India
carries out about 37 percent of the world’s female sterilizations. Quotas set
by state governments and financial incentives for doctors contributed to 4.6
million women being sterilized last year, many for cash and in the unsanitary
conditions Devi encountered. Vasectomies accounted for just 4 percent of all
sterilizations.
“Women are the easiest prey, whether it’s government officials or their
husbands asking them to undergo the operation,” says Kerry McBroom of New
Delhi-based Human Rights Law Network, which provided the lawyer for an ongoing
court case against the government that was filed last year. The lawsuit
documents the brutal practices at sterilization camps, where large numbers of
women are gathered to have the procedure, and calls on the Supreme Court to
issue guidelines to prevent abuse.
Only about half of Indian couples
of child-bearing age practice modern birth control methods, United Nations data
show. The government doesn’t pursue the costly option of teaching
often-illiterate women how to use contraceptives. One in five babies born
worldwide is Indian, straining supplies of land, food, and water. “A
fast-growing population affects everything: the economy, the environment,
quality of life,” says Vishwanath Koliwad, secretary general of the Family
Planning Association of India, an advocacy group.
Outside the clinic in the town of
Sonhoula, 33 women who signed up
for surgery line up in the heat as guards carrying bamboo sticks watch over
them. They are led into a dimly lit room, with bare concrete floors, and placed
on makeshift operating tables propped up with bricks. A.K. Das, the surgeon at
the clinic, moves from one operating table to the next as he makes an incision
below the navel in each woman, then cuts and ties their fallopian tubes. The
patients are laid shoulder-to-shoulder on the floor in a separate room to
recuperate. Das, who spends three minutes on each operation, runs out of
anesthetic with more than 10 patients to go, forcing him to use a weaker
sedative. He says he’s paid an extra $2 per patient by the government for using
the weaker drug. It’s more dangerous because the women are not completely
unconscious during the procedure. After each operation an assistant washes the
scalpel in a tray of warm water.
“Look at this,” says Das, pausing
during an operation to hold up the rust-stained scalpel he’s using. “This is
dirty and that will significantly increase the chance of infection.”
A majority of those attending
sterilization camps in India are lured
by incentives such as money or improved welfare benefits offered by local
officials under pressure to meet targets each year, says Abhijit Das (no
relation to Dr. Das), director of the Centre for Health and Social Justice in New
Delhi. While the federal government formally abandoned
targets for sterilizations in 1996, that hasn’t filtered down to all states.
Most of the operations are
performed in the first months of the year—a period doctors dub “sterilization
season”—to fill quotas before the fiscal year ends on March 31. Health workers
in Gujarat say they were threatened by their supervisors
with salary cuts or dismissal if they failed to meet targets, according to
Human Rights Watch. Women are pressured to undergo sterilization surgery
without being told they will never again bear children, the group said after
interviewing 50 health workers. Repeated calls and e-mails to Gujarat Health
Minister Nitinbhai Patel weren’t answered.
S.K. Sikdar, who runs national
population control programs at the Ministry of Health and Family Welfare,
rejects the idea that women go to the camps under duress. “There’s no pressure.
People are free to do whatever they like,” Sikdar says. “There may be some
isolated districts where there are overeager officials, but they are rogue
operators.” Sikdar says sterilization is “one way” that India
is trying to reduce the population, “but we are promoting different birth
control methods.”
