On ‘Mission Impossible’, this Assam doc uses religious text to propagate health

Dr Ilias Ali has been fighting a war in Assam to accomplish a mission which seemed almost impossible a decade back. But braving all odds, including death threats, Ali has been marching ahead towards that goal with smile.

By Abdul Gani, TwoCircles.net,

Guwahati: Due to the social dogma and superstition, introducing family planning measures has been pretty difficult, especially among the rural Muslims for a long time. But Dr Ilias Ali, Professor of Surgery at the Guwahati Medical College and Hospital, has been able to penetrate the unholy cover with his fearless, continuous efforts.

So far, Ali, 60, and his mission have been able to carry out more than 48,000 No Scalpel Vasectomy (NSV), one of the effective methods of male sterilization, for a large rural populace, most of whom are backward Muslims. Dr Ali is also the State Trainer cum State Nodal Officer, NSV, Assam government since 2009. And since August, 2013 he has also been working as Senior Consultant, Family Planning, National Rural Health Mission (NRHM), Assam.

Born into a cultivator’s family in a village of Darrang district, his village did not even have a primary school. Dr Ali got married to Saira in 1986. Ayesha, his elder daughter, studies in class XI and son Iqbal is in class IX. He also runs a private surgical hospital at Sijubari since 2004 to provide surgical services to the needy people at an affordable price. His family runs a charitable trust, Maleka Foundation, in the memory of his mother since 2009.


Dr Ali takes part in an awareness programme.
Dr Ali takes part in an awareness programme.

He has also travelled to neighbouring Meghalaya to help initiate the NSV programme there. In July 2011, he visited Ratlam (Madhya Pradesh) for an awareness programme. The department of Family welfare, Union Ministry of Health and Family Welfare had invited him thrice (2009, 2011 and 2013) to the National Review Committee meetings at New Delhi to deliver a talk on his innovative mode of advocacy of family planning which aims at overcoming barriers including religious.

Besides, he has also attended ‘NSV workshop’ at Kenya in 2012 as a resource person on the invitation of NSVI, an international organisation of NSV surgeons, based in Florida, USA. He was also the only one from India to attend the first ever ‘World vasectomy Day’ event held at Adelaide (Australia) in October 2013.

In a special interview with TwoCircles.net, Dr Ali explains his mission, what Islam says about family planning and the need for it for a developed India

Q. Using contraceptives or carrying out sterilization is still controversial at some places? What does Islam actually says about it?

A. There is a traditional belief, rather perception, that Islam doesn’t allow family planning. In reality, however, Islamic thought is flexible and quite progressive on reproductive matters. By and large, Islam is permissive of family planning and many Islamic countries have active population and family planning programmes. Here, I would like to say that there is plenty of evidence favouring smaller families in the Islamic holy books.

Islam is in favour of quality of children rather than quantity. Teeming multitudes of underfed, half-clad and uneducated souls cannot be the essence of a true Islamic society. Even an otherwise religious person with several children will find it difficult in abiding by the righteous ways of life as per the strictly laid down instructions of the Holy Quran.

Allah, the Exalted, does not call on his followers to overburden themselves by raising large families simply for material gains, as this could be harmful to their children. Quran says, “Allah desires for you ease; He desires no hardship for you” – Sura 2: Al – Baqara Ayat: 1 8 5. The Quran does not prohibit birth control, nor does it forbid a husband or wife to space pregnancies or limit their number. A verse of Quran ‘wa hamluhu wa fisaluhu selasuna sahran’ means ‘carrying of the (child) to his weaning is (a period of) 30 months’ – Sura 46: Al-Ahqaf Ayat 15. This religious injunction dated back to several centuries, urges families to space their children at least two and half years between two.

The Holy Quran also forbids believers from raising large untenable families. Incidentally, at the dawn of Islam, the Prophet himself had not opposed the methods of birth control practiced in those days, known as ‘Azl’. Even the four great Imams (priest) of Islam had allowed Azl.

Q: So, why does it take so much time to educate people? How did you go about the idea?

A: From monetary point of view, family planning may not be a rewarding subject to a doctor irrespective of caste, creed and religion. Almost all, except very few dedicated doctors, feel engaging in family planning means wastage of time and money. And hence India has failed to achieve the goal of population stabilization, though it was the first country in the world to adopt family planning programme in 1952. Muslim doctors are also a subset of the aforesaid medical fraternity.

