Recent Resources for Feminists
Wednesday July 22, 2015
Australian sex tourists taking advantage of young women in the Philippines
By ROHAN SMITH
Peter, 8, and his mother Grace, 35, with a picture of Peter's Australian father, Max, who stuck around and provided for the family but recently stopped his payments. (Dave Tacon)
IN tiny houses a stone's throw from the red light district in one of the Philippines' most heavily-populated regions, young boys and girls are growing up without their Australian fathers.
The children, born to young prostitutes, will never know their dads. They stopped through like thousands of other Australian men do, looking for cheap sex with young Asian women. They found it, but when the women fell pregnant, the men fled. Others don't even know their children exist.
It's no surprise the offspring of Australians are growing up in Angeles City, the entertainment capital of the Philippines. It's practically a home away from home for many Australians, with hotel names like the Boomerang, the Swagman, the Eureka and the Walkabout.
They attract hordes of Australian men, thirsty for a drink and something else: A young woman for the night.
Described as "blow row" and a "supermarket of sex", the red light district 85km north west of Manila is a hotbed of debauchery and fantasies fulfilled. Money changes hands quickly and sex is a commodity.
Nights out on the infamous Fields Avenue are sold as innocent fun for tourists. But beneath it all is an undercurrent of sadness and heartbreak and crime. It's sex tourism targeted at and propagated by lonely, rich Australian men, and the consequences are long lasting for families left behind.
Journalist Margaret Simons toured Balibago recently. She wrote in The Monthly that she was one of the only western women in a city of tens of thousands of people.
The Swagman Resort, Angeles City.
More concerning still was her discovery that Australian men were fathering children to prostitutes and leaving them behind, either with knowledge of their birth or otherwise.
"Some of the fathers paid to support their children, then stopped. Some never paid at all. Some don't even know they have children," she wrote.
On her visit, she met Kevin, 10, who wants to be a pilot, and Francine, 7, who she says wants to be a teacher. Kevin's father, she said, was a paedophile in his 50s who groomed his victim from Australia using social media.
"Kevin lives ... in a 9-metre-square shed patched together with scraps of building refuse," she wrote.
She also met Judith, 19, who recently gave birth to three-month-old Jaden. His father picked her up in a bar and, according to the Monthly, doesn't know he has a son.
The story paints a picture of a poverty perpetuated by Australian men and a sex industry dominated by them.
"In the front bar of the Walkabout Hotel on Fields Avenue, you sit elbow-to-elbow with middle-aged, board-short-wearing Australian men who could have been plucked from any suburban shopping mall," Simons said.
"More of them are on the street, surrounded by women, moving like lords of creation."
Tourism figures support what she saw first hand. Of the almost five million foreign tourists who enter the Philippines each year, Australians are the third biggest spenders. They're not buying T-shirts and fridge magnets.
Dr Caroline Norma visited the Philippines in 1998, where she worked with an outreach program going bar-to-bar. She told underage women they had other choices and prostitution wasn't the only way.
Seventeen years later, she says little has changed, and that Australian men are the biggest problem.
"Australian men were everywhere then," she told news.com.au.
Dr Norma, who teaches global and social studies at RMIT University, says Australian men are "taking advantage" of a sex industry driven by poverty and corruption.
"I did an internship with a women's organisation and we did outreach to bars in 1998. By that stage, Australian men were everywhere, even as bar owners," she said.
Francine, 7, doesn't know her Australian father. She lives in a slum with her mother and the rest of her family. (Dave Tacon)
"Back then I was surprised because Australia didn't have a military presence in the Philippines like America. There were Americans over there but that was slightly more understandable."
She said she was not surprised to learn Australian men are still flocking to the Philippines because the attraction to Asian women in prostitution is stronger than ever.
"Prostitution of Asian women has become almost the model for prostitution in Australia," she said.
"Rates of Asian women in Australian brothels are about 50 per cent. The research that's been done in Australia all points towards increasing numbers of Asian women in Australian brothels."
Margaret Simons wrote that in Angeles City, "the entire town with a population of about 350,000 is a brothel, and its support system".
Al Jazeera reported earlier this year that $400m is spent on prostitution in the Philippines each year, a large chunk of that from the pockets of Australian sex tourists.
A website promoting Balibago (balibago.com) makes it easy to see why. It promotes young women as sexual slaves.
"In a city that never sleeps, these women are desperate to show you a good time and are known for their love of recreational sex," the website declares.
"Praised for their tolerance to western culture, these girls are hungry to meet you regardless of your age, weight, physical appearance, interpersonal skills, wealth or social class."
Another website explains how a typical night on Fields Avenue might go and offers tips for visitors. It describes how to procure a lady for the night.
Men there pay bar fines an amount of money to a bar owner to secure a prostitute for the night or longer. The money buys them sex and even the "girlfriend experience".
Margaret Simons said Australian men are looking for underage women. That's the reason they go. Others don't ask the age of the prostitute, but are equally complicit in keeping the sex trafficking industry thriving.
"Australians are also one of the groups most active in child sex tourism, although in Angeles City, it seems, most of this is not "preferential" but situational men who have sex with prostitutes and simply don't care about their age," she wrote.
Judith, 19, and her three-month-old son, Jaden. (Dave Tacon)
Dr Norma agrees.
"This idea that western men don't know the age of Asian women because they look the same (as other Asian woman) is false," she told news.com.au.
"Even in western counties, the average age of entry into prostitution is 16, 15, 14. Men who seek to prostitute girls are looking for younger girls. Any pimp will tell you 'the younger the better'."
The Philippines, sadly, is the not the only Asian country where sex tourism has taken hold. It has been happening in Thailand for generations. Disturbingly, it has also increased in Nepal following the deadly earthquake that killed more than 9000 people in April this year.
According to the United Nations Children's Fund (UNICEF), children who lost their families when entire villages were destroyed have been trafficked into the sex industry.
Tomoo Hozumi, working with UNICEF in Nepal, said he feared a surge in trafficking during the chaos of April and May and his fears were realised.
"Loss of livelihoods and worsening living conditions may allow traffickers to easily convince parents to give their children up for what they are made to believe will be a better life," he said.
"The traffickers promise education, meals and a better future. But the reality is that many of those children could end up being horrendously exploited and abused."
Trafficking in the Philippines happens for similar reasons.
Dr Norma said much of the problem is generational a young girls' mother is a prostitute and her daughter follows in her footsteps. It's mostly driven by poverty but she said Australian men can't shy away from their part in the problem.
"Poverty is one thing, but it's also lax laws on foreign ownership of businesses, there's lax laws in relation to employing children and having them on the bar plus corruption on top of that. Having said that, Australian men are taking advantage of the whole thing."
Pole dancers perform at 'Dolls House' go-go bar, one of the largest establishments on Fields Avenue. (Dave Tacon) .
by Mabel Valdiviezo
This project will only be funded if at least $30,000 is pledged by Sat, August 22 2015
Progress to Date: 15 backers /$1,305 pledged of $30,000 goal /29 days to go
A Peruvian-American woman conquers immigration hardship, trauma, and family isolation in this epic story of healing and reconciliation.
About this project
This feature length film follows my journey from feeling lost and helpless to reconciling with my family, embracing my Latina identity, and finding healing in my heart. An artful and emotional story, Prodigal Daughter brings a new perspective to the immigration debate: the mental health challenges shaping immigrant communities today. Our film humanizes these millions of women and men who come to live in the U.S by bringing to light their personal experiences, adversities, and dreams. After an incredibly successfully work-in-progress screening at UC Berkeley's 10th Summer Institute on Migration and Health this June - we have been invited to bring our film to several community centers across the US. And for that. We need your backer support to fund post-production for the film, so we can get to the finish line and share our final cut with you!
Mabel and the PRODIGAL DAUGHTER Team
Follow us on Twitter, like us on Facebook, visit us at HERE. Your participation in getting the word out is just as valuable as your individual pledges.
Family photos are transformed into vibrant paintings to illustrate the emotional and physical separation between Mabel and her family.
