Is this what we call progress?



STARK REALITY: There may be many Uttar Pradeshs lurking in even the best-managed States.

STARK REALITY: There may be many Uttar Pradeshs lurking in even the best-managed States.  

There may be many Uttar Pradeshs lurking in even the best-managed States.

EVERY year, more than half a million women die in India during pregnancy. And 11 million children die before they turn five. This should make us stop in our tracks and ask: is this progress? Are we not deluding ourselves when our media applauds India's progress in IT and other spheres, when we pat ourselves on the back on having some of the richest men in the world, when we headline the fact that our Prime Minister is featured in a leading American magazine? For if in the most basic of issues, in the ability to ensure that our women and children survive, we are failing, then we must question this progress.

A chance meeting with a health activist from Uttar Pradesh this week was like having a cold shower. The stories she narrated of what is happening to women in that State makes for a relentless horror story. It is one that is told locally by some of the media but rarely makes its way to the national media.

But it is a story that needs to be heard and should prompt us to look more closely at the rest of the country. If we do, we are bound to find that there are many Uttar Pradeshs lurking in even the best-managed States in this country.

In U.P., an estimated 40,000 women die each year from complications during pregnancy. While underage and underweight mothers are more vulnerable, an additional factor is unsafe abortions. According to one study, the highest rate of abortion in the country is in this State — over 20 lakh each year. Around 15 to 30 per cent of the maternal deaths in U.P. are the result of unsafe abortions. Women bleed to death, die of infections and injuries — and no one is held accountable for these deaths.

The case studies gathered by women's health groups in U.P., including Sahyog, expose the hollowness of the claims our government makes internationally that it is committed to women's reproductive health and rights.

Is this what we call progress?

If that were the case, women would not be forced to have abortions as they would have known the choices they have to prevent pregnancy. If their health and rights were a genuine concern, they would not have been abandoned after botched abortions and hurried sterilisations.

In theory, women are supposed to be given a choice in contraception methods. In reality, the only choice before them is sterilisation through tubectomies.

Of the total number of sterilisations performed in U.P., 97 per cent are done on women. Just over half of them face post-operative complications and can rarely access treatment. And the failure rate of sterilisations is 4.7 per cent. In other words, even after having these operations, women become pregnant. And if in desperation they seek an abortion, they literally risk death.

A study conducted by the group Healthwatch UP in Bihar and Uttar Pradesh in 2002-2003 exposed the gaping chasm between the standards the government of India sets for female and male sterilisation and the reality on the ground.

To give just one or two instances: the standards lay down that sterilisations must be carried out under aseptic and antiseptic conditions. The study found that internal examinations were being conducted on women with used gloves. The standards lay down that the maximum number of sterilisations in mobile services should not exceed 20 a day. Instead, the study found that in one location, a surgeon had done 75 sterilisations in just two and a half hours — an average of only two minutes per case.

Most of these case studies tell a similar tale — of desperation on the part of the women and of utter indifference on the part of the medical system. "No choice between sterilisation and death" is the heading given to one such case study. This is of a woman from Taktakpur, Varanasi district, who went through four childbirths in six years. She agreed to a sterilisation operation four months after her last delivery.

During the operation, she collapsed when the doctor pulled her intestines by mistake. By the time her family managed to take her to the nearest district hospital, she was dead. The family was given no explanation of how she died. Her husband finally did get compensation of Rs. 10,000 when a non-governmental organisation intervened and filed a case.

Stories like this are abundant not just in U.P. but also in other parts of India. These are poor women. They are paying the price for a mindset that believes that in the "war" against a burgeoning population, there are bound to be some casualties. Collateral damage.

I have personally heard a leading gynaecologist of Mumbai speak in these terms. As long as this mindset prevails — one that refuses to acknowledge that the real problem lies in the lack of development, of health care, of education — women in U.P. and elsewhere will continue to die in obscurity, away from the gaze of the media and policy makers.

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