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India still fighting to 'save the girl child'

by Amelia GentlemanInternational Herald Tribune
April 15th, 2005

In his well-appointed, air-conditioned ultrasound clinic in South Delhi, Dr. Varun Dugal is doing his utmost to enforce a law that bans him from revealing the sex of an unborn child to pregnant women.

A government-issue sign informs patients of this in Hindi and in English: "Here pre-natal sex determination (boy/girl before birth) is not done. It is a punishable act." A poster, tries a more emotional approach, depicting the pleading eyes of a young girl, and begging "Save the girl child." Patients are obliged to sign a form, declaring that they do not want to know the sex, before an examination can begin.

Despite the warnings, the majority of his clients still try to squeeze the information out of him.

"They ask me casually as they leave 'Doctor, should I buy pink or blue?"' he says. "I lose business because I won't tell them. There are plenty of other clinics nearby where they can find out."

New government figures reveal that this expensive area of Delhi - one of the most elite, prosperous areas of the Indian capital - has a growing aversion to girls. The sex ratio at birth has dropped to 762 girls for every 1000 boys, according to a study of births registered in South Delhi in 2004, conducted by the Center for Social Research. It is the lowest such ratio in the capital and one of the lowest in the entire country.

Over the past 15 years, as cheap ultrasound equipment has become readily available, the number of people deciding to abort female fetuses has soared, and despite government attempts to ban the practice, the number of girls being born has plummeted.

With its fleets of expensive cars parked by the roadside, South Delhi seems a peculiarly modern and sophisticated place to be manifesting such an ancient prejudice. A preference for sons over daughters is often explained by India's dowry traditions, which make having a daughter an expensive burden for poor families; but most of South Delhi's inhabitants appear rich enough to shrug off dowry payments.

Dr. Puneet Bedi, a fetal medicine specialist based in South Delhi who has been campaigning against the problem for 20 years, said different factors create this phenomenon.

"In South Delhi, people don't look at this as a life or death issue, or even as an ethical question," the doctor said.

"It's just an extension of our consumer culture. If someone can afford to buy a Mercedes, they feel they can afford to secure themselves a son. If they can pay for an ultrasound, then they don't need to have a daughter - that's the logic."

He added: "Feeling sad is still a widespread reaction to the birth of a daughter, even in prosperous areas. Dowry remains an issue for the urban elite - the amount which people are expected to pay is ridiculous, and it's not just the dowry, it's the obscenely extravagant weddings which have to be laid on, too."

Aside from the costs of dowries and marriages, there are other reasons why daughters are seen as less desirable. After marriage, a woman traditionally lives with her husband's family, leaving her own parents to be looked after by a son, if there is one, in their old age. Sons carry on the family name and often the business, usually inherit the property and perform the last rites.

"It's a misconception to think that this is a problem related to extreme poverty," said Karuna Bishnoi, a Unicef official. "It's quite rampant in upper and middle class families. Female feticide is very high in Punjab and Haryana - some of the best off states in the country. Ultimately, it's a reflection of the low valuation of girls in our society."

Rasil Basu, the chairwoman of Ekatra, a nongovernment organization for women, which has been studying the phenomenon, agreed.

"Even if there's money in South Delhi, there has been no attitudinal change," she said. "The mind-set remains - girls are not important, girls are a burden, sons are more useful. With India's new lifestyle culture, when people are rich they want to spend their money on things, not on dowries or marriages for their daughters."

After almost a decade of delays, the Prohibition of Sex Selection Act came into force in February 2003, aimed at preventing the use of ultrasound examinations for sex determination. Pregnant women who seek help for sex selection could be sentenced to a three-year prison sentence and fined 50,000 rupees, while doctors could be suspended. However, no case has yet come to court.

Campaigners complain that the legislation is impossible to enforce.

Some doctors are happy to provide this service to parents desperate to have a son, in the belief that they are preventing the birth of an unwanted child.

The method of revealing the sex may be oblique - the doctor will hand out blue or pink candy to the family members as they leave, or remark during the examination: "Your child will be a fighter" or "The baby is like a doll."

Since the implementation of the legislation, the business has gone underground. Doctors who will disclose the sex expect an under-the-table fee for breaking the law, ranging from a few hundred rupees in poorer areas to several thousand in more prosperous regions.

Bedi argues that the medical fraternity has not been sufficiently regulated.

"It's a very profitable business. The machines have become cheaper, so an entrepreneurial medical graduate can quickly set up a business," he says. "It may be illegal but it's very rare that India's medical council debars anyone for ethical malpractice."

Based on the number of births in Delhi every year and the sex ratio across the capital - 814 girls for every 1000 boys - Bedi calculates that about 24,000 female fetuses are aborted in the capital every year, and about one million across the country.

Unicef has warned that unless steps are taken to address the problem across the country, India will soon face unexpected social problems - men unable to find brides, gaps in the workforce, increased incidences of trafficking of women.

According to official census figures, India - with its nationwide ratio of 933 women for 1000 men - had a deficit of 35 million women when it entered the new millennium.

Attempts to regulate women's right to abortion inevitably raise delicate ethical questions, but for Bishnoi of Unicef, this is not a pro-choice or pro-life issue.

"Equality is a fundamental right," she said. "This discrimination takes precedence over arguments about women's reproductive rights."

Despite the prevalence of the phenomenon, the decision to abort a female fetus remains a taboo, and it is difficult to persuade women to talk about the issue. But a UN Population Fund Study cited the case of Mr. and Mrs. Ravi, who had three children, to show that a preference for sons is not just a working class issue.

"Their eldest daughter is 23, a second daughter is 21 and a son is 10. Before delivering the son, Mrs. Ravi undertook nine sex determination tests and had eight pregnancies medically terminated," the report states. "She died two days after giving birth to their son.

Her doctor had advised her not to get pregnant as it could pose a threat to her life. Mr. Ravi is a senior executive in a multinational company and the late Mrs. Ravi was a teacher in a public school."

Dr. Sabhu George, another long-time activist in this field, said the shortage of girls is increasing across India, as illegal, laptop ultrasound units travel to remote areas that do not yet have electricity or water. Nevertheless, the problem remains much more intense in areas like Delhi, which have greater access to medical services.

"Whereas in the 1980's people weren't keen to have a second or third daughter, now they don't want their first child to be a girl," he said.

"What we are seeing in South Delhi is very dangerous," he said. "It's these privileged people who set the standards of what's acceptable for everybody in the rest of the country."

George said the situation was unlikely to improve unless a stronger medical regulatory body was created in India and until cultural prejudices were addressed.

"India's attitude to women can be summarized by this old saying: 'If a woman dies, then the man has a chance to get a second dowry. If a buffalo dies, then it's an economic disaster for the whole family.' This has to change," he said.

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