New Delhi: Soni Jangde felt good when she returned home after getting sterilized in central India four days ago: She had 600 in her hand and a belief that she was doing the right thing for her young family.

A few hours later, the 23-year-old mother of three got a headache, followed by abdominal pains and vomiting. She assumed it was a normal side effect until Chhattisgarh state officials came to her village and rushed her to the hospital. Of the 82 women sterilized with her, 11 have died and 68 are hospitalized.

“We are completely afraid," Jangde said on Tuesday from her hospital room, where her six-month-old baby and husband stood by her bed. “With this kind of treatment the government is playing with the lives of women and poor people like us."

The tragedy is one of the worst in recent memory from the one-day sterilization drives India regularly holds to keep its 1.2 billion population from growing too fast. Married women are the most at risk: While more than one-third of them are sterilized, only 1% of men have had a vasectomy, according to a 2006 National Family Health Survey.

“There’s disproportionate pressure on women to be sterilized versus men as it’s easier for a health worker to get in touch with a women when she has a baby," said Kerry McBroom, head of the Reproductive Rights Initiative at Human Rights Law Network in New Delhi, which has sued to improve conditions at sterilization clinics. “Also it’s a patriarchal society. Men haven’t been involved in the family planning discussion."

Population trend

The UN projects that India will surpass China as the world’s most-populous country in about 30 years. In 2007, India increased incentives for women to undergo sterilization, and focused efforts on Chhattisgarh and other underdeveloped states. India now has the world’s third-highest female sterilization rate after the Dominican Republic and Puerto Rico among more than 180 countries tracked by the UN.

Most of the women sterilized on 8 November were under 30. The sound of crying babies filled the hospital in Bilaspur district on Tuesday as anxious relatives stood by. Some mothers breast-fed their infants while laying in hospital beds.

“There is no other option," said Kailashi Yadav, 27, who was suffering from a headache and regular vomiting as she fed her two-month-old girl. “The child has to remain alive."

Jangde and her husband take home the equivalent of $3 a day working on a farm. They have three children and can’t afford to have anymore. So when a village health worker told Jange about the sterilization drive, she jumped at the opportunity.

Blood sample

“We decided that we will restrict our family with three children and remain happy," said Jangde, adding that she wasn’t forced to get the operation. “Men don’t go for sterilization. We do that."

On the afternoon of 8 November, Jangde arrived at the clinic in Bilaspur district. Five medical staff were present: the doctor, two nurses and two other staff members.

They took her blood pressure and then she gave urine and blood samples. The operation room was neat and tidy with two beds. The procedure went smoothly and was over in 10 minutes.

“I don’t know what went wrong," she said in recalling the incident, looking frail and weak.

Raman Singh, Chhattisgarh’s chief minister, pinned the blame on the surgeon, R.K. Gupta. He had been suspended and was facing a criminal investigation. Gupta couldn’t be reached for a comment on Tuesday.

Dirty instruments

Gupta used dirty instruments to sterilize 83 women in about six hours, according to a local medical official who asked not to be named because details of the investigation are private. He also breached guidelines that limit surgeons from performing more than 30 sterilizations a day, the official said.

Four women were still in critical condition after the 8 November surgeries, according to Amar Singh Thakur, chief health officer for Bilaspur district.

Shivkumari Tandon, 30, a village health worker who has participated in sterilization drives for the past 10 years, is also facing criticism. She brought four women to the hospital on 8 November. One of them died.

“People are blaming me," Tandon said while visiting victims on Tuesday. “People are afraid. Family planning will be stopped in my area. Nobody will come forward to do this now."

Sterilizations are voluntary and couples choose between a tubectomy or vasectomy, Harsh Vardhan, who was India’s health minister at the time, told parliament on 18 July. From April 2010 to March 2013, the government paid about 51 crore for 15,264 deaths or failed surgeries, he said.

Jangde, wrapped in a red blanket, says she’s sorry she ever listened to government messages promoting sterilization.

“I’ll never encourage my relatives to do family planning," she said. “If they do, I’ll stand in the way." Bloomberg