Tainted or sub-standard drugs probably led to the deaths of 13 Indian women after sterilisation surgery at a family-planning "camp", and owners of the factories that produced them have been summoned for questioning, a senior official said yesterday.
Meanwhile, the doctor who carried out the sterilisation of 83 women in under three hours at a hospital in the eastern state of Chhattisgarh denied reports the equipment he used was rusty or dirty, and blamed adulterated medicines for the deaths.
“I am not the culprit. I have been made a scapegoat. It is the administration which is responsible for this incident,” said Dr RK Gupta after being taken into custody on Wednesday night.
Gupta said health workers gave the women ciprofloxacin, a commonly prescribed antibiotic, and the painkiller ibuprofen after operations conducted at the weekend in a grimy room of an unused private hospital in a village called Pandari.
Thirteen have died and scores are in hospital. Some of the sick women were operated on by another doctor at a second camp, which Gupta said was evidence he was not to blame.
The government of Chhattisgarh, one of India’s poorest states, banned medicines used at Gupta’s sterilisation camp, including Indian-made brands of ciprofloxacin and ibuprofen.
“Owners of the companies responsible for the sale of drugs have been summoned,” said state chief minister Raman Singh. “They will all be questioned and we have sealed their factories.”
State health officials said police raided a local company, Mahawar Pharma, which had provided the antibiotics. The company's director, Sumit Mahawar, declined to comment.
One of five doctors who have conducted autopsies said the postmortems were inconclusive and recommended chemical analysis for a clearer picture.
“It is a mysterious case,” said the doctor, who declined to be named. “It can be drug toxicity, infection. We believe some mistake has been (made) but it’s purely accidental.”
India is the world's top steriliser of women and efforts to rein in population growth have been described as the most draconian after China. Indian birth rates fell in recent decades, but population growth is among the world's fastest.
With more than four million Indians sterilised every year, a system of quotas encourages officials and doctors to cut corners, say activists.
Rights groups say India’s sterilisation programme is coercive because ill-educated women are often offered money to accept surgery without knowing the full risks. State government officials who run the programme are pressed to meet quotas.
Lalit Mohan Pant, a surgeon who claims to have carried out the highest number of sterilisations in the world, defended the use of quotas as necessary to motivate government employees.
Dr Pant, who lives in central India, holds the record for sterilising 816 people in one day and says he has sterilised over 330,000 patients in all, helping prevent, by his estimate, the births of almost one million Indians.
“I am doing god’s work,” he said.
Gupta, who says he has conducted more than 50,000 female sterilisations, faces charges of causing death by negligence.
Visibly upset, he said it was the government’s duty to control the numbers turning up at the family-planning camp.
“If they kept in that place 83 women, it is my moral responsibility to operate on all the women,” he said. Gupta was awarded a state honour 10 years ago for his sterilisation work.
Gupta said he generally took between two and five minutes on each operation, but gave his assistants time to clean scalpels.
“They are dipped in spirit after an operation and then reused. If I feel it is not working, well, I change it. I do about 10 operations with the same knife.”
Protocols state doctors should spend at least 15 minutes on each operation and perform a maximum of 30 in a day. Several doctors said it was common to perform up to 90 sterilisations a day, leaving little time to maintain hygiene.
Women who survived the operation said they had been promised 600 rupees (€8), but several said they received less or nothing at all.
Mangli Bai, recovering on a drip at a nearby hospital, said she was given 230 rupees. “The health worker duped us, saying the rest was for photocopying and conveyance.”