Posted On May 27, 2023
Bihar has changed, but not for poor Dalit women who continue to be victims of doctors running blacklisted clinics. They end up with stolen uterus or kidneys—and a huge financial debt.
Muzaffarpur/Samastipur: Sunita Devi was wheeled into a tin shed masquerading as a clinic for a hysterectomy on 3 September 2022. She came out without a uterus—and both her kidneys. It took Sunita eight days to realise that her body had been hollowed out by unscrupulous, fly-by-night doctors.
This is Bihar’s latest medical scam, the horrific ‘kidney kaand’, and it has left everyone aghast.
Since her surgery at the unlicensed clinic in Muzaffarpur district’s Sakra Block, Sunita has been trapped in the ICU, kept alive by dialysis administered every alternate day of the week.
Her life and loss is now tied inextricably to hundreds of women like Guriya Devi from Samastipur’s Keshopatti village, who were similarly robbed of their organs in Bihar over a decade ago.
Between 2011 and 2012, in Samastipur, Gopalganj, Saran and other districts across Bihar, nearly 700 women had their uterus stolen by touts and doctors treating them for minor ailments. The jaw-dropping medical malpractices scandal, infamously known as ‘uterus scam’, continues to haunt the state with women still fighting for justice—ping-ponging between police, courts, and hospital administrations. Former Lok Janshakti Party chief, late Ram Vilas Paswan, had demanded a CBI probe, while the state’s then-labour minister Janardan Singh Sigriwal had told BBC the scandal could not be called a scam because “the amount of money involved is not huge”.
In the decade since, Bihar has changed a lot, but not for poor Dalit women left at the mercy of village quacks or get-rich-quick, hole-in-the-wall clinics. Guriya and Sunita’s losses are separated by a decade, but both are victims of malpractice, malfeasance and moral turpitude by a medical community that took the Hippocratic Oath to do no harm to its patients. “Find that doctor from wherever he is hiding and transplant his kidney on me,” Sunita said, with little hope of that happening.
If justice has remained elusive to Sunita, it’s because of her caste, illiteracy, poverty, and gender, according to Padma Shri awardee Sudha Varghese, a social activist who moved to Bihar in 1965 to work with Mahadalits. “These doctors cannot scam a woman from an upper caste or upper class. And even if they do, can you imagine the state staying as a mute spectator? The lives of ultra-poor women are cheap for this nexus,” Varghese said.
A clinical apparatus of fraud
While it was a compounder who operated on Sunita, Guriya had fallen prey to a cabal of doctors and health department officials who conducted unnecessary surgeries on women to siphon crores of rupees under the ambitious central health insurance scheme for the poor, Rashtriya Swasthya Bima Yojana.
The Bihar Human Rights Commission awarded compensation of Rs 18 crore to 708 women victims of the ‘uterus scam’. In an impoverished state of high political competition, providing compensation is easier than cracking down on a corrupt predatory medical system. Illegal nursing homes and clinics have mushroomed across Bihar in the last 10 years, at least 12 district officials, civil surgeons and medical superintendents admitted to ThePrint.
“The number of unregistered clinics and nursing homes is almost the same as legal establishments,” said a Samastipur district health official who did not want to be named. Women are stripped of their dignity and organs by such unscrupulous, incompetent, and predatory medical system that exploits their vulnerability and voicelessness in society.
“A man’s role before and after pregnancy is almost negligible. But among families below the poverty line, it is the men (and elderly women) who persuade women to go for such surgeries. It is a way to end any conversation around uterus, periods and women,” said Samastipur district magistrate Yogendra Singh.
And women in rural areas are especially vulnerable in a male-centric culture as they are often pressured by their husbands to undergo invasive procedures for quick results. Disturbingly, these procedures are frequently carried out with minimal oversight. Such occurrences are not rare either. In a raid conducted in November 2022 in West Champaran, authorities discovered five female patients who had undergone hysterectomies and were receiving treatment without the supervision of any healthcare workers.
Shockingly, many doctors involved in these cases go unpunished. Even in instances where arrests have been made, doctors have secured bail and resumed operating nursing homes. The impunity with which they function reveals how a commonplace surgery like hysterectomy is exploited against poor and unsuspecting women in remote parts of India.
