Female Foeticide

One day last week I head out of station to Mandya, a small town close to Bangalore. In a van with six women from Vimochana, my favorite NGO, I bounce along the two-lane highway, wincing as the van flies around slower vehicles and oncoming traffic rushes towards us. We leave at 7:30 in the morning, intent on arriving at Mandya by 9:30. This is Dona’s show and they want to set up the hall.

Last week Dona invited me to this day-long meeting on female foeticide. In the van they give me the stats: in the 2001 census there were, across India, 899 girl children aged 0 - 6 for every 1000 boys. The rate of female foeticide is increasing and India will soon approach the current crisis China. It falls to the NGO’s to intervene, so today Vimochana is hosting an information session for area community workers and those physicians who may attend. They chose Mandya because it has the highest rate of female foeticide in the state of Karnataka. Higher than Bangalore or any of the large cities.

Ummm, I speculate, Mandya is a poorer area? I base this on a few things I’ve learned: girls are considered to be an economic burden while boys ‘carry on the family name’. Sure, we hear some of this in Canada. The difference in India is the economic burden only ends with marriage. Remember ’way back when I wrote that a girl’s upbringing is specifically geared to her traditional roles of wife and mother? The majority of women in India wed in arranged marriages. It is the norm for them to surrender their marriage decisions to their fathers and their brothers. They may be physicians or MBA’s, sisters in Fatehpur Sirki, daughters of well-to-do agricultural families. Such is the nature of the patriarchy these women seem to accept.

In the process of getting married, the girl child creates a huge economic burden for her family. Marriage is expensive; the meter starts to run when the bride’s family pays dowry to the groom’s family. Maybe the bride’s father can’t make up the entire payment. He begs for six months or a year to pay in full. If the specified time comes and he still doesn’t have the cash, dowry harassment may begin. The women tell me cash is not the only problem; rural and village women are also expected to bring property.

Perhaps the illegal dowry payment is manageable; I know mothers who begin to save the moment a girl child is born. Maybe there is no property involved. But now the bride’s family must raise the rupees for every single detail of the wedding. Details range from renting the marriage hall, providing a full dinner at the reception, breakfast the next morning when the couple weds, even the expensive suit and other necessities worn by the groom. And I don’t know the half. Perhaps 500 will attend the wedding, while 1,000 hungry folk show up for the reception. I was at a wedding reception last night where over a 1,000 sat down to eat, in shifts, to the music of a live band. Parents may cash in their pensions and still pay wedding debts for years. The tab runs into thousands and thousands of dollars, lakhs of rupees. One article I read described the Indian family’s preference for boy children as ‘gender apartheid’, but it isn’t a great conceptual leap to understand why boys are best.

So, why was I thinking female foeticide is a problem of the poor? Stereotypes, maybe? Dona says no. In fact, Mandya is one of the most affluent taluks in Karnataka. Statistics show female foeticide is a largely an action of the affluent, the middle class, the educated, the well-employed. The largest discrepancies are in the affluent states of the North; Punjab, Haryana, Gujarat. In one area of Punjab the census counted 752 girls for every 1, 000 boys. Good heavens. I’m glad I was invited along.

We don’t get there ’til 10 AM, and people are filtering into the hall. Happily, Indian people read a 10 AM start as 10:30. We move quickly, put up banners and posters, get a couple of tables to the front, watch the hall techie set up the PowerPoint gear. We get underway just before 11. The hall is almost full, I count about 250 people, mostly women. I wonder how many are doctors and later learn that seven attended.

The community workers speak the local language, Kannada, so I find some of the presentations fairly inaccessible. Fortunately Bernie, a woman working with UNICEF in Delhi, is taking notes in English. I ask permission to read over her shoulder. She grins, moves her book closer. The UNICEF doctor from Hyderabad speaks English, but his presentation is a string of stats from areas in Karnataka. People pull out their cellphones and check for new numbers. Oh my.

