The Role of the United Nations in Coping with World Demographic Changes

Bakampa Brian Baryaguma
bakampasenior@gmail.com; www.huntedthinker.blogspot.ug

Abstract:

Demographic and socio-economic studies are useful for planning and evidence-based decision making. With this in mind, this essay analyses world demographic changes and the role of the United Nations in coping with those changes in the world.

It analyzes the changes and discusses them in four general categories namely, fertility rates, the family, life expectancy, and migration.

It emerges that fertility rates are declining, but notes that the decline is worse in developed countries, more than developing countries. The family institution is struggling, under attack from negative social, political, and economic circumstances. Social and filial bonds are waning, leading to rampant family disintegration. Life expectancy has increased globally, mainly due to advances in medicines and improvements in living standards that have led to drastic reductions in mortality rates. Migration propels individual prosperity, and national economic development.

The role of the United Nations in coping with these world demographic changes is to enable and/or engineer further momentum in harnessing the positive attributes of change, while remedying the negative effects. It is to facilitate efficient sexual and reproductive healthcare and rights; to strengthen family values, and enable reunification; to ensure secure and dignified ageing for all; and modernize immigration systems and procedures.

These should be done as urgently as possible, before it is too late to salvage the situation, at the expense of our very existence, and prosperity.

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THE ROLE OF THE UNITED NATIONS IN COPING WITH WORLD DEMOGRAPHIC CHANGES

1.                  Introduction

A.                General Remarks

True to the adage that change is a fact of life, our world is constantly changing – in all ways: social, political, economic, and more. Change is unavoidable, for all of us: people, the natural environment, and human institutions.

Notable of the ongoing process of change are demographic changes, a term that literally denotes the study of statistics of births, deaths, diseases, etc, to show the condition of a community.[1] In short, demographic changes refer to dynamics in population of a given society (in this case, the world, as a whole), as indicated by shifts and/or variations in research data. World demography has been changing, and continues to change, rapidly; so much so that it is feared we may be heading for a demographic tsunami, or perfect demographic storm. These fears are not far-fetched: demographic changes have far-reaching implications on economic development, employment, income distribution, poverty and social protections, universal access to health care, education, housing, sanitation, water, food and energy. We must cope with the changes.

A key institution affected by the ongoing demographic changes is the United Nations (UN). The UN is a prominent and crucial actor in contemporary world affairs. As such therefore, its role in coping with world demographic changes should be well analyzed and understood.

B.                 About the United Nations

The UN is established under Chapter 1 of the Charter of the United Nations, 1945 (hereinafter ‘the UN Charter’). Article 1 thereof provides for the purposes of the UN. Briefly, they are:

(a)                to maintain international peace and security;

(b)               to develop friendly relations among nations, with a view to strengthen universal peace;

(c)                to achieve international cooperation in solving international problems; and

(d)               to be a centre for harmonizing the actions of nations in attaining these common ends.

This is the mandate or general roles of the United Nations.

Logo and flag of the United Nations.

The specific role of the UN in coping with world demographic changes can be traced in its third general role i.e. ‘To achieve international co-operation in solving international problems of an economic, social, cultural, or humanitarian character….’[2]

This is because, one, changes in world demography are problematic, in so far as their repercussions threaten international peace, security, and stability, the maintenance of which is a core mandate of the United Nations;[3] and two, these changes satisfy the economic, social, cultural, or humanitarian characteristic test, stated by the UN Charter, in so far as the changes affect the global economy, as well as the social and cultural fabric, thereby necessitating humanitarian intervention.

In fact, some countries, like Belarus, have already classified demographic changes as a national security issue, and instituted national demographic security programs to cope with them.[4]

2.                  World Demographic Changes and the Role of the UN in Coping with Them

Changes in global demography are varied, and multifaceted, owing to differences in the location and composition of the world population. For example, population dynamics in poor countries are different from rich countries; those in predominantly Christian countries are different from predominantly Islamic countries; and so on.

These structural differences automatically translate into variations in demographic changes, hence calling for different approaches in coping with them. Therefore, from the onset, it is clear that the UN cannot have a strait-jacket – one size fits all – approach in fulfilling its role.

Martynas A. Ycas identifies four broad demographic changes namely, fertility, the family, life expectancy, and migration.[5] I have adopted Martynas’ simplified analytical model (since it still holds true, 23 years later), and built on it with further, and current information detail.

A.                Fertility

Fertility refers to the reproductive performance of a woman in her reproductive life.[6] In simple terms, it means the number of children that women of child-bearing age are able to produce. World fertility rates decrease and increase, causing demographic imbalances.

