August 21, 2005 • Family Planning, Gender Equality, HIV/AIDS, Reproductive Health, Serial Dramas, Radio Serial Dramas, Africa, Asia/Pacific, PMC in the News

By Pamela Polston, Seven Days

Western women of a certain age often talk about their “biological clock” – the physical imperative to bear children before it’s too late. But for Mother Earth, that clock is ticking for quite the opposite reason: She has too many children already, and if this terrible human fecundity is not slowed, it may indeed be too late – to feed the ones who are starving, or to sustain the ones who consume too much.

In this, Women’s History Month, it bears noting that the world’s women – and everyone else – will be history one day if there are too many of us scrabbling for a nipple on our universal mother, Planet Earth.

Alarmist? Not really. When the global population reached 6 billion last October, the organization Zero Population Growth issued a “Why 6 Billion?” awareness campaign, but few of us paid any attention – we were too busy worrying about far-more-hyped Y2K. The United Nations predicts that we will reach 8.9 billion in another 50 years; the amount of increase alone – 2.9 billion – was the entire human population in 1957. Even in Vermont, touted as having more cows than people not that long ago, overcrowding is evident in traffic congestion, bursting classrooms and suburban sprawl.

Ecologists and population watchdogs have long warned what environmental, social, economic and political disasters will ensue when the Earth has, for example, run out of oil, created deserts where forests once stood, and forced the world’s hungry and unemployed into desperate mutiny. Individuals who believe and expect that technology will solve all our problems need look no further than the SUV, which gulps down far more fossil fuel than the average family car. This vehicle’s invention and popularity symbolize, at the most basic level, the opposite of forward thinking.

Rapacious consumption is one side of the coin – the “developed” side, if you will; the humans-to-resources ratio is the other. And while countries like the U.S. are not immune to the numbers game – with 273 million, we’re the third most populous nation behind China and India – galloping birth rates are still the bane of the developing world.

If the predictions are grim, there is also reason for hope. That’s because even something as trenchant as fertility behavior – a.k.a. sex – can be modified.

Just ask Bill Ryerson. The Shelburne resident and president of the Population Media Center has seen with his own eyes the resounding success of a methodology designed to decrease birth rate, improve women’s status and, in some countries, decrease behaviors which spread sexually transmitted diseases.

That methodology? It’s called “soap opera.”

Yes, soaps, but with more thought, research, plot and character development – and social-change potential – than any number of episodes of “As the World Turns.” It’s officially called “entertainment-education,” and is based on the findings of American psychologist Albert Bandura that people learn, or relearn, behaviors by imitating others. In the absence of real-life role models, Ryerson explains, a soap opera creates sympathetic characters who model the desired behavior – and “bad” characters whose fate shows where their nefarious actions inevitably lead.

For example, Radio Tanzania produced a four-year serial, 1993 to ’97, with the goal of affecting family planning and AIDS prevention in a country where televisions are uncommon. In the program, a male character with indiscriminate mating habits – who was very interesting to male listeners – ended up dying a slow and torturous death from AIDS. Then executive vice president at the New York-based Population Communications International (PCI), Ryerson’s job was to measure the effectiveness of the Tanzanian show. He found, among other things, that 55 percent of the population ages 15 to 45 listened to it; 82 percent said in a survey that the show changed their behavior with regard to HIV/AIDS prevention.

The serial – its name translates to “Let’s Go With the Times” – also significantly affected attitudes and behaviors regarding family size, contraception and personal responsibility versus “fate” as a determinant of the number of children families have.

“It was by far the country’s most popular show,” Ryerson says. “And there was a 150 percent increase in the use of condoms.”

Ryerson’s career trajectory has centered around family planning and population issues for three decades, from the time he abandoned PhD studies in biology at Yale in 1970 for a more engaging position at the Population Institute in Washington, D.C. “I decided the population field was more interesting than insects,” he quips. That career included a five-year stint in the ’80s as associate director of Planned Parenthood of Northern New England – the job that brought him to Vermont.

As his work is now predominantly overseas, where Ryerson lives in the U.S. is somewhat irrelevant; he and his wife Leta Finch, with their daughter, are happy to remain in the woodsy environs of Shelburne – but not far from an airport.

With his neatly trimmed beard, conventional clothes and mild manner, the 55-year-old Ryerson looks more like a professor than an international mover-and-shaker. But since leaving PCI and founding the nonprofit Population Media Center in 1998, Ryerson has traveled the globe on a mission near-impossible: to “bring about stabilization of human population numbers at a level that can be supported sustainably by the world’s natural resources” and to “lessen the harmful impact of humanity on the earth’s environment.”