Next, Dr. Sanjeev Kulkarni, a gynecologist from Belguam - another hi-female foeticide taluk in Karnataka - rises to speak. He is young, dynamic, he speaks in Kannada but … his PowerPoint slides are in English! Yippee. His title: ‘Pre-natal sex determination and female foetus abortion: An unfolding disaster’. I settle over my notebook and this is what I learn:

The decline in child sex ratios has been happening for 20 to 30 years in different parts of India. Between 1991 to 2002 one in four girls went missing, although the Indian population increased. Prosperous parts of Karnataka are losing more girls; in urban areas the situation is worse. Per capita, the largest number of sex selection clinics in Karnataka is in Mandya, where doctors run 27 clinics. There are 600 clinics in Bangalore.

And female foeticide continues to increase because doctors allow it – they collude in sex selection. When one was arrested two years ago the entire community of physicians insisted that female foeticide was not happening in India. Bernie whispers that UNICEF took a Public Litigation Memorandum to the courts in 2001 to stop pre-natal sex determination. This resulted in the 2002 Pre-Natal Determination Test Act, outlawing female foeticide.

Dr. Kulkarni reminds us that mother in India is held in high esteem, yet the proportion of girl children is dropping. The world sex ratio is 1000 males to 1050 females; the MF sex ratio in nature shows that girls are stronger than boys.

In 1901 there were 1000 boy children n India for every 961 girls. One hundred years later the ration is 1000 to 933. Why the difference? Infanticide. Neglect of female children. Pre-natal sex determination[PNSD]. Selective female foetus abortion[SFFA].

In 1979 the first sex selection clinic opened in Amritsar, site of the Golden Temple in Punjab. It offered PNSD and SFFA using amniocentesis. Soon clinics sprung up in Delhi, Mumbai, and in the state of Gujarat. Ads appeared on the Mumbai local trains and in the railway stations. The late 80’s brought the wonders of ultrasound[USD]; non-invasive, simple, quick. By the early 90’s USD had gone mobile, PNSD delivered right to mom’s door by her ever so helpful physician. The technology spread rapidly across India, but the highest sex selection rates remain in the more affluent centre of the country – Delhi, Punjab, Gujarat. In Maharashtra: capital city Mumbai [Bombay], girl children number 917/1000, Kolapur, 860/1000, Sangli 850. In Gujarat the overall ratio is 879/1000, in the city of Mehsana, 762. For every 1000 boy children 0 – 6 years in Delhi, there are 865 girl children. In Punjab there are 793, with the lowest ratio in Punjab town of Fatehpur Sahib – 752! Imagine.

What does this mean???? For starters, men will not have an equal number of women available for marriage. This will create an increase in the crimes against women: abduction and rape, sexual harassment, polyandry, sale of young girls for future wives, forced prostitution, and the severe restriction of women’s freedom and mobility.

Dr. Kulkarni tells us the sex ration imbalance in human society has reached an unprecedented scale. He points the today of Punjab and Gujarat – and raises the spectre of tomorrow across India.

What are the reasons for this malpractice? First there are the societal reasons: a strong preference for sons in a country with a small family norm and balanced family concept. This concept of balance applauds two parents, two children. Two boys are just fine, as long as there are only two children.

There are economic concerns regarding a female child; dowry and marriage costs. India’s profit-based society, fast-growing with globalization, gives rise to consumer-based economic selfishness. Boys are not just a gift from God; they cost less! Too, they are seen as more productive, able to do men’s work.

What about the Indian doctors who perform female foeticide? Dr. Kulkarni lists the platitudes mouthed by these physicians: they are “assisting with population control”. “If not me, another doctor will do the procedure”. This is a “woman’s personal choice” so we are simply “helping the woman”. He chokes on that last one, and reminds his audience of the intolerable coercion faced many Indian women, wrought by husbands and in-law families. He calls it “individual female domination”. He explains it happens behind the family curtain, from where the patriarchy sends her out to kill her girl-child. Some choice.

He goes on to list some other important factors: Abortion was legalized in 1971 in India. The balanced family concept effort began in 1980. In 1985 ultrasound came to India, and went mobile in 1990. Now doctors just need to put a small machine in the trunk of their car and they’re set. 2002 saw the arrival of new meds; he mentions Prostaglandins.

