A Story Of Life And Death: Population Control Policies And Women’s Right To Survival
By Shalu Nigam
15 November, 2014
Countercurrents.org
Part 1: A Story of a Life and Death
So you have glanced through the news that a few women died in Chhattisgarh after botched sterilization…..and you forget about such news.....and continue with your own life….for you I am just a number, just a woman in some remote area of Bharat who like many others struggled and died….after all, poor people die every day…..who cares?
But I must tell you that I am not a number in your Mortality Rate or Health statistics… I have a life….and like millions of my sisters across the country I was struggling each day to see that my daughters go to a good school…. my sons grow up one day and help me …..and that like you, one day, to read papers and debate about politics or governance or other such things…..
I was born in a small village near Bastar. I hail from a tribal family. My father is a craftsman…..He used to make those beautiful brass metal craft deities which you showcase in your offices or homes….He works for a contractors and gets a small sum of money after putting in his hard labour. My mother works as a peasant to bring up seven of us sisters and brothers….
I have studied up to class seven and I can read a bit….I can also write my name and that of my kids…..I wanted to study further…but my father could not afford sending all his children to school. The school was 7 km far away from our house….
I got married at the age of 16…..here near Takhatpur…..My husband is unemployed right now….My in-laws are marginal farmers….We have a small piece of land…But we are in hand to mouth situation….our earnings are meager and my husband is a TB patient….He needs money for treatment….
My age is 26 years now….I have four children…two sons….two daughters….My two daughters died earlier because I could not receive proper care during pregnancy and child birth….I want my children to study….At this age I feel weak…..after giving birth to these kids and doing work at house and farm I hardly have any energy left…..
I have requested my husband to use birth control measures which the Anganwadi behenji has told us but he does not want to use that….he says it will make him weak and will affect his virility…..his manliness….as if he is the one who is important…..who am I? I have been bearing the pains of child birth…of abortions…and why me…. All those women who live down the lane have similar issues….All these drunkard men …. The men never help us in doing household chores and expect us to do everything….Why we women always are at receiving end? I don’t want my daughters to suffer like this….
He wanted sons…..he said that he heard that now in our community too we have to pay dowry when our daughter will marry…..My father has not paid dowry and no one in our family or our village did so earlier….Why should we emulate others? We lead simple life….and wish we could continue to do so….
The other day when the health worker came and told me about this sterilization programme, where I could get some money after operation, I reluctantly agreed….. I was not feeling well. I had an abortion a few days back… But this money will help us in some way, I thought….I told my husband….He refused initially……but when I told him about this money he agreed….. Earning 800 or 1000 Rs will help us not only in his treatment but also in paying debt we had taken a few months back for treatment of his father…
The health worker told me to reach the hospital early in the morning….
That day, when I woke up I was feeling weak…still I walked 2 kms to get to the bus stand from where health worker took me and 8 other women along. She came with us. She said she will get some money……When we reached this place I found it was not the usual health centre we refer to rather it was an abandoned building… There was no water… Another woman along with us was feeling sick…..It was a sunny day but inside the so called hospital there was no electricity….There was a big queue in front of us… We were made to stand in this queue…The pace was slow, it appeared to me as if it was not moving at all. Standing in the sun I was feeling giddy. One of the women from our group was left unconscious…..but the health worker with us gave her some water; later she regained her consciousness…
The doctor had three other male assistants. When my turn came… one of the assistant injected me and I was knocked unconscious…. I could not recollect what happened…. But when I regained senses I found myself lying in another hospital. I could not open my eyes…..I was feeling weak…..My body was aching….There was a sense of severe pain……
After an hour or so, when I regained myself I slowly opened my eyes….a strange smell of human blood mixed with urine and medicines touched my nostrils….I saw two of those women who were in my group lying in the bed covered with a blood stained sheet near me….I saw the glimpse of the health worker who accompanied us…..She was nervous, she was crying….I could only make out that two out of eight of us had died…..The health worker had sent messages to our homes….. I wanted to see my children…. I wanted to go home……But I could not get up…. Then two men came and pick up the body of a woman lying next to my bed….and another woman who was young, must be 18 or so was made to lie down on that bed….she was vomiting…….
It is midnight now and four women have died in front of my eyes till now and maybe I am next…… My husband has not yet arrived….How can he leave my kids alone at night? Also this place is too far….
