Indian botched sterilisations kill nine women in Chhattisgarh Published duration 11 November 2014

media caption Many women are given an incentive to be sterilised, as Yogita Limaye reports

Eleven Indian women have died after undergoing botched sterilisation surgery at a government-run health camp in the central state of Chhattisgarh.

More than 50 others are in hospital - at least 20 are in a critical condition following the tubectomy operations.

Officials deny negligence. Four health officials have been suspended.

State-run sterilisation camps are held to curb India's 1.3bn population. Most of those operated on are women - many poor and often paid to be sterilised.

The tubectomies were carried out on Saturday in Pendari village in Bilaspur district.

Villagers say 83 women - all between the ages of 26 and 40 - were operated on in just six hours by one doctor and his assistant.

Reports say the women started complaining of pain and fever, soon after being operated on. A relative described the conditions at the clinic as appalling.

"They just operated on them and left them. It's a desolate place, there are no facilities there," DR Shinde told the Associated Press.

image copyright Alok Putul/ BBC image caption Villagers say 83 women were operated on by one doctor in just six hours

image copyright Alok Putul/ BBC image caption Doctors say many of the women are still in a critical condition

Preliminary examinations showed the deaths had been caused by infection or shock as a result of blood loss, state deputy health director Amar Singh told the Press Trust of India news agency.

But Bilaspur district health officer Dr RK Bhange told BBC Hindi: "The cause of the death would be known only after the post-mortem report is available."

Correspondents say all the women came from very poor families. Those who survived are receiving treatment in three different hospitals in the district.

"Their condition is very serious. Blood pressure is low, so keeping the circumstances in mind, we are now concentrating on treating them, not on what caused this," Dr Ramesh Murty told reporters.

image copyright Alok Putul/ BBC image caption Dozens of women are being treated in three hospitals in the district

The state government has ordered an inquiry.

Among those suspended is a doctor who won a government award last year for having conducted 50,000 sterilisations, says BBC Hindi's Alok Putul.

"We've constituted a committee to inquire into the incident. We will take strict action against those found guilty. At the moment though, we are concentrating on giving proper medical care to the women," Chhattisgarh Health Minister Amar Agrawal said.

Botched sterilisation operations are nothing new in India.

In January 2012, three men were arrested in Bihar state for operating on 53 women in two hours. The men had carried out operations in a field and without the use of anaesthesia.

Explaining female sterilisation: Michelle Roberts, Health editor, BBC News website

Female sterilisation works by sealing the fallopian tubes that carry eggs from the ovaries to the womb. This can be done using clips, clamps or small rings or by tying and cutting the tube - this stops the egg and sperm meeting, so pregnancy can't occur.

Eggs will still be released from the ovaries as normal, but they will be reabsorbed by the body instead.

The procedure is very effective and straightforward when carried out correctly and by a highly trained professional. But it is not without risks.

It requires an anaesthetic and there is a risk of damage to other organs during the procedure. There can be bleeding and infection too. It should also be considered permanent - it is difficult to reverse.

Many people are worried about the size of India's booming population - it is expected to overtake that of China by 2030.

Authorities in India have been promoting family planning for several decades, trying to convince people to have smaller families.

Sterilisation camps are frequently held to carry out mass tubectomy operations for women - or vasectomies for men - and authorities in several states have also offered incentives for couples volunteering for sterilisation.

In some states, health workers also receive money for each person they bring to a clinic to be sterilised.

Reports say a sum of about $20 was given to each of the women at the Bilaspur district camp.

The decision to be sterilised is voluntary, although correspondents say in some cases women are put under pressure by officials. Figures show the vast majority opting for sterilisations are women, many of them poor and living in rural areas.