Prodigal Daughter tells the story of a filmmakers reconciliation with her Peruvian family after sixteen years as an undocumented immigrant in California. Fleeing war-torn Peru in the 1990s as a young woman, Mabel Valdiviezo endures traumatizing experiences, depression, and cultural isolation while her family suffers the consequences of her mysterious disappearance. Years later, about to become a U.S. citizen, Mabel seeks to reunite with her parents while battling a life threatening illness. Would Mabels growing spirit of forgiveness, a new acceptance of responsibility, and courage to face the secrets from her past let her recover love and bring healing to herself and her family? Prodigal Daughter evokes universally resonant emotions as it explores the relationship between a daughter and her parents when geography, culture and mismatched expectations set them apart.
Photo self-portraits track Mabels transformation from punk-rebel youth to voiceless immigrant to empowered Latina.
WHY THIS IS IMPORTANT
In a time where the immigration debate has deeply divided our nation, our film will bring people together and spark dialogue about immigration, mental health and well-being across diverse communities in the U.S. Using her own life story to change the narrative, Valdiviezo allows us an all access pass through her 16-year journey from undocumented Peruvian, to the eventual transformation of an empowered U.S. citizen, successful Latina artist and Silicon Valley woman in tech.
The film explores art therapy and art journaling as healing mechanisms with the goal of inspiring immigrants, and anyone who has broken the ties with their families, in finding their own path to health and empowerment. The documentary interactive website will feature a Digital Quilt and an Art Journaling section highlighting short video clips and artwork with people of diverse backgrounds sharing their inspirational stories. We plan to screen Prodigal Daughter in homes, public schools, universities, community centers, and PBS stations throughout the nation.
Just like Mabel did, people can use art therapy and art journaling as a way of healing from trauma.
Mabel recovers love as a fully realized U.S. citizen, Latina, and human being. She is ready to share her story with the world. Photo credits: Claudia Alva
*Ulysses syndrome: A series of physical and emotional symptoms experienced by migrants facing chronic and multiple stressors.
These ladies and community advocates were quite moved by watching a preview of our film at UC Berkeley's Summer Institute on Migration and Health in June 2015. Photo credits: Michelle Villa
WHY RAISING $30,000?
With 90% of principal photography already completed, the $30,000 I raise through this campaign will give me the resources to 1) Shoot the final scenes of the film and have the freedom to create artistic metaphors and re-enactments - about 1 week); 2) Employ a seasoned editor to go from assembly edit to rough cut and beginning of fine cut - about 3 months; 3) Preliminary music from amazing Peruvian musician Riber Or?4) Preliminary graphics
Your contribution is tax-deductible (minus the value of the reward you choose)
OUR MINIMUM GOAL IS $30,000. Every single dollar that comes in from this point will increase the value and the quality of this film and help us tell our story with more clarity.
Stretch Goal #1 - $45,000: This goal covers full original music score, additional music licensing from gifted musicians, and various archival footage sources needed for the film
Stretch Goal #2 - $60,000: This goal supports completion of editing, graphics animation, and final color correction.
To show our appreciation, youll receive a Thank You Reward and our deep gratitude for your contribution.
KEEP IN MIND
Kickstarter is All-or-Nothing, so even if were $1 short we dont get any of the pledges.
Kickstarter uses credit cards to securely process pledges. Your card will be charged at the END of the campaign and only IF we make our goal.
Your contribution is tax-deductible (minus the value of the reward you choose). We will send individual tax-deductible letters for everyone who has pledged at least $100 or more. Our fiscal sponsor is Interfaze Educational Productions, Inc.
MEET OUR AWARD WINNING TEAM
Mabel Valdiviezo Director and Producer
Mabel is an award-winning filmmaker and alumni of the Sundance Producers Conference who creates visually compelling films on socially relevant contemporary issues. She is a winner of the Women in Film Emerging Filmmaker Award and her film, Soledad Is Gone Forever, screened at the Cannes Film Festivals Short Film Corner and at LALIFF. She produced Carlos Baron, Poeta Pan, a documentary short for the KQED arts show, Spark. Her script, Soledads Awakening, was a finalist at the Sundance Screenwriters Lab. With her documentary project Prodigal Daughter, she participated in the NALIP Latino Media Market 2012 and in the NALIP Latino Producers Academy 2013. Mabel is a recipient of the 2013 NALIP Artist Mentorship Grant.
Manuel Tsingaris Video Editor
Manuel is an accomplished documentary editor of award winning films that have aired on PBS and found acclaim on the film festival circuit. His editing credits include: Alive Inside, by Michael Rossato-Bennett; Purgatorio, by Rodrigo Reyes; The Rugby Player, by Scott Gracheff; The Storm That Swept Mexico, by Ray Telles; A Dream in Doubt, by Tamy Yeager; China Blue, by Micha X. Peled; and Writ Writer, by Susanne Mason. Tsingaris edited multiple segments for the PBS program Life360 and has recently edited a segment for the highly acclaimed PBS series Latino Americans.
Jessica Sison KS Trailer Editor
Tupac Saavedra /Aleixo Goncalves Cinematography
Riber Or? Music
Marilyn Mulford Consulting Producer
Jennifer Lauren - Partnership & Outreach
Tracey Hum Marketing Consultant
Michelle Villa Post-production Intern
Risks and challenges
Our biggest challenge is to raise enough funds to finish this film. Thats why all of you are so important! We are highly confident that no matter what obstacles we face, we will complete the film because we have an amazingly experienced team, passionate collaborators, awesome friends, and an engaged community of supporters. Furthermore, we are already in deep conversations with potential community partners discussing how our film will make a difference. That's our biggest prize and our reason to share this vision with each one of you.
We look forward to adding YOU to our list of supporters!
Many thanks to our crew, partners, friends, and followers.\
Sunday Magazine ~ July 5, 2015
Selective amnesiaBy Kalpana Sharma
At a mass sterilisation camp.
Women are the principal targets and easy victims of the government's sterilisation programme. Why are their deaths not being counted?
Forty years is a long period. Since June 20, and the build up to the 40th anniversary of the Emergency, it has been fascinating to watch the politics of selective remembering and determined amnesia. In the former category fall many from the ruling party, barring a few exceptions, who remember their 'suffering' during that period and suggest that they were in the forefront of the resistance to the Emergency. The latter are members of the Congress Party, who will not remember even if they have been told, repeatedly, what happened over those 20 months.
What both sides of the political divide forget is that those who really 'suffered' during that 'dark' period in our history were the poor and the powerless. They were either the targets of Indira Gandhi's repressive policies, or were foolish enough to try and oppose them. In both instances, there was no recourse to justice.
The silence of the media made this worse. Because the press did not report, there was virtually no record of what happened. Much of it had to be reconstructed after the Emergency. This silence, willing or forced, exacerbated the very real suffering of the people at the receiving end of the government's policies. Not only were they denied justice but they were also denied a voice. They had been rendered invisible.
Everyone knows now that one of the most atrocious policies of the Indira Gandhi government was the mass sterilisation campaign devised by Sanjay Gandhi as part of his five-point programme. In the name of 'population control', poor men and women were rounded up and forcibly sterilised. While the poor were always the principal targets of the government's population efforts, this time it was specifically poor men. It is now fairly well-established that one of the main reasons for Mrs. Gandhi's spectacular defeat in the March 1977 elections was the anger among the communities targeted under this campaign.
Was there any rethinking on this policy after 1977? You would think that no political party would risk pushing through a policy that results in such revulsion. Yet, although on paper, population control' is now 'family welfare' and 'women's reproductive rights', in fact sterilisation continues to be the main thrust of government policy. The difference now is that the main target is women, not men. In 2012-13, of the total number of sterilisation cases, 97.4 per cent were women. In fact, since 2005, over 95 per cent of sterilisation procedures have been performed on women.
This government's stated policy is to encourage sterilisation as a method to control population growth. Incentives for health workers to bring in 'cases' for sterilisation have been increased. Women who choose institutionalised delivery are especially targeted; it is so much convenient to coax them into accepting a permanent solution to repeated pregnancies. And most health workers find it easier to persuade or force women than men even though is it well-known that a vasectomy is less complicated, and reversible.
Only a few stories appear about the way these sterilisation camps are conducted. A couple of years back, there was outrage when a story appeared about bicycle pumps being used on 56 women who were sterilised in Banarpal village, 150 km from Bhubaneshwar. The instrument that should have been used is an insufflator that pumps carbon dioxide into the abdomen. As this was not available in the camp where the procedure was being done, a bicycle pump was used. The surgeon in-charge, Dr. Mahesh Prasad Raut, justified this saying: "I am not alone. Surgeons often use bicycle pumps in the rural camps where the facility of an operation theatre and other sophisticated equipment are not available." This doctor had done 60,000 tubectomies and was awarded by the government for this feat. How many of them were done using bicycle pumps is not known.
