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| Vol. 4, Issue 5 May 2012 |
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Reporting & Essays |
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Excerpt |
Unnatural Selection
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| The story behind India’s missing girls lays bare a global history of population control |
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ROBERT NICKELSBERG / LIAISON / GETTY IMAGES |
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| Women sit in the
waiting room of an abortion clinic
in Delhi.
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IDWAY THROUGH HIS CAREER, Christophe Guilmoto stopped counting babies and started counting boys. A French demographer with a mathematician’s love of numbers and an anthropologist’s obsession with detail, he had attended graduate school in Paris in the 1980s, when babies had been the thing. By the time Guilmoto started his
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PhD, birth rates had started falling around the world, but the populations of many developing nations were still growing, and it was hard to shake the idea that overpopulation was a grave threat. Like many of his contemporaries he concentrated on studying the drop in fertility, searching for clues to what factors proved decisive in lowering a country’s birth rate. He did his dissertation research in Tamil Nadu, where the birth rate had fallen to European levels even as income levels remained low, and as he graduated and started working as a scholar he returned there many times. By 1998 he headed up the South India Fertility Project, a formal effort to catalogue the successes of Tamil Nadu and surrounding states. But over the course of working in the region, he realised demography’s big story had changed. People in India were not simply having fewer children. They were having fewer girls. Population growth had been slowed, in part, by reducing the number of daughters.
Guilmoto’s first inkling that something was wrong came in 1992, when he interviewed village nurses in Tamil Nadu for a short research project. A wiry Frenchman with wide-set eyes rattling off questions in Tamil, he must have cut an odd profile, but when he explained that he wanted to understand the demographic history of the area, the nurses spoke frankly and openly. Several offered up the detail that villagers occasionally killed their daughters shortly after birth. The news shocked him—as a demographer, he was well aware that humans committed infanticide at various points throughout history, but in most cultures the practice had disappeared by the early 20th century—and he made it his private mission to determine just how pervasive daughter killing was. Later he visited an orphanage, where he found an aging French volunteer who had lived in India so long that she no longer spoke French. In a mixture of Tamil and English, the woman explained that most of the babies abandoned in the area were female. “Look, in the orphanage we have mostly girls,” she said. “What do you think?”
| COURTESY CARO11NE / FLICKR.COM |
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A group of girls in Pali, Rajasthan wave to the camera.
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The encounters left a deep impression on Guilmoto, and he thought of them at the turn of the millennium when Indian census figures showed 111 boys born for every 100 girls. At first glance, the experiences of the village nurses and the orphanage worker helped explain the disparity, and indeed many foreign press reports blamed India’s dearth of girls on infanticide and abandonment. Looking into the matter, however, he realised they were only a small part of the story. Outside of the pocket of rural Tamil Nadu where he happened to have done field research, Indians rarely killed infants. “Everybody talked about infanticide because it carried more emotional weight,” he recalls. “But actually it was hardly in existence.” Tamil Nadu was in fact one of the states where girls had a better prospect of survival, while the sex ratio in the wealthier northwest worked out to 126: 126 boys for every 100 girls. The real cause for the gap, Guilmoto quickly learned, was that pregnant women were taking advantage of a cheap and pervasive sex determination technique—ultrasound—and aborting female foetuses.
The link to technology was alarming, for it meant that India’s skewed sex ratio at birth was an outgrowth of economic progress, not backward traditions. And India was hardly alone in recently developing a sex ratio imbalance. As he expanded his focus from fertility rates to sex ratio at birth, Guilmoto found that several other Asian countries exceeded the biological upper limit of 106 boys born for every 100 girls. In the 1980s, South Korea, Taiwan and parts of Singapore registered sex ratios at birth of above 109. China reported a sex ratio at birth of 117 in 2000. (Figures in both China and India later rose to 118 and 112, respectively.) Humans, Guilmoto realised, were engineering what he calls “rampant demographic masculinisation”—a change with potentially grave effects for future generations. “It was very difficult,” he recalled, “not to see it as a revolution.”
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OR DR PUNEET BEDI, the intensive care unit in Apollo Hospital’s maternity ward is a source of both pride and shame. The unit’s technology is among the best in Delhi—among the best, for that matter, in all India. The technology is one of the reasons he chose to take his gynecology practice here. But as a specialist in high-risk births he works hard so that |
babies can be born, and the fact that the unit’s technology also contributes to India’s skewed sex ratio at birth gnaws at him. Seven out of 10 babies born in the maternity ward, according to Bedi, are male. He delivers those boys knowing many of them are replacements for aborted girls.
He supports abortion for medical reasons, along with early-term abortion obtained after some deliberation. He performs abortions himself. For sex selection, however, he reserves a contempt bordering on fury. To have his work negated by something as trifling as sex preference—by any preference—feels like a targeted insult. “You can choose whether to be a parent,” he says. “But once you choose to be a parent, you cannot choose whether it’s a boy or girl, black or white, tall or short.”
Bedi says sex-selective abortion has caught on in Delhi precisely because it bears the imprint of a scientific advance. “It’s sanitised,” he says. The fact that sex selection is a medical act, he adds, neatly divides the moral burden between two parties: parents tell themselves their doctor knows best, while doctors point to overwhelming patient demand for the procedure. “There is a complete lack of shame on behalf of the parents and doctors who do it.”
