Recent Resources for Feminists
Monday December 1 2014
30 yrs after disaster, Bhopal's toxic legacy lives on A panel displays pictures of residents who died in the 1984 Bhopal disaster at the forensic department of a hospital in Bhopal November 14, 2014. (Reuters)
Health of Bhopal communities suffers 30 years after disaster BHOPAL/NEW DELHI: Beyond the iron gates of the derelict pesticide plant where one of the world's worst industrial disasters occurred, administrative buildings lie in ruins, vegetation overgrown and warehouses bolted.
Activists call for faster action to remove hazardous waste
Massive vessels, interconnected by a multitude of corroded pipes that once carried chemical slurries, have rusted beyond repair. In the dusty control room, a soiled sticker on a wall panel reads "Safety is everyone's business".
Sixty-four-year-old Zafar Ahmed receives treatment at a clinic supported by Bhopal Medical Appeal in Bhopal November 14, 2014. (Reuters)
On the night of December 2, 1984, the factory owned by the US multinational Union Carbide Corp accidentally leaked cyanide gas into the air, killing thousands of largely poor Indians in the central city of Bhopal.
Thirty years later, the toxic legacy of this factory lives on, say human rights groups, as thousands of tonnes of hazardous waste remains buried underground, slowly poisoning the drinking water of more than 50,000 people and affecting their health.
Activists want this waste removed and disposed of away from the area, and feel Indian authorities, who now own the site, have fumbled on taking action either by clearing up the waste itself or in pursuing Union Carbide to take responsibility.
"There is a very high prevalence of anemia, delayed menarches in girls and painful skin conditions. But what is most pronounced is the number of children with birth defects," said activist Satinath Sarangi from the Bhopal Medical Appeal which runs a clinic for gas victims.
"Children are born with conditions such as twisted limbs, brain damage, musculoskeletal disorders ... this is what we see in every fourth or fifth household in these communities." Sarangi admits there has been no long-term epidemiological research which conclusively proves that birth defects are directly related to the drinking of the contaminated water.
Built in 1969, the Union Carbide plant in Madhya Pradesh state was seen as a symbol of a new industrialised India, generating thousands of jobs for the poor and, at the same time, manufacturing cheap pesticides for millions of farmers.
Fifteen years later, 40 tonnes of Methyl Isocyanate gas was released and carried by the wind to the surrounding densely populated disaster remains unclear and under debate.The government recorded 5,295 deaths, but activists claim 25,000 people died in the aftermath and following years.
Another 1,00,000 people who were exposed to the gas continue to suffer today with sicknesses such as cancer, blindness, respiratory problems, immune and neurological disorders. Some children born to survivors have mental or physical disabilities.
While those directly affected receive free medical health care, activists say authorities have failed to support those sick from drinking the contaminated water and a second generation of children born with birth defects.
In a rehabilitation centre run by the charity Chingari Trust, located 500 metres from the factory site, disabled children aged between 6 months and 12 years gather for treatment which ranges from speech and hearing issues to physiotherapy.
"Our life changed emotionally and physically since we got to know about his medical problem when was just 4 months old," said 26-year-old Sufia, sitting on a mat on the floor, cradling her two-year-old son Mustafa who has cerebral palsy.
"We had to stop the therapy when he was 8-months-old as it was very expensive. My husband is an electrician and doesn't earn much. With the centre it is good as it's free. It's also good to meet other mothers with their children and realise that I am not alone."
Call for clean-up
The government was forced to recognise the water was contaminated in 2012 when the Supreme Court ordered that clean drinking water be supplied to some 22 communities living around the factory site.
"I don't think there is any doubt now that the waste dumped by Union Carbide is a serious problem and that it needs to be dealt with urgently," said Sunita Narain, director of the Delhi-based think-tank Centre for Science and Environment.
Studies by Narain's organisation in 2009 found samples taken from around the factory site contained chlorinated benzene compounds and organochlorine pesticides 561 times the national standard.
The profile of the chemicals found in samples from within the site matched the chemicals in drinking water in the outside colonies, said the report, leaving no doubt that there could be no other source of these toxins than Union Carbide.
Studies since have confirmed water pollution, but the hazardous waste remains in pits in some 21 locations within the 68-acre site and buried in a wasteland outside, largely due to wrangles between authorities and activists on its disposal.
The United Nations this week welcomed a government decision to reconsider the official figure of people affected by the gas leak, and look into additional compensation, but pressed authorities to get rid of the toxic waste.
"New victims of the Bhopal disaster are born every day, and suffer life-long from adverse health impacts," said Baskut Tuncak, UN Special Rapporteur on human rights and toxic waste.