He places the blame for sex selection and female foeticide squarely on the medical profession. He lists their four stances: Deny the problem. Acknowledge grudgingly. Look for loopholes in the law. Act reluctantly.

He wants doctors to stop – “ Stop the supply, stop the demand”.

He asks, “Why do doctors continue to perform female foeticide, the greatest sin on this earth?” And he answers: Substandard, non-comprehensive medical education. Insufficient medical training on the social/economic/cultural aspects of health and illness. No gender-sensitive medical education. Commercialization of the medical profession. No mechanism for automatic regulation by the profession.

All this has lead to a socio-demographic emergency in India. He damns the state and central governments for the obeisance they show to high profile specialists with social/political/legal clout.
He ends with a plea to all in the hall to recognise the magnitude of the problem, educate against myths and misconceptions, and involve willing doctors in an action to stop their illegal practice.

Brisk discussion follows. A female physician stands up and asks why he is blaming her for being a doctor? Dona takes the mic and eventually loses her temper; she is a fiery woman. Bernie whispers to me: the doc is saying she doesn’t know anyone in Mandya who is involved in sex selection. Dona thinks she must live under a rock. Or maybe she is lying to cover up. The implication is clear. I think it is a good exchange for the wide-eyed community workers; they are the ones who work with doctors and pregnant women. They see the level of denial that Dr. Kulkarni identified.

There is a buzz of comment after this. Two mics out on the floor. I’m not going to get a word of this, so I sit and watch the dynamics. People are galvanized. Good.

When the buzz dies down and the questions seem to end, the UNICEF doctor from Hyderabad takes the mic. His PowerPoint presentation wasn’t so hot, but he’s got great mediation skills. And he’s speaking in English, with translation. I have lots of time to write.

He says it is a common response that this practice is one of the uneducated, the ill, the poor, the ignorant, but this is not so. The issue is more in wealthy and middle class families. The drop in sex ratios is not from infanticide, but from technology. It started in Delhi at government institutions, and doctors just can’t say it isn’t happening.

The problem is that girls are not getting the chance to survive. We understand the reasons. The enemy is diffused, in many places, so we will not try to point a single finger. We know it is complex; one enemy is the societal outlook. But the big actors are the machine and the doctor who operates it. He smiles at the defensive female physician and says, “I cannot vouch for the sanctity of all doctors, nor do I represent all doctors. But it is important that we get off the fence, and motivate doctors to come over to our side. We have to work, as doctors, to implement the PNDT Act.”

He talks to the community workers. He wants them to do four things: know the name of every pregnant woman they visit; be a worker for the whole family; form a relationship, a partnership, with the woman and her family; and to their good counselling skills add an understanding of criminality in case a woman asks them about USD.

Well, I’m impressed. So is everyone in the hall. Indians don’t often applaud with vigor; this time they do.

The day is done; we sit and talk in English. A few stray comments: “Education only works for the educated!” I’ll follow that one up later. Another, “Development doesn’t bring enlightenment or education on values. Even an old, illiterate woman has a mission and values. Technology started in the US and keeps moving to India, now we have foeticide and soon we’ll be able to select the sex before conception!” There’s a lot of good words in the air; it’s been a worthwhile day.

Eventually we fall silent. What were the references to the Green Revolution, I ask? Ah yes. Good question. The Green Revolution brought the commercialization and mechanization of agriculture. It marginalized and devalued the women who were once in control of agricultural production. It increased materialism as it changed the face and focus of rural areas; from small, adequate production to the ‘need’ for a bigger machine, a larger field, more animals. And the Green Revolution states have the highest female foeticide rates – Punjab, Gujarat, Haryana.

With increased materialism came an increase in violence against women, increased dowry demands, increased alcoholism. All this contributed to the devaluing of women. Yet women still do 90% of the work in rural India; they rear children, clean, cook, collect firewood, haul water, do field work, attend community meetings to strategise on approaches to government [for bore wells, electricity, roads . . .] and on and on.

And make no mistake, India is still rural. Anyone who wonders just has to look at the recent rout of the former, city-focused, BJP central government. People hope the Congress will remember the forest, tribal, rural people of India. Me, too.