Chhattisgarh tragedy reflects the wrong focus of health programmes in India, suggests neglect of health care needs of women

India Sterilization D_Kand_0In the wake of the Chhattisgarh tragedy, The National Alliance of People’s Movements (NAPM) wants the officialdom to stop playing with lives of women, even as calling for stringent action in incidents of death of women at government-run sterilisation camp in the state. It seeks officialdom to ensure gender-just and human rights approach to family planning. The NAPM statement* released in Delhi:

The tragic incident of death of 14 women, with more than 20 women presently in critical condition, at the Government Sterilization ‘camp’ in Kanan Penderi village of Bilaspur district of Chhatisgarh is yet another instance of serious violations of medical guidelines and brutal repression of reproductive rights and health of women in India. It is a painful reminder of not just the inadequacies of our public health system  but more importantly a reminder of the wrong focus of health programmes in India, which should focus on health of women, not just on sterilisation. In a state like Chhatisgarh, which has one of the highest rates of maternal mortality, the state government organizes such camps regularly with the motive to control population while turning a complete blind eye to other more important health care needs of women.

Furthermore, the incident exposes how human lives are being risked in these botched, ill-equipped and target driven camps. Shockingly, at this camp, 83 women underwent laparoscopic tubectomies with only one instrument in less than 5 hours i.e. less than 4 minutes per operation, completely flouting the central government’s guideline (Standard Operating Protocols for sterilisation camps), of not conducting more than 10 tubectomies with a single instrument, and not more than 30 by a single doctor, in a day. This clearly points out that the operations were performed in a rush and without adequate equipment, thereby blatantly ignoring important hygienic considerations.

While organizing free public health camps is a welcomed strategy to counter the increasing commercialization and privatization of health delivery systems, the general trend to have one-day camps with unsaid high targets to do as many operations as possible within a single day is clearly a flawed strategy. Furthermore, the fact that there are monetary incentives for the doctors and the health workers as per the number of operations they conduct add to the problem of rushing and undermining of ethical and medical procedures.

India’s Family Planning programme, in recent decades, has been targeting only women and almost negligible number of vasectomies is being performed on men, which in fact is a far safer method with zero side effects and post-surgery recovery period unlike tubectomy or hysterectomy for women, which has post-surgery hormonal disturbances and health implications. Furthermore, targeting with monetary incentives to women is problematic as it also suggests coercion especially when the women are from poor and marginalized communities.

National Alliance of People’s Movements (NAPM) expresses its outrage and strongly condemns the medical negligence and failure of the government to ensure safe health care to women. We demand an immediate and independent inquiry into the incident by a team comprising of women’s organisations and civil society networks working on health issues and its report be made public. We demand that stringent punishment be given, including disqualification of medical practitioners involved. A broader investigating body must be set up to look at the phenomenon of sterilizations of women on the national scale so that this once incident doesn’t get cast as a one off incident.

The government must ensure that medical, procedural and ethical guidelines are strictly followed in every government run hospital and health camps. We strongly demand that the focus must shift to expansion and availability of non-surgical contraception to women and enhancing their contraceptive choices, along with programmes to women’s empowerment and counseling around medical needs and reproductive choices.

 *Signatories include Medha Patkar of the Narmada Bachao Andolan; Prafulla Samantara of the Lok Shakti Abhiyan and Lingraj Azad of the Niyamgiri Suraksha Samiti, Odisha; Dr Sunilam Aradhna Bhargava of the Kisan Sangharsh Samiti and Meera of the Narmada Bachao Andolan, Madhya Pradesh; Suniti SR, Suhas Kolhekar and Prasad Bagwe  of the NAPM, Maharashtra; Gabriel Dietrich and Geetha Ramakrishnan of the Unorganised Sector Workers Federation, Tamil Nadu; C R Neelakandan of the NAPM Kerala; P Chennaiah  and Ramakrishnan Raju of the NAPM Andhra Pradesh, Arundhati Dhuru and Richa Singh  NAPM, UP; Sister Celia of the Domestic Workers Union and Rukmini VP of the Garment Labour Union, Karnataka; Vimal Bhai of the Matu Jan sangathan and Jabar Singh of the NAPM, Uttarakhand; Anand Mazgaonkar and Krishnakant of the Paryavaran Suraksh Samiti, Gujarat; Kamayani Swami and Ashish Ranjan of the Jan Jagran Shakti Sangathan, and Mahendra Yadav  of the Kosi Navnirman Manch, Bihar; Faisal Khan of the Khudai Khidmatgar, Haryana; Kailash Meena of the NAPM Rajasthan; Amitava Mitra  and Sujato Bhadra of the NAPM West Bengal; BS Rawat if the Jan Sangharsh Vahini and Rajendra Ravi, Madhuresh Kumar and Kanika Sharma of the NAPM, Delhi.

 

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