"Without cleaning the contamination, the number of victims of the toxic legacy left by Union Carbide will continue to grow, and, together, India's financial liability to a rising number of victims," he added in a statement.
Activists want Union Carbide, which was taken over by Dow Chemical Company in 2001, to take the waste out of the country, saying there are no adequate facilities in India to deal with it. They have also criticised state authorities for not pursuing the corporation for the clean-up. State government officials were not immediately available for comment.
Seventeen people living around the plant have filed a petition in the U.S. courts to get the multinational to bear the cost of the clean-up.
Dow Chemical Co. has long denied responsibility, saying Union Carbide spent $2 million on remediating the site, adding that Indian authorities at the time approved, monitored and directed every step of the clean-up work.
Union Carbide was sued by the Indian government after the disaster and agreed to pay an out-of-court settlement of $470 million in damages in 1989. The company says the Indian government then took control of the site in 1998, assuming all accountability, including clean-up activities.
"While Union Carbide continues to have the utmost respect and sympathy for the victims, we find that many of the issues being discussed today have already been resolved and responsibilities assigned for those that remain," Tomm F. Sprick, Director of Union Carbide Information Center, told the Thomson Reuters Foundation in an email. Reuters
Friday November 28, 2014
Bhopal gas tragedy: Toxic waste disposal still awaitedPTI:
The toxic waste after the Bhopal Gas tragedy lying at the Union Carbide plant here is still awaiting disposal, even after 29 years of the world's worst industrial disaster, amid concerns of air and water pollution.
Though an NGO had in 2004 moved a PIL in Madhya Pradesh High Court after soil sample tests carried out in and around the closed plant revealed that the 350 metric tons of waste was causing air and water pollution in the surroundings having a huge human settlement, the toxic dump could not be cleared due to resistance from different environment groups.
The High Court later directed the Centre and the state that the toxic waste should be incinerated after tests at Pithampur in MP's Dhar district.
But the move could not see the light of the day after stiff opposition by NGOs which claimed that the waste disposal at the incinerator will harm Pithampur's people and its environment, Alok Pratap Singh, president of NGO 'Zahreeli Gas Kand Sangarsh Morcha', who had moved the HC, told PTI.
"After this, the HC ordered that the hazardous waste should be disposed of at Gujarat's Ankleshwar incinerator. Again the NGOs from that state protested against it. The Gujarat government petitioned the apex court to review the decision," Singh said.
Later, the Supreme Court directed that the waste should be incinerated at the Defence Research Development Organisation (DRDO) facility near Nagpur. But, NGOs protested again in Maharashtra following which the state government expressed its unwillingness in court on the issue, he said.
A German firm later proposed to dispose of the waste in Germany, but backtracked following protests by NGOs in the European country, Bhopal Gas Tragedy Relief and Rehabilitation Department's Deputy Secretary K K Dubey said.
After this, the apex court asked for the waste to be incinerated at Pithampur, and in a prelude 25-30 metric tonnes should be disposed on an experimental basis, he said.
The Central Pollution Control Board (CPCB) got similar waste of some organisation in Kochi incinerated at Pithampur. "Now we are waiting for words from CPCB to hand over the waste to them for incineration," Dubey said.
In June 2010, a Group of Ministers (GoM) was formed to look into the problems related to the disaster which earmarked Rs 315 crore for disposal of the waste, he said.
The verdict on Bhopal Gas Tragedy came 25 years after poisonous gas leaked from the plant on December 2-3, 1984, killing over 3,500 people and injuring over 5 lakh residents.
"...but for the people near the defunct factory, the tragedy isn't over as they still face air and water pollution given that the hazard waste lying in the factory," said activist Abdul Jabbar, working for the tragedy's survivors.
India ~ Thursday December 4 2014
A flawed rehabilitation policy adds to woes of Bhopal widows
The widows of the Bhopal gas tragedy live in a residential complex called Vidhwa Colony a Kafkaesque and dystopic world not unlike a penal settlement from another era By Vidya Krishnan
The government handed over the apartments without ensuring basic sewage disposal, a problem that has now grown to pose one of the biggest health crises for residents. (Pradeep Gaur/Mint)
Bhopal: From its tactless name to the design of its buildings and absence of the most basic civic amenities, everything about this place points to neglect and flawed rehabilitationa ghetto of widows who are victims twice over.
Lying a little outside Bhopal's city limits in Karond village, it is a settlement of women who survived the Union Carbide chemical holocaust 30 years ago. Their husbands did not.
They live in a residential complex called Vidhwa (widow) Colonya Kafkaesque and dystopic world not unlike a penal settlement from another era.
