CHAPTER TEN

DEMOGRAPHIC IMPACT OF THE PROGRAM

 

It is difficult to get an accurate demographic picture of the Akha population.  There are logistical problems (getting to all the villages, and getting there when the villagers are home), and cultural problems (they wonder why all these questions are being asked).  Perhaps the biggest problem is the transience of so many families and villages.

 

                                                                                                            Ba Jaw Village

 

I have made a demographic study of a village I call Ba Jaw (not its real name), gathering data first in the fall of 1974, and again in mid 1977.  Data from a single village will admittedly give an incomplete demographic picture, but by combining it with samplings from a wider selection, certain patterns can perhaps be discerned.

 

Ba Jaw is situated in the midst of several other Akha villages.  I have returned numerous times since my first visit in 1969, thus observing change over a period of eight years.  At the time I first chose it for study, it was looked to by most Akhas in the area as the village that would represent them in dealings with government and other groups.  This was due to certain historical factors, as well as to the village leadership.

                                                                                                                                                                                                                        p.185

Figure 6 (page 186) gives an age pyramid showing the population of the village in November 1974.  This can be contrasted with Figure 7 (page 187), which shows the same village in mid 1977.  This is too small a sampling, and too short a time to give a clear picture if taken by itself, however.

 

In November 1974, the population of the village was 175.  By mid 1977 thirteen more children had been added to the population, and five young women had entered the village by marriage., thus adding a total of eighteen to the population.  During the same period of time there were four recorded deaths (three males, age 6, 57, 68, and one female, age 8), three females moved out of the village (ages 52, 25, and 18), and one girl married into another village.  This makes a total of eight who left the village or died during that period of time.  The population was 185 in mid 1977, representing a growth rate of around 1.5% per year over this three and a half year period.

 

Nine women in the village received tubal ligation during this time.  Two of these women had been on oral contraceptives before having sterilization.  Another woman had been on pills and then changed to injections, but she left the village before the second survey.

 

Figure 6: Age pyramid of Ba Jaw village November 1974  [graph]                                                                                                                            p.186

Figure 7: Age pyramid of Ba Jaw village Mid 1977 [graph]                                                                                                                                      p.187

                                                                                                                                                                                                                        p.188

Of the females between 15-44, there were a total of eleven who were unmarried (eight of them not yet nineteen), thirty-four who were married, and two who were widows.  Of the women who were not married in this group, two were deaf mute. (For more information on the village see Table 9, page 189.)

 

                                                                                                Population Sample

 

In accordance with a plan formulated early in the program, I took a census of seventeen Akha villages in June and July of 1977.  These represent most of the larger Akha villages in Thailand, so that even though there is a total of 117 Akha villages the population in these seventeen villages is 4,715, which comprises about one-third of the total Akha population living in Thailand.

 

Four Akha men helped get these data.  They went out in pairs, with an older illiterate man going with a young literate man in each case.  The two older men were well known in the villages to be studied, and thus could win the acceptance of those we wished to survey.

 

The seventeen villages in this census average 277.4 members, whereas the average Akha village has around 120 members.  The villages represented a sampling of northern, central, and southern  regions where Akhas live.  No villages were included from the extreme west or from east of the Chiang Rai-Mae Sai highway.

                                                                                                                                                                                                                        p.189

Table 9.  Comparison of Ba Jaw Village, November 1974, mid 1977

                                                                                                                                                                                                                        p.190

About 75% of the population in the village sample was served by the Akha field worker, whereas he had never been to the remaining 25%.  The percentage he contacts within the sample somewhat exceeds the 60% of all Akha that he visits in Thailand.  Thus the sample is slightly weighted in favor of thosewho have received information concerning contraception.

 

There were about four households that refused to give information about their families to the census takers, and one household that was away at the time.  I made spot checks in four of the villages where the men had completed the census.  There were a few discrepancies regarding the age of some of the elderly people, since they knew the name of the year in which they were born, but they were not always sure of which cycle it was.  For example, a woman claiming to be 82 might be just 70 years of age.  For the most part, however, I believe the figures the men compiled give a good picture of the population.