In the past, women were having many children. In the early 1970s, for instance, women around the world had about four children each.[7]

Currently, world fertility rates are a mixed grill. In developing countries, fertility rates are high, and the population is growing.[8] These countries are characterized by young populations, in which majority of people are children (0 - 17 years),[9] and youths (15 - 24 years).[10]

In contrast, in developed countries, fertility rates are generally declining, and are experiencing slow population growth, or none whatsoever.[11] They are rapidly ageing, or even depopulating.[12]

Overall however, presently women are having very few children. Global average statistics show that in 2014, each woman had around two children.[13] Although also declining, the figures are much higher in developing countries, like Uganda, where fertility rates dropped from 7.1 children per woman in 1991, to 5.8 children per woman in 2014.[14]

 Midwives attending to a pregnant woman in Cambodia, whose fertility rate is 2.7. Fewer women are interested in producing children these days. Photo credit: UNFPA.

The role of the United Nations in coping with imbalanced fertility rates is to promote sexual reproductive health and rights. According to United Nations Population Fund (UNFPA), ‘Good sexual and reproductive health is a state of complete physical, mental and social well-being in all matters relating to the reproductive system. It implies that people are able to have a satisfying and safe sex life, the capability to reproduce, and the freedom to decide if, when, and how often to do so.’[15] This includes voluntary family planning.

For developing countries with high fertility rates, the UN, in conjunction with member states, civil society and donors, should develop comprehensive efforts to ensure universal access to sexual and reproductive health care, in as accessible and simple a manner as possible, by for instance, establishing one-stop-centers where women receive family planning, antenatal care, HIV testing and general health needs, at once. This calls for strengthening health systems, improving human resources, well-functioning logistics systems, and availability of commodities like condoms, for protection against unwanted pregnancies, and sexually transmitted diseases.[16] If this is not done, these societies may remain trapped in a poverty cycle, unable to achieve economic development, and the benefits it brings.

The same goes for developed countries with low fertility rates, but for them there must be added, more ad hoc policies and initiatives geared towards encouraging reproductive women to produce more children. Particular countries are taking steps to increase fertility rates. In Spain, there are radio advertisements calling upon women to have more children, and home and transport subsidies are being introduced; Italy is introducing monthly cash baby bonuses.[17] Parental leaves that make it easy to combine motherhood with working life can also be introduced, since they have performed well in Norway and Sweden.[18] Having small and manageable families has propelled these countries to economic development. But now it is clear that development alone is not useful, if there is no one to enjoy and sustain it. This necessitates producing more people.

More critically however, the issue of youth unemployment needs urgent attention, and redress, because research indicates that some countries like Portugal and Belarus are losing young people in thousands, who are migrating to other countries in search of better employment opportunities, at the risk of collapsing their home economies.[19] In 2015, global youth unemployment stood at 12.9%, and rose to 13.1% in 2016, one year later.[20]

 State of youth unemployment and poverty in 2016. Source: Office of the Secretary-General’s Envoy on Youth.

From the above figure, it is clear that even many of the youth with jobs are actually poor. It means that the jobs they do are not decent, and fulfilling enough. In countries with high unemployment, this situation arouses inter-generational conflict, whereby young people accuse old people of overstaying in workplaces, thereby denying them jobs. In Uganda, some youth activists petitioned government to lower the retirement age, in order to create jobs for them. Economic bottlenecks should be removed so that economies can work for everyone involved.

B.                 The Family

Societies are founded on individuals, who are primarily grouped together in families.[21] The formation, growth, and dissolution of families, has evolved gradually, largely in an unpleasant manner – unfortunately.

In the past, families were firmly rooted and grounded. Right from marriage, for instance, a standard nuclear family of father, mother, and children, was arranged, organized, supervised, and mediated (in case of misunderstandings) by the wider, extended family superstructure, guided by overall social norms of the community in which the family belonged. This rigorous system of social supervision ensured firm and stable families, leading to strong and integrated societies.[22]

Fast forward: today, to a large extent, the communal system that provided social safety nets is no more. Individual tastes and preferences hold sway over competing and conflicting extended family and community standards. Binding social bonds and values are virtually gone.

Consequently, families today are formed loosely, disintegrate flimsily, weaken easily, and break-up very fast.[23] This exposes the family institution to unprecedented sustained attack, left-right-and-centre, mainly due to continued harsh changes in the social, economic, political, and cultural environments in which the family operates.

Hence, as Martynas says, there is, ‘A decreasing propensity towards early marriage (or any marriage at all), an increasing propensity toward divorce, delays in childbearing, and a markedly increased proportion of children born outside of marriage [that] has led to a substantial decrease in “conventional” nuclear families consisting of husband, wife, and children.’[24]

Plus, alternative family types are emerging, headed by single parents (usually mothers), and children, whereby children look after fellow children. Quite unfortunate! These are characterized with low income earnings, hence plunging the members into poverty, often chronic in nature.

