| Indian Journal of Medical Ethics | ||||||
![]() Home Current Issue Past Issues Support About IJME Oct-Dec2001-9(4) |
COMMENT Female foeticide: where do we
go? Mohan Rao The publication of the provisional figures from the
Census of 2001, highlighting a continuing decline in the sex ratio among the
juvenile population in the country, has led to an outpouring of responses, in
many cases extremely naïve and unreflective. Many of those vociferously
condemning female foeticide today are curiously those who uphold 'traditional'
ideologies of women's servitude that largely contribute to the problem. It is
also surprising to find feminists arguing that the technique offers women a
'choice'. As a member of the Jan Swatshya Sabha's campaign against the practice,
I would like to share some of my concerns on the subject. Not to belittle the issue, but it is necessary to
ask the question as to why this focus on female foeticide? Does this emanate
from eugenic ideologies? That more People Like Us are involved? More
upper-caste, better educated and better-off Hindus? Does it stem from a shaming
sense of South Asian identity? Ashamed of what the West would think of us? Does
the concern for missing females conceal what should be our concern for both
missing males and females, who add up to the dismal, and huge, load of infant
and child deaths in our country? These avoidable deaths, overwhelmingly among
the poor, are disproportionately among the dalits, the adivasis and other
marginalised communities. Is it that dalit or adivasi or working class infants
and children dying is somehow natural? Non-volitional, are these deaths also to
be considered immutable? Why then has no demographer or economist worked on
missing dalits? My second set of questions pertains to the language
of rights, currently fashionable in officialese and among many feminists. The
concept of reproductive rights has been so reified that it is unavoidable in the
context of female foeticide also - where it is used to justify the practice.
What does 'empowerment' or 'reproductive choice' mean to women from poor
communities denied access to all other rights as citizens? These fashionable
phrases are intrinsic to the language of coercive population policies. They are
also the words used by multinational companies wishing to break into India's
potential market of forty million couples with injectable contraceptives and
implants. These are precisely the words used by right-wing American
neo-eugenists to illegally sterilise poor women in our country with quinacrine.
Choice, faith and cost-effectiveness
We live in a world of no certitudes except the
illusion of choice offered by the market. Is this the reason for the unthinking
popularity of the language of the neo-liberal market? How else does one explain
the fact that Madhu Kishwar uses the language of the World Bank, arguing that it
is necessary to involve so-called religious leaders in a campaign against female
foeticide since it is cost-effective? (1). I remember reading a tiny news item some months
back that Mr. Giriraj Kishore of the Vishwa Hindu Parishad had condemned access
to abortion in India, arguing that Hindu women disproportionately aborted
foetuses. I need hardly add that lack of access to safe abortion is one of the
leading causes of the high maternal mortality rate in the country. But the Sangh
Parivar has no use for the empirical - these are not matters of faith. More
recently, I read that the VHP was participating in a meeting of religious heads
to oppose female foeticide. The meeting was reportedly taken over by Sadhvi
Rithambara, to the embarrassment of many naïve participants. This meeting had been organised by the Indian
Medical Association on June 23, with support from UNICEF and the National
Commission of Women. UNICEF is one of the many international organisations
flirting with the likes of the Shankaracharya of Puri - when he has time between
reconverting 'tribals' who became Christians. The same Shankaracharya of Puri
hailed the destruction of the Babri Masjid as the dawn of a new and glorious
Hindu age. He also upheld sati at Deorala. It must be added, parenthetically,
that the World Bank health projects in Andhra Pradesh seek to utilise so-called
religious leaders in the campaign against AIDS. Given the influence of the World
Bank on our health policies, it would not be surprising if this 'innovative
scheme' was adopted for implementation across the country. Would it be
exaggeration to say that this is one more nail in the coffin of Talibanisation
of our country? I think it is important for all of us concerned
with female foeticide to be aware of the many threads of arguments in the
discourse, who it emanates from and where their interests lie, before rushing in
where angels fear to tread. No amount of cost effectiveness justifies marching
along these self-appointed religious leaders, who are the struts of patriarchy
and indeed worse, of appalling murderous evil, in our country. We cannot sup
with the Devil, especially when he quotes the scriptures. Offering choices or creating a
demand? On August 7, the Delhi Medical Association, along
with the India International Centre, organised a panel discussion on female
foeticide. This well attended meeting was also deeply disturbing.
