In the beginning there was the baba, who set up shop half an hour's drive from Ludhiana town. Hopeful ghunghat-covered women from neighbouring villages would throng to his unkempt place, and for the price of a bus ticket and one or two hundred rupees take home a small paper packet containing three 'magic' capsules. "I know many women who have had sons after his ilaaj (treatment)," says Saroj, a local villager. "You have to have it with the milk of a newly-calfed cow."
But the crowds at baba's shop have begun dwindling these days. In the heartland of Punjab, notorious for killing its female babies, women like Saroj (not her real name) are shunning the shamans and putting their faith on fertility clinics that have mushroomed in Ludhiana and other towns. They hold out the promise of male babies too, with such euphemistic hardsell to women: "We can treat to give you a manchahi santan (the child of your heart)."
Consider this. There are at least 20 such fertility clinics in Punjab's populous towns, according to one estimate. In Ludhiana alone, for example, there are at least five such clinics. They usually hawk a dubious pre-pregnancy sex determination technique called sperm separation or X-Y sperm separation. Gullible couples cough up anything between Rs 2,500 to Rs 2.5 lakh for the birth of a son.
Clearly, gender discrimination is the reason behind the burgeoning of these suspect clinics. "Everybody wants a son," says Dr Iqbal Singh Ahuja, who runs Iqbal Nursing Home, one of the best-known fertility clinics in Ludhiana. He is the only registered user of Ericson's technique of sperm separation in Punjab. This technique involves washing sperm in albumen (a group of simple water-soluble proteins that are clotted by heat and are found in blood plasma and egg white, among other things) and putting it through a centrifugal machine. This sends the Y-bearing male sperm swimming to the top, to be skimmed up and inseminated into the female. But the likelihood of begetting a son by this or any other of the cumbersome and expensive methods, doctors agree, is no different from the way nature originally designed: a 50:50 chance. It hasn't, however, stopped doctors from advertising their pseudo-scientific claims on billboards, as also in newspapers and brochures. The mumbo-jumbo peddled by one such doctor in Ludhiana goes thus: "Sperm separation by Ericson's modified method. Y enrichment factor 85 per cent. Experience eight years. X-Y separation by free flow Electrophoretic Method."
Doctors say these clinics usually cater to women who have undergone three or four abortions after ultrasound tests. Snared by misleading advertising, they flock to these fertility clinics. Take 33-year-old Savita (assumed name), for instance. She had two daughters and nine abortions in nine years of marriage, before she went to a fertility clinic. The last baby she aborted, she told the doctor, was a boy wrongly diagnosed as a girl through an ultrasound test. By then it was too late for her to conceive. Savita was fortunate that she went to a fertility clinic where the doctor told her the truth. The con-jobs by unscrupulous doctors on desperate women even have a macabre ring: a gynaecologist at the Ludhiana-based Christian Medical College cited the case of a woman who had paid up for an intra-uterine insemination (IUI) at a fertility clinic although her womb had been removed to treat a cancer several years earlier.
The rampant abuse of ultrasound equipment for determining the sex of an unborn child is helping business at such fertility clinics. In Punjab and neighbouring Haryana, rivals in the lowest female sex ratio, the ultrasound machine has become part of every villager's vocabulary. Doctors, nurses and even ayurvedic practitioners carry mobile ultrasound machines into villages, diagnosing, often wrongly, the sex of unborn children. No wonder there are long queues outside neighbourhood gynaecological clinics - some promising "abortion without pain". After four or five - or even nine - such abortions in a pokey room behind a dirty, half-drawn curtain, many women stop conceiving altogether, driving them straight into the arms of fertility experts. "Many couples sell land to pay for their services," says a Delhi-based expert who has worked in this field for over 18 years.
Outlining the modus operandi, the expert says: "Most of these doctors charge Rs 1,000 to Rs 3,000 for IUI and Rs 30,000 to Rs 35,000 for IVF (in-vitro fertilisation). The charges are per menstrual cycle and usually a doctor needs to perform at least six cycles of IUI before an IVF, which usually takes about three cycles. The total cost, without drugs, comes to about Rs 2.38 lakh. Doctors usually tell the patient to deposit half this amount, explaining that if fertilisation takes place before completing all the cycles, he would charge only half. After that, no one, least of all the patient, is wiser if all he did was an IUI and not an IVF."
None of the fertility clinics in Punjab, according to the expert, are equipped to do an IVF. Says the expert: "There are no trained embryologists at these clinics, barring one who is trained to examine animals." And that's not all; basic equipment is also lacking: a 10-year-old clinic in Ludhiana is the only one of its kind in the state which has the critical carbon dioxide incubator. "Even that was purchased a year ago," reveals the expert.
And after all that, chances of carrying a test-tube baby to full term are very slim. "The rate of abortion in IVF is very high," agrees Delhi-based gynaecologist Dr Geeta Shroff, who claims to have perfected a "natural" way of selecting the sex of a child before conception by monitoring the temperature of a woman and telling her to abstain from sex until the right day. She is also a votary of pre-selection. "We Indians suffer from a son complex and women end up delivering more than five daughters in their effort to have a son," she says. "Why not give them a child of the chosen sex and bring down the population? The number of girls will plummet. Then men might start paying a dowry for a bride."
Not quite true, says medical activist Dr Ranbir Singh Dahiya, president of the Haryana Gyan Vigyan Samiti (HGVS). In Haryana, where there are already 110.8 males to every 100 females, the paucity of brides has made no difference to their status. "There is no let-up in violence against women," says Dr Dahiya, a surgeon at the Rohtak Medical College Hospital. The depressing bottomline is that even "progressive members" of HGVS "hunger for sons". And the babas and doctors gleefully exploit this aspiration peddling magic pellets, test-tubes, petri-dishes, "Y-enrichment" drugs and what not. Clearly, it is a choice between the devil and the deep sea.
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