 Child headed household in Aromorach, Gulu district, Uganda. The eldest girl, a child herself, takes over the role of bread winner, taking care of her siblings, and the needy grandmother. The girl cannot adequately provide family basic needs, eventually resulting into deep poverty. Many of them end up as street children, and girls getting pregnant and becoming young mothers. Photo credit: Comboni Samaritans.

To cope with these family demographic changes, the United Nations should promote, and safeguard traditional family values of unity, love, respect, and care for other members. This way, extended relatives will still be obliged to take on, and look after helpless orphans, instead of leaving them to fend for themselves in all kinds of hardships.

Ensuring family reunification, in these times of common family separation due to wars, and natural disasters, is perhaps the most vital role the UN can play. Family bonds are sacred. In situations where families are separated, leading to movement of some members, the UN and its specialized agencies should endeavor to reunite them, as much as possible. The United Nations High Commission for Refugees (UNHCR) can partner with receiving states to ease travel restrictions, for the benefit of identified family members to reunite. For example, a recent BBC documentary found that the wars in the Middle East, like in Syria, have torn apart many families. That fortunately, some men (doubling as husbands and fathers) have obtained asylum and acquired refugee status in European countries like Germany. That unfortunately, after many years of failed attempts, they cannot reunite with their wives and children, because of prohibitive procedures, and blatant refusal by receiving states to accept them in. This subjects the men to psychological torture, and inhibits their social integration, and performance at their new workplaces, due to low concentration and boredom. The UNHCR can come in handy here.

C.                Life Expectancy

Life expectancy refers to longevity of people on earth i.e. how long a person lives, before dying. Previously, life expectancy was low, due to high death or mortality rates. Now that mortality levels are low, it is high. This has ushered in the ageing phenomenon, bringing with it opportunities and challenges, that the United Nations has to cope with.

1.                  Population Trends

Given increased life expectancy, the UN projects that world population will continue growing, except if fertility rates decline rapidly, as the graph below shows.

UNFPA global population projections.

In the past, human life was vulnerable and short, mainly characterized by many killer diseases, hunger and famine, and incessant fatal conflicts. All of these worked in unison to claim millions of lives across the globe. Mankind was subordinate to nature, yet nature is hostile to weaklings, but friendly to the strong. Nature was the biggest killer: brutal, unkind, and unforgiving.

Today, mankind has significantly tamed and conquered nature. It is no longer a mass killer. Consequently, nowadays people live very long lives. Global lifespans have increased from 64.8 years in the early 1990s, to 70 years today.[25] Human deaths have greatly reduced.

Unprecedented advances in science and technology have contributed greatly to high life expectancy. Scientific development has ushered in great inventions in medicines and vaccines, thereby eliminating several killer diseases. Technological growth has introduced safe work, favorable work environments, and user-friendly methods of work. Extremely hazardous work has been dealt away with. Improved healthcare has significantly reduced maternal mortality,[26] and infant mortality,[27] over the years. Improved global governance systems, and effective conflict resolution mechanisms, have reduced wars and other armed conflicts that claimed many lives especially, men’s. The prevailing peace and security in most parts of the globe has made it possible for people to live longer, peaceful, and happier lives, than ever before, although slightly higher mortality rates persist among the billions of people living in developing countries,[28] where life expectancy is slightly lower than the world average. Nevertheless, like in the rest of the world, fertility rates there remain higher, and haven’t fallen at the same pace as mortality levels.

2.                  The Ageing Phenomenon

The net effect of high life expectancy is that for once, more people are dying of old age, than say, killer diseases. It has ushered in the phenomenon of ageing, which is more pronounced in developed countries than least developed ones,[29] bringing with it both opportunities and challenges, that the United Nations should harness productively.

UNFPA points out very well the opportunities presented by ageing as follows:

The contributions of older persons to society are invaluable. Many such contributions cannot be measured in economic terms – such as caregiving, volunteering, and passing cultural traditions to younger generations. Older persons are also important as leaders, often playing a role in conflict resolution within families, in communities and even in emergency situations.[30]

It also points out the challenges as follows:

Yet they are also often vulnerable. They may have weak social support networks, lack income, or be subject to discrimination and abuse. Older women, in particular, are vulnerable to discrimination, social exclusion and denial of the right to inherit property. Women also tend to live longer than men, and may experience deepening poverty as they age.[31]

The cardinal role of the United Nations in coping with demographic changes occasioned by increased life expectancy, particularly ageing, is to ensure that people everywhere are able to age with security, dignity and their full rights. The UN should foster implementation of the 2002 Madrid International Plan of Action on Ageing, which, as stated by Article 1, aims ‘… to respond to the opportunities and challenges of population ageing … and to promote the development of a society for all ages.’[32]

 A beautiful family photo of the Mugesanis in Kenya, of four generations (i.e. grandmother, mother, daughters, and grandchildren) in one photo. Harmony in families is important for achieving the aspiration of the Madrid International Plan of Action on Ageing, of 2002. Photo credit: Mugesani Maureen.

