Forced Sterlisations of Dalits in Nitishkumar regime, Bihar suffers CasteVirus 002BH2012
A Fact Finding Report on the Sterilisation Camp held at Governmnet Middle School. Kaperfora village under Kurshakata Block PHC and P.S Dist Araria, Bihar, on 7.01.2012 by Jai Ambe Welfare Society, Jalalgarh, Purnea (Accredited NGO for Sterilisation Work) by the DHS, Araria and other related incidence
- 1. Fact finding dates:
7.02.2012, 8.02.2012, and 9.02.2012
- 2. The Team:
Mr. Francis Elliot of The Times, London (who went to cover the news), and Devika Biswas (as his translator and accompanying person). This portion of the report and observation is soley owned by Devika Biswas
- 3. Sources of Primary Information:
i. News articles appearing in-
- § Hindustan, Dianik Jagran, P.K dated 9.01.2012 about raid on sterilization camp by SP,
- § Hindustan, Dianik Jagran dated 31.01.2012 about DIG’s visit for sterilisation,
- § Hindustan, Dianik Jagran dated 4.02.2012 about Health Minister’s statement on spurious drug supply at the camp.
ii. Meeting with SP Araria on 7.02.2012
iii. Meeting with villagers, eyewitnesses, sterilized women, school authorities, media, present MO incharge of Kurshakata PHC at the place of incidence and PHC CS, ACMO, DPMO, Reg PMO, other health department officials, Dr. Rajendra Prasad (the then MOIC, Kurshakata), on 8.02.2012
iv. Meeting with DPMO and other government officials of district hospital, on 9.02.2012
- 4. Place:
SP Bungalow, Araria, Kaparfora Government Middle School, PHC, Kurshakata, SP Office Araria, CS Office, Araria, DHS Araria.
- 5. Inteview and Reporting:
- 6. Documents Reviewed:
i. The photocopy of FIR lodged,
ii. The list of sterilized women and their data,
iii. The office order of DHS Araria regarding accreditation of the NGO, and the guideline for conducting sterilization camps,
iv. The faxed photocopy of the report of the DH Araria to the Principal Secretary, Health, Government of Bihar, dated 10.01.2012, on the happenings at the sterilization camps alongwith the inverstigation report of the CS, Araria about the FP camps,
v. The statement of the then MOIC, Kurshakata,
vi. THE SHS letters and guidelines for financial norms for “Accreditation of private providers for sterilization,
vii. For reference purpose, the following guidelines on standards prescribed by the Supreme Court’s order on the PIL writ file of Ramakant Rai vs. Union Government of India and others, 2003: The Quality Assurance Manual.
- 7. Observation of Procedural Violations that took place in Kaparfora Government Middle School in the light of the sanction/accreditation order of the office of DHS, Araria (Memo No 1165/ Araria dated 29.11.2011):No. The following directives have to be followed compulsorily Compliance by the organizing agency
Adherence of Government of India’s Quality Assurance Manual for Sterilization Services (2006) – all directives given in Annexure C, Clause 2. Did not adhere to all guidelines.
Availability of all physical conditions as per Government of India’s Standards for Female and Male Sterilization Services. No, it was not carried out in any government health facility. Rather, it was carried out in a school where all these facilities were not available.
Camp organized at any government health facility, SHC/ Additional PHC, PHC/ CHC/ Referral and district hospitals. No. It was carried in a school, flouting the Supreme Court’s order.
Camp to be organized preferably between 9AM to 4PM. Candidates with ASHA and guardians started pouring in from 12AM. Except enlistment and getting their thumb impression on blank consent form, no health check up, investigation were done with single sterilized women. The actual operative procedure started at about 8PM on the arrival of Operating Doctor, A.K. Chowdhury.
Thus, all operation carried out under dim bulb light, and torch lights between 8.00 to 10.00 PM on 7.01.2012.
Availability of fully equipped ambulance for referral service at the camp site. No ambulance was available.
Discharging women only after physical examination by the doctor if found to be satisfactory after the women come back to their senses, and when they have an attendant with them. The doctor himself left the place at night after all operations were over, without seeing any sterilized women and no government health staff were there at the camp site at night.
Adherence to age limit for sterilization, and carrying advertisement for the same.
Age limit for sterilization:
Men: 22 years to 60 years
Women: 22 years to 49 years
Most of the women were of the prescribed age but due to their frail physical frame and malnourishment, seemed under age and anemic. ASHA workers did mobilize people.
The upper limit for sterilization cases to be handled by single surgeon is 50. If more cases come for sterilization, then number of doctors to be increased accordingly. This norm was violated, as per the government’s own guidelines. The single surgeon operated 53 sterilization cases in the camp, on that day.
