The Hindu : Dead before they are even born

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Sunday, Jun 30, 2002

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Dead before they are even born

Advances in medical technology have led to a spurt in female foeticide. GAURAV VIVEK BHATNAGAR reports.

INDIA WAS rudely woken from deep slumber when the 2001 Census revealed a sharp decline in the sex ratio of children in the 0-6 years age group with the number of females per 1,000 males declining from 945 in 1991 to 927. After the previous decade had witnessed an overall improvement in the skewed ratio of females to males, the sudden drop was proof of the increased incidence of sex-selective abortions or female foeticide.

To their horror, women's groups discovered a dramatic drop in the female population in this age group in Punjab, Haryana, Himachal Pradesh, Gujarat and Maharashtra. All these States had advanced ultrasound and genetic facilities indicating that medical technology was being misused there. The statistics were a stark reminder that if things were not set right immediately and girls given their due place in society, the country would definitely face a crisis. Over the years, the sex ratio has shown a disconcerting decline and the malaise of discriminating against the girl child, which had its roots in North India, has spread towards the more educated and liberal South as well.

Also, due to advanced techniques female foeticide had upstaged female infanticide and in place of amniocentesis, which involved taking of foetal samples, ultrasound scanning had emerged as a simpler and more popular method of sex-determination.

As per Census figures, between 1901 and 1991 only Himachal Pradesh, Punjab, Kerala and Rajasthan had registered an increase in the number of females per 1,000 males with Orissa, Bihar, Madhya Pradesh and Uttar Pradesh showing the maximum decline. It is common knowledge that in many societies a girl child is looked down upon because of the socio-economic factors.

The fact that this discrimination is more prevalent in the intermediate classes and castes with substantial resources in land and money than in the poor and lower caste families indicates that the trend is influenced by the practise of dowry and inheritance laws relating to property.

In 1991, Haryana had the lowest sex ratio of 875/1,000 with Punjab close behind at 882. A study by the State Resource Centre of Literacy Mission, Haryana, showed that the transfer of reproductive technology to India had had an adverse effect and resulted in the abuse of pre-natal diagnostic techniques. These measures had reinforced patriarchal values by discriminating against the girl child. So, a need was felt for fighting the dominant culture of patriarchy. To the relief of those fighting to curb female foeticide, the 2001 Census report came just in time, and in response to public interest litigations the Supreme Court stepped in and ordered a check on the uncontrolled proliferation of ultrasound scan centres.

And in the period since, a number of steps have been initiated to check female foeticide. In this regard the Court ordered the implementation of the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, which had come into being in 1994. The Act, whose rules were framed in 1996 and came into force on January 1, 1996, regulates pre-natal diagnostic techniques and covers the use of ultrasound machines. Since the PNDT Act was not implemented by the Centre or the States, a petition was filed in the Supreme Court by the Centre for Enquiry into Health and Allied Themes (CEHAT), a research centre of the Anusandhan Trust based in Pune and Mumbai, along with Mahila Sarvangeen Utkarsh Mandal (Masum), a Maharashtra-based organisation, and Sabu M. Georges, an expert in the field.

While the Court issued notices to the parties concerned on May 9, 2000, it took almost a year for the various States to file their affidavits. The Court found that "despite the PNDT Act being enacted by Parliament five years back, neither the State Governments nor the Central Government has taken appropriate actions for its implementations".

The Centre was then directed to create an awareness against the practice of pre-natal sex determination and female foeticide through appropriate releases/programmes in the electronic media. This was to be done by the Central Supervisory Board (CSB) as provided in Section 16 (iii) of the PNDT Act.

The CSB was told to have its meeting at least once in six months and its constitution was provided under Section 7, which empowered the Central Government to appoint to the Board 10 members primarily comprising eminent medical practitioners, social scientists and representatives of women's welfare organisations.

The CSB was also ordered to direct to all States and Union Territories to furnish quarterly returns on the implementation and working of the Act. These returns were to specify the survey and registration of bodies and action taken against non-registered bodies operating in violation of Section 3 of the Act. They were to provide details of the complaints received and action taken along with the number and nature of the awareness campaigns conducted and their results.

Further, the States and Union Territories were asked to appoint by notification fully empowered Appropriate Authorities at district and sub-district levels and also Advisory Committees to aid and advise the Appropriate Authority in the discharge of its functions. These Appropriate Authorities were in turn told to take action against any person or body issuing any advertisement in violation of Section 22 of the Act, which barred advertisements of pre-natal sex-determination tests, and against persons operating ultrasound centres without a valid certificate of registration under the Act.

But since the Appropriate Authorities are to furnish compliance reports, many doctors believe this would prompt them to set targets and fulfil them in whatever way possible.

Sanjay Parikh, counsel for CEHAT, says the research centre wants all users of ultrasound machines to register themselves to facilitate proper monitoring of their functioning. Those doctors or centres facing harassment could approach the Court and seek redress. Calling for registration in a time-bound manner, Mr. Parikh hopes the Act will ultimately curb the practice of female foeticide.

The former Union Health and Family Welfare secretary, A.R. Nanda, says the Appropriate Authorities have been vested with powers only within the ambit of the law. "While they were negligent with the use earlier, following directions from the Supreme Court they have started registering all ultrasound facilities."

Mr. Nanda says the idea behind the registration drive is to prevent <147,1,0>the misuse of ultrasound facilities. Admitting that there were bound to be "teething troubles" in the implementation, he said efforts were on to sensitise all officials concerned.

"At the end of June, zonal meetings have been convened of Appropriate Authorities and District authorities in Chandigarh, Bangalore and Lucknow to apprise them of the provisions of the law. The exercise is being undertaken to make the officials understand legal niceties, clear doubts pertaining to implementation of PNDT Act and to sort out the problems."

At one place, officials were even told to register portable ultrasound machines.

However, Mr. Nanda acknowledges that there are bound to be problems with the implementation due to a lack of understanding.

"But then aggrieved parties can always seek redress from the State Government, the Advisory Committees or even the CSB." As for the amendment to the PNDT Act, he insists that it would iron out the rough spots. "It would not equate the ultrasound centres with the genetic clinics and laboratories but treat them as a special category.''

Holding the view that some in the medical fraternity were trying to mount pressure on the amendment which not only seeks to control "pre-natal" but also "pre-conception" techniques, he says the country should gear up to face the new challenge of "pre-conception sex manipulation".

"There are American firms knocking at our doors for setting up facilities for pre-conception techniques. What we need to study is whether this is acceptable. For, when a coercive population policy is introduced heralding a one-child or two-child norm, these techniques would further aggravate the sex-ratio," says Mr. Nanda.

Bureaucrats and doctors feel sending decoy-customers is the most effective way of curbing sex-determination tests.

As of now, improper implementation of the Act and the activities of unscrupulous doctors in collusion with corrupt officials have jacked up the rate of illegal sex-determination tests from Rs. 1,500 to Rs. 4,000 in places such as Gurgaon.

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