One winter morning in December 2013, Anjali Devi (name changed to protect identity) woke up at 3 am at home in Kaithal, Haryana, to take a ‘magic goli’, a pill made from herbs and other ingredients given to her by a faith-healer.
He promised her a miracle. The goli will change the sex of the one-and-a-half-month foetus growing inside her.
The pill or a sex-selection drug (SSD), is an untested indigenous preparation taken by pregnant women believing they’ll give birth to males. Superstitions, lack of education means they are unaware of the fact that the sex of a foetus cannot be changed.
They also don’t know that the pill can be harmful for their child and lead to stillbirths or birth defects.
For many women in Haryana, including Kaithal, where in 2014 the sex ratio at birth was among the lowest in the state at 886 females per 1,000 males, giving birth to a son equals respect in a society with a deep-rooted patriarchal culture.
MALE CALF, MAN’S FACE
Anjali Devi made sure she followed the Barwala-based faith healer’s instructions: that she take three pills on alternate mornings in the early hours with the milk of a cow that had delivered a male calf.
And yes, she had to look at a man’s face when she took the pill with no woman present.
In 2014, after she delivered a male child, Anjali Devi’s sister-in-law took a similar medicinal preparation during her first pregnancy and also delivered a male child.
Till she started working with a government department and understood how such deadly concoctions could harm pregnant women and infants, Anjali Devi believed in the miraculous powers of the faith healers.
Today, she is an informer who assists the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) team of Kurukshetra in arresting such quacks.
She recently assisted the team led by Dr RK Sahai, deputy CMO, Kurukshetra in arresting a woman selling spurious drugs in Devigarh, in Kaithal.
Her anger motivates Anjali Devi to help other women. “I wanted to join the army, but my parents did not agree and got me married. I am also bothered by the fact that people are not giving the girl child the right to live.”
However, except for the mindset of people like her, nothing much has changed in the last four years –demand still exists for SSDs.
“I have a helper who has five daughters but wants a son. She has been taking these SSDs. When I question her, she answers: ek chora toh hona chahiye (one should have a son),” says Anjali Devi who knows at least six women who take the pills.
An Accredited Social Health Activist (ASHA) worker in Jhajjar, which has one of the worst sex-ratios in the state after Palwal (865 till October 2018) says, “They (pregnant women) don’t tell us if they are taking any drug and complain that the pill didn’t work when they have a stillborn child or a female .
“The desire for a male child is intense. We tell them about Geeta and Babita, the famous wrestlers immortalised by the Hindi movie Dangal, but all they want is a son who will inherit their property and carry forward the family lineage,” the worker added.
INCREASED RISK: STUDIES
Unregulated, untested sex-selection drugs, referred to as sau badalne ki dawai or medicine to change the sex (SSDs) are hot-selling items in a number of areas in Haryana.
No one questions the efficacy of these drugs, so blinded are people by their desire for a son.
“Pregnant women are asked to take the drug during the first trimester (6-10 weeks) which is a very critical period during the development of a foetus,” says Dr Sutapa B. Neogi, Indian Institute of Public Health – Delhi, Public Health Foundation of India.
For several years now, she has been studying the SSDs and their impact on the health of mother and child in Haryana.
Worryingly enough, she has found a strong co-relation of SSDs with stillbirths and birth defects.
In a 2015 study, she had said the risk of congenital malformation in children increased threefold among mothers with a history of SSD intake.
Among five mothers exposed to SSDs, one reported a stillbirth, another study claimed.
After establishing the detrimental effects of SSDs on infants, the researchers’ team investigated the drugs for heavy metal toxicity.
In another June 2018 study Bandopdhyay-Neogi found lead and mercury levels in three indigenous sex-selection drugs Shivalingi (Bryonia laciniosa), Majuphal (Gtuercus infectoria) and Nagkesar (Mesua ferrea) were more than 10 times higher than the limits recommended by US Food and Drug Administration or the World Health Organisation.
“Of the principal constituents, Shivalingi had the highest content of mercury at 370 micrograms (μg) per kg while the maximum content of lead was present in Majuphal (18.26 μg per kg). The levels of cadmium were within the recommended limits while arsenic was not detected in any of the herbal seeds,” she said.
Consumption of heavy metals even in traces can be risky for pregnant women. Heavy metals such as lead and mercury can cross the placental barrier, exposing fetuses during the critical first trimester to danger.
Lead exposure can lead to miscarriage, premature birth, low birth weight, abnormal brain development, impaired bone growth, and retarded growth of the newborn.
Exposure to cadmium in pregnancy has the risk of affecting growth, causing cardiac and craniofacial abnormalities, such as smaller eyes and poorly formed nasal bridge leading to renal abnormalities.
The studies also found presence of phytoestrogens – plant-derived edible compounds which mimic the effect of estradiol (major female sex hormone) and interfere with the natural hormones of pregnant women in quantities potentially detrimental to the growth and development of the embryo.
“We collected 30 samples from various parts of north India. Around 63% of the drugs were strongly positive for phytoestrogens, and 20% were positive for testosterone,” said Dr S Bandopdhyay-Neogi, currently researching animal (rat) models to investigate the impact of chemical components.
“The study is over and we are compiling the results. We have found how the average number of pups significantly reduced among rats administered with SSDs. In human beings it would mean stillbirths or abortions.”
TOFFEE FOR Rs 8,000
After the launch of the Bharatiya Janata Party-led government’s Beti Bachao Beti Padhao campaign in Jaunary 2015, the Haryana government has been aggressive in conducting raids under the Pre-Conception and Pre-Natal Diagnostic Techniques (PNDT) Act, but the state still faces challenges.
As the government remains focused on cracking down on pre-natal diagnostic techniques, sex-selective drugs (SSDs) remain off the radar.
Since May 2015 only 69 FIRs have been registered against those selling SSDs. The number is hardly 10% of the FIRs registered under the PNDT and Medical Termination of Pregnancy (MTP) Act.
Just one FIR has been registered in districts with the lowest sex ratios such as Jhajjar and Palwal.
Dr Rakesh, deputy civil surgeon, Jajjhar, says patriarchy is deep-rooted in the upper caste-dominated belt and so is the greed for a male child. “Once they almost shot a health worker who was returning after conducting a raid. They threatened to kill him but luckily the police was present,” he said.
It’s the mindset that needs to change, he says. “We arrested a woman, Mahendari in her late 50s, from a colony in Jhajjar for selling SSDs, which had Guggul (sap or gum resin of the Commiphora mukul tree), camphor, peacock feather and jiggery costing ₹2, 500,” he said.
“Then in one corner, we saw candy wrapped in paper. When we asked her what it was she started laughing, saying ‘saheb toffee hai (it’s toffee)’,” he said. She was selling it to the gullible women for ₹8,000.
An ASHA worker who was involved in the fraud had been suspended, Dr Rakesh added.
Dr Rakesh Gupta, Nodal officer, Beti Bachao Beti Padhao, CM office, Haryana said, “Haryana is perhaps the only state in the country to take major offensive against the menace of use of sex selection drugs. 69 FIRs have been lodged and deterrent punishment awarded to all unscrupulous elements.We only invited researchers from IIPH Delhi to study the impact of these drugs on stillbirths and children born with birth defects and have taken several measures to disseminate the findings with people of Haryana through multiple means.”
He said that due to the concerted efforts of the state government under Beti Bachao Beti Padhao campaign, sex ratio at birth has improved from 861 in 2014 to 914 in 2017 in the state.”