Giving PC & PNDT Act A Boost

NGOs nail doctors conducting sex selection by sting operations. Now, they will analyse ‘Form F’, reports Rita Dutta.

The first-ever prison term for sex-selective abortion in India was recently given to a Haryana-based doctor and his assistant. A Faridabad court sentenced Dr Anil Sabhani and his assistant Kartar Singh to two years in prison and a fine of Rs 5,000 each under the Pre-Conception and Pre-Natal Diagnostic Techniques Act 1994 (PC & PNDT Act), for conducting tests to determine the sex of an unborn baby, a practice which is banned in India. The landmark judgment has given a boost to the campaign against sex selection waged by various NGOs.

B S Dahiya

Dr BS Dahiya, former Director General of Health Services of Haryana, who nailed Dr Sabhani via incriminating evidence in audio and video tapes, in his capacity as district appropriate authority (AA), is glad that his efforts have ultimately borne fruit. The AA raided Dr Sabhani’s clinic on October 11, 2002 and lodged a case against him on November 5, the same year. From 2001 to 2004, during Dahiya’s tenure, the AA registered 23 cases against doctors conducting sex selection.

Analysing Form F

Taking the campaign notches higher, NGOs have joined hands to collect and analyse ‘Form F’ in 10 districts of eight states of the country. According to section 17.3 of PC & PNDT Act, every sonologist is required to fill Form F before conducting an ultrasound on a pregnant mother. The form has 19 questions including the reason for conducting the sonography, along with patient detail. Every ultrasound clinic is required to submit Form F to the appropriate state authority by the fifth of every month. The clinics are supposed to keep the record of Form F with them for three years.

The NGOs will collect the forms from the AA of the various districts for a period ranging from July to September of 2005. The period of three months has been chosen randomly. The study will start from July of this year and will be completed by the end of September.

The Union Ministry of Health and Family Welfare will help the NGOs by getting permission from the AAs for sharing the Form F data, says Rattan Chand, Director (PC & PNDT), Ministry of Health and Family Welfare. “There are 383 cases registered for sex selection in the country. Let us hope that the efforts of the NGOs bear fruit,” he adds.

Some key NGOs involved in the study are Centre for Education into Health and Allied Themes CEHAT (Maharashtra), Centre for Health Education Training and Nutrition Awareness (CHETNA) and Sahiyar Stree Sanghathan (Gujarat), Prayas and IFES in Rajasthan, Sutra (Himachal Pradesh), VHS (Punjab), Samtrita (West Bengal) and Centre for Women’s Development (Delhi). The study will be co-ordinated by CEHAT.

According to health activist Dr Vibhuti Patel, the districts chosen for the study are Bhubaneshwar in Orissa, Chittorgarh in Rajasthan, Ahmedabad and Mahasade in Gujarat, Solan in Himachal Pradesh, Hyderabad in Andhra Pradesh, Kolkata in West Bengal, Madurai in Tamil Nadu, South Delhi and South Mumbai.

Why did the NGOs decide to analyse Form Fs? Advocate Kamayani, CEHAT, explains, “Almost 70 per cent of Form Fs are incomplete, whether deliberate or not. Analysing them will give us crucial insight into the sex selection process in the country.” Analysis of data is just the first step. “We will decide on an action plan after drawing conclusions from the study,” Dr Patel says.

Sting Operations

Members of Dalit Mahila Vikas Mandal during raid of an ultrasound clinic. Varsha Deshpande is standing on extreme left

Mere research and awareness campaigns are not going to curb the menace. Hence NGOs like Dalit Mahila Vikas Mandal (DMVM), CWDS, Vimochana and All India Democratic Women’s Association are conducting sting operations to catch doctors practicing sex selection. The NGOs use pregnant women as decoys with hidden cameras and pen recorders to catch the doctors.

Since 2003, DMVM, a Satara-based organisation, has conducted a series of sting operations using decoy patients and has so far managed to nab over 16 doctors for violating the Act in Satara, Thane, Navi Mumbai, Jalgaon, Raigad and Kolhapur districts of Maharashtra. There are over 4,000 registered ultrasound clinics in Maharashtra.

Says advocate Varsha Deshpande, legal advisor to Satara district’s PC & PNDT Act, “Conducting mere research, awareness programmes and poster campaigns against sex selection does not help. A lot of NGOs have lost their souls and are only doing research, mostly funded by international agencies. What we require right now is to nab the doctors by sting operations.”

Dr Sabu George, consultant with CWDS, has helped in conducting 10 sting operations in Andhra Pradesh, Uttar Pradesh, Rajasthan, Karnataka and Delhi. “Sex selection and female foeticide is a Rs 500-crore business in India and we need to conduct sting operations to catch these culprits,” says Dr George.