More often than not, authorities act against these illegal clinics and nursing homes only when ‘something happens’. In 2021, for instance, notices were served to 5,433 such establishments. However, it was the murder of a local journalist who had filed a Right to Information (RTI) application to expose fake clinics and nursing homes in his hometown of Benipatti that finally pushed the government to intervene.
A life confined to ICU
Women such as Sunita and Guriya are unable to fight for justice. They rely on NGOs, activists, and local media to advocate for their cause and hope the government will take note.
Eight months later, Sunita’s story continues to dominate local news in Bihar, with every detail of her struggle for survival and the accompanying family drama reported with morbid fascination. ‘Sunita is still waiting for a donor’ is a common headline that appears regularly, almost like a daily tracker. Reports have also emerged claiming that Sunita’s family has abandoned her, including her husband.
Chief Minister Nitish Kumar has yet to publicly comment on Sunita’s case or the predatory medical system thriving in Bihar. His deputy Tejashwi Yadav, who is also the state’s health minister, warned the medical fraternity to either improve the healthcare or face action, at a meeting held on 8 September, shortly after Sunita’s case came to light. This is the only government response her case has garnered thus far.
Today, Sunita lies in the ICU bed within the encephalitis ward on the third floor of the state-run Sri Krishna Medical College and Hospital (SKMCH) in Muzaffarpur. Everyone on the floor knows her as the woman of ‘kidney kaand‘ (scandal).
“Every few days, I see a dead body being carried out of this ICU ward. One day, I will be the hundredth body recorded,” said Sunita, who is gradually losing hope of making it through. She constantly gazes at the door, waiting for a potential donor to enter. Although a couple of elderly men, aged 70 and 80, did come forward offering their kidneys, their efforts only resulted in a few minutes of media spotlight.
Sunita remains the state’s top priority patient. “If Bihar acquires a matching kidney, it will go to her,” said UC Sharma, Muzaffarpur’s civil surgeon.
Her body, swollen and pierced with needles, follows a strict diet—half a litre of water in 24 hours and dry vegetables. But she yearns for the dal-bhat (lentils and rice) that she cooked in her home.
“I cry every day. I wish the doctor would allow me to go home, even just for a day.”
The nursing staff and aides attending to her witness her wavering determination to live in the absence of a donor. “It breaks my heart to see her succumbing to despair,” lamented the head nurse.
The four lab technicians, part of the dialysis team in the nephrology department, console her. “Have faith in yourself and in us.”
The state government covers the expenses for Sunita’s dialysis and other medical treatments. Under the SC-ST Atrocity Act, the district administration has proposed compensation of Rs 5 lakh for Sunita but her family is yet to receive it. “We have also enrolled her children in SC-ST hostels run by the state’s welfare department. The state will bear the cost of their education,” said Ashutosh Dwivedi, Deputy Development Commissioner, Muzaffarpur.
However, the family has refused to send the children to SC-ST school hostels. Instead, Sunita’s two sons, aged 10 and 6, remain by her side at the hospital, while her father, Laldev Ram, and her 12-year-old daughter participate in protests.
“Why can’t they provide us with Rs 25 lakh in compensation and a government job?” asked Sunita’s husband, Aklu Ram, during a phone conversation with ThePrint. Sunita claims her husband, a landless daily wage labourer, has abandoned her and hasn’t visited her in months.
About 20 km away, a group of activists led by Praveen Kumar has been staging an indefinite protest under the banner of ‘Sunita maange insaaf‘ (Sunita demands justice) in front of the government referral hospital at Sakra Block. Praveen, a self-described social activist based in New Delhi, arrived in Sakra on 10 February and has been leading the protests since then. He has become a prominent figure rallying support for Sunita. Their demands include a kidney, Rs 25 lakh compensation for the family, and a government job for Sunita’s husband.
Medical malpractice isn’t uncommon in India. The public outrage against negligence and irregularities has been growing in the past decade, with doctors and hospitals facing attacks in states such as Karnataka, Rajasthan, Maharashtra, and Uttar Pradesh. Some doctors have even resorted to hiring gunmen for protection, including in Bihar.
