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No country for baby girls (Hindu.)

The village of Mhaisal on the Maharashtra-Karnataka border hit the headlines recently when 19 foetuses were found buried near a homeopath’s clinic. Jyoti Shelar reports on the trail of rapacious doctors and touts who tapped into the desperation for a male child

On the morning of May 19, 2016, two medical officers came calling at the Bharti Hospital in Mhaisal, a tiny village on the banks of the Krishna river in Sangli district. Perched on the edge of Maharashtra and bordering Karnataka, rumours of sex-selective abortions at the hospital had brought it under the lens of the authorities. Barely a km away, at the government-run Primary Health Centre (PHC), colourful posters on protecting the girl child aimed at changing mindsets. ‘Beti Bachao, Beti Padhao’ (educate the girl child, protect the girl child), the posters exhorted villagers.

Armed with an anonymous complaint received by the Collector, Dr. Vijay Jadhav and Dr. Ashok Mohite, both government medical officers, examined the two-storey bungalow in a narrow lane that also houses a dozen residential premises. They checked the registers and looked around. There were no signs of pregnant women. However, two patients were found admitted — one for diarrhoea and the other with typhoid. Dr. Babasaheb Khidrapure, a Bachelor of Homeopathic Medicine and Surgery (BHMS), the owner of the hospital, was given a clean chit. “Nothing suspicious found,” their report stated.

Ten months later, on March 3, 2017, two State medical officers, Dr. J.K. Momin and Dr. Suresh Kamble, raided the hospital again. Twenty-six-year-old Swati Jamdade had died on March 1, following a botched-up abortion on the hospital’s premises. This time, the doctors arrived with a police team in tow. To their horror, they discovered a full-fledged operation theatre in the basement being run by the homeopath, who was not eligible to conduct surgical procedures. The white-tiled basement also had two clean rooms, with beds. Dr. Khidrapure was nowhere to be seen. He had fled before the raid. A computer table in the corner was stacked with registers. While many things appeared displaced and missing to the raiding officers, they seized everything they could lay their hands on, and questioned locals.

A routine line of questioning led the investigating team to Ravi Sutar, the local milkman who was also tasked with disposing biomedical waste from the hospital. Sutar pointed to an area barely 150 m away. On March 5, the police unearthed what Dr. Khidrapure had been burying — 19 foetuses were exhumed, bundled in blue plastic bags and buried in a mud pit. Some in advanced stages of decomposition, others freshly buried, these were the aborted foetuses over the past two months, concluded the police. The foetuses have been sent for DNA testing.

If Dr. Khidrapure had carried out 19 illegal abortions in two months, how many unborn babies had the doctor killed in his practice over the last eight years, the police now wonder.

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A botched-up abortion

Swati, from Manerajuri village, 40 km away from Mhaisal, was a mother of two — four-year-old Swaranjali and one-and-a-half-year-old Pranjali — and was pregnant with her third child. Her husband Pravin, a farmer, wanted a boy and was desperate to know the sex of the unborn child. “Chachni karun ghe (Get the test done),” a friend suggested to Pravin and referred him to Dr. Khidrapure’s hospital. On February 28, Pravin landed at the Bharti Hospital with his wife, then in her fifth month of pregnancy. After a brief meeting with Dr. Khidrapure, the couple was referred to Dr. Srihari Ghodke’s clinic in the bordering Kagwad village in Karnataka, six km away from Mhaisal, where a sonography was conducted. With the Maharashtra government keeping an eagle eye on hospitals, sex determination was a strict no-no. But in bordering Karnataka, rules were lax. There was no paperwork involved. Dr. Khidrapure informed Pravin that it was a girl and he promptly offered to abort the foetus.

Despite his wife’s pleadings, Pravin admitted her to the Bharti Hospital on March 1. He called his father-in-law Sunil Jhadhav, who lives in Puducherry, to inform that he was going ahead with the abortion. “I dissuaded him from going ahead with the procedure and asked him to consult a doctor,” Jhadhav told The Hindu. But by then, Dr. Khidrapure had already induced labour by placing abortion pills Misoprostol in the patient.

