Tag: now

  • Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem

    Indonesia recently completed the last of its annual large-scale treatment for lymphatic filariasis (also known as elephantiasis or Penyakit Kaki Gajah) in Malaka District located in its southernmost province, East Nusa Tenggara. Unprecedented
    progress by the National Lymphatic Filariasis Elimination Programme has strongly placed the country on the path to achieving the elimination of lymphatic filariasis as a public health problem.

    “We reached an estimated number of 40.7 million people living in the 118 high-risk districts during this month-long treatment campaign in October 2019” said Dr Anung Sugihantono, who recently retired as Director General of Diseases
    Prevention and Control, Ministry of Health Indonesia. “
    Single doses of diethylcarbamazine citrate and albendazole facilitated by WHO were delivered to all eligible populations.”

    In 2010, an estimated 125 million Indonesians were still at risk of the disease and required treatment.

    But things changed considerably in 2015 when Indonesia mounted an annual national campaign to resolutely address transmission of the disease and to tackle the morbidity and disability associated with it. The results were apparent as early as 2017, with
    remarkable progress.

    In Indonesia, LF is considered a significant public health concern. In 2009, risk mapping identified a population of 124.5 million people needing treatment for LF. The country initiated a national level LF elimination campaign in 2015, addressing both
    disease prevention and management. 

    “In 2017 and in just two years we managed to achieve 100% geographical coverage of all people requiring treatment” said Dr Sugihantono. “It meant achieving more than 78% epidemiological coverage – much higher than the generally recommended 65% to stop transmission.”

    Transmission of lymphatic filariasis can be stopped through large-scale treatment (or mass drug administration – MDA) of entire at- risk communities with recommended medicines once a year. These medicines kill the microfilariae in an infected patient’s
    blood preventing mosquitoes to transmit1 the disease to others. Through mass treatment, the aim is to reduce the reservoir of microfilariae in the blood to a level insufficient to maintain transmission by the mosquito vector.

    This strategy to interrupt transmission is the corner-stone of the World Health Organization’s (WHO) Global Program to Eliminate Lymphatic Filariasis (GPELF). Indonesia has been using the GPELF’s strategy since 2002 using a district or city
    as its implementation unit.

    In 2005, it listed the elimination of LF as a national priority for controlling infectious diseases and the medicines it has been using in large-scale treatment programmes are diethylcarbamazine citrate (DEC) and albendazole2 which are
    largely distributed by volunteer community health workers3.

    “Community health volunteers are themselves members of the community and know how to reach people effectively to improve compliance” said Dr. Stefanus Bria Seran, the Regent of Malaka District, one of LF endemic district in Indonesia. “Besides ensuring every single person ingests the medicine given to them, these community workers help in disseminating information well before a large-scale treatment campaign and also assist in reporting activities related to each treatment campaign”. 

    Indonesia’s efforts to eliminate lymphatic filariasis began in the 1970s but faced numerous challenges including programme coordination in the many inhabited islands, conducting information, education and awareness programmes, lack of capacity and
    insufficient medicines.

    Furthermore, the situation in Indonesia is unusual than in many other countries endemic for lymphatic filariasis as the country is endemic for all three species of thread-like filarial worms – Brugia malayi, Brugia timori, and Wuchereria bancrofti –
    that cause the disease. Most of the infections in Indonesia, however, are caused by B. malayi.

    In the past, some of the factors that prevented access to the medicines (DEC and albendazole) were social stigmatization linked to the disease, the vast geography of the territory and challenges in reaching remote populations.

    With an estimated population of 242 million, Indonesia is the world’s largest island nation and consists of approximately 17,000 islands, of which 5,000–6,000 are inhabited. It is the fourth most populated nation behind China, India, and the United
    States.

    Indonesia is endemic for many other neglected tropical diseases and an estimated 110 million Indonesians are believed to suffer from at least one neglected tropical disease (NTD), including lymphatic filariasis and soil-transmitted helminth infections.
    Leptospirosis (not classified as NTD) is also widespread.

    Indonesia is the only country of WHO’s South East Asia Region with endemic schistosomiasis. Like many other countries of the Region, it also faces recurrent threats of dengue outbreaks.

    Global progress

    The world has made significant progress towards the elimination of lymphatic filariasis as a public health problem.

    Sixteen countries4 and one territory are now acknowledged by WHO to have achieved elimination of lymphatic filariasis as a public health problem.  

    Seven additional countries have successfully implemented recommended strategies, stopped large-scale treatment and are under surveillance to demonstrate that elimination has been achieved.

    The disease

    Lymphatic filariasis is caused by infection with parasitic worms living in the lymphatic system. The larval stages of the parasite (microfilaria) circulate in the blood and are transmitted from person to person by mosquitoes.

    Infection involves asymptomatic, acute, and chronic conditions. Most infections are asymptomatic, showing no external signs while contributing to transmission of the parasite. Although asymptomatic, these infections still cause damage to the lymphatic
    system and the kidneys and alter the body’s immune system.

    When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs are common.

    Manifestation of the disease after infection takes time and can result in an altered lymphatic system, causing abnormal enlargement of body parts, and leading to severe disability and social stigmatization of those affected.

     


    1Lymphatic filariasis is transmitted by different types of mosquitoes – e.g the Culex mosquito which widespread across urban and semi-urban areas; Anopheles, mainly found in rural areas; and, Aedes, mainly
    in endemic islands in the Pacific.

    2In 2017, WHO recommended an alternative three drug treatment to accelerate the global elimination of lymphatic filariasis. The treatment, known as IDA, involves a combination of ivermectin, diethylcarbamazine citrate and albendazole.
    It is recommended annually in settings where its use is expected to have the greatest impact.

    3Community health workers, also called ‘cadres’, are volunteers who form part of the communities they serve and work with local
    communities to educate families. Their contribution in promoting health has been significant in the country.

    4Cambodia, The Cook Islands, Egypt, Kiribati, Maldives, Marshall Islands, Niue, Palau, Sri Lanka, Thailand, Togo, Tonga, Vanuatu, Viet Nam, Wallis and Futuna, and Yemen

    Indonesia firmly committed to eliminating lymphatic filariasis as a public health problem
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  • WHO reports fivefold increase in cyber attacks, urges vigilance

    WHO reports fivefold increase in cyber attacks, urges vigilance

    Since the start of the COVID-19 pandemic, WHO has seen a dramatic increase in the number of cyber attacks directed at its staff, and email scams targeting the public at large. 

    This week, some 450 active WHO email addresses and passwords were leaked online along with thousands belonging to others working on the novel coronavirus response. 

    The leaked credentials did not put WHO systems at risk because the data was not recent. However, the attack did impact an older extranet system, used by current and retired staff as well as partners. 

    WHO is now migrating affected systems to a more secure authentication system. 

    Scammers impersonating WHO in emails have also increasingly targeted the general public in order to channel donations to a fictitious fund and not the authentic COVID-19 Solidary Response Fund. The number of cyber attacks is now more than five times the number directed at the Organization in the same period last year. 

    “Ensuring the security of health information for Member States and the privacy of users interacting with us a priority for WHO at all times, but also particularly during the COVID-19 pandemic. We are grateful for the alerts we receive from Member States and the private sector. We are all in this fight together,” said Bernardo Mariano, WHO’s Chief Information Officer. 

    WHO is working with the private sector to establish more robust internal systems and to strengthen security measures and is educating staff on cybersecurity risks. 

    WHO asks the public to remain vigilant against fraudulent emails and recommends the use of reliable sources to obtain factual information about COVID-19 and other health issues. 

    For more information, please visit: www.who.int/covid-19.

     

    WHO reports fivefold increase in cyber attacks, urges vigilance
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  • INFOSAN Quarterly Summary, 2020 #1

    Food safety incidents

    During the first quarter of 2020, the INFOSAN Secretariat was involved in 38 food safety incidents involving 109 WHO Member States and 9 territories of WHO Member States. There were 25 incidents involving a biological hazard (Salmonella spp. [8], Listeria monocytogenes [5], Norovirus [3] Shiga-toxin producing Escherichia coli [2], Clostridium botulinum [2] Bacillus cereus [2], Cronobacter spp. [1], Shigella sonnei [1], unspecified biological hazard [1]), 6 involving an undeclared allergen (milk [3], peanut (1), egg [1], gluten [1]), 5 involving a physical hazard (undetermined foreign matter [2], glass [1], metal [1], plastic [1]), one involving a chemical/toxin hazard (histamine), and one linked to an unspecified hazard.

