Indian women die after sterilisations A government-sponsored mass sterilisation programme in India went tragically wrong this week, with 10 women dying and dozens more left critically ill after undergoing the procedure at a clinic in the rural state of Chhattisgarh. The deaths took place after a visiting physician performed more than 83 laparoscopic tubectomies over five hours at a state-sponsored family planning event for poor women, who each received Rs1,400 ($23) for undergoing the procedure. The Chhattisgarh state government said on Tuesday it had suspended the four doctors that had performed the procedures. Authorities said they were investigating what had caused the deaths. The tragedy has heightened concerns about India's family-planning programme, which relies primarily on female sterilisation. Women in the country often have few other contraceptive options available to them despite New Delhi's pledge to increase its focus on reversible contraceptive options. "This number of deaths is really quite shocking and something we haven't seen but given the context in which these camps are routinely carried out, in unethical, unsafe and unhygienic conditions, it's almost an inevitability," said Kerry McBroom, director of the reproductive rights unit at the Delhi-based Human Rights Law Network. Every year 4.6m Indian women are sterilised, of whom the vast majority have never used any other form of contraception. Rights activists criticise the unhygienic conditions in which the procedures are often performed and say women are in effect coerced to undergo the procedures through a lack of available alternatives. Activists who have observed government-run sterilisation camps in states such as Bihar say doctors do dozens of operations in quick succession without washing their hands or sterilising equipment in between procedures. Some rural primary health centres where the procedures are carried out lack even running water or electricity. The Human Rights Law Network, which has filed a public interest lawsuit demanding independent monitoring of government family-planning programmes, also says that most sterilised women are not given any preoperative counselling on alternative birth-control methods. "No one is against sterilisation, for a lot of women in villages, where they don't have access to any other form of contraception, it's a really great option, but it should be an option with no coercion," Ms McBroom said. "But the lack of choice, the financial incentives for women and field health workers, and the focus on targets creates an environment where there is a lot of pressure," she said. If a woman wants to prevent pregnancy, she essentially has no choice but to choose sterilisation. India has a chequered family-planning history. Although not as draconian as China with its notorious one-child policy, it has tried to promote a two-child norm to control its burgeoning population. During the 1970s millions were forcibly sterilised, which led to a huge backlash against family planning. In the past few years, New Delhi has pledged to move away from its traditional emphasis on sterilisation and to make more modern contraceptives available to its population. But it has struggled to keep pace with growing demand as more and more young people come of age. An estimated 3m women started using modern contraceptive methods last year but the rate of contraceptive availability fell as supplies at health clinics could not keep pace with rising demand.