http://www.countercurrents.org/rathi220910.htm

A story of mine on maternal mortality got published in countercurrents.com a month back.. (a brilliant portal for those interested in socio-politico-economic issues).. i stumbled upon the story by chance today.


http://www.countercurrents.org/rathi220910.htm


And... I am down and out. Three weeks of nonstop work with weekends spent out of town -- leads neha to a feverish, washed-out saturday.
Wanna write more.. maybe later

Maternal Mortality and Morbidity

A few days ago, the media reported an incident about a woman who lay dead on a pavement in Shankar Market, at Connaught Place, the heart of the Capital. The story illustrated the pain of a woman who went into labour and gave unassisted childbirth on a sidewalk, proving to be fatal. Prior to her tragic death, she was found by the owner of a nearby shop, who, having heard the wails of the newborn, came forward to help. Lying unkempt on a watered down, slimy pavement, the woman was hardly aware of the rainwater and the stray dogs lurking about her. She lay prostrate in a sordid state, with her baby girl pressed to her chest. As the story unfolded, the mother died four days later owing to severe weakness. Reportedly, the Police removed the body and took away the baby to a foster home.

In another such case, that surfaced a year ago, Fatima, a 24-year-old destitute girl delivered a baby girl under a tree in full public view. A patient of epilepsy, she simultaneously suffered severe fits at the time of delivery, making her condition critical. Frantic calls of help by her mother and repeated visits to MCD maternity home were not paid heed by the officers. The delivery took place unassisted and miraculously Fatima survived the ordeal. Fortunately for her, an NGO came to know about her and helped file a case in the High Court citing gross violation of human rights. It was through the medium of court and lengthy litigation that Fatima was awarded due compensation. If you happen to go past Nizamuddin Basti, you will still find her inhabiting under a lone tree with her mother Jaitun (Amma) and the daughter she calls Alisha. That tree is her only roof and it is her walls.

Such cases of maternal mortality and morbidity make one's insides churn, not only because these are outrageous and gross, but also because the same could have been averted and many lives saved. Maternal Mortality originally stems from social injustice obliterating access to right to survive pregnancy and child birth. Such deaths are rooted in women's subjugation, unequal status in society and lack of decision-making power. These women die, not because of some incurable illness, disease or heredity but of neglect and absence of health care amenities. In a country where childbearing is feted as 'taking forward of the family legacy', the mother herself is exposed to a risk to her life. When it comes to the duty of the family and the State towards making sure she lives through and after childbirth, the entire palaver fast loses steam.

We still record 63,000 maternal deaths every year, making India home to highest number of women dying during childbirth across the world. If launching of government sponsored schemes were the panacea, then India would have certainly reached the annihilation of maternal mortality by now. The reality is however, that despite the laws and the plethora of schemes, we remain a country where economic boom has left out and overshadowed the plight of its women.

The Central government launched the Janani Suraksha Yojna (JSY) under the National Rural Health Mission (NRHM) in 2005 which was introduced to cater safe delivery with the help of Accredited Social Health Activist (ASHA) and Auxiliary Nurse Midwife (ANM). The scheme aimed at providing cash assistance (ranging between `600-`1400) to all BPL women opting for institutional deliveries.

The service guarantees, as per the NHRM framework, promise minimum four antenatal check ups, iron and folic acid supplementation, tetanus toxoid injection, treatment of anaemia, minimum four post-natal checkups, transport and 24-hour access to emergency obstetric care. The National Maternity Benefit Scheme, Integrated Child Development Scheme (ICDS) and Antyodaya Anna Yojana (AAY) are other such schemes sponsored by the state to cater the nutritional, health and food-based assistance to destitute households.