    The food categories that were most commonly involved in the 38 incidents during the first quarter of 2020 involved fish and other seafood (8), herbs and spices (4), legumes and pulses (4), milk and dairy products (3), nuts and oilseeds (3), snacks, desserts and other foods (3), cereals and cereal-based products (2), composite food (2), fruit and fruit products (2), meat and meat products (2), vegetables and vegetable products (2), products of special nutritional use (1), and food for infants and small children (1). One incident involved an unknown food source.

    During such international food safety incidents, the INFOSAN Secretariat relies on the swift action of national INFOSAN Emergency Contact Points to respond to requests for information. Rapid sharing of information through INFOSAN enables members to implement appropriate risk management measures to prevent illness in their respective countries.

    Geographic scope

    The outlined incidents involved Member States from all WHO regions: Europe (39), followed by the Americas (24), Africa (24), the Western Pacific (18), the Eastern Mediterranean (8) and South-East Asia (6).

    Recall in several countries of frozen spring roll sheets from Singapore due to the presence of an undeclared allergen

    In February 2020, the INFOSAN Secretariat was notified by the European Rapid Alert System for Food and Feed (RASFF) and INFOSAN colleagues in Australia of a recall in Australia and several European countries of frozen spring roll sheets due to the detection of an undeclared allergen (milk), imported from Singapore. In collaboration with RASFF, the INFOSAN Secretariat was informed that the implicated frozen spring roll sheets were distributed internationally to 46 Member States from four WHO regions and 4 territories in Europe and the Western Pacific. Moreover, through engagement with the INFOSAN Emergency Contact Point (ECP) in Singapore, the INFOSAN Secretariat also received details of further distribution of implicated products to additional WHO Member States from all WHO regions, taking the total number of Member States involved to 65. It was also reported that the products involved had been redistributed by some countries to Europe, the Americas and Africa. Consequently, several countries recalled the implicated products to relabel them and investigated the issue to identify illnesses related to the consumption of the implicated frozen spring roll sheets. No illnesses were reported to the INFOSAN Secretariat.

    This incident has highlighted undeclared allergens as an important category of hazards that can result in a largescale international response to implement risk management measures and prevent illness. In addition, it exemplified efficient communication among INFOSAN members and the Secretariat.

    Outbreak of Listeriosis in the United States of America linked to enoki mushrooms imported from the Republic of Korea

    In March 2020, the INFOSAN Secretariat was made aware by the United States (US) Centers for Disease Control and Prevention (CDC) of an outbreak of Listeriosis in the US linked to the consumption of enoki mushrooms, imported from the Republic of Korea. In total, 36 cases including 4 deaths have been reported in the US. Following investigations in Canada, carried out in collaboration with the US, the INFOSAN Secretariat was informed of 6 cases of Listeriosis between 2017 and 2019 in Canada potentially related by whole genome sequencing (WGS) to the ongoing outbreak in the USA. In addition, food isolates (from enoki mushrooms from the Republic of Korea) genetically associated with the cluster of cases have been collected in 2019 by authorities in Canada. The WGS information pertaining to the cases and food isolates were shared on the INFOSAN Community Website to assist the identification of cases in other countries.

    The INFOSAN Secretariat engaged the INFOSAN Emergency Contact Point (ECP) in the Republic of Korea to seek details on any further international distribution of the implicated enoki mushrooms. Investigations are ongoing. 

    News & activities

    Food Sector and the COVID-19 outbreak

    On 31 December 2019, WHO was alerted to several cases of pneumonia of unknown origin in the city of Wuhan, Hubei Province, China. The virus, a previously unknown coronavirus has been named SARS-CoV-2 and is the cause of the COVID-19 disease.

    The WHO Epidemic Information Network (EPI-WIN) aims to share information tailored to specific sectors, including food and agriculture. The INFOSAN Secretariat has recently developed a guidance document for food businesses with regards to COVID-19 and food safety which is now available online. The guidance has also been disseminated through EPI-WIN and presented during two webinars.

    Call for applicants: INFOSAN Train-the-Trainer Workshop

    In February, the INFOSAN Secretariat issued a call for applications for the INFOSAN Train-the-Trainer workshop. With the constant growth of the network, and the increased need for training that this entails, the INFOSAN Secretariat, in collaboration with the Canadian Food Inspection Agency (CFIA), has announced this workshop which aims to increase the human resources available to train INFOSAN members on a range of INFOSAN-related topics, online or in-person. As a result, it is expected that the understanding of the roles and responsibilities of INFOSAN members will be improved, resulting in greater participation that will enhance speed and efficiency during the response to food safety emergencies at the global level. The INFOSAN Secretariat, together with CFIA, look forward to hosting this important workshop later this year.

    Developing the new INFOSAN Community Website

    The INFOSAN Community Website (ICW) continues to be an effective tool for the network to disseminate information during food safety emergencies. Over the past year, through the INFOSAN member survey, the Secretariat has gained a better understanding of how members use the ICW and how it can be improved to enhance information sharing. The information collected, together with the experience of members of the Secretariat, has provided numerous innovative ideas to guide the development of the new ICW. The Secretariat is pleased to announce that the competitive process to select the vendor that will develop the new INFOSAN Community Website has concluded and the work on the creation of the new ICW has begun. 

    Voice of an active network member

    voice-5-2020

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  • Hard fought gains in immunization coverage at risk without critical health services, warns WHO

    Hard fought gains in immunization coverage at risk without critical health services, warns WHO

    Shutting down immunization services in the COVID-19 pandemic risks triggering a resurgence of diseases that can be prevented with safe and effective vaccines, warns WHO in the lead-up to World Immunization Week (24-30 April). 

    When immunization services are disrupted, even for brief periods during emergencies, the risk of vaccine-preventable disease outbreaks, such as measles and polio, increase. Last year’s deadly measles outbreak in the Democratic Republic of the
    Congo, which took more than 6000 lives in a country already facing its largest Ebola outbreak, highlights the importance of maintaining essential health services, such as immunization in times of emergency. Further disease outbreaks will also overwhelm
    health systems already battling the impacts of COVID-19.

    “Disease outbreaks must not remain a threat when we have safe and effective vaccines to protect us,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “While the world strives to develop a new vaccine for COVID-19 at record speed,
    we must not risk losing the fight to protect everyone, everywhere against vaccine-preventable diseases. These diseases will come roaring back if we do not vaccinate.”

    WHO is working with partners all over the world to accelerate research and development of a safe and effective vaccine and ensure equitable access for the billions of people who will need it.

    But even with an expedited process, development of a vaccine for COVID-19 will take time. Precautionary measures are essential now to help keep us safe from disease, including diseases for which vaccines already protect children and adults.

    Too many people are still excluded from the benefits of vaccines

    Prior to the COVID-19 pandemic, the world had made immense progress in ensuring that children are vaccinated. In 2018, 86 percent of children under the age of five globally were vaccinated with three doses of diphtheria, tetanus and pertussis (DTP3) and
    one dose of the measles vaccine, up from 72 percent in 2000 and 20 percent in 1980. The number of children paralyzed by polio has been reduced by 99.9 percent worldwide. 

    Yet, global vaccination coverage is still far from the 95 per cent coverage needed to fully protect communities against outbreaks of this vaccine-preventable disease. 

    In 2018 nearly 20 million children worldwide – more than 1 in 10 – missed out on lifesaving vaccines, such as measles, diphtheria and tetanus. Roughly, 13 million of the children have never received any vaccines, putting them and their communities
    at risk of disease and death. The majority of these children live in countries with already fragile health systems, further limiting their access to essential health services when they fall sick.

    Measles continues to remain an ever-present threat, especially if vaccination rates drops. Current projections indicate that the number of reported measles cases for 2019 will be at least 800 000. In 2020 there are increasing concerns about another
    resurgence, especially if vaccination rates fall due to delay or suspension of scheduled immunization activities as a result of COVID-19. 

    Outbreaks of polio, diphtheria and yellow fever are also of high concern, especially in the countries least able to respond quickly and decisively to address an emerging outbreak, as seen in previous emergencies such as the polio outbreak in Syria in
    2013. 

    Maintaining immunization services during COVID-19

    As the response to COVID-19 continues, countries must act now protect immunization services, in order to further minimize disease outbreaks and loss of life. This includes, facilitating urgent catch up programmes in places where
    services have been disrupted, ensuring strong supply chains, disease surveillance and trained health workers. Caregivers should also make sure they continue to vaccinate their children in line with national policies.

    New WHO guidelines on immunization and COVID-19 recommend that governments temporarily pause preventive immunization
    campaigns where there is no active outbreak of a vaccine-preventable disease. But it urges countries prioritize the continuation of routine immunization of children in essential service delivery, as well as adult vaccinations such as influenza
    for groups most at risk. If immunization services must be suspended, urgent catch-up vaccinations should be rescheduled as soon as possible, prioritizing those most at risk.

