The Other Half Making the Invisible visible

Sep 28,2010

If women are getting more visibility today, it is partly because of the changes initiated
by the UN conferences of the 1990s
The most striking photograph of the farmers' agitation against the Yamuna Expressway last month
was that of a 45-year-old woman, Rajkumari Devi (Indian Express, August 29, 2010). Captioned
Protesting Farmer, Zikarpur Village, Aligarh, the story that accompanied the photograph described
how Rajkumari, holding a lathi in her hands, sat in protest for days on end with other men and
women, demanding more compensation for their lands that had been acquired for the Yamuna
Expressway.
Her life was her land. My day would start at four in the morning, feeding the cattle and then tilling
the land. I would take a brief lunch break and get back to the field. It was during the evening that I
finished my household chores and spent some time with my family and neighbours. She told the
reporter that she knew no other life than working in her fields, something she had done even as a
child as her father was a farmer. A farmer has no holidays. One is supposed to work everyday and all
the time, she said.
I was struck by Rajkumari's photograph and testimony for more than one reason. Her story is that of
every farmer, man or woman, but her story is also that of women farmers, who are rarely
acknowledged when one discusses any matter related to agriculture. Indeed, women as farmers
continue to be invisible in India even though millions of them are as directly involved with
agriculture as the men.
A reader wrote to me a few weeks ago and asked why I find this women's angle in every story. It is
precisely because of stories like Rajkumari's, the invisible women who are an important part of our
economy, our lives and yet their contribution is so routinely overlooked.
Her story reminded me that this month marks 15 years since the UN fourth World Conference on
Women that was held in Beijing from September 4-15, 1995. It was the largest of the series of UN
conferences held through the 1990s, bringing together thousands of official and non-governmental
representatives from 189 countries to discuss women's rights, how to make them more visible and to
strategise ways to ensure that governments legislate and formulate policies that ensure that women
have the same rights as all other citizens in their countries.
I know that these days the United Nations does not have much currency. But through the 1990s,
some of the important conferences that the UN convened saw the emergence of an international
consensus on a number of important issues.
Significant conferences
Of these, as far as women worldwide are concerned, the two really significant meetings were the 1994
Cairo meeting on population and the Beijing conference. Cynics sometimes wonder what is achieved

by these huge jamborees. But there was a time and place for them and in some respects the fruits of
those efforts can be seen in the decades that followed.
The Cairo conference, for instance, established the link between population and development and
between women's rights and population policies. As one of the signatories of the document that
emerged from the conference, the Indian government had to look again at its reproductive health
policies and discard the earlier system of incentives and disincentives that resulted in fudged data
and women being penalised for being the ones who can procreate. The change in policy has, of
course, not been uniformly implemented and every now and then we still hear stories about coercion.
But 16 years after the conference, there is already enough evidence to show that developmental
policies that deal with illiteracy, health and women's rights are a far more effective strategy to limit
population growth than coercive policies such as forced sterilisation or limits on the number of
children you can have.
Women's rights are a trickier issue. One of the star attractions in Beijing was Hillary Clinton, then
the First Lady of the United States. She got the world's attention when she stated unequivocally that
it is no longer acceptable to discuss women's rights as separate from human rights. She said, It is a
violation of human rights when babies are denied food, or drowned, or suffocated, or their spines
broken, simply because they are born girls, when women and girls are sold into slavery or
prostitution for human greed. It is a violation of human rights when women are doused with
gasoline, set on fire and burned to death because their marriage dowries are deemed too small, when
thousands of women are raped in their own communities and when thousands of women are
subjected to rape as a tactic or prize of war.
Uneven results
Of course, not all the countries present carried forward the philosophy behind this slogan in their
policies post-Beijing. Women continue to be denied basic rights in many societies including India.
Violence against women in the home and outside continues in all our societies. While we hear little
today about violence at home, including dowry torture and deaths, statistics establish that women
are far more prone to assault within the home than outside it.
So was the rhetoric, the declarations, the Platform for Action adopted at Beijing worth anything more
than the paper on which they were written?
I personally think they were. What Beijing did was to reiterate standards that are universal within
the rights context. It laid out violations of women's rights that were unacceptable. And it urged
governments to legislate and enact policies that would make these rights a reality. It also gave civil
society actors around the world a handle that was useful for advocacy for change of policy within
their countries.
What does any of this have to do with Rajkumari from Zikarpur village? A great deal. Conferences
like the one in Beijing set in motion campaigns and changes that were aimed at ending the
invisibility of women like Rajkumari. If today we can see her proud face in our newspapers, and
recognise that she too is an Indian farmer, then a small step towards ending her invisibility has been
taken.

