Pregnant and undercover: How decoys in Haryana are taking on female foeticide, one quack or tout at a time

Santosh and other decoys like her are the fulcrum of the Haryana government and the district administration’s crackdown on self-styled babas who “guarantee” the birth of sons and “correct” the sex of foetuses with “holy threads, powders, potions and even steroids”; doctors who sell MTP kits illegally; hospitals that illegally disclose the sex of the foetus; illegal abortion clinics and hospitals; and quacks.

The community health centre and district hospital in Haryana’s Kaithal. The sex ratio in the district in 2017 was 871 girls per 1,000 boys. The number rose to 920 in 2022. Aiswarya Raj

“In 2015, an official from the office of the Chief Medical Officer (CMO) approached me to accompany a pregnant decoy to bust an illegal MTP seller. I pretended to be the decoy’s sister-in-law and we both went to the house of a woman said to be selling MTP kits. She directed us to a doctor at a private hospital. When we reached the hospital, the doctor refused to give the kit but said she would abort the foetus. My job was to ensure the decoy was not scared at this sudden turn of events,” Santosh said, recalling the first raid she was a part of. Not only is the sale of MTP kits without a prescription by a medical practitioner illegal, the MTP Act, 2002, mandates its use at a health facility and under supervision.

Thinking on her feet, the ASHA worker informed the doctor that they did not have enough money for the procedure and that her “sister-in-law” could not get the abortion in her husband’s absence. While MTP kits cost around Rs 400-500, they are sold illegally in Haryana for Rs 1,000-1,500 a piece. While married women are charged Rs 30,000-70,000 for abortion of a female foetus, the rate for an unmarried woman can be as high as Rs 1 lakh.

A few days later, Santosh and the couple returned to the doctor with cash. “The serial numbers on the currency notes were noted down before we handed over the bundle to the doctor. The team that enforces the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994, (prohibits sex selection before or after conception) and the Criminal Investigation Agency (CIA) of Haryana police were stationed near the hospital. As soon as we were informed that the procedure would be carried out, I stepped out. I took my dupatta off my head and put it around my neck — a signal for the teams to rush in and nab the doctor,” she recalled.

The community health centre and district hospital in Haryana’s Kaithal. The sex ratio in the district in 2017 was 871 girls per 1,000 boys. The number rose to 920 in 2022. Aiswarya Raj

Of incentive and scamming clients

For each successful raid, the state government awards a pregnant decoy Rs 25,000 and Rs 1 lakh to the informer. The decoys are usually 14-20 weeks pregnant at the time of these raids, CMO officials said, adding that they use a new decoy for each operation.

Officials said such raids were rare in Haryana before Prime Minister Narendra Modi launched the ‘Beti Bachao Beti Padhao’ campaign in 2015. Since 2014, nearly 1,100 raids have been conducted in Haryana, which means that at least 1,100 pregnant women have participated in these operations. Five ultrasound and two MTP centres have been raided so far this year, the official added.

They said cases of female foeticide increased, especially in the 1980s, after ultrasound machines entered the country’s medical landscape. In 2014, according to the government, Haryana had a sex ratio of 871 girls per 1,000 boys. As of May 2023, the state registered 2,14,810 births (1,02,038 girls and 1,12,772 boys and the sex ratio was 905 girls per 1,000 boys. CMOs across the state’s 22 districts are hopeful that the sex ratio will improve in the coming months.

“We have been carrying out raids and working on the ground. We see a dip in the ratio every year from May to July. The number increases in November and December,” said Dr Ashish Singla, Deputy Civil Surgeon and Nuh’s PCPNDT team in-charge.

Despite being a part of nearly 25 raids since 2015, of which 12 were successful, Santosh has never received a reward due to her role as a second decoy. Still, she continues to motivate pregnant women to pose as decoys to help the district health department and also counsels families traditionally biased towards boys. All this for Rs 8,000-10,000 per month as an ASHA worker, including incentives.

“I know families tend to favour boys; my firstborn is a daughter. When I was pregnant for the second time, everyone wanted a boy. My mother-in-law said, ‘Iss baar ladka hoga (This one will be a boy)’. And it was a boy. If it had been a girl, I would have been pressured to get pregnant again and again till I gave birth to a boy. Locals and my relatives once accused me of being responsible for the lack of male births in the area due to my work with the PCPNDT team,” said Santosh, who has studied till class 12.

