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Women's lives put at risk in India by grasping private healthcare providers Women's lives put at risk in India by private healthcare providers
(about 1 hour later)
Profoundly shocking stories are coming out of India about the exploitation of poor, ill-educated or illiterate women at the hands of doctors in private hospitals. Thousands are being given hysterectomies and caesareans that they do not need by doctors and hospitals that can make substantial sums of money out of the operations. They leave women in pain, infirm, unable to work in the fields to earn a living and in horrendous debt. Profoundly shocking stories are coming out of India about the exploitation of poor, ill-educated or illiterate women at the hands of doctors in private hospitals. Thousands are being given hysterectomies and caesareans that they do not need by doctors and hospitals that can make substantial sums of money out of the operations. They leave women in pain, infirm, unable to work to earn a living and in horrendous debt.
Dreadful as the stories of inadequate care in the NHS have been this week, the neglect and exploitation of women in India at the hands of a greedy and grasping private sector put them in the shade. Indian women earning just enough to feed themselves and their families cannot go to government clinics because they are too few and far between. The private healthcare market has swept all before it. In 1949, the private sector provided 8% of India's healthcare facilities. Now, with the unfettered growth permitted by the unquestioning worship of market forces, it has 93% of hospitals and 85% of doctors. It makes a fortune out of health tourism, attracting people from Europe and the US for high-quality care that is cheaper than at home. Meanwhile, the absence of government regulation allows the appalling abuse of India's own poorest people. Indian women earning just enough to feed themselves and their families cannot go to government clinics because they are too few and far between. The private healthcare market has swept all before it. In 1949, the private sector provided 8% of India's healthcare facilities. Now, with the unfettered growth permitted by the unquestioning worship of market forces, it accounts for 93% of hospitals and 85% of doctors.
Oxfam's staff and partners in India have been amassing distressing evidence of the plight of women who go to private clinics with a minor complaint and come out unable to work and with an impossible burden of debt. This was the account of 38 year old Kaushalya, who works as a farm labourer in a rural district of Rajasthan. She visited a private clinic with stomach pains and was told she must have a hysterectomy. She was charged 30,000 rupees for the operation (around $540). The private health sector in India makes a fortune out of health tourism, attracting people from Europe and the US for high-quality care that is cheaper than at home. Meanwhile, the absence of government regulation allows the appalling abuse of the country's own people.
I went to get medication and have a check up. Because the government hospitals are far away I went to a private clinic. They didn't check me, they didn't give me any medication. But they gave me an injection and performed an operation. Even though I only had a tummy ache, they took my uterus out. I still have the same stomach pain I had before. I can't work, I can't lift heavy things. Being a poor farmer I don't have any money, so I had to borrow money. So far I have not even been able to pay just the interest. Oxfam's staff and partners in India have been amassing distressing evidence of the plight of women who go to private clinics with a minor complaint and come out unable to work and with an impossible burden of debt. This was the account of 38-year-old Kaushalya, who works as a farm labourer in a rural district of Rajasthan. She visited a private clinic with stomach pains and was told she must have a hysterectomy. She was charged 30,000 rupees for the operation (around £360).
Akhil Bhartiya Grhak Panchayat, a local NGO in Dausa district, Rajasthan, found evidence of hundreds of women who had been subjected to medically unnecessary hysterectomies. The NGO filed an RTI (right to information) case. Nearly 70 percent of the women at three of five clinics which provided information had had their uterus taken out. The RTI also revealed a large number of the women who had undergone the procedure were under the age of 29, with the youngest being just 18 years old. Complaints have been made to the police and local government, but no action yet been taken. I went to get medication and have a check-up. Because the government hospitals are far away, I went to a private clinic. They didn't check me, they didn't give me any medication, but they gave me an injection and performed an operation. Even though I only had a tummy ache, they took my uterus out. I still have the same stomach pain I had before. I can't work, I can't lift heavy things. Being a poor farmer, I don't have any money, so I had to borrow money. I have not even been able to pay the interest.