And of course, these horrific violations occur not just in Chhattisgarh or Odisha but also in many other places including Faridabad district, Haryana. Neha Dixit, a freelance journalist, has recently written a searing account of what women lined up for a tubectomy faced in the Badshah Khan hospital. In A Callous Cut [scroll down to read in full], Dixit describes the scene in the hospital where women between the ages of 20-26 await the operation. There are not enough containers to collect urine samples. So only a few women can be tested. They are asked to sign a 'consent' form in English, a language they do not understand. And then, dizzy with pain and sedatives, they are sent off to fend for themselves. Little wonder that so many die from sepsis or other complications, or have to be rushed back to hospital.
Reading her account, and looking back on other such stories in the last 40 years, one is forced to ask: Did sterilisation contribute to Indira Gandhi's defeat only because the target was men? If not, then how come the callous way in which poor women are being sterilised in India in such large numbers is never a political issue?
2 June 2015
A most callous cut The much-heralded family planning programme is in its details little more than the mass sterilisation of mostly illiterate women to complete bureaucratic quotas, rather than safeguard their health.
BY NEHA DIXIT
ILLUSTRATION BY KARTHIKEYAN R
"On one hand, Navaratri, and on the other, the match. Didn't you get any other day for operation?" Nina, the nurse-intern asks the woman on the hospital bed as she gives her a local anaesthetic. The woman is here for a tubectomy.
This is the "recovery ward" of Badshah Khan hospital, Haryana's Faridabad district's biggest government facility. All the district's family welfare programmes are conducted here. The ward is full, half are women who want a tubectomy and the rest their attendants and anganwadi sisters, or behenjis.
It's March 26, and there's a lot of excitement about the India-Australia World Cup semi-final. The radio jockey calls it "national illness day" because lots of people in this cricket-obsessed nation called in sick just to watch the match at home.
The ward was originally white, with new vitrified cream tiles, but they are splattered with countless stains. The ward and the corridor are full of noisewomen chatting and laughing, phones ringing, waiting men discussing the score and Australia's batting order.
In November last year, the ICU was shut for a month because of a shortage of trained paramedics and doctors. Close to 10 people who might have been saved if it had been open died in this period, according to local media reports. Even today some two-thirds of its 307 medical posts are vacant.
The ward has 11 beds and big windows that light up the whole space. The womenall between 20 and 26lie on the beds, dressed in brightly coloured clothes. The last two beds are occupied by four women, one of whom is wearing a bold yellow sari. They're all here for the same thing.
Nina says, "Didn't you know that today was the surgery? You should have worn a suit." The woman looks at her mother-in-law sitting cross-legged on the next bed and replies, "We are from UP, not Haryana. So we are not allowed to."
The stench from an attached bathroom chokes the room. Constructed two years ago, the ward is called "modern" and air-conditioned, which explains the lack of fans. However, the centralised air-conditioning plant has failed. The windows are sealed. There's no way to escape the smell.
Kanta Rani, the head nurse, is middle-aged and dressed in a printed blue kurta, blue salwar, and half-sleeved lab coat. Her henna-dyed hair is pulled back in a bun. She wears pearl earrings and a small maroon bindi in the centre of her forehead. She is examining a patient named Ramvati when Ramvati's sister-in-law Pushpa says, "Sister, it is impossible to sit here because of the stink. I'm feeling dizzy."
"If you're feeling dizzy, go and eat something," Kanta replies.
"How can I eat? I'm fasting for Navaratri. I can only eat once I reach home," Pushpa says.
Kanta looks at her for a moment and then walks toward the door. She steps out of the ward and yells, "Sanjay! Where are you?"
A short, stocky man in his late twenties with white earphones plugged into a big white smartphone is sitting outside the ICU on the visitor's bench. This is Sanjay, the ward boy, in checked shirt and blue jeans. He removes an earphone from his right ear and answers, "Haan?"
"Clean the bathroom, Sanjay. Why aren't you doing it? Told you twice already," says Kanta with authority.
"Australia has already made 250 runs, sister. Kya yaar? Doing it!" he says, re-plugging the earphone and passing Kanta in the recovery ward to enter the adjoining operation theatre section.
Kanta looks at him for a few seconds and mutters "Can't think of anything but the match."
It's now 1 p.m. and the eight women slated to be operated on haven't eaten anything since morning. Patients are not allowed even water four hours before surgery.
Ramvati is worried about Babloo, her three-month-old youngest son. Anaesthesia is to be given at the operation table but it has been given outside already. An hour has passed and no one seems to know how much longer it will take. Pushpa had taken Babloo out into the corridor for a stroll but he wouldn't stop crying. Three other toddlers are also in the ward, all dependent on breastfeeding.
Pushpa gives Ramvati the baby, saying, "Feed him; God knows when next you will be able to after the surgery."
Ramvati was married at 18 and had her first child, a son, a year after. Next year, she had a daughter and two years later, one more. The village behenji (anganwadi worker) told her to get an operation done since she already had three children. "No more children," she said.
Ramvati says every time the behenji saw her she promised to take her for the operation. "She wasn't saying anything wrong. Even I didn't want any more. But my husband wanted one more son. He said we must have "two eyes and two arms". Ramvati got pregnant again and "fortunately" delivered a son. Three months later, she is here for the surgery.
It's been five hours since she reached the hospital from Kheri Kalan village, 30 kilometres away, with her husband Sandeep and Pushpa, all on one motorcycle. But surgery hasn't even begun. The ICU is still occupied. The doctor for the previous surgery reported late and so did the technician. Pre-operative procedures took time.
As Sanjay told Kanta, "Sister, if they love their country, they will be okay with a little delay today."
The term "birth control" was coined by Margaret Sanger in 1914 to provide ways to poor women to avoid pregnancy. Decades later, when President Lyndon B. Johnson pushed for birth control in the US, it was seen as a part of "black genocide". The targeted people were mostly blacks because of their poor socio-economic situation.
In 1962, human rights activist Malcolm X suggested that "it would be more successful if the term family planning is used instead of birth control." Thus, what started as a reproductive right for women was appropriated within patriarchal norms in the years to come.
Matthew Connelly, a professor in Global history at Columbia University in his frequently referred paper, "Population Control in India: Prologue to the Emergency Period" mentions that in the pre-independence era, the Congress party's National Planning Committee issued a report advising that all barrierssocial and politicalin inter-caste marriages between upper caste Hindus must be done away with to stretch upper caste Hindu reproduction to the best. The report suggested that government should start birth control campaigns for lower caste Hindus, Muslims and tribals to lower their population. The aim was to "prevent the deterioration of the racial makeup." It did not materialise.
The sterilisation camp approach was introduced in the Fourth Five Year Plan (1969-74). The camp came in handy because birth control and condoms depend on the agency of the person to use them. The primary motive was to sterilise a large number at one go and meet targets. It became a symbol of the Indira Gandhi administration's excesses during the Emergency, from June 1975 to January 1977. She implemented it in lieu of food aid from international lobbies which were paranoid because of the growing population of the developing world.
Her defeat, among other things, was attributed to the forced vasectomies during the period. The subsequent governments, to avoid political ramifications, almost entirely focused Family Planning effortswhich have now been repackaged as Family Welfareon women's sterilisation.
According to government guidelines issued in 2006, the women patients should be between 22 and 46. Counselling about sterilisation, its possible side effects and failures along with other methods of contraception is a must before the surgery. In addition, a health check up, record of last menstrual cycle and current pregnancy status is required. Information about health insurance is also mandatory.
The consent form should be signed before surgery when the patient is not under sedation and without any coercion.
Local anaesthesia should be given on the operation table and not outside.
After surgery, the pulse, respiration and blood pressure of the patient must be recorded every 15 minutes for one hour, or longer if the patient is not awake. The patient can be discharged four hours after surgery when she is fully awake, has passed urine, can walk, drink or talk and has been evaluated by the doctor. A sterilisation certificate is issued after a month of surgery or after the first menstrual period by the medical officer of the facility.
Ramvati was the first in the hospital at 8 a.m. with her BPL card as identification. The anganwadi worker had met her at the family welfare section, where two counsellors had told her "tubectomy is comfortable and hassle free".