I feel a deep sense of pain….uneasiness swallows me….I know it is now my turn to die…..My eyes cannot remain open to face the harsh reality now….Is it a slow death? I want to ask that health worker why she did not tell me earlier that my life will be at risk….I don’t want to die….for that money which I thought could help me get medicine for my husband….I am now paying the price through my life…
I want to ask that assistant as to what medicine he injected…was it safe?.... Has the doctor used the sterilized equipments…Was it a safe procedure? Why did they choose that abandoned building that gave me a strange feeling? Since morning I knew something was not right… Are they taking out or sterilizing millions of uteruses of women like me just for the sake of small amount of money? Is the value of human life less than the value of money? Or is it just that because we are women therefore we are bound to suffer that way? Why life is so unjust? Oh! Professionals please do not kill us for your small incentives…..Don’t you think our lives are important? Just because we are poor please do not treat us like cattle….
They say that Hitler adopted this technique of Genocide and created camps to kill masses of people…..Aren’t you using the similar techniques for eliminating reproductive capacities of millions of my poor sisters across in North India in UP, Bihar, Rajasthan, Jharkhand and Madhya Pradesh...…terming it as mass sterilization... And in the process putting our life in danger…..
They say that they are doing it because they want to control booming population? But why don’t they understand that it is my womb and my body. Who are they to make decisions for my life? I have heard somewhere that rich people have a right to choose – a right they exercise even if they buy little things for their big houses; so just because I am poor can you deny me the right to make decisions about my own life?
You want to sterilize us…remove our uterus…..control fertility…. You are exploiting us…..by alluring us with money…. taking advantage of our situation…. Oh! You are worried about the numbers….you say that the population is increasing….population bomb is ticking….and we women are responsible for this….Do you really think so? Or is it that by your population agenda you wish to eliminate us- all poor women?
Are you under the illusion that I as a woman really control my fertility? Don’t you know that the decision to marry is not in my hand…When to have babies and how many to have, I do not control……Most of these decisions are taken by other family members….My father, my husband and my mother in law! Why don’t you go and educate them… Negotiating for my rights on my body with my family is difficult…..so by sterilizing me can you really control population?
Aren’t the men responsible for increasing the numbers? But still 98% of sterilization operations are being performed on women…..why? And why men, if the government would have taken the steps to eradicate poverty, ensure development, availability of adequate health facilities and proper education …the population would not have grown so much…after all like you rich people we poor people too have aspirations…. dreams…hopes….to prosper…to send our kids to good schools….to see that they are well fed…to ensure that they are happy….
But you choose to target women’s body. Why? Because they are more vulnerable and easily controllable… You are not concerned by the health of my children or my health as a mother but your target is how would you bring more women into the ambit of family planning through coercion or regressive practices or by incentives or disincentive ….Because you could not succeed in implementing development goals for so many years after independence therefore you decided that coercive population control will help…..How easy it is for you to manipulate the development indicators by exploiting women’s bodies, subjugating women’s souls and then hiding your flaws? Where are your ethics, your constitutional goals of social justice and equality? Are we women not the citizens of this free country? Why you men as rulers in homes and in country always have ideas to defeat the women’s persona?
.... You know that the ratio of girl child is declining as compared to the male child because of your short sighted policies…..Many girls are not being allowed to be born or are killed even before they open their eyes….because again of those unbalanced uneven norms that treat women as second grade citizens….
The religion, the community, the state all wanted power over my body, but they forget that they too have duties? If the religion, the state and the community all would have fulfilled their responsibility in providing awareness, sensitization, facilities then may be the population would not have become a major factor…
You want to privatize health because you think that private sector will bring efficiency….. but what about access to health care….will people like me be able to afford that cost of care….You cannot improve the quality of health care in public sector…Alas! If you had done so, I would have been able to get my husband treated for his TB without any problem…..Or last year my mother would not have died because we had to go to a local doctor who was quack and used a knife to conduct surgery….. Instead of worrying about the number of people born if you could have worried about the quality of health care, a lot of problems would have been taken care of…..
Instead of being concerned about the general health your focus is on reproduction and targets… why? Because international organizations like WTO and IMF are pressurizing you?... Or more and more donor agencies are targeting family planning and reproductive health rather than overall health….But who are they to decide about me and my family?
I am dying….But I wish that my daughters have a bright future….They should at least be able to exercise the right to control their body, integrity and personhood. They should have right to choices, right to safety, right to health and right to survive with self-respect. I wish that as a citizen of this country no woman should be denied of her rights to livelihood, right to safe drinking water, right to sanitation, right to health care, right to education, and a right to dignified life. I hope that somebody will listen to my story and will do something to fulfill these wishes and make this country a better place for my daughters and my sisters1.