This can be done through technical, financial, or moral support, of age-friendly policies in member states, in the wider scheme of policy dialogue, capacity building, data collection, research and advocacy. There are good examples of such policies and ideas from the East African Community (EAC), in Uganda and Kenya.

In 2009, the Government of the Republic of Uganda, through the Ministry of Gender, Labor and Social Development (MGLSD) adopted a National Policy for Older Persons,[33] with key emphasis on Ageing with Security and Dignity. Under this policy framework, the Government has a pilot program dubbed Senior Citizens Grant under which elderly people are given monthly grants of Uganda shillings twenty five thousand only (Ugx 25,000/=, about USD 7$), to old people of 60 years and above.

 An excited elderly woman receives a Uganda government senior citizens grant. Photo credit: The Guardian.

The program is meant to ensure that older persons are protected from risks and repercussions of livelihood shocks, by overcoming constraints that impede the development of their productive capacities. It is essentially a social security program, designed to fill gaps left by deaths and diseases (especially HIV/AIDS) in the traditional extended family social support mechanisms, leaving many older people with grandchildren to fend for.[34] The program is having a big impact, empowering Uganda’s vulnerable older people, since they can now afford to buy a few basic necessities like salt, paraffin, and soap.

Another one is a non-governmental self-help project in Kenya, launched in 2007, that trains old women, most of whom are grandmothers, in self-defense skills of kung fu, karate, and taekwondo, in response to young bandits who were raping women three or four times their age.[35]

 Older women in Kenya undergoing kung fu self-defence training. Photo credit: AJ+.

This is a physical security program, but it also fits well into the objectives of the 2002 Madrid International Plan of Action on Ageing, of ensuring that these vulnerable women are able to age with security, dignity and their full rights, which includes inviolability of their persons.

The United Nations can support these programs, and promote similar initiatives globally.

D.                Migration

Migration means moving from one place to another, with a view of living there.[36] We live in a highly fluid and mobile world today. People are constantly on the move. Migration has therefore accelerated; and changed in character, with people moving in huge, organized groups.[37]

 Over 7000 Central American migrants walk along the highway in Tapachula, Mexico, near the border with Guatemala, on 21 October 2018, as they continue their journey to the US. This caravan has set the US against Guatemala, Honduras, and El Salvador, with the former threatening to cut aid to the latter, accusing them of failing to stop the migrants’ advance. Photo credit: Reuters.

Millions of people are moving from one place to another, within their states (internal migration), or to other states (international migration). Most of the movement is from rural areas to urban areas i.e. urbanization. The year 2007 ushered in a situation where more people lived in urban areas than rural areas,[38] and this will continue.[39]

On the whole, migration is a positive force that should be encouraged. It improves migrant’s lives,[40] and spurs economic development at places of origin,[41] and destination;[42] although it has its own attendant challenges, like separating loved ones.[43] In Europe, immigration is slated to deter economic collapse, by bringing more capable and energetic people in the workplace.[44]

The cardinal role of the United Nations should be to integrate migration and development issues, for purposes of empowering people, and accelerating economic development. This can be achieved through partnering with member states and other international actors, to promote and encourage migration. The following can be specifically done jointly:

(a)          Combating trafficking

Human trafficking is a big threat, and hindrance to proper, decent, and beneficial migration. It wastes valuable human talent, depletes financial and time resources, and undermines economic growth. Trafficking should be resisted, and fought through all legal and socially acceptable ways. Traffickers should be arrested, prosecuted, and punished, in accordance with the law.

(b)          Preventing irregular migration

The movement of people should be regular, supervised, and legal. Irregular migration concerns are at the heart of the economic rift between the rich countries, and their poor counterparts. The rich countries are perceived and portrayed as not wanting to share some of their wealth with the poor ones. This, in fact, is not accurate, per se. For instance, Europe and America that are struggling to keep away huge numbers of illegal immigrants are not necessarily rejecting them for the sake of keeping them away. Rather, they want immigrants to enter their borders through proper channels, where they are vetted for quality, quantity, and security assurance. And it’s well within their rights and best interests to do so – as it is for everyone else.

(c)           Modernizing and strengthening immigration and customs services

Many countries’ immigration and customs systems are outdated, slow, and inefficient, unable to offer good quality services in clearing immigrants and their possessions. The UN can avail its financial and human resources, and diverse technical expertise, to upgrade these countries’ systems to world class standards, for greater efficiency and effective service delivery.

3.                  Conclusion

Demographic changes pose grave imbalances for the world. Left unchecked, they truly pose grave threats to the existence of humanity, and economic development.

At the heart of the mandate of the United Nations, as stipulated under the UN Charter, lies the implied fundamental mandate of preserving humanity, and prosperity of everyone on earth.

