The death of 13 women at a state-run sterilisation camp in Chhattisgarh underlines flagrant violation of rules on implementing population stabilising campaigns as well as inadequate monitoring of such projects by health authorities across the country.
Although the coercive campaign spearheaded by Sanjay Gandhi in the 1970s has been replaced with a voluntary policy that promotes education of women and healthcare rather than demographic control, the Indian sterilisation programme remains deeply flawed, experts say.
For instance, the surgeries in Chhattisgarh were conducted in violation of a 2005 Supreme Court ruling that said a medical team could conduct only up to 30 surgeries a day with two separate laparoscopes. And, a doctor could do no more than 10 sterilisations a day.
But in Chhattisgarh, a lone surgeon performed 83 operations in less than 5 hours, showing that these operations were not done under standard protocols.
Official guidelines also say that all sterilisation camps must be organised in government facilities. The Chhattisgarh camp was organised in a private charitable hospital which had been closed for a year now. Media reports said rusty scalpels and tools were used and some of the medicines administered could have been spurious.
“The systemic failures which led to this incident need to be addressed,” said a joint statement of health workers and women’s groups said on Wednesday.
“The ‘camp method’ of sterilisation needs to be stopped with immediate effect as quality of care is seriously compromised in mass sterilisation programmes that are meeting earmarked targets.”
Sterilisation is the most popular form of birth control in India. Encouraged by cash incentives, about 4 million people a year undergo surgery. Almost all are women.
Experts say last week’s deadly incident is also a result of the pressure to meet the government’s sterilisation targets. In 2012, India committed to providing 48 million additional women and girls with access to contraceptives by 2020. However, in India about one in 5 women of reproductive age do not have access to modern method of contraception such as condoms and pills.
Chances are that India’s promises at the 2012 Family Planning Global Summit in London will reinforce the pressures of meeting ‘targets’, which has dangerous and long-term implications for the health of the people.
Many states such as Uttar Pradesh, Bihar and Rajasthan are accused of setting unofficial sterilisation targets, violating the target-free population policy of 2000.
The overt emphasis placed on sterilising women is also out of step with best practices because male sterilisation such as vasectomy involves comparatively lesser health risks.