    Hard fought gains in immunization coverage at risk without critical health services, warns WHO
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    https://www.who.int/news-room/detail/23-04-2020-hard-fought-gains-in-immunization-coverage-at-risk-without-critical-health-services-warns-who

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  • THE FOURTH STORY—BABY ANIMALS AND MAN

    As the days and months glided by, our little girls were greeted one autumn morning by the advent of a little baby brother. Wife had given consent, years gone by, for me to tell the foregoing stories of life; but, only a few months before the above event, she had requested the privilege of telling this last story, as the girls would naturally ask of her how the little fellow came. This she told them, in a way no doubt, better than I could have done.

    In lecturing to multiplied thousands of boys and many hundreds of girls, I have told the stories of life much as I did to my little girls, with this story added.

    Baby animals.—We will now study God’s plan of increase in the higher animals and man. We shall find many striking resemblances and interesting variations between the lower forms of life that we have studied and the higher forms that we shall now study. All along the ascending scale of life we have found male and female organs of sex, possessing male and female natures. We have found that the male organs of sex produce a fertilizing substance called pollen in plants and semen in animals; that the female organs of sex produce seeds in plants and eggs in animals. We have found that every new plant, fish, insect, and bird comes from the union of the pollen with the seed, or the semen with the eggs. This last fact is true of the higher animals and man. We found that the seed of the plants are fertilized in the ovaries of the mother organs; that eggs of fish are fertilized outside of the body of the mother; that the eggs of insects and birds are fertilized inside of the mother’s body. This last plan is also true of the higher animals and man. We found that the seed of plants were sown or planted in the soil; that the eggs of fish were deposited in water; that the eggs of insects and birds were laid in some specially arranged place for them, usually called nests. In the higher animals and man the young starts from a tiny fertilized egg and grows in an organ in the mother’s body, called the womb, until it is strong and old enough to be born.

    The earliest stage of plant life in the little seed is called an embryo. When the seed has been planted and the little embryo appears above ground, it is then a little baby plant. The earliest stage of animal life in the egg of the fish, insect or bird, is an embryo. The mother part of the plant stores up food in the seed and the growing embryo feeds upon this food, until its little roots have grown down into the soil where they can take up food from the soil and the blades or leaves are large enough to receive light and heat from the sun and food from the atmosphere. The mother fish, insect and bird store up food in their eggs for the little embryos to live upon until they are hatched. Among the higher animals and man, the embryo begins with the tiny fertilized egg in the mother’s womb and receives nourishment and life from the mother’s blood through a duct, called the placenta, which is connected with the mother’s womb at one end while the other end connects with the body of the embryo at a point called the navel. In this way the mother furnishes the young with all the air, food, water and life that it gets until it is born. Among the higher animals and man the young when born are very tender and helpless. For several weeks or months they are fed on milk from their mother’s breasts. In higher forms of life the birth of young is attended by greater sacrifice and suffering than in lower forms of life. For months, and in the case of man, for years, the parents must labor and sacrifice to feed, protect and educate them. Birth in the human family is attended by greater suffering and the little baby is more helpless and tender, and for this reason requires more tender care than the young of any other animal. You have observed that in the lower forms of life where the parents do not have to suffer to bring their young into{ the world or labor to provide for them food or shelter that they do not love their young. As we ascend the scale of life in our study, we find that love exists between the parents and young just in proportion as the parents suffer and labor for their young.

    One of the most impressive and effective ways of telling the story of life in man was told by a wise and queenly mother in the following true story. This mother introduces the story by telling how solicitous she became about her little boy when he was about seven or eight years old. He was in the public school where he was likely any day to hear the story of life from some wicked boy. She was anxious that her boy should hear this story first from his mother’s lips.

    How a mother told the story of life to her boy.—In telling the story, the mother said:

    One morning, the opportunity that I had been praying and watching for, came. I observed my little boy playing rather roughly, not cruelly, with the pet cat. Speaking kindly to him, I said, “Son, don’t be rough with the old cat; handle her gently.” “Why, mamma?” he replied. “Son, mamma cannot make the reason clear to you now, but you obey mamma and in about ten days, mamma will tell you a very beautiful story, and, then you will understand.” As those days glided by, with pride I observed the unusual attention and kindness he showed the old cat. One morning, about ten days later, he came running into my presence, perfectly delighted, wonderfully elated, and overflowing with joy, he invited me out the back way to see what he had found. I anticipated his discovery, but I wanted him to have all the pleasure. So, I offered him my hand while he proudly led the way. As we stepped from the back porch, turning he pointed his finger under the floor; I looked, and there was the old mother cat and by her side were four as beautiful little kittens, basking in the sunlight, as the human eye ever saw. He bragged about having found them; called my attention to their color and markings; and claimed two of them as his own.

    We sat down on a rustic seat where we could still see them. We admired their plumpness, color, eyes and playfulness and chatted together about them. At length I said, “Son, do you remember about ten days ago when you were playing rather roughly and I asked you to handle the old cat tenderly?” Promptly he replied; “Yes, mamma, and you promised me that in about ten days you would tell me a beautiful story that would explain why I should handle the old cat kindly. Can you tell me that story this morning?” “Yes, son, mamma is ready to tell you the sweetest and purest story that a mother can tell her son. When mamma asked you to be kind to the old cat, those fourlittle kittens were then in her body. That was why the old cat was larger than she is now. The little kittens were then much smaller and very tender, and, had you been rough with the old cat, you might have injured them; and, then, they might have been born crippled, deformed or dead. When they were born three or four days ago their little eyes were so tender that the full light of the sun would have put out their sight, so they were born with their eyelids closed and glued together. The old cat knew how tender their eyes would be, so three or four days ago she went away back under the dark floor and gave them birth. As they have grown older and their eyes have become stronger, every few hours the old cat has brought them a few feet nearer the light. Meanwhile, their eyelids have gradually opened until they can now look up at the sun as well as you can. If they had been born out in the open, the full light of the sun would have made their tender little eyes very sore or put them out.”

    By this time I saw that my boy was very anxious to ask me a question. I was just as eager for him to ask it. I believed that he was going to ask the very question that my mother heart longed for him to ask; the very question that I believed God wanted my little boy to ask. I paused and looked into his little upturned face. As his deep, true blue eyes met mine, spontaneously, naturally, seriously he enquired, “Mamma, was I once in your body, too?” “Yes, son, you were formed in mamma’s body, in a little nest or home underneath mamma’s heart. You started as a little cell. For two hundred and eighty long days, nine full months, nearly a whole year, you were growing in mamma’s body. Mamma knew that you were there and loved and prayed for you long before you were born. Mamma had to be careful not to meet with an accident lest you might be born crippled, deformed or dead. Mamma had to be cautious about the food she ate, the air she breathed, the water she drank, the exercise she took, all she thought and did; because you were united to mamma by a little cord filled with blood vessels, through which mamma was supplying you from her blood with all the materials necessary for your forming body, mind and soul. In this way you were being influenced by mamma. Mamma was anxious that you might have a healthy and perfect body and grow up to be a smart, good and great man. If mamma had been angry, untruthful or dishonest during these months that you were a part of her, you might have been born with an ugly disposition, tendency to steal or be untruthful. Mamma was very careful about all she thought, said and did during the months you were a part of her body.

    “Mamma knew about the day that you would leave your little home and come into this world. For hours mamma suffered great pain. The faithful doctor was present and did all he could to lessen mamma’s suffering. Papa stood at my side, held my hands in his, often stooped over and kissed my lips, cheeks and brow. As soon as you were born, the air rushed into your lungs and you cried, just as all little babies do when they are born alive. Mamma heard your baby cry and it thrilled her with joy known only to a mother, when she knows that her little baby is alive. But, son, when you were born and for many weeks and months, you were tiny, tender and helpless. No one in this world, and, God could not have found an angel in all of heaven who could have cared for you as well as mamma could. Mamma fed you at her breast, held you in her lap, fondled you in her arms and sung lullabies to you. When you were only a few weeks old you would have the colic. All night long your little body would be racked with pain and mamma would walk the floor with you, rub your little body and sing to you.” By this time my little boy was standing up close by my side, had both arms thrown around my neck, his little lips were kissing my cheek, and tears were rolling down his on to mine. Then he said, “Mamma, I am glad you have told me that story. I love you better now. I did not know that you loved and prayed for me before you ever saw me; that you were so careful that I might be well born; that you had to suffer so much when I was born; and that you cared for me so good when I was so small and when I was sick. This story will help me love you better and I will try never to disobey or tell you a falsehood.”