Why do _ die?

Women in rural India continue to die because of indifference and neglect by healthcare
authorities...
This is a public health warning. Do not express concern for the state of healthcare in this country. Do
not express anger that women die because they are either denied care or help is delayed when they
have complicated pregnancies. Do not demand that healthcare is an entitlement that the poor have a
right to demand and that the government must deliver.
Chances are if you are too vocal about an issue like this, and if you happen to be working in an
adivasis-dominated district anywhere in India, the district administration will hint that you have
Maoist tendencies. And that alone is enough to land you in jail and even, as in the case of Dr. Binayak
Sen who has spent a lifetime working as a doctor for the poorest, get you a life sentence for sedition
under an antiquated law.
This is no exaggeration. On December 28, 2010, more than 500 adivasis demonstrated peacefully in
front of the district hospital in Barwani, Madhya Pradesh. They were not demanding wages or forest
rights. They were protesting the death of a 22-year-old pregnant adivasi woman, Vypari Bai, caused
by callousness and negligence of the medical authorities.
Vypari Bai's story is not unusual. It is enacted hundreds of times in the poorer parts of this country.
On November 27, Vypari Bai, who was eight months pregnant, developed high blood pressure and
eclampsia, a life-threatening condition of pregnancy. She needed urgent medical help. From her
village of Ban, her relatives carried her in a cloth sling for 10 km to the nearest Primary Health
Centre at Bokarta. There she was told that the place was not equipped to deal with her condition. So
she was sent to the Community Health Centre at Pati by ambulance. There again there was no help
and the family was told to take her to the district hospital in Barwani.
Made to run around
The story did not end there. In Barwani, at the time of admission her blood pressure was high. The
normal procedure in such situations is to try and normalise the blood pressure and induce labour.
Although she was given some medication for the BP, nothing was done to induce labour. Instead, her
relatives were asked to take her to a private hospital for an ultrasound in an auto rickshaw even
though the facility existed in the hospital. The ultrasound confirmed that the foetus was still alive.
Yet, despite her relatives pleading for help, no doctor was ready to attend to Vypari Bai. Instead, they
were advised to take her to Indore, 150 km away. For refusing to do so, they were asked to sign a
statement that they took full responsibility for the consequences. By this stage, it would have
required a miracle for this young woman to survive. She did not. On November 29, in the early hours
of the morning, she died.
Her death has enraged the adivasis in Barwani district who have seen too much of this kind of callous
neglect. A survey of maternal deaths in the district hospital from April to November 2010 revealed
that there were 25 maternal deaths during this period, nine just in November.

