Krishnendu Nair is 20-year-old law student intent on improving the justice-delivery system of the country. She believes that even the smallest unit of a society holds the power to profoundly transform a community. She enjoys spending time with children and getting to know the world from their perspective. In her free time, she’s most likely be found in the company of books, surfing online content or watching documentaries that unveil hard-hitting realities of life.
Women’s Health: The Reality of Family Planning and Botched up Sterilization
We, Indians, take pride in saying that India was the first country in the world to adopt a population control policy in the 1950s but at the same time we keep forgetting that we have failed successively to achieve any concrete results. Despite the government’s long-standing goal to achieve population stabilization, India is still gaining about 18 million people each year, with more than half its population within reproductive age. In such a situation, the authorities are trying hard to get a large number of people sterilized. There is nothing wrong with sterilization surgeries as long as it is consensual, fully informed and carried out with utmost care. But why target only women?
It is clear that the family planning policy of India overtly focuses on female sterilization. The Chhattisgarh government alone had planned for 150 000 female sterilizations in 2014, while its estimate for vasectomies is only 8000.
Vasectomy has failed to form a major part of the sterilization drive even though it is far less complicated and painful. This can be attributed to the patriarchal structure of our society. According to health activists, rural women are under enormous pressure from husbands and in-laws to not go in for any oral contraceptive method or injections.
To add to the woes of women, maintaining proper standards for implementation in family planning policies does not seem to be the concern of people working towards fulfilment of family planning objectives. In November 2014, the tragic death of 15 women at the sterilization camp in Chhattisgarh garnered international attention. More than 80 women underwent surgery for laparoscopic tubectomies at a free government-run camp, shortly after which about 60 women fell ill. The Newspapers were soon flooded with the report that the operations in Chhattisgarh were carried out by a single doctor and his assistant in about five hours. The relatives alleged that the health workers herded the women like cattle. It’s shocking to note that operations were performed on top of classroom desks and that too in a school that did not even have the facility of running water. Thankfully, criminal cases were filed and the Chief Minister of the state accepted that there was serious negligence.
Subjecting rural women to such botched up sterilization affairs are not rare occurrences in India. In past too, people have died and in some cases sustained permanent injuries due to negligence or want of post-operative care. The need, therefore, is to critically analyze the government policy and to find a redressal to such problems is urgent.
According to Dr. A.L. Sharada, Director, Population First, a Mumbai-based NGO, “Though in principle, the government adopted a target-free approach in 1995, targets continue to haunt the service providers. Governments and camps are organized to achieve the targets.” As pointed out by a health activist, targets are set like cricket scores to impress the funding agencies but the care taken to perform surgeries is inadequate. Community health workers are also paid for bringing women into the camps or clinics for sterilization.
It has to be understood that the target class is poor women which is a sort of double discrimination. Also, it is easy to attract such women to undergo surgeries on the ploy of incentives. These incentives include everything from a sewing machine to the chance of winning a car. The statistics suggest that the budget allocated for family planning schemes in past few years were used by the authorities for providing incentives instead of utilizing it for providing better services (contraceptive methods, equipment, transportation, and staff expenses).
As is clear from the above instances, the quality of treatment meted out to the people to be sterilized is substandard. Often the surgeries are conducted under unhygienic conditions, are done hastily and the aspect of post-operative care is not even thought about.
Sterilization camps were started in 1970 under the family planning program in India with the help of the UN Population Fund and the World Bank. A total of 1,434 people died from such botched sterilization procedures in India between 2003 and 2012 and the government has paid compensation for 568 deaths.
The gloomy state of affairs has also prompted international organizations to look into this matter. A 2012 report by Human Rights Watch urged the government to set up an independent grievance redressal system to allow people to report coercion and poor quality services at sterilization centers. But there is little evidence that this has been implemented.
A study has found that engaging men in family planning can substantially improve contraceptive practice and reduce sexual violence among married couples. The government is trying to increase the availability of options, for both men and women, under national family planning scheme but that is not enough. It is true that some awareness campaigns launched with catchy slogans advising people to have fewer children have worked to some level. Mass distribution of free condoms has helped bring down the birth rate over the decades.
The Supreme Court has played instrumental role in realizing the goals of family planning and the need for proper healthcare facilities to women. In a landmark court ruling on September 14th 2016, it ordered that all sterilization camps across the country be closed. The Court also urged state governments to substantially increase compensation paid to women and their families for botched sterilization procedures. But simply paying off compensations from taxpayer’s money and not using adequate safeguards is not justified. The whole system at present is infected with corruption and it needs to be addressed urgently because innocent lives are dependent on it.
Thus, there is a need for people friendly schemes and without victimization of women in order to ensure their health. Informed choices and availability of choices is the need of the hour. The recent Supreme Court’s recommendations and directions to Central Government are laudable but the real problem during implementation of policies at grass root level needs to be resolved. Further, the doctors associated with running sterilization camps need to be cross-checked.
To drive forward the idea of equality, we must all pledge to ensure proper sexual and reproductive health of women.
Opinions are of the writer.