     

    Do you not see how much better it was for this boy to hear the story of his life from the pure lips of his loving mother, than to hear it first from the lips of some ignorant and wicked boy or man? Well this is the story of your life. You cannot understand now how much your mamma suffered in bringing you into this world. Then, both your father and mother have made many sacrifices for you and are deeply interested in your future. If you should make a shipwreck of life, I am sure that their old days would be spent in grief. How can you repay your parents for all their sacrifices? If you will keep your thoughts, words and actions pure, every time your parents see or think of you, they will be thrilled with joy and appreciation. Will you not now promise yourself and promise God that by His forgiveness of the past, grace and help now and in the future, that you will keep yourself pure? When you have done this will you not go and kiss mamma, and tell her that you love her better than ever before and that you are determined to live up to her prayers and wishes?

    Extract from EBook of Self Knowledge and Guide to Sex Instruction, by T. W. Shannon

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  • THE GIRL’S RELATION TO THE HOME

    The girl in the home is a member of the partnership plan of the family. She should have the same financial, social and moral rights of her brother. Her moral training should be no better than his. If she is properly trained in the home, her services are as valuable as her brother’s and she should have the same financial rights.

    The girl and her father.—The father, if worthy of being such, should have the confidence, respect and love of his daughter. She should feel free to approach him with her wishes and her problems. His advice and council will be of great value to her in her social relation with young men. Many girls fail to show themselves interested in their father. Girls should be attentive, kind and loving in their relations to their father.

    The girl and her mother.—A mother should not forget the experience of her girlhood. Though busy and burdened with many cares, she should take time to talk, often and intimately, with her daughter, of her own girlhood, her own temptations, her own experiences in the various vicissitudes of life. By wisely cultivating the relation of a sympathetic companionship, the mother can often bridge her daughter over that period of adolescence, when many girls come to regard their mothers as “old fogies.” This is a stage of growth in a girl’s life. It usually occurs when they are in the high school. They openly and unkindly criticise their mother’s dress, speech, advice, council and religion. This is a period of development that girls pass through. The right relation between the girl and her mother would save the mother from many tears and heartaches and the girl from many regretful memories of misconception and blindness.

    Fortunate, is the girl, who has never had an attack of “high school snobbery,” who has never spoken lightly of the imaginary deficiencies of mother; but, who has always found it a joy to divide gifts with mother, to hand her the prettiest rose and to read her a choice story.

    The girl and her brother.—Girls do not always appreciate the influence they are exerting over their brothers. A boy’s estimate of woman is often received from his sister’s influence. A sister has it largely in her power to make her brother gentle, true and pure. She can make home attractive and pleasant for him and thus save her brother from seeking pleasures in questionable places and ways. Brothers and


    Chums in the Home

    Chums in the Home

    sisters should grow up together, be educated together, play together and, as far as possible, help each other. Their joys and sorrows, aims and purposes should be mutual. Her lack of physical strength, her natural tastes and aspirations, her duties and mission in life, being in many respects different from her brother, require a line of preparation unlike her brother receives.

    Her first and most valuable training.—Marriage is not the only goal toward which a young woman may turn, but it is the most natural, important and worthy. Most all girls look forward to marriage as a possible and desirable goal. Perhaps no woman would refuse marriage, if the right man should propose. It is for this reason that every girl should prepare herself thoroughly to be a housekeeper, a wife and a mother. This should be her first and most thorough training. She should not rest satisfied until she has learned every phase of how to keep house, to care for the wants of small children and to manage hired help. This training should begin in childhood. A girl should be able to dress herself and to keep her own room by the time she is ten years old. Whatever may be her career in life, she will always be the better off because she is a good housekeeper. She may not have to be a housekeeper, for she may have servants, still she is all the better off, as she will understand how to manage the servants.

    The independent girl.—In addition to having prepared herself for a housekeeper, a wife and a mother, she should now prepare herself for some vocation in life. The right man may not present himself, she may be called upon to support an aged mother or father, or an invalid husband, and she will need to know how to earn a living. A girl, unprepared to support herself, waiting year after year for some man to come and marry her, is an object of profound pity. If the right man comes along and marries her, all is well. But she often marries the wrong fellow, or waits for many weary years and yet, he never comes. A generation ago few opportunities of earning a support were open to a girl. Conditions have changed, woman’s ideals have grown and the world offers her other vocations than housekeeping, wifehood and motherhood, and unless these come in very attractive form she can choose the vocation of art, music, teaching, stenography, book-keeping or some other calling. By the time she is eighteen, a girl should be able to keep a house or earn a living in some business way. This will give her an assurance of independence. Regardless of the wealth of her parents, she should have these two qualifications. If her parents are poor and she is ambitious, she can now work her way through college, if she desires.

    If the morals of a girl have been properly safeguarded by her mother’s training and teaching, the independent girl is little more likely to fall than the girl who remains at home and waits for a husband.

    The independent girl who goes out into the world with her brother, shoulders the same burdens, wrestles with the same problems, fights the same battles and overcomes the same difficulties, will meet a better class of men than those who would likely seek her out in her home. She is more likely to be happily married, than if she remained at home. She is now better fitted to be a housekeeper, wife and mother, than if she had remained at home. She has learned how to produce a dollar, she now knows the value of it and how, wisely, to spend it.


    Mother’s Responsibility.

    Mother’s Responsibility.

    Extract from EBook of Self Knowledge and Guide to Sex Instruction, by T. W. Shannon

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  • Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO 1

    GENEVA: World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus warned here on Friday that lifting restrictions “too quickly” could lead to a deadly resurgence of Covid-19, Xinhua news agency reported.

    Noting at a regular press briefing that “some countries are already planning the transition out of stay-at-home restrictions,“ the WHO chief warned that lifting restrictions too quickly could lead to a deadly resurgence.

    “The way down can be as dangerous as the way up if not managed properly,“ he said, underlining that the WHO is working with affected countries on strategies for gradually and safely easing restrictions.

    Some European countries are already considering relaxing their restriction measures as they see a slowing trend in the number of Covid-19 infections.

    Austria, for instance, aims to gradually ease the exit restrictions and reopen shops and businesses from mid-April. Switzerland also suggested “the first relaxations” by the end of April.

    The WHO chief stressed that decision of lifting restrictions should be made on the condition that transmission is controlled; that sufficient public health and medical services are available; that outbreak risks in special settings like long-term care facilities are minimised; that preventive measures are in place in workplaces, schools and other places where it’s essential for people to go; that importation risks can be managed; and that communities are fully aware and engaged in the transition.

    Globally, nearly 1.5 million confirmed cases of Covid-19 have now been reported to the WHO, as well as more than 92,000 deaths. — Bernama

    Lifting restrictions ‘too quickly’ could lead to deadly resurgence of Covid-19: WHO
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    https://www.thesundaily.my/world/lifting-restrictions-too-quickly-could-lead-to-deadly-resurgence-of-covid-19-who-IB2245956

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  • New Ebola case confirmed in the Democratic Republic of the Congo

    A new case of Ebola virus disease was confirmed today in the city of Beni in the Democratic Republic of the Congo (DRC).

    “While not welcome news, this is an event we anticipated. We kept response teams in Beni and other high risk areas for precisely this reason,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.  

    As part of the active Ebola surveillance system in place to respond to this ongoing outbreak in DRC, thousands of alerts are still being investigated every day. An alert is a person who has symptoms that could be due to Ebola, or any death in a high risk area that could have been as result of Ebola.

    As with all confirmed cases, efforts are already underway to find everyone who may have been in contact with the person in order to offer them the vaccine and monitor their health status.

    “WHO has worked side by side with health responders from the DRC for over 18 months and our teams are right now supporting the investigation into this latest case,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “Although the ongoing COVID-19 pandemic adds challenges, we will continue this joint effort until we can declare the end of this Ebola outbreak together.”

    The news of the confirmed case came minutes after the conclusion of a meeting of the International Health Regulations Emergency Committee on Ebola in DRC. The Emergency Committee will reconvene next week in order to re-evaluate their recommendations in light of this new information.

    Prior to this, the last person who was confirmed to have Ebola in DRC tested negative twice and was discharged from a treatment centre on 3 March 2020.

    As of 10 April 2020, 3456 confirmed and probable cases and 2276 deaths have occurred as a result of the outbreak.

    Read More
    https://www.who.int/news-room/detail/10-04-2020-new-ebola-case-confirmed-in-the-democratic-republic-of-the-congo

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  • THE ARGUMENT FOR BIRTH CONTROL

    THE ARGUMENT FOR BIRTH CONTROL

    Let us now consider the general and special arguments advanced in favor of rational and scientific Birth Control, as stated by the advocates thereof.