If the UN does everything within its power to fulfill the roles as stipulated in this essay, and more as its leadership deems fit, to cope with world demographic changes, then its stated and implied international mandate will be achieved.

These should be embarked upon urgently, before it’s too late to do anything meaningful and useful. Lest the world population will phase out, and we become extinct. Perhaps slowly, in the most unapparent manner, and unsuspectingly. But surely so – without a shadow of doubt.

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Notes and References

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[1] A. S. Hornby, A. P. Cowie, and A. C. Gimson, Oxford Advanced Learner’s Dictionary of Current English (1983),  at 232.

[2] Charter of the United Nations, 1945, Article 1(3) thereof.

[3] Ibid., Article 1(1). To this end, the UN Charter mandates the UN, ‘to take effective collective measures for the prevention and removal of threats to the peace …,’ which threats, I submit, include world demographic changes.

[4] Ryhor Astapenia, ‘Belarusian Demographic Trends: Rapid Ageing and Depopulation’, BelarusDigest (2014). Available at http://belarusdigest.com/story/belarusian-demographic-trends-rapid-ageing-and-depopulation-17533. Accessed on 24 October, 2018, at 18:41 GMT.

[5] Martynas A. Ycas, ‘The Challenge of the 21^st Century: Innovating and Adapting Social Security Systems to Economic, Social, and Demographic Changes in the English-Speaking Americas’, 57 SSB (1994) 4, at 4-6. But Martynas specifically focuses on immigration, not the wider subject of migration.

[6] Uganda Bureau of Statistics, The National Population and Housing Census 2014 – Main Report (2016), at 16.

[7] United Nations Population Fund, ‘World Population Trends’ (2017). Available at http://www.unfpa.org/world-population-trends. (Accessed on 24 October 2018, at 18:44 GMT) This is the world average. But the figure was much higher in developing countries.

[8] Ibid. UNFPA observes that, ‘According to conservative projections, the population of the world’s least developed countries will double by 2050, and in some countries it will even triple.’

[9] The threshold given by Article 1 of the United Nations Convention on the Rights of the Child, 1989 (came into force on 2 September 1990), which defines a child as ‘… every human being below the age of eighteen years….’

[10] The definition of youth used by the United Nations, for statistical purposes. See, United Nations Youth, ‘Definition of Youth.’ Available at http://www.un.org/esa/socdev/documents/youth/fact-sheets/youth-definition.pdf. Accessed on 24 October 2018, at 18:47 GMT.

[11] United Nations Population Fund, supra note 6.

[12] Ashifa Kassam et all, ‘Europe needs many more babies to avert a population disaster,’ The Guardian (2015). Available at https://www.theguardian.com/world/2015/aug/23/baby-crisis-europe-brink-depopulation-disaster. Accessed on 24 October, 2018, at 18:49 GMT. This paper learnt that in some provinces in Spain, ‘… for every baby born, more than two people die. And the ratio is moving closer to one to three,’ and notes that ‘Spain has one of the lowest fertility rates in the EU, with an average of 1.27 children born for every woman of childbearing age, compared to the EU average of 1.55. … The result is that, since 2012, Spain’s population has been shrinking.’

[13] United Nations Population Fund, supra, note 7.

[14] Uganda Bureau of Statistics, supra note 6.

[15] United Nations Population Fund, ‘Sexual & reproductive health’ (2016). Available at http://www.unfpa.org/sexual-reproductive-health. Accessed on 24 October 2018, at 18:51 GMT.

[16] Ibid.

[17] Ashifa Kassam, supra note 12.

[18] Ibid.

[19] Ryhor Astapenia, supra note 4.

[20] Office of the Secretary-General’s Envoy on Youth, ‘Global Youth Unemployment is on the Rise Again’ (2016).

[21] There are other social groupings like workplaces, schools, religious settings, entertainment centers, rehabilitation facilities, informal social support networks like secret societies and gangs (which are usually criminal), and others, but these are secondary, since at the end of the day, everyone goes back to their point of origin i.e. the family.

[22] But, of course, it should be noted that this system also had its own peculiar challenges, flaws and weaknesses. For example, it tended to undermine and vitiate consent of marrying couples, which sometimes resulted into unequal unions, where usually the wife and eventual mother was disadvantaged and weak. This entrenched gender inequality hindered development. On the whole however, the communal system worked well enough, at least in this regard.

[23] Ryhor Astapenia, supra note 4, earmarks marriage and family as one of the causes of Belarus’ poor economic and development performance. He says that ‘Belarus remains a country of broken marriages, as about half of all families split up, and there is no reason to believe that this figure will change in the near future.’ Clearly, this subject demands serious attention.

[24] Martynas A. Ycas, supra, note 5, at 5.

[25] United Nations Population Fund, supra, note 7.

[26] This means women who die in child birth.

[27] This means children who die during, or soon after birth i.e. up to the age of five years.

