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Failed Health Systems and Unwarranted Hysterectomies - Shital Morjaria

In my three years experience of producing Naveena, the daily show on women and society for the Telugu Channel TV9, I had come across several heart warming stories about women and their achievements, which I had showcased through my programme. But there were as many distressing aspects about women’s lives that I covered on a regular basis through Naveena. And yet, the story that went on to win the Ramnath Goenka award shook many of us up. It came to us as a chilling reminder of the newer forms of exploitation that some vulnerable sections of women in particular were facing. The story was about large scale hysterectomies that were being performed in a few hamlets close to Hyderabad. We covered the issue extensively and telecast it on Naveena. The exposure of the case is in fact closely connected with the journey of the show itself. In many ways the effective coverage of the particular case would not have been possible without the path that Naveena had staked out earlier and therefore I speak of both here, the particular story that won the award as well as the programme.

The winning story:

When I first heard the news I could not decide which of the two problems was worse: Menopause at 25 years? Or prescriptions of hysterectomies (removal of uterus) for ailments as routine as abdominal pain? Both these disturbing dimensions were an essential part of what was taking place in Kowdipally Mandal of Medak district in Andhra Pradesh. From among the 125 families that lived in the mandal, hysterectomy cases were reported from every second household. More than 700 women from two villages were operated upon for removal of the uterus, accompanied at times by the removal of ovaries as well. What was shocking was that girls as young as 19 and 20 too had undergone hysterectomies. Almost all the women who were operated upon were poor and uneducated lambada (tribal) women. The irony of the whole situation was that the women gave up their land and life savings for a procedure that cost them their uterus as well as anywhere between 15,000 to 50,000 rupees.

The Naveena team first came across some of these startling facts through a newspaper article that carried the findings of a survey conducted by CARPED (Center for Action Research and People’s Development), an organization working in the Mandal. We decided to carry out our own investigations. Naveena spoke at length to women from Kannaram and Mohammad Nagar villages in Koudupally Mandal, visited the Primary Health Care Centers in the village, paid a surprise visit to the Ayurveda doctor who had conducted most of the hysterectomies and checked all the medical records of the women who had got operated.

Most women who had their uterus removed through the hysterectomies had approached the doctor with gynecological problems such as white discharge, pain in the stomach, urinary infections or cysts. However the Ayurveda doctor who had a practice in the vicinity told them that the problem was very serious, that it could get worse and that they could even die if the uterus was not removed at the earliest. The consequence was that his practice thrived while the women’s health degenerated either with increased pain, debts, menopause or further illness for which they had to again seek medical help. As one of the women who had gone through the operation told us, “My back aches terribly, I cannot bend. Earlier even with the pain I felt a lot better. Now it has become worse.”

On the whole, our findings from the investigation were depressing:

  •  Majority of the women on whom hysterectomies were performed were in the age group of 19- 40. Many of them were unmarried.

  •  Some of the women who had got hysterectomies done were deserted by their husbands since they could not work or produce children.

  • Most women had side effects in terms of severe pains or other health problems.

  • The women were poor and became victims of the huge loans that they availed at exorbitant rate of interest in order to pay for the surgeries.

  • The women complained that the Government Primary Health Care (PHC) Centre did not cater to their medical problems because it was hardly ever open.

After carrying out our investigation, the Naveena team broke the story on television. The telecast of our story had an impact that was heartening. We were told that the doctor had closed down his practice and disappeared, the PHC cleaned up its act to a certain extent by keeping the clinic open and getting a gynecologist once a month. The women themselves became more alert to their health needs and shared information among themselves about their experiences with the health system. Some gynecologists from Hyderabad who conducted medical camps in the Mandal for the tribal women admitted that they had their own suspicions about the hysterectomy racket but had not been able to prevent them. They were appreciative of our programme that had provided them a context to raise the issue more forcefully with the women themselves as also the health department.

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