    General Argument. The general argument in favor of Birth Control may well be begun by the statement that rational and scientific Birth Control is not the fixing upon the race of a new and unfamiliar practice or policy, but is rather the scientific correction of a practice and policy which is now followed by the majority of married persons in civilized countries, though in a bungling, unscientific, and frequently a harmful manner. The modern advocates of scientific methods of Birth Control seek to replace these bungling, unscientific, and frequently harmful methods by sane, scientific, harmless methods, approved of by capable physicians and other experienced and capable authorities, and under the sanction of the law rather than contrary to it.

    The advocates of Birth Control seek to place upon a scientific basis, under cover and protection of the law, a subject which heretofore has been but imperfectly known, and more imperfectly practiced in some form by the majority of married couples, and which has heretofore been under condemnation of the law so far as concerned the actual dissemination of information concerning methods of contraception. They hold that it is the veriest hypocrisy to pretend ignorance of the fact that the great majority of married couples in civilized communities know and practice to some extent contraceptive methods—usually imperfectly and bunglingly, it must be added.

    One has but to consider the families of married couples, and to count their children, to become aware that at least some form of contraception has been known and practiced in many cases. This is particularly true of the more intelligent and cultured members of civilized society, among whom we find large families of children to be the exception, and small families to be the general rule. Among the less intelligent and uncultured classes the reverse of this condition is found.

    It is hypocritical folly to assert that these small families to be found among the more intelligent classes of society are due to the fact that the husbands and wives are physically incapable of procreating off-spring—the mere suggestion produces an incredulous smile from the reader. No one who is acquainted with the habits and customs of married people would in good faith offer such an explanation. Rather is it tacitly acknowledged by all thinking persons that such married couples practice some form of Birth Control, or else commit the crime of abortion. All physicians, particularly those who practice in the large cities, are fully informed as to the appalling facts concerning the prevalence of abortion among the women of the “respectable” classes, and are likewise fully informed as to the terrible consequences so frequently arising from this criminal course.

    The question, then, to many intelligent persons is not so much that of “Should contraception be employed in order to avoid excessively large families?” as that of “Should not contraception be employed to obviate the crime of abortion with its terrible train of consequences?” And the Birth Control propaganda which is so vigorously underway in all civilized countries may be stated to be designed for the following purposes: (1) to replace abortion, and other harmful methods of restricting the size of families, with rational and scientific methods of contraception; and (2) to supply to married persons the best scientific knowledge concerning the regulation of the size of families, and the methods of producing the best kind of children, under the best conditions, and at the times best adapted for their proper care and well-being. These advocates of the Betterment of the Race face the facts of human nature and married life fearlessly, instead of trying to cover them over with pretty words and sentimental generalities. They take “things as they are,” and not as certain persons insist that “they should be”—they live in a world of facts and try to better things as they find them, instead of trying to live in a fool’s paradise and contenting themselves with denying the existence of the facts which they consider “ugly.”

    Dr. William J. Robinson, one of the leading American workers in the field of Birth Control, ably presents the main contention of the Birth Control advocates as follows:

    “We believe that under any conditions, and particularly under our present economic conditions, human beings should be able to control the number of our offspring.They should be able to decide how many children they want to have, and when they want to have them. And to accomplish this result we demand that the knowledge of controlling the number of offspring, in other and plainer words, the knowledge of preventing undesirable conception, should not be considered criminal knowledge, that its dissemination should not be considered a criminal offense punishable by hard labor in Federal prisons, but that it should be considered knowledge useful and necessary to the welfare of the race and of the individual; and that its dissemination should be permissible and as respectable as is the dissemination of any hygienic, sanitary or eugenic knowledge.

    “There is no element of force in our teachings; that is, we would not force any family to limit the number of children against their will, though we would endeavor to create a public opinion which would consider it a disgrace for any family to have more children than they can bring up and educate properly. We would consider it a disgrace, an anti-social act, for any family to bring children into the world which they must send out at an early age into the mills, shops, and streets to earn a living, or must fall back upon public charity to save them from starvation.

    “Public opinion is stronger than any laws, and in time people would be as much ashamed of having children whom they could not bring up properly in every sense of the word, as they are now ashamed of having their children turn out criminals. Now, no disgrace can attach to any poor family, no matter how many children they have, because they have not got the knowledge, because society prevents them from having the knowledge of how to limit the number of children. But if that knowledge became easily accessible, and people still refused to avail themselves of it, then they would properly be considered as anti-social, as criminal members of society. As far as couples are concerned who are well-to-do, who love children, and who are well capable of taking care of a large number, we, that is, we American limitationists, would put no limit. On the contrary, we would say: ‘God bless you, have as many children as you want to; there is plenty of room yet for all of you.’”

    Another writer, a celebrated English thinker along these lines, has said of the general argument in favor of Birth Control:

    “It used to be thought that small families were immoral. We now begin to see that it was the large families of old which were immoral. The excessive birth-rate of the early industrial period was directly stimulated by selfishness. There were no laws against child-labor; children were produced that they might be sent out, when little more than babies, to the factories and the mines to increase their parents’ incomes. The diminished birth-rate has accomplished higher moral transformation. It has introduced a finer economy into life, diminished death, disease, and misery. It is indirectly, and even directly, improving the quality of the race. The very fact that children are born at longer intervals is not only beneficial to the mother’s health, and therefore to the children’s general welfare, but it has been proved to have a marked and prolonged influence on the physical development of children.

    “Social progress, and a higher civilization, we thus see, involve a reduced birth-rate and a reduced death-rate. The fewer the children born, the fewer the risks of death, disease, and misery to the children that are born. The fact that civilization involves small families is clearly shown by the tendency of the educated and upper social classes to have small families. As the proletariat class becomes educated and elevated, disciplined to refinement and to foresight—as it were aristocratised—it also has small families. Civilizational progress is here on a line with biological progress. The lower organisms spawn their progeny in thousands, the higher mammals produce but one or two at a time. The higher the race, the fewer the offspring.

    “Thus diminution in quantity is throughout associated with augmentation in quality. Quality rather than quantity is the racial ideal now set before us, and it is an ideal which, as we are beginning to learn, it is possible to cultivate, both individually and socially. That is why the new science of eugenics or racial hygiene is acquiring so immense an importance. In the past, racial selection has been carried out crudely by the destructive, wasteful, and expensive method of elimination, through death. In the future, it will be carried out far more effectively by conscious and deliberate selection, exercised not merely before birth, but before conception and even before mating. Galton, who recognized the futility of mere legislation to elevate the race, believed that the hope of the future lay in eugenics becoming a part of religion. The good of the race lies, not in the production of a super-man, but of a super-humanity. This can only be attained through personal individual development, the increase of knowledge, the sense of responsibility toward the race, enabling men to act in accordance with responsibility. The leadership in civilization belongs not to the nation with the highest birth-rate, but to the nation which has thus learnt to produce the finest men and women.”

    Let us now proceed to a consideration of the special arguments in favor of rational and scientific Birth Control as advanced by its leading advocates.

    The advocates of rational and scientific Birth Control have presented the strongest points of their case in their replies to those opposing the general idea, and without positively taking the stand that the burden of the proof in the argument concerning Birth Control rested upon those opposing the idea, have practically assumed that position. They claim that the right to Birth Control is so self-evident, and its application so generally recognized (though usually sought to be smothered with silence) that the case in favor of Birth Control is really quite apparent to anyone seriously considering the same without prejudice. The opposing side of the question is held by them to be represented principally by statements based on prejudice and disingenuous statements, which are capable of being turned against those advancing them.

    And, the present writer, likewise is of the opinion that the strongest possible case for Birth Control is presented in the answer to the arguments advanced by the opponents thereof. But, before proceeding to the latter phase of the argument, it may be well to examine briefly the several leading points of argument advanced by the advocates of rational and scientific Birth Control, in order to clear the way for the answers to the opposite side of the question. The reader is, therefore, invited to consider the said points, briefly presented in the following paragraphs:

    Birth Control Encourages Marriage. The advocates of Birth Control hold that a scientific knowledge of contraception would speedily result in a large increase of marriages, particularly among persons of limited incomes. Persons who have not been able to accumulate the “little nest egg” which prudent persons consider a requisite on the part of those contemplating marriage and the responsibilities of rearing a family of children, are in many cases caused to hesitate about contracting marriage, and often relinquish the idea altogether. Many of these persons are well adapted for marriage, being of the domestic temperament and having the home ideal prominent in their mental makeup.

    The increasing number of bachelors and unmarried women past thirty years of age, who are in evidence in all large centers of population at the present time, is undoubtedly due to a great extent to the fear on the part of these men and women regarding the proper support of a family of children. Many men and women feel that the man is able to earn enough to support himself and wife comfortably, by the exercise of economy, but that the said earnings are not sufficient to provide properly for a family of children. Some would be willing to have one or two children, born after the couple have well established themselves, but are appalled at the thought of bringing into the world a practically unlimited number of little children for whom they would not be able to provide properly.

