A paper published in the peer-reviewed Indian Journal of Medical Ethics has found that doctors provided “grossly unscientific information” to poor Dalit women to instil the fear of ‘cancer’ in them, and misled them to undergo hysterectomies. This was based on data gathered from a fact-finding exercise in two districts — Kalaburagi and Chikkamagaluru — to trace how government and private doctors alike “pushed women to undergo hysterectomies”.
Following this, many suffered complications and at least four died in three years from 2012, the paper published on October 26, 2016 claims.
‘Medically unwarranted’
Titled ‘Instilling fear makes good business sense: Unwarranted hysterectomies in Karnataka’, the paper examined reviews made by two panels of experts and women’s medical records from private hospitals to illustrate that a large proportion of the hysterectomies performed were “medically unwarranted”.
It has concluded that private doctors were using “highly suspect diagnostic criteria”, based on a single ultrasound scan, to perform hysterectomies and had not sent even a single sample for histopathology. Medical records were “incomplete, erroneous and, in several instances, manipulated.”
Written by activists from the Karnataka Janaarogya Chaluvali (KJC) Teena Xavier, Akhila Vasan and Vijaykumar S., the paper has described how a combination of “patriarchal bias, professional unscrupulousness and pro-private healthcare policies” posed a serious threat to the survival and well-being of women in Karnataka.
Activists from the KJC, a people’s movement for health and healthcare rights, undertook two fact-finding exercises after they observed an increase in the number of hysterectomies in the two districts. The first one was undertaken in June 2013 at Hebbalagere, a village of 500-odd households in Chikkamagaluru district. In the second exercise, undertaken from June to July 2015, the activists followed the trail of the “big bimari ” (illness), which women said was claiming their uterus, in 38 villages falling under 19 panchayats in four taluks of Kalaburagi district.
‘No exact data’
“In both the sites, doctors had planted the fear of cancer in the women’s minds and this seemed to be driving the hysterectomy epidemic. Although there is no exact data on the number of unwarranted hysterectomies, a State government-appointed committee that probed the unwarranted hysterectomies found that 2,258 women had been misled to undergo the surgery from April 2013 to October 2015,” said Ms. Vasan, one of the authors.
Key findings
According to the paper, all the 15 women interviewed at Hebbalagere underwent hysterectomy in a government facility, 14 of them in the Birur government sub-divisional hospital. An overwhelming 98 per cent of the 707 listed women in the Kalaburagi villages underwent hysterectomy in a total of 61 private hospitals.
Four of these 61 private hospitals accounted for 344 (55 per cent) of all the hysterectomy cases.
The ages of the women who underwent hysterectomy at Hebbalagere ranged from 26 to 40.
The paper recommended strengthening regulatory mechanisms to protect patients’ rights and curb malpractice instead of what the government is presently doing by empanelling the very same unregulated, unaccountable private hospitals under various insurance schemes, said Ms. Vasan.
