INDIA - CASH INCENTIVES FOR STERILIZATION OF WOMEN - CONCERNS FOR MANDATORY INFORMATION ON PROCEDURE & ALTERNATIVES + HEALTH SAFETY

 

 

By Swapna Majumdar - WeNews Correspondent – December 5, 2012

Spurred by cash incentives, state workers in the state of Rajasthan offer prizes to women to undergo tubal ligation in mass sterilization drives. Critics call it a coercive process that restricts women's right to know their contraceptive choices.

Credit: Swapna Majumdar - Women await their turn for sterilization at a primary health

A few days after Rukma Devi underwent sterilization in the Rajsamand district of Rajasthan, she suffered intense pain in her abdomen. Fever and body aches followed.

Devi had registered at one of the state's "sterilization camps," part of the nation's campaign to reduce the number of births. The effort is characterized by drives conducted in village primary health care clinics that aim to meet government targets of sterilizing as many women, through tube tying, as possible within a certain time span.

A few months later, when the abdominal pain still hadn't gone away, the mother of four went to a local doctor and got some shocking news.

She was pregnant.

Rajasthan, in the north of India, has earned the dubious distinction as the state with the most failed sterilizations in 2012. Out of 2,609 failures reported so far this year, 772 were registered in Rajasthan, according to the national government's statistics. The average number of children a woman bears in Rajasthan is 3.3, far higher than the national average of 2.6

These statistics provided the backdrop for legal and health activists to discuss ways to curb the sterilization push over a two-day meeting in New Delhi in late November.

Kerry McBroom is director of the reproductive rights unit of the Human Rights Law Network, a New Delhi-based group of lawyers that has already spurred the Supreme Court to rebuke the national and state governments for unhygienic sterilizations of poor, low-caste women in many parts of the country, including Rajasthan. She said women's rights at sterilization camps are being violated by doctors and health facilities across the county who flout national and international ethical and procedural guidelines.

"The quality and nature of information that health workers provide women and their families to convince them to be sterilized is questionable, raising doubts about informed consent," McBroom said.

She cited the Indian government's 2006 quality-assurance protocol for sterilization services as well as 2011 guidelines by the International Federation for Obstetricians and Gynecologists on female contraceptive sterilization.

Mandatory Information

Both standards say that before a woman undergoes sterilization she must be informed about other, reversible forms of family planning. She must also be counseled about possible complications and, if deciding on the sterilization option, be provided with hygienic conditions and adequate medical equipment.

Of the 225 million women aged 15 to 49 sterilized worldwide, 40 percent live in India.

Roughly 80 percent of all women in India use sterilization as their contraceptive method primarily because the government promotes sterilization as a means of family planning and population control.

But this sterilization overdrive leads to an inordinate degree of failure.

In the past three years Rajasthan has paid more than $10 million to compensate women for failed sterilizations, according to information obtained under the national Right to Information Act by Yedunath Dashanan, an activist based in Jaipur, the state capital.

The government's reply to that application, released in September 2012, showed 4,200 failed sterilization cases in Rajasthan between 2009 and 2011. The response also showed 16 deaths due to sterilization complications. Tubal ligation is generally safe, but in parts of India such procedures are carried out in violation of prescribed safety standards, often with fatal consequences for marginalized women.

Still, the state government continues to promote female sterilization to stabilize its population and lower fertility rates. In keeping with its goal of achieving 698,604 sterilizations in 2012-13, the state medical and health department asked its health workers in July this year to sterilize 100,000 people within the fortnight coinciding with World Population Day (July 11).

To meet these targets, state health officials offer cars on a lottery basis and free cooking gas connections to promote sterilization. Each health worker who facilitates the operation also receives cash incentives, which are openly mentioned in family planning programs.

Coerced Sterilizations

Incentives such as these lead to coerced sterilization, mainly of women, said Dr. Abhijit Das, director of the Centre for Health and Social Justice, a New Delhi-based nongovernmental organization working on gender equity and health.

"India focuses on female sterilization as its main tool of family planning," said Das. "There is a lack of choice as providers focus only on sterilization. Women accept it as the best option as no information is provided about other family planning methods."

Das added that the lack of information violates the National Population Policy 2000, which stresses informed choice and target-free approaches in administering family planning services. State medical practitioners, he said, reveal a worrying degree of ignorance about national and international ethical guidelines on sterilizations.

About 1.7 million women in Rajasthan do not have access to contraceptives, Das said. "There is also a lack of understanding of potential adverse outcomes for sterilizations. The poor technical quality of the services provided is leading to increased deaths, increased failures and morbidities."

In a 2010 study of 749 women who underwent these sterilizations in the Bundi district of Rajasthan, authors found 2.5 percent became pregnant, far above the international standard for pregnancy following failed sterilizations of 0.5 percent.

The study was conducted by Manjri, a nongovernmental organization based in Nainwa, Bundi district, in collaboration with the Centre for Health and Social Justice. It found that 88 percent of participants were not told about failures or complications and 27 percent received no advice about post-sterilization care.

Violations included conducting only three of the 11 mandatory physical examinations before the surgery.

Almost all the women were discharged within four hours of the operation, which involves cutting or blocking the fallopian tubes, although 7.6 percent of them were still unconscious. This too apparently violates the nation's health standards that say a patient can be discharged four hours after the tubal ligation surgery only if her vital signs are stable, she is fully awake, has passed urine and can walk.

http://womensenews.org/story/reproductive-health/121204/cash-prizes-fuel-indias-sterilization-overdrive

WHO DETERMINES WHAT REAL BEAUTY IS?

