by Warren Hern
The site that Eleanor Roosevelt
Into this mutilated landscape the newly born miner’s child is thrust. The mother, battered by repeated childbearing, struggles against sheer physical exhaustion. Years in the mines have left the father with a chronic cough, frequent chest pain, shortness of breath, and other symptoms of severe lung disease and early heart failure. If he is lucky enough to have a job at all in the mines, he may earn as little as $2.75 a car loaded with 1 to 1 ½ tons of coal; and he loads seven cars a day in a 12-to-14-hour day. The work is dangerous and sporadic. In the smaller mines, he buys his own equipment. There are no fringe benefits. The coal is sold for up to $12 a ton to others, or perhaps slightly less if he buys it to heat his own tumbledown shack. The shack has no running water, sanitation or privacy. When it is available, electricity powers a few naked light bulbs and, if work has been steady recently, perhaps a new refrigerator. Except for a TV and a telephone, which works only occasionally, the refrigerator is the only appliance. For this, the miner pays “so much a month” – perhaps up to four times the real retail price.
To the south of
On a crisp, sunny November
morning, I stood in the littered front yard of a
We had come to
visit one of the poorest families near the unemployment-stricken
A woman finally asked us to come in. she invited us to sit on a tattered sofa in a room otherwise barren except for a pootbelly iron stove and a broken wooden chair. She pulled the chair near the glowing stove and sat down. As we talked, she slumped forward and watched her children listlessly, her arms crossed. She spoke in a monotone. She was 38 years old. She and her husband had nine living children. She was six months pregnant. “I tuck them pills for awhile, but my stumick got to botherin’ me like it did afor I tuck ‘em so I quit for three months. Couldn’t afford ‘em, no how.” Brooks told her that she could get free medical exams and birth control help at the OEO clinic, and she said, “Well, I’ll be down after the baby’s got borned, but ain’t there some way asides a pill?”
from families with all the children they want are commonly heard by Brooks and
his fellow OEO outreach workers in
One man, a seasonally employed garage mechanic, wanted a vasectomy done on himself as soon as it could be arranged. He and his 26-year-old wife have three children. She has also had two miscarriages. She cannot take birth control pills because of chronic kidney disease, high blood pressure, chronic urinary tract infections, and rheumatic heart disease. Other forms ofcontraception have been ineffective or unsuitable for her. Yet she will be risking pregnancy for the next 20 years. Herlast unplanned child was delivered by Caesarean section. Any future pregnancy would probably require a similar operation. Some of their medical bills are paid by public sources, but one more child would plunge them even deeper into debt.
Another woman in
her early twenties, an outreach worker for one of the
As an outreach worker, she has found that many women are in situations similar to hers. She herself was unaware of the possibilities of help before she was contacted by an OEO outreach worker. “I knew that there was a pill, but I didn’t know if I could get it until one of the volunteers came and told me about it.”
A young woman in her late twenties told me that neither she nor her middle-aged unemployed husband, who has had two heart attacks, wants any more children. None of her three children was intended. Her first child was born out of wedlock; the others have been born since she married in 1968. She was using foam and the rhythm method, respectively, when she became pregnant with the last two. They came 13 months apart. Her first thought, she says, when she discovered her last pregnancy, was “…how can I get rid of it?” They live in a cramped trailer house, and she says, “Each one makes it harder on the ones we already got. We couldn’t really afford them, but here they are so what can you do?” She wants to be sterilized and “…would go this afternoon if I thought I could get it done,” but they don’t have the money to pay. Her youngest child is six months old.
A dejected, tobacco-chewing young man shifted nervously in front of a squat iron stove which provided the only heat for his one-room tarpaper shelter. He looked past his 31-year-old wife at one of their seven children, who was screaming and pummeling a younger brother, and said, “I git another I reckon I’ll shoot myself.” Their house burned down two years ago Christmas and he has been unemployed “for a long time.” He takes odd jobs and they get food surplus, but there seems to be no way to get ahead. Their “house” has no running water, toilet, adequate cooking facilities; they have no refrigerator. His wife looks nearly twenty years older than her age. The youngest child is three months old. All the children are anemic and dirty. Two appear to be mentally retarded. The others go to school only when the weather is warm. They have no shooes or warm clothes. The man wants his hernia fixed and a vasectomy done at the same time. “We got all we kin handle.” His wife became pregnant with their youngest child when she ran out of birth control pills and couldn’t afford to buy more at the time. She was recently contacted by the local OEO family-planning outreach worker and has begun attending the clininc, but both she and her husband feel that temporary measures such as the “pill” are not enough to suit their need. However, they cannot afford an operation, which would cost around $100 for the man’s vasectomy or as much as $400 for the woman.
Families like these need jobs, decent housing, a healthy environment, adequate food, clean water, sanitation, and education. OEO health programs, including the 450 projects primarily concerned with family planning, provide a network of services which are meeting some of these individual needs. But one of the most important needs is freedom from the tyranny of their own biology.
WARREN HERN is a physician and epidemiologist on the
Headquarters staff of the OEO family planning program. Views
Expressed here are his own.