By ALLY FRIEDMAN

MANAGING EDITOR

At last count, 13 women have died at a mass sterilization camp in the central Indian state of Chhattisgarh this week. Dr. R.K. Gupta sterilized 83 women in just six hours on Saturday, despite protocol that prohibits surgeons from performing more than 30 sterilization procedures in a day. The fatalities at this government-run “health camp,” raised concerns over the Indian state’s capacity to curb population growth while ensuring access to quality public healthcare.

Officials claim the victims may have suffered from blood poisoning or toxic shock owing to contaminated medicines and rusty surgical equipment. The New York Times reported that these botched surgeries account for the highest death toll from a sterilization campaign in recent history. Aside from the fatalities, dozens of women are currently hospitalized and at least 13 are in critical condition.

Do Indian women feel pressured to undergo sterilization procedures? Although the government officially ended female sterilization quotas in 1996, there is some speculation that women feel coerced into sterilizations, and that Indian health workers are still required to meet certain targets. Poor, rural women in particular may be at risk for coercion, considering that it is not uncommon for the state to pay and even bribe women to be sterilized.

In the case of Chhattisgarh, all of the victims were from poor rural villages, and each was offered 1,400 rupees ($23 USD) for opting to undergo sterilization surgery. Dr. R. K. Gupta is a “senior and respected surgeon,” says Dr. S. K. Mandal, the chief medical officer in Chhattisgarh. Mandal added that he believed Gupta to be under pressure to meet government targets for sterilization.

Men, too, are offered compensation for choosing sterilization surgery in India. In fact, the cash incentive for vasectomies is higher at about 2,000 rupees ($33 USD). However, it is reported that less than 1 percent of Indian men have undergone vasectomies, compared to the 36% of Indian women who have chosen sterilization procedures. From 2011 to 2012, approximately 4.6 million women were sterilized, and about 37% of all female sterilizations in the world reportedly take place in India.