Stunning reprieve

In a stunning development, the Chhattisgarh High Court on Tuesday let off Dr RK Gupta, accused of conducting a botched sterilisation camp in Bilaspur district in November 2014, which claimed the lives of 13 women. He was let off merely on technical grounds. The court noted that the investigators did not have the necessary sanction from the state government required to prosecute a public servant. Even though the court took cognisance of the matter after the errant doctor was suspended, permission from the government would still be required.

For the uninitiated, Gupta and one assistant had allegedly performed 83 sterilisation surgeries on women in a span of 90 minutes at a free family planning camp at a private hospital in Bilaspur district. The botched procedure soon resulted in the death of 13 women, while nearly 70 others were impaired. This is one the darkest chapters of India's family planning programme since the Emergency (1975-77) when the Indira Gandhi government introduced a compulsory sterilisation programme to limit population growth. Though the surgeon was arrested following public outcry, he was eventually released because of protests by the state medical association. Why is the Chhattisgarh government withholding the sanction to prosecute one of its employees? Do officials or ministers in the government have something to hide?

The manner in which the operations were conducted paints a disturbing picture. Basic medical ethics went out of the window. The same syringe and suture needle were used for all the women, while the staff did not even change their gloves. The hospital floor, on which the operated women lay down in the absence of beds, was barely clean. Any medical practitioner will tell you that these are ideal conditions for the spread of infections. To top it off, among the medicines that given to the women post-op, one of them was contaminated with zinc phosphide, a chemical compound commonly used in rat posion. According to the report of the one-member judicial commission appointed by the State government, the deaths were caused by the distribution of substandard and poisonous drugs and medical negligence. Some medical experts, however, contend that the deaths were due to infection caused by unhygienic conditions and negligent medical practices at the camp.

The sterilisation deaths in Chhattisgarh are also a result of the government's obsession with population control, where disproportionate emphasis is laid on female sterilisation. Numerous studies indicate that a vast majority of sterilisations in India are conducted on women, even though male sterilisation or vasectomy is a less complicated and safer procedure. What's worse, there is a complete lack of empathy or regard for the health and rights of poor women. With more than four million Indians sterilised every year, a system of fixed targets encourages officials, doctors and health workers to cut corners, and force poor women to undergo the procedure against their will. In a significant judgement, the Supreme Court last year had directed the Centre to "make efforts to ensure that sterilisation camps are discontinued" within three years.

The Centre was ordered to persuade state governments to drop the practice, especially after reports of gross negligence and human rights abuses. Given the abysmal state of affairs, what does one make of India's perennially under-performing, resource crunched public health system which is forever groaning under the weight of an exploding population beset with increasing healthcare needs in a deteriorating environment? The sterilisation deaths in Chhattisgarh is a painful reminder of how India is not getting its essential public health care checklist in order - poor hygiene and contaminated drugs have been the bane of India's healthcare system for long.