Thirteen women die from mass sterilisation in Chhattisgarh
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6868 (Published 17 November 2014) Cite this as: BMJ 2014;349:g6868
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Tainted drugs are involved in these botched sterilizations: poison chemicals have been found in antibiotics linked to the deaths of Indian women being surgically sterilised.
The deaths have triggered widespread criticism of a government-run programme that offers poor Indian women sterilisation. A doctor who performed the operations on 83 women in just a few hours blamed the drugs for the deaths after his arrest. He said he was being made a scapegoat for the controversial family planning scheme.
Preliminary tests of antibiotic tablets found they contained zinc phosphide. Indian women who died after undergoing sterilisation procedures may have been given antibiotic laced with this poison, officials say, and the public has been warned off buying any of the tablets.
Alok Shukla, principal secretary in the health department of Chhattisgarh state, warned the public not to buy the ciprofloxacin tablets manufactured at a local factory and banned from sale following the deaths.
Competing interests: No competing interests
The recent reported deaths of women after sterilization in Chhattisgarh show how a population control programme in India has gone wrong. The responsibility lies both with the organizers of the sterilization campaign and the health professionals involved in the sterilization process. The blame game between the doctor and health services organization has begun. Organising sterilization operations at camp for 83 women at such a large scale needs careful planning. It seems the doctor was in a hurry to complete the target of 83 women on a single day. Playing with the lives of women, mostly innocent to the procedures, does not qualify for a marathon race of operations, viewing at creating records for the operations. Human error has crept in and led to the failures. The operating environment needs to be evaluated for proper sterilization procedures such as fumigation, cleanliness, availability of functioning equipments, sterilization of equipments, changing of coversheets before operating on each woman, changing of gloves, availability of required medications, quality of medications used, neglect in the surgical procedures, post operative care including proper hygiene, cleanliness of the post operative ward, etc., before finalizing the assessment report.
The target approach to achieve sterilization goals has been abandoned under the National Health Mission. Instead, a practical approach depending upon the doable capability of the health workers has been in place. We often talk about quality of care in the health care sector without realizing the fact that the concept needs to be applied. It remains a theoretical proposition and merely in black and white. The humane approach to sterilization is the need of the hour. A meagre monetary incentive can obviously lure the poor to adopt sterilization, but it does not mean that they should be ignored and considered merely a lifeless object for the surgical procedure. A respect for humanity, her life, needs to be considered. The paraphernalia of the sterilization camp including the supply of equipment, drugs, and other medications should have been checked for quality as per standard operating procedures, which presumably is lacking in this situation. Under such circumstances, can anybody ever come to such sterilization camps in future, anywhere in India? I doubt about the active participation of the people in this programme. The incident has immensely affected the outlook of the people towards Government run health programmes. The image is tarnished and it will take a long time to get people’s confidence in public health programmes in India.
Competing interests: No competing interests
Re: Thirteen women die from mass sterilisation in Chhattisgarh
It is indeed very sad that to complete targets health workers go to such extent. The Baiga tribe is endangered and tubectomy is prohibited in women belonging to this tribe.
The sorry state of informed consent is a matter of grave concern. Consent is just limited to signing forms or a thumb impression. The health workers and even doctors do not have any concept of informed consent. The death of 13 women is in the news so all involved are trying to cook stories about spurious drugs as it has happened for the first time. Spurious drugs are very common in India and legislation is not stringent.
People involved in the healthcare network seem to have lost respect for human life. It is more about earning money in a capitalist society. The government cannot be blamed. The intentions are never to kill its citizens but the people who are involved in executing such programs, including the businessmen who supply drugs, must show some concern about human life if such incidents are to be prevented.
Competing interests: No competing interests