"Did she tell you anything else?" I ask.
"No. That was all," she says.
After five more women gathered, the group was taken to a small, dingy section on the ground floor. One by one, they were given forms to sign and place their thumb impressions on.
"The form was in English. I didn't ask (what it said) because the nurse was in a hurry," Ramvati says.
Once the forms are stamped, they are asked to move to the laboratory. Blood samples are taken. Urine samples are required next, but "there were not enough containers for all of us, so only four gave samples," says Ramvati.
All eight women are from the Jatav community, part of the Scheduled Caste.
The recovery ward on the second floor is next to the ICU. By the time the women reach, it's already 11 a.m.
Two hours pass this way: nurses administering anaesthesia, demanding the bathroom be cleaned, Babloo being fed, patients dozing, Sanjay watching match updates on his phone. Finally, Dr. Sangeeta Agarwal, middle-aged, dressed in a yellow kurta with a red border and white tights, enters the ICU. The women are told to go for surgery five at a time. The other doctor, Dr. Sandeep, has left; he wants to watch India batting.
Kanta and another nurse do a quick head count and wake up the first five patients. "All of you go and urinate," they are told. "The bladder should be empty."
There is a bathroom at the other end of the floor, soiled and dirty. Its aluminium-framed main door and the doors inside have no glass at all. So the patients use the bathroom attached to the recovery ward, which Sanjay has still not cleaned.
Hardly able to walk because of drowsiness, the women are taken to a small waiting chamber with an L-shaped bench. A security guard, the only one on the floor, sits outside. The door is half-open.
Each woman holds a few sheets of paper stapled together: forms, photocopies of their identity proof, their BPL cards and others. A nurse examines their eyes and asks the first patient if she has had dengue, malaria or typhoid in the past. "I had fever a month back for two weeks. Don't know what it was," she says.
The nurse says, "You don't have it now, no?"
"No," the woman says. She is sent to the ICU.
A patientmiddle-aged, emaciated, dressed in green pyjamas and shirtpeeps into the ICU, where an operation is in progress. From the door, blood-soaked cotton and internal organs are visible.
The guard asks, "Why are you peeking inside?"
The man replies, "The next operation is mine."
Five minutes later, the first woman comes out. Sanjay is pushing her on a wheelchair. She looks faint, dupatta trailing on the ground as he takes her into the recovery ward. Sanjay taps her shoulder. "Get up!"
He takes her arm and stands her next to the bed. An attendant makes her lie down and covers her with the dupatta to save her from the flies. There are no sheets to cover the patients.
The routine is repeated with the second patient.
The fifth patient has not signed her form. There is some commotion for a couple of minutes to find a stamp pad. The nurse helps the half-asleep woman put her thumb impression on the form before taking her into the ICU. A few minutes later, at 2 p.m., she returns.
When the next three women are taken to the waiting room, two more come into the ward. Kanta tells the interns, "Inject them and take them with the other three."
Nina says, "Why more? I'm fasting today. Need to go home early." Nevertheless, the last two women are efficiently given anaesthesia and taken along.
By 2.30 p.m., all 10 are done. The nurses pack their bags and proceed to the staircase.
The National Family and Health Survey-3 (NFHS-3) data show that in India three quarters of contraceptive users have undergone sterilisation. In the last two decades, female sterilisation has risen from 27 per cent to 37.3 percent. Male sterilisation accounts for just one per cent. Temporary contraceptive methods have hardly shown any change over years: the current use of condoms is 5.2 per cent. Nearly 45 lakh tubectomies have been performed each year since 2000.
Globally, one in 200 female sterilisations fails. One woman in 100 gets pregnant after surgery, complications are reported in one in 100 cases, and the risk of death is reported in three in 10,000 cases. There's no scientific data in India for these parameters as there is no follow up of cases or qualitative survey.
If we plug in these data on an average of 47 lakh female sterilisations every year, a back-of-the-envelope calculation suggests 2.35 lakh failed procedures every year and 14,100 deaths. Experts estimate the number to be much higher.
Dr Sangeeta Agarwal explains the sterilisation procedure."The procedure is to go to family welfare department, to the counselling centre. Once all formalities are done, they are operated here. Yesterday, there were six, sometimes there are 30-40 in a day. Today 10; two were not operated because one had ovarian cysts and the other one's bladder was full. She has been told to come tomorrow."
"What about tubectomy failures?"I ask.
Sangeeta says, "We have a committee. You can ask Dr Swamy. He is the head of the family welfare department. Everyone knows him." She leaves.
"Did they tell you about insurance and compensation?" I ask Ramvati.
"No. What is that?"
Twenty minutes later, the chattering stops. The women leave the hospital with their discharge certificates.
Dr R. N. Swamy is the deputy civil surgeon and head of the family welfare department in Faridabad. His office is in the old building. The entrance is lined with cardboard boxes full of Nirodh condoms, awareness posters, and medicines. A board enumerates the achievements of Faridabad's family welfare department. In 1991-92, the department met 51 per cent of the sterilisation target for the district. In 2013-14, the figure was 131 per cent.
Swamy's office is at the end of a long passage divided into small cabins. The entry to his cabin is through a small room occupied by his attendants and assistants. I wait in the room as Swamy is in a meeting with two senior police officers. India is batting now; the assistants are busy refreshing scores on
Twenty minutes later, the cops leave and I enter Swamy's office. He is middle-aged and bespectacled, wearing a blue shirt. He asks his assistant, "What is the status now?"
The assistant replies, "140 for four wickets."
Swamy turns to me. I say, "I wanted to know about the sterilisation process in the hospital. How many are conducted every day? What is the process? Are there any male sterilisations too?"
He says, "The ANM or ASHA worker brings them here. We counsel them and after medical tests perform the surgery, not more than 30 a day. Male sterilisations are very few. No one comes."
"What about sterilisation failures? Are they given compensation?"
"There are very few. We have a committee to review the cases and then give them compensation," he replies.
"What about Santosh's case? It's pending for two years now." I show him a legal notice sent by Santosh to the hospital asking for a response to her compensation claim after a sterilisation failure in 2014.
Dr Swamy goes through the document and says, "I am aware of the case. I am from the same village. But I am sorry I cannot talk to a reporter about the status. Please give a written request and we will pass it on to our seniors who will respond after the financial year closing, in the second week of April."
"But why has she not received an acknowledgement of her notice?" "I cannot respond to that," Swamy says.
Anangpur village is a few kilometres from Surajkund, the annual handicraft mela site in the National Capital Region. A well-constructed road lined with several real estate and housing projects leads to the village through a big gate. After the main square, the village is divided into several colonies.
"Where is Sant Lal's house?" I ask a passerby. Sant Lal is Santosh's husband.
"Which one? Just Sant Lal or Sant Lal from the Harijan basti?" asks the man.
"The one who works at the petrol pump?"
"The Harijan basti one, then. Go straight. There is a well. Ask anyone there," he replies.
A few metres away, the well, surrounded by houses on all sides intersected by narrow lanes, almost blocks the entire passage. It has an iron grill over it with water pumps placed nearby. To its left is a building with a board saying "Ambedkar Kalyan Samiti" with Ambedkar's picture above it. Santosh's house is on the right.
Painted in blue, it looks massive. A small courtyard serves as the entrance, with several rooms around it. Santosh is away, but her sister-in-law Preeti sends a boy to look for her. A cluster of households live in the house; each room with a chulha outside is a family unit, with separate income and expenditure.
Meanwhile, a teenage girl in school uniform of grey salwar kameez and white dupatta with fresh chicken pox scars on her face walks in barefoot, pencil box and paper in hand. "This is Kajal, Santosh's elder daughter. There are five siblings. One died last July. This one had mata 10 days back. Still recovering," says Preeti. Mata is a local reference for chicken pox.
Kajal has three sisters and one brother. The third sister was born after Santosh's tubectomy in April 2013. One brother was playing near the well and got electrocuted in July 2014. He died on the spot. "If a son had been born after the surgery it would have been still okay. What will she do with one more daughter?" says Preeti.
Kajal gets her mother's documents from their house next door, a small eight-by-five foot room. They're in a yellow plastic bag that she empties on the floor, swiftly separating the hospital documents from the others.
"Mummy has managed to get six out of seven papers from the hospital."