A year earlier, in 2008, in a similar incident, a pregnant woman was turned away from the Primary
Health Centre in Menimata in Barwani district when she had already begun labour because she
would not pay. She was entitled to free treatment. As a result, she delivered her child literally on the
road, outside the hospital. Those who expressed their disgust at this were charged by the district
administration under various sections of the Indian Penal Code.
On December 28, the district administration once again slapped charges against some of those who
demonstrated peacefully in front of the hospital and arrested Bachhiya Bhai on charges framed
against him in 2008. He was finally released on bail after eight days. But the charges against him,
under Section 146 IPC (unlawful assembly, rioting, armed with deadly weapon which when used is
likely to cause death) and Section 186 IPC (obstructing public servant from discharge of public
function) remain. Over 200 of those who participated in the December 28 demonstration have also
been charged.
We know about Barwani because there is a group there, the Jagrit Adivasi Dalit Sangathan that is
organising and working in the area. But there must be hundreds of similar stories from around the
country.
The response of the district administration is shocking enough. What is worse is that this is
happening five years after the National Rural Health Mission (NRHM) was launched to check
precisely these kinds of incidents, where poor women are made to go from pillar to post for help
when they develop complications during pregnancy. Institutional deliveries were seen as a way to
bring down the unacceptably high maternal mortality rate. Yet, according to the National Family
Health Survey 3, only 13 per cent of births to the poorest women and 18 per cent of births to
women with no education or who belong to the scheduled tribes are delivered in institutions. So no
one will argue that increasing access to medical help when women need it most is an urgent need.
Only on paper
This need was supposed to have been addressed by the NRHM. Its guidelines state that every
Community Health Centre that comes between the Primary Health Centre and the District
Hospital is supposed to provide 24-hour delivery services including normal and assisted
deliveries and Essential and Emergency Obstetric Care including surgical interventions like
Caesarean Sections and other medical interventions. Furthermore, specific districts have been
selected in every state where the district hospital is designated as a Comprehensive Emergency
Obstetric and Neonatal Care Centre (CEMONC). The Barwani district hospital is designated as such.
Yet, despite a staff that includes four gynaecologists and two anaesthetists, no one was available to
help Vypari Bai.
The real story of India's progress lies in the detail of how programmes like NRHM are implemented,
or not implemented. It is a story that is not told often enough to make us angry. Occasionally, we pay
attention to the needs of our children. But women like Vypari Bai, who die because no one cares,
remain invisible, the ghosts of another India.

Every eight minutes a woman dies in our country due to pregnancy-related

complications. Why aren't we able to devise an accessible healthcare system?

She gave birth, died. Delhi walked by. This was the headline of a six column news item on the top
of an inside page in Hindustan Times (August 29, 2010). Illustrated with four telling photographs,
the story was about a pregnant destitute woman, who lay on the footpath of Delhi's busy and wellfrequented Shankar Market, which is adjacent to the iconic Connaught Place. Thousands of people
must have passed her, but no one spared a glance at what appeared a bundle of rags covered in a red
cloth.
On July 26, this woman gave birth, unaided by anyone. The cries of the newborn infant caught the
attention of some of the shopkeepers and one of them, the owner of a garment shop, picked up the
baby. The mother apparently refused help and died on that same spot where she had given birth,
four days later. The police came and removed her body and took the child, who had been in the care
of the Good Samaritan until then, to a foster home.
This is an item that should have been on the front page of all our newspapers because it illustrates
two things. One, the increasing indifference of people who live in our metro cities, who are so
absorbed with their own lives that they don't even look around to see how other people survive or
die. We have lost our ability to see, to feel. No one wants to get involved. There is a fear that you
might be asked to commit more of your time, your resources, your emotions than you are willing to
do. So our eyes glaze over, we look the other way and we walk away.
And two, it brings home the reality of maternal mortality in this country where even as we boast of
becoming an economic super power and the media celebrates the few Indians who are joining the list
of the richest in the world, millions of our women are dying in the process of giving birth to a child.
Of course the story of this woman, whose name we do not know, is one extreme. But it should remind
us that this is the reality that we have to address in this country.
Countless more
One can just imagine with rains and the floods that have taken place in the last months how many
more such nameless women there must be on the streets of Mumbai, Delhi, Chennai, Bangalore, a
part of the thousands who have no shelter, who have to sleep out in the open. All our cities,
particularly Delhi but other cities too, are in the midst of a huge construction boom. This is bringing
in thousands upon thousands of people from the surrounding areas. Those who have a skill and find
regular work in these construction sites are possibly provided temporary shelter by the contractors.
But many more do causal work, as and when it is available. The rest of the time they do what they
can to earn a few rupees everyday, sometimes send their children out to beg and find whatever place
they can to sleep.
In Mumbai, for instance, the fancy new skywalks that have been built connecting railway stations to
business hubs have become temporary homes for these homeless people. It is an eerie spectacle to
see these bodies laid out in a row, all ages, men, women and children, some sleeping under mosquito
nets strung to the side of the skywalk, somehow catching a few hours rest under the relentless yellow
light that shines all night. By morning the skywalk reverts to being what it is meant to be, a
pedestrian walkway. No one can complain or say anything because there is no solution. But what
happens to the children, especially the small babies, what happens to the women, some of them fairly
young who become pregnant and have no recourse to any healthcare?

