Gender determination can be stopped if stricter audits on how ultra-sound machines are followed.  But this would mean a straight 70-80% drop in business in India. Which manufacturer of ultra-sounds wants to see that happen?

The previous article Satyamev Jayate: Follow the money trail to catch a criminal ended with a promise to reveal more about the core reasons behind gender determination. Here it is, and let me be frank, this has not been an easy article to write. It is very difficult to try to present these facts in a simple and lucid fashion. The reality is that one is living through these issues, and the strain that medical episodes have on oneself, close friends and family, do have an impact. Most of all, there is this amazing reluctance, bordering on fear, within many in the medical community, to discuss this subject-unless in the strictest of confidences. So, some facts first:
 
Fact # 1: Today, the business of 'healthcare' as it is known is almost 15% of the GDP (gross domestic product) of the United States of America. This percentile figure would be the natural target in a rapidly evolving economy, like that of India's, especially with the middle-class as a target.
 
Fact # 2: It takes immense strength of purpose, character, intelligence, scheming, support as well as available power, to be able to take on the multiple lobbies which support this global healthcare business. These are not just the direct lobbies from within the profession, but also the lobbies representing other entities which stand to gain from expenses incurred on healthcare.
 
Fact # 3: Within the Indian context, there is the additional issue of superstition, social issues like female infanticide and more. And they are being misused for fiscal gains by the explosive mixture of religion and politics that prevails in India.
 
Fact # 4: The benefits of modern medicine and healthcare are, at the same time, not to be denied in any way whatsoever. Many of us are alive and kicking today because of this boon to mankind. Some of us have the strength to live out our truths because of this, too, present company included.
 
But it is the misuse which has deeper roots than simply the superstitions and social evils that provide business opportunity for the petty greed of clinics and hospitals offering gender determination and infant or foetus murder services. And, as always, this misuse starts from the top. In this case, both corporates and authorities are involved, without which this business can not survive.
 
Simply defined gender determination would not be possible without an ultrasound machine. Typically, the gender of a baby is known around the 18th week or so, though some clinics claim they can do so earlier-14th week also-the reliability decreases the earlier the ultrasound is done. It is also claimed that there is a DNA-based test available, which can be used as early as the 10th-12th week, with a blood sample, but results from this are not reliable at all. In both cases, it is not unknown for these illegal gender determination clinics to claim that the foetus is that of a girl, so that they make more money in the abortion.
 
If the manufacturers of the ultrasound machines and consumables used wanted to participate in blocking gender determination, then it would be as easy as (a) installing a hard drive that will retain data for an extended period of time and (b) audit with electronic records the consumables used on these ultrasounds. Matching the data thus obtained with the identity of the patient would provide a very decent mapping of misuse, if any, by the people owning and operating the ultrasound machine.
 
It would also mean reduced business for the sellers of the ultrasound machine and consumables, and the full business chain therein, as well as reduced income for the authorities if this was implemented. That part is simple to see, it is pure economics, and the parties involved will do anything to protect their business. Include kill the fully-formed girl child, if required, and let us not squirm away from these hard facts. And let me not name the global MNCs involved, because that is simple to find out, and dangerous to publish.
 
That's one part, the business model of the purveyors of a technology which has its good side also-the same technology is used, as mentioned in the previous article, also to help childless couples have babies. And more. But then, as more than one source from the ultrasound industry told me-if the illegal gender determination business were to somehow stop overnight, then business in India would be down by a straight 75%-80%. Which manufacturer of ultra-sounds wants to see that happen?
 
But it is the dark side of the foetus termination and infanticide business, which goes deep into the economics of life re-generation therapies and supposed cures for everything from sexual disorders to skin rejuvenation, and much more-including organ farming. This is the one which flourishes and provides what commerce has always called a "new income stream" -and becomes the subject of much speculation. That it exists is a simple fact of life-and that it is getting absorbed in mainstream healthcare is also becoming acceptable.
 
So how does one follow these diverse money trails?
 
1) Stricter audits on how ultra-sound machines are used. Implementation of the Pre-Natal Diagnostics Test Act of 1994 on a war footing with exemplary punishments. Existing and new ultra-sound machines to be provided with un-eraseable hard drives and "silent observer" tools which can be monitored online. External audits to hold the manufacturers, who typically also provide AMCs, liable for not detecting compliance by the owners/operators of these ultra-sound machines.
 
2) Stronger tracking back of airway bills and customs documentation from the Indian customs and central excise sources pertaining to the export and domestic movement of body parts, amino acids, and foetuses-exported for whatever reason.  This will require opening up of such information into the public domain without the typical issues of 'privacy'. The rules for carriage of such human remains, organs, tissue, amino acids or any other nomenclature, by air cargo out of India, are a good point to start from, without going into grisly details here.
 
If just these two money trails are suitably tracked, and action taken, then a large part of the problem can get solved.
 
Of course, the solution from the sociological approach is not covered here. But then, this was more about the money trail.

(Veeresh Malik had a long career in the Merchant Navy, which he left in 1983. He has qualifications in ship-broking and chartering, loves to travel, and has been in print and electronic media for over two decades. After starting and selling a couple of companies, is now back to his first love-writing.)