India is the world-leader in sterilisations, with almost five million people undergoing the operation annually. Last year, the dumping of dozens of semi-unconscious women in a field in West Bengal after the operation caused outrage – surgeons said there was no space for them inside the operating site. Several months later a Bloomberg investigation revealed how women in Bihar – the poorest state in India, with the highest levels of illiteracy – were being operated on in battery farm-style conditions, by a surgeon using a rusty scalpel. He has since gone into hiding, and court proceedings are ongoing – but it served to emphasise how it is the poorest and least educated women who are being sterilised, in return for cash or electrical goods. In the state of Madhya Pradesh women were offered a Tata Nano car for having the operation. Some states use the "2CN" rule – Two Child Norm – meaning that those with large families do not qualify for benefits.