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The Real War on Women: USAID and India

In his fascinating book Merchants of Despair, Robert Zubrin tells the shameful story of how Lyndon B. Johnson pressured Indira Ghandi to enact draconian population control measures in India as a condition of receiving U.S. foreign aid. The quotas and goals put in place resulted in insanitary and degrading mass sterilization camps.

The more things change, the more they stay the same.

Scores of women were dumped unconscious in a field after a mass sterilization because there was no room in hospital for them to recuperate, medical officials said on Thursday.


Medical experts also voiced shock over conditions at the hospital, where four doctors carried out a total of 106 sterilizations in one day.

The Population Research Institute has more on how these women were induced to put themselves at the tender mercies of such a medical system and permanently give up their fertility:

“The camps are happening non-stop right now throughout the country because the end of the financial year — March 31st — is approaching and there is pressure on health workers to meet their sterilization quotas,” Kerry McBroom, an American lawyer with the Human Rights Law Network (HRLN) in Delhi told PRI Review. “We’ll have a constant stream of injured women and dying women as a result.” Although India denies having targets for sterilizations, quotas are, in fact, set by local health administrators and are well publicized, she added. In 2011, for example, officials in the district of Rajasthan determined to sterilize 1% of the population. To meet this target, they offered mobile phones to men undergoing vasectomies and lottery tickets for cars, motorcycles and refrigerators to anyone who agreed to be sterilized. While paying people for sterilization is against the law in the U.S. and other countries—and has been widely denounced in India—most Indian states are still in the business of bribing people to give up their fertility. The amounts offered range from 150 rupees (about $2.70 US) to about 600 rupees (about $11 US). So-called Accredited Social Health Activists (ASHA workers) or “motivators” are also paid a bonus for every person from their district that they bring to a sterilization camp.
In March, HRLN photographed a sign in a village in Bihar stating that every ASHA worker would be required to bring 12 women and one man in for sterilisation. In Bihar there are 8,400 ASHA workers. This means that the ASHA workers, if they met their quotas, would be responsible for over 100,000 sterilizations. “The ASHA workers are just other women in the village,” said McBroom. “They’re not usually motivated by ideology or population control. But they are definitely motivated by incentives. Just like all the other women in the villages, they’re trying to eek out an existence.”
One of HRLN’s affidavits, from a Jitna Devi, who was 22 years old at the time, claims that she was three months pregnant when she was sterilized and that she miscarried 19 days later. She also claims she did not understand the procedure would render her permanently sterile.

So these women, who are hardly free and liberated even within their own families, are offered pathetic financial incentives to be sterilized, which they may not even understand means being permanently sterilized, under horrific, unsafe conditions. Indian wives (in case you didn't know this) are very much under the control of their husbands' families, who may harm them if their dowries don't come up to snuff. That they would have much of a choice one way or another in accepting these "incentives" is highly dubious. Plus, most people understand that there are some things you shouldn't pay people to do--getting sterilized being one of them.

Who is paying for these programs? That's where it gets really interesting. (Emphasis added)

Whatever the Supreme Court of India rules this spring, it is hard to see how Indian women will be better treated as long as their fertility is tied to foreign aid. Tens of millions of dollars from the US Agency for International Development (USAID), the UK, the World Bank and other population control agencies flows into Indian programs whose primary aim is reducing fertility. A 2008 USAID document discusses implementation of the “population policy” in the state of Uttar Pradesh, for example, whose primary stated goal is reducing the state’s fertility rate from 4.3 to 2.1 by 2016. It is hardly surprising then, that each year 450,000 women in the state undergo sterilizations, most of them at government- sponsored camps. The US budget for health programs in India in the 2011 fiscal year was $78 million, $23 million of which is specifically earmarked for family planning.

Allegedly, U.S. dollars cannot be given to programs that involve bribes for sterilization.

A U.S. law called the Tiarht Amendment prohibits USAID from funding any family-planning program that has targets or quotas, is coercive, has financial or other incentives or involves non-consensual experimentation. If any of these requirements is violated or a “pattern or practice of violations” emerges, the administrator of USAID has 60 days to submit a report of findings and remedies to the Committee on International Relations and the Committee on Appropriations of the House of Representatives and the Committee on Foreign Relations and the Committee on Appropriations of the Senate.

It's moderately obvious that the Tiarht Amendment is not being enforced when it comes to USAID and India. Couldn't the relevant House or Senate committees demand that USAID be held accountable? They could, and they should.

This is a real "war on women," and it's being waged with U.S. dollars. This isn't something the Taliban is doing. This is something our country's foreign aid agency is directly funding with dollars earmarked for "family planning" programs, and the buck needs to stop somewhere, in both senses. USAID shouldn't be allowed (as the UNFPA is so often allowed) to pass the buck to the local officials on policy violations while continuing to pay for the offending programs.

