I was at a paediatrician's private clinic, screening preterm babies (born before 37 weeks of pregnancy) for a pathology specifically seen in the retina of these babies and called retinopathy of prematurity (RoP). Now this paediatrician runs, along with his colleagues, one of the best private neonatal intensive care units (NICUs) in my city of Jamnagar. While documenting the patient details, I was surprised to find that 18 of the 21 babies I had screened over my three visits there were male. So I casually remarked to my paediatrician friend, “Lots of male babies, eh?” “The females are in GG, Ruchirbhai”, he replied matter-of-factly, ‘GG’ here being Guru Gobindsingh Hospital, the government hospital in Jamnagar.
Now GGH, Jamnagar has a well-run paediatrics department with a team of capable doctors running their neonatal care unit. But it has its limitations as in the case of most of the government hospitals in India. The staff are overworked and the infrastructure is lacking. A professionally run private hospital aims to give quality care to its patients, and one important way of doing this is not to let the resources get unduly stretched. The cost of care in private practice is high, and from there arises the gender bias.
So, did my paediatrician friend’s reply shock me? No. Did it surprise me? No. As a doctor I see this gender prejudice every single day. But you know, there are certain things that are so despicable that every time it happens you discard it as a one-off event and hope you never see or hear of it again. Gender bias is one such thing for me. Now I am not proclaiming myself to be a feminist or anything but I just find it err… despicable. But whenever this happens it gets me thinking, why the hell do people do this? And it is not just the males who force this bias on the family, the females are complicit, either by acts of commission or omission.
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The joint family culture is quite prevalent in India, especially in Hindu households — multiple generations of the same family living together under one roof. It is a brilliant system with many positives. I lived and still live in a joint family. Great grand-parents living with their sons’ families who are in turn living with their sons’ families. Such a happy system. But here lies the problem. Parents are living with their sons and not their daughters, although there might be a few exceptions. All of them have wed someone else’s daughters and brought them into their homes.
India is a low-to-moderate income country, and quality healthcare is not cheap. Although quality healthcare in India is among the cheapest in the world, the ‘not cheap’ bit is for the Indian poor. Also, government-provided healthcare is shoddy at best.
Now, spending on healthcare is an unplanned and unwanted expenditure for the people, and Indians are extremely reluctant in this regard. So the parents’ attitude towards the health of their children is abject. Another pediatrician friend told me that parents at his clinic deny treatment for their ailing newborns saying they could always produce another one. For them it is an investment they cannot afford to make. Producing another child is lot cheaper.
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Now if the child is a daughter, it gets worse. The first thing they think is that spending all this money on a child who would grow up and marry into another family is a dead investment. As they do not see any ‘returns’ from this investment made on a girl-child. After all, it is their sons who are going to support them in their old age, and their daughters will be looking after someone else’s parents. So they do the bare minimum for the girl-child and hope for the best. The sad part is that this bias is not limited to the poor of society. I have an aunt who was happy her daughter-in-law had a son as her first-born as the birth of a daughter would have left the family incomplete and would have made further endeavours in reproduction necessary.
Need proof? A detailed analysis of Census 2011 data showed that 27% of the households in Uttar Pradesh had two or more married couples living together. Uttar Pradesh was followed by Rajasthan, Haryana, Punjab, Gujarat, Bihar, Jharkhand and Madhya Pradesh in this. In Rajasthan, 25% of the households were found to be joint families, while in Haryana the corresponding figure was 24.6%, Punjab 23.9%, Gujarat 22.9%, Bihar and Jharkhand 20.9% and Himachal Pradesh 20%. In West Bengal, 15.5% of the households were joint families, in Maharashtra it was 17.6%, in Madhya Pradesh 17.7%, in Odisha 12.32% and in Goa 12.6%. In contrast, in south India, in Andhra Pradesh only 10.7% of the households were joint families, in Tamil Nadu it was 11.2%, in Pondicherry 11.4%, in Karnataka 16.2% and in Kerala 16.6%.
Incidentally, Census 2011 showed that the States of Punjab, Haryana, Uttar Pradesh, Uttarakhand, Rajasthan, Gujarat and Maharashtra have among the worst child sex ratio figures in the country. In contrast, the southern States of Andhra Pradesh, Tamil Nadu, Puducherry, Karnataka and Kerala have a far better child sex ratio. Odisha and West Bengal have a better child sex ratio compared to the western and northern States. Sample that.
Of course, literacy and income levels do play a role as seen in Kerala. Kerala has a higher number of joint families than the rest of the southern States but it still has one of the best child sex ratio figures in the country.
All in all, the joint family system is a dominant cause of a poor child sex ratio, higher rates of female foeticide, female infanticide and female illiteracy.
So, do I blame the parents for all this gender bias? I am not quite sure I do, not completely… Do I think this gender bias is wrong? Hell, yes… Do I think the joint family culture is responsible for this gender-bias? Of course. Do I think we should do away with the joint family culture? Umm...
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