http://www.outlookindia.com/full.asp?fodname=20060227&fname=Cover+Story+%28F%29&sid=1
Feb 27, 2006
Death Becomes Her
Punjab has the worst sex ratio in the country. Female
foeticide is at an alarming high. The worst culprits
are the affluent.
CHANDER SUTA DOGRA
***
Kulwinder Kaur Housewife: "I have two daughters and
my mother-in-law is threatening to get another wife
for her son if I dont have a boy. I got an abortion
done last year when the scan showed it was a female
foetus. This time I have been lucky."
Simran College Lecturer: "I have one girl and cannot
afford to have another daughter. Its so difficult to
marry them off as boys demand hefty dowries. I have
undergone five abortions at a private nursing home as
all of them were female foetuses. I may not be able to
conceive again."
Kashmiri Devi Housewife: "Ive two daughters, after
which I had four abortions because the foetuses were
female. Now, I want to have a son of my own so that he
can take care of us in our old age."
Satinder Kaur Wife of a landed farmer: "I have one
daughter, and I know that if I dont have a son soon
my status in the family will come down. Femicide is
not an issue in our family. I got my last pregnancy
aborted, it helped me to limit our family size.
Otherwise I could be saddled with a whole lot of girls
until I get a boy."
Satnam Singh Sarpanch, Nai Majara: "No matter what
people might say, at heart everyone wants a son.
Imagine the plight of a couple who has two daughters
in a row. Life in Punjab is cruel for those with too
many daughters."
***
Look hard and you won't find anything out of the
ordinary in Dhanduha village in Punjab's Nawanshahr
district. But anganwadi worker Harminder Kaur knows
well the foul secrets her village keeps. As she
produces her register, which maintains a record of all
births which take place in the village, she says,
"I've been telling these women not to go in for female
foeticide as it's against the law and bodes ill for
our society." Words which most anganwadi workers and
health department officials in rural Punjab can mouth
in their sleep. Dhanduha's register shows that of the
seven babies born in the last six months, there were
six boys and just one girl. In the last one year,
against 12 boys only three girls were born, and in the
last five years, 34 baby boys were born as against
only 18 girls. A sex ratio of just 529:1000!
But it's not fair to point fingers at Dhanduha.
Everyone in the district knows of Nai Majara, the
village where an on-the-spot survey conducted by
deputy commissioner Krishan Kumar a month ago, of
children in the 0-1 age group, came up with a ratio of
437:1000. A local NGO staged an instant demonstration
in the village but its sarpanch Satnam Singh wrings
his hands in despair. "It's such a shame for our
village, but what can I do? This happens everywhere."
Sure it does. And much more than anyone previously
imagined.
Gobindpura is a village just off the main road to
Jalandhar, with pretty bungalows built with money sent
home by its expatriate population. With its fields of
yellow mustard, the wheat crop just beginning to ripen
and the juicy sugarcane ready for harvesting,
Gobindpura presents a picture of agrarian prosperity.
A prosperity which many feel is responsible for the
village's fast falling sex ratio. Out of the 24 baby
boys born in the last one year, the village produced
just 10 girls. A sex ratio of 416:1000. A few years
ago it was slightly better, at 636:1000.
Nawanshahr district's gory secrets began tumbling out
when Krishan Kumar took over as the deputy
commissioner in May last year. Kumar took it upon
himself to improve the female sex ratio of his
district to a respectable level.Nine months into the
campaign and Nawanshahr has uncovered a sordid story
of rampant female foeticide which goes on with the
active participation of the state's health department
officials. It all began when Kumar initiated a survey
of all children from 0-6 years in the 477 villages of
the district, to gauge the extent of the problem in
his area. It turned out that there are 16 villages
where the ratio is in the range of 500:1000. And 65
more villages recorded a ratio of below 700:1000.
These are prosperous villages in the state's Doaba
belt. Mud houses are a rarity in these parts, and
grand mansions built by NRIs or even prosperous
villagers are common. Incidentally, Nawanshahr had
emerged as one of Punjab's better districts according
to the sex ratio mapped in the 2001 census, in which
it stood at 808:1000. By 2004, it had fallen to 775.