In a span of four hours, Misoprostol induces cramps and bleeding through which a woman aborts. Doctors also carry out a vacuum aspiration to remove the contents of the uterus. But before Dr. Khidrapure could carry out the procedure, Swati became breathless and her condition deteriorated. Ill-equipped to handle an emergency, Dr. Khidrapure asked Pravin to rush his wife to the Bharati Vidyapeeth Hospital in Miraj, 20 km away from Mhaisal. Swati succumbed on her way to the hospital. Her family subsequently forced Pravin to take the body to the Sangli Civil Hospital. As the patient was brought dead, the doctors informed the Miraj police as per protocol. The police, in turn, quizzed Pravin, who blurted out that his wife had died during an abortion.

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But when the police stumbled on the foetuses, what emerged was a multi-State racket that Dr. Khidrapure was running. To date, the police have arrested 12 people including Dr. Khidrapure, two doctors from Karnataka who conducted the sex determination tests, and four agents — Saatgonda Patil and Veerangonda Gumte from Belgaum and Yasin Tehsildar and Sandip Jadhav from Kolhapur — who preyed on couples desperate for a male child and eager to abort the female foetuses.

While authorities were sleeping…

Dr. Khidrapure grew up in Kanwad village that falls under Kolhapur district. After completing his studies in homeopathy in Belgaum, he opened a small dispensary in Mhaisal where he prescribed medicines for minor ailments like fever, pain and dog bites. It was sometime in 2008 that he bought a piece of land on which he built the Bharti Hospital and began offering hysterectomy and appendectomy surgeries by inviting doctors from Sangli, most of whom were retired practitioners from the Sangli Civil Hospital, to operate on patients. The police are questioning the doctors who worked here.

“The district health officials were well aware about all the illegalities from the very beginning. But they simply turned a blind eye,” alleges Ashok Wadar, an activist from Mhaisal who had written the anonymous letter to the Collector in 2016 following which the medical officers were sent for an inspection. He also claims to have made 30 calls on the government’s toll-free number meant for whistle-blowers who want to highlight Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act violations. “But no one paid heed to my complaints,” he says, adding that Dr. Khidrapure had “top connections” due to which no one dared to take him on.

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Incidentally, the PHC that stands within a km from Dr. Khidrapure’s hospital is administered by a District Health Officer (DHO) who also has the responsibility of keeping tabs on private nursing homes in the area. “I never received any complaints about the hospital,” says Dr. Ram Hankare, DHO since the past three years. “The doctor was probably conducting illegal abortions during night and it is the civil surgeon’s job to keep a watch,” Dr. Hankare told The Hindu. When questioned, the civil surgeon, Dr. Sanjay Salunkhe, tossed it right back at the DHO: “It is the DHO’s responsibility to keep a watch on the medical establishments in his area.”

Of the 25 private nursing homes in Mhaisal, only one has the licence to run an In-Patient Department (IPD) and can admit patients. Bharti Hospital does not feature on this list but Dr. Khidrapure still admitted patients.

During the March 3 raid on Bharti Hospital, the police found, besides the basement operation theatre and two rooms, surgical equipment such as abdominal retractors, curved artery forceps, Sims speculum, dilator, allis tissue forceps and spiral needles; oxygen cylinders; an X-ray machine; huge quantities of abortion pills; and other medications that were charred. A large pipe connects the basement to the drainage system outside and the police suspect that some of the aborted foetuses would have been discarded through it. The police have learnt that most of the abortions were carried out using Misoprostol; the hospital was buying the drug in bulk from a Sangli-based distributor, Sunil Khedkar. However, the absence of a sonography machine used to determine the sex of the foetus puzzled the police. The search took the police across the border into Karnataka.

The multi-State racket

During the search at Bharti Hospital, the Miraj Rural police stumbled upon names of some doctors in the registers. A raid conducted in Dr. Srihari Ghodke’s clinic in Kagwad, Karnataka yielded two sonography machines. The clinic functioned mostly at night. “The patients were sent for sonography tests to Kagwad and the abortion would be conducted in Mhaisal,” says Dattatray Shinde, Superintendent of Police, Sangli.