    These people shrink at the idea of abortion, and doubt the efficacy of the popular so-called contraceptive methods of which their friends tell them, and they either defer the marriage until later in life, or else give up the idea altogether as being impossible for them under the existing circumstances. A scientific knowledge of the subject would give to such persons—and there are many thousands of such—an assurance of their ability to safely and properly control and regulate the size of their families, and would lead to many a marriage which would otherwise be out of the question.

    If it is agreed that the marriage state is the one normal to the average man and woman, and that marriages are in the interests of society—and few would seek to dispute this—then it would seem that anything that would tend to encourage marriage among the right kind of persons should receive the encouragement of society and be fully protected by the laws of society; and that the old prejudice against the subject, and the laws which discourage the same, and place a penalty upon the dissemination of scientific methods leading to the said result, are unworthy of civilized society and modern thought.

    Earlier Marriages and Curb on Prostitution. It is generally conceded by students of sociology that earlier marriages tend to decrease the causes of the evil of prostitution, illicit sexual relations, and general sexual morality; and the consequent spread and existence of the venereal diseases which have followed in the trail of such relations. And it is likewise conceded that prostitution is an evil, and a cancer spot upon modern social life, and that venereal diseases constitute a frightful menace to the health and physical welfare of the race. Therefore, it would seem that anything which would promote early marriages among healthy, intelligent young men and women would be a blessing to the race and to society. And as these earlier marriages are unquestionably prevented in a great number of cases by reasons of the fear of inadequate financial support for large families of children, it would seem to follow that the best interests of society would be served by the encouragement by public opinion, under the protection of the law, of the teaching by competent authorities upon the subject of rational and scientific methods of Birth Control.

    Health of Wives. The advocates of Birth Control lay considerable stress upon the fact that a scientific knowledge of Birth Control would practically obviate the state of broken-down health so common among married women, particularly among those who have been compelled to bear large numbers of children during the first few years of married life. Many a young married woman is in bad health—often reaching the state of chronic invalidism—as the result of having had to bear too many children, and in too close succession.

    Not only is the above the case, but there is to be found on all sides many cases of invalidism and shattered health caused by the horrible practice of criminal abortion. It is doubted whether anyone outside of medical circles can even faintly begin to realize the frequency of this practice of abortion among the well-to-do, and those in “comfortable circumstances”—not to speak of the countless deaths which arise from the prevalence of this curse. Were a physician to even faintly indicate the number of cases coming under his personal professional attention, in which the patient is suffering from the effects of one or more abortions, he would be accused of gross exaggeration, and would be condemned as a sensationalist.

    Without going into detail concerning these things, the writer states that it is a matter of common knowledge among physicians that in every large city there are thousands of unscrupulous (including those who call themselves physicians) who are kept busy every week in the year performing criminal operations designed to produce abortions. Some of these practitioners have many regular patients—women who visit them regularly for the purpose of having abortions produced by criminal operations. It seems almost incredible, but it is a veritable fact, that there are to be found many women in the large cities who actually boast to their friends of the number of operations of this kind they have had performed on them.

    Surely, any instruction which would prevent the physical breakdown of so many women by reason of excessive child-bearing on the one hand, and abortion on the other hand, would seem to be worthy of the hearty support of society, and the encouragement of its laws, rather than the reverse. So true does this seem, that it is difficult to realize that there are any intelligent persons who would condemn such instruction as evil and harmful to society. That such persons do exist is a striking proof of the persistence of ancient superstitions and the survival and tenacity of old prejudices.

    Morality of Married Men. It is a matter of common knowledge among physicians, and students of sociology, that many married men, particularly those living in the large cities, indulge in extra-marital or illicit sexual relations, with prostitutes and other women of loose morals, and this not because these men are naturally vicious, depraved or licentious, but rather because they fear causing their wives to bear them more children—the wives either being in delicate or broken-down health, or else the family already too large to be reared properly in justice to the children.

    Many persons who would see only what “ought to be,” and who refuse to see “things as they are” in modern society, will be disposed to pooh-pooh the above statement, and to accuse those making it to be sensational or even morbid on the subject. But those who are brought in close contact with men and women, as are family physicians and specialists, as well as honest students of sociology, know only too well that the above is not an over-statement, but is rather a very conservative recital of certain unpleasant, but true, facts of human society.

    Justice to the Children. The advocates of scientific Birth Control hold that a scientific knowledge along the lines favored by them would prevent the gross injustice to children which is now only too obvious to anyone who candidly considers the matter without prejudice. The child brought into the world, unwanted, undesired, unprepared for, and unprovided for before and after birth, is handicapped from the very start of its existence upon earth. The present state of affairs works a terrible injustice upon countless children brought into the world in such conditions. Nothing that the present writer could put into words would state this fact more concisely and clearly than the following statement made by Dr. Wm. J. Robinson, a leading authority along these lines, who has said:

    “The responsibility of bringing a child into the world under our present social and economic conditions is a very great one. The primitive savage or the coarse ignorant man does not care. It does not bother him what becomes of his offspring; if they get an education, if they have enough to eat, if they learn a trade or a profession, well—if they don’t, also well; if they achieve a competence or a decent social position, he is satisfied—if not, he can’t help it. God willed it so. But, on the other hand, the cultured, refined man and woman look at the matter differently. The thought of bringing into the world a human being which may be physically handicapped, which may be mentally inferior, which may have a hard struggle through life, which may have to go through endless misery and suffering, fills them with anguish. * * * * *

    “We see about us millions of working men and women who go through life, from cradle to grave, without a ray of joy, without anything that makes life worth living. In the higher classes we see a constant, hard, infuriated struggle to make a living, to make a career, and the spectre of poverty is almost as unremittingly before the eyes of the middle and professional classes as it is before the eyes of the laborer. And all over we see ignorance, superstition, beliefs bordering on insanity, hardness, coarseness, rowdyism, brutality, crime and prostitution; prostitution of the body, and what is worse, prostitution of the mind, the hiding or selling of one’s convictions for a mess of pottage. And our prisons, asylums, and hospitals are not decreasing, but increasing in number and inmates.

    “It is my sincerest and deepest conviction that we could accomplish incomparably more if only a small part of the energy and money now spent on philanthropic efforts were expended in teaching the women, the married women of the poor, how to limit the number of their children; in other words, how to prevent conception. It would work a wonderful reform in the lives of the poor, and our slums would be metamorphosed in ten years. * * * It is we who are to blame now for the large families of the poor, and for this reason we are morally obligated to give them the financial and medical aid that they demand. But when effectual means are put into their hands for limiting the number of their offspring, then they, and not we, will be to blame if they do not make use of them. * * * *

    “The rich and the upper-middle classes, those to whom several children would be the least burden, are quite familiar with the various means of prevention. The poorer middle classes use preventives recommended by their friends; these preventives sometimes succeed, sometimes fail, and sometimes ruin the woman’s health. While the very poor, the wage-earners, those who can least afford to have unlimited progeny, knowing no means of prevention, go on breeding to their own and to the community’s detriment. The result, as you can plainly see, is a general lowering of the physical and mental stamina of the race. For if the cultured and the well-to-do do not breed, or have only a few children, while the poor and the ignorant go on having a numerous progeny for which they cannot well provide, and which they cannot afford to educate properly, it stands to reason that the percentage of the uneducated, the unfit and the criminal, must go on constantly increasing. And this is something that no lover of humanity can look upon with equanimity.”

    Surely the above recited special points of argument in favor of Birth Control seem to be statements of self-evident facts to the unprejudiced mind, do they not? And the person of this kind who considers them carefully for the first time usually finds himself wondering what rational argument can be fairly urged on the other side of this important question. And, when he acquaints himself with the arguments of “the other side” he usually finds himself even more established in the belief that scientific Birth Control is advisable, sane, and along the lines of the mental evolution of the race. At any rate, it is difficult to escape the conviction that the burden of proof needed to controvert a proposition so nearly self-evident as intelligent and scientific Birth Control, must be placed squarely upon the shoulders of those opposing the proposition.

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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  • THE FETICH OF THE BIRTH-RATE

    THE FETICH OF THE BIRTH-RATE

    To the student of the progress of the human race the consideration of the state of public opinion regarding the Birth-rate of nations is of great interest. To the careful observer there is evident the gradual evolution of intelligent public opinion on this subject even in the comparatively short space of time in which the present generation has played its part on the great stage of human development.

    Public opinion on this subject during the period named may be said to have passed through three general stages. These stages are, of course, more clearly defined among the peoples of the most prosperous and intelligent countries, as for instance, in Western Europe and America, and particularly in England, France, and the United States. While the peoples of certain of these countries have passed through these stages somewhat more rapidly than have others, still it is perceived that each of these peoples have in the main followed the same general course.