Santosh, a 32-year-old Accredited Social Health Activist (ASHA) in the district, has usually participated in raids as a second decoy. Since her first raid in 2015, she has been a part of nearly 25 raids, of which 12 were successful.

In 2016, she accompanied a decoy to an ultrasound centre for foetal gender determination. “We got the scan done at a private hospital. After the scan, the doctor said it was ‘positive’. A girl was born to the decoy four months later, much to the disappointment of her family,” she added, adding that she has seen quacks use foetal dopplers connected to laptops or tablets for “scans”. Kaithal-based PCPNDT officer Dr Gaurav Punia said, “A foetal doppler is used to monitor an unborn child’s heartbeat. However, these quacks use it instead of a handheld ultrasound scanner to fool unsuspecting victims. While ‘scanning’ the abdomen with a foetal doppler, they play the video of an actual ultrasound on YouTube to trick the client into thinking they are getting a real scan.”

Sex ratio in Haryana

One of 22 officers across Haryana’s 22 districts, the 38-year-old joined the Kaithal team in 2017 and became the PCPNDT in charge in 2018. In 2017, Punia said, the sex ratio in the district was 871 but the number rose to 920 in 2022.

Recalling a particularly gruesome incident, he said a Haryana-based woman was wrongly told by an illegal centre in another state that she was carrying a girl child. “She went to a clinic in Haryana for abortion. After the procedure, to the horror of the unqualified doctor, the foetus turned out to be male. They cut off his genitals to pass him off as a girl,” he said.

Quacks also use handheld ultrasound scanners, said Punia. The small devices are available on popular e-commerce websites based out of the United States and China for around Rs 70,000. “These devices are 100 per cent accurate and their use has become rampant in India. Some of the quacks we busted had purchased them for Rs 1.5 lakh from people who got them shipped to India,” he said.

Punia has also tried to zero in on illegal sale of MTP kits online. “I had two kits delivered to my home. After successful deliveries of these kits, we sent notices to the e-commerce giants, kit manufacturers and sellers. The sale of MTP kits stopped on the platforms but the sites are yet to send their response,” he said.

Dr Gaurav Punia (38) joined the Kaithal team in 2017 and became the PCPNDT in charge in 2018. He has successfully taken on e-commerce giants, kit manufacturers and sellers over illegal sale of MTP kits online.

Talking about the role of ASHAs like Santosh in bringing down these illegal practices, Punia said ASHAs talk to pregnant women in their villages about becoming decoys, besides speaking to them about the incentive and concerns like safety. “We ask pregnant decoys to be honest when touts or quacks ask them questions. But they are rarely asked many questions,” he said, adding that the burden of making up a cock and bull story usually falls on the second decoy or the companion. “And Santosh does the job really well,” he said.

Santosh said most women join the team for the cause and not the money. She added, “I speak very confidently. Once we are in touch with a tout, he asks many questions. I usually tell him that the pregnant woman is my sister-in-law who has four girls and cannot afford to have another girl. Some touts are more persistent. They ask how we can afford to pay for a scan if we are labourers. So I pretend to be clueless about the PCPNDT Act. I also pretend to be naive regarding the possibility of a raid when they have the smallest of apprehensions.”

In their greed for money, she said, some touts don’t bother to run a background check on new clients since they usually keep 90 per cent of the cash paid by a client.

Dr Gaurav Punia, the Kaithal PCPNDT in charge since 2018, said some quacks busted by them used handheld ultrasound scanners. The devices are available on e-commerce websites based in the US and China for around Rs 70,000. He said these devices are 100 per cent accurate and their use has become rampant in India.

“However, others are extremely careful. Once, I was once taken to a hospital for an MTP kit. However, I wasn’t given one right away. The next time, I went with my husband and told them that we were in desperate need of the kit since we already had too many daughters. They gave a kit readily after that,” she said.

Unfortunately, Santosh and her family are not immune to the pressures that comes with being a decoy. Though addresses of decoys are not divulged by the health department, Santhosh was tracked down by a quack’s men, who approached her to change her statement in court. After her name started getting traction due to multiple raids and through lawyers, these men started pouring into her village.

“When a trial starts, people come to my village and talk to the sarpanch. And then my family starts to feel the pressure. They don’t level death threats, but the constant nagging wears my family down. My mother-in-law eventually got tired and scared. When the police started coming home for summons, she would get rattled. I stopped going on raids after that,” Santosh said.