Here, the taps run dry, the drains are choked with filth, the drinking water supply line is mixed with the sewage pipeline and electricity supply is erratic.
Nearly every widow here is either a patient herself or cares for someone suffering from ailments caused by exposure to the 2-3 December 1984 leak of methyl isocyanate (MIC) gas from Union Carbide India Ltd's (UCIL) pesticide plant in Bhopal.
The diseases range from cancer, lung injuries and the aftermath of cardiac failures to neurological disorders. "Aise jeene se to maut aasan hai. Jo tab mar gaye, woh bach gaye (it's better to have died than to live like this)," said 56-year-old Jamna Bi, who lost her husband and mother-in-law after 40 tonnes of MIC leaked from the UCIL plant.
The so-called Gas Widows' colony was built by the Madhya Pradesh government in 1992. It is essentially a multistorey slum with 2,486 one and two-bedroom apartments. The state government announced a monthly pension of Rs.275 that would take care of them in their new homes and pay for medical care and other expenses that living entails. This tiny amount remained the same until 2010, when the central government revised it to Rs.1,000 per month. Even this was discontinued in April 2014, after an audit revealed that the arrears had been wrongly paid.
"I was given a first instalment of Rs.18,000. My lawyer (pursuing the compensation case in Bhopal's district court) kept Rs.16,000 and said I could keep the second instalment completely. We were later informed that there was a clerical error in calculation of the pensions and so it was discontinued," said 60-year-old Seema Bi, who now works as a domestic help to make ends meet.
The Madhya Pradesh government's deeply flawed rehabilitation plans for the widows fell to pieces almost as soon as the flats were allotted. To begin with, the government handed over the apartments without ensuring basic sewage disposal, a problem that has now grown to pose one of the biggest health crises for residents.
In 1998, eight residents died of cholera in Vidhwa Colony.
"The height of the building was the problemmost people living in the colony had respiratory illnesses and could not climb four flights of stairs. Clearly, very little thought was put into this," said Abdul Jabbar, convener of the Bhopal Gas Peedit Mahila Udyog Sangathan (BGPMUS), a civil society organization fighting to get the women's pensions reinstated.
"None of the top floor houses got water supply. The area was not connected well by public transport, did not have street lights or schools, hospitals or even employment opportunities. This is a classic example of dumping the city's garbage outside in the name of rehabilitation. That place is a dump yard," added Jabbar.
In 2010, chief minister Shivraj Singh Chouhan had promised to turn Vidhwa Colony into a "model town". On the occasion of the festival of Rakhi, when brothers pledge to protect their sisters, he renamed the settlement Jeevan Jyoti colony and adopted all the residents as his "Rakhi sisters".
The Madhya Pradesh government sanctioned Rs.15 crore to fix sewage and drainage, build roads and maintain the apartment buildings. It promised to set up an Anganwadi centre, a higher secondary school and a vocational training centre in the colony.
Four years later, only the nomenclature remains changed.
Between 1989-1993, over 2,000 widows were accommodated here but over the years, nearly half of the original allottees have moved out, preferring to give the flats out on rent.
"The municipal corporation cleans the area when a politician is about to visit, usually before an anniversary. The sewage system is so dysfunctional that the filth flows back into our houses now. It also gets mixed in our drinking water pipeline," said Irshad Khan, who rents a flat originally allotted to a ‘gas widow'. "Once their children start earning, most women move out of the settlement and rent out the flats allotted to them. Who would want to live like this?"
Pensions and official records are buried in bureaucratic jargon that are impossible to make any sense of. According to the state government, Jeevan Jyoti colony has a total of 4,422 pensioners under various social benefit schemes such as widow pension, differently abled pension, senior citizen pension and below poverty line benefits.
Of these, 2,914 people are supposed to have postal accounts. But officially only 873 beneficiaries are registered in the municipal ward and of them, only 350 have post office accounts.
"The main cause of the problem in Bhopal has been faulty survey, which has been greatly addressed through ongoing Aadhaar seeding," said Nishant Warwade, district collector, Bhopal.
This problem, he said, will be solved once all beneficiaries have core banking system accounts.
"The widows pension had run into some difficulty due to overdrawal by some beneficiaries. It has been restarted after an enquiry now with appropriate deductions over a period of time to readjust the (withdrawals). Some unscrupulous elements found guilty in this shall face action as per law," chief minister Chouhan said in reply to e-mailed queries.
He also pledged to fix the drainage system soon. "The sewage system needs a complete revamp on account of changed gradient, which has adversely affected the drainage system.
"After a proper scrutiny and advice of experts, a Rs.4.12 crore project has been sanctioned, agency identified and work is to begin shortly. The municipal corporation of Bhopal will oversee this work and it should be completed in the next three months," Chouhan added.