If it sounds overwhelming, at least Ryerson’s medium – the soap opera – is entertaining. With funding help from other international non-governmental and private organizations, Ryerson facilitates the development of soaps, and the evaluation of their effects – “There’s a lot of hand-shaking,” he says modestly of his role as initiator. The programs are specifically designed for a target culture; importantly, the creators and actors of the resulting radio or TV soap are all “in-country” – people who understand the culture and its values – not Westerners.

Entertainment-education was not Ryerson’s invention, though; he’s quick to credit Miguel Sabido with that.

In the 1970s Sabido was a vice president with Televisa, the dominant multi-media conglomerate in Mexico, and a leading producer and playwright. He had thought a lot about how to promote social change, according to Ryerson, and discovered Bandura’s “social learning theory” backed by studies which indicated “people of all ages learn by example.”

Following an interview with Bandura, a professor at Stanford University, Sabido came up with the idea of telenovelas – soap operas – that would create role models to influence social values and behaviors. His first series, in 1974, was actually about literacy – or rather, illiteracy and its effects. Describing Sabido’s technique, Ryerson says, “He always created middle-of-the-road characters, and positive and negative characters who try to influence the middle-of-the-road people. The negative ones add drama; the ambivalent ones go back and forth but ultimately adopt positive values.”

Sabido’s illiterate soap characters suffered from poverty, unemployment and embarrassment, just like much of Mexico’s citizenry at that time. The program was a smash hit, with a 33 percent viewership nationwide. An epilogue to the show informed viewers how they, too, could learn to read and change their lives. A quarter-million people showed up at literacy offices in Mexico City the day after one of the characters took the same step; ultimately, 840,000 people signed up for courses.

This astonishing success not only validated Sabido’s soap-opera methodology; it encouraged him to tackle another subject: contraception.

“Acompaname,” which translates “Come With Me,” would prove to be the prototype for other countries as well. This serial, which ran over two years, featured a fairly typical, poor young family. The mother, a sympathetic but ignorant character, was desperate to stop at the three children she already had but didn’t know how. Her husband, macho and lusty, resented her efforts to try the rhythm method. Over a period of time, and many melodramatic arguments and tears, the woman decided to seek the advice of another she knew who had “miraculously” restricted her family size. Eventually, she learned about birth control. By the time she and her smiling husband walked out of the gynecologist’s office with a prescription in hand, values had changed – in this family and among viewers – about ideal family size, about not having more children than one can afford, and about the woman’s role in her family.

“Following the show there was a 33 percent increase in family planning appointments at clinics” around the country, notes Ryerson. “Contraceptive sales increased 23 percent in one year.”

It was critical that attitudes were slowly influenced over a significant period of time. “You can’t change people very, very rapidly overnight,” he cautions. “The way to bring about meaningful change is in maybe 50 or more episodes, to hook people on the characters and issues. Then finally you put the characters, that the audience is fond of, in some situation where they gradually adopt new behaviors. The audience hangs in there.”

“Acompaname” hinted at what population and family planning experts would soon corroborate worldwide: The number-one factor in reducing birth rates is the empowerment of women – even if only with the choice to use contraceptives.

Over the next decade, and with continued family-planning soap operas, Mexico’s birth rate would decline by 34 percent, earning the country the United Nations Population Prize in 1986.

At the time of Sabido’s initial successes on Mexican television in the ’70s, Ryerson was working at Washington’s Population Institute as the director of the Youth and Student Division. His colleague at the institute’s Communications Center was David Poindexter, a man who would influence American television throughout the decade – particularly director Norman Lear – to incorporate family planning, gender roles and other issues into prime-time programming.

“David got several story lines into shows like “Maude,” says Ryerson. “She had a change-of-life pregnancy – Lear said years later that David got her pregnant – and this was before Roe vs. Wade. She had an abortion.” Poindexter also had something to do with Michael, a.k.a. “Meathead” on “All in the Family” getting a vasectomy.

American television was more liberal then, and Poindexter’s influence was not insignificant; even so, the social-issue episodes were usually “one-shot deals,” says Ryerson. When Poindexter learned of Sabido’s success in Mexico, he was impressed with the long-running series and its results. He personally encouraged Televisa to produce more family-planning soaps, and to get Miguel Sabido to train broadcasters in other developing countries in his methodology.

Poindexter took Sabido to India to meet then-President Indira Gandhi. In a previous population-reduction effort, she had authorized an involuntary sterilization campaign, Ryerson explains, which had been a complete disaster. But Gandhi knew the power of television; she had lost votes where there was no TV. “She had the ministry install a transmitter a day until the entire country was covered by television,” says Ryerson. “But it was god-awful; no one watched it.”

