Eight women have died in India and dozens more are in hospital, with 10 in a critical condition, after a state-run mass sterilisation campaign went tragically wrong.
More than 80 women underwent surgery for laparoscopic tubectomies at a free government-run camp in the central state of Chhattisgarh on Saturday. Of these, about 60 fell ill shortly afterwards, officials in the state said.
Such camps are held regularly across India as part of a long-running effort to control the emerging economic power’s booming population.
“Reports of a drop in pulse, vomiting and other ailments started pouring in on Monday from the women who underwent surgery,” Sonmani Borah, the commissioner for Bilaspur district where the camp was held, told AFP news agency. “Since Monday eight women have died and 64 are in various hospitals.”
Four doctors have been suspended and police have registered a criminal complaint. Television footage showed women on stretchers being rushed into hospital with anxious relatives by their side.
Borah said authorities would investigate the incident, which took place at the government-run Nemi Chand hospital in the Pendari area of Bilaspur, 69 miles (110km) from state capital Raipur. The chief minister of Chhattisgarh, one of India’s poorest states, has ordered an investigation.
Deaths due to sterilisation are not a new problem in India, where more than four million of the operations were performed in 2013-14, according to the government.
Between 2009 and 2012, the government paid compensation for 568 deaths resulting from sterilisation, the health ministry said in an answer to a parliamentary question two years ago.
Authorities in eastern India came under fire last year after a news channel unearthed footage showing scores of women dumped unconscious in a field following a mass sterilisation.
The women had all undergone surgical procedures at a hospital that local officials said was not equipped to accommodate such a large number of patients.
The Indian Express daily said the operations in Chhattisgarh were carried out by a single doctor and his assistant in about five hours. “There was no negligence. He is a senior doctor. We will probe [the incident],” the chief medical officer of Bilaspur, RK Bhange, told the newspaper.
So-called “sterilisation camps” are held in Chhattisgarh between October and February as part of a larger programme to control India’s 1.26 billion population. Women who go through the surgery are given 1,400 rupees (£14) by the state.
Local governments in India often offer incentives such as cars and electrical goods to women volunteering for sterilisation.
Government-imposed quotas and financial incentives for doctors also contribute to problems, encouraging officials to botch preparations or rush procedures. Medicine within the public health system in India is often badly prepared, with varying dosages, or is out of date. Basics such as disinfectant are in short supply and are watered down to save money. Corruption is rife in the sector.
Health advocates worry that paying women to undergo sterilisation at family planning camps is dangerous and, by default, limits their contraceptive choices.
India’s family planning programme has traditionally focused on women, and experts say that male sterilisation is still not accepted socially.
“The payment is a form of coercion, especially when you are dealing with marginalised communities,” said Kerry McBroom, director of the Reproductive Rights Initiative at the Human Rights Law Network in New Delhi.
Pratap Singh, commissioner of Chhattisgarh’s department of health and family welfare, told Reuters that the state’s sterilisation programme was voluntary.
The state government has already announced compensation packages of 200,000 rupees for the families of the women who died and 50,000 rupees for those hospitalised. Payments are customary in such cases in India.
Two years ago, the police in the eastern Indian state of Bihar arrested three men after they performed botched sterilisation surgery without anaesthetic on 53 women over two hours in a field.
Politicians in the state are campaigning against “quacks and fake doctors” whom they accuse of causing many deaths. In a recent incident, a one-year-old girl died after an unqualified doctor operated on her with a kitchen knife.
No government has successfully formulated policies to manage India’s population growth which stands at 1.6% a year, down from a high of about 2.3% in the 1970s.
That decade saw aggressive sterilisation campaigns which have stigmatised family planning ever since. India is currently forecast to become the world’s most populous nation in 2030, with numbers approaching 1.5 billion.
India was the first country in the world to introduce a population control policy in the 1950s, and has missed successive objectives ever since.
Though large numbers of young people can be an economic advantage, a combination of unfulfilled aspirations, scarce land and water, overcrowding in growing cities as well as inadequate infrastructure, could lead to social tensions and political instability.
One major problem is a gender imbalance, a result of selective abortion of girls. In some communities there are fewer than eight women for every 10 men, with ratio skewed even further among younger people.
A 2012 report by Human Rights Watch urged the government to set up an independent grievance redress system to allow people to report coercion and poor quality services at sterilisation centres. It also said the government should prioritise training for male government workers to provide men with information and counselling about contraceptive choices, but despite the recommendations to the government, problems persist on the ground.
The UN has expressed concern at the deaths. “If the facts are confirmed, then a grave human tragedy has occurred,” said Kate Gilmore, deputy executive director of the UN Population Fund. “Where there is deviation from clinical standards, there must be consequences.”
Additional reporting by Manoj Chaurasia, Patna