When a young, eight-weeks pregnant mother living in Gurugram wanted to find out the sex of her unborn child, she went to an agent in the city who, according to the word in the area, would be able to assist her. About three weeks after she had met the agent, they were called to a discreet location near Pataudi by the agent who said the procedure would be conducted that very night. “We reached the place but then got another phone call from the agent, who told us it wasn’t safe there and asked us to come to another place in Civil Lines,” said the husband. Once there, they met two men who conducted the sex determination. They were then given abortion medicines for ₹7,000, the husband said. According to the police, the ultrasound machine and medicines used to terminate the pregnancy were found to be procured from Meerut in Uttar Pradesh.

Prenatal sex screening and female foeticide is banned and punishable under the Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act, 1994 (PC-PNDT Act). The Act was promulgated to address the skewed sex ratio in the country which, in 1981, stood at 962 girls in the age group of 0-6 years for every 1000 boys.

The ratio continued to fall over the decades — to 945 girls in 1991, to 927 girls in 2001, and then to 918 in the 2011 Census.

Of the states, Haryana’s sex ratio has been the lowest for the past four censuses. In 1981, it stood at 870, and only improved marginally to 879 in 2011. Gurgaon district had the lowest sex ratio within Haryana — 854 as per the 2011 Census.

The city has several sex determination centres that charge anything between ₹10,000 to ₹60,000 for sex determination and subsequent selective abortion, officials of the district health department said. Gurugram has only 221 ultrasound centres that are registered with the health department, and officials said many more operate discreetly, making it difficult to keep a count.

According to the officials, people who want sex determinations done and seek to illegally abort foetuses often travel to Meerut and nearby regions in states, as well as the other way around.

“There is a nexus between clinic operators in UP and Gurugram. Offenders in Gurugram often procure their medical termination packs or MTP kits from cities like Meerut and Agra,” Amandeep Chauhan, district drug control officer, said. In December last year, four people were held for running a sex determination racket in Rajiv Chowk, and according to Chauhan, all of them were repeat offenders and would procure MTP kits from a hospital in Bareilly.

A three-member PC-PNDT committee has, with the help of the police, raided around 32 sex determination centres and abortion clinics running illegally in the district in the past three-and-a-half years. More than 70 FIRs have been registered in the district against the offenders, including doctors, quacks, lab technicians and paramedical staff, according to data available with the police. Yet, many still continue to set up business in the city.

“We constantly receive tip-offs and information about sex determination clinics and illegal abortion centres from local residents, most of who are pharmacists selling abortion pills. We gather information and the resources and act on it, as and when the situation is appropriate,” Chauhan, also a member of the PC-PNDT committee, said.

In January 2019, the state government released data to claim the sex ratio in Haryana had improved to 924, as on December 31, 2018. Rakesh Gupta, additional principal secretary to the Haryana chief minister, said, “The improvement is a result of strict adherence to the PC-PNDT Act. About 600 raids were conducted on illegal diagnostic centres in the state.”

However, only five raids were conducted in Gurgaon district last year, and no convictions made. Social health workers said not much has changed on the ground. “As long as there is a demand for such procedures, quacks will find a way to cater to it,” said Sandeep Gogoi, a healthcare activist, adding that just conducting raids, and not actively addressing the issue of female foeticide would not solve anything. “What is needed is a change in mindset, along with stronger implementation of the law,” he said.

Why no deterrence?

On March 21, 2017, the committee raided the clinic of a woman in Sector 11 who was allegedly charging ₹25,000 for an ultrasound screening for sex determination. According to authorities, she was earlier caught using an unregistered ultrasound machine that had been confiscated. She allegedly bought a new machine to set up shop again, officials said.

The Act mandates that all ultrasound facilities be registered and medical practitioners maintain records of every scan of a pregnant woman. However, according to officials, the woman had purchased a second-hand ultrasound machine from the grey market.

According to officials, despite the high number of FIRs for violating the Act, there has been only one conviction till date in the district, and the low conviction rate aids such centres and professions in springing up.

In September 2014, Sanjay Khatana, who ran a website where he would entertain couples who desired a male child and sell them MTP kits with medicines to terminate the pregnancy medically , was arrested by the district PC-PNDT committee. He had allegedly supplied more than 60 MTP kits to couples in Haryana and Punjab. Khatana was sentenced to a year in prison and levied a fine of ₹5,000 in May 2015 by a district court.

According to officials, not only qualified radiologists, but quacks, fly-by-night ultrasound machine operators and agents are all involved in the business.

In November 2016, two men were arrested for giving home-made medicine to women, claiming it would lead to the conception of a boy, official records say. In March 2017, a man was arrested from near the main bus stand for performing ceremonies to facilitate the birth of a boy for a charge of ₹7,500.