Such help will come too late for some victims of the gas leak tragedy, an event that for 30 years has cast a long shadow on Bhopal.
The trajectory of 34-year-old Sunil's life captures these decades of neglect most succinctly.
The night that gas leaked from the plant, Sunil lost his parents and five siblings. Along with his younger sister, he was placed in an orphanage run by the charity SOS Children's Villages in Bhopal.
In 1994, his sister turned 18 and both had come ‘of age' and could not stay in the orphanage any longer. "They moved to the widows' colony and initially he was fine. But slowly the lack of a support system started getting to him. He used to work but after moving here, his mental health progressively deteriorated," adds BGPMUS' Jabbar.
He was found hanging from the ceiling of his flat in Widows Colony on 26 July 2006. He was wearing a black tee shirt that said No More Bhopals.
"People have just been boxed together with little or no support from the system. With each passing year, there are fewer of us left to demand rights, fight for it or even remind people of what happened in Bhopal," said Jamna Bi. "Eventually, we will all be dead and no one will be left to chase after the government or companies. They can feel happy thinking that the day is coming soon."
Wednesday December 3, 2014
Bhopal Gas tragedy: No accurate data on deaths 30 years on, alleges NGOPTI:
An NGO working for the Bhopal gas tragedy victims has alleged that there are no accurate figures available on the death toll of the world's worst industrial disaster even after 30 years and has also raised concern over the toxic waste lying in defunct Union Carbide plant situated near the densely populated old Bhopal area.
Though unofficial estimates claimed that the death toll due to the Bhopal gas tragedy had exceeded the 25,000 mark, official figure stands at 5,295 for whom the government had compensated.
"So far we have compensated for 5,295 deaths due to Bhopal Gas Tragedy," Madhya Pradesh Department of Gas Relief and Rehabilitation deputy secretary K K Dubey told PTI.
However, NGO Bhopal Group for Information Action's (BGIA) activist Rachna Dhingra claimed that as per their information, the death toll had crossed 25,000 since the disaster took place.
"We are demanding compensation for the same, but the state government has so far compensated only for 5,295 deaths," she said.
Notably, the Madhya Pradesh government had in 2012 demanded from the Centre's Group of Ministers a compensation of Rs 10 lakh each to the kin of 15,342 deceased in the tragedy, as per revised figures in Indian Council of Medical Research (ICMR) report, a government release had then said.
Besides, concern has been raised over non-disposal of 350 MT of toxic waste lying in the defunct chemical plant which is a major cause for pollution, especially water contamination in and around the factory.
Hearings have been going since 1999 in Southern District Court of New York against the Union Carbide Corporation, seeking that the poisonous waste should be removed from its factory in Bhopal, Dhingra said. (MORE) PTI LAL MAS GK SG 12031153
Around 17 people, living close to the plant, supported by some NGOs, had moved the US court in 1999, but the timid response to the case by successive Madhya Pradesh governments has not yielded any result, she alleged.
"It is high time that MP government should intervene in the US court and get the waste cleared," she demanded.
In India too, an NGO moved a PIL in Madhya Pradesh High Court in 2004, after a soil sample test carried out in and around the closed factory revealed that the waste was causing air and water pollution in the surroundings having a huge human settlement. But the toxic dump couldn't be cleared following resistance from different environment groups.
In the last decade, the High Court directed the Centre and the state that the toxic waste should be incinerated after tests at Pithampur in Dhar district of Madhya Pradesh.
But the move couldn't see the light of the day after stiff opposition by some NGOs alleging that disposal of the waste at the incinerator will harm people and the environment of Pithampur, Alok Pratap Singh, president of NGO Zahreeli Gas Kand Sangarsh Morcha, who had moved the HC, told PTI.
After this, the HC ordered that the hazardous waste should be disposed of at Ankleshwar incinerator in Gujarat. Again, the NGOs of Gujarat protested against incinerating plan in that state. The Gujarat government petitioned the apex court to review it decision, Singh said.
The Supreme Court had then directed that the waste should be incinerated at Defence Research Development Organisation (DRDO) plant near Nagpur after assessing its after effects, but NGOs protested again in Maharashtra following which the state government expressed its unwillingness in court on the issue, he said.
Maharashtra Assembly passed a resolution against the disposal of the waste at DRDO, Singh said. MORE PTI LAL MAS GK SG 12031153
Later, German company GIZ handed a proposal to the MP government to dispose of the waste in Germany, Dubey said.
