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Technology and its Impact on Female Feticide in India

Technologies, apart from sensitizing people against this practice, can also play a highly interventionist role by proactively pursuing cases against erring doctors, booking them under the law of the land as well as helping people in general change their opinion about the value of a girl child.

In an age when females have made progress in almost every field, there are people who still accord a lower status to women. In some of our Indian societies, while a childless woman is perceived as incomplete, one who has given birth to daughters is partially complete. Only the one who has produced a son enjoys a status of sorts. The problem is intimately related to the institution of dowry. "If it's a girl child, we will have to spend first on her education and then on her marriage and dowry ... It doesn't stop there. We will also have to meet some of her expenses after marriage. How I wish I could get a son!"



Social pressures in India, and the presence of low-cost technologies like ultrasound, have led to sex-based abortion of female fetuses, and an increasingly smaller percentage of girls born each year.



The bias against females is also related to the fact that sons are looked at as a type of insurance. Even our religions have been prejudiced towards women. According to Manu, a woman has to be reborn as a man to attain moksha (redemption). A man cannot attain moksha unless he has a son to light his funeral pyre. Also, it says a woman who gives birth to only daughters may be left in the eleventh year of marriage. It is a common saying in India, Ladka marey kambakth ka; Ladki marey bhaagwaan ki ("It's a fool who loses his male child and the fortunate one who loses a girl child"). Obviously, it shows the gender bias in our male-dominated, patriarchal society.

Prevalence and Spread of Female Feticide
In India, the practice of sex-selective abortion or female feticide (in which an unborn baby is aborted or killed before birth simply because it is not a boy) is only the latest manifestation of a long history of gender bias, evident in the historically low and declining population ratio of women to men. Moreover, the medical fraternity in India has been quick to see entrepreneurial opportunities in catering to the insatiable demand for a male child. Until recently, the technology was prohibitively expensive.

The three chief pre-natal diagnostic tests that are being used to determine the sex of a fetus are amniocentesis, chronic villi biopsy (CVB) and ultrasonography. Amniocentesis is meant to be used in high-risk pregnancies, in women over 35 years. CVB is meant to diagnose inherited diseases like thalassaemia, cystic fibrosis and muscular dystrophy. Ultrasonography is the most commonly used technique. It is non-invasive and can identify up to 50 per cent of abnormalities related to the central nervous system of the fetus. But sexing has become its preferred application.

A ban on the government departments at the centre and in the states, making use of pre-natal sex determination for the purpose of abortion -- a penal offence -- led to the commercialization of the technology; private clinics providing sex determination tests through amniocentesis multiplied rapidly and widely. These tests are made available in areas that do not even have potable water, with marginal farmers willing to take loans at 25 per cent interest to have the test. Advertisements appear blatantly encouraging people to abort their female fetuses in order to save the future cost of dowry. The portable ultrasound machine has allowed doctors to go from house to house in towns and villages. In a democracy it is difficult to restrict right to business and livelihood if the usual parameters are fulfilled.

Female Feticide and Law
There has been an inability to discuss the issue of feticide without the larger debate on abortion, which is legally allowed and has been seen as a triumph of the women's rights movement in the country. India has allowed abortion on broad medical and social grounds since the Medical Termination of Pregnancy (MTP) Act was passed in 1971. The Pre-Conception and Pre-Natal Diagnostic Techniques Act and Rules 1994 (PCPNDT) mandates that sex selection by any person, by any means, before or after conception, is prohibited. But while the Act seeks to regulate and prevent misuse of pre-natal diagnostic techniques, it rightly cannot deny them either. The PNDT Act allows pre-natal diagnosis only for chromosomal abnormalities, genetic metabolic disorders and congenital abnormalities. The law, however permits ultrasound clinics, clinics for medical termination of pregnancies and assisted reproductive facilities as a routine matter and as a legitimate business.

In addition, there is the legally binding Code of Medical Ethics, constituted by the Indian Parliament in the Medical Council Act, 1956 that many doctors ignore. Doctors are legally bound to report medical malpractice. The PCPNDT Act mandates that any person conducting ultrasonography or any other pre-natal diagnostic technique must maintain proper records. The Act requires the filling up of a written form, duly signed by the expectant mother, as to why she has sought diagnosis. Violations are punishable by imprisonment and a fine. The law also permits abortions for failure of contraception. It is a huge challenge for the government to detect violations of the PNDT Act, since it is a crime of collusion and by consensus.

