"I would have gone for this option (liver transplant) if the baby was male, but I cannot spend so much money for a daughter."

-- A father of a patient quoted in research from the All India Institute of Medical Sciences

Diminishing returns

By Astrid Lobo Gajiwala

MUMBAI, India -- For Indian women hounded from the womb to the tomb, the sex ratio revealed in the Census of India 2001 puts the writing on the wall -- 933 females per 1,000 males, indicating that there are over 35 million fewer females than males.

This discrepancy in male female numbers is even more disturbing given the biological advantage that enables women to live longer than men. In a population where the women do not face discrimination, Nobel economist Amartya Sen puts the sex ratio at about 105 women to 100 men. By these standards, India is woefully short.

And yet, these figures are an improvement over the previous census sex ratio of 927 women to 1,000 men. Whilst the Indian government sees this increasing sex ratio as a sign of the better status of women, Pavan Nair of the Pune based organization Jagruti postulates that it is in fact due to a big chuck of missing men. According to him, the millions of males lost to illnesses like tuberculosis, kala azar, cholera, malaria, plague, AIDS and diseases related to stress, alcohol consumption, smoking and drugs, "accounts for the unexpected reversal of the overall sex ratio at a time when discrimination against girls and women is still rampant." He therefore warns of the "horrors at both ends of the spectrum -- with female foetuses and girls being killed at one end, and men falling victim to illnesses at the other end."

Welcome exceptions to this declining trend are India's 24 million Christians who account for 2.34 percent sof the country's population, and include Catholics of every rite and Christians of all denominations. They are the only religious group with a positive sex ratio. Growing from 994 in 1991, to 1,009 women in 2001, they have recorded the country's highest sex ratio among religious groups. Clearly, Christian women appear to be enjoying better healthcare and living longer than before. No mean feat in a society where women are still sold or killed for dowry, beaten into submission or denied adequate healthcare.

The adverse sex ratios are a grim reminder of the low status of India's women. The sub-continent has the dubious distinction of having one of the highest maternal mortality rates in the world (408 per 100,000 mothers) and an infant mortality rate to match (72 per 1,000 births). India also reports the highest incidence of low birth weight babies, again reflecting the ill health of the mother. "Marrying girls off young is (another) indication that women have low status. They are recognised only in their role as mothers and are denied opportunities for education or economic independence," says Dr. Malini Karkal, demographer and long time social activist. Early and repeated pregnancies and abortions take an additional toll.

Population Control
The situation is aggravated by the government's two-child family policy introduced to control the burgeoning population, which currently stands at 1.02 billion. Based on the data available from the National Family Health Survey (NFHS) that claims to cover 99% of the Indian population, Dr. Karkal points out that women are increasingly shouldering the burden of population control. Sterilisation is 8 times more prevalent in women than in men, and women are being coerced into using it as a means of contraception, often before the age of 30, without having tried alternatives. A significant number of these women suffer from health problems post-sterilisation and are left to deal with these on their own.

Abhijit Das, expert on population studies, further cautions that the current emphasis on a two-child norm in a family where women have no decision-making power only results in pre-selection, repeated abortions and violence against women. In certain states, the standard of healthcare is so low, that the failure and death rates for abortions are 5 times higher than internationally accepted standards.

Child Sex Ratio
India's child sex ratio is another cause for concern. In the decade 1991-2001, it recorded its highest fall, dropping 18 points from 945 to 927 girls to a thousand boys. Even the Christians who can boast the country's highest child sex ratio, fall below the ideal average, with 964 girls to a thousand boys in the 0-6 age group.

So where are the "missing girls" that Amartya Sen drew attention to? Stifled before birth, or lost to neglect.

According to demographers, some of these declining figures for girls can be attributed to a decrease in the growth rate due to smaller families. Couples opting for planned families are also choosing the composition of their families. Many are using sex selection tests followed by the selective abortion of female foetuses. Kerala, for instance, which has the highest number (6,057,427) of Christians, and which ranks 12th in the index of son preference, has shown an adverse juvenile sex ratio for the first time since 1951. Similarly in West Bengal, according to the Director of Census Operations, Kolkata too is seeing the lowest child sex ratio in the last 50 years, going from a high of 1,011 females per 1,000 male children in 1951, to an abysmal 923 in 2001.

