Eight women died and 50 others were hospitalised after botched up sterilisation surgeries as reported an article in the Times of India last week. This was at a health camp in Takhatpur, Bilaspur,Chhattisgarh .A senior health official said that 38 women are admitted in district hospitals and seven each have been referred to Apollo hospital, Bilaspur as their condition started deteriorating in the evening.The state health department, which had organised the camp has ordered inquiry into the incident. Four health officials, including chief medical health officer of Bilaspur, was suspended according to this article.
Most countries offer women a mix of modern methods of contraception including oral contraceptive pills, intra uterine devices (IUDs), injections and condoms along with sterilisation. In India, however, women especially in the rural areas are not counselled about alternative contraception methods according to various experts.
“Health care workers tasked with hitting sterilisation targets deliberately seek out women and don’t inform them about the risks of the procedure or alternatives of birth control’ says Abhijit Das. He is the director of the Centre for Health and Social Justice in New Delhi, India.“There is no other method being provided consistently,” he said, as mentioned in an article in Al jazeera website which covered the same issue. He adds that “a fear of overpopulation in Indian policy circles drives politicians to prefer female sterilisation over other methods of population control”.
Poonam Muttreja has a similar view. She is the executive director of the Population Foundation of India. “Leaving men out of the family planning conversation has put the burden of population control entirely on women.” “Contraceptive counsellors do not discuss vasectomies as a suitable alternative to female sterilisation.”she said.
We had interviewed Dr. Saroj Pachauri last August and thus had the opportunity to get her views on this issue before these stories came out . Dr. Pachauri is a community health physician who has been extensively engaged with research on reproductive health. She was the Regional Director for the Population Council-South and East Asia till 2012 and continues to serve as a Population Council, Distinguished Scholar. According to her, we do have several technologies available even in the current basket of services that the government provides. But, women are not given a choice. In the public sector, female sterilisation is still the most common method used.
“In India, we have a growing young population and they need non-terminal methods such as the condom, pill and IUD to help them delay their first child and space the birth of their second child. But, the government still doesn’t provide a choice of methods. So in theory, there is a basket of services available, but in reality the method provided is sterilisation, which is not appropriate for young people.The government is now making an effort towards an integrated approach to deal with MCH and family planning and to enhance the use of spacing methods such as the pill, condom and the IUD. Efforts underway are very nascent at the moment and I don’t think we are going to see an impact immediately”, she said.
Another point that many articles covering this issue fail to mention- is that generic medicines are equally responsible for killing these women. . According to this article, fake, diluted or contaminated drugs made by the small-scale enterprise are to be blamed as well .
Dangerous generics are sold because — as the Indian health minister pointed out a few months ago — India’s decentralised drugs regulatory scheme is “a snake pit of vested interests”.Indian industry leaders and health activists say that “ the questions over the medicine distributed at the sterilisation camp highlights the urgent need for tougher regulation of India’s domestic pharmaceutical industry”.Industry leaders such as Kiran Mazumder Shaw of Biocon have called for much tougher central regulatory standards. These medications are part of the equation and those supply chains must be improved urgently.