By Gajanan Khergamker

“We have all read the fable of a shepherd and tiger, the way media is cooking up rape stories, it would be difficult to believe even a genuine rape case,” is what Mamata Banerjee had said with regard to the spurt in rape cases in West Bengal. She claimed the media was to be blamed for the ‘rise’ in number of rape cases in her state. While it was, on the face of things, a political attempt to save face by placing the blame squarely on the media for its coverage, the slack in enforcement and failure on its part to protect women in the state is evident from official figures.

The National Crime Records Bureau figures indicate West Bengal, along with Andhra Pradesh, had registered record high rates of crime against women in 2011. According to the report, West Bengal accounted for nearly 12.7 per cent of total crime against women by reporting 29,133 cases. Also, of the 24,206 rape cases reported all over India, West Bengal registered a total of 2,363 rape cases in 2011, coming second to Madhya Pradesh which recorded a total of 3,406 rape cases.

So, when the CM charged the media with fabricating rape cases to such an extent the state is having a hard time sifting out ‘genuine’ rape cases from the lot of fake, she really needs to look at the  state’s ‘official’ dismal performance in the regard before making such comments.

When a state head, and a woman herself, talks loosely about a crime as heinous as rape by saying that representatives of the media with vested interest were paying women to file fake rape cases, it only dissuades the affected from coming forward and filing complaints for fear of it not being taken seriously.

After all, not every woman is as strong as P. Vasanthi who reportedly refused to buckle under pressure and ensured that her complaint mets its logical end. Tamil Nadu’s Theni District-based victim P. Vasanthi claims she was picked up along with her three-year-old son, from a bus stop by a policeman in the night and taken to a police station only to be assaulted and raped in front of her child.

That her complaints to the authorities went unheeded didn’t dissuade Vasanthi who dashed off a letter to DGP, National Human Rights Commission and the Women’s Right Commission.

Incidentally, she approached an NGO which helped her petition her case before Madras High Court. The NGO also helped her retrieve evidence of police brutality from the records of the prison medical officer and the Trichy government hospital through RTI applications.

It was revealed the doctors had attended to Vasanthi and recorded she bore multiple injuries, especially from her waist down to the legs. Also, the doctors, reportedly, found her face was swollen and left ear hurt on arrival.

Theni’s SP Praveen Kumar reportedly said he didn’t know about the RTI application but said they didn’t register her FIR because her complaint was baseless. The matter is still in court and is awaiting justice.

It isn’t for the first time that police officials in authority have been charged with misusing power to molest, assault or rape women. There have been convictions on the count, across states, as well.

So, when a politician like Mamata Banerjee makes public statements about women filing fake rape cases, it only lends an air of incredulity to the charge of rape itself and almost exonerates sexually-deviant officials who would continue to misuse authority.

A little earlier, Anna Hazare’s team member KiranBedi found herself in the news for a similar faux pas. She had, allegedly, said the media was not giving enough importance to serious issues of corruption but were giving coverage to “small rape” cases.

The retired lady IPS officer was flayed widely in the media for making light of an issue as grave as rape speaking volumes about much safety of women is given importance.

Apart from India, politicians across the world are known to make disparaging comments about women. Just a few days back, an US Republican was reported to have said ‘derogatory’ comment against rape which caused uproar in the US.

US Republican Todd Akin said “From what I understand from doctors, (pregnancy resulting from rape is) really rare. If it’s a legitimate rape, the female body has ways to try to shut that whole thing down. But let’s assume that maybe that didn’t work, or something, you know, I think there should be some punishment but the punishment ought to be on the rapist.”

Mamata Banerjee who seemed to have made a habit of claiming all rape cases in her city are fake had reportedly asked the media to see the ‘positive’ side of rape stories. She made this remark while speaking to the media following the rape of a Mumbai-based woman in a park. She claims that the “rape and murder” stories have been cooked up to “malign the government.”