Sabu George, an activist female foeticide, said filing FIRs isn’t the only way to convict offenders. “There needs to be proper documentation of evidence. The PC-PNDT law is very strong, if implemented properly,” he said, adding that many cases have been dropped in the past due for “poor investigation and insufficient evidence against the accused”.

An alleged nexus

Hospitals and clinics that provide ultrasound facilities have to be registered with the health department. After submitting documents, such as proof of ownership of the machine, proof of ownership of space and required qualifications, a license is issued for five years, after which period it has to be renewed, health department officials said, adding that the renewal certificate is granted within 90 days. However, radiologists and clinic operators who have previously been arrested for sex determination said the health department deliberately delays granting the license and conducts raids during the time-frame.

Rajiv Bhatia, a former radiologist who was booked under the PC-PNDT Act twice — in 2001 and in 2015 — said he had been made a target by the health department for not registering his ultrasound machine. He was also sentenced to prison by the district magistrate for not filling the requisite forms for ultrasound scans properly before the diagnosis of a pregnant woman in his clinic.

Bhatia alleged that the incident was a clerical error and not an incidence of sex determination, but he had to pay a huge price for it.

Bhatia had also filed a public interest litigation (PIL) in the Punjab and Haryana High Court in May 2015, alleging that the health authorities were selectively targeting radiologists for PC-PNDT law violations, and protecting those who were paying up. He was arrested by the police days after filing the PIL and booked under the Act. The high court, in July 2015, rapped Gurugram authorities for arresting Bhatia days after his PIL, and sought an explanation over his arrest.

Bhatia also alleged that no action had been taken against several offenders despite the existence of evidence. “I have given evidence of violations multiple times to the officials but no action has been taken,” he said.

Another radiologist who works closely with the health department said several people who have been booked under the Act have been let go in a few days in return of money.

Dr BK Rajora, civil surgeon, said the allegations were baseless and chose not to comment on them.

A societal problem

The couple who sought sex selection procedures in Gurugram through a local agent said they wanted only one child and having a boy is just “cheaper and easier”.

“Every couple in our locality is greedy for a male child, and rising living costs are forcing people to have a single child. The first one, in such a scenario, has to be a boy,” the husband said, adding he has long been hearing about ultrasound machines and technology that gives couples such as them the male child they desire. The wife added, “Even if we do have a girl, our families in our villages near Gurugram will give us and her a hard time.”

In the past, the Gurugram police has recorded several cases of abandoned female foetuses and newborn girls — the latest incident was in January this year when a newborn girl was found dead close to a canal near Sohna. The police had said the girl might have frozen to death. A few weeks before this incident, a newborn girl was found abandoned in the back seat of an auto-rickshaw parked outside a house in Fazilpur Jharsa. On December 31 last year, a foetus was found abandoned in a vacant plot in Sohna.

Gurgaon district has the highest literacy rate in the state — 84.7% , as per the 2011 Census. However, it also had the lowest sex ratio — 854 girls per 1,000 boys – the same year. But urban parts of Gurugram recorded a lower sex ratio (844) than the rural parts (878). Activists said the difference could be due to the easy availability of sonography centres in urban parts. “Rising income in urban areas of the city makes such sex-selective procedures more accessible,” George said.

A 2015 report by the Comptroller and Auditor General (CAG) found that “the availability of genetic clinics in urban areas and awareness of literate people about usage of sex determination techniques could also be attributed to declining child sex-ratio in urban areas”.

Dr Naval Kishore, district nodal officer, PC-PNDT Cell, said better sex ratios in rural areas as compared to urban areas is also a result of intensive drives to educate locals about sex determination and selective abortions by accredited social health activists (ASHA workers) in primary health centres (PHCs). “ASHA workers play an important role in educating women who come to local health centres in rural areas. They have been conducting awareness camps at village panchayats as well,” he said.

George, who has been working against sex-selective procedures in rural and urban parts of Haryana, said fewer and fewer people in rural areas are seeking such procedures. “There is a growing awareness in districts such as Rewari, Jhajjar, Nuh about the sex determination tests. In my experience there, less women are seeking the procedures now than they were earlier, as compared to urban parts of the state such as Gurugram,” he said.

Radiologists and gynaecologists in Gurugram said the low sex ratio in the district is not only a medical or a legal issue, but a societal one. “The PC-PNDT Act is holding radiologists responsible for an issue that is mainly societal,” said Navya Jain, a radiologist at a private clinic in the city. “The problem of skewed sex ratio shouldn’t only be viewed as a medical one. Strict implementation of the Act will help reduce the number of cases of female foeticide, but won’t address the larger problem of gender discrimination,” Jain added.

First Published: May 27, 2019 00:43 IST