WUNRN

http://www.wunrn.com

 

http://online.wsj.com/articles/eight-women-die-in-india-after-botched-sterilizations-1415720471

Larger type size for easier reading.

 

India - Eleven India Women Die After Botched Sterilizations

 

India Government Pays Millions of Poor Women to Undergo Sterilization Operations

 

Women who underwent sterilization surgery receive treatment at the Chhattisgarh Institute of Medical Sciences in Bilaspur on Tuesday.

Women who underwent sterilization surgery receive treatment at the Chhattisgarh Institute of Medical Sciences in Bilaspur on Tuesday. Associated Press

 

By Shanoor Seervai and  Geeta Anand  - November 11, 2014

MUMBAI—Eleven women are dead and dozens more were hospitalized after they underwent sterilization surgery as part of India’s population-control program—highlighting the risks of a government campaign that annually pays millions of poor women to undergo the operations.

Public-health authorities said the women suffered fevers and pain after a surgical team performed a laparoscopic procedure on 83 women Saturday at a hospital in the central Indian state of Chhattisgarh. The deaths and complications are under investigation.

India has been trying for decades to control its growing population—now 1.2 billion—and sterilization operations remain the backbone of family-planning efforts in India. Around 4.5 million women were sterilized in the year ended March 31, 2013, according to government figures. Doctors often perform dozens of surgeries a day at sterilization “camps.” in a country plagued by a shortage of doctors and dirty, decrepit hospitals the government offers women about $10 to undergo the procedure. Doctors get paid about $2 per patient sterilized.

‘When one surgeon does more than 50 surgeries a day, that violates a woman and puts her at risk’ - —Poonam Muttreja, of the Population Foundation of India

 “This was a disaster waiting to happen,” said Poonam Muttreja, executive director of the Population Foundation of India, a New Delhi think tank. “When one surgeon does more than 50 surgeries a day, that violates a woman and puts her at risk.”

It isn’t clear how many people die or suffer complications from India’s sterilization procedures. In response to a question in Parliament in July, the Health Ministry said it had records of more than 350 people dying after such surgeries from 2010 to 2013. Public-health activists said they believe the actual number is much higher.

The Health Ministry didn’t respond to messages seeking comment. Prime Minister Narendra Modi, on Twitter, expressed concern over the “unfortunate tragedy” and called on state officials to investigate and take action.

Thirty-four percent of more than 700,000 households surveyed across the country by the Indian government reported using female sterilization as their current family-planning method. Only 1% relied on male sterilization.

Less-permanent methods of family planning aren’t widely used. Fewer than 6% of households used condoms and 4.2% relied on the pill, the government household survey said. Bobby John, a physician who advises Global Health Advocates, a New Delhi nonprofit, said the deaths of the 11 women show the danger of relying on female sterilization, particularly when the public-health infrastructure is weak.

“All it takes is one bad infection, and it kills people,” Dr. John says. Ramanesh Murthy, medical superintendent of the Chhattisgarh Institute of Medical Sciences, where women were being treated for complications, said the state had suspended four doctors involved in the surgeries and initiated a police investigation to find out what went wrong.

It wasn’t immediately possible to reach the hospital or the doctors involved in the surgery for comment.

Men can receive a payment of $20 for sterilization, which is a far less risky surgery. Still, in India’s male-dominated society, where masculinity is synonymous with ability to reproduce, men rarely opt for vasectomies.

Women register for a free sterilization procedure at the Mohan Lal Gautam District Women's Hospital in Aligarh, India, in a file photo from February 2011.

Women register for a free sterilization procedure at the Mohan Lal Gautam District Women's Hospital in Aligarh, India, in a file photo from February 2011. Associated Press

“They were well-trained,” Dr. Murthy said of the doctors who were involved. “I don’t know how this happened.”

Amar Singh Thakur, a physician and the joint director of medical services in Bilaspur, the district where the weekend sterilization camp was held, said one surgeon had performed all the operations and that three other doctors were also suspended because of what he termed “a management problem.”

The government’s manual on sterilizations says surgical teams should do a maximum of 30 procedures a day with three laparoscopes, and not more than 50 regardless of the number of instruments.

Dr. Murthy said doctors in Bilaspur had performed minimally invasive laparoscopic, or keyhole, surgeries, which each take less than five minutes, and discharged the women the same day. The surgery closes the women’s fallopian tubes, which connect the ovaries to the uterus.

Many of the women who had undergone surgery began to return Monday with complaints of pain and fever, and by late that night, eight had died, he said. By Wednesday morning, 11 women were dead, while 69 were in the intensive care units of three hospitals in the district where the surgeries took place, according to Dr. Thakur.