According to the norms, any patient applying for compensation in case of sterilisation failure has to submit an array of documents: a claim form and medical certificate in original, signed and stamped by the designated officer at the district level; a copy of the consent form; a copy of the sterilisation certificate; and a copy of the discharge certificate. Additionally, a person must also provide medical bills in the event of complications, a death certificate in the event of death, or proof of pregnancy in a failed procedure.
"Her claim form is yet to be signed by the officer," explains Kajal, arranging the documents in orderher mother's sterilisation certificate, discharge certificate, pregnancy report, and ultrasound. She points out the blue marks on the sonogram pictures and says, "See, Anmol is here."
Sant Lal, Kajal's father, works at a petrol pump on the Surajkund road and is an alcoholic. He earns Rs 6,000 a month and does not let Santosh work outside the house. Santosh filed this complaint with the help of an uncle, Chavan Singh. He is a tall, lean man, with salt-and-pepper hair, and calls himself a social worker.
"There have been many cases in the village," Singh says."The first one was that of Rameshwari, 20-25 years back. She had to finally withdraw her complaint because her husband was a government servant." It was not easy to work with the government and complain against it simultaneously.
Anangpur has a population of 5,000 with 2,500 votes. It is dominated by the Gujjar community with approximately 400 Jatav households in the Harijan basti and some Kumhars, Muslims and Pandits.
"She wanted to file a claim. They are very poor and I helped her."
Singh says the Gujjar biradari panchayat asked the Ambedkar Samiti to tell Santosh to withdraw the complaint. There has been tension between the communities since last year. During chakbandi (land redistribution) the Gujjars took away all the land to be given to Dalits. "Not even 100 square yards was given to us," says Singh.
"Since they have land, money and power, all officials listen to them. After her complaint, officials approached them to withdraw the complaint. The village pradhan is also a Gujjar. It has become an issue of honour for them. Plus, it is not a problem their caste women face."
At this point, Santosh enters. Thirty-four years old, she is thin as a stick, short, and wearing a loose light green salwar kameez. She covers her face with her faded, torn white chunni on seeing Singh.
He ignores her and continues. "We had cattle but now there is no place to take them for grazing. We were anyway weak. Now unemployment has risen. All MLAs, all corporators, all pradhans listen to the powerful, not to us."
Santosh asks me to join her in another room. That is her house. A dressing table with a broken mirror stands in one corner. There's an old television and a bed. Santosh's wedding photograph hangs on one wall next to a garlanded photo of her son Amit, who passed away.
She says, "I lost all strength after his death."
After Santosh found out she was pregnant at a private clinic, she went to the B. K. hospital to get an abortion done. "They told me I was anaemic so they can't do it. I asked them, why did they do a tubectomy? The doctor told me that when the child is born, give it to us. She will give it to her friend. I am not literate but tell me: who gives away their child like that? Would she have said this to a rich person?"
Santosh says Anita behenji, an anganwadi worker, took her for the tubectomy. " After my fifth child Mayank was bornhe is three nowI decided to get the surgery done. There was a lot of tension at home. My husband is an alcoholic. He does not beat me up but gives us hardly any money to run the house. So when I said that I want the operation, he didn't object."
"How did you get the sterilisation certificate if you did not have your period the following month?"
"I don't know. One month later, I went to the hospital and got it. I found out in August that I was four months pregnant. Anita behenji said she will help me in following up the complaint. Now she has also been pressured by the Gujjars. If I had money I would have also gone to a private clinic, like the Gujjar women. "
According to the government scheme, in a case of failed sterilisation (pregnancy)the compensation is Rs 30,000. In case of death within seven days of surgery, Rs 2 lakh. Within a month, it's Rs 50,000 and for other health complications, Rs 25,000.
Santosh received nothing.
The "family planning festivals" that started in Kerala in the 1970s introduced the practice of "motivators". Anyone who needed to get government work done was supposed to bring a sterilisation case. The present roles of motivators like ASHA and ANM workers, and incentive programmes, are inspired by this.
ASHA workers were appointed soon after the National Rural Health Mission (NRHM) was launched in 2005 to help vulnerable sections. They are considered honorary volunteers and paid Rs 600 for an institutional delivery, Rs 150 for immunising a child, and Rs 150 for family planning. There have been nationwide protests for the last two years, where ASHA workers have demanded permanent status in the health department. Currently they are contract workers and will be jobless when the NRHM closes in 2018.
Auxiliary Nurse and Midwife (ANM) workers are responsible for anganwadi centres, to take care of child and maternal health in a village. They also train ASHA workers and are paid a nominal salary by the Central government, about Rs 1,500 per month.
Anita behenji's house is locked. Kajal looks for her at a neighbouring house where a group of women are huddled in a circle. A woman "possessed" by her dead husband's spirit is issuing instructions through clouds of incense. Kajal walks up to one of the women in the group. This is Anita.
In her mid-30s, Anita is dressed in a peach salwar kameez with a green border and golden embroidery, and wears dark lipstick. She sits on a sofa in her house with a second woman, Pushpa, an ANM worker in the village.
"Navratras are on. You will find many such scenes in the village. We try to tell them it is mental illness, stop them. But who listens to us?"Pushpa says.
Anita looks at Kajal who is sitting nearby. "What happened with her mother was wrong. Doctors are careless and we have to suffer."
"How?" I ask.
"Do you think women will come with us for operations? The village women don't understand that we have no role in the failure. We can only take them to hospital and figure out medicines and documents for them," says Anita.
Pushpa says, "Rich people go to private hospitals but not Harijans. They don't have money to go to the doctor even for illness. The Gujjars are the ones who don't even tell us about the pregnant women for immunisation and for our records in their houses. They say, 'we go to private doctors, not consult behenji.' We then tell them okay then, don't come to us for pulse polio for the newly born child later. That medicine you can't get privately. Then they send the pregnant women for immunisation."
Anita didn't find it easy to apply as an ANM worker. "No one in my family approved; I had to apply secretly. When my name appeared on the list, my father-in-law, brother-in-law, husband, everyone opposed it. They wanted to throw me out. Now, after five years, my husband roams around with my ATM card. In the past, he would say, is my money not enough? I really wanted to work and this is good work," Anita says.
"How many male sterilisations happen in the village?" I ask.
"None. Who will talk to them? We have no male workers, and they aren't bothered. The women tell us they don't even want to use condoms. They force themselves even when women are advised abstinence after delivery or surgery. Does the husband ever listen?"
According to the family welfare programmes, the state government is supposed to pay half the salary of a Male Health Worker (MHW) in an anganwadi centre but estimates suggest that half the centres in the country do not have MHWs.
In the past few years, several state governments have announced additional incentives including DVD players, Tata Nano cars, and washing machines for doctors, motivators and women who undergo sterilisation to meet population control targets.
The first two-child norm was recommended by the National Development Council's Committee on Population in 1992 to curb India's reproduction rate by 2010. Since India started family planning programmes in 1952, the average number of children per couple or total fertility rate (TFR) has come down from 6 to 2.5. The current population is growing because of momentum effect. That is, there are more reproducing couples compared to the 1960s and 1970s than the number of children being born now.
The National Development Council also recommended that any representative, from Panchayati Raj to Parliament, should forfeit their seat if they had more than two children while in office. Further, any Indian having more than two children after the policy's implementation would be permanently denied the right to contest the election.
Since 2000, 11 states have adopted the two child norm. The idea was to make elected representatives "role models". While Madhya Pradesh, Haryana, Himachal Pradesh and Chhattisgarh revoked the norm, fiveRajasthan, Gujarat, Maharashtra, Odisha, and Andhra Pradeshcontinue with the policy.
On December 1, 2014, Manisha Patel, a 35-year-old BJP councillor at Gujarat's Valsad Nagarpalika, lost her job after it was established that she had given birth to a third child after being elected to the post. Chief Officer of Valsad Nagarpalika J. U. Vasawa in a public statement said, "We have suspended Manisha Patel after finding (that) all the allegations made by (the) Congress leader were genuine and she had given birth to a third child."
In 1996, India adopted a target-free approach and a National Population Policy. It aimed at the reproductive and health needs of young people, spacing methods, and number of contraceptive choices.