Many Muslim doctors, because of their poor religious knowledge, behave like laymen, thinking that family planning is irreligious. Moreover, the doctors with such poor knowledge shy away from learning the facts fearing backlash.

In January 2009, Assam government handed over to me the responsibility to popularise No Scalpel Vasectomy (NSV). We began our work by arranging NSV services, but the response was not encouraging. Some of the participants, particularly from the non-indigenous Muslim community – most of whom are the inhabitants of riverine areas – were even subjected to social boycott. In some areas, the Muslims were not only against male or female sterilisation procedure but also against the use of any form of family planning method including tablets.

I had very little religious knowledge in this field. I was confused: to proceed or to quit? Then I sought out to check if Islam is really against adopting family planning or not. With no option left, I started reading religious books. Ultimately, I found out the truth that there is nothing in Islamic holy texts that goes against regulation of family size. Rather, Islam endorses it.

Q: But convincing people to go for sterilization, barring their religion, is pretty difficult. How you do that?

A: Obviously, India being a patriarchal society and with the social domination of men, the women have no choice but to go for family planning methods all by themselves. Most importantly, since independence, the nation has paid no attention towards Male Reproductive Health. All the efforts and resources have been directed towards Female Reproductive Health only. As a result, the male members of our society not only hesitate to take part in family planning programmes but also fail to seek medical help relating to male reproductive health such as infertility, erectile dysfunction and reproductive tract infection.

Another important point is the legacy of forced sterilisation during mid 70s still persists in the form of misconception and apprehension that vasectomy may lead to impotency and males may become physically weak.


Dr Ali interacting with some religious leaders and local leaders in a rural village of Assam's Morigaon district.
Dr Ali interacting with some religious leaders and local leaders in a rural village of Assam’s Morigaon district.

Q: We know that you have received threats for your work. Have you ever thought of shying away from this?

A: Yes, there have been several instances where we had to face opposition. I did receive threat to my own life and my family members. But I was determined. I never gave up and faced all these threats head-on.

Then there were these fatwas. In June 2010, following a sterilisation camp at Hatsingimary, a remote area of Dhubri district, where 304 people underwent sterilisation procedures, a fatwa was issued by an Islamic organisation of the locality. The edict proclaimed that the people undergoing sterilisation procedure would not be offered the last rites in accordance to religious customs. In another incident at Gohia, Barpeta district, in 2010, many people who had undergone vasectomies were subjected to social isolation, boycotted by their own community members and were barred from attending religious prayers inside the mosques. There were also demonstrations against family planning programmes and excesses committed on allied health workers.

I resorted to religion to counter the religious heads. It’s very unfortunate how religions are misconstrued in our society to suit vested interests. Not just because I am a doctor, but being a socially concerned person, it is my duty to show the path of truth and do my best in reducing the population. I think this is the biggest problem our country is facing at present.

Q: But if such threats or fatwas continue, how will you march ahead?

A: The people are my biggest strength. The only thing they need is to make them aware, make them understand the reality. I never engage security personnel while visiting some of the rural areas during my mission.

Since it is a national programme, I get full support from different government organs, particularly the department of Health & Family Welfare, Assam, to carry out these programmes. I also get help from different social organisations, NGOs, intellectuals, local public, friends and my family. And of course, the media.

Q: Has your wife or children ever asked you to stop work, if there were threats to your life?

A: My wife is a very courageous woman. She never asks me to stop the mission. Even she had accompanied me on several occasions. My children, though they are still young, always encourage me to go ahead with the mission. Even Ayesha and Iqbal have accompanied me to remote places to attend the awareness programmes.

Q: What are the main topics are you focusing at to make people aware?

A: I begin with global and Indian population dynamics and their deleterious impact on the earth and on India. Then I talk on the onus of human beings in protecting of nature and the earth from religious standpoints. After this, I talk on women’s education and empowerment. I also talk about the ill-effects of early and multiple marriages. I also point out the role of breast feeding in birth control. During my talks, I extensively refer to the Holy books particularly the Quran and the Hadith.

Towards the end, I elaborate the different methods of family planning and their uses. I conclude the talk with an appeal to the audiences to start a social movement against population explosion and to those audiences who are eligible for family planning to adopt any method that is suitable for them.