Same as condition number 2, regarding OT facility and other physical infrastructures. Not adhered to, as it was a make shift temporary arrangement. Violation of all hygienic conditions.
Prior plan approval from CS office with copy to MOIC of that area unit. Perhaps it was done as it was in the knowledge of the CS. Dr. Rajendra Prasad, the then MOIC, Kursakata, gave a statement to police that all operations were done under his supervision. Even, involvement of ASHA confirms that the health department had prior knowledge and approval.
The supervision of camp to be done at the venue on the fixed date and time by the concerned MOIC/MO/BHM/BCM, and also supervise giving all details of man power (with name, address, and designation). Though the health officials only accepted that all operation took place under the direct supervision of Dr. Rajendra Prasad, the then MOIC, Kursakata, but they are silent about other team members and about the team of NGO involved in the work. Their qualification, age, address, designation, not made available.
The MOIC /MO/BHM/BCM of the concerned area would verify and attest the number of sterilization cases done as per the QAC manual(page-13) and only after doing that would put his or signature on the sterilization register at the camp itself. 12.The health dept certifies that 53 sterilization took place under the direct supervision of the MOIC . It implies that he has done the verification attestation and put his signature on the sterilization register at the camp site (But no public saw him there on 7th at the camp).
The accredited organization has to do the photography / videograph of the beneficiaries of sterilization camp compulsorily and to submit within 3days all activity reports photocopy of the sterilization register, all photographs and videographs to the office 13.Per haps no photography or videograph been conducted this time(as the public told us)It is not been confirmed from any source.It appears that as the heads of the organization are absconding to avoid arrest so it could not be ascertained from any source. To shoot videos at the camp seems to violate privacy of women.
The concerned MOIC have to submit his report on the second day of the camp certifying the number of sterilized person toh DHS office Information could not be obtained on this but as the then MOIC and CS, both certified that 53 cases of sterilization took place, implies that they have his report at the DHS office.
As per the letter number 4437 dated 26.6.2007, of SHS, the register has to be maintained at camp site by only the government staff. The public did not see any government health staff, except ASHA health workers on 7.01.2012. Only on the next day, after raid by police, the public saw the MOIC, as well as, CS, and DPM, on 8.01.2012, after about 1.30PM.So, it is a mystery whether such register was maintained by any government staff at all.
The concerned organizing organization would get Rs.1500/- per sterilization case. Not known to us whether they got the amount form DHS, as per the norm for this case.
As per the conditions laid down by the SHS vide their letter number 4437 dated 26.06.2007, that before starting sterilization work, the accredited organization has to submit a demand draft or bank guarantee of Rs.50,000/- in favour DHS Araria, along with a letter of oath that they would adhere to all rules/norms, as laid down by DHS, Government of India, and Government of Bihar. Information not gathered on this point. But without furnishing all pre-conditions regarding submission of bank guarantee or demand draft, the organization could not start working. So, it is assumed, they might have, submitted bank guarantee or demand draft.
This accreditation letter is valid for only one calendar year from the date of its issue. But if work is not found satisfactory, the sole right of cancelling the order of accreditation will remain with DHS Araria. Now the DHS has sought explanation from the accredited organization, and ordered not to carry sterilization work, till further order. All accredited organizations are asked not to carry sterilization work in future.
The permission to further work in the next year can be given only after it is found competent by the District QAC, on physical verification and inspection. It depends on future decision of District QAC.
All conditions are mandatory and obligatory for adherence by the organization. But under the direct supervision of government officials, all main conditions were overlooked. Hence, the government themselves, are much in fault as they did not stop them. Rather, they suppressed facts, saying all work was done as per norm. The health system must be asked to give explanation as to why such blatant violations are taking place all over India, particularly in Bihar.
The reporter feels gross violation of all conditions/Supreme Court’s order and wants to move the Supreme Court, for stopping further family planning camps for sterilization, till a high-level expert committee (consisting of retired judges, health activists, lawyers, doctors (experts in family planning), human rights activists, dalit right activists) to go to each government health facility centres and certify what are their status to conduct such sterilization work, scrutiny the empanelled doctors’ list (both government and private), and required manpower, and submit a report to the Supreme Court. Based on their report, the Supreme Court should allow only those government and private hospitals which fulfill all physical, manpower, and other standards. The dignity of poor dalit women and their right to privacy should be maintained by all as a part of protection of basic human rights. All the sterilized women had undergone private post-operative care at their own expense. They must get compensation and CSG. The pregnant woman, Jitni Devi must be compensated for miscarriage and treatment due to sterilization done on her.
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