So, from blaming women for enticing men into rape them, trying to figure if the rape was ‘legitimate’ or not, dismissing rape as a petty offence to stating women had made a ‘habit’ of filing fake rape cases and taking money for the same, sadly, seems to have become a favourite line for politicians and officials alike. A few years back, in Mumbai, when an inebriated More raped a teenager at a crowded Marine Drive police booth, it vindicated popular fears of a sexually-depraved lot on the loose and in the police force.

When a two-year-old girl is raped by her neighbour, would you blame her for ‘enticing’ him? Or absolve a father for raping his daughter to ‘satisfy’ his demands who says it’s the daughter’s duty to fulfil his needs?

(Readers keen on seeking help on draftingRTI applications may write in to This email address is being protected from spambots. You need JavaScript enabled to view it. or call Gajanan Khergamker on 022-22841593 for any assistance on RTI or to have their findings / issue featured here)

 

“I don’t have a degree but I have experience,” is what quack Zulekha Sheikh reportedly said after she was arrested in February, last year.

Zulekha Sheikh, who claimed to be a doctor, had been running a 13-bed Warsi Hospital in Mumbra for years before it was shut down this June. The hospital was once shut down five years back for illegal abortions but it was reopened recently when Sheikh said she hired a new qualified doctor to run it.

Warsi was reportedly run as a family business. Initial reports indicated, Zulekha portrayed the resident doctor, her matriculate passed daughter played nurse and 11th standard student son playing the ward boy apparently without fear of the law.

It was only a couple of month ago, when a healthy 22-year-old Hina Sayed who delivered a healthy baby in Warsi hospital died of profuse bleeding allegedly owing to medical negligence, that the issue came to light. Hina took her last breath while being shifted to another hospital and declared dead on arrival. Zulekha was arrested after the police were called in.

Despite reports of uneducated ‘doctors,’ under-qualified ‘nurses’ and junior college student ‘ward-boys’ running a medical show undeterred for years, the Brihanmumbai Municipal Corporation’s (BMC’s) Executive Health Officer rather oddly suggests there are only 43 fake doctors in Mumbai.

It was following an RTI activist’squery to the BMC asking for the number of quacks in the city identified by the civic health department that the corporation provided the reply that seemed preposterous on the face of it. Although there are more than a dozen ‘qualified’ doctors in a single slum, the civic body’s assertion of there being 43 such doctors in the entire city comes as a shocker.

Although the RTI query was filed in April 2011, the reply came only in January 2012 i.e. a good eight months for the BMC to collate the figure. According to the statistics with the BMC, the total number of doctors in the city range from 35,000 and 40,000 and of these, barely 43 are quacks.

Delhi with a population of around 1.38 crore has an estimated number of 40,000 quacks and in comparison, Mumbai with a population of 1.24 crore, has barely 43 quacks. There evidently seems to be something amiss here, doesn’t it?

Zulekha Sheikh went on with her practice for years after being arrested. The so-called-doctor who claimed she learned to be a doctor by observing other doctors’ work went on with her work and risking other people’s life for years on end.

A string of allegations emerged following Hina’s death. In one, an old man who came to Warsi hospital complaining of a stomach ache, reportedly due to appendicitis, allegedly died because the ward boy pressed his appendix by mistake which went on to burst thereby killing him.

In another case, a new-born baby was allegedly dropped on the floor by the hospital staff causing permanent brain damage while a pregnant woman’s abortion reportedly remained incomplete despite a Medical Termination of Pregnancy procedure undertaken at the Hospital.

Incidentally, barely five months after BMC released its report stating there were only 43 quacks in the city, the District Health Officer was ‘alarmed’ by the number of fake doctors in the district and started conducted raids at many places.

In May last, eight bogus doctors were arrested in Nalasopara in a drive conducted by Vasai Virar Municipal Corporation (VVMC). It has been reported that there are around 300 bogus doctors in Vasai Virar region – which has a population far lesser than Mumbai.

Three years back, a ‘fake’ doctor was arrested from Bombay Hospital after, equipped with fake certificates, he ‘treated’ patient for seven years. It may be recalled that scientist Munir Khan too was in the news for practicing and selling his ‘wonder drug’ for years in Mumbai before being arrested in 2010.