A tall, broad-shouldered man with a disarmingly gentle voice, Bedi has an immaculate British accent that hints at years spent studying at King’s College in London. “I am so emotionally involved in the subject,” he says, his voice wavering, “that it’s difficult for me to be very articulate.” Sex selection, he says, is “probably the single most important issue in the next 50 years that this country and China are going to face. If you’re going to wipe out 20 percent of your population, nature is not going to sit by and watch.” But hospitals have little incentive to do anything about the problem, he adds, because maternity wards bring in substantial business. At Apollo, a deluxe delivery suite outfitted with a bathtub, track lighting, a flat screen television and a large window looking out onto landscaped grounds runs to  9000 a night. Although India outlawed foetal sex determination and sex-selective abortion in 1994, the law is poorly enforced, and as sex selection is an easy procedure in high demand, doctors continue to openly perform it. “Almost a third of Indian gynecologists’ income comes from abortion,” Bedi tells me. “Among those who do female foeticide, 90 percent comes from abortion. Who the hell is going to stop it?” He says he makes less money than many Delhi gynecologists simply because he refuses to abort female foetuses. Some of his patients, he says, are “extremely disappointed when I do ultrasounds. They think it’s just a waste of time and money if you don’t even know whether it’s a boy or a girl.”
Indeed, some of India’s top physicians help patients scan for foetal sex. A notorious case in Delhi is that of Mangala Telang, a Harvard-educated physician who is something like a gynecologist to the stars. Telang’s patients range from wealthy foreigners—both the American and British embassies recommend her to citizens living in Delhi—to Bollywood glitterati. In 2007 a pregnant British reporter of South Asian descent sent undercover by the BBC’s Asian Network caught Telang ordering an ultrasound scan for sex determination and assuring the reporter she could recommend an abortionist if the foetus turned out to be female. (Bedi appears in the segment, commenting dryly: “I’m not surprised at all.”) After the show aired, the health ministry suspended Telang’s licence, but at the time of my visit to Delhi she was practising again. The BBC reporter, moreover, found three other doctors in South Delhi willing to identify the sex of her baby. One didn’t even bother to mention that sex selection was illegal—and then, smelling British money, charged the reporter twice the going rate. “When you confront the medical profession, there is a cowardly refusal to accept blame,” Bedi tells me. “They say, ‘We are doctors; it’s a noble profession.’ This is bullshit.” Later he adds: “When it comes to issues like ethics and morality you can have an opinion, but there is a line which you do not cross. Everybody who does it knows it’s unethical. It’s a mass medical crime.”
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Female infanticide awareness campaigns have generally
focused on portraying daughters in a positive light rather than
putting pressure on the medical lobbies that help perpetuate
the practice.
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To this day, in India and elsewhere, activists often point to tradition as the cause of sex-selective abortion. Instead of challenging Asia’s history of population control or bringing entrenched interest groups like the medical lobby to task, these activists launch awareness campaigns directed at changing prejudices and societal mores. Positive reinforcement is a common theme in such campaigns. Daughters are portrayed as loving, intelligent, capable, fun—everything a parent could want in a child. In India, there is the Save the Daughter Campaign, Shakti—An Initiative to Empower the Girl Child, the 50 Million Missing Campaign. There is even a “motorbike campaign against female foeticide”, which involves politicians touring the country on motor scooters to preach the merits of having girls. Organisations lead focus groups in remote villages. They hire television writers to pen soap operas showing women rejoicing over the birth of daughters. They enlist Bollywood stars to film public service announcements. They sponsor playwrights and hold art contests and develop school curricula. An awareness campaign was the reason well-known Indian designers and models took time out from the shows during Delhi’s 2009 Fashion Week to pose with children plucked off the street. “Through fashion,” one celebrity told Thaindian News, “we want to show that young icons of India are stepping forth to support the unborn girl child.” Even Apollo Hospital runs an awareness campaign staffed by employee volunteers at the hospital’s branch in Punjab. As their coworkers stay back to help well-off urbanites abort girls, the volunteers disperse throughout poor villages to preach the merits of daughters.
To Bedi, this approach is infuriating. “If people had a son simply because they want a son, girls would have disappeared from this country one thousand years ago,” he says. The campaigns, he says, are an attempt to pawn off modern-day oppression on intransigent cultural mores. He believes it is time for India to start asking hard questions. What if the indiscriminate elimination of girls is the result of subterfuge—of decisions made not by individual parents thinking only of themselves but by those responding to some larger force? And if the Indian and US governments and leading Western organisations played a role in that subterfuge?
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Readers' Comments |
Total Comments
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A K
13 May 2012
08:24 PM
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Thank you for the article details!
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AG
8 May 2012
03:01 AM
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Indian Pediatr. 1975 May;12(5):381-5.
Prenatal diagnosis of genetic disorders.
Verma IC, Joseph R, Verma K, Buckshee K, Ghai OP.
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A K
24 October 2011
12:03 AM
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I would like to read the paper by I C Verma and others published in 'Indian Pediatrics' that this article talks about. But since neither the title of the paper nor its publication year are mentioned, I am unable to trace it on the journal's website. Can anyone put up a link to the paper or give its title and year of publication? Thanks in advance.
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Kay
6 August 2011
04:15 PM
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Extremely disturbing and alarming.
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