Bangalore-based Vimochana has done two sting operations in Bangalore so far. “In one case, the patient had gone for genetic counselling and also asked for choice of sex, all of which was video-recorded. But the court acquitted the doctor on the grounds that only a pregnant mother can do sex selection and not a woman who has gone for genetic counselling,” informs Dona Fernandes, member of Vimochana. Vimochana has appealed in the higher court. The other doctor is being tried.

Does It Help?

Do these operations help? Due to sting operations, the sex ratio in Faridabad has improved. Sting operations also act as a deterrent to doctors indulging in such malpractice. “If you do one sting operation in one block, all the doctors in that block are scared of doing sex selection,” says Deshpande.

Nabbing doctors can take anywhere between one visit to the doctor and a series of them. The modus operandi goes like this: First the NGOs research the ultrasound clinics in the area doing sex selection. Then they find a pregnant woman who is willing to act as the decoy. After they videotape the doctor doing or agreeing to do sex selection with the decoy, they inform the AA, who has been empowered to conduct investigations, seize the ultrasound machine and try the doctor in a court of law. Then, along with officials of the AA and the decoy, the doctor is trapped for the final time.

However, getting pregnant women to act as decoys and convincing them to give evidence is an uphill task, rues Fernandes.

And often, the same doctor who has agreed to do sex selection for the decoy, denies it in front of the AA. Of course, this is due to an unholy nexus between the AA and the doctor. Besides sting operations and research, NGOs also exert pressure on the government to lodge cases against the guilty. Says Tej Ram Jat of Prayas, Rajasthan, “We have pressurised the government to lodge three cases of sex selection.”

The Sordid Story

Although the PNDT Act came into effect on January 1, 1996 it was never implemented in the ‘90s. The Act was amended in February 2003 after a PIL was filed by three petitioners: Dr Sabu George, CEHAT and Mahila Sarvangeen Utkarsh Mandal (MASUM) in the Supreme Court urging implementation of existing legislation banning prenatal sex-selection and also an amendment of the law to include newer sex selection techniques. “It took 18 months for my lawyer to accept the case,” recollects Dr George. Any violation of the provisions of the Act is punishable with imprisonment of up to five years, and a fine.

According to estimates, around three lakh girls are eliminated before birth by sex selective abortions as of 2001. “These figures may become a million within a few years’ time, if the right steps are not taken,” cautions Dr George.

The mushrooming of ultrasound clinics has also abetted sex selection. Interestingly, the number of ultrasound clinics is directly proportional to the killing of female foetus, informs Dr George.

Interestingly, 76 per cent of over 4,000 ultrasound clinics in Maharashtra are located in the sugar and milk belt, says a study conducted by the Gokhale Institute of Pune, commissioned by the Union Ministry of Health. This belt contains upper caste people, a category which does not require females to work on the field, says Deshpande, adding, “Sex selection and female foeticide is not a health issue, it is a crime issue. While other health issues are related to poverty, sex selection is related to prosperity.”

The Hurdles

Faulty interpretation of the law aggravates the matter. Cases of sex selection are often confused with abortion, which is legalised under the Medical Termination of Pregnancy Act, 1971. Cases registered against doctors face legal hurdles in court because of the delay on the part of the state government to notify the AA. Additionally, complaints against medical practitioners are often not entertained, as the appropriate authorities themselves belong to the medical fraternity, says Fernandes. “Doctors have political clout and often they are hand-in-glove with the AA,” laments an activist.

However, it is too early to lose patience with delays in hearings and acquittals. “The Act is a few years old. It takes a minimum of 10 years for any law to be perfect. We need to have more case laws for the cases to be expedited,” says Deshpande.

The big challenge still lies in altering the mindset of people who prefer a boy child. “In Delhi, you would hardly find a family which has two girls. If the first one is a girl, the family ensures that the second one is a boy,” says Dr Puneet Bedi of Apollo Indraprastha Hospital, New Delhi.

The Road Ahead

Besides creating awareness that sex selection is a crime and nabbing the guilty doctors, NGOs believe that the right steps need to be taken to take the campaign forward. “In some cases, the victims (women) of sex selection have been further victimised when activists have held slogans in front of their house lambasting them. It is important to crucify the medical practitioner, who indulges in such heinous act than the victims, who may have been forced to abort,” says Dr George. Agrees Dr Bedi: “Doctors who practice sex selection are cold-blooded criminals and stringent action should be taken against them.”

To which Fernandes adds, “Doctors should not forget that they have taken the Hippocratic oath to save lives. Unless they make a commitment to stop genocide, awareness and intervention will not serve any purpose.” Dr George concurs, “The civil society must come forward to stop the genocide.”

Directions from the government about its various programmes should not indulge in gender discrimination. “Why does the advertisement on family planning show one girl and one boy? This way the government is subtly telling everyday that a family needs a girl and a boy. Why cannot they show two girls?” asks Deshpande.

Others point out that the AA also needs to be more pro-active. Thus a little co-operation from the Government will enable strict enforcement of the Act, which will lead to less adverse child ratio against girls.

rita@expresshealthcaremgmt.com