"Whatever abdominal stomach problems they are coming to doctors with, the doctors make them scared that they have cancer and are going to die. They mislead them to undergo surgery even though it is not necessary and scare the women in their greed for money," said Durga Prasad Saini of the NGO. Akhil Bhartiya Grhak Panchayat, a local NGO in Dausa district, Rajasthan, found evidence of hundreds of women who had been subjected to unnecessary hysterectomies. The NGO filed an RTI (right to information) case. Nearly 70% of the women at three of five clinics which provided information had had their uterus taken out. The RTI also revealed a large number of the women who had undergone the procedure were aged under 29, with the youngest being just 18. Complaints have been made to the police and local government, but no action has yet been taken.
Chandra Kala, a mother of two in her late twenties, was told she must have a caesarean by a private clinic for both of her deliveries. She was charged 20,000 rupees ($360) for the delivery of her first child and 15,000 rupees ($270) for the second baby she delivered recently. "Whatever abdominal stomach problems they are coming to doctors with, the doctors make them scared that they have cancer and are going to die. They mislead them into undergoing surgery that is not necessary … in their greed for money," said Durga Prasad Saini of the NGO.
I said I don't want an operation done to me, but they said I had to have one and they charged me. We are only villagers doing farming, but I managed to borrow some money from here and there. But being a farmer now I can't work, I can't lift anything heavy or bend too low, I don't feel well enough to work. I only finished off paying my debts two months ago from my first child who is now nine years old. Chandra Kala, a mother of two in her late twenties, was told she must have a caesarean by a private clinic for both of her deliveries. She was charged 20,000 rupees for the delivery of her first child and 15,000 rupees for the second baby she delivered recently.
There have been accounts of unnecessary, health-risking operations taking place in other parts of India too. Dr Satyaveer Singh, chief medical officer for a government hospital near Bharatpur, said the abuse was widespread: I said I didn't want an operation performed on me, but they said I had to have one and they charged me. We are only villagers who farm, but I managed to borrow some money from here and there. But being a farmer now I can't work, I can't lift anything heavy or bend too low, I don't feel well enough to work. I only finished off paying my debts two months ago from my first child who is now nine years old.
For private doctors to do a normal delivery, what will they get? Only 5,000 or 6,000 rupees ($90 - $110). But whenever they perform a caesarean they will charge 18, 20,000 ($320 - $360). And they will add a bed charge, a consultation charge, with all these included it's about 30,000 (approx $540). Most of the women having a caesarean face problems financially. They have to sell their assets, or lend money. There have been accounts of unnecessary operations that risk lives taking place in other parts of India too. Dr Satyaveer Singh, chief medical officer for a government hospital near Bharatpur, said the abuse was widespread:
For private doctors who do a normal delivery, what will they get? Only 5,000 or 6,000 rupees. But whenever they perform a caesarean, they charge 18, 20,000, and they will add a bed charge, a consultation charge – with all these included, it's about 30,000. Most of the women having a caesarean face problems financially. They have to sell their assets, or borrow money.
Dr Narendra Gupta from Prayas, a partner organisation working with Oxfam India, said:Dr Narendra Gupta from Prayas, a partner organisation working with Oxfam India, said:
Subjecting women to unethical and unnecessary hysterectomies or Caesarean sections for financial gain is a violation of human rights and most awful form of gender based violence. The mass hysterectomies by private clinics in Dausa is a wicked act, but such malpractice is happening in other areas as well. Subjecting women to unethical and unnecessary hysterectomies or Caesarean sections for financial gain is a violation of human rights and most awful form of gender-based violence. The mass hysterectomies by private clinics in Dausa is a wicked act, but such malpractice is happening in other areas as well.
The stories of these exploited women, damaged by doctors for financial gain, are the strongest possible testimony in favour of a comprehensive system that delivers affordable healthcare to all people. Oxfam is calling for the Indian government to make healthcare for all a priority - and on international donors to support them and back regulation of the private healthcare sector in developing countries. The stories of these women, damaged by doctors for financial gain, are the strongest possible testimony in favour of a comprehensive system that delivers affordable healthcare to all people. Oxfam is calling for the Indian government to make healthcare for all a priority – and is urging international donors to support them and back regulation of the private healthcare sector in developing countries.