Part 2: Looking at Everyday Experiences of Women through the Social Lens
Recent reports of women who have died in a state-run mass sterilisation campaign in Chhattisgarh because of negligence and wrong practices are disgraceful. However, deaths due to sterilization are not a new phenomenon in India. Every year more than four million of these operations are performed as part of a long-running effort to control the booming population and most of these are performed on women’s bodies. Only, a few cases are reported, however a majority of complications, negligence or failure incidents never come into limelight.
This is a matter of serious concern because India as a country boasts its medical tourism yet there are many areas in the health care sector where much is required to be done. On one hand there are technologies developed for the modern India that are highly sophisticated, based on the precise technical surgical procedures, yet on the other hand there are masses in Bharat who are being denied and deprived of their basic health rights. Also, women’s health is one of a major concern where policies are now focused on family welfare/planning, reducing population while controlling women’s reproductive choices and decisions rather than focusing on improving maternal and child health through providing adequate nutrition, safe drinking water or proper health and medical care facilities at the local level.
And even in the area of reproductive health, women are targeted, abused and subjugated because the entire paraphernalia consisting of state machinery, community, religion, national or international organizations working on the issue, has failed to convince men to adopt safe and healthy reproductive choices. In the process women’s bodies have become battlefields which continue to be used and misused to achieve health and development targets over the years.
In addition, with the advent of globalization and neo liberalization, new political terminology was introduced; and health as well as family planning were clubbed together and re-aligned with a new envelop comprising of rwomen have been at the receiving end of the government’s pro-privatisation, pro-profit, and anti-poor policies in the last few years. In 2012 nearly 7000 women had their uteruses taken out by private hospitals within a period of 30 months in order to profit from the Rashtriya Swasthya Bima Yojana package money. From 2011 to 13 more than 80 people lost their eyesight due to botched up cataract operations. This year in Raipur city, more than 30 people died of Hepatitis E outbreak, of which nearly half were pregnant women.
All these incidents reflect the utter callousness of the government of Chhattisgarh in ensuring any kind of health for its people, especially poor and rural women.
eproductive health and rights. However, under this new umbrella, the old practices of family planning continue to flourish. International organizations and donor agencies allotted funds to control population in the name of reproductive rights and choices while basic health care was neglected. The state also allocated almost its entire budget on health to family planning beneath the new banner of `family welfare’ under pressure from international organizations like IMF and WTO. The debate on health and reproductive rights is focused on quantitative aspects, numbers and targets rather than enhancing the quality of the health services. Targeting the sheer size of population as a burden or a liability rather than achieving the goals of development and empowerment of those who are marginalized is the major thrust area that is being promoted. This shift in the debates from improving the quality of health services to target reproductive rights has resulted in denial of basic rights of women to take decisions about their fertility.
What went wrong in Chhattisgarh?
In Chhattisgarh, 83 women underwent a surgery for laparoscopic tubectomies at a free government-run camp. Most of these women were in the age group of 26 to 40 years and all hailed from poor families. Of these about 60 fell ill shortly afterwards. Reports claimed that the blood loss, infection, poisoning or hemorrhagic shock might have been the cause and this has happened due to the use of unclean surgical equipment. It is being reported that these surgeries were conducted in an abandoned private hospital which had no facilities and it was not equipped to accommodate such a large number of patients. The doctor who was awarded earlier by the local government,2 was accused of operating on more than 80 women in five hours with the help of two assistants thus spending an average of two minutes per surgery3. All this is done while ignoring the guidelines and protocols which says that one doctor can perform not more than 10 sterilisations in one day. The Supreme Court order saying that a medical team can conduct a maximum of 30 operations in a day with two separate laparoscopes were also violated4. Further, these women were discharged immediately without any follow-up care.
After much hue and cry, four doctors were suspended and police was forced to register a criminal complaint. The state government has announced compensation packages of 4 lakh rupees for the families of the women who died and 50,000 rupees for those in hospital. The Chhattisgarh High Court took suo motu cognisance of the incident and sought a detailed report within 10 days from the state government5. A team of experts was created which consisted of medical professionals from AIIMS to probe these botched up tubectomies.