For the other side of this tragic story from a busy street in our national capital is that one woman dies
every eight minutes due to complications arising due to pregnancy such as sepsis, haemorrhage or
obstructed labour. These deaths could be avoided if there is timely medical intervention. But such
help is hard to come by if you live in a remote area or if you are poor woman in city or village. Even if
you get some help, it is often too late to make a difference between life and death.
India's current Maternal Mortality Rate (MMR) is 254 in 100,000 live births. According to the World
Health Organisation (WHO), half of all maternal deaths in South Asia occur in five Indian states
Rajasthan, MP, UP, Bihar and Orissa. We have committed ourselves as part of the UN's Millennium
Development Goals (MDGs) to bring the MMR down to 109 by 2015, in just five years. Is that
possible?
The central government has launched the Janani Suraksha Yojana (JSY) to specifically address the
problem. It provides cash incentives to women who choose institutional delivery in the belief that
this will reduce maternal mortality. If we believe official data, then it would appear that many poor
women are benefitting from the scheme. For instance, according to one report, two months before
the destitute died in Delhi's Shankar Market, another poor woman living in an open park near the
Nizamuddin Dargah was lucky enough to be found by an NGO that helped her get the benefits under
this scheme. As a result, the baby girl she delivered in the park has a chance to live, she has a birth
certificate unlike others like her, and the mother too is receiving healthcare.
Different reality
Sadly, just as the exception in the case of the woman who died on the street does not make the rule,
neither does the woman who survived in the park. Cash incentives in this country have usually led to
corruption and fudging of data. This is already evident from reports from Bihar and Jharkhand. Also,
the media often remains content with reporting official figures without investing in investigating
what is actually happening on the ground. The few investigative stories that do appear on healthcare
on websites like indiatogether.org or infochangeindia.org tell a very different story. They inform
us of the struggle poor women face to reach a hospital, how they are either turned away or have to
wait as there are no trained personnel around. As a result, regardless of new schemes or incentives,
they are either too weak to survive childbirth or die because the promised help never turns up.
Maternal mortality means women are dying of causes not related to diseases or epidemics. Their
ability to survive something like childbirth is inextricably linked to poverty, malnutrition and the
absence of basic healthcare. We can set ourselves all kinds of targets but a realistic plan to improve
the survival chances of millions of Indian women is to ensure that our systems of healthcare actually
cater to those at the bottom of the economic pyramid, women like that poor, nameless destitute in
Delhi.

S assault

The sentence in the Ruchika Girhotra case is a small step in rectifying an anomaly in
the law. The draft Criminal Law (Amendment) Bill 2010 now seeks to tighten laws
dealing with sexual assault