The Constitution of India guarantees the right to life to the citizens of India under Article 21. In the landmark case of Paschim Banga Khet Mazdoor Samity & amp; ors v State of West Bengal & anr (AIR 1996 SC 2426) the Supreme Court held that the right to life includes the right to adequate medical facilities for preserving human life as well as the right to timely treatment in Government hospital. Article 42 (d) of the Directive Principles of State Policy guarantees the right to just and humane conditions of work and maternity relief. Article 14 (right to equality), Article-15 (freedom from discrimination) and Article 51(c) (respect for international law and treaty obligations) are further torchbearers of the right of a woman to a safe delivery as well as pre and post check up and assistance. Shockingly, 1,000 women are still dying daily from pregnancy-related causes in the country.

It is clear from above that there is no dearth of schemes or laws when it comes to maternal mortality and morbidity, but the implementation of the same is despondent. Most maternal deaths are caused by severe bleeding after childbirth, infections soon after delivery, blood-pressure disorders during pregnancy, and obstructed labour. Apart from these medical conditions, in many areas, health workers are not present or vaccines and medicines are not available. Patients are asked to purchase medicine from private chemists, which they cannot afford. The treatment of doctors and nurses is so harsh and insulting that women prefer unassisted childbirth with the help of dai (unqualified midwife) or quacks instead of qualified medical practitioners. Denial of pregnancy related entitlements, financial as well as medical, is quite common. In the absence of regular check-ups and physical examination, a pregnant woman's health deteriorates and chances of her and the baby's survival become slimmer. Reports of misrepresentation of facts and figures as well as corruption, when it comes to vaccine and medicine delivery, have further raised a question mark over state sponsored schemes and their implementation.

Though India has seen a fall in maternal mortality rate (MMR) by 59% between 1990 and 2008, the country is still grappling with one of the highest maternal death rates globally. According to the latest report, "Trends in Maternal Mortality", released jointly by WHO, UNICEF, UNFPA and the World Bank, India's MMR stood at 570 in 1990, which fell to 470 per 100,000 live births in 1995, 390 in 2000, 280 in 2005 and 230 in 2008 (see table). In contrast, the MMR of China is 37 per 100,000 live births.

There is a need for accountability and periodic assessment of facts at the ground level with strict scrutiny and a dedicated National Health Law. As per the Millennium Development Goals of 2015, India should bring down its MMR to 109 by the year 2015. If we are to reach anywhere near the promised target, the implementers need to pull up their socks and make sure the benefits of these schemes tenaciously percolate into the bottom of the social hierarchy, so that birth of a child continues to be a celebration and not a funeral.

Table:

Year	MMR (per 100000 live births)
1990	570
1995	470
2000	390
2005	280
2008	230

Neha Rathi

16.09.2010

The Gotra-ization of Honour

As Khap Panchayats across the spectrum face flak in the media and beyond about their draconian and unacceptable diktats with regard same-gotra marriages, a recently held India/Independent People’s Tribunal (IPT) was held to bring to fore untold stories of shock and horror that stage themselves live in many families in India today. And as it appears, it is not just the Khap-rulings in a rural backdrop that are fuelling such barbarity. And neither does it all stem from the same-gotra debate that has polarised the issue. There are many incidents of such violence being reported from middle class educated households in cities like Delhi, Jodhpur and Faridabad where such crimes are being committed irrespective of the gotra or lineage. The focal point it seems is ‘defiance’ by the couples’ and exercise of their ‘right to choose’ instead of flouting of gotra norms by them.

The IPT, organised by Shaktivahini and Human Rights Law Network in collaboration with many state-based women rights groups, brought to fore astounding and gruesome testimonies from men and women whose only crime was that they fell in love and dared to defy the mandate of the ‘honourable’ samaj. Take this example. Delhi based Nikhil married his sweetheart Himani against her family’s wishes. Eight days into the marriage, and the police barged into their home and took Himani away. Their marriage certificate was torn off and he was further slapped with charges of abduction and kept behind bars for a month. By the time Nikhil filed a habeas corpus writ petition in the High Court and got a decree in his favour, he was informed that Himani was already dead. He was casually handed over Himani’s death certificate on the day he was to see her. While her family asserts she died from severe Pneumonia, the doctors concerned rubbish the same. His case remains pending in the courts.

