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Your support makes all the difference.Dr Tim Black was a visionary pioneer of family-planning who founded Marie Stopes International and served as its chief executive from 1976 until 2006. Black was a man of action and had little time for those that wanted "to talk" about issues. Consequently, he antagonised many and encountered countless pitfalls, but MSI became a global success. He was fond of quoting the mantra that "the best committee is made up of two people – with one away sick."
MSI has gone on to help more than 100 million poeple worldwide, providing contraception and safe abortion services while turning over more than £213 million. Black co-founded the organisation, buying the lease with his wife Jean and friend Phil Harvey in 1976, after the Marie Stopes Foundation had been declared bankrupt. They transformed it into a "social business", established to turn a profit and to develop family planning services in developing countries.
Black carried out more than 15,000 vasectomies – he performed one on live television in 2005 – introduced a "morning after" procedure in the late 1970s, and then, in 1997, pioneered "lunchtime" abortions performed under local anaesthetic in an hour for £285. More than 7,000 women used the two centres in the first year, but Black was accused of trivialising abortion, receiving flak from the Catholic church and pro-life campaigners. "Women don't lease their bodies from the state or even from the Church," he retorted. "They own them." This was his raison d'être. He condemned those preoccupied with making women "climb over fences and do backflips" for wanting to exercise their rights under the 1967 Abortion Act.
With his sometimes controversial high-profile publicity campaigns, Black wanted to shake up family planning and reproductive health care and bring it out into the mainstream. He wanted those using their services to be treated like customers rather than patients. This he succeeded in doing. By 2012, MSI provided family planning and reproductive health services including contraception, screening, pregnancy testing, abortion and sterilisation through more than 600 centres, 2,900 social franchises and 370 mobile clinical teams in the 38 countries where it works. MSI today provides modern family planning methods to around 15 million women globally.
Born in Sussex in 1937, Black found his soulmate and future wife, Jean Carter, in the village they grew up in. Both enjoyed travelling and, after Black qualified in medicine they married in 1962, travelling to Harare in Zimbabwe, where Black was a house doctor; here he first encountered extreme deprivation, particularly poverty-stricken mothers.
Black returned to the UK and completed his studies while working as a senior house officer and registrar at Croydon General and Harefield hospitals, his wife working as a medical secretary at Queen Mary's Hospital in Carshalton. In 1966 the couple drove and sailed their way to Papua New Guinea, where Black took the reins of a hospital and 10,000 square miles of bush. Here his life changed for good.
One day a malnourished mother and her baby arrived at the hospital. Black operated and saved the baby, but upon presenting the mother, who was widowed with four other children, with her baby, his elation turned to shock at the despair etched on her face.
"I suddenly realised that I had presented her not only with her baby, but with another mouth to feed – another dependent human being to whom she could offer nothing, merely the cruel ritual of her bare survival. She had wanted the baby to die, not live. It was at that moment that I began to realise that preventing a birth could be as important as saving a life."
Black returned briefly to the UK and earned a Diploma in Tropical Medicine and Hygiene before taking a Masters in population dynamics at the University of North Carolina in 1969. He and Phil Harvey, a fellow student, began selling condoms via mail order, advertising in over 300 college newspapers with the slogan, "What will you get her this Christmas – pregnant?" They could have been arrested; such marketing was legally contentious in the US.
The campaign, however, was a success, and all profits were used to establish Population Services International, offering family planning services in the world's poorest countries, their first project being in Nairobi, Kenya.
Back in London, in 1976 Black saved the ailing Marie Stopes Clinic, which had begun life in 1925 as the Mothers Clinic, founded by Marie Stopes, buying the central London lease and quickly turning its fortunes around. As the enterprise grew, clinics opened overseas, first in Ireland, then in Sri Lanka and Kenya. He generally worked and met colleagues in his shed at the bottom of the garden, except on Fridays, when he performed vasectomies at the central London clinic, while his wife dealt with the constant meetings.
Vasectomies had become more popular and profitable, particularly since an eye-catching publicity campaign featuring an apparently pregnant man and the slogan "Would you be more careful if it was you that got pregnant?" All the money from the UK clinics was used to establish family-planning clinics overseas. During the 1980s, with Mozambique embroiled in civil war, Black established services in a refugee camp across the border in Malawi, providing sexual and reproductive health when the camp had over 250,000 people in it.
In the 1990s, MSI's services were called upon during the Balkan conflict. Black suggested to the government that counselling services could help those women dealing with pregnancies caused by rape; within a year he had opened 67 centres and even managed to persuade Marks & Spencer to donate 100,000 pairs of panties after clients complained of a shortage.
He recalled with amusement that the success of MSI had all been done on the fly. "We never had a business plan. Still don't. They're too inflexible. If we had put it all down on paper it would have seemed too daunting." Black collapsed and died near his home following a walk in a nearby wood.
MARTIN CHILDS
Timothy Reuben Ladbroke Black, physician: born Sussex 7 January 1937; CBE 1994; married 1962 Jean Carter (two daughters); died Lower Beeding, Sussex 11 December 2014.
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