Doctor Used Infected Tools on Indian Women as 10 Dead

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India Woman
A woman who recently delivered a baby lies on a bed at a hospital in Shivpuri, in central Madhya Pradesh, India. State governments routinely carry out sterilization drives for family planning in the world’s second-most populous country. Photographer: Roberto Schmidt/AFP/Getty Images

An Indian surgeon used infected instruments to sterilize 83 women in about six hours, according to a local medical official, leaving 10 of them dead and another 69 hospitalized in the central state of Chhattisgarh.

The doctor breached guidelines that limit surgeons from performing more than 30 sterilizations a day, said the official, who asked not to be named because details of the investigation are private. He also failed to disinfect the instruments before using them again, the official said.

“It’s a case of negligence,” Raman Singh, the state’s chief minister, told reporters at a news conference today, adding that the doctor, R.K. Gupta, had been suspended and a criminal investigation is under way. “It is unfortunate that such an incident occurred in a scheme of national importance.”

Women often suffer most from efforts to control population growth, such as one-day sterilization drives, in the nation of 1.2 billion people. India has the world’s third-highest female sterilization rate after the Dominican Republic and Puerto Rico among more than 180 countries tracked by the United Nations.

“Chhattisgarh was a culmination of no accountability in the system and when basic hygiene conditions aren’t met,” Kerry McBroom, director of the Reproductive Rights Initiative at the New Delhi-based Human Rights Law Network, said by phone. “The most appalling and terrifying thing is that it’s so commonplace in India for women to suffer these surgeries” under poor conditions, she said.

Four women were still in critical condition after the Nov. 8 surgeries, according to Amar Singh Thakur, chief health officer for Bilaspur district. Eight died yesterday while two passed away today, he said.

15,000 Mishaps

“The deaths were due to infection causing septic shock,” Thakur said. “We are investigating but it is too early to say that it was due to sterilization.”

Prime Minister Narendra Modi asked Chhattisgarh’s leader to ensure a “thorough investigation and action” on the “unfortunate tragedy,” his office posted on Twitter.

Sterilizations are voluntary and couples choose between a tubectomy or vasectomy, Harsh Vardhan, who was India’s health minister at the time, told parliament on July 18. From April 2010 to March 2013, the government paid about 510 million rupees ($8 million) for 15,264 deaths or failed surgeries, he said.

Women are offered as little as 600 rupees ($10) in compensation for participating in the procedure, which usually takes about 15 minutes and is done under local anesthesia, according to Alok Banerjee of Advocating Reproductive Choices, a coalition of health groups.

“If they follow the guidelines, then sterilization is a very safe method of contraception and population control,” Banerjee said.

37 Percent

India’s National Family Health Survey in 2005-2006 showed that about 37 percent of married women have been sterilized while only 1 percent of men have had a vasectomy. About 29 percent of Chinese women surveyed around the same time had been sterilized compared with 4.5 percent men, according to UN data. The vasectomy rate compares with about 24 percent in Canada and 11 percent in the U.S.

India in 1952 was the first country to start a family planning program. Emergency rule in the 1970s allowed then-Prime Minister Indira Gandhi to forcibly sterilize people, according to the Population Research Institute.

Between June 25, 1975, and March 1977, about 11 million men and women were sterilized and 1 million women were inserted with intra-uterine devices, the U.S.-based group said in a report, citing Marika Vicziany’s book “Coercion in a Soft State: The Family-Planning Program of India.”

‘Coercive Environment’

About 47 percent of women in the survey aged between 20 to 24 said they were already married by the legal age of 18, while 16 percent of 15-19 year-olds were mothers or pregnant when the survey was being conducted.

While cash incentives are offered to couples who stay childless until prescribed ages or opt for contraceptives, the use of numerical targets has contributed to a “coercive environment for several decades,” Human Rights Watch said in a 2012 report. Although the federal government has announced a “target-free” approach to family planning, district health workers are threatened with salary cuts or dismissals if local targets aren’t met, according to the report.

“This is an exceptional case which unfortunately happens once every four or five years,” said Abhijeet Phatak, medical program specialist with International Planned Parenthood in New Delhi. “The fault lies with the person who did not disinfect the equipment on a day when 80 or 90 women are being sterilized. But also the strategy of having one-day camps for sterilization is to blame and should be reconsidered.”

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