iconimg Wednesday, July 29, 2015

Ejaz Kaiser, Hindustan Times
Raipur, July 17, 2012
A young woman’s womb is worth as little as Rs. 7,500 in rural Chhattisgarh, where unscrupulous doctors are conducting unnecessary hysterectomies — uterus-removal surgeries — to claim money under the Rashtriya Swasthya Bima Yojana (RSBY), the national health insurance scheme.

The Chhattisgarh state health department has initiated action against 22 of the 34 nursing homes against which it found prima facie evidence of surgeries being done without legitimate medical reasons.

They have recommended the cancellation of registrations of nine doctors working in the private sector.

Over the last eight months, hospitals and nursing homes have claimed Rs. 2 crore under RSBY for removing the wombs of 1,800 women, said state health minister Amar Agrawal.

“It has become a sensitive and serious problem. We are investigating whether these surgeries were being done just for the money or were genuinely needed. The government will take stern action against those found guilty,” Agrawal told HT. The state has ordered a probe and sought information from all districts.

The scam has affected women like Kamla (name changed to protect her identity), 18, from Jheet village in Durg, 45 km west of Raipur, who lost her right to have a baby because her doctor advised she get her womb removed to cure her abdominal pain. http://www.hindustantimes.com/Images/Popup/2012/7/17_07_12-metro1c.jpg

Like her, Tinkeshwari Bai, 29, in Dongartarai, and Sonali Devi, 26, from Manikchouri village, both near Raipur, were asked to get their wombs removed to fix their back pain.

A distressing number of complaints show these women agreed to the surgery because they were told that not getting it done would lead to cancer and other complications.

“Panic and fright left us with no option,” said Bimla Kunti, 31, who has also lost her child-bearing capability.

An estimated 7,000 hysterectomies may have been done across Chhattisgarh over the past two-and-a half years.

“The health department tracked some cases from newspaper reports and others by sending out teams to investigate,” said state health director Kamal Preet Singh.

Dr Yogesh Jain of Jan Swasthya Sahyog, a community-based NGO in rural Bilaspur, said RSBY is inherently flawed as it tempts the unregulated private sector to do medical procedures that are not needed.

Agreed Singh: “People lack awareness and do not question doctors or seek a second opinion. Besides, there is no effective regulatory and monitoring system available.”

Doctors in the private sector are worried that the scam may lead to patients refusing surgery even when they need it. “One cannot rule out the possibility of unnecessary hysterectomies, but there are important indications for it, some even life-saving ones, so the surgery itself should not be condemned,” said a senior surgeon in a private nursing home.

(The names of the women have been changed to protect their identity)