By: Lauren Webb In countries like the United States and the United Kingdom, a hysterectomy (the removal of a woman's uterus) is an operation of last resort, conducted only after a biopsy or other tests confirm cancer and rarely necessary for women under age 40. In several states in India, however, a recent Oxfam report found that private clinics perform unnecessary hysterectomies on rural women to take advantage of government healthcare funding. A government investigation in just one district of Bihar, Samastipur, the district magistrate found that 12% of the hysterectomies were unnecessary.[i] A right to information case in a rural district of Rajasthan showed that 70% of the women who visited a clinic had undergone a hysterectomy. Women told a local NGO that, after only an ultrasound, the doctor told them the uterus was cancerous and needed to be removed.[ii] Independent doctors have said that an ultrasound on its own is not enough to determine if a hysterectomy is necessary.[iii]
In addition to the physical problems that unnecessary hysterectomies cause, these operations are generally too costly for the farm laborers doctors often target. A price tag of $200 often means that families have to sell property or borrow money to fund the surgery.[iv] This leaves families even more vulnerable, as they often don’t have the means to pay for a second opinion or to travel to government-run hospitals.
While tragic on their own, these incidents are just examples of corruption in a broken healthcare system that has been called one of “the most corrupt services in India.”[v] Illiteracy and poverty make rural Indians—particularly women—the most vulnerable targets of these schemes. While unnecessary operations are the most blatant ethical violations, many patients also report that they were asked to pay bribes for expedited treatment or appointments with better doctors.[vi]
Oxfam’s report, along with reports from other experts, suggests that a major part of the problem is the lack of progress in public healthcare, which strengthens the less-regulated private sector.[vii] Indian public spending on healthcare is among the lowest in the world, while the private healthcare industry has seen tremendous growth in the country.[viii] Low salaries for government doctors encourage bribes and unnecessary treatment as a way to supplement their income. A shortage of medical doctors, due in part to a shortage of public medical colleges, and limited access to healthcare gives patients few alternatives to paying the bribe.[ix]
Poor healthcare threatens India’s future development in its mission to become one of the world’s next great powers. The Indian government should empower the Medical Council of India to create and enforce stricter ethical standards within the medical profession. Law enforcement must be encouraged to investigate allegations of healthcare corruption and, when necessary, prosecute healthcare providers. As with all areas of government, battling corruption in healthcare will be a long-term battle, but it is vital for the good of India’s people and the country itself.
[i] Jill McGivering, “India’s Hysterectomy Scam,” BBC, February 6, 2013, sec. Magazine, http://www.bbc.co.uk/news/magazine-21297606.
[ii] “Unregulated and Unaccountable: How the Private Health Care Sector in India Is Putting Women’s Lives at Risk,” Oxfam International, February 6, 2013, http://www.oxfam.org/en/pressroom/pressrelease/2013-02-06/unregulated-unaccountable-private-health-care-india-womens-lives-risk#fn-2.
[iii] McGivering, “India’s Hysterectomy Scam.”
[v] Sanjay Kumar, “Health Care Is Among the Most Corrupt Services in India,” BMJ : British Medical Journal 326, no. 7379 (January 4, 2003): 10.
[vi] Amit Sengupta and Samiran Nundy, “The Private Health Sector in India: Is Burgeoning, But At The Cost Of Public Health Care,” BMJ: British Medical Journal 331, no. 7526 (November 19, 2005): 1157–1158.
[vii] “Unregulated and Unaccountable: How the Private Health Care Sector in India Is Putting Women’s Lives at Risk”; Sengupta and Nundy, “The Private Health Sector in India: Is Burgeoning, But At The Cost Of Public Health Care.”
[viii] Sengupta and Nundy, “The Private Health Sector in India: Is Burgeoning, But At The Cost Of Public Health Care.”
[ix] “Crack down on Doctor-pharma-laboratory Nexus, Reform MCI to Rejuvenate Healthcare,” The Times Of India, accessed March 1, 2013, http://articles.timesofindia.indiatimes.com/2012-08-20/edit-page/33273729_1_healthcare-mci-drug-companies.