However, GIZ backtracked following NGOs' protest in Germany on the issue, he said. After this, the apex court asked that the waste should be incinerated at Pithampur and in a prelude 25-30 metric tonnes should be disposed on experimental basis, he said.
The Central Pollution Control Board (CPCB) got similar waste of some organisation of Kochi in Kerala -like the one lying in Bhopal Union Carbide Factory - incinerated at Pithampur.
"Now we are waiting for words from CPCB to hand over the waste to them for incineration," Dubey said.
After the June 7, 2010, verdict on Bhopal Gas Tragedy, the Group of Ministers (GoM) was formed to look into the problems related to the disaster. The GoM in June 2010 earmarked Rs 315 crore for disposal of waste.
The verdict on Bhopal Gas Tragedy came 25 years after poisonous gas leaked from the plant on the intervening night of December 2-3, 1984.
"...But for the people near the defunct factory, the tragedy isn't over as they still face air and water pollution given that the hazardous waste lying in the factory was seeping into the ground," said activist Abdul Jabbar, working for the survivors of the tragedy.
Wednesday December 3, 2014
On Bhopal anniversary eve, a cry for justiceBy P. Sunderarajan
The Hindu Survivors of the 1984 Bhopal gas tragedy during a protest demanding adequate compensation, in Bhopal recently. (A. M. Faruqui)
Coalition writes to PM, says Union Carbide was the original ‘Make in India’
A coalition of five organisations working for the welfare of the victims of the Bhopal gas tragedy urged Prime Minister Narendra Modi on Tuesday to ensure that Union Carbide and Dow Chemicals were brought to book and the victims got adequate compensation at the earliest.
In a letter to the Prime Minister on the eve of the 30th anniversary of one of the worst industrial disasters of the world, they noted that while Union Carbide had been “absconding’’ for the past 22 years, Dow Chemicals had refused to appeared in the Bhopal district court despite summons.
Making a reference to the government’s recent initiative to bring in foreign investment and promote India as a manufacturing hub, the letter said that while welcoming foreign companies, they should be made to follow Indian laws.
“We hope that you and the government will be as enthusiastic in making U.S. corporations obey Indian laws as you are in welcoming them to invest in our country. We write with the hope that you and your government are aware that Bhopal was the original ‘Make in India’ in the profoundest sense of the phrase,” it said.
On the issue of compensation, the organisations expressed the hope for an early follow-up on the agreements which they had recently reached with Union Minister for Chemicals and Fertilizers Ananth Kumar.
Tuesday marked the inauguration of a museum that portrays the trauma and 30 years of relentless struggle by the victims to get justice.
Called “Remember Bhopal,” the museum is collectively curated by the community of survivors and activists fighting for human rights. It relies predominantly on the oral history testimonies of the survivors and the narrative of the museum is shaped by their experiences and objects of memory from the tragedy and the struggle for justice.
Inaugurated by a survivor, the museum has nearly 50 original audio recordings of the survivors cut into three minutes loops that can be heard by picking up phone receivers hung on the walls. Besides, families of the several victims have given artefacts.
Museum curator Rama Lakshmi, a journalist, said the museum carried the message of the movement as it did not use any toxic material and has not accepted any money from large corporate houses or the government.
Sunday Magazine ~ November 23 2014
The Other Half
No more births... or deaths
By KALPANA SHARMA
Women who underwent sterilisation surgeries receive treatment in Bilaspur, Chhattisgarh (PTI)
Women continue to pay the price for the government’s desire to fast-forward population control programmes through sterilisation.
Should we forget about the 14 poor women in Chhattisgarh who died earlier this month? Can we write this off as another “unfortunate” incident? Or should we see it as reminder of the fundamental question that Indian policymakers need to ask: are Indian women, especially poor women, entitled to respect and rights due all human beings or will they continue to be viewed as baby-producing machines whose bodies the State can appropriate and control when it deems they have completed their assigned task?
The debate has been sparked by the ghastly tragedy that befell some of the 83 women who were herded into a disused hospital in Takhatpur, Bilaspur district, and subjected to laparoscopic tubectomies within a few hours. The same instrument was used. No time for sterilisation. No time to check if the women were in good enough health to undergo the surgery. And no time to relax and recover before being packed off. And, of course, no one to follow up to see whether they survived the journey home.
Within a day, eight women were dead. In the next days, in other locations where similar sterilisation camps were held, another six died, 14 in all. The doctor who performed the 83 tubectomies – he was rewarded earlier this year for having performed 50,000 tubectomies – was arrested. He says he was not at fault and insists that the women died from consuming contaminated drugs post-operation. It is suspected that the ciprofloxacin tablets given to the women were contaminated with zinc phosphide, a rat poison. And the state government refuses to explain why such a camp was held at a disused, run-down private hospital.
