The following is an essay by Sarah G. Epstein from Marilyn Hempel’s book, Facing the Population Challenge: Wisdom from the Elders (Blue Planet United, 2014).

What I Would Say to World Leaders
by Sarah G. Epstein

I have spent most of my life as a social worker in the field of family planning, so I am well aware of the advantages of contraception for families everywhere. Now my deepest concern is for the generation of my grandchildren and beyond. What kind of world are we leaving them? With world population today at more than seven billion and still growing, we are already robbing the future of fresh water, oil, adequate farmland, and the joy of untrammeled open spaces. We are already negotiating clogged roads, breathing smog-laden air, and losing somewhere near 100 species of animals and insects every day.

Each new disaster—flood, earthquake, fire—seems to kill and displace more people. And of course, the reason is that there are more people. If these ills are to be overcome, it will only be if there are far fewer people than are now here.

Therefore, our top priority should be to ensure that free contraception is available to everyone everywhere in all cities, towns, villages and rural areas of the world. Trained doctors, nurses and social workers, male and female, should make sure that all the world’s inhabitants learn—through public meetings and discussions—about the health and economic benefits of small families with well-spaced children. Early marriage should be discouraged, and all children (especially girls) should be educated using a curriculum that includes health and sex education, food and nutrition, and ecology. And there should be an emphasis on human rights for all, in order to eliminate religious strictures, especially those that affect women.

I ask all world leaders to emphasize the need for a smaller population, brought about by educated people voluntarily choosing small families and a healthy lifestyle including good diet and exercise.

We live in a far different world than the one in which I grew up. I hope our external electronic brains and technological capabilities will help us reverse the effects of climate change and leave a better world. Only by reducing population to a level where the world can sustain itself can we hope to pass on a stable and safe world to our grandchildren. Endless population growth is suicidal!

Excerpted from Facing the Population Challenge: Wisdom from the Elders. Used with permission of the authors and Blue Planet United.

Sarah Louise Gamble Epstein was born in 1925 in Philadelphia, Pennsylvania, to Sarah Bradley Gamble and Dr. Clarence James Gamble. She attended Germantown Friends School (Philadelphia), Milton Academy (Milton, MA), Wellesley College for two years, Oberlin College (Class of 1948) and Simmons School of Social Work. Since her father, Clarence Gamble, was an advisor to Margaret Sanger, she grew up believing all children were planned and wanted. When she realized this was not the case, she decided to work in the field of family planning. Her father was the founder of Pathfinder International, an organization that pioneered the provision of family planning services.

After a summer in Austria (1949) with the Experiment in International Living, she met Lionel Charles Epstein, a student at Harvard Law School and a participant in the Experiment program. They were married in 1951 and moved to Washington, DC, where they raised five children. She remained active with the Experiment and volunteered with Planned Parenthood, often counseling women in the maternity ward at the City Hospital. She was involved with Pathfinder International, and often traveled abroad to observe family planning programs at work.

She and Lionel were divorced in the early 1980s. She continued to travel and work in the family planning field. She met Donald Collins when he organized a group to go to Vietnam in 1993 to study a sterilization method called QS, which is a safe, sure, inexpensive and non-surgical permanent contraception for women. The QS procedure uses insertions of seven quinacrine tablets into the uterus. When they dissolve, they cause an inflammation inside the opening of the Fallopian tubes that results in a scar that seals the tubes closed. In Vietnam, they found that QS had been successfully used by thousands of women. Studies from around the world report no deaths or life threatening complications. However, after pressure from religious sources, the World Health Organization banned its use or further testing worldwide in 1993.

Shortly after returning from Vietnam, Sally married Don and they began work to have QS approved by the U.S. Food and Drug Administration. The FDA cancelled the Phase III trial for QS on the basis of an unscientific study that the FDA had designed and which overdosed the rats with enough quinacrine to cause cancer. Since then they have been stalled despite numerous meetings with the FDA.

However, they do not intend to give up. Too many women in the world are seeking just such a method so they can easily stop having more children when their families are complete.

Sally stays involved with many other international family planning programs. For example, she has helped Molly Melching, the founder of Tostan, to succeed with her educational program in Senegal where the villagers decided to abandon female genital cutting. The Tostan education program is spreading across Africa and now many more African villages are eliminating the practice.