The deaths of 15 women in a sterilization camp in Chhattisgarh are an indictment of the criminal complicity of the Chhattisgarh Government in a corrupt and callous healthcare regime. They are also a wake-up call for the entire country, about the grievous violence done to women’s bodies by the ‘population control’ policies pushed by international funding agencies and the Indian State.

The Chhattisgarh Government simply cannot wash off its responsibility for the deaths of the poor women who were killed. The emerging evidence shows that the immediate cause of the deaths could be either polluted drugs or due to sepsis from rusty or infected instruments used during the surgery.

The drugs administered apparently showed traces of toxic substances. The State Government must answer why it continued to procure drugs from the Mahawar Pharma company even after it was charged with selling sub-standard drugs two years back? In March 2012, the Health Minister Amar Agarwal himself had informed the State Assembly that a case had been registered against this company for selling duplicate generic drugs. Seven medicines supplied by this company had been banned by the State Government at different points in time.

The sterilization camps in the Health Minister’s own constituency (one of them a short distance from his own home) had abysmal standards of basic hygiene. Operations were done on the floor, women were piled on to beds, rusty and infected instruments were used – all presenting a grim reality check that contrasts with the ‘Clean India’ hype pushed by the BJP Governments in the Centre and States.

The doctor (since arrested) performed 83 operations in 5 hours. Though India adopts no sterilization targets nationally, states routinely adopt and push sterilization targets. In Chhattisgarh, too, the Government cannot deny that it had a policy of rewarding ‘record numbers’ of sterilization surgeries – on Republic Day this year, the Government had awarded a medal to the same doctor for performing 1 lakh sterilizations in his career. Target-driven and incentive-driven sterilizations lead to women being pressurized into having the surgeries, held in ‘camps’, thus privileging speed and volume of surgeries over safety and individual women’s informed decisions. The State Government must squarely accept responsibility for the target-driven and incentive-driven approach.

The Chhattisgarh Government and the BJP have been touting the State as a model of ‘development’, boasting of its forest cover and mineral wealth in order to woo investors. The fact is that the poor and the adivasis in the State have already been at the receiving end of a brutal war waged by the State in order to grab those very resources. Now, it becomes clear that the claims of ‘development’ mock the fact that the poor and deprived in the State have no access to basic, regular healthcare and contraception. Instead, they are given ‘camp-based’ healthcare – which means that time and again they are herded into camps where large numbers lost eyesight in botched cataract operations and 7000 women had uteruses illegally removed in botched and unnecessary hysterectomies 2012, making it clear that the latest deaths are by no means an exception.

The Chhattisgarh Government’s attempts to shield its Health Minister are highly condemnable. The Chief Minister himself should resign if he continues to deny the responsibility and liability of his Minister.

But the problem goes beyond that of a single State alone. Facts presented in Parliament show that 707 women died between 2009 and 2012 because of botched sterilization operations in camps. This means that 15 women are dying every month in these sterilization camps – and these numbers are likely to be much higher since in many cases the health authorities distance the camps from the deaths. The sterilization massacre in Chhattisgarh has shocked the world – but the fact is that a massacre of the same scale happens routinely every month in India. If we are to stop this bloodshed of women, we need to review and reverse India’s approach to contraception.

The question of people’s and women’s access to safe contraception needs to be prioritised, and the framework of ‘population control’ and ‘family planning’ needs to be abandoned. ‘Overpopulation’ in ‘poor countries’ as a cause for poverty and environmental damage is a racist myth that colonial and imperialist powers have historically peddled. Poverty, hunger, and pollution are caused, not by ‘too many poor people’ in ‘poor countries’, but because of the unequal distribution of the world’s resources and wealth and by exploitation and plunder by the world’s corporations.

International funding agencies are also implicated in the violence against women’s bodies in the name of ‘population control’. In the name of controlling ‘overpopulation’, these agencies, backed by the Governments of US and UK and powerful corporations, fund sterilization, as well as dangerous contraceptive implants, that endanger the lives and health of women in India and other target countries. The funds that flow in fuel the race to ‘achieve’ a high number of sterilizations, and the Indian health authorities also offer ‘incentives’ to women and men to get sterilized, but also to touts for herding large numbers of people for these operations. Rural health workers are rewarded for persuading larger numbers of women to come to sterilization camps, and penalised for failing to do so.

The Indian Government must stop accepting aid for ‘population control’ under any pretext. The Government must stop trying to control and regulate family size or population size. It must, in particular, end the practise of identifying ‘high fertility’ and ‘low fertility’ regions and communities. Instead, it must ensure that every Indian woman has access to a range of safe contraceptive methods. Sterilization surgery must be the last recommended contraceptive option, and hormonal implants must be disallowed entirely. Instead of these invasive methods, safe and non-invasive contraceptive methods must be made available. And women must be able to make informed, individual decisions about contraception. The camp-based approach to healthcare also must be abandoned, and replaced by public spending to ensure high-quality healthcare in the farthest corners of India, available to every Indian citizen.