The enhancement of the sentence of former Haryana DGP S.P.S. Rathore, charged with molesting
14-year-old Ruchika Girhotra, from just six months to one and a half years, is a very small step in
rectifying the glaring anomaly in the law that allowed him to almost get away with a serious crime. In
the absence of the popular furore over what happened, and the determined efforts of the young
woman's friends and family, it is possible that Rathore would have continued to hold office and
escape the jail sentence awarded to him. But even as many will believe that 18 months is hardly
adequate punishment for a crime that led to a young woman taking her own life, the sentencing is
the beginning of an important process of change in our antiquated laws dealing with sexual assaults
of all kinds.
Ruchika's is only one case. There are hundreds of such cases in India that never reach the point of
conviction. And many more incidents that are never even reported. But because more such cases are
coming out in the open, the demand for a change in the law has built up to the point that the
government has finally taken note.
Change, finally
The draft Criminal Law (Amendment) Bill 2010 aims to tighten current laws dealing with rape and
sexual assault. This has happened not because of a sudden flash of enlightenment by those who make
laws but because of the sustained campaign by women's groups for well over three decades. The fact
that such a law is finally on the anvil illustrates yet again how important it is that civil society groups
exert pressure and provide detailed alternatives when opposing existing laws.
For, in this case, what women's groups have done is not just to point out the obvious, that the
existing provisions in the Indian Penal Code (IPC) dealing with rape are antiquated (based on a 19th
century law) and ineffective but have also submitted to the government detailed suggestions on how
these provisions can be changed. The National Commission on Women has also provided the
government with a draft law. Such interventions ensure that the discussion does not remain in the
area of generalities but actually deals with the specifics.
But here is where the problems often begin. While civil society groups work on changes based on
their actual experiences of dealing with cases such as those of rape, sexual assault, child abuse etc
the bureaucrats who draft laws appear to have a different set of concerns. So some of the
suggestions are incorporated but loopholes are allowed to remain that will permit offenders to slip
through.
Yet, despite its apparent weaknesses, the Criminal Law (Amendment) Bill 2010, also popularly
referred to as Sexual Assault Bill, will herald important changes in the sections of the IPC dealing
with rape. It has enlarged the definition of rape to sexual assault, thereby bringing under the aegis of
the law many other forms of assault on women that so far have not been considered rape and that
have allowed offenders to get away with the minimum punishment of just two years. This is a
welcome change. (The entire draft is available on the Union Home Ministry's website:
http://mha.nic.in/writereaddata/12700472381_CriminalLaw (Amendment)Bill2010.pdf)
It has also specified that such a crime would be treated more seriously when the offender is a police
officer, a public servant who has taken advantage of his official position, a person on the
management or staff of a jail or remand home, a person on the management or staff of a hospital, the

relative or a person in a position of trust or authority etc. The punishment would be a minimum of 10
years extending to life. Clearly, if such a provision had been in place earlier, Rathore would never
have escaped with such a light sentence.
The draft law has also included specific provisions on child abuse that should be welcome. Groups
working on children's rights have been demanding a separate law dealing with this but lawyers point
out that having specific provisions within the IPC helps as the police usually act on the basis of these
provisions. Thus the punishment for sexual abuse of a minor (defined as under the age of 18) will
now be a minimum of seven years extending to life.
Women's groups are not entirely happy with the version of the law presented by the government
because they hold that it is poorly drafted, is vague in some parts and could provide offenders a
window through which they could escape. Their detailed responses have been sent to the Home
Ministry and one hopes that they will be taken on board seriously.
What is important at this stage is that these provisions in the law are debated and that people, and
particularly women, are made aware of what their rights would be if the law is passed. In India, a
major problem is the absence of accurate information on important laws. And the media does not
always help as the manner in which these issues are reported leads to a misunderstanding of the law.
Skewed balance
For example, instead of looking more closely at provisions in the draft law, some newspapers have
been emphasising the opinions of little known groups that insist that the law will victimise men. This
is an amazing form of balanced reporting where you place on an equal footing the very real
problem facing millions of women who have been sexually assaulted, and their rights, with small,
fringe men's rights groups who are given equal or sometimes even more media space.
Instead, what we need to consider is why the graph of assaults against women has been steadily
climbing in this country, and why the rate of conviction remains pitifully low. According to the latest
figures for 2008 assembled by the National Crimes Records Bureau, there has been a five per cent
increase in crimes against women from 1,85,312 in 2007 to 1,95, 856 in 2008. These crimes
include rape, molestation, kidnapping and abduction of girls, sexual harassment, trafficking (defined
as importation of girls) and cruelty by husband and relatives. The last has the largest number of
recorded cases 81,344, followed by 40,413 of molestation, 22,939 of abduction of girls, 21,467 of
rape and 12,214 of sexual harassment.
It goes without saying that a change in the law by itself will not reduce crimes. But in this instance,
the important expansion of the term rape into the much more specific term of sexual assault is
long overdue. The real challenge, if and when the law is tabled in Parliament, and hopefully passed,
will be how well it is implemented.