People's Democracy

JUSTICE FOR YUMA SHERPA

No to Commodification of Women’s Body Parts

                                                                          Sudha Sundararaman

ON January 29, 2014, 26 year old Yuma Sherpa, died in the aftermath of a surgical procedure to harvest eggs from her body, as part of the egg donation programme of a private clinic based in Lajpat Nagar, New Delhi.

Yuma was persuaded by agents to donate her eggs for a surrogacy, and started undergoing the procedure early this year. Subsequently, she wanted to stop the procedure and back out altogether as she was suffering from discomfort caused by the injections, but was told by the doctor at the clinic that it was too late to go back.

After the final procedure for egg removal, she was moved to the recovery room, where her husband, Sanju Rana, found her lying listless when he came to pick her up. He complained to the staff, but was told that Yuma had been given some drugs, and she may be sleeping. When she was still not responding after an hour, Sanju forced the staff to check, by which time it was too late. Despite last ditch attempts to revive her, she was pronounced dead after a few hours.

With great difficulty, and after an intervention with the police by JMS Delhi, a complaint was recorded. Subsequently, a medical panel from AIIMS has submitted a preliminary post mortem report, however, the viscera report is still awaited from the forensics lab. As a result, till date, the culpability of the clinic has not been fixed and acted upon, and no FIR has been registered against those guilty of criminal medical negligence. A joint delegation representing AIDWA, JMS, NFIW, SAMA, Saheli, and JWP, met the Special DCP on February 25, along with Sanju, urging him to ensure time bound investigation and action against those guilty of causing Yuma’s death.

This shocking and tragic death of a young woman in the prime of her life is a serious indictment of the money spinning industry that has cropped up around the whole business of surrogacy, egg donation, and related IVF technologies.

The expansion of assisted reproductive services is one of the fastest growing and most lucrative industries in India within the last couple of decades. These private clinics have been mushrooming dramatically, not just in urban centres, but even in small towns and outlying villages in our country. It is time to tear aside the veil of altruism hiding the serious violation of rights that underlies the boom in surrogacy, and tackle the multiple issues to prevent women falling prey to business interests which are spiralling out of control by the day.

LACK OF

REGULATION

The development of Assisted Reproductive Technologies has taken place almost entirely within the private sector, and there is as yet no law regulating them, while there are laws to prevent sale of human organs and the sale of blood in our country. Some non binding guidelines have been issued by the ICMR, but they are observed more in the breach. With no prescribed uniform protocols, no accountability for implementation of ethical guidelines, no monitoring of impact on the health of women, most clinics just do as they please.

The Draft ART Bill 2013 pending with the central government does not do adequate justice to the concerns of women. Protection offered to egg donors and surrogates are completely inadequate, especially in terms of the medical risks that they undertake. There is no mention of “death” in the entire Draft Bill. A comprehensive, effective and enforceable law is essential to safeguard the interests of poor women who are the worst affected by the unscrupulous and unethical practices that are gaining ground.

In an era of liberalisation, and global networking, the lack of regulation in this sector is seen as a great business opportunity, and is consciously being promoted by policy makers. Many of the advanced countries like the US, Canada, Europe, etc have enforced various restrictions on its commercial use. In India, IVF services are provided without too many questions asked.  The cost of the procedures are also much less. The Indian doctors are able to provide requisite skills at much lower rates. Thus, India has become an attractive destination for the business of surrogacy. There are no proper official records of the huge profits being garnered by the fertility industry, but it runs into billions of dollars.

There are hardly any safeguards in place for the women whose services are being utilised. While there may be some instances of women exercising their own choice willingly, it is important to note that it is often women from economically depressed backgrounds in dire need of money who are used as surrogate mothers. The combined impact of poverty and patriarchy render the woman especially vulnerable to commercialised interests. Lately, the aspirations for a better education for themselves, or for their children (Yuma Sherpa for instance wanted to give her 3 year old daughter a good education in Delhi) has led women to make these risky choices. The industry takes skillful advantage of these aspirants, who are hardly aware of the implications of their so- called free choice.  

NEGLIGENCE OF WOMEN’S

HEALTH CONCERNS

Hardly any attention is paid to the “service providers” and the range of problems they face. These women have to undergo intensive hormonal treatment which might lead to a number of potential health risks. These include multiple pregnancy, hyper ventilation syndrome, spontaneous abortion, miscarriage, ectopic pregnancy, and so on.  In surrogacy, the foetus might also inherit genetic defects which might necessitate termination of the pregnancy or lead to the birth of a child with disabilities. Long term effects of the intensive hormonal treatment have hardly been studied. There has also been little thought given to the emotional trauma that the mother who gives away her child may undergo. Women’s bodies are being brought onto the global market, without any thought of the consequences that are being borne by her. In fact, whether at all such a commodification is desirable or acceptable is an issue to be addressed.  

The market for womb space in India is no longer a furtive one operating in the shadows. It is an open industry, with huge advertising. Fertility centres are openly inviting childless couples, and women in the age group of 25-30 to join up in the service providing group. Selling the use of their bodies is pushed as a way of easy income generation for women! In a well advertised interview, leading health professionals in Gujarat expressed satisfaction that they are giving an avenue for earning to unemployed women!

The ideology of motherhood and the stigma of childlessness are deeply rooted in Indian culture. A married woman gains respectability and status through the birth of a child, especially a male child. Childless women can and do face tremendous psychological, social and economic pressure. Bizarre rituals are often imposed on women, never on men, for barrenness. Earlier, when nothing worked, adoption arrangements within the extended family would often be worked out to everyone’s satisfaction. In recent times, many childless couples had started opting for adoption of children left orphaned or deserted. Now, with the upsurge of ART, a medical, magical solution appears on the horizon. But in this shift, the practice of adoption comes a poor second. The expectations from, and the assault on the woman’s body tend to get intensified. The notion that a child has to be borne to become part of the family, gets reinforced. Instances of sex selection within these procedures have come to light.  

AT WHAT

COST?

IVF procedures are expensive and not always successful. Long-drawn treatment has often imposed huge costs on the families. The egg donor, or the surrogate mother in the ART industry, gets hardly anything in this transaction. There have been reports that clinics “harvest” eggs from women at the rate of 25 to 30 eggs per cycle. They receive around Rs 20,000, or Rs 25,000 for every procedure. Eggs are provided to customers at Rs 50,000 per cycle of treatment. A margin of 20 eggs from each harvesting procedure is indicated, though this is an arbitrary guesstimate, and no accurate figures are available. A cursory calculation gives us a glimmer of how profitable this enterprise is, and why the private sector is balking at regulation of ARTs!

It is in this context that we see the death of Yuma Sherpa as a call to action for the women’s movement, and the democratic movement at large. The unethical practices of many of these IVF clinics in the private sector have to be exposed. We have to fight for legal safeguards, and lay bare the multiple dimensions of exploitation embedded in the market dynamics, so that we can tackle a trend which is fast assuming serious proportions for women in our country.  Let us resolutely combat the attempts of the neo-liberal development paradigm to commodify body parts and the use of new technologies that promote the  exploitation of human life for the profits of a few.