The Ground Reality
It is not only the poor, but even the middle classes and the rich in India that are biased against the girl child and women. The provisional figures of the 2001 Census, which has astonished even the Health Department, show that the Child Sex Ratio (CSR the number of girls in the age group of 0 to 6 years per thousand boys of the same age group) has declined sharply from 945 females per 1000 males in 1991 to 927 females a decade later. Furthermore, the CSR is actually worse than the national average in Himachal Pradesh, Punjab, Chandigarh, Uttaranchal, Haryana, Delhi, Rajasthan, UP, Gujarat, Maharashtra and Daman and Diu. The Overall Sex Ratio (OSR, which looks at the ratio of all females to males, and not just those in the 0-6 age group) is even worse in places like Chandigarh (773:1000), Delhi (821:1000), and Punjab (874:1000). Health experts say these are some of the lowest sex ratios in the world.

During the final decade of the last millennium, the CSR recorded its highest fall, dropping 18 points from 945 to 927. However, during the same decade, the OSR recorded its highest gain, rising 6 points from 927 to 933. In every census since 1951, the two ratios have gone more or less hand in hand, dropping steadily except in the late 1970s The sudden fall in the number of girls in the youngest age group is believed to be proof of the increased incidence of sex-selective abortions or female feticide. Most of these abortions are the result of the misuse of sex determination technologies such as ultrasound scanning and amniocentesis.

What is a woman's role in all this? Does her choice or decision really matter when choosing a spouse, contraception methods, the first pregnancy or place of delivery? Is it really possible for a woman to decide about having an abortion, if she has to survive as a daughter-in-law in the family? Let's assume her husband supports the birth of a female child. Even then she may prefer to have a male child in order to get respect from her in laws' family, in order to save her marriage.

If a woman doesn't have any say in this matter, a good case can be made that female feticide is an act of violence against women.

A Cure?
So where is the cure of this disease? With law? Doctors in India believe 2 million fetuses are killed every year through abortion, simply because they are female, even though it is an illegal practice. And with the increasing availability of sex determination tests it is impossible to keep track of such cases. There is little doubt that in India the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994, has not been very effective. The facts revealed by the census speak for themselves. We need, rather, to attempt more broad-reaching strategies that will address the economic and cultural roots of the problem.

Technology Employed for Education
Progress of science and technology is mandatory for the progress of a nation, but what matters most is its manifestation and beneficial application. Today, information technology has changed the communication paradigm, making it no longer difficult to reach a large number of people more or less at the same time. Information technologies can also enable them to respond and interact as well as obtain copies of relevant information at low cost.

Information Communication Technologies (ICTs) apart from sensitizing people against this practice, can also play a highly interventionist role by proactively pursuing cases against erring doctors, booking them under the law of the land as well as helping people in general change their opinion about the value of a girl child.

A Web site established by the Datamation Foundation Charitable Trust and dedicated solely to the issue of female feticide is an important tool helping the government of India accomplish its cherished goal of stopping female feticide altogether. This major ICT-based campaigning and advocacy program is to help prevent occurrences of sex selective tests and selective abortions of the female fetuses in India. The purpose is to sensitize the population that apparently wants female feticide, a medical system happy to supply the necessary technology, and a section of feminists arguing that female feticide is about reproductive rights and choices.

Online Attempts to Check Female Feticide
provides some rich background information on the prevalence and practice of female feticide, including reasons for the sex-selective tests. The site not only covers the regulatory aspects -- PNDT Act, 1994 and the Medical Council of India's code of conduct to crack down on sex selection, but also includes a The India female feticide portal includes some distinctive features. The Femicide sectioncomplaint-lodging process in the best tradition of e-governance. The complaint-lodging process is a very critical feature, as it protects the identity of the complainant, and yet provides an effective vehicle for booking the doctor, maternity home, ultrasound clinic or radiology clinic. The complaints are retrieved into a database format at Datamation from where they are handed over to the central PNDT Cell (Ministry of Health and Family Welfare) and other respective state and district authorities, for re-addressal.

To date the Foundation has received about 580 complaints, and has passed these to respective authorities. The interpretation of the law in form of demographic data is also put on the Web site. Another important platform for the Web site is the Pledge Support page that highlights two features -- Pledge Support and Information. Through the pledge support feature one can enter the information regarding the type of the volunteer service the person or the organization is ready to offer, and the information option allows one to enter the information about any ultra-sound clinics, doctors, radiologists etc., to enable database building.

