Missing girls of Morena

Print edition : October 07, 2005

Despite a crackdown in February on sex determination tests, ultrasound machines at nursing homes and clinics in Morena district in Madhya Pradesh are back in business even as the Department of Public Health and the Minister in charge prefer to look the other way.

ANNIE ZAIDI in Morena, Madhya Pradesh

Activists of Jagosakhi, a non-governmental organisation, stage a street play in front of a clinic in Morena in protest against the use of ultrasound tests for sex determination.-COURTESY JAGOSAKSHI

DR. RITU RATHI is wary of the word check. Whenever a pregnant woman tells her "check karana hai", she knows what is coming next. Usually it is "ghar mein klesh hai" (there is conflict at home), followed by a request to know whether the foetus is a girl or a boy. Dr. Ritu said she had recently stopped a couple from suffocating their newborn girl. "But we had to send the baby home with the same parents. Who knows what has become of her?"

Dr. Ritu works at Rathi Hospital, one of the hospitals in Morena district of Madhya Pradesh that have earned a reputation for turning down requests for sonographies to know the sex of the foetus. It is also one of the few whose licence to operate an ultrasound machine was not cancelled following the inspections conducted earlier this year. Said Dr Ritu: "I don't encourage sonographies unless there are complications. But I often get requests (for sex determination). There was more pressure during the period when the licences of the other clinics were cancelled."

Morena found itself at the centre of a storm in February when the local administration swooped down on nursing homes and laboratories equipped with ultrasound machines. It cancelled the licences of seven machines only to restore them later.

The district has a dismal sex ratio of 822 women for every 1,000 men. In Kailaras and Pahadgarh blocks, at least 100 villages have a sex ratio of less than 600 and in Jaura block it is less than 500 in some villages.

Sonkali Devi (right, with her daughter and granddaughters) wanted an ultrasound test on her daughter-in-law and decided against it only after activists threatened her with legal action. She now has a third granddaughter.-ANNIE ZAIDI

Morena's missing girls came into focus in February when the District Collector, Dr. Manohar Agnani, started checking the anganwadi records. "On one such visit, I found that there were very few girls named in the register, and scolded the anganwadi worker. Imagine my shock when she told me, `Gaon mein ladkiyaan hon to darj karein' (only if there are girls in the village can I register them). That was when we started a door-to-door survey."

Inevitably, the survey pointed to the local nursing homes and clinics with ultrasound machines. Many women of the villages admitted to having had an abortion after discovering that the foetus was female, said Dr. Agnani. They even named the doctors who conducted the tests, he added. Performing a test for the purpose of sex determination is a cognisable, non-bailable and non-compoundable offence under the amended Pre-natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act (PNDT Act) and punishable with a jail-term of up to five years and a fine of Rs.5 lakhs.

Dr. Agnani, whose specialisation as a doctor is in international public health, began to follow the paper trail. The Chief Medical and Health Officer (CMHO) seized and examined the records of all clinics where ultrasound machines were registered under the PNDT Act. The District-level Appropriate Authority (headed by the CMHO) is authorised to grant, cancel or suspend the licences of genetic clinics or laboratories and conduct independent investigations.

It turned out that several clinics were not filling up the required forms, especially Form F, which seeks information on, among other things, the number of existing offspring and their sex, why an ultrasonography is recommended, and whether an abortion is recommended and why.

Show-cause notices were issued to seven clinics on the grounds of violating the PNDT Act and subsequently their licences were cancelled. All the clinics appealed against the decision to the State-level Appropriate Authority, which is headed by the Director of Public Health.

At Singrauli in Morena district, a woman with five of her seven daughters. She said she had three abortions, all following ultrasound tests, and still yearns for a son.-ANNIE ZAIDI

By June, the clinics got back their licences. The Authority admitted that the clinics violated the PNDT Act, but condoned them, saying there were no "gross irregularities".

Dr. Agnani's frustration is palpable. He said: "What else is gross? The victim dies before she is born. The doctors will not confess; their clients will not speak up. A crime is committed in 30 minutes or less and nobody is the wiser. A paper trail is like a verbal autopsy and that is all we have. There were 11 registered machines in Morena district. We mapped them and found the ratio was the worst in areas that are located close to an ultrasound machine. Morena (rural) had a ratio of 787. Ambah had a machine and the ratio was 788. What does this mean?"

The clinics appealed more than 60 days after their licences were cancelled, which is in violation of the PNDT Act, but no explanations are forthcoming about why such appeals were allowed. Interestingly, the appeals were filed a few days after Dr. Agnani was transferred to the State Finance Department in Bhopal and the local MLA, Rustam Singh, was made the Minister for Public Health and Family Welfare.

When Frontline asked Rustam Singh about these events and the adverse sex ratio, he said: "But Delhi is worse. Why speak of Morena? We at least have a few districts which have more females."

When it was pointed out that these were predominantly tribal districts or those lacking ultrasound facilities, he said: "This is not a criminal problem. Poor people don't even know they are committing a crime. In Morena, the administration shut down the machines. That was wrong. If a tap has foul water, will you stop the water supply?"

At the signature campaign against female foeticide in Morena.-

"Yes," said Dr. Agnani, "If the water is poisoned, you initially have to stop supply. The administration can only help if it is allowed to."

But Rustam Singh was not willing to use what he calls the "shaasan ka danda" (the stick of administration). He said this was a social evil best left to social workers to tackle. When Frontline asked him what the government was doing, he said the department had many plans, but he did not wish to publicise them.

The doctors and radiologists whose clinics were raided claimed that they were victims of "personal vendetta" and "enmity with local officials". Dr. Meera and Dilip Premi of Premi Nursing Home, one of those that had temporarily lost their licences, claimed that the CMHO's office asked them to fill forms D and G, but said nothing about Form F. However, they admitted that they used to get several requests to determine the sex of the foetus.

All but one of the ultrasound machines in Morena are back in action. A case is pending in the District Judicial Magistrate's court against a clinic that was found in possession of two ultrasound machines, but had only one registration. Six months on, the public prosecutor is yet to frame charges, while the defendant has filed an affidavit claiming that the machine was not registered because it was broken.

Asha Singh, legal adviser to Jagosakhi, a non-governmental organisation working for gender equity and the prevention of violence against women, rubbishes this argument. "Under the law, each machine, each venue, each doctor/radiologist needs separate registration. This machine is like a weapon. If you keep a gun without a licence, you are guilty. The argument that the weapon is old or irreparable is not admissible. Let the charges be framed and the law take its course."

Jagosakhi's other interventions comprise a mix of cajoling, educating and threatening. When Sonkali Devi wanted to get a sex-determination test done on her pregnant daughter-in-law, the activists tried to dissuade her, but when she did not relent they threatened her with legal action. Sonkali Devi now takes great joy in rocking her granddaughter to sleep.

In August, Asha Singh and her team took their protest to the street and they held street plays outside the clinics. They have also organised a signature campaign in the city to build awareness on the issue.

As news about the raids spread, fewer pregnant women visited Morena for ultrasound tests. Some of the women Frontline spoke to said that they used to get `checked' in Morena earlier, but had stopped going there after "the machines shut down". (Most of the people are not yet aware that the machines are back in action.) Some of them now go to clinics in Bhind, Gwalior, Agra and even Delhi and Kanpur, despite the fact that it costs twice as much if not more.

Clearly, Morena's ultrasound machines are only a part of a larger national problem that sex determination is.

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