[28] The World Bank Group, World Development Report 2009 – Reshaping Economic Geography (2010), at 1.

[29] United Nations Population Fund, ‘Ageing’ (2015). Available at http://www.unfpa.org/ageing. Accessed on 24 October 2018, at 18:54 GMT.

[30] Ibid.

[31] Ibid.

[32] Second World Assembly on Ageing, Political Declaration and Madrid International Plan of Action on Ageing, 2002.

[33] MGLSD, National Policy for Older Persons: Ageing with Security and Dignity (2009).

[34] Richard M. Kavuma, ‘Dignity, not poverty – the cash grants helping Uganda's older generation,’ The Guardian (2016). Available at https://www.theguardian.com/global-development/2016/oct/10/uganda-dignity-not-poverty-the-cash-grants-helping-older-generation. Accessed on 24 October 2018, at 18:58 GMT.

[35] Eleonor Botoman, ‘Meet the Kung-Fu Grandmas Of Kenya Who Are Fighting Back Against Rapists.’ Available at  http://bust.com/feminism/18473-kung-fu-grandmas.html. Accessed on 24 October 2018, at 19:01 GMT.

[36] A. S. Hornby, A. P. Cowioe, and A. C. Gimson, supra note 1, at 543.

[37] Consider for example, the millions of Africans, Arabs, and South Americans, currently flocking to Europe and United States of America, in boats or on foot, in search of better economic opportunities, and living conditions.

[38] United Nations Population Fund, supra, note 7.

[39] See, Ibid., where UNFPA projects that by 2050, 66% of global population will be living in cities.

[40] Jeni Klugman et al, Human Development Report, 2009 – Overcoming barriers: Human mobility and development (2009), at 2, states that, ‘Most migrants, internal and international, reap gains in the form of higher incomes, better access to education and health, and improved prospects for their children.’

[41] Ibid., at 71-82. The most notable reward is in form of financial remittances, which, as the report notes, at page 72, ‘… are vital in improving the livelihoods of millions of people in developing countries. … An important function of remittances is to diversify sources of income and to cushion families against setbacks such as illness or larger shocks caused by economic downturns, political conflicts or climatic vagaries.’

[42] Ibid., at 83-92. The report notes, at page 84, that, ‘Migrants can bring broader economic benefits [like taxes, and job creation], including higher rates of innovation.’

[43] The report notes, Ibid., at 72, that, ‘Despite these financial rewards, separation is typically a painful decision incurring high emotional costs for both the mover and those left behind.’

[44] Ashifa Kassam, supra note 12. It is estimated that Germany, will need an average of 533,000 immigrants every year, to offset shortages in the workplace, which the UN predicts will drop by 7% to just 54% by 2030.

Memories of My Blood Donation Exercise

Bakampa Brian Baryaguma

bakampasenior@gmail.com; www.huntedthinker.blogspot.ug

On Tuesday, 21^st November, 2017, I donated 450 millilitres (almost half a litre) of my precious blood to all potential recipients, in this world. This was during a blood donation drive organized by Uganda Blood Transfusion Service (UBTS), at the City Square, Kampala.

 

A sign post of UBTS at the Uganda Blood Bank Headquarters.

The gate of UBTS offices, at Nakasero hill, Kampala.

I have never been in need of blood transfusion (in fact, I have never even been on water drip), but I consider it very important to donate blood to people in need of it. I do not have to be told that. To my mind, donation is a matter of common sense, and duty to other people, since blood is not manufactured anywhere. Donating blood is simply the right thing to do. It was not my first time to donate, but I had taken long without donating again. So, it was my first, in a long time.

 

I first donated blood on 14 June 2013.

My second time was on 20 January 2014.

Although I had donated before, I realized that donating blood is actually not an easy thing to do, because there is always a feeling of fear associated with the whole exercise. So, as I got closer to the venue, I was somewhat scared, as on previous occasions.

But, I was determined to donate. So, once again, I garnered courage and strength to sustain me. I said to myself, ‘Bakampa, you are a renowned warrior, a formidable combatant and street fighter, who has successfully fought against dictators, with all their repressive terror machines; you went through the pain of circumcision; you even conquered Satan by accepting Jesus Christ as your Lord and Saviour! Now, how can mere needle pricks on the finger and arm vein, scare you to death, in a mockery of your brevity? No, no, no! Impossible!’ With this courage, that is only comparable to that of a night dancer, I stormed the blood donation venue, probably like nobody else before.

 

 I was very excited to take my seat, and start the process.

On the first table, I was counselled, generally, about the whole exercise, by a lady, who also took and recorded my particulars like name and age, place of residence, district of origin, and interestingly, my mother’s name (but not father’s), were taken and recorded. When I asked why only my mother’s name was necessary, I was told that while it is possible that my known father is actually not my real father, this is not so with my mother; that a person’s mother is definite. At this moment, I shuddered, recollecting numerous stories of women and their terrible lies!

