A BBC investigation has revealed that thousands of hysterectomies performed on Indian women are unnecessary, motivated by the greed of unscrupulous private doctors.
The BBC investigation included an interview with a young woman called Sunita. Aged around 25, she was unsure of her exact age, her hysterectomy was performed following a consultation regarding heavy menstruation.
In the West such a radical course of treatment would only be a last ditch effort. Other means such as non-surgical intervention, diagnostics and perhaps minor surgery would be used as treatment. In the case of Sunita an ultrasound test was all that preceded her operation. She told the BBC reporter "I went to the clinic because I had heavy bleeding during menstruation. The doctor did an ultrasound and said I might develop cancer. He rushed me into having a hysterectomy that same day."
Such an important decision would not normally be rushed unless there was hard evidence of an immediate threat to life. Instead alternative treatments would be discussed with all the possible outcomes explained. No such care for some women in India.
Sunita lives in a small village in Rajasthan, north-west India. The BBC investigator discovered that around 90% of all women in the village had undergone a hysterectomy. Many of the women were young, aged in their 20s and 30s. Far too young normally to be offered a hysterectomy.
In the case of Sunita, unless her ultra sound test showed firm evidence of an aggressive, untreatable cancer, more investigations would be normal. Menorrhagia, heavy menstrual bleeding, is one of the most common types of abnormal bleeding from the uterus. It can be hormonal, as in the case of a patient with thyroid problems. There are many possible causes and most are treatable without major surgery.
When the doctor that performed the hysterectomy on Sunita was located he denied wrong doing. He admitted that he often did no other tests than an ultrasound before performing the operation. He claimed that biopsies were taken from the uterus once it had been removed. As the investigator points out, that is too late. It also means that finding any evidence as to whether or not the surgery was necessary is often impossible.
Campaigners, including the charity Oxfam, are now pushing for change. Sadly statistics from Indian states such as Rajasthan, Bihar, Chhattisgarh and Andhra Pradesh, indicate the problem is not isolated. Many women aged under 40 in these regions have also had an hysterectomy.
The accusation is that the surgery is unnecessary and solely performed on the basis of making money.