October 29, 2006

Women have always been accorded a low status in our part of the world. Sadly, a son is given preference over a daughter in all aspects of life including nutrition, health, education, and even sports and employment opportunities. A daughter is discriminated against from the moment she is born till the time of her death. She is denied many basic rights — often the right to live which is evident in the form of female infanticide, where she is killed soon after birth.

A woman who gives birth to a son occupies a privileged position while a woman who has many daughters is looked down upon. Husbands have divorced wives just because they failed to mother a son. A she-child is considered a burden, which has to be passed over to her husband as soon as possible. In societies where the dowry system is prevalent, the girl is considered a greater encumbrance. All her life a woman remains dependent on one or the other male member of the family — as a child on her father, as a wife on her husband and in old age, especially if widowed, on her sons. This gender discrimination started only after birth, until now that is.

Since the development of sex determination techniques like ultrasonography — a test that uses sound waves and echoes to create an image through which the internal parts of the human body are visualised — gender bias has taken a new turn, i.e. the female foeticide. Through this new technology, the sex of the unborn child can now be determined and if the foetus is a female, abortion is often sought.

The extent of this practice and its implications are discussed in the book Missing Girls by Dr Manohar Agnani. Dr Manohar has a Masters degree in International Health from the University of Copenhagen, Denmark. A practicing doctor before he joined the civil services, he is strongly aware of the adverse sex ratio that is induced and aided by modern technology. As the district collector of Morena, Madhya Pradesh in India, he has shown how the existing laws are flouted by the medical fraternity and enforcement authorities, and how, given the will, law can also be used against those who flouted the law and denied the girl-child’s right to live.

In Missing girls, Dr Manohar highlights the discrepancy in the sex ratio in India. In most developed countries there are more women than men, while in India and some of its neighbouring countries the men are in greater number. He highlights the areas where this trend is more prominent using census data i.e. states like Punjab, Haryana, Delhi, Gujarat, Rajastan, Maharashtra and Uttar Pardesh, and religious communities like the Sikhs and the Jains.

He goes on to trace the traditions of gender inequalities through the ages, particularly in India and deals with the practice of dowry, its historical role and its transformation into a social evil. It is this custom of dowry that has assumed such a menacing form that from her very birth the girl child has come to be treated as a “Bojh” — a burden or a liability — whereas the boy child is a “post dated cheque” to be cashed later.

Manohar is also critical of the population policy in India that advocates small families. People have become conscious of the advantages of a small family, but everybody wants one son and one daughter. They want to limit the family size to a two-child norm but only if they have a son and a daughter; nobody wants two daughters. If they already have a daughter, at the time of the second pregnancy they go for prenatal sex determination and if the foetus is a girl, they often opt for an abortion.

Manohar cites the example of China where people opposed to the one-child policy and in turn the government had to make special provisions for couples who had daughters as their first child. Along with the two-child norm, the government should make efforts to promote gender equality, which is also one of the eight Millennium Development Goals set by the Unicef. Unless gender equality is promoted, people will keep resorting to measures like female foeticide in their quest for sons.

The book also covers issues related to medical ethics and ethical questions regarding the use of ultrasound technology for sex determination and selection. Ultrasound is a diagnostic technique and should not be used for sex selection. The Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994 (PNDT) clearly prohibits the use of diagnostic techniques for sex determination and restricts sharing of information on the sex of the foetus if discovered. It clearly lays down the conditions and purposes under which such techniques can be used. But in many cases health professionals are forced to do so either by the expectant mother herself or her family; and they have to oblige fearing that failure to do so might expose the woman to torture.

Abortion is legal in India on broad medical and social grounds under the Medical Termination of Pregnancy Act (MTP) that was enacted in 1971 and amended in 2002. When this Act was implemented the problem of sex determination and subsequent female foeticide had not gained such proportions. Now many clauses in the Act are being misused and abortions are being carried out as a contraceptive measure to limit the family size. Manohar suggests that a law based on Israel’s model — which he calls “intrusive law” — be adopted wherein the state limits individual discretion by requiring approval for all abortions but provides services for all abortions that have been approved.

He calls for more stringent checks on all ultrasonographies done and stricter punishment for health professionals who carry out sex determination sonography and abortion (female foeticide). He also suggests amendments in the present laws to check such practices as he believes that the weakness with the present law is in its implementation. He gives elaborate and useful ideas about how this can be strengthened, through social and socio-medical audits and suggests computerisation and audit of hospital records.

The book also discusses the MPT and PNDT Acts and the various conditions where prenatal diagnostic techniques can be used and/or abortion is allowed; giving in detail the criteria and relevant authority for keeping a check. Community leaders play an important role in forming public opinion and bringing about a social change. In order to promote gender equality community leaders can be involved to convey the message across and establish the dignity of the girl-child. Until and unless women are given their rightful place in society, it is difficult to curb actions such as female infanticide and foeticide.