On the second table, a gentleman measured my blood pressure, to ensure that I am fit enough to donate. If blood pressure is high or low, one cannot donate blood, because then it is not safe for transfusion to another person. I was also told that when it is high, the blood has to be reduced, by removing some of it from the body, though at a cost to the patient. My blood pressure was normal, and I was asked to continue to the next stage.

  An attendant records my blood pressure level, in a form.

 The attendant explaining to me the importance of measuring blood pressure before donation.

After confirming that my blood pressure is normal, I underwent testing to confirm that I had enough blood to donate. The same gentleman cleaned one of my fingertips with moist cotton wool, pricked it, squeezed it gently, drew out some blood using a transparent test-tube, and poured it in a chemical mixture, in which it sank like a heavy stone in water, and then sealed my fingertip with the cotton wool, to enable clotting. The sinking of blood indicated that I had excess (and probably idle) blood in my body, enough to donate some, to people in need of it.

 Blood being drawn from my finger.

 Sealing the needdle prick with cotton wool.

 Pressing the cotton wool on my finger to stop bleeding.

Then, finally came my turn to lie on the bed-like donation chair, from where blood would be drawn out of my body. This point was manned by a lady. I shivered a bit, seeing her prepare her gadgets, tying some of them on me to locate the vein and spot to pierce, ready to finally go for the red liquid, which is the life support of all mammals (sic). It felt like I was giving up my life.

 Making final preparations for donation.

 Making final preparations for donation.

 Making final preparations for donation.

Making final preparations for donation.

Then she inserted the syringe-like needle in the vein on my right arm, complete with its transparent bag, in which the blood is collected. Dear reader, the fear of the unknown can be quite threatening. I shed some tears out of fear (or so I believed), seeing my precious blood flow out of my body, into the syringe, and settle in the bag. I momentarily felt even my breath leaving me. My life was really over! So I thought.

My blood flowing into the collection bag.

But remember that I came with great will and determination to donate. So, I pumped blood and filled the approximately half litre bag in just about five minutes, as I engaged my attendant in a discussion as to why they were not striking like other doctors. She explained that they are part of emergency personnel, who continue working, to save most critical lives.

 I filled the bag in record time; faster than some people I found.

As I saw my blood flow out of my body, I felt happy and proud of myself because I knew that I was thereby saving a needy life somewhere.

 Donating blood brings incredible joy to the donor.

 The attendant preparing to remove the bag, now full of blood.

My vein was sealed after drawing blood.

After donating, I was given an identification number to use for purposes of finding out my blood test results from Nakasero Blood Bank, after two weeks, from the date of donation, for tests like my blood group and diseases like HIV, Hepatitis B, and others, which when detected in the blood sample, it is poured. It basically goes to waste, since it cannot be given to another person.

 Uganda Blood Transfusion Service (UBTS) headquarters, Nakasero, Kampala.

 UBTS headquarters, Nakasero, Kampala.

I was given soda to drink, and biscuits to eat. I was told that these help the body to immediately generate energy for the body to use, like in generating more blood to replace the one taken out.

I enjoyed the soda, and biscuits.

On Wednesday, 20^th December, 2017, in the morning, I went to Nakasero Blood Bank to get my results, as advised.

 A billboard inside UBTS premises, giving directions to different offices.

 I took the opportunity to pose for a photo.

 Feeling swaggerific, while enjoying my photo pose.

At the reception, there was a lady and gentleman. I introduced myself to them, and stated my purpose for coming i.e. getting my blood test results after donation. They welcomed me, and the lady directed me to a counselling room, where details of my results would be given to me. I went through a door labelled ‘Donor Room,’ before reaching the counselling room. The donor room is a mini-department of sorts. It hosts the counselling room, a store, and a separate actual donor room from where one can donate blood, once at the facility.

I have always wanted to be a hero (I think everyone does); on this door was a symbol of a heart stating that, 'OUR BLOOD DONORS ARE HEROES!' When I read it, I felt that I am finally a hero. There is a banner next to the door, stating ‘Pre-donation instructions,’ to generous donors, many of which, I must confess, I have never complied with.

The counselling room is quite comfortable, and relaxing, but is also intimidating because thoughts of possibly getting unpleasant results, for example HIV+ results, can be very discomforting and difficult to bear.

 The counseling room is profoundly ambivalent: it's relaxing, but also scaring.

I met there a beautiful lady called Annet Akiror, who attended to me. When I asked her job description, she said that she is three-in-one, professionally speaking: a phlebotomist, laboratory technician, and counsellor. This job description basically means that she gets blood from a donor, conducts tests on it, and then updates the donor in form of counselling. So, for instance, the lady who drew blood from me at City Square, on 21 November 2017, was a phlebotomist. Ms Akiror received me warmly, and spoke very nicely until the end, answering all my questions eloquently – and they are always many, especially if I am learning new things.