So you think you know what Beauty is? Instead I think we should ask WHAT IS REAL BEAUTY? WHO DETERMINES WHAT REAL BEAUTY IS?

Do you subscribe to the notion that being beautiful means being thin, or having high cheek bones and terribly defined collarbones? Does being beautiful, to you, mean donning skimpy outfits and looking like a million bucks in them? Or does being beautiful mean looking like a plastic doll, decked up in the finest of jewels and clothes?

Get this.

70% of women get depressed after looking at fashion magazines

A majority of women would give up 5 yrs of their lives to look different

American women spend $40 billion on beauty products and about 2 billion on hair products

Americans spend $10Billion per year on beauty products, and much more if you count personal grooming products. If you focus on core beauty products, such as those at http://www.russellorganics.com that include cleansers, toners, and moisturizers then the answer is $10Billion. If you focus on over all beauty such as skin care, hair care, etc such as http://www.spaskin.com then the answer is much higher.

Asian women pay money to make their eyes look rounder

Accented people use their “Greek status” to describe perfect beauty and use it as a yardstick to measure perfect beauty

African women decide between good hair and bad hair and to them straight hair is good!

Japanese women put steel in their legs to make them look taller because tall is “beautiful”

Most Jordanian women have gone through plastic surgery

Girls starve themselves to death to look like models

And here’s the didactic quotient to all this.

Do women in the world realize what it takes to make those women look good in magazines?

Do they know how many people worked on them to make them look good?

Do they know of the hormone shots that are injected under eyes to make the puffiness go?

Do they know of the duct-tapes that adhere to their bodies to keep clothes in place to make them look perfect?

Or do they know of the use of Photoshop to remove any scars and blemishes in the skin?

So, who decides what perfect beauty is?

Here’s the simple answer.

YOU.

You, by smiling and being cheerful, are beautiful.

You, by loving, caring and sharing, are beautiful.

You, by doing good, are beautiful.

You, by spreading happiness, are beautiful.

You, by lending a helping hand, are beautiful.

You, by JUST BEING WHO YOU ARE, are beautiful.

LOVE YOUR SELF, DON’T TRY TO BE SOMEONE ELSE! IF GOD WANTED TO MAKE U LOOK DIFFERENT HE WOULD HAVE MADE YOU SO.

PROUD TO BE A WOMAN

As I sit and write this, I know that I am proud of my existence and of my womanhood and would not have it any other way. I am proud to be a woman.

But how many other women are there who share this feeling?

Today, I don’t want to talk about how women are subjugated in society or analyze their situation from a feminist view point but rather examine how women can improve their own social standing and be taken seriously. There are those circumstance which cant be changed and those that can be by a simple adjustment of reaction and attitude. Its time for some serious introspection and I ask all you women out there to recognize the opportunities in and around you - You can if you believe you can.

Be prepared to reinvent yourself as that beautiful force of energy, which is very much what you were meant to be. Make your presence felt, voice your opinion and speak you against those customs and norms that bind you. We, women, need to be proud of our gender and should identify ourselves with pride, while expecting to be treated with respect and dignity. As Janis Joplin nicely puts it “Don’t compromise yourself. You are all you’ve got.”

As a mother, teach your daughters’ that they are no less than men and your sons’ that a woman is no less than him. We ourselves are guilty of propagating the current injustice against the girl child if we support discrimination. In many developing countries such as India and the middle- east, the girl child is still considered a liability and a lot of women abort the female foetus. These women have been victims of gender discrimination themselves and do not want their child to endure the same. Furthermore, it has been often wired into the heads of these women that “bringing a male child into the family will ensure them a better status in the family. They view the birth of a boy as an avenue to improve their self worth.

But do they realize that by doing so they are indeed supporting the discrimination rather than fighting against it? This behavior is a reflection of how by being oppressed throughout their lives, they have stopped taking pride in being a woman.

It is a vicious circle that needs to be broken somewhere. A lot of it can be changed by educating women and by empowering them to become financially independent. So that girls can be treated more fairly, ensuring them a happy childhood complete with education minus forced labour or abuse of any form.

As a partner, empower yourself and stand up and speak out against physical and emotional abuse. Women accept physical abuse from men who not only physically humiliate them, but also "brainwash" women into believing that they're being beaten because of something that she has done. It's never the man’s fault, the woman makes him do it.

The woman needs to know that she has the power to stop this. Financial independence may be one of the ways to break the shackles of domestic abuse. A woman may not have anywhere safe to go and may not have the financial means to leave, but if she is self-supporting, it will be a different ball game altogether.

As an employer, treat your employees without gender bias and as an  employee trust your female leaders. Women leaders tend to trust their male sub-ordinates with more responsibility than female ones. Furthermore men and women both view male leaders as more effective than female leaders. (Rosen and Jerdee (1974a & b) .They believe that women do not have desirable task abilities. This goes to show, that women do not trust each other with responsibility. This perception is harmful in the context of what we are trying to achieve. Women need to trust each other before we can change the male perception towards them.

And finally: As a teacher and a spiritual guru, empower your followers with the spirit of equality. Learning, discipline, accomplishment and wisdom— are all qualities a step in the right direction.  Teach them to be human.

I ask you all to believe that you can indeed make a difference.  I call upon all you women out there to improve your present and to contribute to improving the present of those around you, which in turn will create a better future for our descendents, who can look at themselves in the mirror and say, “I am proud to be a woman and I feel worthy; I feel worthy of life”

I implore you to believe that you yourselves can make a difference and to this end I quote Margaret Mead who says “Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has.”

By Kanika Jain Sah