The horrifying deaths of at least 14 women who had undergone surgery at sterilisation camps in the Indian state of Chhattisgarh, highlight the violence of the population control policies that the British government is at the forefront of promoting globally.
Far from giving poor women in the global south much-needed access to safe contraception that they can control, these policies dehumanise them as “excessively reproductive” and set targets that make atrocities like those in Chhattisgarh possible. While these policies are rooted in deeply racist and patriarchal ideas, they are implemented in the name of reproductive rights and choice.
Two years ago, the British government co-hosted the London Family Planning Summit, where along with other international organisations, they announced a $2.6bn (£1.7bn) family planning strategy aimed at getting 120 million more girls and women in the poorest countries to use voluntary family planning by 2020. A few months later the development secretary, Justine Greening, announced further “determined UK action on family planning” including the increased distribution of contraceptive implants.
Despite its insistence that it opposes coercion, it had already been revealed that the Department for International Development (DfID) was funding forcible sterilisations in the Indian states of Madhya Pradesh and Bihar. Here, too, poor women, many of them Dalits, died after allegedly being lied to about the operation, and threatened with the loss of their ration cards or their access to government welfare schemes. They are said to have been bribed with small amounts of cash or, as with this latest case, forcibly taken to camps, where they were operated on under appallingly unsafe conditions.
Female sterilisation has long been the main method used in India’s population control policies. During India’s “emergency” in the mid-1970s, with civil liberties suspended, men were taken to similar camps for vasectomies but this generated massive opposition contributing to the historic electoral defeat of the Congress party in 1977. Research conducted in 2005-06 suggested that around 37% of married women had undergone sterilisation. Officially recorded deaths caused by sterilisation between 2003 and 2012 translate into 12 deaths a month on average, and actual figures may be much higher. In 2012 a Human Rights Watch Report warned that without a change of policy on sterilisation, the commitments made by the Indian government at the London Family Planning summit would lead to further abuses and increased pressure on health workers to meet targets.
Britain’s support for the mass sterilisation of poor and marginalised women, which characterises India’s population policy, is covert – but many of the injectable and implantable contraceptives that DfID and its corporate partners more openly promote also deny women control and put their lives in danger.
For example, DfID’s current initiative with Merck Sharp & Dohme involves promoting the long-lasting implant Implanon to “14.5 million of the poorest women by 2015”. New prescriptions of Implanon were discontinued in the UK in 2010 because trained medical personnel were finding it too difficult to insert, and it was feared that faulty insertion was leading to unwanted pregnancies. Merck has since introduced a new version, Nexplanon, which is detectable by x-ray, but has been allowed to continue selling Implanon. This is the drug that is being promoted in DfID and UNFPA programmes in the poorest countries (despite a huge deficit of trained health personnel) including in Ethiopia.
Like earlier approaches dating back to Malthus, current population control strategies are based on shifting responsibility for poverty on to the poor themselves. Population growth in the global south is being linked to climate change, shifting attention from the role of carbon emissions in the north, and is held responsible for the escalating food crises generated by the land grabbing of transnational corporations and foreign governments. Current population discourse insists that the neoliberal policies imposed by the World Bank and IMF – in which health provision, along with education, sanitation and other essential public services, has been decimated since the 1980s – can remain in place. Tellingly, the UK’s former development secretary Andrew Mitchell described population policies as “excellent value for money”, citing the example of Tanzania which he claimed would “need 131,000 fewer teachers by 2035 if fertility declines – saving millions of pounds in the long run”.
Today population control is, in fact, part of a broader strategy of global capital in which women’s labour is extended and intensified. It is this, not concern about rights and choices, that underpins policies such as those of DfID and its corporate partners, which deny women in the global south real control over their bodies. Yet increasingly, women are demanding “reproductive justice”, which involves exposing this strategy and confronting structures of power and inequality as the only ways of preventing more deaths like those in Chhattisgarh.
This article first appeared in The Guardian on 14 November 2014 and is reposted here with the author’s permission.