Commentator Aaron Gross suggested below that, when the leftists come up with a fake crisis, one response by conservatives should be to come up with a counter-crisis. I tend not to like the word "crisis," but it's actually exceedingly easy to come up with things that the left either doesn't care about or overtly promotes that are real outrages, while the left simultaneously tries to drum up crises or outrages that are either trivial by comparison, non-existent, or not best dealt with by public policy at all. Hence, the left makes up a completely fake "war on women" on the grounds that Republicans and conservatives resist paying for every woman's birth control pills, of all things, while the left is solidly on-board with U.S.-funded worldwide population control programs that leave wounded women lying in open fields after being sterilized for a bribe of eleven bucks apiece.

Whether pointing out the left's upside-down priorities will "get us anywhere" politically, there is certainly plenty of fodder for a campaign to take the offensive on these issues. Will the left find something to say? Sure, the left always finds something to say, as we may even see in this thread, and it may be that that specious facility with words, magnified a hundredfold by the expressly complicit MSM, will sap the political power of any such counter-crisis political campaign. As everyone knows by now, I think we make a mistake if we make "I'm sure this will work" the lodestone of our political approach. But here, for what it is worth, is the raw material for one such counter-crisis campaign.

Comments (17)

I agree. I have posted this on Facebook and Twitter.

People need to bring up these horrors.

It's moderately obvious that the Tiarht Amendment is not being enforced when it comes to USAID and India. Couldn't the relevant House or Senate committees demand that USAID be held accountable? They could, and they should.

They could, but the most they could do is threaten to try to defund USAID. This is why it is such folly to give the President authority over the Office of the Inspector General. The OIG for USAID would be more effective if, like the CBO, he were accountable directly to the US Congress. His priorities would be far more in line with the law.

USAID does a lot of harm. As far as I'm concerned, it would be no great tragedy if it were defunded altogether. But I realize that is considered a mean position, and no doubt it would be considered "un-strategic" even to say such a thing.

Consider the opposition Rand Paul got to his bill to defund the aid to Egypt, Pakistan, etc. over the anti-American surge we saw in the last 1-3 years. The Republicans denounced him as an anti-Israel radical because donchaknow funding those states that teach that Israeli Jews are pigs and apes who rape Palestinian women is all that keeps Israel safe (No, really, the Republicans really did denounce his bill as dangerous for Israel).

As a general rule I would say that these giant U.S. agencies that throw money at everything and its uncle (so to speak) do more harm than good and that defunding them across the board might very well do more good than harm.

I think people don't really realize how much crazy stuff abroad we are funding, including coercive-bribing population control.

No, really, the Republicans really did denounce his bill as dangerous for Israel

That's because the aid money in question is danegeld we pay on Israel's behalf, and the aid to Egypt in particular has long been a keystone of post-1972 peace-keeping in the Levant. You can make an argument that such money isn't working as intended anymore, but the policy isn't prima facie crazy.

Lydia, this is another example of your excellent expose reporting resume. This is really good work.

Mike T, although Congress should be able to utilize the OIG better, they still have the power of subpoena and can always call the agency's execs on the carpet. Even if the Republicans only own the House, that's enough to create a furor that the Dems won't want to brush under the rug at funding time.

Sage, I agree that in 1972 the danegeld was within the realm of reasonable ideas to solve regional problems. I don't think that we can say conditions are, today, sufficiently similar to make that argument. Admittedly OTHER forms of payment might be useful, but the danegeld is sort of goofy at this point.

Tony, credit where it's due--PRI. They keep on top of this stuff and even send their own people on-site or work with on-site groups to get personal reporting.

There was some recent report about which I'm highly dubious to the effect that China is closing down its family planning office (by merging it with its Ministry of Health) and that maybe this means they are phasing out the one-child policy. I'm waiting for PRI's response on what's really going on there.

That's because the aid money in question is danegeld we pay on Israel's behalf, and the aid to Egypt in particular has long been a keystone of post-1972 peace-keeping in the Levant. You can make an argument that such money isn't working as intended anymore, but the policy isn't prima facie crazy.

It certainly is crazy now with respect to states like Egypt. It was always crazy with respect to Pakistan.

Mike T, although Congress should be able to utilize the OIG better, they still have the power of subpoena and can always call the agency's execs on the carpet. Even if the Republicans only own the House, that's enough to create a furor that the Dems won't want to brush under the rug at funding time.

How's that working out with DoJ over Fast and Furious and DHS over that infamous ammo shopping spree?

The multilingual journalist Mara Hvistendahl, in her book Unnatural Selection, describes how the same horrors also occurred in China and Korea, for the same reasons.

as far as i know, being an indian, our prime minister indira gandhi back in 1975 implemented this forced sterilization thing, but it was poorly implemented and resulted in the havoc described above, and since we are a democratic country she was thrown out of power soon after it, but believe me today this is not the scene, i have been to villages of the states described above, i tour a lot, there is no problem like this there, and i dont want to be rude but the USaid is just about 1 billion dollar, and it dosent affect the economy of about 4.5 trillion dollar, it dosent matter they give us aid or not.
i wasent even knowing that we receive USaid, there is a lot of difference between india 1975 and india 2013, i will not lie, i agree we still have 30% of population in poverty, there is problem of corruption, but still our cities are developing fast, infrastructure development of villages is also the important part of current policy, with the current rate we will finish the poverty in 10-15 years, avg middle class of india earns aroun 30000 to 40000 dollar a year, i think soon in future u will have to change the perception! lastly i will say come and visit india u will surely fell in love with my country... if u want u can say whatever u want, but i know what is the real thing because i live here

