Writ Petition Civil No. 209/2003.
Ramakant Rai & Anr. Vs. Union of India& Ors.
The petitioners, Health watch UP & Bihar and Initiatives: Women in Development, NGO’s advocating for women's health and empowerment in population policy have conducted surveys and reports which reveal the appalling conditions in Government-run sterilisation centres. This is in spite of the Guidelines on Standards of Female and Male Sterilisation, the purpose of which is to protect against such abuse.
Representing the petitioners, HRLN filed this case in the Supreme Court of India, advocating the need to change the coercive approach towards sterilisation and cited an appalling state of affairs within the sterilisation process. Before the surgery commences women are not made aware of other forms of birth control and are not warned of the dangers associated with the operation or given any counselling. Most women are below the minimum age limit of 22 years, often as young as 15, as such no written consent is attained. False promises and monetary incentives are also given in order to lure women to be sterilised. In addition under-qualified staff performs pelvic checks and sterilisations that often result in death and/or serious infection, male doctors pass indecent comments and there is no assurance of privacy whatsoever. There are huge problems with unhygienic conditions whereby public health centres and camps lack basic amenities such as electricity and medical equipment; surgery is performed on the floor or on broken or slanting tables, often with the blood of previous operations still on the operating surfaces.
Moreover the same needles are used for many patients with up to 50 procedures performed a day, when the prescribed limit is 20. Post-surgery women are discharged with septic stitches without proper examination and no post-operative instruction, monitoring or counselling is provided. These appalling conditions have resulted in huge post-operative complications and intense mental and physical trauma for the women involved, and in some cases even death.
Just one horrendous example is that of a fifteen-year-old from Kushinagar District in UP, who was taken by a health worker, without her parents’ knowledge, to a government run facility where she was forcibly sterilised. In another case, hospital staff beat a woman after she was sterilised and had complained about the pain following the surgery. The woman later learned that she had developed an infection from rotted stitches.
The Guidelines on Standards of Female and Male Sterilisation were issued in order to improve the quality of family welfare services and ensure the well-being of the person undergoing sterilisation during every aspect of the procedure. Women have the Human Right to voluntary sterilisation services that are not coercive, unsafe or violent. International Human Rights Law, specifically under The Convention on the Elimination of All Forms of Discrimination against Women, 1980 (CEDAW) and the declarations from the International Conference on Population and Development, Cairo, 1994 (ICPD) and the Fourth World Conference on Women, Beijing, 1995 (FWCW) protects the rights of women to have access to voluntary sterilisation services free of coercion, discrimination, and violence. The fundamental right to safe health inherent in the Indian Constitution under articles 14, 15, 21 and 47 is also violated with the these despicable practices.
The petition calls for an end to this negligence and abuse of women and advocates the following relief: · A Direction for the erring states to strictly follow the standards set out by the Guidelines
- For the respondents to prominently display a copy of the Guidelines in all Healthcare facilities and to ensure that all medical practitioners have access to said Guidelines
- To award damages and compensation to victims of medical negligence
- To fix accountability and responsibility on Government officials and doctors who have failed to follow the Guidelines
- To mete out due punishment to those who have breached the Guidelines
The Writ has been accepted by the Supreme Court. The Court ordered each state to file affidavits regarding their individual levels of compliance with the Guidelines. The states have responded in a piecemeal fashion and issued incomplete affidavits, after which the Court issued subsequent orders, most recently on 6 December, 2005, requiring further affidavits regarding the said compliance with the Guidelines.
Furthermore in March 2005, the Supreme Court ordered state Governments to take immediate steps to comply with the Guidelines and thus regulate doctors and other health-care providers who perform sterilisation procedures. They also ordered them to compensate women who suffer complications due to substandard practices and the relatives of victims who may die from botched operations. The Court instructed the state Governments to respond to the order indicating steps taken in compliance with it.
The outcome is of profound importance, because a failure to implement these Guidelines violates the fundamental rights of those women who are victims of this negligence and abuse.
Contact Person: Sarita Barpanda; firstname.lastname@example.org