Mass Sterilisation in India flouts all existing standards

P Ravi

Chhattisgarh, Nov 12: Human life has yet again proved to be insignificant in the bigger scheme of things in India. Around 11 women died and several others were left in critical condition during mass sterilisation surgeries done at government-run mobile health clinic in Bilaspur district of Chhattisgarh. 83 women were operated in six hours’ time by one doctor who had two assistants in a mobile clinic. It is not unusual for rural India, where several such horrific incidents had happened in the past, when the minimum standards of hygiene and surgical procedures and pre and post medical attention were grossly neglected.

The women who were operated at Chhattisgarh as a part of health camp developed complications, and when eleven of them died, the others were shifted to various hospitals. And some local health officials were dutifully suspended. Dr RK Gupta, the surgeon who performed the operations (wonder if he was just adding the numbers to his biodata) obviously is not to be held responsible; as the onus of ensuring post-operative care has long ceased to be the prerogative of the specialist surgeons. ever mind the camp and the doctors that flouted every rule in the book!

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“This is devastating news and is certainly shocking to hear, but we cannot say we are totally surprised by this,” said Kerry McBroom, director of the Reproductive Rights Initiative at the Human Rights Law Network in New Delhi. “It was almost inevitable, given the unsafe, unethical and unhygienic conditions that persist throughout India in these camps,” he told CNN, a television channel. “You might find that there is no electricity, there is no running water and not enough staff in these facilities. They won’t have things like blood, in case someone haemorrhages. … they won’t have enough gloves or aprons,” she said. “Women will go to the facility wearing their clothing and remain in that facility until they go. So there is no attention paid to basic prevention.” Hundreds of people have been killed during sterilization, McBroom added, citing government data on pay outs to victims who have died.

One does not need to look much into the past to revisit the horrors of unsystematic sterilisation programmes in the country. In February, 2013, 106 women were sterilised in a single day by two doctors at a state run Manikchak Rural Hospital in West Bengal. After the surgery, the women were left to recover in the fields outside and the car park, while the minimum monitoring required for sterilisations is atleast three hours. Many of them who were left in the open fainted out of pain; a few were ferried off in rickshaws. One such patient fell off the rickshaw and had to be rushed back with critical injuries. There were obviously no facilities in place to fight infection. No one remembered the basic rule of not more than 25 sterilisations per day. When the incident was reported in the media, there were the usual suspensions.

At this point, one cannot help but remember Sanjay Gandhi, infamous for his mass sterilisation programmes during emergency that was declared in 1975. He was the most powerful man after Indira Gandhi during the period and he was of the view that population is the major problem plaguing India; which is true. However, forced sterilisations of both men and women during his time, made him extremely unpopular.

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Today, it is not the case of forced sterilisation. However, with misplaced enthusiasm to hike up the number of sterilisations and to boast the maximum percentage of population control, the health officials of rural India and even urban health care centres come up with innovative schemes. One official in Rajasthan, in 2011, had even offered a Tata Nano car for the lucky one, in addition to motorcycles and cycles. He hoped atleast 20,000 would show interest in getting sterilised, lured by the incentive. There is a government hospital in Hyderabad that promises a steel water pot along with some money for every woman who gets herself sterilised. Eventually it is all a number game and rights of individuals and safety of surgical procedures and health care take severe beating as a part of this game. India did abolish target and incentive based population control in the mid-1990s, at least in principle. And on various international forums, the country boasted of making contraceptives available at the doorstep and steer away from target-based sterilisation programmes, which are anything but violation of human rights of the rural poor; unlike the urban women who choose their contraception and informed choice is why they choose sterilisation.

It is ironic that even though sterilisation is an accepted form of birth control, it is only the women in India who are offered the incentive, while men do not get financial sop for getting a vasectomy done, atleast not as attractive as when a woman does tubectomy. So, obviously poor women are more inclined to take up the operation; more so, the myth of becoming impotent after vasectomy is what prevents men to undertake the operation, despite it being much safer and simpler than tubectomy.  A report published in TOI in 2003 says that 2.1 percent of the total number of government sterilisations is done on men.

We know where we are lacking, we known what needs to be done; however health care is the most abused and manipulated in India. And, the poor and the uneducated rural Indians take the brunt of government negligence.

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