What happened at Bilaspur in Chhattisgarh during the sterilization program as part of the family planning initiative is a tragedy of unimaginable proportions and our heart goes out to the young poor women who died a tragic death during the procedure and their families. We also pray for the speedy recovery of the patients who are seriously ill following the procedure.

This is an incident that should never have happened and it is the duty of the nation to do justice to the victims of this extremely sad and preventable tragedy and ensure that this never happens ever again.

The need of the hour is an impartial honest enquiry into the incident – punish the guilty, a generous assistance to the affected families to help them deal with this very unfortunate and extremely sad incident. Most importantly, put in robust implementable measures to prevent these tragedies in the future. The greatest disservice to the women who have lost their lives would be to forget the incident in a few months, brush the enquiry findings under the carpet and carry on with life as usual. I am hopeful the government and the courts will not allow this to happen.

Population control is certainly a very important and vital tool in helping our nation to move forward and we should not lose sight of it in spite of this terrible tragedy. If we do we will soon overtake China as the most populous country and it will be an unbearable burden on the nation.

The tragedy of population explosion is that it drags down the economy and by and large a poor socio economic status leads to population explosion, as is very evident in the population growths in the developed vs developing countries.

There are many reasons for this. By and large the infant and childhood mortality is higher in the poorer nations and this may be one of the reasons to have more children so that at least some of them grow on to be adults. Also many of the children in the poorer sections of the society are put to work which becomes an additional source of income for the families.

It is truly a Catch-22 and we need to come up with novel ideas of breaking this cycle.

There are many ways of controlling the population

  • Educational and awareness campaigns
  • Temporary measures like the birth control pills, barrier methods (condoms), intrauterine devices like Copper T etc.
  • Permanent measures like tubectomy for women usually done laproscopically now a days (as happened here) and vasectomys for men

Of all these procedures for various reasons tubal ligation is a very common and popular procedure in India, and right or wrong, we probably do the largest number of sterilizationsin the world. We need a serious rethink on this and unless we can provide a safe environment for the women undergoing this procedure we should look at alternate means of controlling the population.

Incentives to have lesser number of children both in the private and public sectors and disincentives for larger families are a very powerful tool (widely practiced in China albeit in an autocratic way which we cannot and should not do).

In my opinion improvement of the socio economic and educational status of the general population is the most powerful tool of controlling the population but unfortunately is a slow and difficult process.

Let us all work together to do justice to the victims of this tragedy by ensuring we have an honest, impartial transparent enquiry, punish the guilty, assist the families in all ways possible and most importantly take measures to prevent this in the future. At the same time let us not lose sight of our long term goals of population control in a safe controlled humane manner which is absolutely needed to take the country forward.

Dr H Sudarshan Ballal, MD, FRCP(London)
Chairman – Med Adv Board & Medical Director – MHEPL,
Manipal Hospitals, 98, HAL Airport Road, Bangalore-560017
Email: s.ballal@manipalhospitals.com

Disclaimer: The views expressed in this article are of the writer and not of the hospital.

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