Yet targets continue to haunt poor communities across the country. According to a report by the Centre for Health and Social Justice, "In 2002, in Lakhimpur Kheri district of Uttar Pradesh, five farm labourers from the Dalit community, aged 18 to 32 years, were taken to a hospital by their upper caste landlord on the pretext of being inoculated against malaria and given injections and knocked out. They found out later that they were sterilised. Two of the five were not even married. The UP government in its zest to promote family planning offered gun licences to anyone who brought five cases. The farmer got the licence."
The same happened in the Emergency when in several parts of Uttar Pradesh, gun licences were issued to men who underwent vasectomies.
A 2011 study by Surat-based Centre for Social Studies says the law is being used to settle personal scores and has no structured implementation mechanism. Action is only taken if someone complains about the third child. In Manisha's case, it was the rival political party, the Congress.
Reports suggest the law, implemented in Odisha since 1994, affects women in the reproductive age more when the age for contesting elections was lowered to 21 years from 26 years. A two-child policy thus not only pressures women to undergo sterilisation but also leads to increased sex selective abortions to ensure male heirs.
A Mahila Chetna Manch study in 2002 revealed that 82 per cent of 113 disqualified persons in Panchayati Raj due to the two-child norm were from the SC/ST and OBC communities.
People who adopt the two-child norm get preference in land allotment, allotment of surplus agricultural land, assignment of house sites and houses and sanitation schemes. Other public benefits denied to families with more than three children in the five states include maternity and public distribution benefits. Thus, the law is further penalising marginalised communities in the name of population control.
This is Urmila Pal's first journey outside Uttar Pradesh, arriving in Delhi from Mirzapur. Dressed in a synthetic saree with purple flowers on light pink background, a red cardigan, and socks, she doesn't mind the cold on this smoggy winter morning on December 16, 2014.
Urmila is here to attend a public hearing on "Informed Choice and Quality of Care in Contraceptive Services in India", organised by the Centre for Health and Social Justice and some other organisations, after the deaths of 11 Bilaspur women at a sterilisation camp in Chhattisgarh last November. She is here to talk about her botched tubectomy at the primary health centre in Mirzapur two years ago.
Urmila is 24 and the mother of three sons. She was married at 17 and delivered her first child a year later, in 2008. After numerous abortions, miscarriages and the death of one child three months after delivery, she delivered the second son in 2011. "I grew up in a large family in Allahabad. I didn't want a big one for myself. Plus, two sons were enough to keep my mother-in-law from not asking for more," she says.
Soon after the birth of her first son, Urmila had to replace her father-in-law, who died of silicosis, as a stone quarry labourer. Her husband's family was indebted to the upper caste local landlord for a loan to buy a buffalo, roughly 30 years ago. It was called the kamiya-malik system where kamiya, the male member of the family along with his family, provide labour in the home and farms of the malik. No one remembers the initial amount but the next generation was still unable to repay. The family was then sold to the stone quarry owner in the late 1990s. The debt obligation was transferred along with that.
Urmila studied till Class 8. "I come from a bada ghar (well-off family) in Allahabad. I had never worked before my marriage but now there was no option. My father has a pucca house and land. But he married me and my sisters off to a landless family, saying we will build our own fortunes. How is it possible when he did not give us any land, and gave it all to my brothers?"
Urmila is paid Rs 80 a day, her husband Rs 140. The UP government rate for unskilled labour in stone quarries is Rs 250. The combination of backbreaking work at the quarry, meagre wages, and frequent health problems because of repeated pregnancies drove her to choose sterilisation.
Urmila approached the ASHA worker in her villagewho had been advising her to go for the surgeryto take her to the hospital for a tubectomy. "It was like they catch monkeys in the Mathura temples and dump them all the way in the Mirzapur jungles. And when the number grows, they catch hold of them and sterilise them. That is how ASHA volunteers keep tabs on us. Like a bandariya!"
Urmila knows the ways of the jungle too well. She is from the Kol community, originally a forest dwelling tribe that is being consistently stripped of its livelihood because of increasingly restricted access to the jungles by the forest department. It is classified as a Scheduled Tribe in the bordering state of Madhya Pradesh but as Scheduled Caste in Uttar Pradesh.
The sterilisation camp was at the primary health centre in Padari, Mirzapur. Even when the government restricted the number of surgeries in camps to 30 per day, this isn't always followed: in Bilaspur, 200 women were operated upon in a single day. The Padari camp was smaller, between 50 and 60 women. She was operated on without anaesthesia, without medical check-up,without privacy. After the surgery she and several other women lay on the bare floor. An hour later she was handed Rs 600 as an incentive from the government and let off.
Before the surgery, Urmila was neither given a consent form to sign nor a no-objection certificate later to prove that she underwent tubectomy.
Two months after the surgery, she discovered she was four months pregnant. The tubectomy was performed while she was pregnant. The doctor was never traced since he was not from the primary health centre. "The health staff said 'What has happened? Have you been raped? Eat the pill and get rid of it'," recalls Urmila.
The ASHA volunteer was initially supportive but switched sides after the health centre staff's denial to help. She gave Urmila medicines and told her to abort the child. "Aborting the child meant taking a few days' rest. I could not afford to take leave. Delivering the child was easier than aborting."
That is how the third son was born in September 2012.
"There are so many women who die after such surgeries. This morning I met Wakim bhaisahab from Purnea in Bihar whose wife died in a sterilisation camp. The doctor, instead of informing him about her death, transfused one unit of blood and two glucose bottles in the dead body and directed him to take it to the bigger hospital, only to find she had died long back," she tells me.
Wakim is also fighting a case in Bihar and is one of the participants in the conference. Three hundred women were operated upon in that camp and the doctor took no responsibility.
Mirzapur is one of 51 districts in India which has more than 26 per cent Scheduled Caste population. Most of the people rendered ineligible if Uttar Pradesh starts following the two-child norm will be from marginalised sections.
Ramakant Rai, a man in his 50s at the same conference said, "The Supreme Court has said sterilisation is not a disease but a therapeutic intervention and that is why it should be 100 per cent safe." Rai filed a petition in the Supreme Court in 2003 on unsafe female sterilisation practices which violated patients' "reproductive rights, women's rights, and health rights".
In 2005, the court gave a landmark judgment with strict guidelines to state governments on female sterilisation. It directed states to set up a family planning insurance scheme to support victims of poor procedural quality and adverse outcome in a sterilisation surgery.
Urmila got the tubectomy seven years after this judgment. A bicycle pump instead of high-precision pneumoperitoneum insufflation equipment was used to pump air into her and other womens' abdomens for laparoscopic sterilisation. The midwife attached the tube of the pump to the laparoscope and pumped, giving no thought to pressure, speed, quality and quantity of air pumped into the abdomen.
Many women complained of cramps and pain for months but no one had the time or inclination to enquire into the after-effects. Their pelvic regions were examined openly in the presence of several men and women in the room. The doctor even used the same pair of rubber gloves while operating on 50 women.
The nurse injected all the women with the same needle, using only a cotton swab to disinfect it once in a while. After surgery, the women were laid on the bare floor in the corridor which serves as a post-operative care hall. Within half an hour of surgery, they left for home.
This is a clear violation of protocols but until today no medical staff or doctors have been penalised, except for temporary suspension for botched tubectomies.
Rai says, "The government has tied up with private insurance companies who reject the claims of women who underwent a botched-up sterilisation surgery on grounds as flimsy as the quality of food patients eat."
The same practice was seen recently in the Bilaspur case, where a lot of patients are being blamed for not maintaining "hygiene" after the surgery.
Apoorva Gupta, a Delhi-based gynaecologist, says, "In an entire year I get only two to three per cent middle- and upper-class patients wanting a tubectomy. Most prefer pills or other temporary methods." These decisions can be directly related to higher education levels in upper classes.
Female sterilisation in private clinics costs Rs 30,000 to Rs 40,000. Gupta says, "That is because not all private clinics have facilities for laparoscopic sterilisation and women who can afford do not want to go to government hospitals because of poor reputation.
Dr Abhijit Das, a health activist at the Centre for Health and Social Justice, says, "A sterilisation-focused approach, which India continues to adopt, leads to a fear psychosis where families quickly complete their desired family size through multiple pregnancies and miscarriages and then opt for terminal sterilisation. This speeds up population growth instead of slowing it down."
According to NFHS-3, in India, 46 per cent of females in the six to 50 age group are illiterate. Female sterilisation is highest47 per centfor women with less than five years of education, and decreases steadily with education. This makes them more vulnerable to early marriage and repeated pregnancy.