 

Figure 8.  Age pyramid for Akha sample (mid 1977) [graph]                                                                                                                                   p.191

 

Figure 8 (page 191) is an age pyramid of this sample of 4,715 Akhas in seventeen villages.  It appears to agree with the evidence from Ba Jaw village, in that it shows a drop in the composition of the 0-4 year age group.  In a population that was not using any contraceptive methods and had a high growth (and death) rate, the 0-4 year age group would represent nine or ten percent, instead of the 7.2% shown on both the male and female sides here.  Under ordinary conditions, the 0-4 year age group should be much larger than it is  Does this mean that perhaps contraceptive methods are helping to change the demographic picture"  It is certainly inconclusive to say either way at present, but in order to analyze this larger picture with more understanding, let us return to the micro study of Ba Jaw village to see what parallels there might be:

 

1) Eleven women in Ba Jaw village have accepted contraceptive help during the course of the program, including nine who have been sterilized.  This has contributed toward reducing the birth rate of the village. (Compare the demographic profile of Ba Jaw village with the profile of the larger population.)

 

2) There has been a high rate of opium addiction in Ba Jaw village despite the attempts of some of them to detoxify.  This also may have depressed the birth rate.  One woman twenty-five years of age left her addicted husband and their two sons to go somewhere south of Bangkok, and later took an eighteen year old girl with her.  The husband has not remarried.  Another addicted man thirty-nine years of age has been married five times, but was single throughout the period of this program.

 

3) There are six men in the village (five of them married) who serve part-time with the Border Patrol Police.  Ten nights a month they stay in the BPP barracks in a nearby village.  They are occasionally called out at other times, which means they are often away from home.  This may also have effected the birth rate.

                                                                                                                                                                                                                        p.193

Keeping these factors in mind, let us turn to the sample of seventeen villages comprising one-third of the total Akha population in Thailand.

 

1) Many of these women have also taken part in the family planning program.  The rate of contraceptive acceptance is not high (somewhat less than 20% of the married women of reproductive age have been sterilized or are using some contraceptive aid), which probably means that there are other factors involved which causes the 0-4 age group to decrease in this manner.

 

2) The role of opium addiction in the demographic picture is difficult to assess due to its complexity.  Physiologically opium use inhibits sexual activity.  At the same time, addiction may create such percarious dependence that the husband is reluctant to let his wife go for sterilization, or such poverty that they are unable to pay for oral or injectable contraceptives, so that in the long run opium addicts do not take advantage of contraceptive service as much as non-addicted couples do.  Using data from the field worker's reports, I separated the villages with heavy opium addiction from those with light addiction for purposes of comparison.  I considered a village to have heavy addiction when the number of addicts equaled 75% or more of the total number of households in the village.  I considered a village to have light addiction if the number of addicts equaled 25% or lessof the number of households.  For example, in a village with twenty households, if there are fifteen or more addicts, it is considered a highly addicted village, whereas if there are five or less addicts, it is considered a lightly addicted village.  I discovered that there tend to be more births per 1,000 in heavily addicted villages than in lightly addicted villages (although it is not significant at a p = .05 level).  At the same time there is a higher death rate in the villages with higher addiction, so the natural rate of increase is almost the same. (See Table 10, page 195.)

 

3) Polygynous Unions in the villages are a factor which I did not see in Ba Jaw, so I was not alert to the significance of this until I found that 9.1% of all of the married women of reproductive age in the survey are in a polygynous union.  The slightly decreasing number of offspring per woman caused by such union would not of itself account for the drop in the 0-4 age group, but it may be a contributing factor (Dorjahn 1958).

 

4) There may be a larger number of widows who are not remarrying.  In the seventeen villages examined, 3.5% of the women between the ages of 15 and 44 were widows (see Table 11, page 196).  This is not a large percentage, especially since there are those of the number who will no doubt eventually remarry.  The remarriage rate may be down somewhat, however, because Akha women tend to avoid marrying opium addicts, and so many of the eligible men are addicts.

 

5) There may be sampling error that would cause the 0-4 year age group to be smaller.  For example, if there were a child still unnamed that had been born recently in an Akha house in one of the villages, the household head would probably not mention that child to census takers.

 

Table 10.  Comparison of Villages where Addiction is Heavy and Light                                                                                                                    p.195

Table 11.  Akha women 15-44 in seventeen villages                                                                                                                                               p.196

 

Table 12 (page 197) contains data from the survey of seventeen villages which are pertinent to the total demographic picture.