Where the quacks rule
Sunita, 27, lived in Mathurapur village with her husband and three children with minimal health complications. But her life changed in June 2022, when she began experiencing abdominal pain. She was admitted to SKMCH, where an ultrasound diagnosed her with a cyst in her right ovary. As per the ultrasound report, her kidneys were normal.
Due to a subsequent Covid infection, Sunita was discharged from the hospital with instructions to follow up after 15 days. When the pain persisted, her mother Tetari Devi consulted with a quack named Pawan Kumar, who claimed to be a surgeon. Pawan, who was only qualified as a compounder, operated a three-room tin-shed hospital called Shubhkant Clinic located on Bariyarpur Main Road at Murgi Farm Chowk.
Pawan told Tetari that Sunita needed a hysterectomy, which would cost Rs 20,000. “He asked us to bring Sunita to the clinic on 3 September,” Tetari said. Sunita was scheduled for surgery at 4 pm, but before the operation, she went to the bathroom to urinate.
“That was the last time that I peed,” Sunita recalled.
The surgery was performed by Dr Jitendra Kumar Paswan, Dr RK Singh, and Pawan Kumar. Pawan’s wife was also present there. When Tetari was called in after the surgery that lasted for two and a half hours, she found her daughter unconscious. “They showed three large clots of flesh on a steel plate and said ‘Look, her disease was this big’,” she said. Sunita’s kidneys and uterus lay exposed on the plate.
Following the operation, Sunita was put on a saline drip for 24 hours, which only worsened her condition. Pawan then arranged for a Bolero and told the family that she needed to be taken to his “guruji” in Patna.
“Pawan fled after admitting her (in Sri Ganga Ram Hospital),” Tetari alleged, stating that the hospital administration demanded Rs 40,000 before discharging Sunita. They subsequently took her to Patna Medical College and Hospital (PMCH), where an ultrasound conducted on 5 September revealed that both her kidneys were not visible. Two more ultrasounds were performed on 7 and 9 September, only to confirm the shocking truth the family had discovered by then—both of Sunita’s kidneys had been stolen.
Finally, she was admitted to SKMCH in December when the state government announced that it would cover the cost of her treatment. But the family had spent about Rs 1 lakh by then.
“We have never seen a case like this before. How could the quacks remove both kidneys when they are anatomically far apart from the uterus?” said Dr Satish Kumar Singh, deputy superintendent of SKMCH.
Dr Jyoti Meena, a gynaecologist at AIIMS-Delhi who has only read about the case in the media, said Sunita received misguided advice. “They could have started medication or removed the infected ovary. Removing the entire uterus was unnecessary,” she said.
The shocking details and media attention prompted swift police action. Pawan and Jitendra Paswan were arrested and are currently in Muzaffarpur Central Jail, while RK Singh remains at large. They have been named as accused in the FIR under various sections of the Transplantation of Human Organs and Tissues Act 1994, and the Scheduled Castes and the Scheduled Tribes (Prevention of Atrocities) Act 1989. Pawan’s three-room tin-shed clinic has been sealed.
“The hospital was not registered, didn’t have an operation theatre, and did not display the doctors’ degree,” said a police officer.
The police have not found any evidence of kidney sales. “They must have decomposed them when the case came to light,” said Rakesh Kumar, senior superintendent of police, Muzaffarpur.
Building up a debt trap
Pinki Devi, another Dalit woman from Sakra Block, opted for sterilisation in December 2022 due to her circumstances — three children to feed and a husband who “drinks day and night”. A local doctor, Rakesh Kumar Roshan, who runs two makeshift hospitals, convinced her to undergo a hysterectomy, charging her Rs 18,000. Pinki would later discover that her ureter—the tube that carries urine from the kidney to the bladder—had been severed during the procedure.
The makeshift hospital where Pinki underwent the surgery was close to the now-sealed Shubhkant Clinic, where Sunita had her operation. By the end of January, Pinki’s health had deteriorated, but Roshan dismissed her concerns, claiming that the swelling of her body was normal and would reduce if she drank less water. When her condition worsened, he took her to a private hospital in Patna but brought her back to Sakra when the doctors informed him about the cost of the operation — Rs 90,000.