 

 Ms. Annet Akiror explaining to me my blood test results.

We sat in front of a computer that had my results. She asked me whether I expected good or bad news from the results. I said I hoped for the best. She logged into the computer, and displayed the page with my results, indicated as ‘DONOR DATA.’ She asked me to confirm that they are my results. I said they are mine. After perusing the computer’s records, Ms Akiror told me what I expected: that I tested nonreactive, and therefore negative, for all the diseases and health conditions checked, before clearing blood for transfusion to another person. I learnt that the word 'Eligible' means that the blood is safe to be given to people in need of it. I expected this because I am as chaste as the Pope. I trust myself. I don’t indulge in harmful sexual habits. She informed me that my blood was taken to Bombo Military Hospital, where it was used to save someone’s life. I was very happy to hear this.

 The computer had good news for me, having tested negative of all the diseases and health conditions checked, before clearing blood for transfusion to another person.

Then she asked me whether I know my blood group. ‘No, I don’t,’ I said. ‘Your blood group is AB+,’ she said. I studied about the science of blood groups in primary school, but that was long ago. I needed a reminder of what this meant. She explained that generally, there are four blood groups namely, A, B, AB, and O. That these are divided between positive (+), and negative (-). And that people with either positive or negative can only give or receive blood to, or from people within their bracket. There is no crossing over, unless one is a universal donor or receiver. I was reminded of universal receivers (those who get blood from all blood groups, within their bracket of either positive or negative), and universal donors (those who give blood to every blood group, within their bracket of either positive or negative). AB+ and AB- are universal receivers, within their respective categories, while O+ and O- are universal donors, within their respective categories. But the ABs are unilateral donors i.e. they only give blood to fellow ABs, while the Os are unilateral receivers i.e. they only get blood from within their respective category; they don’t receive from other blood groups. Since I am blood group AB+, this means that if I ever need blood, the doctors will just pick whichever blood is available nearby, without first having to confirm that the sample is compatible with my blood type, as long as it is labelled +.

Interestingly, God is so amazing that He balanced the equation by creating few ABs and very many Os; such that there are few receivers, but many givers. So, since there are very many Os, who only receive blood from themselves, they can easily satisfy their blood needs, and since there are very few ABs, who receive blood from everyone else, they can easily rely on steady blood supply of other groups to meet their needs. There was an extremely important moral lesson here: that the world needs more donors (givers) than receivers (takers). That is why Jesus Christ said that the hand that gives is better than the hand that receives. He was encouraging more people to become givers.

 

 The information about blood groups was very mesmerizing and captivating. It shows on my facial expression. The Darwinists are definitely wrong in thinking and teaching that the world resuted from accident. Everything in the universe is so neatly and purposely organized that it is abundantly clear that it was the deliberate creation of God. Clearly, there is nothing accidental.

Later on, while chatting with another friend of mine, a medical practitioner, I learnt more good (and really funny) news for us people with blood group AB+: that scientists have discovered that people of this blood group, AB+, belong to the lineage of monkeys! Hahaha…. The good news in this is that, assuming that all the people in the world refused to donate blood to us, monkeys would be found anywhere, blood got from them, and transfused in our bodies. Isn’t that nice? It is, for sure. Actually, now I have decided that since monkeys are my blood relatives, I should treasure and guard them jealously. I am very protective of them. I have therefore, declared war on all those who harass and kill them, especially the poachers. I shall not sit idle while my own are butchered by mean, cruel and heartless people! Please, stand duly warned!

 

 After explaining to me the science behind blood groups, Ms. Akiror, filled for me a Blood Donation card, since I couldn't recall where my previous cards were kept. Now I intend to carry my card with me always.

Dear reader, donating blood is quick, painless, and the right thing to do. I encourage you to donate. Just go to any blood bank offices near you, and donate. You don’t have to wait for roadside blood donation campaign drives, in towns. The Blood Bank personnel are very professional and hospitable, with good client care values and practices. They will not disappoint you. This time round, I shall also donate more regularly. Men donate again after three months, and women four, from the date of the previous donation. So, my next due date for donation will be on 21 February 2018.

 

UBTS even sent me a merry Christmas, and Happy New Year's message.

Immediately after donating blood, I took to encouraging my friends on social media platforms like WhatsApp, Facebook, and Twitter, to donate blood. Below, are screenshots of hillarious comments from members of some WhatsApp groups I belong to.

 After someone joked that I was only looking for soda and biscuits, due to hard times, another person proposed that UBTS starts giving beers and roasted meat, after donation, instead of sodas and biscuits.

 

 Joan doesn't like being asked her age, before donating. That freaks her out.

 Someone was concerned that blood donors have to buy blood, when they are in need of it. That's not nice, if true. I can’t imagine buying blood, after donating mine free of charge, many times.