Enter Sabido. With his help and training, India introduced its first-ever soap opera in 1984, “Hum Log,” which translates “We People.” The 17-month series achieved 60 to 90 percent ratings; evaluators reported that 70 percent of the viewers said they had learned from “Hum Log” that women should have equal opportunities; 68 percent said they learned women should have the freedom to make personal decisions; and 71 percent said family size should be limited. “People remembered what happened to the characters,” Ryerson recalls, “as if they were their own family.”

From the Population Institute, Ryerson had moved on to development jobs at Planned Parenthood in Pennsylvania, then Vermont. Meanwhile, Poindexter facilitated a second soap in India, and took the methodology to Radio Kenya, again with favorable results: Contraceptive use increased 58 percent in Kenya, and desired family size declined from 6.3 to 4.4 children per woman.

In 1985 Poindexter founded Population Communications International in New York, on the heels of the second U.N. conference on population in Mexico City. “It was clear that what was required was a truly international organization with a focus on population,” says Poindexter, reached by phone at his suburban Portland, Oregon, home. “I needed someone who was competent and knew how to raise money, and I knew Bill was the best person in the world.”

Poindexter didn’t have to twist his arm to get back into population work. Ryerson joined PCI as executive vice president; his first task was designing the evaluation of India’s second soap opera. Projects followed in Brazil, Tanzania, the Philippines and Madagascar.

But it was that extensive, four-year Radio Tanzania study in the mid-’90s that particularly affected Ryerson’s subsequent efforts in other African countries – both for PCI and, now, for Population Media Center.

“He didn’t know much about radio or mass communications when he started,” Poindexter says, “but he’s become a master. The project in Tanzania is a landmark because Bill helped design scientific evaluation research and nailed down the fact that [the soap-opera methodology] really worked. He’s really more of a scientist than I am.”

Now, with Ryerson at the helm of his own nonprofit, the “semi-retired” Poindexter serves as its Honorary Chair and consultant. “Bill asked if I would help if he started a new organization, but Bill is the central figure. I’m amazed at him at times; he’s increasingly omni-competent. He’s very good, and frankly, very good is required right now. Africa is going down the tubes unless someone can step in and affect reproductive health and birth rates.”

“He is excellent with people in different cultures,” concurs Dr. Christine Galavotti, chief of the Behavioral Research Unit, HIV Section, at the Centers for Disease Control in Atlanta. She accompanied Ryerson on a recent trip to Ethiopia, where he is facilitating the development, training and technical assistance for a radio program. “I have been very impressed with his energy, his ability to talk with potential collaborators, to build collaborative relationships with other organizations, with ministries of health,” Galavotti adds. “People welcome the PMC into the ‘family’ of other, existing organizations in the country.”

Galavotti went to CDC to do HIV prevention work and has long been interested in sexual-behavior change. “We’ve done a lot of community-based projects, but this methodology is so exciting,” she says of the enter-education strategy. “It has the potential for a powerful effect, and to reach a large audience.” A psychologist, Galavotti says she’d like to see the methodology tested on inner-city youth in the U.S. – say, “on a good cable show during a time that young people will watch. We’re a TV society, people do follow shows, get to know the characters. I really think this could work.”

Ryerson is interested, too, in how well the telenovela approach might work in a more media-savvy country. “We’re talking to a cable producer who wants to have a station for urban America to help black youth with issues that affect their lives,” he notes.

But right now, his PMC agenda is overflowing with projects in Africa. That trip to Ethiopia, where Ryerson is setting up a locally managed office for project development, included stops in Uganda and Kenya – where a TV producer plans to create a version of “Wheel of Fortune” with questions about family planning. “We’re looking at a project in Ghana,” he adds. “There’s a staff in Mexico City working on a radio project for young people. We’re trying a variety of new strategies.” And then, long-term, there’s China, the Philippines and back to India.

Time is of the essence – and Ryerson is one male acutely aware of that biological clock. How could there ever be enough time to persuade the world that “zero population growth” is a good thing? If facing down the global billions seems like waking up to a daily disaster, Ryerson’s calm and amiable demeanor doesn’t let it show. His remedy to getting depressed is to simply keep working. “It’s knowing that I can make some contribution,” he says.

“My belief is that it’s better to do what we can now and avoid whatever we can of what perils face us in the future,” Ryerson adds. “There is a lot of evidence indicating we may have a huge ecological catastrophe in the next 50 years.” The population issue, he says, is like a car hurtling down the road: “Some people are driving it faster, some are trying to apply the brakes – and some politicians are saying we don’t have a problem yet.”

© Copyright Seven Days
Courtesy of the author

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