Is India's sterilisation programme barbaric and anti-women? The terrible tragedy of the deaths of women undergoing sterilisation in India's Chhattisgarh state should inspire anger about the much larger issue of the anti-women and barbaric nature of controlling population in the country. Local and international media reported it as a result of poor hygiene and the use of out of date medicines. Few referred to the fact that sterilisation is the blunt instrument used on women, either by coercion or by alleged choice (encouraged through "incentives" - in this case, a meagre 1,400 rupees - about £14) or that it has been used as a form of bio-political control for many years in India. Indira Gandhi's government famously imposed sterilisation on about 10 million people in the 70s - mainly men - for which there was eventually severe backlash. After that, the focus switched to sterilising women. Now, sterilisation of women and even full hysterectomies are the birth control tactic most practiced in India. I visited a rural clinic recently and asked about birth control offerings and the doctors proudly stated that many women come there for sterilisation. India carries out 37% of the world's sterilisations, with 4.6 million women sterilised in 2012. Some states even offer pay increments to government employees if the female employee, or wife of a male employee has been sterilised after the second child. Sterilisation camps are held across the country, promoted by state governments and encouraged by an army of health workers. Women aren't given other options for birth control. The contraceptive pill is considered taboo, while condoms are shunned. Male sterilisation rates are a fraction of those of women. Of the almost 50% of couples who practice birth control in India, 75% do so through female sterilisation, undoubtedly because women have few choices, if any, over their bodies. Yet few campaigners and practitioners have raised it to the level where public anger would force the government to change the practice. Some see it as imposing something far beyond population control; it's a form of control over local, mainly marginalised populations. In the Wayanad district of Kerala, where tribals make up the majority of people attending sterilisation camps, it's believed by some to be contributing to the slow decline of the local Adivasi (indigenous people of India) community, making it easier to acquire their land for development. According to a report by Bloomberg, this approach to population control has so far failed to achieve its intended outcomes, in spite of many years of trying. Despite the coercive nature of the programme, India has missed every target in the past five decades to reduce its population, which at the current rate will eclipse China's by 2021. Chhattisgarh, where the latest tragedy occurs, is among the poorer states in India. It has a high proportion of scheduled tribes and castes, and is predominantly rural. Education or income opportunities in these regions areinadequate, while tribal people face threats to their traditional livelihoods. Reducing fertility and overcoming taboo associated with less blunt forms of family planning, particularly in these circumstances, is something that can only be tackled through poverty alleviation, education, and changing social values, as has happened in other parts of the world, all of which require political will. Forced or so-called voluntary sterilisation of women, however, embodies none of these. In fact, the latest incidence may have the perverse outcome of causing fewer to opt for any family planning at all, especially if the choices are sterilisation or nothing at all. It's not that there aren't positive lessons to be learned even from within India. Kerala, with the top literacy rate in the country, also has one of the lowest birth rates. According to the latest census, its population growth rate was halved between 2001 and 2011. While sterilisation of women is still commonly practiced and focused on marginalised groups - other forms of birth control are also readily available, and practised by both men and women alike. Meanwhile, the families of the deceased will be offered £2,000, and hospitalised victims will be offered £500. I doubt that will go far to compensate the women and their families who, either by force or desperation opted for a path that was neither necessary nor just, and should long ago have been consigned to history. Teenage girls in southern Malawi reject "sexual cleansing" • FGM and child marriage: grandmothers are part of the problem and the solution • Responding to Rana Plaza: a made-in-Bangladesh boycott won't help girl