NEW DELHI // Eight women have died, and at least 50 more have been hospitalised as a result of a botched state-run sterilisation programme in central India.
Government doctors ran a free sterilisation camp in the district of Bilaspur, in Chhattisgarh, on Saturday, performing laparoscopic tubectomies on 83 women, as part of India’s drive to check its population.
But many of the women – nearly all of them from villages – fell ill in the days afterwards, reporting nausea, respiratory trouble and falling blood pressure. Officials said on Tuesday that autopsies would be required to determine precisely what went wrong in the procedure.
The three government doctors who performed these operations – all in a matter of just five hours – have been suspended. The government has promised a compensation of roughly 200,000 rupees (Dh12,000) to the families of each of the victims.
But underlying this tragedy are the flaws in the sterilisation programme, which have been criticised frequently.
“These women have become victims because of the target-based approach to population control,” said Brinda Karat, the leader of the All India Democratic Women’s Association.
Sterilisation campaigns in India first gained notoriety in the 1970s, particularly during the two-year Emergency imposed by then-prime minister Indira Gandhi, when men were coerced into having vasectomies.
The government later changed tack, offering incentives to women to undergo sterilisation procedures. Today, women receive anywhere from 600 to 1,400 rupees from the federal government if they agree to be sterilised. State governments further sweeten the offer, even throwing home appliances into the offer.
But these incentives, especially when offered to poor women, have been likened to a softer form of coercion.
Ms Karat said that state governments set and pursue unofficial targets for the number of sterilisations performed every year – a practice that can also encourage doctors to push women into agreeing to the procedure.
“Health workers who miss sterilisation targets because they give proper counselling and accurate information about contraception risk losing their jobs in many parts of the country,” Aruna Kashyap, a women’s rights researcher at Human Rights Watch, said in a report two years ago.
The Human Rights Watch report included testimony from a public health worker that illustrated the pressure to hit sterilisation targets.
“They shout at those who have not fulfilled their targets during meetings,” the worker said. “It’s humiliating. They say, ‘If others can achieve the target, why can’t you? You must know some women? You must have relatives or some contacts after working in the villages? Use them and get women operated.’”
Even international aid money has been poured into such campaigns. Britain, for instance, gave £166 million (Dh968m) for India's sterilisation programme, according a report by the London Observer in 2012.
As a result, India has among the the highest rates in the world of sterilisation among women. The government’s most recent national family health survey, conducted in 2005-06, found that 37 per cent of married women between the ages of 15 and 49 opted for the procedure.
In 2011-12, the last year for which statistics are available, 4.6 million Indian women were sterilised – a sharp rise from the half a million sterilisations in 2008-09.
But the campaigns have caused numerous deaths due to procedures that went wrong. The previous Congress party-led government revealed in parliament two years ago that it had paid compensation to the families of 568 women who had died as a result of sterilisation operations between 2009 and 2012.
Other controversies have also dogged the campaigns. Rumours have circulated, for instance, that women are sometimes told that these operations will only enhance their reproductive well-being.
In January 2012, three men posing as sterilisation doctors were arrested, after they had performed surgeries on 53 women in a town in Bihar.
Later that year, in the state of Madhya Pradesh, the wife of a labourer bled to death because doctors had failed to realise that she was pregnant with twins when they performed the sterilisation procedure.
In December 2012, researchers from the University of Portsmouth and the Mumbai-based International Institute for Population Sciences published a paper in the journal International Perspectives on Sexual and Reproductive Health, in which they found evidence of considerable numbers of Indian women experiencing “sterilisation regret” after undergoing the procedure.
Key reasons, the researchers said, included the “quality of follow-up after the procedure and women’s involvement in decision making about their sterilisation”.
ssubramanian@thenational.ae