“Throughout this time, I was peeing drop by drop. It didn’t stop,” Pinki said.
Her family took her to Sadar Hospital Muzaffarpur, then to PMCH, then AIIMS-Patna and finally to Indira Gandhi Institute of Medical Sciences. By the time she was discharged earlier this month, they had built up a debt of Rs 3.5 lakh.
“How will I pay this money?” Pinki asked helplessly.
Her story received less media attention compared to Sunita’s, echoing the fate of Guriya and other victims of the 2012 uterus scam.
When several women approached Samastipur District Magistrate Kundan Kumar during a Janta Darbar in 2012, he discovered something foul in the Rashtriya Swasthya Bima Yojana. The women narrated how their wombs had been removed by doctors who claimed they would get cancer. Similar reports emerged from other parts of Bihar.
“The details were shocking, but I didn’t want to sensationalise the matter because it involved a very important health insurance scheme meant for the poor,” Kumar told ThePrint, recalling the days of struggle that set the template for future policymaking and became part of the public debate on hysterectomies in the country. In 2015, Kumar won the PM Award for Excellence in Public Administration for his initiative.
He organised a camp where 2,606 women were re-examined. Ultrasound reports confirmed that 316 of them had undergone hysterectomies despite carrying healthy wombs. It was at this camp that Guriya Devi discovered that she had been robbed of her uterus.
“Six months after the surgery, I learnt that I didn’t have a womb. Who could have I complained to?” said Guriya, who was among the 259 victims traced by the Samastipur administration and awarded Rs 2.5 lakh in compensation after a decade.
Guriya, a 25-year-old with four children, opted for tubal sterilisation at Maa Tara Nursing Home, run by one Dr Jitendra Kumar. There was no consultation on her case and Guriya wasn’t asked any questions before she entered the operation theatre. She woke up after four days of unconsciousness, and was discharged on the fifth day.
The Samastipur police registered an FIR against five hospitals, including Mala Nursing Home run by RR Jha and Mala Jha, Krishna Hospital by Shraddha Thakur and Mahesh Thakur, Lifeline Hospital by Vishnu Dev Prasad, Mishra Nursing Home by Rajiv Kumar Mishra, and Pragya Seva Sadan by Sangeeta Kumari.
Twelve hospitals were blacklisted and de-empaneled but most are functioning today under different names. Tara Nursing Home operates out of a two-storey building—with seven beds, two nurses, six ward boys, and a receptionist. Jitendra Kumar, who was an MBBS from New Delhi’s Sri Ganga Ram Hospital in government documents in 2012, is now an MBBS from Chennai, ThePrint confirmed after visiting his Tara Nursing Home and C-Max Hospital, another clinic that he has opened in Samastipur. He refused to talk about his involvement in the uterus scam.
Moreover, all 33 doctors arrested in the uterus scam are out on bail, according to Samastipur health officials.
The National Family Health Survey-5 data shows that half of the women in India undergo hysterectomies before the age of 35. A 2022 IIT-Delhi study said that women are more likely to undergo unnecessary hysterectomies when state health insurance schemes reimburse private hospitals on a fee-for-services basis.
The Union health ministry recently urged state governments to audit hysterectomy trends, after the Supreme Court gave states three months to implement the Centre’s health guidelines in April.
“Organs are not man-made or cash compensations. In most cases, kidney donors are blood relatives,” said civil surgeon UC Sharma.
Sunita’s decision to seek a quack’s help in removing her uterus was influenced by her mother’s lack of awareness and her husband’s approval. Finding a kidney donor within her family is now her best chance, but nobody has come forward.
“Her parents have passed the matchability age, and her four siblings have refused to donate their kidneys,” Sharma said.
Sunita’s mother Tetari understands her children’s stance. “Who will look after their children if my other sons and daughters donate their kidneys?” she asked, and recalled Bihar’s former chief minister Lalu Prasad Yadav receiving a kidney from his daughter Rohini Acharya.
“But Sunita isn’t an elite or a man.”
Courtesy : The Print