities in Assam. The shrinking land availability due to the population growth is a matter of concern,” he said, adding that his efforts have shown results over the years.

Ali said that the total fertility rate (TFR) among the Muslims in Dhubri district, where the number of non-Indigenous Muslims is greater, have come down over the years – from 2.7 percent before 2007 to 2.6 percent at present.

“We believe that the population growth will stabilize when the TFR comes down to 2.1 percent. Our target is to achieve this by 2019,” he added.

For Ali, this success has come after much pain. He had to risk his life for trying to popularize sterilization among the Muslims. In 2009, an Islamic organization issued fatwa against Ali and his programmes were boycotted for being un-Islamic.

“I had received several threats in those days. My meetings and NSV camps were boycotted and some organization issued fatwa against me. My family was threatened if I continue my mission. But I do not blame anyone for this. I am happy that I have been able to break the jinx and popularize NSV,” he said.

“Of late, the marginalized sections of the Muslim community have realized that a well planned family is the key to prosperity and progress. That is why they have extended their support to our programme,” he added.

Hasan Ali, a resident of Dhubri district who underwent NSV at a camp organized by Ali in 2009 said, “We have two children. I was first hesitant to accept what doctor sahib was trying to convince us in our village. However, he mentioned about the Holy Quran and explained to us that Prophet Mohammed was not averse to family planning. I decided to undergo NSV and now I encourage my friends to also do so.”

Educationist and associate professor of North Eastern Hill University (NEHU) Dwijen Sarma termed Ali’s efforts as path breaking. “I had the opportunity of meeting Dr Ilias Ali during a programme and he explained how he works among the rural uneducated Muslims encouraging them for birth control,” said Sarma.

“It was a herculean task to convince Muslims in remote areas to go for birth control. However, Dr. Ali has succeeded in his mission and I am sure he will achieve his target of bringing down the TFR to 2.1 percent,” he added.

(With inputs from IANS)

Next Story

State Legislature Working on Easy Access to Birth Control

The measures are seeing bipartisanship support in those states and come after similar laws have passed in nearly a dozen other states

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Several Republican-led state legislatures are advocating for women to gain over-the-counter access to birth control in what they say is an effort to reduce unplanned pregnancies and abortions, Ames, Iowa, March 15, 2019. VOA

Several Republican-led state legislatures are advocating for women to gain over-the-counter access to birth control in what they say is an effort to reduce unplanned pregnancies and abortions.

State legislatures in Arkansas and Iowa, for example, are working on legislation that would allow women older than 18 the ability to receive birth control from a pharmacist rather than going first to a doctor for a prescription. The measures are seeing bipartisanship support in those states and come after similar laws have passed in nearly a dozen other states.

Arkansas legislation

Arkansas state Representative Aaron Pilkington, a Republican, said he started working on the bill after seeing “about a 15 percent decrease of teen births” after other states passed similar legislation. Arkansas consistently has one of the highest birth rates among teenagers in the country.

Pilkington said support for the bill “in many ways, it’s very generational. … I find that a lot of younger people and women are really in favor of this, especially mothers.”

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Iowa state legislators have proposed a bill that would allow women to access birth control directly from a pharmacist, Ames, Iowa, March 15, 2019. VOA

According to the Oral Contraceptive (OCs) Over the Counter (OTC) Working Group, a reproductive rights group, more than 100 countries, including Russia, much of South America and countries in Africa, allow access to birth control without a prescription.

Women are required to get a doctor’s prescription to obtain and renew birth control in most of the U.S., much of Europe, Canada and Australia, according to the reproductive rights group.

Pilkington, who identifies as a “pro-life legislator,” said he brought the bill forward partly as an effort to counter unwanted pregnancies and abortions. The bill would require a doctor’s visit about every two years to renew the prescription.

Rural residents

Arkansas has a population of about 3 million people, a third of whom live in rural areas. Pilkington said the bill would likely benefit women who reside in rural areas or those who have moved to new cities and aren’t under a doctor’s care yet.

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Arkansas state Rep. Aaron Pilkington, a Republican, said he started working on a bill easing women’s access to birth control after seeing “about a 15 percent decrease of teen births” after other states passed similar legislation. VOA

“A lot of times when they’re on the pill and they run out, they’ve gotta get a doctor’s appointment, and the doctor says, ‘I can’t see you for two months,’” he said. “Some people have to drive an hour and a half to see their PCP (primary care physician) or OB-GYN (obstetrician-gynecologist), so this makes a lot of sense.”

What Pilkington is proposing is not new. In 2012, the American College of Obstetricians and Gynecologists endorsed the idea of making birth control available without a prescription. Today, at least 11 other states have passed legislation allowing for patients to go directly to the pharmacist, with some caveats.

In October, ahead of a tight midterm race, Iowa Republican Governor Kim Reynolds raised a few eyebrows when she announced she would prioritize over-the-counter access to birth control in her state. Like Pilkington, she cited countering abortion as a main driver behind the proposed legislation. The bill closely models much of the language used in another Republican-sponsored bill In Utah that passed last year with unanimous support.

The planned Iowa legislation comes after the Republican-led state Legislature passed a bill in 2017 that rejected $3 million in federal funds for family-planning centers like Planned Parenthood.

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FILE – Iowa Gov. Kim Reynolds delivers her inaugural address in Des Moines, Iowa, Jan. 18, 2018. VOA

The loss of federal funds forced Planned Parenthood, a nonprofit organization that provides health care and contraception for women, to close four of its 12 clinics in the state.

Since then, Jamie Burch Elliott, public affairs manager of Planned Parenthood of the Heartland in Iowa, said that anecdotal evidence shows that sexually transmitted diseases and unwanted pregnancies have gone up.

“With family planning, it takes time to see the impacts, so there are long-term studies going on to really study the impact of this,” said Burch Elliott. “Right away, we saw STI (sexually transmitted infections) and STD (sexually transmitted diseases) rates go up, particularly chlamydia and gonorrhea. As far as unintended pregnancy rates, we are hearing that they are rising, although the data is not out yet.”

Pro-life pushback

So far the Iowa legislation has received some pushback, mostly from a few pro-life groups.

The Iowa Right to Life organization has remained neutral on the issue of birth control, but the Iowa Catholic Conference, the public policy arm of the bishops of Iowa, and Iowans for LIFE, a nonprofit anti-abortion organization, have come out against the bill, citing concerns that birth control should not be administered without a visit to a physician.

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Democratic presidential candidate Sen. Amy Klobuchar, center, talks with State Rep. Heather Matson, right, at the Ankeny Area Democrats’ Winter Banquet, Feb. 21, 2019, in Des Moines, Iowa. VOA

Maggie DeWitte, executive director of Iowans for LIFE, also pointed out that oral contraception can be an “abortifacient [that] sometimes cause abortions,” challenging Reynolds’ motivation for introducing the bill.

On the other hand, Iowa family-planning organizations and Democratic legislators are mostly on board.

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“Policywise, I think this is really good,” said Heather Matson, a state representative of a district located just outside the state capital, Des Moines. She appreciated that insurance will still cover birth control, but took issue with the age restriction, saying she would like to see an option for people younger than 18. “Is it exactly the bill that I would have written, if given the opportunity? Not exactly.”

“Policywise, I think this is really good,” said Heather Matson, a state representative of a district located just outside the state capital, Des Moines. She appreciated that insurance will still cover birth control, but took issue with the age restriction, saying she would like to see an option for people younger than 18. “Is it exactly the bill that I would have written, if given the opportunity? Not exactly.” (VOA)