Table 12.  Demographic facts related to Akha sample                                                                                                                                           p.197               

 

                                                                                    Comparison with Other Populations

 

                                                                                          Comparison with the Thai

 

Hogan (1977) made a study of the "Fertility and Family Planning Profile of the Hill Tribe People of Northern Thailand" in 1977.  The team, consisting of staff members from Chiang Mai University, interviewed a random sample of 1,921 ever-married [sic] Thai women aged 15-44 residing in 205 villages in Chiang Mai and Chiang Rai Provinces.

                                                                                                                                                                                                                        p.198

Through translators the team also interviewed 97 women (from sixteen villages) "belonging to one of the Hill Tribe ethnic groups resident in the Chiang Mai and Chiang Rai Changwats" (1977:1).  Husbands of 84 of the women were also interviewed.  Hogan does not tell us which tribe it was.  From the responses I would presume they were Lahu.  Table 13 (page 199) gives a comparison of the "Hill Tribe" group with the Thai that were investigated. {footnote 2: Why Hogan calls it a "profile of the Hill Tribe People of Northern Thailand" is not clear, since only 4.8% of the respondents are tribal, and obviously not all of the tribes are included.}

 

Hogan concludes that,

            The reproductive potentials of both populations remain quite high with about ninety percent of each group classified as fecund.  The Thai women more    effectively control their fertility potential through the practice of contraception (1977:4).

He further states that since the Thai practice contraception at twice the rate of tribal women, they have less than half the fertility of the tribal people.

 

                                                                                    Comparisin with One Lahu Village

 

It was not possible to get extensive data on Lahus at the end of the program.  However, I was able to get an educated Lahu friend now living in Goshen, the largest Lahu village in Thailand (on the road going up to Wat Doi Tung), to give me a complete list of the persons in every household in the village.  This is quite a typical pyramid for a population which is growing very rapidly, and has no family planning aid.

 

Table 13.  Comparison of tribals and Thai in Hogan's survey                                                                                                                                   p.199

 

The enigma is that at the time of the census there were twenty-four women who had had sterilization.  Two of them had had the operation in 1961 when they lived near Kengtung town in Burma, the rest during our program.  Eight of the women had been sterilized shortly after giving birth to a child during the year under survey, so although they are part of the reason for the forty-six births during the twelve months prior to the survey, they will no longer be producing children.  A few women are on pills or injections as well.  What makes the major difference in their demographic profile as compared with the Akhas?

 

Figure 9.  Lahu village of Goshen (mid 1977)                                                                                                                                                         p.200

                                                                                                                                                                                                                        p.201

In Table 14 (page 202) this population is compared with all of Thailand, as well as my sample of 4,715 Akhas.  It must be remembered that the Lahu sample is very small.  Even so, if the forty-six births for the year are computed for the number of births per 1,000 population, it gives a staggering Crude Birth Rate of 69 per 1,000 per year.  There were only three deaths in the past year, which would give a Crude Death Rate of about 5 per 1,000 per year.

 

Table 14.  Comparison of three populations                                                                                                                                                          p.202

 

This village, located in the midst of several Akha villages, has several characteristics different from the Akha population:

 

1) There is no opium addiction in the village.

 

2) There is a higher degree of education, with more knowledge of health, hygiene, and nutrition.

 

3) It tends to be a young population, since most of the inhabitants have migrated from Burma within the last five years, although this would probably be true of roughly 15% of the Akha sample.

 

4) The headman has a pickup truck he uses to take seriously ill people (including women having difficult labor) to a hospital.  He also is quite skilled in dispensing medicine.

 

5) the Lahus do not live in extended households for the most part.

 

6) There is less frequent divorce among Lahus.

                                                                                                                                                                                                                        p.203

7) There is a large school in the village where many of the children study under Thai teachers.  In the evenings some of the young adults study as well.

 

There is a chance of sample error, but the man who made the census has done this type of work before, and did an excellent job.  The fact that he lives in the village and knows many of the people intimately also helped.

 

Some of the factors listed above should make for a decreasing population, whereas others of them may have the opposite effect.  All that can be said now is that the demographic profile is not clear.  Within five to ten years it should show the same change as the Akha profile is now showing.

           

                                                                                                            Conclusion

 

Three and a half years is not a long enough period on which to judge the degree of acceptance of the family planning program by the Akhas, or to measure the demographic impact.  The following factors are apparent, however:

 

1) The knowledge of contraception has diffused to over half of the Akha population in this period.

 

2) Reversible and irreversible methods have been accepted by many Akha couples who probably would not have engaged in contraception if this program had not been started.