TH18New Sangli map

Run from a two-storey bungalow, the clinic stands barely 100 m from the Kagwad police station and another 200 m from the government-run Community Health Centre. Dr. Ghodke, 68, who has been arrested, is said to have been running the clinic for over two decades. “It was a maternity home at first that abruptly shut down. Later on, we could only see some action after 11 p.m. There would be couples going in and out of the bungalow,” says a local, adding that everyone in the area knew that something illegal was happening. But the police chose to turn a blind eye. “Why should we visit any clinics? We only investigate cases that come to us,” says Laxman Ajjanagi, head constable at the Kagwad police station. Kagwad falls under the Belgaum district that has 242 registered PCPNDT centres and over 2,400 medical centres.

Meanwhile, the Miraj police have arrested another doctor, Ramesh Devgikar, 64, from Bijapur in Karnataka who has a Diploma in Medical Radio Diagnosis and is suspected to have sent several patients for abortion to Dr. Khidrapure’s hospital. The police have seized two sonography machines from him as well. The Devgikar X-ray and Sonography Centre is among the dozen-odd small and large hospitals, nursing homes and radiology centres strewn across a 300-metre radius in the busy, narrow lane in Meenakshi Chowk. A retired doctor from the government-run district hospital in Bijapur, Devgikar set up his private centre 15 years ago. His tryst with the law dates back to 2015 when he was first booked under the PCPNDT Act by health officials who also seized his sonography machine. While the machine was later returned, the case is still pending in court. Neighbours say Devgikar had the busiest practice in the area. On average, he conducted more than 50 obstetric sonographies in a day. Police are still investigating into how many of these were for sex determination.

Health workers from Bijapur say that sex-selective abortions are extremely common in the area. “We come across many women who have one or two daughters and tell us that they don’t want another girl. Suddenly during a medical check-up, we learn that these women have had a miscarriage or a stillbirth,” says a health worker, adding that the government has made it mandatory for them to maintain ‘tayee’ or mother cards on which details of pregnant women and their existing children are mentioned. According to her, a health worker keeps track of 20-22 pregnant women annually, of which at least 3-4 undergo abortions.

Sources from Bijapur say most clients coming to Devgikar were from Sangli and Miraj. “The doctors are closely connected with the agents who operate from border districts of Karnataka such as Belagavi. Some of the agents have their own vehicles which they use to carry the pregnant women to Bijapur from Maharashtra for sonographies,” says a source, adding that the gender is disclosed in a very methodical way. All the doctors have their unique code words. “The disclosure is done to the agent always. One of the most popular codes is pointing at the ear when it’s a girl, as girls wear earrings. If they touch the nose, it means a boy.”

A massive crackdown on sonography centres had begun in 2011 in Maharashtra, and health officials and the police suspect this is what prompted Dr. Khidrapure to explore options across the border. According to Deputy Superintendent of Police (Miraj division) Dheeraj Patil, Dr. Khidrapure charged anywhere between ₹15,000 to ₹25,000 per abortion while the doctors conducting the sex determination tests would charge ₹3,000 to ₹10,000 per test depending on the profile of the patients and the agents would make ₹3,000 to ₹5,000 per couple.

Oh, for a boy!

At the core of these abortions is the deep-rooted desire in society to have a boy, an heir to the family. “Everyone wants one boy at least. What is there to understand in this?” says Namdeo Suryavanshi, a Mhaisal farmer who has two daughters aged four and two and whose wife Meenakshi is expecting a third baby soon. “It is not that I am not going to look after my daughters. They are also important. But a son will complete our family,” says Suryavanshi, who works in a sugar-cane farm. When asked if he went for any sex determination tests, Suryavanshi promptly says, “I have got all my wife’s tests done at the Miraj Civil Hospital.”

Shafiabi Inamdar, 62, from the neighbouring Kanwad village has seven daughters. “Today if I had a boy, he would have been there to look after me and take care of this house,” she says. “The mothers are helpless. There is tremendous pressure on them to have a boy. The in-laws and the husbands are brutal when it comes to having a girl child back-to-back,” says Rajashri Zare, an Accredited Social Health Activist (ASHA) from the village. “Everyone just wants vanshacha diva (lineage flame).”

“All I ever wanted was for my son-in-law to keep my daughter happy,” says Swati’s father Sunil Jhadhav. “We had shelled out ₹3 lakh in cash, 150 grams of gold and an entire ‘sansar set’ that consists of all household things like television, refrigerator, dining table, sofa set, utensils, bed etc.”

Clearly, that was not enough.

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