His wonder drug, he claimed cured every disease including cancer, turned out to be nothing but a few herbs mixed in honey.  What is ironical is, before starting his own ‘ayurvedic research’ Khan used to work as a compounder for an ayurvedic doctor, who years later went on to claim the ‘wonder drug’ was his creation and Munir stole it from him.

In 2009, four fake doctors were arrested from Andheri for selling ‘a white powder’ which, they claimed, cured skin diseases.

While there had been reports across the nation of an Ayurvedic doctor killing patients by performing surgeries or another treating a patient for ‘acidity’ when the patient was having chest pain owing to heart blockage, Maharashtra even planned a move that would allow ayurvedic, unani and homeopathic doctors to prescribe allopathic medicines legally.Thankfully, the move was opposed by the Indian Medical Association that moved court against this decision.

On this decision, IMA State secretary Dr Jayesh Lele reportedly said, “This step of the state government shows it is bypassing not only the Medical Council of India, but also the decision of the court (In 1996, the HC had said that doctors registered with the Maharashtra Council of Homoeopathy will practise only homoeopathy and not any other stream of medicine). If the government is serious about providing better healthcare, it would have focused on improving amenities in rural areas and giving better working conditions to doctors. This ‘crosspathy’ will only serve to provide a platform for quacks.”

Already there are ayurvedic, homeopathic and unani doctors who practice and prescribe allopathic medication illegally due to various reasons varying from corruption among officials, ignorance among people and failure to adhere by norms. The state’s plan to allow them practice allopathy legally is perceived as the perfect recipe for disaster.

“This lenient attitude of the state towards quacks or doctors of one stream prescribing medicine from other streams has what led Munir Khan to loot people of lakhs of rupees openly and to top it advertise about it on media channel. This so-called doctor who used to sell a 100 ml bottle of his wonder potion for Rs 15,000 duped hundreds of unsuspecting patients of lakhs of rupees before the law caught up with him,” feels a medical practitioner on grounds of anonymity.

The state and the city’s civic body needs to urgently relook at rectifying the anomalies that risk thwarting public health instead of sweeping it below the carpet by arbitrary regularisation.

(Readers keen on seeking help on drafting RTI applications may write in to This email address is being protected from spambots. You need JavaScript enabled to view it. or call Gajanan Khergamker on 022-22841593 for any assistance on RTI or to have their findings / issue featured here)

By Gajanan Khergamker

It didn’t come as a surprise when the Annual Health Survey (AHS), findings revealed recently, the number of caesarean delivery in private hospitals across the nation was more than that in government hospitals throughout India.

The findings endorsed those revealed by an RTI query filed in December last. The query threw up scary facts of the situation in Mumbai. In 2008, a total 77,533 deliveries were conducted in private hospitals in Mumbai of which a whopping 18,194 or 23.47 per cent were C-sections. The numbers only went on to grow to 26.35 per cent in 2010.

While the recent Annual Health Survey’s findings that private hospitals opt for Caesarean section over normal vaginal deliveries didn’t come as a surprise, what was of concern was the huge differential. It revealed the number of caesarean deliveries in private hospital was almost three to 10 times more as compared to government hospitals.

Figures in some of the states were far worse than one could comprehend. In Assam, 10 per cent of deliveries in government hospitals were by C-section while in private hospitals, the percentage rose to 41 per cent. Likewise, in Bihar only three per cent of deliveries were done by C-section in government hospitals while this share rose to 22 per cent in private hospitals.

This data was collected by the Census office during the period  between July 2010 and March 2011 covering a sample of 1.8 crore people in over 284 districts in 9 states - Assam, Bihar, Chhattisgarh, Jharkhand, Madya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand.

These states were selected because they had a history of poor health facilties and had been given special attention by both the government as well as non-governmental agencies.

ONLY 10-15 PC OF BIRTHS NEED SURGERY - WHO GUIDELINES

According to the World Health Organisations guidelines, only 10-15 per cent of the births require surgical intervention in India. But many disagree with these guidelines as some gynaecologists believe there are several complications that can arise during the entire term of pregnancy which cannot be predetermined and so fixing a number to it was difficult.