Mass Sterilization as Targeted Interventions
Investigations reveal that such targeted tubectomies and sterilization programmes were conducted not only in Chhattisgarh but are also being carried out on a continuous basis in five other states namely UP, MP, Bihar, Jharkhand and Rajasthan. In all these places, focus was laid on permanent methods of family planning, where local women were targeted and subjected to surgeries to completely exterminate their reproductive capacities. All these six states are categorized as “very high focus states” for population stabilization. Under pressure to reduce their total fertility rates (TFR), these states are adopting targeted approach for mass sterilization. Their goal is to achieve TFR of 2.1, and therefore in order to quick pace their targets, they are adopting camp approach and in the process end up botching tubectomies.
In Chhattisgarh, TFR is more than 3 as against the national average of 2.4 and in the year 2011-12 about 1,32,286 sterilisation procedures were performed of which 1,25,620 were tubectomies and only 6,666 of the cases were vasectomies. Thus the state health authorities facilitated 344 female sterilisations every day6. In Bihar, TFR is 3.7 and it performed 5,44,701 female sterilizations in 2011-12, which implies that it sterilised 1,492 women per day. UP has a TFR of 3.5 and it conducted tubectomies of 3,20,168 women that year, which translates into 877 women per day. Madhya Pradesh with a TFR of 3.2 performed 5,51,966 tubectomies in 2011-12, meaning 1,512 women were operated every day. Rajasthan has a TFR of 3.1 and it conducted 3,06,777 tubectomies that year, which means 840 tubectomies per day. Unsurprisingly these states in which the targeted population control programme' had been launched are precisely the states which performed poorly in indicators for social development, especially female literacy, infant and child survival, maternal morbidity and mortality and other indicators relating to gender development.
Although, apparently the procedure is voluntary, to motivate such large number of women to sterilize, incentives schemes have been introduced by the state. In fact, these `women are coerced, bribed or forced to accept tubal ligation’7. Initially, women are given Rs. 800 rupees and men are allured with Rs. 1,000 in public facilities as an incentive to undergo sterilization. The latest data indicate that for women this amount was enhanced to 1,000 rupees and 1500 to men, whereas in accredited facilities Rs 1500 to both men and women in high focus states8. The health worker or the motivator is paid Rs 200 per case. Paying poor women to undergo sterilization limits their contraceptive or reproductive choices. This form of payment in itself is a form of coercion, especially when women are from poor and marginalised communities. Women are treated as cattle with no rights and are being forced to sterilize without any medical examination being performed or considering their prior medical history.
Most of these women hailing from poor communities often have been found to be suffering from anaemia, asthma, malnutrition or other such disease.
Reports claimed that the medical professionals and others involved in the deal are also paid certain fixed amount for each completed operations. As this is a target driven programme, therefore the targets for the state apparatus are fixed for a year and in this case of Chhattisgarh botching, it has been reported that daily target was set to conduct 40 sterilisations per physician per day. However, on that fateful day the number of operations held was double the figure9. Burdened with the task to achieve targets physicians are bound to spend as little time with each patient as possible and therefore follow ups are often ignored. What is propagated through this entire incentive approach is that money holds more value that human life, that greed is more important than the virtue of caring and that corruption can rule over ethics. Most of these state run programmes are clinically unsafe. They are neither transparent nor beneficial in stabilization of population.
Though public money is being spent on achieving these targets, however, not enough attention is being paid to equip the infrastructure to deal with such huge requirements. As evident in this case, the building, other facilities or amenities as well as medicines, disinfectants, equipments and machines were either below par or not at all available. Corruption is rampant in the sector and in the process not only women’s rights but their rights as patients and right to adequate health care are neglected. It has been reported that in these sterilization camps, no hygienic precautions are being taken. Rather, in many places, half a dozen tables are set next to each other and are covered with blood stained sheets. Health staff hardly uses protective masks and tools are often rinsed in hot water to be used to operate other patients in the queue10
Women are Targets of Coercive Population Control Strategies
Last year about 4.2 million sterilization operations took place and 98% of these were carried out on women11. Between the year 2003 to 2012, 1434 sterilization deaths have been reported and in the year 2009 alone, 247 deaths took place. While deaths due to sterilization procedures have ranged from 153 to 184 a year between 2010 and 2012, cases of post-operative complications have more than doubled in the past four years. Between 2009 and 2012, the government paid compensation for 568 deaths resulting from sterilisation, the health ministry responded to a query in the parliament two years ago12. On an average, 12 deaths occurred every month over the last 10 years. In the 2012 itself, nearly 7000 uteruses were removed by a private hospital within a period of 30 months in order to gain profit from Rashtra Bima Swasthaya Yojana package13. Almost 37% of all tubectomies in the world are done in India. In fact, India is the only country in the world where profoundly regressive practice of female sterilization predominates among the various birth control measures.