Manjit Kaur with her husband, daughter, mother-in-law
who had an abortion at the nursing home
Kumar suspects the situation in the four towns of the
district, still to be surveyed, would be much worse
because of greater accessibility to scanning centres
and clinics. Villages like Sekhopur, Kador, Sultanpur,
Sajawalpur, Jatpura, Kherevewal and many others like
them, all with a sex ratio below 700:1000, are a sad
reflection of a chilling trend which, despite the
'efforts' of the government machinery to enforce the
Pre-Natal Diagnostic Techniques (Prohibition of Sex
Selection) (PNDT) Act, refuses to ebb.
When statistics tabulated by the 2001 census came out
a few years ago, the country sat up and took note of
the dismal sex ratio which the prosperous, green
revolution states of Punjab (793:1000) and Haryana
(820:1000) threw up. The government framed laws to
deter would-be mothers from tearing out female
foetuses from their wombs. The state machinery
launched awareness drives, and researchers
enthusiastically set off for the villages with
satchels filled with questionnaires. But the mothers
continued doing what they must in the gender-biased
society which they inhabit. At Dhanduha, a clutch of
mothers and pregnant women look the other way when
asked whether sex determination testing is common in
their village. The village midwife or 'dai', Jeeto, is
the only one who speaks up. "It's quite simple. They
all go to Banga (a nearby town) to get tests done.
Most girl foetuses are simply aborted."
Everywhere in Nawanshahr, people talk about a well-
entrenched network of educated 'dais', nurses,
midwives and doctors, encompassing private practioners
and those from the government's health department, who
facilitate violations of the act with impunity.
Paramjit Kaur, the child development project officer
of Banga block, admits candidly, "Health department
officials, particularly the auxiliary nurses and
midwives (ANMs), lady health visitors (LHVs)
supervisors and doctors are deeply involved in the
business because these are the people who are
intimately connected with pregnant women as part of
their duties." A recently detected case of female
foeticide in Naura village is revealing. Manjit Kaur
and her husband Santokh Singh have been hauled up for
allegedly aborting their female foetus at a nursing
home in Hoshiarpur. Since Nawanshahr had become too
hot to conduct a medical termination practice (MTP),
because of the deputy commissioner's aggressive drive
against female foeticide, Manjit simply went to a
relative's place in nearby Hoshiarpur district and got
her pregnancy terminated at Shashi Nursing Home and
Scan Centre. Investigations have revealed that the
nursing home is being run by a doctor couple, where
wife Dr Shashi Bala is a former government doctor and
husband Dr Gurdial Singh is none else than the
district family planning officer in Hoshiarpur.What's
worse, Dr Gurdial also heads the district committee
constituted to enforce the PNDT Act! A case has duly
been registered against the nursing home. But it's
common knowledge that government doctors in Punjab run
private nursing homes and clinics on the sly in the
name of their relatives or spouses. A sullen Manjit
had only this much to say, "This is our fate. What can
we do? Luckily the village is supporting us."
Students at a rally against female foeticide in
Nawanshahr
A few months into the campaign and Krishan Kumar
realised that he needed to do some tough talking with
the private and government doctors of the district.
The meeting opened a can of worms. Private doctors
accused doctors and staff of the government health
department of indulging in large-scale sex
determination scans and female foeticide. Says Dr
Gurmej Singh Saini, a lady gynaecologist in private
practice, "As vice-president of the Nawanshahr chapter
of the Indian Medical Association (IMA), I pointed a
finger at the wife of chief medical officer (CMO) Dr
Kuldip Kumar, who is working as a radiologist at the
government civil hospital at Nawanshahr." Dr Saini
alleged at the meeting that the woman in question
conducts sex determination scans and then refers those
desirous of undergoing abortions to dais, ANMs and
doctors known to her, for a commission. Dr Saini also
alleged that she is being pressurised by the CMO to
conduct abortions on women referred by his wife, and
that her nursing home was sealed for two months on
false charges when she refused to do so. Reacting to
the allegations against him and his wife, Dr Kuldip
Kumar told Outlook, "Let them prove their allegations,
then I will see. They are making false allegations
because their business is suffering due to our
enforcement."
In villages located close to towns like Nai Majara,
it's easy for pregnant women to catch a bus to town
and get a scan done. But more remote villages are
serviced by nurses, and dais, who scour the villages
for pregnant women and work either as middlewomen for
nursing homes or do the abortions themselves. The
government and private nurses are generally girls from
the local villages, and officials see a link between
the presence of a nurse or trained dai in a village to
its low sex ratio. These nurses or dais charge
anything from Rs 500 to Rs 3,000 for an abortion.