A study published in National Journal of Community Medicine revealed the presence of factors that affected the rate of Caesarean deliveries in India. Reasons varies from psychological, the medical institution in question and socio-demographic factors which play vital roles in the rise in number of C-Sections.

According to this study, there was a vast variation in the figures across states and rural and urban areas ranging from 2 per cent – 30 per cent. Also, there is large difference between births in public and private health facilities averaging almost 30 per cent.

THE ABSENCE OF ‘INFORMED CONSENT’ ALSO A TRIGGER

The study stated ‘Evidence shows that patients who are knowledgeable about their conditions are able to actively participate in shared decision-making. Due to their ignorance about childbirth, they just submissively do what their provider tells them to. Therefore, they can’t effectively talk about birth interventions with their providers, and agreeing for Caesarean delivery for medical and even for non-medical reason without knowing true risk and benefits of the procedure.

Since many providers (doctors) prefer doing caesarean sections, the ignorance of pregnant women is probably what is raising the caesarean section rate.’

In another cross-sectional study of 247 women (published in National Journal of Community Medicine) undertaken in an urban health training centre field practice area of a tertiary care hospital at Nagpur, 65.1 per cent of the women admitted they had very little knowledge about a Caesarean Delivery and 54.7 per cent admitted that whatever knowledge they had was from family and friends.

The study also revealed more than half of the respondents, i.e., (63.6%) conceded that doctors/ hospitals were deliberately opting for caesarean deliveries instead of normal vaginal deliveries.

Other than lack of knowledge, the labour pain associated with normal deliveries is also one of the reasons that women themselves prefer caesarean deliveries. Also, there are a few who prefer caesarean for astrological reasons i.e. wanting a child to be born on an auspicious day. It was revealed that 85 per cent of women who had had their first delivery by Caesarean section have their second delivery by C-Section as well.

According to a finding by University of Washington, women with a prior caesarean section, who undergo labour for their second child, are at increased risk of a rupture of the uterus compared with women who elect another caesarean section birth.

In a first of its kind move, Turkey has banned C-Section delivery and elective caesarean is punishable by law. Turkey has one of world’s higher caesarean rates with almost 48 per cent of births being C-Section. According to their health ministry, up to 70 per cent of all births in some private hospitals involve caesareans.

The Turkish ministry accuses doctors of pushing women towards the operations out of greed – they cost 1,000 lirai.e. aroundRs 24,000 more than natural births in some private hospitals.  Opting for C-Section delivery in Turkey is now a crime punishable with fine of up to 1,000 lira.

Reportedly, China by far has the highest number of women opting for C-Section delivery. Reportedly, almost half pregnant women in China opt for C-Section delivery over normal.

A World Health Organization study, which reviewed 1,10,000 births from nine countries in Asia including India in 2010, revealed more than 60 per cent of the hospitals studied, where these C-sections took place, did it for financial gains and not because it was required.

A C-Section costs upto 4 times more than normal birth

On an average, a C-Section delivery in India can cost anywhere between Rs 30,000 to Rs 80,000 depending on the hospital and the facilities whereas a normal delivery in the same situation will cost somewhere around Rs 20, 000 to Rs, 60,000. It’s said that every forth pregnant woman in the city opts for caesarean section delivery over normal ones and this number only increases in women in the higher age group.

While most of the hospitals and doctors opt for caesarean section delivery for monetary gains, most women opt for it to avoid pain. But what these women don’t realise is that unnecessary C-sections are not just costlier, but relatively dangerous as well.

 

According to a study published in the Lancet, women who undergo a Caesarean section without requiring it were 10 times more likely to be admitted to ICU than those opting for normal vaginal delivery.

In cases where labour had already started, women who had a surgical delivery despite not requiring the procedure were 67 times more likely to be admitted to ICU than those who had a natural birth.

(Readers keen on seeking help on drafting RTI applications may write in to This email address is being protected from spambots. You need JavaScript enabled to view it. or call Gajanan Khergamker on 022-22841593 for any assistance on RTI or to have their findings / issue featured here)