Dr Ali (extreme right) travels to rural part to take part in family planning camps with other doctors and health officials.
Dr Ali (extreme right) travels to rural part to take part in family planning camps with other doctors and health officials.

Q: Are you targeting only Muslims in this mission?

A: Certainly not. The main objective of our mission is to reach out to the people of all communities irrespective of caste, creed and religion. However, more emphasis has been laid upon the Muslims, particularly the non-indigenous Muslim community of Assam. Indigenous Muslims have similar fertility rate as that of Hindus.

Q: Why are you focusing more on non-indigenous Muslim?

A: Socially and demographically it has been observed that in this community there are significantly high rates of illiteracy, poverty and practices such as early marriage, bigamy or polygamy etc. as compared to the general population at large.

Moreover, religious misbeliefs and misconceptions are also widespread. There is also a general belief among them that Islam prohibits family planning. As a result population growth is significantly high in this demographic group.

Q: You spoke about religious believes, fatwas etc. What do Islamic countries do? Do they permit sterilization or usage of contraceptives? Why do you think it is important for the Muslim community to accept?

A: Most Islamic countries have family welfare programmes and several nations in the Islamic world have achieved remarkable success in birth control. As against India’s fertility rate of 2.7, Iran’s rate is 1.88 while that of Indonesia is 2.2 (2009). The respective governments have implemented family planning schemes in a scientific manner and it is noteworthy that the clergy has come out in open support of such policies.

There are shining examples of religious heads campaigning for the robust execution of such programmes. It bears recalling that Ayatollah Khomeini, the late supreme religious leader of Iran, had once issued a religious edict that if a couple has two children and is struggling against odds in raising them, then they are bound by the Shariat to adopt family planning methods.

The Vilayat-e-Fiqh (Council of Islamic Jurisprudence) of Iran was in sync with the Ayatollah and the Ulema was in the vanguard of the noble mission of spreading the message of population control. Iran was the first nation to launch a programme of permanent sterilization of both genders. Iran is also the only country in the world where it is incumbent upon all seeking to enter into wedlock, to undergo counseling in family planning to be entitled for marriage registration.

Indonesia, with the largest Muslim population of any country in the world, has had one of the most successful population stabilisation programmes, far more successful than ours. A major reason for the success was the government’s ability to convince the Indonesian religious leaders that family planning and population control was in national interest.

In contrast in India, poverty, illiteracy, insecurity and inaccessibility to birth control programmes are the root causes for the rampant population growth in the downtrodden sections of the community irrespective of caste and religion. Majority of Muslim population belongs to this group. Among the Muslims, at the bottom-end of the social pyramid; illiteracy, underage marriage, polygamy, poverty and population outburst are not only pervasive but are also inter-related. Among such Muslims, religious dogmas and social taboos are deeply entrenched. High birth rates have accelerated their misery. I believe birth control programmes will immensely help in elevating the social status of Muslim society.


Dr Ali receiving an award in Guwahati for his service in population control.
Dr Ali receiving an award in Guwahati for his service in population control.

Q: What is the impact of population explosion on our country?

A: I sincerely believe that population explosion is primarily responsible for environmental degradation and serious resource crunch what India is facing today. Terrorism, rebellion, communalism, regionalism and social unrest are the by-products of scarcity and unhealthy competition, which are becoming the order of the day. Now such ugly phenomenon has terribly shaken the very foundations of unity and integrity of our country and they are pushing it relentlessly towards the brink of anarchy.

Q: India had started family planning programme way back in 1952. But there has been rapid population growth. How to face this challenge?

A: Undoubtedly, the control of population is the primary responsibility of Union Health and Family Welfare Department but my feeling is that stabilisation of population is a herculean task and it is quite impossible to control the population without mass involvement.

I believe, first of all every citizen, policy maker, intellectual should realize that population explosion is the greatest threat to India today and it is the primary determinant of our future. Earlier, population was regarded as one of the most important resource of the country, but unfortunately this human resource comprising unhealthy, underfed, uneducated and unskilled population has become a Frankenstein for us. India should pay more attention to keep this monster in check.

Related:

Awareness on birth control in Assam’s Hailakandi

Bid to control population: Assam doc Ali to represent India at World NSV day in Australia

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