The civil surgeon of Nawanshahr, Dr Dilip Kumar,
estimates that nursing homes charge anything between
Rs 5,000 and Rs 10,000 for a package which involves
scanning the foetus and conducting an MTP if it's a
female. The middlewomen pocket a hefty commission for
every case brought by them. The PNDT Act has only
pushed up the pricea sex scan now costs Rs 3,000 or
so, as against the Rs 400 which a normal ultrasound
costs.
The entry of untrained dais and nurses into the female
foeticide business is also because abortion techniques
have changed and now become much simpler. The earlier
invasive surgical techniques for abortion, such as
suction aspiration or syringe methods are fast
becoming obsolete. Popular among Punjab's army of
trained and untrained medics is the trend of chemical
abortion wherein M cradil, a dye, is injected into the
uterus which leads to intra-uterine death of the
foetus, followed by its expulsion. Some prefer to give
two injections of Prospadil, a hormonal formulation
which leads to uterine contractions and expulsion.
A street performance on female foeticide
Even with the kind of abysmal figures which Nawanshahr
has turned up, the district has some good news to
report too.The entire state is watching with wonder
the results of the rigorous anti-female foeticide
drive undertaken by the district administration.
Results of strict enforcement have begun coming in
places like Khothran already. According to a
government assessment in 2004, the ratio in the 0-6
years group in this village was 787:1000. Strict
monitoring had increased it to 904:1000 by the end of
2005. Satisfying yes, but Kumar feels that even the
better villages cannot be taken for granted because
the socio-economic conditions which led to the problem
in the first place remain. As Channan Singh at Nai
Majara says: "It's all very well for the DC to launch
a campaign, but will he help us to marry our daughters
when the time comes? Boys nowadays ask for huge
dowries. If it's an nri groom the amount doubles."
The emergence of the two-child norm and even the trend
of one male child preferred by rural landed families
nowadays are other factors encouraging female
foeticide. Dr Renuka Dagar, a senior fellow with the
Chandigarh-based Institute of Development and
Communication, studied the phenomenon in 2003 and
found that in one village of Bhatinda district, 40 per
cent of the couples over 35 years of age had only one
offspring, a male. With land holdings shrinking,
people don't want too many children or even too many
sons. Ensuring that the one child that they have is a
male, she points out, is one more reason for the
increase in female foeticide.
A couple at the Baba Budha shrine near Jalandhar
seeking a male child
It's not surprising to find that the overall sex ratio
for Punjab is dipping further. According to data from
the latest sample registration system of the office of
the registrar general, the overall sex ratio at birth
(considered a more accurate indicator of female
foeticide) for Punjab is now 776:1000 (in 2001 it was
793:1000). In Nawanshahr district alone, the ratio
fell from 810:1000 in 2001 to 775:1000 in 2004. Again,
a state-wise analysis done recently by an
Indo-Canadian team, which appeared in the latest issue
of British medical bible Lancet, has found that if the
first birth in a family is a female child, the figures
for Punjab show a dismal sex ratio of 614:1000. This
gets worse in urban areas, where it goes down to
560:1000. Described as the first systematic and
scientific study on female foeticide, it was carried
out by Prabhat Jha, formerly of the World Bank who is
now with St Michael's Hospital, University of Toronto,
and Dr Rajesh Kumar of the Post-Graduate Institute of
Medical Education and Research in Chandigarh. Dr
Rajesh Kumar observes that their study reveals a cruel
paradox: "Since our study shows higher incidence of
female foeticide in well-off and better educated
segments of society, we feel that Punjab registers the
lowest sex ratio because of the relative prosperity of
people here. This signifies that as prosperity levels
go up, the problem will worsen in the years to come."
As for enforcement, out of the 77 cases registered in
the last four years under the PNDT Act, there have
been only two convictions so farmeasure that against
the estimated 10 million foeticides in 20 years.
Health department officials say convictions are
difficult to come by because there are no
complainants. Consequently, evidence is difficult to
get because both the patient and doctor have a nexus.
A convenient nexus, which is fast catapulting Punjab
towards sociological disaster.
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