JF, I doubt that the fact that you live there means that you know or even have evidence that the events reported in the story didn't happen or don't happen. It's not as though you were standing at that hospital at that time and saw that no women were brought out and laid in the field. You can't be everywhere at once. We have what purports to be eyewitness testimony of these events, as well as photos supporting the claim of quotas and targets in Bihar, the existence of ASHA workers, the affadavit of Jitna Devi, and so on and so forth. These people live there too, you may have noticed. At the moment, I'm not moved by, "I live here and I never saw this." Plenty of people lived in Soviet Russia and never saw a Siberian labor camp, either. (For example.)

But hey, if it doesn't matter to you whether USAID gives India money, great. Let's stop giving it. I have a feeling your country's leaders won't agree with you on that "doesn't matter" bit, though.

Lydia, let me make some clear points,
1) i live in UTTAR PRADESH the state u have mentioned above in your article, and i have been to almost each city of my state, i havent seen the scene that ur article describes about UP, and you r talking about bihar!, do u know its economic growth rate this fiscal year is 12%
2) in our country media is totally free from any government control, and everyone here trusts indian media and they really work hard in exposing any irregularities done by govt.! even in history they have even forced govt. to act upon any human rights violation or some topics like that,
3) people here are not lame, we have mass pool of highly educated people and people can force govt. to act on specific things that govt. is not willing to do by creating mass protests,
4)we have elections in 2014, no party will dare to force such things otherwise they will be thrown out of power, so in election period its extremely hard to do such things,
5)u want to know about leaders, then listen, just six months back UK announced to stop aid to india by 2015 or 16, our finance minister, who is a very truthful man, told media that we were already telling them to stop aid, we dont need it, the aid is just a peanut against our 4.5 trillion dollar economy, i was rather asking them if they want us we can help them in there programs of africa, but the problem is that western leaders want to show there people that see we r giving aids to those countries they r poor, they cant stand without us,
6) if my country is poor and needs aid, then why ur president came to india during recession and cried for jobs, then our prime minister created 50,000 jobs in your country by signing a deal, why your media dosent show these facts huh?
7) do u know between 16th to 18th century india accounted for 40% of the total wealth of the world, then what happened cuz india was always the land of peace and never was prepared of foreign invasion, then british has devastated our land and now giving us aid, bastards! once a westerner said who traveled india during that period, that i never found such peace anywhere else in the world and such mixing culture and diversity, people of all religion living happily and peacefully together
8)u r saying that i dont know about my country, i m going to join politics so i collect information from each and every source
9)sorry for the rude tone lydia but things are not like that, we know the value of human being, okay if u r saying so, i will look into the matter of bihar, if it is so i have contacts in media i will take it to the lime light..

Her name is 'Gandhi', not 'Ghandi'.

JF, you're getting het up about issues of poverty and what-not, and I'm not talking about that. I'm talking about goals and quotas for sterilization, paying people to be sterilized, and about the mass sterilizations. Nothing that you have said indicates that you actually have evidence that the mass sterilizations are not taking place, that people aren't being paid to be sterilized, or that the ASHA workers aren't being pressured to meet quotas. Stop bringing up irrelevancies like economic growth of Bihar!

Perhaps you shd. check out HRLN's affidavits from eyewitnesses. Emphasis added.

Last year, the HRLN filed papers in the Supreme Court of India documenting widespread abuse of the national guidelines governing mass sterilizations. These date from 2005 when the Supreme Court ordered state governments to take immediate action to regulate conditions under which sterilizations were performed to to end coercive practices. The states were also specifically directed to compensate women who suffered complications as a result of sub-standard practices, as well as the relatives of victims who died from botched operations. Eight years on “unsafe sterilization camps are the norm throughout India” still, affirms the HRLN petition, and its attached affidavits include those from some of the 53 lower caste women who were sterilized at a “camp” by a single government doctor in two hours one evening at a high school in Bihar in January 2012. The operations were carried out on school desks which had been shoved together to make a makeshift operating table. Since the school had no electricity or running water, the operations were carried out by flashlight. In their affidavits, the women allege that they were laid out on grass mats on the floor to recover, and that they were medically abandoned after being given a single dose of out-of-date painkillers.

i said na, that i am going to study this matter here in india in detail because i asked many people around me and they all were unaware of it, and i said so much about economy because people on this page are having a myth that india can do anything for money(USaid), such a horrific act! let for a moment i agree on your article, the main problem i m not able to understand is this that the whole south indian population fertility rate is around 1.5 and they counterbalances northern states whose fertility rate is around 2.9 and net indian fertility rate is 2.5, and the india's goal is 2.1, which is easily achievable through awareness campaigns then why sterilization is needed?

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