With a family planning programme driven by female sterilisation, it is not surprising that more than half the women who get sterilised have the operation before 26. Early sterilisation is common in Andhra Pradesh where 50 percent of the patients are under 23.
NFHS data suggest that 45 per cent of young women marry before 18 and 63 per cent by 20. Like Urmila, about 25 per cent of girls in the 15-19 age group have their first child before 19. In May 2014, Karnataka chief minister Siddaramaiah reportedly attended a mass marriage of 42 couples where 16 girls were child brides under 18.
Das says, "Women who undergo sterilisation before the age of 30 face four times the risk of hysterectomy and higher risk of menstrual dysfunction and dysmenorrhea."
It is important to remember that 13-15 million children die before five as high risk births lead to high child mortality. If children were born two years apart, three to five million of these deaths could be avoided. Had Urmila got access to spacing methods she might have managed to avoid multiple pregnancies and the death of one of her children before finally going for sterilisation.
Moreover, government family planning schemes are only focused on "eligible couples". Twenty-eight per cent of India's population is 10-24 years old. A 2005 survey conducted by the Population Council for boys and girls aged 15-24 in Pune concludes that one in five young men and one in 20 young women have premarital sex. In urban areas, youngsters are more sexually active.
Importantly, most of the budget approved for family planning under the NRHM launched in 2005 is directed towards female sterilisation. In 2013-14, Madhya Pradesh approved a budget of Rs 8,417 lakh for family planning services out of which Rs 7,835 lakh was meant for terminal methods (sterilisation) and only Rs 87 lakh for spacing methods, which includes condoms, intra-uterine devices, contraceptive pills and others.
"After my first child, I asked my husband to use condoms. I heard about it at the primary health centre. Sometimes he would, sometimes he forgot. I didn't want it to continue forever," says Urmila.
Once, a co-worker was beaten up by her husband when he came to know that she was pregnant. Three months before the incident, the husband had undergone a vasectomy. The man accused his wife of having a loose character. When health activists intervened, they found out that his surgery was botched, too.
"I didn't want to take that chance, at any cost," Urmila says.
It is also telling that only 27 per cent of married women decide about their health care by themselves and only 11 per cent decide about visits to their family or relatives themselves, according to NFHS-3 data. Studies show that most men approve of contraception only after having a second or third child and that the husband's approval of a particular method is critical.
The idea that poor people with more children consume more of the nation's wealth has also been challenged, both nationally and globally. The increasing divide between rich and poor in India has to be addressed while rethinking population policies.
Das says, "A simple check on how much water, electricity and food is used by a middle-class family with two children and a set of parents in comparison to a poor family with five children in an urban slum will give you the answer."
International researches also suggest that a strain on natural resources has been typically seen in urban areas. Sana contractor, a feminist health activist says, "The state must address issues like migration and rural infrastructure instead of brazen short cuts like female sterilisation for sustainable growth."
Muslim women, for whom contraception is a religious taboo, are not considered while forming population policies, leading to questions around equity in access to contraceptives for minority communities.
Matthew Connelly, who has extensively worked on population policies across the world, writes in Salon that the idea of ticking population bombs in developing countries needs to be thought through in much greater detail. In the present form it is only penalising the poor.
NHRC member Cyriac Joseph who attended the conference says, "It is sad to hear the testimony of so many people who have been wronged. They should post a letter of complaint to their respective State Human Rights Commission. That will build pressure against coercive tactics."
The conference Urmila attended had invited a number of people from the Health Ministry and Women and Child Development Ministry.
Not one turned up.
(Neha Dixit is a freelance journalist based in Delhi. She covers development, gender and conflict in South Asia.)
Monday, June 29, 2015
State Lawmakers Target Guns and Domestic Abusers
By Sharon Johnson/WeNews senior correspondent
In the wake of the latest mass shooting in the U.S., gun control frustration is back in the headlines. One area of activism: 20 states where politicians are trying to fill loopholes in the current federal gun-control law that leave women vulnerable
(Elvert Barnes on Flickr, under Creative Commons)
(WOMENSENEWS)--When President Barack Obama came on national television to respond to the June 17 massacre of nine worshippers at a church in Charleston, S.C., he expressed angry resignation at the failure of the Congress to pass legislation to keep deadly weapons out of the hands of dangerous individuals.
And when Mother Jones, in the wake of that attack, released its latest map of deadly mass shootings in the United States, it tweeted "we hate updating our database of mass shootings, again and again."
But one light at the end of the tunnel surrounding the prospects of gun control could come from a crossover pressure group: state lawmakers who in the past year or so have been focused on doing something about the high rate at which women are killed by intimate partners.
Nearly one-third of all women murdered in recent years have been killed by current or former intimate partners, reports the Bureau of Justice.
Gun control advocates are hopeful that the massacre at Emanuel African-Methodist Episcopal Church in Charleston will stimulate action by the states, particularly those like South Carolina, which has weak gun laws.
From 2002 to 2011, 6,132 people--one every 12 hours--were killed in South Carolina, reports the San Francisco-based Law Center to Prevent Gun Violence, which tracks legislation in 50 states
In 2012, South Carolina ranked second to Alaska in the nation on the rate of women killed by men and nearly double the national average of one woman killed per 100,000 women. Seventy-one percent of the killings of women in South Carolina involved guns, compared to 52 percent in the nation.
Two months before the Charleston shooting, the South Carolina House passed a bill on April 14 that includes a provision giving judges and prosecutors leeway in pleading out domestic violence cases as assault and battery, apparently in response to pro-gun lobbyists. The South Carolina Crime Victims Council criticized the measure because the new law would not bar domestic violence offenders from possessing guns.
The state also received an F on the Law Center to Prevent Gun Violence's 2014 state scorecard. In addition to permitting guns in bars, South Carolina does not require background checks on private sales, require reporting of mental health information or allow law enforcement the discretion to deny concealed handgun permits.
Unlike Congress, which views gun control through the lens of Constitutional rights, state legislators are concerned about ensuring the safety of family and friends.
"State legislators recognize that if we don't step up to the plate, nobody will," said Missouri State Rep. Stacey Newman, a member of the New York-based American State Legislators for Gun Violence Prevention, in a phone interview conducted before the Charleston shooting. "Founded in December, our bipartisan group includes 200 female and male legislators from 50 states who will be developing and passing legislation to reduce access to guns for those who commit certain crimes like domestic violence and for those who are experiencing mental health problems that make access to guns dangerous."
Loopholes in Federal Law
Nearly one-third of all women murdered in recent years have been killed by current or former intimate partners, reports the Bureau of Justice.
Newman, a Democrat, said a federal law adopted in 1996 has saved thousands of lives. Commonly called the Lautenberg Amendment, after its sponsor the late Democratic Sen. Frank Lautenberg of New Jersey, the law prohibits the purchase of firearms and ammunition by people convicted of misdemeanors for domestic violence or those who are subject to certain domestic violence protection orders.
By July 31, 2014, over 109,000 people convicted of misdemeanor domestic violence crimes had been denied permits. The FBI reported this as the third most common reason for rejecting applicants.
However, Newman added, many perpetrators fall outside the federal law's provisions. Many domestic violence cases never go to trial or result in a conviction. And survivors of dating relationships and stalkers fall outside the law's scope because of antiquated definitions of relationships. People convicted of domestic violence offenses against partners they have never been married to, cohabited with or had a child with may possess guns.
This is a dangerous oversight: Between 2003 and 2012, more nonfatal violence was committed against women by current or former dating partners (39 percent) than current or former spouses (25 percent), the Bureau of Justice reports.
Federal law also excludes stalking, as the assumption is that stalking offenses do not necessarily include violence or even personal contact because these incidents may be conducted through the mail, online or by telephone.
The increasing number of female legislators has helped spark passage of gun control measures, said New Jersey State Sen. Loretta Weinberg, a Democrat, in a phone interview.
Women now hold 24 percent of the 7,383 seats in state legislatures, reports the Center for American Women and Politics at Rutgers University in New Brunswick, N.J.
"Female legislators view gun control laws as a public health and safety issue," said Weinberg, majority leader of the New Jersey State Senate. "I have been able to get gun legislation aimed at domestic violence perpetrators passed by emphasizing that it prevents domestic incidents from turning into bloodbaths that kill the victim, other family members and innocent bystanders."
