After undergoing surgical sterilization at a government-run camp in India earlier this week, a dozen women have died and many more have fallen ill, the New York Times reports. Officials cite the surgeon’s negligence as a key factor; some medical professionals said he didn’t sterilize his surgical instruments.
Each woman received the equivalent of $10 to undergo the procedure. Hours after leaving the facility, reports of giddiness, vomiting and low blood pressure started to come in. Nearly 70 women are being treated for septic shock. Officials also said that four women currently lie in the hospital in critical condition and hooked on ventilators.
“This incident is a reflection of a very bad, poor system, of a nonexistent and nonaccountable public health system, where such tragedies are waiting to happen,” Dr. Raman Kataria, a member of Jan Swasthya Sahyog, a nongovernmental organization that carries out sterilizations in India, told the New York Times.
According to a 2001 United Nations report, India carries out nearly 37 percent of the world’s female sterilizations. The practice has remained popular since the 1970s when then-Prime Minister Indira Gandhi carried out a mass sterilization campaign as a means of controlling population growth. India’s fertility rates have since declined from six children per women in the 1950s to less than three today.
In recent years, endorsement of the procedure has waned nationally, due in part to humans rights activists’ concerns about the unsanitary procedures under which doctors carry out the sterilizations. In the 1990s, India supported the U.N.’s recommendations to offer voluntary contraceptive choices, abandon sterilization targets, and improve educational programming.
Concerns about high fertility rates in other some parts of India, however, have compelled state-level policy makers to introduce financial incentives for participation and the transport of patients to sterilization camps. Surgeons have also ignored sterilization safety guidelines, often performing well beyond 30 procedures daily as part of an effort to cut the high fertility rates in some parts of the country.
The effects have been catastrophic. The Indian government reported nearly 600 deaths between 2009 and 2012. Last year, the Human Rights Law Network filed a complaint with the Supreme Court of India that documented disregard for the national sterilization guidelines. The attached affidavits recounted an instance when a doctor sterilized more than 50 lower caste women two hours at a school that had no electricity or running water.
According to the document, the doctor in question sterilized the women on school desks pushed together into a makeshift operating table. The women — many of whom said they had little understanding of the procedure — alleged that they were given one painkiller and left to their own devices on grass mats in the school. While the Union of India and half of the states have since replied to the petition, critics say that financial support of population control programs perpetuates a system that harms women.
While the recent deaths have placed sterilization on center stage, the procedure has always been a staple in population control efforts in more than a dozen countries, including the United States. Between 1929 and 1974, the state of North Carolina used fear of the loss of state benefits to sterilize more than 7,600 people — including children — who state officials deemed “unwholesome.” In 2012, the state doled out nearly $50 million in restitution.
Earlier this year, the health committee of California’s state assembly banned sterilization procedures of prison inmates after an eight-year audit of the California Department of Corrections and Rehabilitation found that prison officials sterilized nearly 40 female inmates without their consent. And just last year, Sweden — a country with a history of mass sterilization going back to the 1930s — nullified a law that required those having sex-change surgery to undergo sterilization.