Indian state tries to save unborn

By Nidhi Dutt
BBC News, Mumbai

image captionIndian authorities are concerned about female foeticide

A pregnant woman waits to see the tiny outline of her unborn baby on an ultrasound screen.

Hanging on the wall next to her is a board that reads: "Disclosure of sex of foetus is prohibited."

In India, this mum-to-be will not know the gender of her baby until the moment it is born.

In places such as Kolhapur, Maharashtra, the reason for this is simple: authorities are worried that if a family finds out it is a girl, they may terminate the pregnancy.

The United Nations Population Fund claims that between 2001 and 2007, pre-natal sex selection, or female foeticide, resulted in the disappearance of 1,600 girls across India every day.

Saving girls

A six-hour drive from Mumbai, the capital of Maharashtra, Kolhapur is the centre of the state's fight against the killing of unborn girls.

India's last national census in 2001 left the region with a record most locals are far from proud of. Official figures suggest it has the worst male-to-female birth ratio in Maharashtra. For every 1,000 boys that are born, there are only 829 girls.

image captionDr Satish Patki conducts a routine ultrasound on a pregnant woman

Local gynaecologist Dr Satish Pakti says that birth registration, migration and a change in economic circumstances could have some impact on the ratio.

But he and local authorities firmly believe that the main reason Kolhapur's is so skewed is female foeticide, the act of terminating a pregnancy before it reaches full-term.

Panhala is a semi-urban district of Kolhapur. It has a population of 264,000 people. It also has a birth ratio that is worse than the state average.

According to 2001 census figures, for every 1,000 boys that delivered and officially registered in Panhala, there are only 729 girls.

For decades, authorities here say they have been fighting a losing battle. They admit they have been unable to save thousands of female foetuses from death.

However, they are also convinced that something needs to be done before the absence of girls is felt by local communities, workplaces and India's rapidly growing economy.

Socially smart business

Female foeticide is a nationwide problem, it does not discriminate. It is taking a toll on semi-urban towns where the roads are choked with peak-time traffic and markets put on a daily, colourful, show.

It is also hurting small village communities such as those that call the lush, fertile plains of Kolhapur home.

India's rich and poor have struggled to curb pre-natal sex selection for generations. Traditionally, families across the country have preferred boys, as they are seen as more able to provide financial stability.

Moreover, when girls marry, families often have to pay huge, and costly, dowries.

Experts say technology and money are also exacerbating the problem. They say female foeticide is being compounded by readily available, and relatively inexpensive, ultrasound technology and the increasing wealth of India's middle class.

Now, in an effort to fight an age-old problem, doctors in Kolhapur are employing new technology. Some have invested almost £400 ($600) of their own money in the Silent Observer, a tracking and data recording device.

Approximately 240 ultrasound machines in the area have been fitted with the Silent Observer. The rather plain, nondescript black box records sonography imagery in real-time and then links it to details of the unborn child and its parents on an online portal called Save The Baby Girl. The interactive portal then traces ultrasound data and information for the duration of the pregnancy.

Accessed only by Magnum Opus staff and local government officials, the information stored on this interactive portal can then be used as evidence in cases where a doctor or parents are suspected of conducting a pre-natal sex-selective abortion.

Costing £550 to produce, the project is a good example of social business being smart business, according to its creator, Girish Lad, the chief executive officer and founder of Magnum Opus.

image captionGirish Lad says the project is cost-effective

He says the Silent Observer trial in Kolhapur is not about making a profit.

However, if it stops female foeticide and proves to be a good deterrent, it could be rolled out across Maharashtra and possibly across India.

With more than 7,000 ultrasound machines in Maharashtra alone, Mr Lad adds a successful trial period could mean a definite change in fortunes for the project in the future.

Mr Lad says that working with the government sector and honing in on one particular project or service could be restrictive. But on the other hand, there is also a good chance that Magnum Opus could establish a monopoly in the sonography tracking and data recording market in India.

He says candidly that being a path-breaking company in an industry that is still evolving is not a bad payoff.

Benefits versus cost

Doctors such as Satish Patki say the Silent Observer is not a very expensive device. Local officials such as Laxmikant Deshmukh, the district collector of Kolhapur, strongly support the cost versus benefit analysis.

Mr Deshmukh says the expected success of the Silent Observer trial in Kolhapur already warrants greater consideration of a more coordinated roll-out of the tracking and recording software in other parts of the state.

However, Dr Milind Salunke, a consultant to Maharashtra's directorate of health services, says it may not be the most cost-effective way to tackle the problem in the long term.

He claims it is not just a matter of paying a one-off sum for the Silent Observer, taking it out of the box and plugging it in.

Dr Salunke says the government also needs to consider how it will accommodate the costs of creating an interactive portal specific to each region in the state, and how it will carry out long-term maintenance of the system.

He also adds that the impact the use of such devices and technology could have on warranties and insurance of ultrasound machinery is yet to be determined.

If 21st-Century technology does prove to be the best way to fight female foeticide, Dr Salunkhe argues it may be worthwhile gauging whether or not devices such as the Silent Observer can be installed inside ultrasound machines at the time of manufacturing.

He adds that this will not only streamline the process, but give doctors and medical practitioners who use the technology peace of mind when it comes to dealing with maintenance and servicing.

Early days

image captionThe Silent Observer is a nondescript, plain black box

It is still early days for the Silent Observer. Experts say it will be some months before the impact or success of the system can be measured by way of actual births. So far, they say the technology is giving hope to communities across Kolhapur.

Local doctors, authorities and the creators of the device say they are confident that in the near future, they will be able to say they have a tried and tested way of fighting female foeticide.

With the United Nations claiming that thousands of pre-natal sex selective abortions take place across the country every day, supporters of the online tracking system say their way could go a long way to save the lives of many baby girls, in rural and metropolitan India.

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