Weinberg said that joining forces with national organizations like Americans for Responsible Solutions, which was founded by former U.S. Rep. Gabby Giffords, has helped overcome the opposition of the 5-million member National Rifle Association, which maintains a muscular lobbying effort at the state level.
Twenty states have introduced bills to fill loopholes in the Lautenberg Amendment, which leaves women vulnerable, finds a March 30 analysis by the Law Center to Prevent Gun Violence.
7 Laws Passed in 2014
"In 2013, many advocates felt dispirited after Congress failed to overhaul the nation's gun laws in response to the massacre at Sandy Hook Elementary School," said Lindsey Zwicker, a staff attorney at the nonprofit center.
But thanks to the growing awareness of the link between domestic violence and guns, seven states passed laws in 2014, she said in a phone interview.
In the past, the NRA has torpedoed bills in state legislatures by claiming that gun control proponents are determined to take their Second Amendment rights away.
Giffords, who was critically wounded at a meeting of constituents near Tucson, Ariz., in 2010, joined Weinberg at a roundtable event at the New Jersey Statehouse March 18 where she argued that an integral part of protecting the Second Amendment is ensuring that the right to bear arms is exercised responsibly. Like Giffords, over 49,000 of the 81,000-member Americans for Responsible Solutions, are gun owners.
She also urged women to take the lead in overhauling the nation's gun laws by adding non-cohabitating dating partners and convicted stalkers to the list of domestic abusers who cannot legally purchase a gun.
"In 2014, only 10 states barred those who abuse someone they were dating from purchasing a gun if they did not live together or have a child together," said Zwicker of the Law Center to Prevent Gun Violence. "This is a serious loophole. In 2008, individuals killed by current dating partners made up almost half of all spouse and non-dating partner homicides."
One in six women is stalked at some point in their lives, so more states need to protect women against stalkers, Zwicker added. Only nine states now prohibit individuals convinced of misdemeanor stalking from obtaining guns.
"These laws will save many lives," Zwicker predicted. "One study of female murder victims in 10 cities found that 76 percent of women murdered by their intimate partners were stalked during the year before the murders."
Modeled after Mothers Against Drunk Driving, which emphasized its opposition to drunk driving rather than the drivers themselves, Moms Demand Action for Gun Sense in America has also helped build support for laws that will keep guns out of the hands of domestic violence abusers and other dangerous people.
The group is part of Every Town for Gun Safety, an umbrella organization founded by former New York City Mayor Michael Bloomberg who pledged $50 million in 2014 to make the political climate more supportive of gun control.
Law Enforcement Officers' Support
Support by law enforcement officers has also buttressed advocates' public safety arguments. In Minnesota, State Rep. Dan Schoen, a police officer and paramedic, spearheaded the passage of a law that takes all firearms, including rifles, away from stalkers and abusers.
A member of the Democratic-Farmer-Labor Party, Schoen won the support of GOP Gov. Mark Dayton, a devoted gun owner, and Republican legislators, who had received campaign support from pro-gun groups.
Although Democrats have proposed most of the bills, Republican state legislators such as Kansas State Sen. Barbara Bollier, a retired physician, are doing so too. Republican governors such as Scott Walker of Wisconsin and Rick Snyder of Michigan have also supported the measures as a means of ensuring public protection.
Pro-gun groups have used a variety of strategies to oppose the measures. In California and New Jersey, for instance, they have claimed that federal law is sufficient to protect victims. In other states such as Washington and South Carolina, the NRA has lobbied legislators to water down bills.
The original bill in Washington called for individuals served with restraining orders to surrender their guns to government officers or firearm dealers; now they can give the firearms to their friends.
But mostly, the gun lobby has concentrated on passing legislation that would make it easier for everyone to carry guns. Kansas became the fifth state April 20, along with Alaska, Arizona, Vermont and Wyoming, to allow loaded guns to be carried in public without a permit.
Gun control proponents such as Weinberg, the New Jersey state senator, remain optimistic that the movement to keep guns out of the hands of domestic violence abusers will succeed.
"Critics told me when I started working on gun control 10 years ago that I would never get any bills passed, but now New Jersey has some of the nation's strongest laws," she said. "In the long run, we will triumph because these measures save lives."
Sharon Johnson is a New York-based freelance writer.
Tuesday June 16, 2015 Tuticorin stands first in family planning
Registering a sterilisation percentage of 96.5, Tuticorin district has earned the distinction of standing first in birth control in the State for 2014-15.
Collector M. Ravikumar said here on Monday that against the target of 9,200 surgeries set by the Family Welfare Department, 8,882 surgeries were performed. Since only 19 men came forward for vasectomy, the rest of the surgeries were tubectomy procedures.
During a conference of Collectors, a special project with an outlay of Rs. 34.3 lakh was proposed to give a thrust on birth control measures in coastal villages of Tuticorin district. Through a survey, it was identified that 2,724 women had been giving birth to more children in the target areas. Maternal mortality rate had come down to 80 per one lakh deliveries in 2014-15 from 90 per one lakh in 2013-14.
The high sterilisation rate was possible thanks to the efforts of health care personnel at 53 primary health centres, 253 health sub- centres, Government Medical College Hospital in Tuticorin, District Headquarters Hospital in Kovilpatti, eight government hospitals and 63 private hospitals in the district, the Collector said.
Deputy Director of Health Services S. Uma said that one day in every week had been dedicated for performing family planning surgeries alone at all GH, nursing homes and 14 PHCs.
Tuticorin was placed sixth in sterilisation in 2013-14, she said. Regarding infant mortality rate, she said that 21 per thousand live births was registered in the State and 12.7 per thousand in Tuticorin in the last fiscal.
Thursday June 18, 2015
Despite odds, there’s hope of a healthy India
By Poonam Muttreja
Indifference to women's health: It can never be an option
A key aspect of the NDA’s approach is evidence-based policy analysis. This is bound to fetch results
Although the Budget did not fulfil our healthcare expectations, there are good reasons to be optimistic. One, the UPA government failed to increase public spending on health. Under-spending on health has been a major cause for the growing inequities, insufficient access and poor quality of healthcare services. In fact India’s health spend is among the lowest in the world. The extremely high private out-of-pocket expenditure on health close to 70 per cent has also emerged as a major cause of impoverishment: it drives close to 50 million people into debt and poverty every year.
Sadly, public spending on health by India has stagnated at around 1 per cent of GDP for close to a decade now. The draft health policy put out by the NDA government does talk about increasing public spending to 2.5 per cent of GDP which is a welcome sign though there is no indication of the timeline by which this target will be met.
Two, the political leadership of the UPA government had only reluctantly bought into the idea of universal health coverage, though some of the recommendations of the high level expert group on universal health coverage were incorporated into the Twelfth Five Year Plan document. The NDA government breathed new life by talking about universal health assurance very different from universal health insurance.
To many of us, health assurance has three dimensions. The first is access to affordable good quality healthcare for all, similar to the notion of universal health coverage which is being pursued by over 75 countries today. The NDA government has talked about free medicines and free diagnostics. Global evidence suggests that a tax-funded single payer system is the best option.
The second dimension is to recognise upfront that health outcomes are determined not just by investments in the health sector but equally significantly by investments in non-health sectors. This is the reason why the draft health policy talks about setting up seven task forces to specifically deal with many of the social determinants of health. These include the Swachh Bharat Abhiyan; the promotion of balanced and healthy diets; addressing tobacco, alcohol and substance abuse (Nasha Mukti Abhiyan); increasing road safety (Yatri Suraksha); advancing women’s safety and security (Nirbhaya Nari); reducing stress and improving safety in the workplace; and reducing indoor and outdoor air pollution.
The third dimension has to do with accountability.
Some of the discussion in this year’s Economic Survey is insightful.
Such evidence-based policy analysis is refreshing and much wanted. It raises hopes of new policy thinking and action. Bold steps are needed to fulfil the promise of a healthy India by 2022.
It is not beyond a government that believes in good governance to do away with targets and cash incentives for sterilisation, stop mass sterilisation camps, and focus instead on spacing methods of family planning that are more appropriate for young people. It is not beyond the acumen of a finance minister who has promised to raise over 70,000 crore for Indian Railways to mobilise a similar amount for investing in people’s health undoubtedly an equally important national priority.
The writer is the executive director of the Population Foundation of India, New Delhi
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