Doctors at the meeting were agreed that there is
perhaps a problem, which is very unfortunate. But doctors, it was agreed, merely
respond to women's needs. They come from the same society as everyone else so
they cannot alone be held responsible. Further, since foeticide is a criminal
offence, it is up to the government to take action against erring doctors: the
IMA could not do anything about it. Indeed the IMA - which has not initiated
disciplinary action against any erring doctor - must be congratulated, we were
told, for keeping the issue in the public eye. The problem, it was felt, lay
with the people who needed to be educated. Doctors can perhaps be forgiven for not reflecting
on Say's Law that supply creates its own demand. They have evaded the
responsibility of creating an injection culture in our population just as they
now evade the responsibility of a 'tests' culture. But at this meeting there was
no reflection on the adoption of medical technologies for sex determination
either. It is well known that the prevalence of congenital abnormalities in 1.5
per cent of all pregnancies; that of these, possibly fifty per cent can be
identified by non-invasive technologies. Indeed, that from a public health
perspective, there is very little role for such technologies in a poor country
like India. Yet there has occurred an epidemic of the spread of sonogram and
ultra-sound clinics in a completely unregulated manner. Indeed there was no
rethinking on the role of Pre-Implantation Diagnostic Techniques (PDTs) already
available in our metropolitan cities. There was no thought given to issues of
monitoring medical practices or regulating them. Above all, there was no
discussion on questions of ethics. What also went unsaid was that the import of
such expensive technologies - with the State stepping in with exemptions from
import duties and other such measures - sets off a logic of its own: of profit
maximisation for entrepreneurial doctors. One interesting fact that emerged is
of new marriage patterns among doctors: obstetricians and gynaecologists are
apparently increasingly marrying radiologists. A self-confessed feminist, for 15 years till very
recently the head of Women's Feature Service, who had made a documentary film on
female foeticide, was also a panelist. She argued that technology is neutral and
value-free. Her experience had been that women from all sections of the
population sought sex determination tests, indeed that demand exceeded supply.
We cannot and should not stand between people and their access to technologies;
we should not play God. Who are we, she asked, to tell women what they should
want? People have no use for abstract concepts as sex
ratios, she argued. The lives of Indian women were so terrible that this
technology offered them an element of choice, indeed of empowerment. Over time a
decline in the supply of girls might improve the demand for girls and thus their
status. The only way forward at this juncture was to increase consciousness
among women through education. Religious leaders, she averred, could play an
important role in this regard as she could attest from her experience of a
village in Punjab. We must remember that India is a religious civilisation.
What is curious is that this civilisation is by
definition upper-caste, and Hindu. Thus we were told sons are needed to light
the father's funeral pyre. What was ignored is that a large proportion of
Indians actually bury their dead. That cremation is by and large an upper-caste
custom. Similarly, that dowry and anti-female biases are associated with wealth
and with education, both monopolised by the upper castes. Indeed that the spread
of these practices is frequently described, evocatively, as sanskritisation. In
this context, to talk of choice offered to women who are victims - of the
medical industry, of the medical profession, of families and of patriarchal
ideologies - is to make a travesty of concepts of agency and indeed of choice. A
progressive lawyer on the panel argued very convincingly that we must not expect
the law to provide solutions to all social problems. The law on female
foeticide, he said, had apparently been drafted not only to exonerate the
medical profession, but also to further victimise women. In fact it had thus
been drafted so as to be non-implementable. After the Narmada and Bhopal
judgements, he said, we must be cautious about approaching the courts. To this
list could be added the Rajasthan High Court's judgement on the constitutional
validity of the two child norm for contesting panchayat elections or the recent
Andhra Pradesh High Court's judgement on vedic astrology as a science.
Where do we go from here?
It seems to me, then, that we find ourselves in an
odd bind over the issue. We have a population that apparently wants female
foeticide, a medical system happy to supply the necessary technology, and a
section of feminists arguing that female foeticide is about reproductive rights
and choices. On the other hand, on our side, are strange bed-fellows of the
Sangh Parivar. I would also argue that a retreating state has no intent on doing
anything about the issue. Indeed punitive and coercive population policies,
especially those announced by several States, are an invitation to female
foeticide. Not curiously, a large number of respondents in a study of female
infanticide in Salem district explicitly stated this. The women interviewed felt
that they could not use many modern contraceptives as they interfered with their
ability to work on the fields. What they were doing, they argued, was
'traditional' and achieved precisely what the government of India wanted. Indeed
a study in Mumbai revealed that a majority of doctors performing sex-selective
abortions stated that they did so in order to control population growth (2).
There is therefore a familiar conundrum to activists, familiar with the debate
on the Universal Civil Code in our country. But where do we go from here?
References 1. The Times of India, July 17, 2001. 2. FRCH study cited in Gupta Jyotsna Agnihotri. New Reproductive Technologies, Women's Health and Autonomy: Freedom or Dependency?, Sage, New Delhi 2000, p.521. Dr Mohan Rao,Centre of
Social Medicine and Community Health, School of Social Sciences, Jawaharlal
Nehru University, New Delhi 110067. |
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