    The first stage of this evolution of popular opinion may be said to have been begun about 1850, and to have ended about 1880. In this stage the ideal of a large and rapidly increasing birth-rate became a popular fetich before which all men and women were supposed to fall down and render worship. In this period public opinion manifested great satisfaction and joy in the evidences of a high and rapidly increasing birth-rate. It was held that this increasing birth-rate tended toward the success and glory of the particular nation, and incidentally to the race as a whole. The idea of Quantity was elevated to the throne of public favor, and the question of Quality was ignored or overlooked.

    This period was one of an unusual expansion of industry, and the rising birth-rate was regarded as a token that the world was destined to be exploited and eventually governed by the people of those nations who were able to demonstrate the greatest efficiency in industrial pursuits, and who at the same time were wise enough to increase their respective populations by an increasing birth-rate. The populace were excited by the idea of the dominance and prosperity of their own countrymen, while the leaders of industry were delighted with the idea of an increasing supply of laborers which would tend to keep down the rate of wages which otherwise would have reached proportions which would have interfered with competition with other countries. At the same time, the militarists were secretly delighted by the signs of an increasing supply of military material with which to build up gigantic armies.

    A writer on the state of public opinion on this subject during this period has well said: “It seemed to the more exuberant spirits that a vast British Empire, or a mighty Pan-German, might be expected to cover the whole world. France, with its low and falling birth-rate, was looked down at with a contempt as a decadent country inhabited with a degenerate population. No attempt to analyze the birth-rate, to ascertain what are really the biological, social, and economic accompaniments of a high birth-rate, made any impression on the popular mind. They were drowned in a general shout of exultation.”

    But this period of uncritical optimism was followed by a natural reaction. The pendulum stopped in its course, and soon began to swing in the opposite direction. Here, about 1880, the second stage may be said to have begun. Public opinion began to manifest a subtle change, and this mental attitude was accompanied by a physical manifestation in the form of a decreasing birth-rate. The rate of births began to fall rapidly, and has continued to fall steadily since that time.

    The writer above quoted from says of this second period: “In France the birth-rate fell slowly, in Italy more rapidly, and in England and Prussia still more rapidly. As, however, the fall began earliest in France, the birth-rate was lower there than in the other countries named. For the same reason it was lower in England than in Prussia, although England stands in this respect at almost exactly the same distance from Prussia today (1917) as thirty years ago, the fall having occurred at the same rate in both countries. It is quite possible that in the future it may become more rapid in Prussia than in England, for the birth-rate of Berlin is lower than the birth-rate of London, and urbanization is proceeding at a more rapid rate in Germany than in England.”

    It is not difficult to arrive at the psychological reason underlying this great change in public opinion, as manifested in this second stage. In the first place, the wonderful era of world-expansion was arrested, by natural causes well understood by students of sociology. The ambitious dreams of world-empires were rudely interrupted. Moreover, public opinion was being affected by a quiet education along the lines of sociology and economics.

    The working classes began to perceive, on the one hand, the tendency of overpopulation to hold down, or even decrease, the scale of wages. The evils of over-production, and of under-consumption were dimly perceived. And, on the other hand, the capitalists began to perceive that another factor was at work—one which they had failed to include in their optimistic calculations. Instead of the cheaper wage rate which they had expected by reason of the over-abundance of human material, they found that the growth of popular education in the democratic countries had caused the working classes to demand greater comforts of life, and to oppose the cheapening of human labor. And at the same time, the masses began to revolt against the idea of raising children to become “cannon fodder” for ambitious autocratic rulers. The masses began to protest against selling their labor and their lives so cheaply.

    These changed viewpoints of the working classes began to result in attempts on their part to form associations to resist the tendency on the part of capitalists to force down the scale of wages to fit the increased population. Trade unions flourished and became powerful, and the same impulse carried many into the ranks of socialism, and still beyond into the fold of anarchism and syndicalism. And, here note this significant fact, with these new perceptions and these new movements among the masses, the birth-rate began to fall rapidly.

    The writer above quoted from says of this period: “The pessimists were faced by horrors on both sides. On the one hand, they saw that the ever-increasing rate of human production which seemed to them the essential condition of national, social, even moral progress, had not only stopped but was steadily diminishing. On the other hand, they saw that, even so far as it was maintained, it involved, under modern conditions, nothing but social commotion and economic disturbance. There are still many pessimists of this class alive among us even today, alike in England and Germany, but a new generation is growing up, and this question is now entering another phase.”

    It would seem that the race is now well started in the third period, phase, or stage of this conception of the birth-rate. Even the Great War is not likely to seriouslyinterrupt its ultimate progress, though conditions in all civilized countries will unquestionably be disturbed by the unusual conditions now prevailing and caused by the great conflict. The spirit of this third stage seems to be that the Truth is to be found between the two extremes, viz.: (1) the extreme of passive optimism of the first stage; and (2) the extreme of passive pessimism of the second stage. It realizes that there is excellent ground for hope in better things; but it equally realizes that hope alone is vain, and will accomplish nothing unless it is accompanied with and directed by a clear intellectual vision manifested in individual and social action based on that clear intellectual vision.

    The writer above quoted from says of this developing period: “It is today beginning to be seen that the old notion of progress by means of reckless multiplication is vain. It can only be effected at a ruinous cost of death, disease, poverty, and misery. We see this in the past history of Western Europe, as we still see it in the history of Russia. Any progress effected along that line—if ‘progress’ it can be called—is now barred, for it is utterly opposed to those democratic conceptions which are ever gaining greater influence among us. Moreover, we are now better able to analyze demographic phenomena, and are no longer satisfied with any crude statements regarding the birth-rate. We realize that they need interpretation. They have to be considered in relation to the sex-constitution and the age-constitution of the population, and above all, they must be viewed in relation to the infant mortality rate.

    “The bad aspect of the French birth-rate is not so much its lowness as that it is accompanied by a high infantile mortality. The fact that the German birth-rate is higher than the English ceases to be a matter of satisfaction when it is realized that German infantile mortality is vastly greater than English. A high birth-rate is no sign of a high civilization. But we are beginning to feel that a high infantile death-rate is a sign of a very inferior civilization. A low birth-rate with a low infant death-rate not only produces the same increase in population as a high birth-rate with a high death-rate, which always accompanies it (for there are no examples of a high birth-rate with a low death-rate), but it produces it in a way which is far more worthy of our admiration in this matter than the way of Russia and China where opposite conditions prevail.”

    The evolutionary process which all students of sociology clearly perceive to have been underway in the matter of the attitude of public opinion toward the birth-rate, and which is now underway with increased impetus, is perceived to be a natural process. It is a natural process which has been underway from the beginning of the living world. For a long time it operated and manifested along unconscious and instinctive lines of activity, but now it has emerged into the light of human consciousness and manifests along the lines of conscious, voluntary, and deliberate human action.

    In its present state of evolutionary progress human thought along these lines has found expression in what is generally known as “Birth Control.” The process which has been working slowly through the ages, attaining every new forward step with waste and pain, is henceforth destined to be carried out voluntarily, in the light of human reason, foresight, and self-restraint. The rise of Birth Control may be said to correspond with the rise of social and sanitary science in the first half of the nineteenth century, and to be indeed an essential part of that movement.

    The new doctrine of Birth Control is now firmly established in all the most progressive and enlightened countries of Europe, notably in France and England; in Germany, where formerly the birth-rate was very high, Birth Control has developed with extraordinary rapidity during the present century. In Holland its principles and practice are freely taught by physicians and nurses to the mothers of the people, with the result that there is in Holland no longer any necessity for unwanted babies, and this small country possesses the proud privilege of the lowest death-rate in Europe.

    In the free and enlightened Democratic communities on the other side of the globe, in Australia and New Zealand, the same principles and practice are generally accepted, with the same beneficent results. On the other hand, in the more backward and ignorant countries of Europe, Birth Control is still little known, and death and disease flourish. This is the case in those eight European countries which come at the bottom of the list of the Birth Control scale, and in which the birth-rate is the highest and the death-rate the heaviest—the two rates maintaining such a constant correspondence as to lead to the inevitable conclusion that they are associated as cause and effect.

    But even in the more progressive countries Birth Control has not been established without a struggle, which has frequently ended in a hypocritical compromise, its principles being publicly ignored or denied and its practice privately accepted. For, at the great and vitally important point in human progress which Birth-Control represents, we see really the conflict of two moralities. The morality of the ancient world is here confronted by the morality of the new world.