Serving as a knowledge repository on the issue, is the What's New page. The attempt here is awareness generation and capacity building both amongst the community and the stakeholders. Through e-mails, to date the Foundation has sensitized 8 million people worldwide on this issue. The Links/Resources page contains the contact addresses of different NGOs and agencies working for the prevention of female feticide, and gives data for statewide, sex ratio and female feticide and sex selection. To enable sensitization through sound and visual media, radio and video links have also been added to the Web site. suse of pre-natal diagnostic techniques, it rightly cannot deny them either. The PNDT Act allows pre-natal diagnosis only for chromosomal abnormalities, genetic metabolic disorders and congenital abnormalities. The law, however permits ultrasound clinics, clinics for medical termination of pregnancies and assisted reproductive facilities as a routine matter and as a legitimate business.

In addition, there is the legally binding Code of Medical Ethics, constituted by the Indian Parliament in the Medical Council Act, 1956 that many doctors ignore. Doctors are legally bound to report medical malpractice. The PCPNDT Act mandates that any person conducting ultrasonography or any other pre-natal diagnostic technique must maintain proper records. The Act requires the filling up of a written form, duly signed by the expectant mother, as to why she has sought diagnosis. Violations are punishable by imprisonment and a fine. The law also permits abortions for failure of contraception. It is a huge challenge for the government to detect violations of the PNDT Act, since it is a crime of collusion and by consensus.

The Ground Reality
It is not only the poor, but even the middle classes and the rich in India that are biased against the girl child and women. The provisional figures of the 2001 Census, which has astonished even the Health Department, show that the Child Sex Ratio (CSR the number of girls in the age group of 0 to 6 years per thousand boys of the same age group) has declined sharply from 945 females per 1000 males in 1991 to 927 females a decade later. Furthermore, the CSR is actually worse than the national average in Himachal Pradesh, Punjab, Chandigarh, Uttaranchal, Haryana, Delhi, Rajasthan, UP, Gujarat, Maharashtra and Daman and Diu. The Overall Sex Ratio (OSR, which looks at the ratio of all females to males, and not just those in the 0-6 age group) is even worse in places like Chandigarh (773:1000), Delhi (821:1000), and Punjab (874:1000). Health experts say these are some of the lowest sex ratios in the world.

During the final decade of the last millennium, the CSR recorded its highest fall, dropping 18 points from 945 to 927. However, during the same decade, the OSR recorded its highest gain, rising 6 points from 927 to 933. In every census since 1951, the two ratios have gone more or less hand in hand, dropping steadily except in the late 1970s The sudden fall in the number of girls in the youngest age group is believed to be proof of the increased incidence of sex-selective abortions or female feticide. Most of these abortions are the result of the misuse of sex determination technologies such as ultrasound scanning and amniocentesis.

What is a woman's role in all this? Does her choice or decision really matter when choosing a spouse, contraception methods, the first pregnancy or place of delivery? Is it really possible for a woman to decide about having an abortion, if she has to survive as a daughter-in-law in the family? Let's assume her husband supports the birth of a female child. Even then she may prefer to have a male child in order to get respect from her in laws' family, in order to save her marriage.

If a woman doesn't have any say in this matter, a good case can be made that female feticide is an act of violence against women.

A Cure?
So where is the cure of this disease? With law? Doctors in India believe 2 million fetuses are killed every year through abortion, simply because they are female, even though it is an illegal practice. And with the increasing availability of sex determination tests it is impossible to keep track of such cases. There is little doubt that in India the Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994, has not been very effective. The facts revealed by the census speak for themselves. We need, rather, to attempt more broad-reaching strategies that will address the economic and cultural roots of the problem.

Technology Employed for Education
Progress of science and technology is mandatory for the progress of a nation, but what matters most is its manifestation and beneficial application. Today, information technology has changed the communication paradigm, making it no longer difficult to reach a large number of people more or less at the same time. Information technologies can also enable them to respond and interact as well as obtain copies of relevant information at low cost.

Information Communication Technologies (ICTs) apart from sensitizing people against this practice, can also play a highly interventionist role by proactively pursuing cases against erring doctors, booking them under the law of the land as well as helping people in general change their opinion about the value of a girl child.

