In the last post I discussed how women are being systematically killed all over the world and the negative consequences this has for the health of society. I ended with a question: what does the concept of missing women look like on the ground?
It’s a strange phenomenon that’s actually hard to see. It’s not like there’s an obvious lack of women walking around the villages or households that are devoid of a female presence. If anything, women stand out in rural Rajasthan with their brightly coloured suits, smiling faces and vibrant personalities. I’ve also barely seen the type of overt, often state-sanctioned violence against women that’s common in places like Saudi Arabia, Yemen, Iran, Afghanistan and Pakistan. Where I am in India, femicide is more hidden behind closed doors and sanitized through sex-selective abortion – killing your daughter before she can smile at you undoubtedly makes it easier. Living and working here for the better part of a year, as I have now, has allowed me a peek behind the veneer.
Mostly, the missing women phenomenon is perceptible only through rumour and echo. Several months ago there was news of an honour killing in a village about an hour away from us in 35BB. There are hushed stories of people who have had multiple sex-selective abortions (including stories of accidentally aborted male fetuses). During our village surveys, many mothers expressed their grave fear of giving birth to a second or a third girl, especially if they hadn’t yet had any sons yet. And then there are the extra wide smiles of the family-members blessed with a baby boy compared to the muted joy of those blessed with a girl.
All of this is obviously intangible and what I’m hearing and seeing is most likely influenced by what I know. But there is one concrete, undeniable thing that has really brought this issue home for me: Of the over 200 babies that have been delivered through our facility, boys far outnumber girls by a ratio that’s far worse than those listed in government surveys. The district of Ganganagar, where our hospital is located, has a sex ratio of 861 girls to 1000 boys (much worse than the overall Indian average). Our ratio at birth, meanwhile, is 640 to 1000.
What does this mean? First of all, it must be said that not a single person on our team condones sex-selective abortion or would facilitate it in any way (they wouldn’t be on our team if they did). We are firm in our beliefs on this principle and fully attend to Indian laws which forbid revealing the sex of a foetus to parents or family members. The problem is that despite these laws there’s just too many places people can go to get the information they need. As I alluded to in the last post, even the most reticent of medical practitioners can succumb to parents willing to pay a lot of money to get the information they need. The problem is, people are coming to our prenatal clinic and then going elsewhere for sex-selection services.
So what do we do about this issue? To be a truly impactful maternal and child health centre – and to aspire to big societal changes – this is a complex issue that we’ll have to contend with.
Unfortunately, there’s been a lot that’s been tried already and not a lot has worked. Both the Indian government and civil society groups have been involved in this issue for some time. The government, for example, has passed strict laws forbidding dowries, sex-selective abortion or the use of ultrasound and amniocentesis technology to reveal the sex of a foetus. None of these laws really work because they’re very hard to enforce. The government has also enacted programs such as the National Plan of Action for the Girl Child (1991-2000), The National Policy for the Empowerment of Women (2001), and several others which try to address the issue. Local and international non-governmental groups have, with some success, tried to increase the perceived value of women.
The bottom line is that boy-preference is culturally ingrained and remains fairly immune to laws or NGO’s trying to impose a different point of view. The upside is that the conversation has started and it’s important for us to keep this issue in the forefront of our minds as our project expands and becomes more established. It will be important for us to actively be a part of the conversation – to enact awareness programs, conduct research and even do some advocacy – to hopefully nudge a tipping-point in the mentality of, at the very least, the families that come to us for care.
These are not strictly clinical or medical solutions to achieving our objective of improving maternal and child health outcomes in Ganganagar. They are absolutely vital to achieving those objectives nonetheless. I think it’ll be important to build on what’s already here – not everyone, not even most people, believe in sex-selection and most value the presence of daughters, sisters and mothers in their lives. Perhaps we can take my grandmother, Kartar Kaur, for whom our prenatal clinic is named, as our inspiration. She bore 10 children on the very spot the Mata Jai Kaur hospital is being built – 5 girls and 5 boys. The perfect ratio.
All photos copyrighted