Live
Audio Only
On Saturday November 8, 2014, a surgeon with one assistant sterilized 83 women in six hours at a camp in Pendari village, Chhattisgarh, India. The surgeon was equipped with rusty scalpels, and antibiotics that may have contained rat poison. Throughout India, surgeons and health workers are rewarded financially for meeting sterilization targets. In Chhattisgarh numerous sterilizations have taken place recently as part of the annual sterilization drive to control population growth in the country.
Operations at these sterilization camps have resulted in the deaths of 15 women and, in total, more than 60 women have suffered health complications. One of the women that died had just given birth just days before.
All the women came from poor, rural backgrounds. Some were enticed by the 1,400 rupees (USD$23) they received for undergoing the operation, – the equivalent of half a month’s wage for a poor family. Others were allegedly forced to undergo the operation.
Coerced and forced sterilization are prohibited under international human rights law. Yet, “family planning” policies in India – which focus on the sterilization of women – prioritize population control over the autonomy and rights of individuals.
Rather than educate men and women on the use of alternative forms of contraception, the Indian government continues to rely on the cheaper option: sterilization. This is a hangover from the 1970s when the World Bank and other development agencies “encouraged” debtors to engage in sterilization as a key form of population control. Indeed, such “encouragement” saw the Indian government of the 1970s led by Prime Minister Indira Ghandi forcibly sterilize millions of people throughout the country, predominantly poor people.
India: Development Assistance and Sterilization
Sterilization is the most widespread form of birth control in the world, but it is especially prevalent in India. Coercive and involuntary sterilization with the aim of “improving” the genetic constitution of the human species became an instrument of population and public health control during the heyday of eugenics, between 1870 and 1945.
In Nazi Germany, Japan and the United States of America many hundreds of thousands of people, particularly those with disabilities or from ethnic, religious and other minorities, were sterilized without their consent. In the years after the Second World War, most countries reformed their laws and practices, abandoning eugenic sterilization and strengthening the requirements for informed consent, according to a joint UN agency report.
India’s use of sterilization can be charted back more than forty years. In the 1970s, India became a significant debtor to the World Bank and other development agencies who in turn encouraged “family planning” or – more accurately – sterilization drives.
Countries who then made large contributions to the World Bank, such as the U.S., made clear the link between development assistance and sterilization. In his 1967 State of the Union address, President Johnson said “nations with food deficits must put more of their resources into voluntary family planning programs.”. At the time, “voluntary family planning programs” referred predominantly to sterilization.
In 1975, Indian Prime Minister Indira Ghandi imposed a State of Emergency in the country. Human rights were suspended as millions of labor organizers were detained and tortured, slums were forcibly destroyed and millions of people were sterilized. Sanjay Gandhi, son of Indira Gandhi, began a "gruesome campaign" to forcibly sterilize poor people. During the State of Emergency, 6.2 million Indians were sterilized. This was "15 times the number of people sterilized by the Nazis", science journalist Mara Hvistendahl.
Salman Rushdie’s 1981 magical realist novel Midnight’s Children features Indira Gandhi’s sterilization campaign, as well as the destruction of slums. In the novel, the children, born at midnight on August 15, 1947, the exact moment India gained its independence from British rule, are rounded up and sterilized, effectively destroying the powers that threaten the prime minister. Later, however, in the novel Indira Gandhi looses the first election she holds.
Discrimination
Globally, voluntary, coerced and forced sterilization programs have targeted those socially excluded, including people living in poverty, indigenous peoples, transsexual individuals, those born intersex and ethnic minorities.
In many countries, information is not made available in accessible formats and local languages, and so informed consent is not obtained before sterilizations are carried out. Women are, misleadingly, told that operations will be simple and they will return home with only a small stitch in their stomach.
Although male sterilization operations are easier to perform, in India, women are targeted to take responsibility for family planning. India is a largely male-dominated patriarchal society. Male sterilization is not socially accepted, with many saying it impacts a man's virility. Teaching men and women in remote communities how to use other forms of contraception is more expensive than the mass sterilization campaigns that continue to take place throughout the country.
It is estimated that 37 percent of all married women in India are sterilised. In 2011-12 alone, the government said 4.6 million women had undergone a tubectomy sterilization operation. When compared to other countries, only Puerto Rico, the Dominican Republic and El Salvador ranked higher in number of sterilizations. Even China, notorious for its one child policy and forced sterilization policies, ranks lower than India.
Underlying issues of discrimination need to be addressed within India. We still see reports of universities restricting access for women within libraries. A candidate for Congress recently listed his daughter’s marriage as a “liability” in the liabilities column of his nomination form.
Most disturbingly, female infanticide and female foeticide are still rife within India. Women are perceived as failures if they give birth to a female. Often, they are perceived of as experiencing negative “karma”: women that fail to give birth to a son must have done something wrong in this, or a past, life. There remains a significant degree of shame when a female is born.
In parts of India, this has resulted in a gender imbalance, arising from selective abortion of girls or their murder immediately after birth. In some communities there are fewer than 8 women for every 10 men, with the ratio skewed even further among younger people.
But, men are not excluded from coerced sterilizations either. In one case, a father was told he must get sterilized if he wanted his son to receive treatment for rabies.
In addition to addressing underlying issues of female discrimination, focus should be on spreading information about alternative, less risky and permanent, forms of contraception. Autonomy and choice must be protected. Claims that sustainable development policies are contingent on mass sterilization must be resisted.
Autonomy, Rights and Population Control
From the 1960s, coercive sterilization has been used in Asian, European and Latin American countries as an instrument of population control, without regard for the rights and autonomy of individuals. International human rights bodies have explicitly condemned coercive population policies and programs, noting that decisions about sterilization should not be subject to arbitrary requirements or targets imposed by the government or health-care workers.
Throughout countries in Asia, Latin America and Europe, a range of incentives – or coercive pressures – have been employed to secure sterilizations, including offers of food, money, cars, land and housing, or threats, fines or punishments, together with misleading information as to the nature of the operation. Moreover, the UN reports these procedures are often carried out in unsafe and unhygienic conditions, without follow-up care. Women are often the focus of discriminatory and violent sterilization initiatives. Human rights bodies have clearly stated that forced sterilization is torture. Any form of involuntary, coercive or forced sterilization violates ethical principles, including respect for autonomy and physical integrity.
Newsletter
