103 Women Sterilized, 14 Dead – All in a Day’s Work at One Camp

India’s sterilization camps: where young mothers are taken to be sterilized—and sometimes to dieReports that 14 women had died following surgery at a government-run sterilization “camp” in central India last month sent shock waves around the world. But such butchery is not unusual in populous India. Urged on (and quietly funded) by the dying West, the subcontinent has long relied upon mass sterilizations carried out in assembly-line fashion in temporary camps set up for just this purpose.

Now, thanks to a new investigation by the New Delhi-based Human Rights Law Network (HRLN), we know more details surrounding this particular tragedy, which occurred in the central Indian state of Chhattisgarh at an abandoned rural hospital. We know that a single doctor, R.K. Gupta, over the course of just a few hours, carried out some 83 (eighty-three!) surgical sterilizations in rapid succession. We know that he was in such a hurry that he didn’t bother to wash his hands beforehand, or even, as he began cutting into woman after woman, bother to once change his bloody latex gloves. We know also that he was paid per operation, and so was eager to cram as many 100-rupee procedures into an afternoon’s work as possible.

As far as the women themselves are concerned, they were led like lambs to the slaughter. They were not informed in advance about the risks of the procedure. Some were bribed with a promise of 500 rupees – about $8 – if they agreed to sterilization. Others were simply told to report to the camp. There they were told to lie down on a makeshift operating table, had their wombs inflated with bicycle pumps, and were injected with a small amount of anesthetic. Only one needle was used for all the women. As the doctor began to cut, some could see – and feel – Gupta pull shreds of their organs from their abdomens.

The cause of death of the fourteen victims is still unknown. Some of the women many have died because they were infected during the course of these too-hasty surgeries. The rusty surgical equipment used by Surgeon Gupta was reportedly not sterilized between procedures. The authorities themselves have blamed tainted drugs, and went on to arrest the head of a local drug factory for selling antibiotics and painkillers tainted with rat poison. Rat poison.

The victims were all young mothers with anywhere from one to three children. Chaiti Bai, for instance, was 22 years old and the mother of a six year old and 7 month old baby. She had never used contraception between her pregnancies but she had been feeling unwell this past fall and was suffering from jaundice. So when the community health worker—called a mitanin in Hindi–came to her door and told her she could receive free medical treatment at the Community Health Center in Bilaspur, she agreed. Unbeknownst to her, the health center was under extreme pressure to meet its government-mandated quota of sterilizing 800 women per year. But the mitanin never mentioned sterilization, or family planning, or anything of the kind to Chaiti. She just offered her “free” health care.

Upon arrival at the so-called center, Chaiti found herself at an abandoned rural hospital. There her husband, Budh Singh, was given a blank piece of paper to sign for her medical treatment. Both he and Chaiti could read and write, unlike many of those who had been brought to the center, but there was no text on the paper. Thinking that she was going to receive a medical examination and treatment for jaundice, he signed anyway. No one had mentioned family planning or sterilization to him or to his wife. Budh was told to go outside and wait.

A few hours later, when he was allowed into the recovery room, Budh found it crowded with women lying side-by-side on a filthy floor. His wife, Chaiti, was lying among them, barely conscious. A health worker handed him some medicines, but there were no instructions to go with them, and no paperwork describing what had been done to his wife.

The following evening Chaiti began vomiting. Her conditioned worsened overnight, and the health center sent her by ambulance to the district hospital three hours away the next morning. She died en route. After a public outcry, the government agreed to pay Bud Singh and the other grieving husbands a “compensation check” for 200,000 rupees, or about $3200.

One would think that a mass murder—with 14 dead and dozens hospitalized–would lead to a moratorium, at least temporarily, on the holding of sterilization camps. That is not what happened. The sterilization camps are the centerpieces of India’s entire population control campaign, and they went forward without pause.

Two days after the news broke about the deaths of the women—at a time when Indian health officials and human rights activists were denouncing the sterilization camp and Surgeon Gupta was hiding from angry family members and protesters–it was business as usual in the rural town of Gaurella 20 miles to the north. The family planning workers were holding their regular twice-weekly sterilization camp at the local health center.

The death toll at that camp was not as high as it had been at Bilaspur. Only one woman died, but many more were hospitalized. In fact, deaths in the camps are so common that the single Gaurella death probably wouldn’t have been reported at all in the media except for the events earlier in the week. Or if the Delhi-based Human Rights Law Network had not been on the scene in the person of an activist and two lawyers to interview the deceased women’s relatives and health workers in Chhattisgarh. The stories they heard – like Chaiti’s above – are chilling.

As we at PRI have documented in years past, sterilization camps like those in Chhattisgarh are routinely held throughout India. Some women are convinced to undergo sterilizations by means of cash incentives, while others are simply misled or even coerced into submitting. And in almost all cases the women will not have given their informed consent. Indeed, they could not, because they had not been told about the risks of the procedure at all. There have even been cases of very young women with no children being tricked into consenting to sterilization by thumbprint unaware that it would leave them infertile.

Human rights groups like HRLN have documented cases of abuse in harrowing detail, from dozens of women being sterilized on school desks by doctors operating by flashlight, to women maimed in hasty procedures carried out to meet government sterilization quotas. Just last year, the Indian public was outraged after footage of dozens of bleeding, unconscious women lying on the ground was aired on national television. The sterilization camp where the footage was taken had sterilized 103 lower caste women in less than five hours.

Who is to blame for these abuses?

Those involved in the Bilispur case engaged in a round robin of blame. Government officials pointed fingers at the surgeon’s lack of hygiene and rusty implements. The surgeon in turn blamed the government, saying, “It is up to the administration to decide how many women would be kept for operation,” he said. And both of them later came to blame tainted drugs.

Human rights activists call for an end to the sterilization camps, which not only violate basic national health and safety standards, but also violate the human rights of the women who–by bribery and deceit and even force–are induced to come in.

But the real culprit is the national population control plan, under which numerical targets are set for sterilizations to be carried out by states, localities, and individual health centers. The sterilization camps are an outgrowth of an effort by the health centers and health workers to meet the quotas that they have been assigned.

Indian officials claim that in 1996 the country abandoned quotas and adopted a “target-free approach” to family planning. But recent investigations by human rights activists in India have found that population targets and sterilization quotas are still routine and widespread.

“Every state sets targets in its annual health plan for female sterilization, male sterilization, insertion of IUDs, and distribution of contraceptive pills,” Human Rights Watch (HRW) concluded in 2012 based on interviews with 50 Indian health workers. “A central government body, the National Project Coordination Committee, reviews these targets and allocates funds for family planning in every state.”

“They shout at those who have not fulfilled their targets during meetings. It’s humiliating,” one worker told HRW. “They say, “If others can achieve the target, why can’t you? You must know some women? You must have relatives or some contacts after working in the villages? Use them and get women operated [sterilized].”

“In much of the country, authorities aggressively pursue targets, especially for female sterilization, by threatening health workers with salary cuts or dismissals,” the HRW report explains.” As a result, some health workers pressure women to undergo sterilization without providing sufficient information, either about possible complications, its irreversibility, or safer sex practices after the procedure.”

“I have to keep going to women’s houses,” one worker explained. “Sometimes in one week I go 10 times to one woman’s house.”

When you threaten government workers with the loss of their jobs unless they bring in a certain number of young women to be sterilized, it is not surprising that they will do or say anything to meet their quotas.

This is why young, vulnerable Indian women are dying in sterilization camps. They are victims of one of the darkest and cruelest population control regimes on earth. Second, perhaps, only to China.