Everyone is blaming someone else. In the midst of all this noise, and the silence that has descended on the homes of the dead women, we must remember that what happened in Chhattisgarh earlier this month is not an exception, a one-off aberration that we can all forget about once the blame is fixed. Between 2003 and 2012, on an average 12 women die due to botched tubectomies. That is 12 too many. No woman should die from this procedure.
Also, whatever government officials might say to the media, the reality is that health workers are expected to fulfil targets by bringing women to these sterilisation camps. If such pressure was not exerted on them, it is possible that fewer women would come. But at least those who agreed to be sterilised would do so after having understood the consequences. And doctors would not rush through with the procedure at the vulgar speed as did the doctor in Chhattisgarh.
Government officials have consistently argued, as they do even today, that sterilisation is the best option for a poor woman with more than two children because she cannot insist her husband uses a condom and she cannot use other spacing methods, such as injectables for instance, because of the absence of health care in the case of complications. But by the same measure, how do governments justify sterilising women and sending them back to their villages without any follow-up? The women who died did so because they could not access emergency health care in time.
Even if poor women opt for sterilisation, surely they are entitled some dignity while undergoing the procedure. We thought the days when women were lined up like cattle, as depicted so starkly in Deepa Dhanraj’s path-breaking 1991 film “Something like a war” ( https://www.youtube.com/watch?v=6Fq7HSIPVq4), was something in the past, harking back to the days of the 1975 Emergency when mass sterilisation campaigns were implemented ruthlessly across India. But Chhattisgarh reminds us that this is happening even today, although on a smaller scale.
So respect for poor women is the very minimum that must inform any population programme. India has signed an international convention in 1994 committing itself to guaranteeing women their reproductive choice and rights. Simply put, this means that all women have the right to choose the kind of contraceptive method they want to use. It also means that population programmes must be centered on women’s health and choice.
Clearly, this is so much talk without substance. In 20 years, under one guise or another, central and state governments have continued with the policy of targets and camps. And women are those who are targeted, not men. The skew in the population programmes is more than evident, even if one looks at government data.
Also, despite scores of meeting, conferences, policy documents, including the National Population Policy (2000) that links a decline in fertility to many other aspects such as education, overall health, housing, drinking water and sanitation, the desire to fast-forward population programmes through sterilisation appears irresistible to policy makers of all political hues.
As a result, women continue to pay the price for this persistent myopia – especially poor women.
Sunday November 23 2014
Oops, sorry, we’ve killed you
16 women dying in a sterilisation camp in Chhattisgarh was no isolated incident, 15 women die on an average across the country every month during and after botched-up family planning operations
By Aditi Tandon
Patients recovering at a Bilaspur hospital after complications following sterilisation operations at a special camp. Sixteen women who underwent sterilisation in the camp died. (AFP)
S hocking stories of disregard for human life continue to surface from Chhattisgarh’s Bilaspur, where 16 women recently lost their lives following a botched-up sterilisation camp at a local hospital.
Those who survived told investigators how they woke up during the procedure to feel unbearable pain and see fallopian tubes coming out of their abdomen. Their shared memory of laparoscopic tubectomy, a common family planning practice in India’s seven high focus states with the largest share of population, is of horror, pain and shocking neglect.
None of these women were told by the operating doctor if they were fit to undertake the procedure, though it is mandatory under Government of India manuals to inform acceptors of female sterilisation the status of their health before they agree to a procedure.
But in testimony after testimony from Bilaspur, survivors have spoken of their urine and blood samples being taken but no reports being shared.
All they remember is they were hastily herded towards unclean beds where they lay shoulder to shoulder as someone administered them injections (local anaesthesia). That the sedation was ineffective is clear from the fact that majority of these women woke up in pain screaming for relief while the doctor, now arrested, continued the procedure, finishing 83 tubectomies in five hours.
All participants were discharged within minutes of the operation despite the requirement of overnight post-operative care under the Government of India rules. They went off with sachets of medicines later found contaminated with rat poison.
Although the Bilaspur deaths remain by far the darkest chapter in the history of female sterilisations in India, deaths and complications in tubectomy camp settings are routine.
Every month, around 15 women on an average die on account of botched-up sterilisations, a permanent method of birth control which forms 37.3 per cent of India’s 48.4 per cent contraception figure.
Records of the Family Planning Division of Ministry of Health reveal that between 2008 and March of 2012, 675 cases of deaths of women post-sterilisation procedures were accounted for.
