Champion of women’s health and rights who rejected the expected domestic life

One hot August evening in 1947, an 18-year-old girl stood in the high commissioner of Pakistan’s compound, handing out soap and lavatory paper to a queue of women.

The creation of a new republic of Pakistan had forced streams of Muslims off the bloody streets of Delhi and into the safety of the commissioner’s estate and Nafis Sadik, who was training to be a doctor, had taken it upon herself to check on their health. So when a pregnant woman was rushed through the doors it was Sadik who delivered the baby, using water heated from a woodfire, a lantern and a sterilised razor. It was the first time she had deviated from working on dissected frogs.

She had arrived in Delhi with her family the week before when her father,

Muhammad Shoaib, a Muslim economist who represented Pakistan on the Joint Properties Commission, was summoned from their home in Calcutta. For the next two weeks they would remain on the commissioner’s estate, living off the rations sent by Jawaharlal Nehru, the Indian prime minister, and by October they set sail for Karachi, the capital of Pakistan and their new home.

She was born Iffat Nafis Shoaib in 1929, when her family lived on a large estate in Jaunpur in British-ruled India. Her mother, Iffat Ara Shoaib, was a housewife. Her father went on to become finance minister of Pakistan and later served as vice-president of the World Bank in Washington.

As a girl she had a private tutor and was forever accosted by marriage proposals, which her father was liberal enough to fend off. At 13 she announced that she wanted to volunteer to teach English and poetry at the local orphanage, waking at 5am and leaving in a chauffeured car.

At the convent school Loreto College, amid mostly Hindu, Jewish and Protestant students, her rebellious streak flourished; she got into trouble in ‘‘moral science’’ for challenging the teacher’s view that marriages were divine. ‘‘Marriages are not religion . . . they are not made in heaven. In my religion, divorce is allowed,’’ was her brisk reply.

Still, she was an assiduous student. She sang in the choir, learned classical Indian music and performed in plays. She became a champion badminton player, representing her university and eventually Pakistan in international competitions.

Yet when it came to choosing a respectable career path she was hesitant to stay on track. ‘‘I considered many professions; becoming a tennis pro, a singer, an engineer,’’ she recalled in Champion of Choice, a biography by Cathleen Miller. ‘‘Engineering wasn’t going to change the world . . . I remember vaguely thinking, ‘I’m going to help the poor.’ ’’

Her father supported her and when her science results ranked her as one of the top students in India, she used the scholarship money awarded to her to buy tennis rackets for the entire family.

At Calcutta Medical College she was one of only 10 women accepted, versus 200 men, and one of only two Muslim women. She later received a doctorate in medicine from Dow Medical College in Karachi, before completing an internship in gynaecology and obstetrics at City Hospital in the US.

In 1954 she married Azhar Sadik, a major in the Pakistani army and later an oil executive, in Washington. When he returned to Pakistan she accompanied him and worked in women’s and children’s wards in military hospitals. In their domestic life it was Azhar who assumed the responsibility of running a household of five young children, even though they had servants. He died in 2011 and a daughter,

Mehreen, died in 2015, but Sadik is survived by a son, Omar, and three daughters.

Sadik’s interest in family planning was piqued when she expanded her obstetrics work into poor rural villages in Pakistan. She saw mothers living in squalid conditions bearing as many as 15 children, often at the expense of their own lives.

‘‘I found that when you told women, ‘You must plan your next birth at least two years later,’ they would say: ‘Not for me. I must have a son,’ ’’ she said. ‘‘They were so anaemic, so ill – and yet they had no control over their lives.’’

There were no family planning services in 1950s Pakistan so Sadik started a programme and asked her commanding officer for money to buy contraceptives. ‘‘He nearly fell off his chair,’’ she remembered, but he agreed.

In 1963 she went to Johns Hopkins University to study public health and health planning and the following year helped to orchestrate Pakistan’s five-year family planning programme. By 1970 she was director-general of Pakistan’s Central Family Planning Council. ‘‘I say with certainty that regardless of country or culture, no woman wants a baby every year,’’ she declared.

Yet Sadik was also conscious of the other extreme and argued that repressive government edicts on birth quotas, such as those in China, were both inhumane and ineffective, believing instead that women’s reproductive rights were the key to population control.

In 1987 she was appointed executive director of the UNpopulation fund, the first woman to lead a weighty United Nations agency, with a staff of 800, a budget of US$300 million, and a surging world population (in 1990 the agency estimated three babies were born every second).

In 1994 Sadik presided over 20,000 delegates at the International Conference on Population in Cairo, at the end of which 179 nations signed a 20-year agenda for stemming population growth. It sought to make family planning services more widely available and set targets for improving educational opportunities for women and children, as well as for cutting rates of infant and maternal mortality.

Sadik received death threats from the Muslim community and her plan was strongly opposed by the Vatican. She also raised awareness about subjects that for years had been taboo at international conferences filled with diplomats, particularly female genital mutilation.

Sadik later worked as the UNsecretarygeneral’s special envoy for HIV/Aids in Asia and the Pacific. In 1995 she sat between Hillary Clinton and Madeleine Albright at the World Conference on Women. A year later The Times ranked her as one of the world’s 100 most powerful women.

obstetrician and women’s rights campaigner b August 18, 1929 d August 14, 2022

‘‘Engineering wasn’t going to change the world . . . I remember vaguely thinking, ‘I’m going to help the poor.’ ’’