An ill-conceived plan

One-sided “There is no stress on male contraception.” File picture shows some of the women who underwent sterilisation surgery at a camp in Bilaspur, in 2014 REUTERS   | Photo Credit: ANINDITO MUKHERJEE

Women in Chhattisgarh are now facing a new crisis. Over 27 months after 13 women died and 65 took ill at a State-run mass sterilisation camp, the State government has now discontinued all sterilisation services. The botched event focussed attention on India’s dark history with family planning services.

After recommendations

Open camps, an important part of family planning services were discontinued as per the recommendations of a judicial commission headed by retired district judge Anita Jha. “We have complied with all the recommendations of the judicial commission. The doctor who performed [the] surgeries has been terminated and representatives of the pharmaceutical company which supplied [the] medicines are in jail. In compliance with the Supreme Court and the commission’s report, open camps have been discontinued in Chhattisgarh,” says Subrat Sahoo, principal health secretary, Chhattisgarh.

As a result, women have turned to private clinics, if they can afford the ₹8,000- ₹10,000 bill. Government-run family planning services require going to neighbouring Jharkhand and Madhya Pradesh. “Instead of providing quality sterilisation services in the aftermath of so many deaths, the government [has] responded by discontinuing the services. Health facilities, including district hospitals [have] stopped sterilisations. Tribal areas have suffered the most. It is only two years later that some community health centres [CHC] and district hospitals have started the services,” says Sulakshana Nandi, national joint convenor, Jan Swasthya Abhiyan, India-chapter of People’s Health Movement.

No focus on men

It has been a long-standing demand of the health movement in India that open camps be discontinued. However, they have to be replaced by adequate facilities at CHCs and district hospitals. It needs to be accompanied by awareness on male contraceptive methods such as condom use and vasectomy. “We do not see either happening. There is no stress or campaign on male contraception,” says Ms. Nandi.

Since the discontinuation of open camps, sterilisation rates in Chhattisgarh for both men and women have dropped drastically. According to Chhattisgarh’s Health Department data, 1,35,407 were sterilised between April 2012 and March 2013. The number dropped to less than half in 2014-15, with only 52,082 availing the services. The number continues to be low.

“We have put the entire burden of family planning on women, but it is equally a men’s issue. The government does not convince and cajole men into sterilisation the way it does for women. The tragedy in Chhattisgarh was a wake up call. It showed that there is high demand, especially among women, despite bad quality services. The government should have responded by providing quality services to men and women, rather than withdrawing the existing services. It’s as if the government is saying ‘either you take bad services or nothing’,” says Poonam Muttreja, Executive Director of the Population Foundation of India.