Tuesday 18 November 2014

Indian sterilisation patient: ‘I was slapped and told to calm down’

Woman recounts treatment at camp where 15 women have died after taking antibiotics possibly tainted by rat poison chemical
Shivkumari Yadav sits with daughters Prisha, two months, Mansi, three, and her mother Mahasin Bai
Shiv Kumari Yadav (right) sits with daughters Prisha, two months, and Mansi, three, as her mother Mahasin Bai looks on. Photograph: Alok Putul for the Guardian
A woman who became seriously ill at the Indian sterilisation camps that have killed 15 women has spoken of being slapped by a doctor and told to “calm down” after screaming in pain at the procedure.
Shiv Kumari Yadav, 27, attended one of the clinics in Chhattisgarh, eastern India, at which antibiotics were handed out that authorites have said might have contained rat poison. She said she had stomach cramps and vomited after taking antibiotic pills following the operation.
Yadav is a tall, slight mother-of-three, her hands and feet roughened from hauling bricks all day. Her two-month-old daughter, Prisha, sat in her lap as she spoke about the camp, which has ignited debate in India about the country’s population control policies and healthcare system.
Yadav’s story appears to implicate the pills for the illnesses and possibly the deaths. Officials say samples have been sent to laboratories in Delhi and Kolkata for further testing.
Yadav said she went voluntarily to the sterilisation camp on 8 November. “We decided after my youngest was born that we did not want any more children,” she said from her bed in the large ward at the government-run Chattisgarh Institute of Medical Science (CIMS), where many of those who fell sick have been admitted.
During the surgery, Yadav said, she was awake and at one point screamed because of the pain. But the doctor slapped her lightly and said: “Calm down – it’s almost over.”
Ten minutes later, after she had been stitched up, Yadav said she and her husband paid for an auto-rickshaw home, an extravagance for a couple who earn $4 between them on days when they can find work hauling sand, concrete or bricks at construction sites in Bilaspur town.
“We were given $10 for having the operation,” she said. “We spent $8 to hire the autorickshaw.”
Hours later, back home in their village of Ghutgu, 16km away, Shiv Kumari said she swallowed two of the white, oblong Ciprocin pills that had been prescribed.
“First I got terrible stomach cramps,” she said. “Then I began vomiting. I went to our local government clinic and the nurse gave me medicine to stop the vomiting, but the next day it started again, and then I fainted.”
Yadav was initially taken to a private hospital where doctors said her condition was too serious. She ended up at CIMS, along with other women who had attended the camp.
One woman from her own village, who arrived a day after Yadav, died.
“We’re lucky that we live close to town,” said Mahasin Bhai, Yadav’s mother. “If the hospital had been any further away, there would have been a carpet of corpses.”
State officials said on Saturday that tablets were found to contain a chemical compound commonly used in rat poison. Preliminary tests of Ciprocin were found to contain zinc phosphide, said Siddhartha Pardeshi, the chief administrator for Bilaspur district.
However on Sunday the company involved denied any wrongdoing, claiming all that had been found was a sticky pad used to catch rats in a storeroom and this had snowballed into “exaggerated” reports that the pills contained rat poison.
The antibiotics were handed out at the sterilisation camp. Three other patients, not involved in the camps but who reportedly took the same pills, have also died.
The deaths have fuelled criticism in India about its population control and family planning policies – from the unofficial targets set to sterilise women, to the appalling conditions in camps and the lack of contraceptive choices for women.
The discovery of potentially tainted antibiotics highlights yet another problem, that of India’s largely unregulated pharmaceutical sector.
Activists and patients have described an assembly-line operation at last week’s camp, where nurses filled in women’s names on consent forms and did blood and urine tests without sharing the results.
“The women we spoke to said they were placed four to five on a bed and given five injections, two in each arm and one in the abdomen,” said Kerry McBroom, of the Human Rights Law Network, a Delhi-based collective of lawyers and activists. “They were taken into the operating theatre and after the procedure they were put in other beds or on the floor and stitched up.”
McBroom, who was in Chattisgarh to document women’s stories as part of ongoing litigation challenging the government-run camps, said none of the women nor the health workers she spoke to knew anything about the tubectomy procedure being performed. Only three of 15 women had heard of any other form of contraception.
McBroom said her interviews revealed potentially disturbing issues surrounding sterilisation targets, although none of the women said they had been physically forced to attend.
“In early November, there was a meeting held for all field-level health workers and a very senior person, though we don’t know who, told them they had to bring in at least three patients each because it would be good for this person’s career.”
State and national inquiries have been ordered, along with postmortem reports for the victims. Four health workers including the doctor RK Gupta, who performed 83 tubectomies in a matter of hours, have been arrested.
Yadav was critical of the way the camp was conducted in such haste.
“If they had told us we were weak and maybe the surgery wouldn’t suit us, I would have hesitated.”
Yadav said she had taken birth control pills for a year after her second pregnancy, but had heard from villagers that they might not be good for her.
“What can we do? This was the only way to stop more children from coming.”
http://www.theguardian.com/world/2014/nov/15/indian-sterilisation-camp-victim-antibiotics-rat-poison

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