In Bihar, in the year 2012, 53 women were sterilized in two hours with the help of unqualified staff in absence of basic amenities like running water or sterilized equipments14. The theory of `population bomb’ is emphasized while actual health concerns of a large number of women are neglected in the process. In this pathetic situation, a three month pregnant woman was operated and other three were left profusely bleeding while rest were left in state of agony and pain, without any medical assistance they were dumped unconscious. These inhuman sterilizations particularly in rural areas continue recklessly with utmost disregard to the lives of women. Counseling, consent and care of women are blatantly ignored. Poor rural and tribal women are victimized by the unsafe and illegal practices. In many cases quacks and fake practitioners were deployed while violating all guidelines and procedures. The guidelines prepared by the Ministry of Health and Family Welfare in October 199915 often are neglected.
India’s family planning programme has traditionally and exclusively targeted women just because male sterilization is not acceptable in a patriarchal society. Instead of addressing misapprehensions of sterilization affecting male virility, sterilization is being promoted among women. Such practices result in gender injustice and inequity. Women have always been at the receiving end of government’s regressive, anti-poor, pro-privatization and pro-profit programmes. Rather than viewing women as human beings who need better health care facilities to grow, most of the health and population programmes or policies see them mainly as child producing machines that have to be repressed and controlled to target population growth.
Such situations that arise out of short sighted population policies are also resulting in gender imbalance as a result of selective abortion of girls. The declining child sex ratio is one of the outcomes of such biased insensitive policies. Often, due to excessive focus on sterilization, the promotion of utilization of other contraceptive choices like IUD, Pills, and condoms is getting neglected. Clearly, population stabilization in this form cannot be seen as the only goal since it leads to profoundly unbalanced populations and restrained contraceptive choices.
Also, one of the crucial aspects that was ignored in the whole process of inducing coercive population stabilization programme is that in the matters of fertility decisions, multiple forms of power converge and it is not the sole decision of women to choose when to marry, whom to marry, when to have children, spacing between children, number of children or even the sex of children to be produced. Various actors mediate control over women’s bodies which include the husband, the family, the community, the religion, availability of technologies, health practices and the state. Within the family, gender and social hierarchies play a major role. Woman’s subordinate position within a household and her relationship determines her role in decision making and in negotiating for her control over her own fertility. In the given socio-cultural context, women do not make individual personal decisions about their fertility. Men and elderly women play a decisive role in shaping these `choices’. Outside the household, within the ‘public’ sphere, the thrust of population control policies dictate the options and choices available to women. Thus `choices’ no longer remain choices, rather these become compulsions dictated by factors which are beyond the control of individual women.
Voices Against Coercive Unsafe Mass Sterilization
Frequently, voices have been raised by the health activists and workers in the field and a Public Interest Litigation was filed where the Supreme Court of India directed the Union of India and all the state governments to implement the Ministry of Health and Welfare’s Guidelines on Standards of Female Sterilization, enacted in October 199916. The petition sought compensation for victims of negligence in sterilization procedures, as well as accountability for violations of the guidelines. Activists and organizations in the field of health and development have constantly urged the government to set up an independent grievance redressal system to allow people to report coercion and poor quality services at sterilization centres.
Further, it has been asserted that instead of evoking the umbrella of reproductive rights, health issues should be construed within the domain of larger social, economic and civic rights like right to livelihood, safe drinking water, sanitation and general health care. This is because the concept of reproductive rights is not clearly understood in India and it is often used or manipulated to reduce women’s identity to uterus, diminish their value as human beings and ignore their basic health and survival needs. Also, under the guise of reproductive rights what is sold is family planning and population stabilization strategies and the women’s right to birth control get hijacked by the state’s agenda of population control.
