Unsafe wombs

Take a look at the Indian subcontinent. It has more men than women, while in most other countries it is the exact opposite - because women now live longer than men.

Even in India, in the state of Kerala, it is estimated that women live five years longer than men. So this differential in the number of women to men in India as a whole indicates an extreme manifestation of elimination before birth. The social gains we have made as a country, including the raising the life expectancy of women in some parts, are being wiped out because of this one reality.

A fundamental tenet of the Indian Constitution is non-discrimination. Yet, because of medical malpractices, a country that promises gender equality is witnessing the killing of millions of girls. Over the last decade, India has lost seven million girls and we are likely to lose a million a year in the current decade.

China, too, has been seeing a similar trend. But where China is different from us is in the uncompromising way it is cracking down on sex selective abortions. It is estimated that over the last two years China has had 15,000 cases of illegal sex-selective abortions, and there have been 15,000 convictions. In India, by contrast, since 1994 – when the Pre conception and Pre Natal Diagnostic Techniques (Prohibition of Sex Selection) Act (PCPNDT) came into force – there have been only 110 convictions.

When the disappearance of an estimated seven million girls, as an outcome of 21 million medical crimes of sex selection and sex selective abortions, lead to 110 convictions, it means that there is practically no risk of a doctor being caught for perpetrating the practice of elimination based on sex.

Making connections

We need to be alert. We also need to make connections between developments in political economy and their impacts on society. Take the case of Andhra Pradesh. In 1995, when Chandrababu Naidu took over as the state’s chief minister, there were seven medical colleges, all of which were in the public sector. By the time he left office in 2004, there were 23 new medical colleges in the state - all of them in the private sector and one that he partly owned. Naidu was able to do this because of a close alliance with Ketan Desai, then head of the Medical Council of India.

But what is the connection between the rising commercialisation of medical education in Andhra Pradesh and the issue of sex selective abortions? You need only look at the figures of the 2011 census to understand the link. The sharpest drop in the child sex ratio took place in Andhra among the South Indian states, even while the state had the highest levels in the 1991 and 2001 census. The commercialisation of the medical education is now, they say, a bigger industry than defence!

We should also be concerned about the social acceptability of violence. In the Punjab of the 1980s, when militancy was at its peak, sex selection spread. We should also be concerned about the social acceptability of violence.

It is precisely during such periods, when the social fabric has been weakened, that those profiting from sex selection are allowed a free rein. Punjab today has shown a marginal improvement. But if every state has to go through the same experience that Punjab did – some districts in the state had once touched 758 girls to 1000 boys - before getting better, it would mean losing hundreds of millions of girls.

Then take Jammu and Kashmir. Why is it that in a state where relatively higher respect is accorded to women, we saw the sharpest drop ever experienced by the state in the census of 2011? Here we need to look at the big drive for population control undertaken at a pan-India level. In the 1980s, a happy family was projected as a couple with two children – a boy and a girl. Two girls did not make a happy family; a son was seen as imperative. By the 1990s, the family had become a couple and a child.

Look at the other facts. In 2001, the 10 worst performing districts were all in Punjab or Haryana. Today, we even see Pithoragarh in Uttarakhand in this list. Of the 10 worst performing states, six are in Haryana. The other are: Beed in Maharasthra; Pithoragarh in Uttarakhand; Jammu and Samba in Jammu & Kashmir.

Declining sex ratio

The declining sex ratio is also very much the outcome of a population programme. We need only go back to the Emergency Period of three decades ago when sterilisations and abortions were seen as very important instrumentalities for the reduction of family size. It saw lakhs of women and men being sterilised forcibly. In the case of sex selection, which was developed by population control lobbies – the first programme was started at the Indian Institute of Medical Sciences in New Delhi.

A doctor, supported by strong family planning lobbies, came from New York and set up a department to do sexing. Simultaneously, an intellectual justification for amniocentesis tests was being mounted by genetic scientists. It was agreed that it was better that a girl be eliminated rather than be allowed to be born and then have to suffer discrimination.

There were eminent social scientists like Dharma Kumar arguing that such an approach would actually raise the status of women. In the mid-1980s, when people in Mumbai were talking about sex selection for the first time – it involved the amniocentesis technology at that point – we were all very confident that such things would not happen in South India because there were no clinics of that kind.

Traditionally, it was in North India that sex ratios were skewed. We were thus lulled into complacency and that was a big mistake. We did not even have the vision to look at the possibilities of this practice proliferating all over the country and doing something to stop the trend.

Today, the practice has spread inexorably across India. It is taking place in the Kashmir Valley, it is taking place in pockets of the Northeast, it is taking place in Odisha and in Bengal. In regions where the child sex ratios were once very good, we are now seeing sharp declines. It is this persistent spread of sex ratio declines that is disturbing. It shows you what India is up against.