    The old morality, knowing nothing of science and the process of Nature as worked out in the evolution of life, contented itself with assuming as a basis the early chapters of Genesis in which the children of Noah are represented as entering an empty earth which it is their business to populate diligently. So it came about that for this morality, still innocent of eugenics, recklessness was almost a virtue. Children were held to be given by God; if they died or were afflicted by congenital disease, it was the dispensation of God, and, whatever imprudence the parents might commit, the pathetic faith still ruled that “God will provide.”

    But in the new morality it is realized that in these matters Divine action can only be made manifest in human action, that is to say through the operation of our own enlightened reason and resolved will. Prudence, foresight, self-restraint—virtues which old morality looked down upon with benevolent contempt—assume a position of first importance. In the eyes of the new morality the ideal woman is no longer the meek drudge condemned to endless and often ineffectual child-bearing, but the free and instructed woman, able to look before and after, trained in a sense of responsibility alike to herself and to the race, and determined to have no children but the best.

    Such were the two moralities which came into conflict during the nineteenth century. They are irreconcilable and each firmly rooted, one in ancient religion and tradition, the other in progressive science and reason. Nothing was possible in such a clash of opposing ideas but a feeble and confused compromise such as we find still prevailing in various countries of Old Europe. This is not a satisfactory solution, however inevitable, and is especially unsatisfactory by the consequent obscurantism which placed difficulties in the way of spreading a knowledge of the methods of Birth Control among the masses of the population. For the result has been that while the more enlightened and educated have exercised a control over the size of their families, the poorer and more ignorant—those who should have been offered every facility and encouragement to follow in the same path—have been left, through a conspiracy of silence, to carry on helplessly the bad customs of their forefathers. This social neglect has had the result that the superior family stocks have been tampered by the recklessness of the inferior stocks.

    In America, we find the two moralities in active conflict today. Until recently America has meekly accepted at the hand of Old Europe the traditional prescription. On the surface, the ancient morality had been complacently, almost unquestionably, accepted in America, even to the extent of tacitly permitting the existence of a vast extension of abortion, under the surface of society— a criminal practice which ever flourishes where Birth Control is neglected.

    But today, a new movement is perceptible in America. It would seem that, almost in a flash, America has awakened to the true significance of the issue. With that direct vision of hers, that swift practicality of action, and above all, that sense of the democratic nature of all social progress, we see her resolutely beginning to face this great problem. In her vigorous tongue she is demanding “What is all this secrecy about, anyway? Let us turn on the Light!” And the best authorities agree that America’s answer to the demand will be of the greatest importance, and of immense significance to the whole world.

    In concluding this portion of our discussion, I ask my readers to consider the following quotations from writers who have touched upon the question of the stimulation of the birth-rate by the State, for the purpose of military policy. These quotations speak for themselves, and need but little comment.

    The first authority, a German, whose name has escaped me for the moment, laments the falling birth-rate in his country, and urges his own nation to stimulate it by offering bounties; he says: “Woe to us if we follow the example of the wicked and degenerate people of other nations. Our nation needs men. We have to populate the earth, and to carry the blessings of our Kultur all over the world. In executing that high mission we cannot have too much human material in defending ourselves against the aggression of other nations who are jealous of us and our achievements and progress. Let us promote parentage by law; let us repress by law every influence which may encourage a falling birth-rate; otherwise there is nothing left us but speedy national disaster, complete and irremediable.”

    Havelock Ellis, an Englishman, says: “In Germany for years past it has been difficult to take up a serious periodical without finding some anxiously statistical article about the falling birth-rate, and some wild recommendations for its arrest. For it is the militaristic German who of all Europeans is most worried by this fall; indeed Germans often even refuse to recognize it. Thus today we find Professor Gruber declaring that if the population of the German Empire continues to grow at the rate of the first five years of the present century, it will have reached 250,000,000 at the end of the century. By such a vast increase in population, the Professor complacently concludes, ‘Germany will be rendered invulnerable.’ But Gruber’s estimate is entirely fallacious. German births have fallen, roughly speaking, about 1 per 1,000 of the population, every year since the beginning of the century, and it would be equally reasonable to estimate that if they continue to fall at the present rate (which we cannot, of course, anticipate) births will altogether have ceased in Germany before the end of the century. The German birth-rate reached its climax forty years ago (1871-1880) with 40.7 per 1,000; in 1906 it was 34 per 1,000; in 1909 it was 31 per 1,000; in 1912 it was 28 per 1,000; in an almost measurable period of time, in all probability before the end of the century, it will have reached the same low level as that of France, when there will be but little difference between the ‘invulnerability’ of France and of Germany, a consummation which, for the world’s sake, is far more devoutly to be wished than that anticipated by Gruber.”

    Writers of Teutonic sympathies have asserted that the aggressive attitude of Germany at the beginning of the Great War was to be legitimately explained and apologized for on the ground that the War was the inevitable expansive outcome of the abnormally high birth-rate of Germany in recent times. Dr. Dernburg, the German statesman, said not very long ago: “The expansion of the German nation has been so extraordinary during the past twenty-five years that the conditions existing before the war had become insupportable.” Another writer has said: “Of later years there has arisen a movement among German women for bringing abortion into honor and repute, so that it may be carried out openly and with the aid of the best physicians. This movement has been supported by lawyers and social reformers of high position.”

    Thus, it would seem that a birth-rate stimulated by unusual circumstances or by deliberate State encouragement, seemingly draws upon it the operation of natural laws which tend to increase its death-rate by War, as well as by an increased number of abortions, and an increased death-rate. It would seem as natural laws operate to bring down the population to normal by war if the other factors do not operate sufficiently rapidly and efficiently.

    Havelock Ellis makes the following interesting statement: “If we survey the belligerent nations in the war we may say that those who took the initiative in drawing it on, or at all events were most prepared to welcome it, were Germany, Austria, Serbia, and Russia—all nations with a high birth-rate, and in which the fall of the birth-rate has not yet had time to permeate. On the other hand, of the belligerent peoples of today, all indications point to the French as the people most intolerant, silently but deeply, of the war they are so ably and heroically waging. Yet the France of the present, with the lowest birth-rate, was a century ago the France of a birth-rate higher than that of Germany today, and at that time the most militarist and aggressive of nations, a perpetual menace to Europe.”

    Finally, let us quote Havelock Ellis once more; he says: “When we realize these facts we are also enabled to realize how futile, how misplaced and how mischievous it is to raise the cry of ‘Race Suicide.’ It is futile because no outcry can affect a world-wide movement of civilization. It is misplaced because the rise and fall of the population is not a matter of birth-rate alone, but of the birth-rate combined with the death-rate, and while we cannot expect to touch the former we can influence the latter. It is mischievous because by fighting against a tendency which is not only inevitable but altogether beneficial, we blind ourselves to the advance of civilization and risk the misdirection of our energies. How far this blindness may be carried we see in the false patriotism of those who in the decline of the birth-rate, fancy they see the ruin of their own particular country, oblivious of the fact that we are concerned with a phenomenon of world-wide extension. The whole tendency of civilization is to reduce the birth-rate. We may go further, and assert with the distinguished German economist, Roscher, that the chief cause of the superiority of a highly civilized state over lower stages of civilization is precisely a greater degree of forethought and self-control in marriage and child-bearing. Instead of talking about Race Suicide, we should do well to observe at what an appalling rate, even yet, the population is increasing; and we should note that it is everywhere the poorest and most primitive countries, and in every country (as in Germany) the poorest regions, which show the highest birth-rate.”

    The same authority says: “One last resort the would-be patriotic alarmist seeks when all others fail. He is good enough to admit that a general decline in the birth-rate might be beneficial. But, he points out, it affects social classes unequally. It is initiated, not by the degenerate and unfit, with whom we could well dispense, but by the very best classes in the community, the well-to-do and the educated. One is inclined to remark, at once, that a social change initiated by its best social class is scarcely likely to be pernicious. Where, it may be asked, if not among the most educated classes, is any process of amelioration to be initiated? We cannot make the world topsy-turvy to suit the convenience of topsy-turvy minds. All social movements tend to begin at the top and to permeate downwards. This has been the case with the decline of the birth-rate, but it is already well marked among the working classes, and has only failed to touch the lowest stratum of all, too weak-minded and too reckless to be amenable to ordinary social motives. The rational method of meeting this situation is not a propaganda in favor of procreation—a truly imbecile propaganda, since it is only carried out and only likely to be carried out, by the very class which we wish to sterilize—but rather by a wise policy of regulative eugenics. We have to create the motives, and it is not an impossible task, which will act even upon the weak-minded and reckless lowest social stratum.”

    PRIVATE Sex Advice to Women By R. B. Armitage, M. D.

    For Young Wives and those who Expect to be Married.

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