NGO says many women misled into undergoing needless surgeries

A section of doctors – both in the public and private sectors – has instilled a sense of fear among poor and illiterate women in Karnataka, misleading them into undergoing uterus removal operations that were medically unnecessary, public health activists have claimed.

The activists, who interviewed several hundred women in Chikkamagaluru and Kalaburagi districts and scrutinised their medical records, found that surgeries were performed without adequate clinical evidence on the need for the procedure and proceeded based on poor diagnostics.

Following reports from Karnataka Janaarogya Chaluvali, a non-government outfit that works on public health, the Karnakata health department too probed why so many hysterectomies were carried out in Kalaburagi district.

The government report concurred that many hysterectomies were done with no proper indications and women who could have been treated conservatively, were subjected to surgeries. It was also highly critical of the diagnostic criteria and took serious objection to the fact that barely any specimens were sent for histo-pathology, before the operations.

The KJC had the medical records and oral evidence examined by three practising doctors – two gynaecologists and one community medicine expert.

They found in 67% cases, the operation was not required and in 27% cases, the available information was too inadequate to form an opinion.

Out of the 707 women interviewed by KJC workers in Kalaburagi, an overwhelming 98% underwent hysterectomy in 61 private hospitals in the towns of Kalaburagi, Umerga, Tandur, Zahirabad and Bidar. Four of these 61 private hospitals accounted for 55% of all the cases.

All 15 women interviewed in Hebbalagere village of Chikkamagaluru underwent hysterectomy in a government facility, 14 of them in the Birur government sub-divisional hospital.

“A medical procedure such as a hysterectomy has morphed into a business strategy in the medical-healthcare market, with poor women’s bodies being trafficked for profit,” three KJC researchers wrote in a report in the latest issue of the Indian Journal of Medical Ethics. Acute shortage of doctors in the government health system compounded the problem.

In almost all the cases, the women visited the doctors because of some other complications related to her reproductive health and menstrual cycle. But the doctors had planted the fear of cancer in the women’s minds and this seemed to be driving what the researchers described as the “hysterectomy epidemic”.

The procedure costs anywhere between Rs 10,000 and Rs 2 lakh, depending on whether it was a government or private facility. In both sites, they found serious violation of professional integrity and ethics.

Since 2010, an alarming number of hysterectomies were reported from Andhra Pradesh, Bihar, Chhattishgarh, Rajasthan and Gujarat because of a government-sponsored medical insurance scheme that assured payments for surgeries.
DH News Service