India: Joint Memorandum on Deaths and serious health consequences for women following sterilisation procedures in Chhattisgarh

To
Shri Dr Raman Singh,
Chief Minister,
Chhattisgarh
Chief Minister’s Office
Civil Line, Raipur
Chhattisgarh – 492 001

17 November 2014

Subject: Deaths and serious health consequences for women following sterilisation procedures in Chhattisgarh

Shri Dr Raman Singh,

We, Health networks, Coalitions, Women’s Groups and concerned citizens, are deeply shocked at the negligence of the Health Department, Government of Chhattisgarh that has led to the deaths of 16 women and the critical condition of 47 other women following procedures of laparoscopic sterilisation in Bilaspur, Chhattisgarh.

As you are aware that these deaths and morbidities are evidently a result of a botched-up sterilization operation camp organized by the Department of Health and conducted in the premises of a non functioning and abandoned private hospital under the National Family Planning Programme in Takhatpur Block of Bilaspur District on 8 November 2014. Horrifically, during this camp, 83 women were subject to surgeries in a short span of 5 hours. Those who have died—predominantly Dalit, tribal, and OBC women—are victims of the worst violation of their reproductive and health rights, and have left behind shattered families and young children.

This tragedy raises grave questions about the unsafe, unhygienic conditions and the slipshod attitude with which these operations were conducted. Moreover, the women who are presently critical continue to get treatment in inadequate conditions, exposing them to further risks and danger.

The surgeries were conducted in complete violation of the Supreme Court Orders (Ramakant Rai Vs Govt. of India, 2005 and Devika Biswas Vs Govt. of India, 2012). These orders instruct that a maximum of 30 operations can be conducted in a day with 2 separate laparoscopes only in government facilities. Also, one doctor cannot do more than 10 sterilizations in one day. Despite this, a single surgeon in Chhattisgarh performed about three times the permissible number of surgeries (83) in less than 5 hours in a private hospital which has reportedly remained closed for 15 years. a blatant and complete violation of standard protocols.

The announcement of Rs 4 lakh compensation and suspension of officials (Director–Health Services; State Family Planning Nodal Officer; BMO,Takhatpur; the operating Surgeon; and Bilaspur CMHO) are not adequate to ensure that such incidents will not happen again. The systemic failures which led to this incident need to be addressed.

While understanding the specific lapses in the way the sterilisation camp in Chhattisgarh was organised, one should not forget the role played by the misguided and dangerous policies and practices of the governments in the area of family planning services. Such ‘Camps’ (euphemistically called ‘fixed day static’ camps) are routinely organised in many States tin the country in an irresponsible manner. Health providers in many parts of India, confess that they are under pressure to fulfil unwritten targets coming from the top.

The state still focuses on permanent methods of family planning rather than temporary methods. In addition to this, the two-child norm significantly contributes to the pressures for sterilisation. All this despite the Government of India’s promises of ‘Repositioning Family Planning’ – to move away from permanent methods to spacing methods, and to increasing access to safe and effective contraceptives.

This incident must be declared an emergency, and we demand that:

-* Immediate responsibility must be fixed in terms of criminal negligence not only on the medical team which performed the operations, but also in identifying higher officials of the state who sanctioned this particular camp.

• A proper epidemiologically-sound investigation into this incident should be carried out. A three-member probe team has been constituted but these members are a part of the state, which signals a serious conflict of interest and thus, there should be an independent inquiry committee.
  
• Further deaths and damage should be minimized. It must be ensured that the technically most competent medical care is provided to the women to avoid further deaths.
  
• The ‘camp method’ of sterilization needs to be stopped with immediate effect as quality of care is seriously compromised in mass sterilization programme to meet earmarked targets. Instead, sterilization should be provided as a service through strengthened basic primary health care services.
  
• Women, adolescents and men need to be provided with safe choices for contraception. Emphasis should also be placed on male sterilization such as vasectomy, which involves comparatively lesser health risks.
  
• Quality of contraceptive services, including counseling, has to be monitored both from within the system and from outside through community monitoring.
  
• The family planning programme needs upheaval and a re-analysis, that centre-stages the reproductive and health rights of women.

  Endorsed By
  1. Jan Swasthya Abhiyan
  2. Sama Resource Group for Women and Health
  3. CommonHealth
  4. National Alliance for Maternal Health and Human Rights
  5. Medico Friend Circle
  6. Centre for Enquiry into Health and Allied Themes (CEHAT)
  7. Saheli
  8. North East Network
  9. Manasi Swasthya Sansthan
  10. Muslim Womens Forum
  11. Nirantar
  12. Sadhbhavana Trust
  13. Vanangana
  14. Sahiyar Stree Sanghtan
  15. National Alliance for Peoples Movements (NAPM)
  16. SOPPECOM
  17. Olakh
  18. SANGRAM
  19. Queer Feminist India Reclaim the Night
  20. Jagori
  21. LABIA
  22. Forum Against Oppression of Women
  23. Prayas
  24. AIDWA
  25. Oxfam India
  26. Centre for Health and Social Justice
  27. Partners Law In Development
  28. AIPWA
  29. AKL KA DHABA Collective
  30 . National Federation of Indian Women
  31. PWESCR
  32. Bhopal Gas Peedit Mahila Stationery Karmchari Sangh
  33. Bhopal Group for Information and Action
  34. Dr Kavita Panjabi
  35. Prof Gita Sen
  36. Prof Uma Chakravarthy
  37. Admiral L Ramdas
  38. Lalita Ramdas
  39. Prof Ilina Sen
  40. Rajashri Das Gupta
  41. Dr Veena R Poonacha, SNDT Women’s University
  42. Shahida Murtaza
  43. Rachana Johri , AUD
  44. Neeraja Ved Malik
  45. Nandini Rao
  46. Anuradha
  47. Farah Naqvi, Journalist
  48. Sadhana Arya
  49. Kalyani Menon Sen
  50. Surabhi Sharma
  51. Juhi Jain
  52. Ayesha Kidwai
  53. Radhika Desai
  54. Poulomi Pal
  55. Ramlath Kavil
  56. Supriya Madangarli
  57. Amrita Shodhan
  58. Geetanjali Gangoli
  59. Shreya Ila Anasuya
  60. Lata PM
  61. Vasudha Mohanka
  62. Prof Vibhuti Patel
  63. Runu Chakraborty
  64. Swati Sheshadri
  65. Sumi Krishna
  66. Prof Mohan Rao
  67. Dr Amar Jesani
  68. Dr Dhruv Mankad
  69. Dr Veena Shatrugna
  70. Paromita Vohra
  71. Dr Joe Varghese
  72. Dr Bijoya Roy
  73. Sulakshana Nandi
  74. Indira Chakravarthi
  75. Ravi Duggal
  76. R. Srivatsan
  77. Kiran Shaheen
  78. Lata Singh
  79. Dr Sunil Kaul
  80. Sandhya Srinivasan
  81. Bindhulakshmi TISS
  82. Dr Mira Shiva
  83. Nandita Gandhi
  84. Roshmi Goswami
  85. Janaki Abraham
  86. Amrita Nundy
  87. Dr Hazel D’Lima, Retired Prinicipal, Nirmala Niketan College of Social Work
  88. Astrid Lobo
  89. Dr Kaveri RI, WSS
  90. Dr Padmini Swaminathan
  91. S. Srinivasan LOCOST
  92. Kamla Bhasin
  93. Soma KP
  94 Jarjum Ete, APWWS
  95. Dr Anita Ghai
  96. Rohini Hensman