New Delhi, November 11
Prime Minister Narendra Modi today asked for a thorough probe into the death of 11 women at a mass sterilisation camp in Chhattisgarh's Bilaspur's district in the past two days. The condition of two women is extremely critical.

The camp, attended by 83 women at a government-run Nemi Chand Hospital, was part of a routine exercise in several states to achieve population stabilisation goals and the total fertility rate (TFR) of 2:1 (two children per woman).

Such camps, where doctors conduct sterilisations mostly under allotted targets by states, have gone on for years even though the Centre had banned the targeted approach many years ago.

The latest case is the worst in the history of female sterilisations in India. In 2012, 53 women in Bihar's Araria fell seriously ill following sterilisations in unhygienic conditions in a school with no running water. Local activist Devika Biswas had filed a public interest litigation seeking directions to prevent tubectomy of poor women in the name of population control. The matter is pending in the Supreme Court.

The Chhattisgarh Government has removed Director Health Dr Kamal Preet Singh along with sterilisation camp in charge RK Gupta. Three doctors have been arrested.

Chief Minister Raman Singh will arrive in Delhi tomorrow to meet Health Minister JP Nadda who today said the Centre had asked for a detailed report from the state government.

Though the reason of deaths is unclear, Health Ministry officials fear use of infected instruments during the operation. The state government was also looking into the possibility of low-priced fake medicines being administered to victims.

India must achieve TFR target of 2.1 to stabilise its population. The current TFR is 2.4. As many as 23 states and UTs have achieved 2.1 TFR. In Chhattisgarh, however, the TFR is high at 2.9.

A Health Ministry official said the targeted approach for population control was banned long ago. Laggard states, however, tend to conduct sterilisations to achieve TFR targets, they said. In India, sterilisation remains the chief of population control with female sterilisations making up 96% of all operations and vasectomies (male sterilisations) being minimal. Only half of India's married couples use other forms of birth control.

The Centre had laid down standard operating procedures for sterilisation camps in 2008. These include getting women's consent, information regarding permanence of the procedure and its risks. Sources, however, said most of the norms are violated. Many states offer incentive to Accredited Social Health Activists (ASHAs) to motivate poor women for sterilisations and also pay doctors per procedure. The woman is also paid to undergo the operation.

In Bilaspur, Rs 1,400 was fixed as the subject's incentive with 83 women being operated in five hours. Hygiene was clearly not ensured, said Health Ministry sources. They also feared that pre and post-operative care mandatory under manuals was also not offered.

One of the arrested doctors admitted that the team had targets to meet. Another doctor said the target given to them was 40 sterilisations per day, but actual operations conducted were double in number.