Families of these victims were legally compensated under the little-known National Family Planning Insurance Scheme the ICICI Lombard Bank runs in collaboration with the Centre. The scheme, effective since November 29, 2005, offers the following packages – Rs 2 lakh for death following sterilisation in the hospital or within a week of discharge; Rs 50,000 for death following sterilisation within eight to 30 days of discharge; Rs 30,000 for a failed procedure; and Rs 25,000 for any complication within 60 days of discharge from the hospital.
By the Health Ministry’s admission, payment worth over Rs 50.76 crore was made between 2010-11 and 2013-14 for 363 deaths and 14,901 surgery failures. During this period, 15,264 cases of sterilisation deaths, failures and severe complications were officially recorded and for each case, an average of Rs 33,255 per person was paid.
Needless to say, the maximum burden of complications was reported from the six very high focus states which practice female sterilisations with impunity to meet the national Total Fertility Rate (average number of children per woman) target of 2.1. These states are Bihar, Uttar Pradesh, Madhya Pradesh, Rajasthan, Jharkhand and Chhattisgarh.
Women survivors of Chhattisgarh sterilisations recently said they went for surgeries because they had no other option and wanted to control their families. All of them admitted to having been motivated by Accredited Social Health Activists whom the Centre pays incentives to encourage couples to opt for birth control methods.
A Community Health Centre doctor in the state when asked if targets were prescribed acknowledged the trend, saying, “I personally have a target of around 800 sterilisations a year. One can never achieve more than 60 per cent. Non-achievers are publicly humiliated by government functionaries while achievers are publicly rewarded.”
Dr RK Gupta, under whose watch 16 out of 83 acceptors of tubectomies died in Bilaspur, was last year rewarded by Chhattisgarh Chief Minister Raman Singh for completing 50,000 tubectomies.
Feb 2012: Sterilisation camp at Kaparfora govt middle school, Araria, Bihar: 53 women operated in two hours; pregnant Dalit miscarries; many suffer physical harm
2010: Bundi camp, Rajasthan: 88 pc women not told of permanence of procedure; only 3 of 11 mandated pre-operative tests done; mother of three dies
Aug 2013: Odisha: Researchers document cases where women in labour are forced to agree to tubal ligation after they deliver the second child at a health facility
Nov 2013: Shanti Mahanand dies of excessive bleeding after sterilisation at Bargarh, Odisha. Vein cut in haste to operate
2011-12: In UP, 79 women aged 15 to 19 sterilised against GOI manuals which allow procedures only on women above 25 years.
Sunday November 23 2014
Setting targets, missing aim
The Government of India may have abandoned the targeted approach to family planning in 1996 in deference to international conventions like the CEDAW which it signed, but it continued to promote incentives for sterilisations, boosting it as a preferred mode of birth control in India.
Since 1981, the government has been implementing a centrally-sponsored scheme to compensate acceptors of sterilisation for loss of wages for the day on which he or she attends the medical facility for undergoing the procedure.
Wages under the scheme have been frequently revised, and the last revision took place on September 7, 2007 when the compensation for male sterilisation (vasectomy) in a government facility was raised from Rs 1,000 to Rs 1,500 per person and for female sterilisation (tubectomy) from Rs 800 to 1,000.
Similar procedures in private settings attract more incentives – Rs 1,500 each for vasectomy and tubectomy.
The reason for increasing numbers of sterilisations in private camp settings is also hidden in the Centre’s own data on incentives for sterilisations.
When conducted in public facilities, the majority incentive goes to the acceptor of sterilisation but when conducted in a private facility, it goes to the facility and the motivator.
So, of the Rs 1,000 compensation for female sterilisation in a government hospital, the acceptor gets Rs 600 as against Rs 150 for the motivator; Rs 100 for drugs and dressing; Rs 75 for the surgeon; Rs 15 each for the nurse and operation theatre technician; Rs 10 for refreshments and Rs 10 for camp management.
In the private facility, however, the acceptor of sterilisation gets no money. Of the promised Rs 1,500 per surgery, Rs 1,350 goes to the facility and the remaining to the motivator.
“This incentive-based approach to sterilisations must end. The government has the responsibility of providing couples with a basket of contraceptive choices where the preference should be for spacing methods instead of permanent methods of birth control such as sterilisations. Let us not forget, 96 per cent sterilisations in India still involve women,” says Poonam Muttreja of the Population Foundation of India.
All women’s groups agree with the need to do away with incentives for sterilisations which they say are as good as target setting. Health Minister JP Nadda, however insists, “The Centre does not set any targets for sterilisations. Family planning is a voluntary, consent-based movement.”
Camps to meet numbers
The Centre has for the purpose of monitoring population growth categorised states into three, depending on their Total Fertility Rates (TFRs) or the average number of children per woman.