Road Ahead
Over the years, emphasis has been laid on targeted population control measures when millions of women and children especially from the poor and marginalized communities suffer from deprivation, high levels of morbidity and mortality and their need for health care services have been neglected. This trickle down top to bottom approach which is targeting to reduce population is against the norms of democratic participation, justice and equity. This needs to be replaced by bubble up approach based on gender just health and development policies that provide for enabling environment and strengthen universal primary health care. Thrust must be laid on local needs and major public health issues like eradicating TB, polio eradication, immunization of women and children, provisions of safe drinking water, sanitation and adequate nutrition for women and children while focusing on comprehensive health care rather than programme specific interventions. Socio-cultural conditions need to be kept in mind by the state mechanism and ensuring meaningful convergence with other programmes aimed at improving physical, social and economic well being of population may help to ensure development. Budget should be allocated and should be utilized to improve health services rather than spending it on population control and family planning measures. The concept of health needs to be redefined in comprehensive terms.
Forced sterilization or incentives based strategy to compel women to undergo sterlization is no way will reduce population. Providing safe and healthy choices to women is essential. State has the ability to enable women to control their fertility and take decisions about their own bodies by providing safe, affordable and effective care services. Issues concerning women's health and reproductive rights can only be resolved once these are seen as a part of a larger package of a health and social development policy. Overall development and empowerment of those marginalized is the best method to control the population. Focus on empowering the marginalised communities through education and economic development is an alternative to reduce family size and control growth of population.
Shalu Nigam is an activist, researcher and a social worker. She may be contacted at [email protected]
Notes
1 This story is inspired by the recent incident of death of women in Chhattisgarh as well as authors interaction with women from different walks of life and her experience of working with women as an activist, a researcher, a womanist and a social worker over a long period
2 Samar (2014) Sterilizing Women to Death, Countercurrents dated November 13, http://www.countercurrents.org/samar131114.htm
3 Jaiswal Anuja (2014) Botched Govt Sterilization kills 11 women in Chhattisgarh, The Times of India dated November 12
4 Ramakant Rai v UOI, W.P ( C) No 209 of 2003 , Supreme Court of India, 12/06/2007
5 Tandon Aditi (2014) To cut fertility rate, C’garh sterilized 344 women a day, The Tribune dated November 12 http://www.tribuneindia.com/2014/20141113/nation.htm#1
6 Tandon Aditi (2014) To cut fertility rate, C’garh sterilised 344 women a day, The Tribune dated November 12 http://www.tribuneindia.com/2014/20141113/nation.htm#1
7 Mukherjee Krittivas (2014) The Chhattisgarh Lesson: Cash for Sterilization drive may be masking grave tragedy, dated November 11 http://www.hindustantimes.com/comment/analysis/india-s-cash-for-sterilisation-campaign-maybe-masking-a-grave-human-tragedy/article1-1284927.aspx#
8 Ministry of Health and Family Welfare Revised compensation guidelines issued on October 29, 2007, http://mohfw.nic.in/WriteReadData/l892s/4869725324file8.pdf
9 Das Ranjan (2014) Chhattisgarh Sterilisation Deaths: PM Modi Asks Raman Singh To Ensure Thorough Probe, The NDTV dated November 12 http://www.ndtv.com/article/cheat-sheet/chhattisgarh-sterilisation-deaths-pm-modi-asks-raman-singh-to-ensure-thorough-probe-619338
10 Mukherjee Krittivas (2014) The Chhattisgarh Lesson: Cash for Sterilization drive may be masking grave tragedy, dated November 11 http://www.hindustantimes.com/comment/analysis/india-s-cash-for-sterilisation-campaign-maybe-masking-a-grave-human-tragedy/article1-1284927.aspx#
11 Varma Subodh (2014) Women Undergo 98% of Sterilization in India, The Times of India dated November 12 http://timesofindia.indiatimes.com/india/Women-undergo-98-of-sterilizations-in-India/articleshow/45116790.cms
12 Burke Jason (2014) India mass sterilisation: women were ‘forced’ into camps, say relatives The Guardian, 12 November http://www.theguardian.com/world/2014/nov/12/india-sterilisation-deaths-women-forced-camps-relatives
13 AIDWA (2014) Statement issued after Chhattisgarh case
14 Mahapatra Dhananjay (2012) 53 Women Sterilized in Bihar in 2 hours, The Time of India, dated April 3 http://timesofindia.indiatimes.com/india/53-women-sterilized-in-Bihar-in-2-hours/articleshow/12511547.cms
15 Ministry of Health and Family Welfare (1999) Standards for Male and Female Sterilization, Division of Research Studies and Standards, GOI http://www.2cnpop.net/uploads/1/0/2/1/10215849/standards_for_female_and_male_sterlization_mohfw_1999.pdf
16 Ramakant Rai v UOI, W.P ( C) No 209 of 2003 , Supreme Court of India, 12/06/2007
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