By Puneet Bedi, IANS
It was not an Ekta Kapoor serial this time but Dr Mangla Telang, a Delhi gynaecologist looking at the ultrasound in a BBC report. She is shown offering an illegal sex determination and promising to do the needful if it was a girl, with the nonchalance of a surgeon talking about removing a wart or a mole. The nation is disgusted but not furious. Foeticide does not cause the public outrage we saw in the Nithari killings or in the Jessica Lal and Priyadarshini Mattoo murders. Perhaps because the killing is before birth, or maybe we have accepted this genocide as doom.
For decades, social scientists and medical politicians have been telling us that foeticide occurs because people want sons. If by not wanting daughters, girls could be eliminated, women would have disappeared from our society long ago. Women have survived violence in the form of infanticide, girl child neglect, early marriages, domestic violence, rape and even sati for thousands of years. All these are called social evils and not crimes!
The unborn female however has no chance against direct violence perpetrated by her own parents and the medical profession. Couples want a son and pay for sex determination and if it is a girl, they give a contract (supari) to kill her. In both these steps, a doctor makes money. This is done with clinical precision; the cruelty is being lost in this discourse and the right to be born is denied to these girls. Thus the ‘social evil’ theory is over-simplistic. Euphemisms like sex selection and family balancing trivialise this genocide. Over six million girls are dead in the last two decades and the nation wants to know who killed them.
In 1975, the year of Emergency and forced sterilisations, amniocentesis and female foeticide started in the All India Institute of Medical Sciences (AIIMS) and was touted as “the solution to the population explosion”.
The practice spread to prosperous states like Punjab, Haryana, Delhi and Gujarat initially. When amniocentesis changed to ultrasound as the mainstay of sex determination, it spread all over the country. Ultrasound, which was developed to save mothers, has become a Weapon of Mass Destruction (WMD). There is no evidence that routine pregnancy ultrasound reduces maternal mortality or perinatal mortality (WHO RHL 2007, NICE Guidelines 2003), yet it has become popular as it makes economic sense. Its misuse has killed millions of girls and is now a major cause of maternal mortality. The medical profession not only invented foeticide, it continues to shamelessly profit from it. What started as a cottage industry in Amritsar has now grown into a multi-million nationwide industry.
The medical profession stands accused of genocide, and we see a lot of crocodile tears on this ‘issue’ but any attempts at bringing the erring doctors to book are fought tooth and nail by medical associations. “Let us now resolve that we are a trade union,” Dr Ajay Kumar, the president of the Indian Medical Association (IMA), declared in his Vision 2007 and indeed he is one politician in this country who intends to walk the talk.
Despite over 800,000 (almost a million) females dying before birth every year in this country, over 20,000 every year in Delhi alone, IMA claims there is no proof that doctors are doing it. When TV stings expose the criminal doctors they say that action will be taken once it is proven in court. Taking a cue from their colleagues in national politics, and knowing the pace at which Indian courts work, medical politicians evade responsibility and the criminals are never debarred. Doctors are oath bound to ‘expose incompetent or corrupt, dishonest or unethical conduct on the part of members of the profession’. Yet though every doctor in the locality knows who is involved in foeticide, they protect their corrupt colleagues rather than unborn girls. The medical profession clearly refuses to self regulate.
Only two doctors have been put behind bars for a few months each in the last 13 years for millions of dead females. The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act is a powerful law with elaborate enforcement machinery. The law will work only if criminal doctors are given exemplary punishment.
Under the act, every ultrasound machine is registered and a form ‘F’ has to be filled up and submitted to the local PCPNDT authorities for each ultrasound done on a pregnant woman. These forms have to be audited. This is not being done in clear contempt of a Supreme Court order and the ‘appropriate authority’ in each district is dormant. Audits would show exactly what is going on in each clinic all over the country, and all crimes would be caught.
We need to change society but not wait for that to stop female foeticide. We need to do something now. Foeticide is now the leading cause of foetal death. The BBC story is obviously the tip of the iceberg. The practice is widespread and if the nation is serious in controlling the menace we must recognise the ‘problem’ as a genocide caused by medical crime and not a ‘social evil’. We must resolve to eradicate foeticide. It can be done under the existing law if we decide to do it.
A few hundred polio cases every year until a few years ago prompted the nation to dedicate the whole public health machinery to the ‘Polio Eradication Programme’. Nearly a million dead females deserve more attention from our nation.
(Puneet Bedi is an obstetrician, gynaecologist and foetal medicine specialist. He can be reached at [email protected])