The Haryana government has been taking various measures to implement schemes like ‘Aapki Beti Humari Beti’ to curb female foeticide. In May, Nuh district, 264 km from Kaithal, was served a notice by the office of the CMO over failure to check the falling sex ratio. They reported a sex ratio of 870 in April, the worst in 22 months since July 2021.

An ASHA from Nuh said, “We have a meeting thrice a month at every anganwadi. ASHAs meet pregnant mothers and women of child-bearing age to drive home the message that girl children should not be discriminated against.”

A year after she became an ASHA in 2016, 28-year-old Gurjeet Kaur was pregnant with her daughter. Posing as a decoy, she went for an ultrasound to determine the gender of her foetus. The PCPNDT team and the police left her in a village with an officer who was posing as her brother. The tout took Gurjeet, then 14 weeks pregnant, alone in his vehicle. After 20 minutes, the quack arrived in another car and took her to a farmhouse in Ahmedgarh. As they reached the farmhouse, far from the last signs of village life, she was asked to switch off her phone. Then, she was taken to a room, with curtains blocking even the tiniest ray of light. She was asked to lie down on a cot, while the man ran the small handheld device over her belly. “Instead of telling me the sex of my child, he told the tout,” she said.

‘Attacked but not scared’

While she was being dropped off at the spot where her “brother” was waiting, the tout had seemingly thrown all caution to the wind. Suddenly, the team waiting with her “brother” zeroed in on him. “The tout grabbed my neck and pushed me from the vehicle. I was not expecting that at all. I was scared, but the team ensured my baby and I did not get hurt,” she recalled.

Though the centre was sealed, the quack, Malkeet, who has 11 FIRs against him, got away with the scanner. He was arrested in another raid in the state in July.

During these raids, the teams don’t rely on phones or WhatsApp to relay the decoy’s location. A small device is stuck to their bodies and the team keeps a watch from a distance of 5 km — close enough if something goes awry, but far enough to throw quacks and touts off their scent, an officer said.

Gurjeet, who is responsible for the health of 659 villagers in Kaithal’s Harnola, said at the time of the raid, she was carrying a “negative” test result, which implied that she was expecting a girl. “I am yet to give my statement in court,” she said.

Gurjeet said she was not disheartened after her first raid. In 2020, pregnant once again, she went undercover to get another scan. “This time, it was a boy. They told me right away,” she said. It was a watertight case, Gurjeet said, since the informer had told them the location and the quack was involved directly. Gurjeet and an officer posing as her husband were taken to the centre on a scooter by the quack. He was breaking the “good news” to her “husband”, when she signalled the team stationed nearby. “He was sent to jail but got out after five months,” she said, adding there is no information on the quack’s current whereabouts.

For some quacks, mere word of mouth is not good enough. “One quack was so careful that he asked his touts for wedding photos. When the team raided his shop, he managed to get away. The team has never been able to catch him,” she said.

An informer who helps bust illegal clinics with his team of 36 direct sources said, “We work on a case for about six months. At times, there are as many as six men working between my source and the quack. The trust, network, money and risk involved are studied carefully and that takes time. Once I get a green flag that the raid will be successful, I inform the team,” he added. Officials said very few raids are conducted as soon as the team receives a tip-off.

The informer added, “Once I learn of a centre working in Rajasthan, UP, Delhi and Haryana, I work with my contact in the area. They dress up as a local, speak the local dialect and get in touch with the tout. I coordinate with my contact closely and tell them a convincing story for the tout. Some tours are smart and we have to ensure there are no loopholes in the narrative. In some instances when a raid is successful, the doctors or quacks find a way to escape or get bail. It is the tout who ends up going to jail.”

Talking about planning a raid, Punia said, “Most raids take time to plan. Information on places conducting illegal ultrasounds is mostly received at a very short notice, usually a few hours. However, the informer is working behind the scenes for about six months at this stage. The time taken to plan raids can range from a few days to 2-3 months. We go back to these culprits till we are able to destroy their operations. This is why we take time to plan raids.”

Lamenting the low conviction rate despite successful raids, Punia said even if touts and quacks get caught, they are released and go back to illegal sex determination. “Conviction rate is usually between 10-15 per cent. Most cases take at least 4-5 years in lower courts. The wait has become even longer since the pandemic,” he said,

Cradling her son, Gurjeet, who retired as a decoy after her third child, said, “I got a tubectomy after my third child. I wanted a boy since my husband is the only man in the family. Now I just speak to expectant mothers about how sex selection is wrong.”