A Web site established by the Datamation Foundation Charitable Trust and dedicated solely to the issue of female feticide is an important tool helping the government of India accomplish its cherished goal of stopping female feticide altogether. This major ICT-based campaigning and advocacy program is to help prevent occurrences of sex selective tests and selective abortions of the female fetuses in India. The purpose is to sensitize the population that apparently wants female feticide, a medical system happy to supply the necessary technology, and a section of feminists arguing that female feticide is about reproductive rights and choices.

Online Attempts to Check Female Feticide
provides some rich background information on the prevalence and practice of female feticide, including reasons for the sex-selective tests. The site not only covers the regulatory aspects -- PNDT Act, 1994 and the Medical Council of India's code of conduct to crack down on sex selection, but also includes a The India female feticide portal includes some distinctive features. The Femicide sectioncomplaint-lodging process in the best tradition of e-governance. The complaint-lodging process is a very critical feature, as it protects the identity of the complainant, and yet provides an effective vehicle for booking the doctor, maternity home, ultrasound clinic or radiology clinic. The complaints are retrieved into a database format at Datamation from where they are handed over to the central PNDT Cell (Ministry of Health and Family Welfare) and other respective state and district authorities, for re-addressal.

To date the Foundation has received about 580 complaints, and has passed these to respective authorities. The interpretation of the law in form of demographic data is also put on the Web site. Another important platform for the Web site is the Pledge Support page that highlights two features -- Pledge Support and Information. Through the pledge support feature one can enter the information regarding the type of the volunteer service the person or the organization is ready to offer, and the information option allows one to enter the information about any ultra-sound clinics, doctors, radiologists etc., to enable database building.

Serving as a knowledge repository on the issue, is the What's New page. The attempt here is awareness generation and capacity building both amongst the community and the stakeholders. Through e-mails, to date the Foundation has sensitized 8 million people worldwide on this issue. The Links/Resources page contains the contact addresses of different NGOs and agencies working for the prevention of female feticide, and gives data for statewide, sex ratio and female feticide and sex selection. To enable sensitization through sound and visual media, radio and video links have also been added to the Web site.

An important feature started under this initiative is our e-Newsletter through which we disseminates news, articles, reports and other studies on a weekly basis to sensitize the various segments (students, NGOs, medical community, educationalists, government officials, researchers) of the society on issues of gender inequality, female feticide and sex-selective abortions. Youth Voices, a newly started section on the portal is an effort to motivate and encourage youth participation in eradicating this menace and spreading awareness among other groups. To enable communication on this issue among various segments of society we have started a discussion forum that allows free flow and exchange of ideas among people.

What Can be Done?
Fully understanding that an evil such as this cannot be addressed in isolation, we are also closely examining related social malaise such as dowry, women's underemployment and exploitation in the society, education standards of the girl child as well as high-school dropouts amongst the girls, early marriages and the arranged marriage system. It is our endeavor to develop sustainable development models for each of the above listed social malaise in India so that these have an impact on improving the ratio of females in Indian society.

Earlier articles about the Datamation Foundation and its Work
http://www.centerdigitalgov.com/international/story.php?docid=92645
http://www.centerdigitalgov.com/international/story.php?docid=37907
http://www.centerdigitalgov.com/international/story.php?docid=91182

References
1. Death in the Womb Sex Selection Law Fails To Check Foeticide; Anna Dani
2. The Social Context of Sex Selection and the Politics of Abortion in India; Radhika Balakrishnan
3. A Boy for You, a Girl for Me: Technology Allows Choice; Rob Stein
4. Female Foeticide: The collusion of the medical establishment; Lalitha Sridhar
5. Why this gender bias towards womankind?; SPK
6. Abortion vs. selective conceiving or heading toward imbalanced society?; Puneet Kaur
7. Sociological perspective of female foeticide; Manmeet Kaur
8. "The two-child norm only leads to female foeticide"; Madhu Gurung
9. Sex ratio: the hidden horrors; Pavan Nair

Chetan Sharma serves on the National Apex Committee set up by the Government of India on E-governance mandated to examine E-readiness and E-assessment of government departments and the public infrastructure for E-governance. He also serves on various Civil Society Groups under the aegis of the World Summit on Information Society (WSIS) and UN ICT Task Force. Divya Jain is a staff member of the Datamation Foundation Charitable Trust in Delhi, India.