Newsletter March 1998

The campaign against the quinacrine method of female sterilisation has gathered momentum in various parts of India. Some women's groups in Bangalore under the banner of Mahila Arogya Rakshana Samiti, as also the Mahila Jagriti, have been focusing attention on the issue of hazards involved in unethical testing of the quinacrine method. Strong protests in Bangalore against the private practitioners and NGOs promoting the method forced the Drugs Controller of Karnataka to publicly state that his office had not given permission to any practitioner to use quinacrine as a method of sterilisation. Sit-ins and protest demonstrations outside the clinic of Dr. Bhateja, one of the foremost proponents of the method, led her to state that she would discontinue using the method. She also claimed that she was unaware of the harmful effects of the method, and had come to know about them only in the International Conference of Obstetricians and Gynecologists, held in Copenhagen in August '97. Dr. Kini, who heads CHIP, the NGO through which training of doctors and dissemination of information, pellets and kits for quinacrine sterilisation is carried out, is also reported to have stated that he is no longer carrying out quinacrine sterilisations.

In West Bengal, Dr. Mullick claimed to have stopped using the quinacrine method after members of the Ganatantrik Mahila Samiti held demonstrations outside his clinic. However, women's groups need to be wary of the veracity of these claims, and ensure that the method is not driven underground, where it will be more difficult to detect and monitor. In Karnataka and Bengal hundreds of doctors have been trained through NGOs (CHIP and Rural Medical Association). With increasing privatisation and the government health sector shrinking at a rapid rate, more and more NGOs are jumping into the field of health care, especially reproductive health. Monitoring these activities, ensuring adherence to acceptable standards and demanding accountability from these doctors is a challenging task ahead.

At Saheli, we have attempted to keep up the pressure on the Drugs Controller of India (DCI) to take a stand. The case in the Supreme Court by the AIDWA and the faculty members of the JNU, also seems to have acted as a pressure on the government. In December 97, we received a communication from the DCI that the Drugs Technical Advisory Board had deliberated on the matter, and on benefit - risk consideration, had recommended the banning of quinacrine pellets. The banning of the import of quinacrine pellets is to be effected under Section 10A of the Drugs and Cosmetics Act, while distribution and sale of quinacrine pellets is to be banned under Section 26A of this Act. The notification of this ban is yet to be published in the Official Gazette. However, loopholes exist in the very law under which quinacrine is being banned. For instance, Section 10 of the Drugs and Cosmetics Act itself contains a proviso: “Provided that nothing in this section shall apply to the import, subject to prescribed conditions, of small quantities of any drug for the purpose of examination, test or analysis or for personal use." The vague wording i.e. ‘prescribed conditions‘, ‘small quantities’, ‘any drug’ etc., leaves plenty of scope for misuse.

Unless there is strength of conviction and the political will to ensure that women's health is not put at risk, a mere technical ban may not be of much use. With the bogey of ‘population explosion’ ringing in their ears, policy makers are not committed to ensuring ethical standards for blatantly unethical clinical trials and hazardous procedures. It is imperative that women's groups continue the struggle to ensure accountability of NGOs and private doctors, as well as pressurise the government to carry out its responsibilities.

The Yellow Haze, an investigative documentary on the unethical use of the Quinacrine method of sterilisation raises vital questions of medical ethics and informed consent. For copies of the film, contact Netwaves, No. 74, 10th Cross, 1st Phase, J.P. Nagar, Bangalore 560078. Fax 080-6647316.