There are six very high focus states with TFR of more than or equal to 3; high focus states with TFR more than 2.1 and less than 3 and non high focus states with less than or equal to 2.1 TFR.
Evidence shows sterilisation camps for females are mostly organised in very high focus and high focus states which are constantly under pressure to deliver the TFR targets. Incidentally, it was also in these very states that the most significant dip in population growth rates was recorded as per 2011 Census.
Health Ministry insiders acknowledge that India’s goal of reaching TFR of 2.1 by 2015 depends mainly on the performance of very high focus and high focus states which, in turn, resort to mass female sterilisations in camps to push targets.
SAMA, a women’s group working on reproductive rights, has now called for a blanket ban on camp sterilisations. Imrana Qadeer, a women’s right activist, says, “According to the Registrar General of India, the very high focus states will take 25 years to reach the TFR of 2.1 if the family planning programme is implemented in its mandated voluntary form. You can see why these states are pushing for the camp approach.”
The Health Ministry’s own compilations reveal that the very high focus states wait for central family planning funds to land in the fag end of the year so these can be used to sterilise women in camps and meet the yearly sterilisation targets which almost all states set.
Brinda Karat of CPM says camp sterilisation of women in private settings is the worst form of human rights violation. “What you need is a 24 by 7 public health service where women wishing for permanent birth control can access sterilisation when they want. Why should there be camps?” she asks.
877 tubectomies a day!
Chhattisgarh, a very high focus state, has a TFR of 2.8 and sterilises on an average 344 women every day. Bihar, with the highest TFR of 3.7 in India, sterilises on an average 1,492 women a day; Madhya Pradesh with a TFR of 3.2 resorts to 1,512 female sterilisations daily on an average. Rajasthan with a TFR of 3.1 sterilises on an average 840 women a day and UP with 3.5 TFR conducts an average of 877 tubectomies a day.
The latest data available with the Centre for 2011-2012 reveals a whopping 49,06,430 sterilisations being conducted in a single year across India. Of these, 47.3 lakh (over 95 pc) involved tubectomies as against 1.75 lakh vasectomies on men.
Sunday November 23 2014
Huge unmet need for family planning
Spacing between two childbirths in India is less than three years in 61 pc of all births. (File photo)
Population experts feel the focus of the Centre is grossly misplaced. Though India had in 1952 become the first country to launch a national programme emphasising family planning, it has not achieved much in terms of results. By 2050, it is projected to surpass China’s population and by 2026, it would be home to 1.4 billion people as against 1.21 billion today.
Contrast these challenges with access to contraception and one traces a huge gap. Contraceptive use among married women aged 15 to 49 years is just 56.3 per cent. Though the wanted fertility rate across India, as revealed by the National Family Health Survey-3, is 1.9, the actual national Total Fertility Rate is 2.1.
Clearly, there is a huge unmet need for family planning. “Yes the need is 22 per cent as per the District Level Health Survey of 2008,” admit Health Ministry officials. They add that spacing between two childbirths in India is less than the recommended three years in 61 per cent of all births. That explains female sterilisations as the easy option to attain population stabilisation goals.
“It is not just easy, it is financially rewarding with little or no accountability for operating doctors, who treat women as cattle. In none of these sterilisation camps are doctors ever equipped with gloves, disinfectants, equipment or clean linen to ensure safe procedures,” says Devika Biswas, the Araria-based activist currently pursuing in the Supreme Court a petition that documents the horrors of India’s female sterilisation camps and calls for strict directions to states which treat women as tools to meet TFR targets.
In January 2012, a single surgeon performed sterilisations on 54 women in a government school in Kaparfora of Bihar’s Araria district. Spending less than two minutes per surgery, he left the women writhing in pain with most of them finding themselves in a pool of blood. The case led to a petition in the Supreme Court, which is seeking directions to states to follow Government of India’s sterilisation guidelines. The final arguments are due on December 2.
The guidelines had come into force following another SC judgment in 2005 which called for protection of women’s dignity during sterilisations.
“We have documented a series of violations of guidelines which say that not more than 30 surgeries can be held in a day; no camp will be held in schools; 18 people must form the team at each sterilisation camp and every state must maintain a record of women’s consent forms complete with their age, number of children and health condition,” says Biswas.
States are also supposed to ensure that each sterilised woman is given a certificate of the procedure as proof of surgery. “In 80 per cent cases, women are not given a certificate of sterilisation. So, deaths or complications are never recorded,” says activist Ramakant Rai, whose petition in the Apex Court had forced the Health Ministry to lay down Male and Female Sterilisation Guidelines and Manuals.
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