A Voice for the Voiceless

ICC Office of the Prosecutor Weekly Briefing June 2012 Issue 124

Courtney Schuster
Special Contributor, Blog Entry #2

Controlling the population growth in India has become a priority for government officials.  Yet, 25% of patients seeking contraception at public health facilities are turned away.  Instead, in order to slow the population increase, government hospitals are encouraged to hold sterilization camps.  Most sterilization camps are aimed at encouraging women to undergo tubal ligation, though some also perform vasectomies on men.  All of the patients are poor and most are considered, Below Poverty Line (BPL).  Those with enough money and time, choose to visit the private hospitals.

The Indian government set certain standards for sterilization camps; those standards are similar to what exists in developed countries.  For instance there must be: a trained staff of eighteen members; clean running water, a clean operating room with surgical lighting; clean gloves and equipment for each procedure;  patients must undergo a pre-operative test during which their vitals must be monitored; and post-operative care must be provided.  The camps typically operate from 9 am to 4 pm and a maximum of thirty sterilizations can be performed in that time.  Under no circumstances are the camps to be held at school buildings.

Unfortunately,  operational sterilization camps fall extremely short of the standards written on paper.  One of the cases I have been working on involves a sterilization camp that took place in the state of Bihar.  It violated almost every standard set by the Indian government.  There was a single doctor and an unqualified staff, totaling only five people.  Between 8 pm and 10 pm, operations were performed on a total of fifty-three women.  That means that the doctor spent, on average, 2.26 minutes per woman.  The camp operated out of a school that had no running water; additionally, no water was supplied to wash hands or sterilize the equipment.  There was no blood supplies available in case of an emergency.

The women were even required to buy some of the medical equipment and bring those purchases with them to the surgery.  They  were not given sterilized clothing to wear and were administered expired anesthetics.  They did not undergo a pre-operative check up, nor were they counseled about repercussions and side effects of the operation or alternatives to surgery.

School desks were used as operating tables without any sheets or sterilization.  The only light source was a  single, dim, generator-powered light bulb.  The doctor used the same gloves for multiple procedures.  None of the womens’ vital signs were monitored during the procedure.

After the women underwent the procedure, they were placed on a straw mat and left uncovered with no bandages to protect the incision.  They did not receive any post-operative care and they were not given a sterilization certificate for their medical records.

This case is just one of the many sterilization camp cases in which HRLN is involved.  Unhygienic and poorly run sterilization camps are commonplace in India because the government is pushing states to lower their population growth rate.  In turn, state governments are pushing public hospitals to sterilize a substantial portion of the population, at any cost.  For example, in the state of, Madhya Pradesh, the goal of 3,000,000 sterilizations in one year was set by the state government.  Basic cleanliness and patient health and safety is sacrificed to meet this outrageous goal and pacify both state and federal governments.

It seems odd that family planning via sterilization operation is emphasized since less invasive forms of contraception are available.  However, these less invasive methods are rarely promoted.  Condoms, hormonal birth control, and IUD’s are almost never handed out or prescribed by doctors around India.  Perhaps sterilization camps are so popular because the monetary incentives for operating a camp (totaling 1500 rupees per sterilization) are far more appealing to doctors and health centers than achieving a long-term solution to population growth by promoting the alternative contraceptive techniques available.

Courtney Schuster is a third-year student at Syracuse University College of Law.  She is currently working as an intern in India for the summer.  She will be contributing personal blog entries throughout her internship, documenting the challenges of solving human rights issues in international settings.