Thursday, November 13, 2014
Enforced mass sterilization - probably not a good idea!
Police arrest doctor who performed more than 80 operations as news emerges that surgeries went on despite mounting toll
A woman is mourned as her body lies in the back of a van after botched sterilisation surgery in Chhattisgarh, India. Photograph: Reuters
A woman died after a second sterilisation camp was held in the central Indian state of Chhattisgarh even as the death toll mounted from a clinic held two days before, it has been revealed.
The number of fatalities reached 14 on Thursday and was expected to rise, while the doctor who performed many of the operations, RK Gupta, was arrested, according to authorities.
The news of the second camp – held after several deaths from the first, and while dozens of very seriously ill women were being treated – will increase pressure on authorities in the poverty-stricken Indian state.
The women who died spent their last hours in tremendous pain, relatives have said.
About 80 women attended the first free government-run camp on Saturday where they each had a laparoscopic tubectomy, usually a straightforward surgical procedure. About 60 fell ill shortly afterwards, officials said.
Family members have claimed the women were pressured to accept 1,400 rupees (£14), the equivalent of two weeks’ work for a manual labourer, to have the surgery.
“The [health workers] said nothing would happen, it was a minor operation. They herded them like cattle,” Mahesh Suryavanshi, the brother-in-law of one casualty, told the Indian Express newspaper.
Though at least 10 women were already dead and many more in a critical condition in local hospitals, no attempt appears to have been made to stop other camps being held in the state.
Around 30 tubectomies were performed in around an hour at the second camp held on Monday by a different doctor, local news reports said. The way the procedures were carried out was a clear breach of protocols – but, as has become increasingly clear, an apparently routine one. Patients reported nausea, vomiting, abdominal pain and high temperatures. The woman who subsequently died, and many of the others, were from one of India’s “protected tribes” – ancient communities that are among the most marginalised in the country.
Chhattisgarh police inspector general Pawan Deo told the Agence France-Presse news agency that Gupta had been arrested and police were planning to seize equipment used during the surgeries.
In all four doctors and officials have been suspended and police have registered a criminal complaint of negligence.
Fatalities included a woman who had given birth only days before. Others were reported to have been hospitalised with anaemia, severe asthma and diabetes. None appeared to have been properly examined before the operations at either camp, nor was there any follow-up care.
Ramavtar Suryavanshi, husband of one victim, described how his wife was told she would be home by sunset and back to work in the fields within two days with the equivalent of about 10 days’ wages as a manual labourer in her pocket.
Instead the 35-year-old mother-of-five was incapacitated within hours of having the surgery and died “in tremendous pain” within 20 minutes of being admitted to hospital the next morning.
At the first camp operations were carried out by Gupta and his assistant over the course of about three hours.
One official said the daily target for one team was 40 sterilisations “but the number of operations held on Saturday was double that figure”.
Gupta had been honoured by the state government in January for performing more than 50,000 laparoscopic tubectomies. “He’s a very senior and respected surgeon,” said Dr SK Mandal, the chief medical officer in Chhattisgarh.
The sterilisation drive in Chhattisgarh is part of a long-running effort to control population growth across India.
Mandal said he believed Gupta had been under pressure to meet government-set targets of 220,000 sterilisations in a year including 15,000 in Bilaspur, the district where the botched surgeries took place.
“The people from the health department set up some targets and we have to achieve them by 31st March,” Mandal said.
A spokeswoman for the federal health ministry said she was not aware of sterilisation targets for states. India’s government has said it stopped setting targets for sterilising women in the 1990s.
But doctors and human rights workers have alleged for years that targets exist, leading to inevitable coercion in villages where most people have very limited access to education and healthcare.
“The government of India denies that there are targets but they’re clearly set and when it goes down to the district or village level that’s a real problem. Extreme pressure is the crux of the problem,” said Sona Sharma, joint director for advocacy at the New Delhi-based Population Foundation of India.
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