No more births... or deaths

The Hindu, Sunday Magazine, Nov 23, 2014

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PTI Women who underwent sterilisation surgeries receive treatment in Bilaspur, Chhattisgarh

Should we forget about the 14 poor women in Chhattisgarh who died earlier this month? Can we write this off as another “unfortunate” incident? Or should we see it as reminder of the fundamental question that Indian policymakers need to ask: are Indian women, especially poor women, entitled to respect and rights due all human beings or will they continue to be viewed as baby-producing machines whose bodies the State can appropriate and control when it deems they have completed their assigned task?

The debate has been sparked by the ghastly tragedy that befell some of the 83 women who were herded into a disused hospital in Takhatpur, Bilaspur district, and subjected to laparoscopic tubectomies within a few hours. The same instrument was used. No time for sterilisation. No time to check if the women were in good enough health to undergo the surgery. And no time to relax and recover before being packed off. And, of course, no one to follow up to see whether they survived the journey home.

Within a day, eight women were dead. In the next days, in other locations where similar sterilisation camps were held, another six died, 14 in all. The doctor who performed the 83 tubectomies – he was rewarded earlier this year for having performed 50,000 tubectomies – was arrested. He says he was not at fault and insists that the women died from consuming contaminated drugs post-operation. It is suspected that the ciprofloxacin tablets given to the women were contaminated with zinc phosphide, a rat poison. And the state government refuses to explain why such a camp was held at a disused, run-down private hospital.

Everyone is blaming someone else. In the midst of all this noise, and the silence that has descended on the homes of the dead women, we must remember that what happened in Chhattisgarh earlier this month is not an exception, a one-off aberration that we can all forget about once the blame is fixed. Between 2003 and 2012, on an average 12 women die due to botched tubectomies. That is 12 too many. No woman should die from this procedure.

Also, whatever government officials might say to the media, the reality is that health workers are expected to fulfil targets by bringing women to these sterilisation camps. If such pressure was not exerted on them, it is possible that fewer women would come. But at least those who agreed to be sterilised would do so after having understood the consequences. And doctors would not rush through with the procedure at the vulgar speed as did the doctor in Chhattisgarh.

Government officials have consistently argued, as they do even today, that sterilisation is the best option for a poor woman with more than two children because she cannot insist her husband uses a condom and she cannot use other spacing methods, such as injectables for instance, because of the absence of health care in the case of complications. But by the same measure, how do governments justify sterilising women and sending them back to their villages without any follow-up? The women who died did so because they could not access emergency health care in time.

Even if poor women opt for sterilisation, surely they are entitled some dignity while undergoing the procedure. We thought the days when women were lined up like cattle, as depicted so starkly in Deepa Dhanraj’s path-breaking 1991 film “Something like a war” (https://www.youtube.com/watch?v=6Fq7HSIPVq4), was something in the past, harking back to the days of the 1975 Emergency when mass sterilisation campaigns were implemented ruthlessly across India. But Chhattisgarh reminds us that this is happening even today, although on a smaller scale.

So respect for poor women is the very minimum that must inform any population programme. India has signed an international convention in 1994 committing itself to guaranteeing women their reproductive choice and rights. Simply put, this means that all women have the right to choose the kind of contraceptive method they want to use. It also means that population programmes must be centered on women’s health and choice.

Clearly, this is so much talk without substance. In 20 years, under one guise or another, central and state governments have continued with the policy of targets and camps. And women are those who are targeted, not men. The skew in the population programmes is more than evident, even if one looks at government data.

Also, despite scores of meeting, conferences, policy documents, including the National Population Policy (2000) that links a decline in fertility to many other aspects such as education, overall health, housing, drinking water and sanitation, the desire to fast-forward population programmes through sterilisation appears irresistible to policy makers of all political hues.

As a result, women continue to pay the price for this persistent myopia – especially poor women. 

(To read the original, click here.)

Crossing over

The Hindu, Sunday Magazine, November 9, 2014

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A stretch of the US-Mexico border. Photo: Reuters

 

Sometimes a documentary film speaks louder than a thousand words. And so it was last week when I chanced upon a powerful documentary film, Maria in Nobody’s Land. Made in 2010 by a first-time filmmaker, Marcela Zamora Chamorro, and winner of several awards, the film portrays a picture of illegal immigration into the United States about which I had little knowledge.

If you have lived in the U.S., you would know about the push from people living in the countries south of the border to enter the U.S. in any way they can. This has been happening for decades and continues even today. A stark reminder of that is the U.S.-Mexico border, south of the city of San Diego in California. On the U.S. side of the border is vast open land; some of it declared a protected area to conserve a particular bird species. On the other is the town of Tijuana, visible from the U.S. side, a dense urban settlement with houses almost touching the border. Separating the two countries is a steel fence that extends into the sea, slicing the shared beach into two. The entire area is a militarised zone with helicopters constantly buzzing overhead keeping an eye out for desperate immigrants trying to make their way across. Mexico and the U.S. are not at war. Yet, looking at that border, you would think they are.

But the story of the desperate immigrant begins thousands of miles away from this and other similar border posts all along the south of the U.S. And not just in Mexico but even further south. It is also a gendered story, with many of those taking enormous risks to cross what appears an impenetrable border being women. These are single mothers, sisters, aunts — women who are convinced that by crossing over they will guarantee their families a better life. And, as legal immigration appears impossible, they risk taking the illegal route.

The film follows some of these women from the impoverished country of El Salvador, south of Mexico, to the U.S. border. What they encounter en route is a grim and frightening story. That they survive is a miracle; others like them are raped, robbed, kidnapped and killed by criminal gangs along the way. Their own government couldn’t care less. And neither does Mexico. If there is any solace, it comes from voluntary immigrant support groups who provide shelter and food.

One remarkable episode in the film shows a group of women who prepare packets of water and food every day. As a freight train carrying scores of these migrants passes their village, they stand near the tracks and pass out the packets. The train does not stop. It doesn’t even slow down. And yet, these women have figured out a way of getting all their packets to the people hanging on for dear life on the roofs of these trains.

Apart from bringing out the dangers that these women and men face even as they make their way to the American border, the film also reminds us of the gender dimension of immigration. The immigrant — legal or illegal — is not just a man. Increasingly, she is a woman.

In Asia too, women are migrating to other countries to find work and money to support their families. Over the years, women from Southeast Asia (the Philippines, Thailand, Indonesia) and South Asia (Sri Lanka, Bangladesh, India, Nepal and Pakistan) have been migrating not just to West Asia but further afield to Europe and the U.S. Unlike the women depicted in the documentary, many of these women are legal migrants. Yet, quite often, the job they think they will do turns out to be something else. Promised jobs as domestic help, for instance, they find themselves in the so-called ‘entertainment’ industry, another name for commercial sex work.

Many of these stories are never recorded. The illegal immigrants constantly fear being found out and deported. And those who have papers fear that if they report ill treatment, they will lose their jobs. Either way, silence is their only option as even the hardships they confront in the countries in which they work are bearable compared to the poverty — and in the case of women, domestic violence — that is the daily burden of their lives at home.

There are many more films waiting to be made, many more books waiting to be written, that will tell these stories. For only then is their hope that countries and their citizens will view the migrant sympathetically and as a person whose only ‘crime’ is to seek a better life. 

(To read the original, click here.)