On February 5, 2013 a mega female Minilap Ligation operation camp was held at Manikchak Rural Hospital (RH) of district of Malda, in West Bengal. On this particular day 103 women were sterilised. It was reported in the local media that the women who were sterilised in this camp were kept on the open ground (hospital campus premises) in semi conscious state, and their relatives were asked to take them back home immediately after the operation. This was highlighted in the media (NDTV and other news channels) as gross human rights violation and later enquires were conducted by the state health department and the national human rights commission. The National Human Rights Commission (NHRC) has issued notices to West Bengal’s Principal Secretary Health West Bengal and the Malda district magistrate, taking cognizance of an NDTV report that showed how nearly a hundred women were dumped unconscious.
Civil Society Fact-Finding: There was strong opposition to this from civil society groups as it is felt that despite government guidelines on quality assurance and standard procedures to be followed in camp settings are not being followed and implemented properly. This is a summary of this fact-finding exercise.
On April 6, 2013, an independent fact finding was conducted by a team comprising of public health experts, health and women’s rights activists and members of networks including Heath Watch Forum, Bihar; Coalition Against Two-Child Norm and Coercive Population Policies and Human Rights Law Network (HRLN). National Alliance for Maternal Health and Human Rights (NAMHHR) supported the team by sharing the ethical guidelines and checklists for case documentation. The team members are working actively on issues related to reproductive health and rights and are engaged in post ICPD processes in India. Dr. Prabir Chatterjee, RCH Raiganj, West Bengal; Praveer Peterfrom HRLN, New Delhi; Kanti from Smokus local NGO Raiganj, Leena Uppal from Coalition Against Two-Child Norm and Coercive Population Policies, New Delhi; Devika Biswas from Health Watch Forum, Bihar (also filed the PIL in Supreme Court earlier in 2012 about 53 women who were sterilised in a government school in Araria district of Bihar) formed the team.
The main aim of the fact-finding was to systematically document whether the standards specified in different guidelines (a) ‘Quality Assurance Manual for Sterilisation Services, 2006’, (b) ‘Standard Operating Procedures for sterilisation services in camps, 2008′ (c) ‘Standards for Female and Male Sterilisation Services, 2008’ were adhered to during this camp and assess whether the providers are maintaining standards of care as specified in the service guidelines.
Villages Visited: The team visited six villages in Malda district from where women had come for the operation. Villages included Niranjanpur, Nawada Maheshpur, Fakirtola, Gopaltola, Bagditola and Najiruddinpur. Women who had undergone operations on February 5, 2013 and their families were interviewed. Meetings and interviews with the Chief Medical Officer of Health (CMOH), Block Medical Officer of Health (BMOH) of Malda district, five ANMs and four ASHAs were also conducted.
Key Findings: The fact-finding report describes the concerns and challenges faced by the women and their relatives, who underwent operations in the camp. It also throws light on the lack of basic minimum standards adhered by officials in the camp.
One of the key finding was the fact that the standard camp protocols of the GOI were not followed. Infection control practices were inadequate. Though the GOI guidelines emphasise maintenance of prevention of infection, however the health care providers are unable to monitor or maintain records of infection control mechanisms followed at such family planning camps, given the large number of operations that that they conduct in a single day.
A total of nine women were interviewed. All women interviewed reported that they were not provided options for informed choice at the camp. All the women and their families voiced an environment of utter confusion and chaos at the camp. Women reported pain and minor complications after the operations, lack of complete knowledge about the operation procedure, consent being only in terms of thumb impressions and out of pocket expenditures during and after the operations.
A quick analysis of number and sex of children of all the women interviewed clearly showed a high preference for male child. Most of these women reported that they have been waiting for at-least one son before they go in for permanent sterilisation.
Discussion: Women, who have undergone inhuman treatment where their dignity and rights have been denied, must be provided some form of redressal. The Family Planning Insurance Scheme which includes provisions for compensation to women who face failures and complications (and death) should be expanded to include humiliation of this nature. The Department of Family Welfare must also audit and ensure strict compliance of the quality assurance mechanisms it has already issued. The state government urgently needs to put the grievance redressal system/complaint box in place and ensure that such negligence is not repeated and the underlying deficits are addressed effectively.
It is hoped that the analysis from fact-finding will be of use to the larger community concerned with the experiences of women who have used family planning services and who are going to use them in future. It is also hoped that these findings will be deemed as relevant by the district officials at Malda, West Bengal who have been a part of this fact-finding process.
We request you to share this summary widely and to urge your governments to stand up for women’s rights including their right to control their own bodies, fertility and sexuality!