In another case of the kind, Seema, a Delhi-based woman married one Satish in an Arya Samaj Mandir against the wishes of her family. Since after the marriage they were forcibly separated and she has not been allowed to meet her husband. Though her own family has taken her in, but her brothers wash their hands off her saying that she has brought this fate upon her self by choosing to marry of her freewill.

For Rajasthan Police staffer like Tannu, who fell in love with and married a boy belonging Scheduled Tribe, her marriage has taken a dramatic turn. Though the families have accepted the couple, it is the societal and self-styled guardians of Hindu dharma who have ostracised and threatened the couple to the extent that the duo has been keeping their marriage under wraps since two and a half years. One look at her and you understand why this girl is not wearing any bangles in her wrists and is bereft of the quintessential vermilion which is otherwise considered quite the hallmark of a married woman here. Her family is now concerned about the fate of her younger sister who is facing trouble getting married owing to Tannu’s ‘choice marriage’. Hence, the concealment. “The moment the groom’s side gets to know that I got married by my choice, they reject my sister and break the alliance. I have been trying to hide my marital status but how does one hide a five-month-old baby? The attitude of police officers who work with me is the same as they discourage me from any kind of advice that I may give to people who come to the police station seeking help. So many times I have been sent on duties away from jail on trivial pretexts so I may not be allowed to inform prisoners about their rights,” she says.

24-year-old Kailash tied the knot with Babita (23) in August this year. The couple did not inform her family as they knew their reaction would be inimical. After the marriage ceremony, Babita went home to talk to her parents who, furious with her marriage, have kept her under confinement at her home. Attempts made by Kailash to take his wife home have failed time and again. He fears Babita’s life and waits for Dalit Foundation, an NGO which has come for his aid, to help him get his wife back.

The gotra issue is only hogwash in order to push the underlying agenda of caste-based politics. The more a political organisation is seen as a preserver of societal norms, the more votes it aims to garner, oblivious of the fact that their harsh views spiral down to crimes and cause social banishment of the worst kind. The self-appointed custodians of this ambiguous entity have become so mighty that a daily mockery of ‘rule of law’ is being played out in the name of honour.

These tales of shock and horror smack of the urgency with a new legislation with regard such crimes needs to be formulated and implemented in the country. Hopefully, the law with regard honour crimes - in line with the provision of murder, hurt and illegal detention of the Indian Penal Code (IPC)- would take into account the issue of compensation to the victims and envisage proper record keeping of such crimes so that region specific action can be taken by the Government and NGOs. According to Haryana State All India Democratic Women's Association (AIDWA) president Jagmati Sangwan, honour crimes are such that unless a separate law is articulated and aggressively implemented, more and more people will fall victims to its hypocritical fangs. “Till now the police have not been maintaining any separate record for such crimes. AIDWA’s three month recording and survey has shown that within the 6000 odd villages in Haryana itself, five to six incidents of honour crimes are recorded in one village in a year.” 

What is really being penalised by Khaps is the right of individuals to choose their marriage-partners and the same is being portrayed under the subterfuge of incestuous relationships in order to seek majority support. Otherwise what is to answer the spate of cases where the girl and the boy belonging to different gotra are also killed or put through torture? Besides, Khap Panchayats primarily exist only in some parts of Haryana, Punjab, Rajasthan and western Uttar Pradesh although such cases are reported from all over the country. The need is to separate the gotra-issue from the issue of defiance viz-a-viz the reaction of families and community. According to data collected by HRLN, in most of the cases where diktats have been issued by the Khap, the couple in question was not from the same gotra but was punished nevertheless.

Though Khap and political satraps are to blame for this social bigotry but to hold them singularly responsible for all crime that takes place in the name of honour would be missing the woods for the trees. Right from forceful confinement, to beating up, to starvation and forcible separation of couples, honour crimes are being perpetrated even in average, educated middleclass households, away from realm of Khap. The need is to depoliticise the issue and sensitise people about the evils of the same and to help them broaden their outlook by way of progressive laws and proactive campaigning.

(Names of victims have been changed for privacy and security concerns)


-- Neha Rathi