#dnaEdit: End the horror

The latest horrors of botched tubectomy operations in Chhattisgarh dredge up sinister memories of Sanjay Gandhi’s notorious sterilisation drive during Emergency. Twelve women died and 50 were hospitalised, half of them in a critical state, following mass sterilisation operations at a government camp in Chhattisgarh’s Bilaspur district. Depressingly, this narrative of government and medical callousness repeats itself across India, revealing over and over how dispensable the lives of the underprivileged — particularly  women — continue to be, in India. 

Earlier this week, a total of 83 underprivileged women underwent laparoscopic tubectomies in a state-government run sterilisation camp in Bilaspur.  In violation of every medical guideline in the rulebook, Dr RK Gupta — single-handedly — conducted over 80 operations with simply one surgical instrument, and in just five hours. 

Consider the extent of these violations:  medical regulations do not permit more than 30 laparoscopic tubectomies in a single day. The operations need to be conducted with three separate laparoscopes — in other words — a single instrument can be used only in 10 tubectomies. And as mandatory in any surgery, each instrument needs to be thoroughly sterilised before and after every operation. But these guidelines are merely on paper. On the ground, particularly away from the media glare in metropolitan cities and abetted by the wink-nudge policy of political leaders, doctors routinely violate the basic rules. 

Notwithstanding the criticism from experts against target-driven and gendered sterilisation, state governments — across the board — continue with their covert and overt strategies — camouflaged as ‘incentives’ — to make underprivileged women to submit themselves to messy sterilisation procedures. 

Rewind to August 2010 and the Madhya Pradesh Chief Minister Shivraj Singh Chouhan’s praise for Sanjay’s sterilisation drive. Speaking at a function, Chouhan then said, “After the Emergency the leaders abandoned population control completely. One remembers Sanjay Gandhi in these times. The programme that he started is praiseworthy”.

Last February, 100 women, were sterilised in a single day by two doctors at a government hospital in West Bengal’s Malda district. Later, the women were dumped in open fields, without receiving any post-surgery medical attention. 

Remember, India has already agreed to the The Cairo Plan of Action, adopted two decades ago, which called for civilised reproductive choices instead of forced target-driven sterilisations. Recall that the population policy India adopted in 2000, mandates a target-free approach to stabilise population. It’s important to return to the 2005 Supreme Court ruling on sterilisation services, in this context. The Court had asked the government to constitute committees at state and district levels to investigate post-operative complications. Besides prescribing qualifications for doctors who can perform sterilisation, and besides laying down that only empanelled private and government hospitals can perform the procedure.

That women bear the burden of India’s population stabilisation programmes, should be a matter of grave concern for any civilised nation. The majority of mass birth-control programmes operate by controlling female fertility.

Even when vasectomy (a surgical procedure for male sterilisation) is a far more simple surgery, more women instead of men, are routinely sterilised. Male sterilisation is still not socially accepted in a patriarchal society like India.  According to estimates, 37% of all married women in India are sterilised. In 2011-12 alone, the government put the number of women who had undergone tubectomy, at 4.6 million. 

The ghastliness of the Bilaspur incident is one more blot on India’s claims to modernity and progress. It’s not enough for the Chhattisgarh government to penalise the doctors concerned. The health minister must own up responsibility for this terrible mess. Last and not least, governments must stop playing with the lives of the poor.