Sterilisation sans basic needs rampant in India

A study on the quality of services delivered under the Indian family welfare programme at one such camp in a rural taluk hospital in Palakkad district of Kerala found that even the most basic needs of women like space for rest and toilet and water facilities were not available.

Laparoscopic sterilisation has been available in india since the early1980s. Though requiring a very high level of skill on the part of the physician it can be performed on an out-patient basis under local anesthesia. Women find it more acceptable because it can be performed quickly and leaves only a very small scar. However, sterilisation and the disinfection of instruments has to be strictly followed to eliminate any risk of infection.

In keeping with guidelines, the maximum number of laparoscopic sterilisations that can be carried out by a single team using two laparoscopes in a period of two hours is six. However, the camp in Palakkad was carrying out as many as 48 sterilisations in two hours, says Mala Ramanathan of the Achutha Menon Centre for Health Science Studies here and a co-author of the study.

Quality of service delivery is often discarded by the short-staffed trained medical personnel, who buckle under pressures exerted by heavy demand for laparoscopic sterilisations. Ironically, the poor conditions prevailing at sterilisation camps in palakkad are much betterthan elsewhere in the country, Ramanathan said.

She cited studies in rural Bihar which indicate that sterilisation camps are conducted in makeshift locations without even a thought to aseptic conditions. School classrooms have been used without any effort to disinfect them prior to operation. Rusted, broken down tables draped with soiled rubber sheets were found to be used as operating tables. Surgeries have been performed with just one bucket of water for the surgeons to disinfect their hands before operating. The same syringe was reportedly used on all the patients and at times, operations were conducted using battery-operated torches as the only source of light.