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