“NOT A second daughter,” was Jaya Prasad’s reaction when the midwife predicted a baby girl just by looking at his wife Guddi Devi’s gait. He wanted a sex determination test to confirm the gender of the yet-to-beborn child. Suddenly, Devi felt as if she’d become one of the women she’d been seeking out near her village in Morena, Madhya Pradesh, for the last three years, to save female foetuses.
Devi refused the test and convinced her husband through the NGO she works with. “We told him that both the doctors and the patients involved could be jailed,” says NGO member Jitender. Luckily, Prasad accepted her decision. Her younger daughter is now two years old, and Devi continues to work for women’s rights.
Unfortunately, this is a rare case. Sex determination, often the precursor to abortion and foeticide, is rampant not because of lax laws but poor implementation. The Pre-conception and Pre-natal Diagnostic Techniques Act (PCPNDT Act) was passed in September 1994 “for regulation and prevention of misuse of diagnostic techniques.” More than 17 years on, TEHELKA found that the Act, though strong on paper, serves as no deterrent in reality.
Mitu Khurana’s story is proof enough. Hers is an urban nightmare. Mitu, a Delhi paediatrician, was tricked into sex determination by her doctor husband. She claims her in-laws fed her cake knowing that she was allergic to egg, after which she had to be hospitalised. The reports say that the doctor recommended an ultrasound of her kidney. “He actually determined that I was carrying twin girls. After that incident, my in-laws suddenly wanted me to have an abortion,” she says. This was in 2005. Mitu refused, moved to her parents’ house and filed a case against her husband under the PCPNDT Act. “An official told me I’m wasting my youth and my life,” she recalls. “Just give him a son if he wants one, they said.” Though her case was highlighted by the media, no action has been taken. “If I, a doctor, am being bullied, what will happen to an uneducated woman? How much can we tolerate?” she adds.
In 1992, Nobel laureate Amartya Sen estimated that 37 million women had already ‘gone missing’ in India till 1986. Contrast that with the total number of ongoing cases under PCPNDT in the country (till September 2011) — a mere 1,040. No wonder that 28 of the 35 States and Union Territories have 0 convictions (till September 2011). Even the ones that secured convictions stand dismaly at: Chandigarh – 1, Rajasthan, Delhi, Gujarat – 4 each, Maharashtra – 18, Punjab – 23, Haryana – 29.
India’s child sex ratio (0-6 years) has declined from 945 in 1991 to 927 in 2001 and now to the lowest since independence: 914 females per 1,000 males in 2011. But the total number of ultrasound machines seized/sealed (till September 2011) stands at just 869. The individual figures for states are more disturbing. Not a single ultrasound machine has been sealed or seized in Delhi, one of three worst states (other two being Punjab and Haryana) in the 2011 Census, with a child sex ratio of 866 girls per 1,000 boys in 2011. Why does sex determination still thrive?
“Because it’s profitable for the medical profession and therefore propagated by it,” says health activist Dr Sabu George, one of the movers of the public interest petition which led to the passing of the PCPNDT Act. Also a member of the National Inspection and Monitoring Committee (NIMC), constituted under the Supreme Court’s orders, George says that mutual secrecy allows the doctor to get away. “The client is conniving with the doctor, so it’s obviously not going to get reported. For her, it may be an individual choice or family pressure but for the doctor, it’s purely about profits,” he says.
The greed factor is real. “An ultrasound test costs about Rs 400 but a doctor can charge Rs 1,500-10,000 depending on demand,” says UP-based gynaecologist and Central Supervisory Board member, Dr Neelam Singh.
BEYOND THIS, it’s the lack of government will, says Asha Sikarwar, an NIMC member who works with the Madhya Pradeshbased Jan Mukti Sangathan. She cites the example of two clinics in Gwalior and Bhopal that were found conducting sex determination tests on 22-23 December 2011. There is no case in court and NIMC lacks the powers to file one directly.
Activist-lawyer Varsha Deshpande (also an NIMC member) say that PNDT is the strongest law and that it’s good there is a system where the District Magistrate or the State Supervisory Board (both designated authorities to implement PNDT) has to file a case. “I can’t file a case in, say, Odisha from here,” she says. Deshpande, known for carrying out sting operations in various clinics in Maharashtra, feels that the real problem is administrative and judicial accountability. “The health department is the most corrupt next to revenue but they aren’t held accountable. Similarly, when a public prosecutor loses a case, nobody questions him/her. Maharashtra has lost 27 cases simply because the concerned officials didn’t turn up,” she fumes.
District officials are often blamed for the lax implementation of the PNDT Act. But Arvind Kumar, former Hyderabad Collector, says that there’s nothing too technical or time-consuming for a District Magistrate. “It’s ignorance, lack of awareness. There’s no monitoring at the State level,” he says. In 2005, he asked 394 ultrasound scan centres for their Form F records, which it is mandatory to maintain. He issued notices to 80 percent of the clinics and seized 154 machines, of which 71 were released after a fine. The result: “Hyderabad, which had the worst sex ratio in Andhra Pradesh in the 1991 Census, has emerged as the 3rd best in the 2011 provisional Census,” he says.
Sex determination is profitable for the medical profession and therefore propagated by it
Even when NIMC members or activists get clinics sealed, the local authorities often reverse the action, admits Anuradha Gupta, Joint Secretary in the Ministry of Health of Family Welfare. “States need to be more aware of their role. When ultrasound machines are unregistered, authorities often let them off with a fine, which is not permissible. The Act makes no distinction between minor and major offence. Not keeping records is as severe as sex selection and equally punishable with both imprisonment and fine,” she says.
The data for June-December 2011 does show improvement: 460 clinics have been sealed and 30 convictions secured in that period but we have a long way to go.
The Act, last amended in 2003, is being reviewed. Close monitoring of the sale of second-hand or re-assembled machines and a ban on portable ultrasounds, which has been vetted by the Law Ministry, are expected to come into force soon. “Portable machines are the easiest way to bring sex determination to people. Why should they be portable? Are fractures diagnosed at road accident sites?” asks Anuradha Vemuri, Director of the PNDT Division.
While technology keeps progressing at a rapid pace, society at large seems stuck in a feudal age. And the girl child continues to go missing.
Shonali Ghosal is a Correspondent with Tehelka.