Over 700 Women Killed in Indian Sterilization Camps Between 2009-2012

By Stefano Gennarini, J.D. | November 18, 2014

According to an informative opinion piece in the Indian Express over 700 women (probably many more) have died as a result of India’s population control programs in only a three year period. The author criticizes India’s policy, in particular how it targets poor people, fails to secure informed consent, and creates perverse incentives for health workers to disregard safety measures in favor of higher volumes of sterilization procedures. Below is an excerpt.

The National Population Policy, 2000, had strongly advocated doing away with “targets” and emphasised voluntary and informed choice in family planning. The Union health ministry has since issued several handbooks for health workers, which clearly spell out the new focus on individual wellbeing. The brochures also urge health workers to follow proper pre- and post-op procedures and maintain clean and safe facilities where sterilisations are carried out. And the Supreme Court has also ruled that no more than 30 surgeries can be performed in a day by a team led by two doctors. But four decades after Delhi’s infamous Turkman Gate disaster, the same troublesome family planning philosophy based on monetary compensation has resurfaced. Five to six million women are sterilised each year in India. Government data, usually known for underplaying bad news, reveals that botched up operations have killed 707 women between 2009 and 2012.

The key component of all health services under the National Rural Health Mission, the prime “motivator” for sterilisation camps, is the ASHA (accredited social health activist), a locally recruited woman. Preferably literate, she is trained to service her community, particularly women and children, and help them get access to health services. It is notable that the ASHA is not paid a regular salary. But for motivating and accompanying women to sterilisation camps, she receives a “performance-based incentive” — Rs 150 per “case”. The amount, one learns, was recently increased. The doctor, anaesthetist and nurses are all paid cash incentives. It is not hard to see how this may be a big “motivator” for the medical teams, which are in such a hurry to perform a record number of sterilisations that they forego basic safety norms. The doctor supervising the nefarious Chhattisgarh camp was allegedly awarded Rs 50,000 for the record number of surgeries he performed in a day. But obviously, nothing was spent on the creation or maintenance of medical facilities for patients.