Brother-in-law of one victim says women were ‘herded like cattle’ after 12 die and scores injured following botched operations

This article is more than 5 years old

This article is more than 5 years old

Relatives of the 12 women who died after a state-run mass sterilisation campaign in India went horribly wrong have told local media they were forced by health workers to attend the camp.

More than 80 women underwent surgery for laparoscopic tubectomies at a free government-run camp in the central state of Chhattisgarh on Saturday. About 60 fell ill shortly afterwards, officials said. At least 14 were in a very serious condition by Wednesday and the death toll was expected to rise.

“The [health workers] said nothing would happen, it was a minor operation. They herded them like cattle,” Mahesh Suryavanshi, the brother-in-law of one casualty, told the Indian Express newspaper.

Such camps are held regularly across India as part of a long-running effort to control population growth.

Four doctors and officials have been suspended and police have registered a criminal complaint.

“It was a serious matter of negligence. It was unfortunate,” said Raman Singh, the chief minister of Chhattisgarh.

Singh said the authorities would investigate the incident, which took place at the disused private Nemi Chand hospital in the Pendari area of Bilaspur, 69 miles from the state capital, Raipur.

The dead included a woman who had given birth only days before. Others were reported to have been suffering from anaemia, severe asthma and diabetes. None appeared to have been properly examined before the operation. Being from poverty-stricken rural communities, many would have been in poor physical condition.

The operations in Chhattisgarh, one of India’s poorest states, were carried out by a single doctor and his assistant in about five hours.

Facebook Twitter Pinterest Victims lie on hospital beds. Photograph: EPA

The exact cause of the deaths was not yet clear but officials said they suspected blood loss and infection caused by unclean surgical equipment. Government guidelines recommending that a surgeon should not use a single instrument for more than 10 operations appear to have been ignored.

The women were discharged immediately and given no follow-up care, reports said.

Deaths due to sterilisation are not new in India, where more than 4m 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.

A total of 1,434 people died from such procedures in India between 2003 and 2012.

Authorities in eastern India came under fire in 2013 after a news channel unearthed footage showing scores of women dumped unconscious in a field following a mass sterilisation.

“Sterilisation camps” are held in Chhattisgarh between October and February as part of a programme to control India’s population, which stands at 1.26 billion. Women who go through the surgery are given 1,400 rupees (£14) by the state, the amount reportedly paid in this latest case.

One of the suspended medical officers told the local NDTV channel that the camp was set up to meet targets. “April to March there are annual targets – this was done according to that,” the official said.

A second suspended official told the channel the daily target of a team was 40 sterilisations “but the number of operations held on Saturday was double that figure”.

Amit Agarwal, the state health minister, denied any targets had been set.

Facebook Twitter Pinterest A victim receives treatment on a hospital bed. Photograph: EPA

Health workers, including doctors, are paid for each operation completed. 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.

Local governments in India often offer incentives, such as cars and electrical goods, to women volunteering for sterilisation.

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 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 announced compensation packages of 400,000 rupees for the families of the women who died and 50,000 rupees for those in hospital. Payments are customary in such cases in India.

Two years ago, 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 that have stigmatised family planning ever since. India is forecast to become the world’s most populous country in 2030, with numbers approaching 1.5 billion.

Facebook Twitter Pinterest Narendra Modi has promised to reform India’s health system. Photograph: Prakash Singh/AFP/Getty Images

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 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 the 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 latest 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.”

India’s prime minister, Narendra Modi, has promised to reform India’s health system. Modi, whose Bharatiya Janata party rules in Chhattisgarh, expressed concern over the tragedy.

Workers of the Congress party, the main opposition party in the state, demanded the state’s health minister and chief minister resign.

Additional reporting by Manoj Chaurasia in Patna