Besides female foeticide, Dr. Karkal also draws attention to what is sometimes referred to as "extended infanticide." Girls are breast fed for shorter periods, taken for fewer medical consultations, and often very late or not at all to hospitals. Even among the well heeled, girls are dispensable as evident in a news item in a leading daily earlier this year, highlighting the insignificant numbers of girls that are being brought in for organ transplants as compared to boys. In the Capital's posh Apollo Hospital, last year only 5% of girls were treated for liver failure as opposed to 90% boys. Figures at the All India Institute of Medical Sciences (AIIMS), another leading hospital in the same city, also show an appalling 100:560 female to male ratio of organ recipients. The article quoted one father who bluntly said, "I would have gone for this option (liver transplant) if the baby was male, but I cannot spend so much money for a daughter."

Shockingly, female foeticide and infanticide is not a scourge of only undeveloped rural India. For every religious community the child sex ratio is worse in urban India than in the villages, and the Christian community is no exception, though the decrease is admittedly, marginal (1 point). Contrary to popular belief, the higher literacy rate and improved economic status of city dwellers does not translate into better care for girls. The dice is so heavily loaded against her that these advantages are being used instead to better access sex selection tests and abortions. Ultrasonography clinics used for prenatal diagnostic tests are big business these days. A microstudy by Sunita and Joy Elamon in a city in Kerala, for instance, found 37 such clinics in the area, of which only six were in the public sector.

Why this hankering for sons? In India, it is linked with the Hindu belief that the soul can reach svarg or heaven, only if a son performs the last rites and lights the funeral pyre. Additionally, few want to waste money on paraya dhan, or "someone else's property", another name for the Indian girl, reflecting her non-identity after marriage and the exorbitant dowry that inevitably is demanded by a bridegroom at the time of marriage. The joint family and all it implies in terms of sons caring for ageing parents is another consideration in choosing the sex of a child.

Ironically, it is their role as child bearers that is making the "missing girls" the focus of public concern. Who will provide the much desired sons if there are no women? Where will the men find brides 20 years hence if the decline in the number of women continues?

And so, once again, women and girls are made victims. To make up the deficit in local brides, in India, anxious mothers in northern Haryana, the state with the second lowest sex ratio (820:1000), are importing brides from Madhya Pradesh a state in central India. In the Gujjar community of Rajasthan, fraternal polyandry is slowing making an appearance. "A young woman is formally married to only one brother. Neither she, nor her parents, have any idea of their real intentions. Later her husband's brothers also have sex with her," says sociologist Ravindra Bhalla. This brings side benefits. Since the children of the union are owned collectively, and the brothers do not go their separate ways, the family property remains intact. The woman however, is reduced to little more than a bonded labourer as she cooks, cleans and services the men. Sometimes, she becomes a bone of contention. In Uttar Pradesh, five cases of female fratricide have been registered, murders provoked by sexual rivalry.

The Christian Lens
For Indian Catholic feminists, the census figures are both reassuring and disturbing.

It is surely a matter of pride that of all the religious groups, the Indian Christians are the only ones with a positive sex ratio for women. Moreover, they also return a favourable sex ratio in 13 out of 35 states and union territories. In comparison, other religious communities touch the 1,000 mark in barely a handful of states. Goan Christians record the highest sex ratio with 1,107, followed by the Christians in Pondicherry. These results reflect in some measure the better status that Indian Christian women enjoy in society.

It comes as a bit of a surprise therefore, to find that in the predominantly Christian northeast states, only Meghalaya has a positive sex ratio. Mizoram follows with a ratio of 986, and Nagaland, which is 90% Christian, has a ratio only eight points above the national average.

The child sex ratio for Christians too has some unexpected twists. While Christians can boast of the country's highest child sex ratio with 27 states and union territories demonstrating a child sex ratio above the national ratio, when seen through the "Christian" lens however, these figures are not high enough. Only the small community of Christians in Dadra and Nagar Haveli fare well in this age group, with 1,009 girls to 1,000 boys.

The gender imbalance amongst the Christians uncovers a disturbing truth -- Indian Christians too have a bias against girls. They may not need sons to conduct their funeral rites, but they still reserve family property for their sons, and the continuity of their lineage through sons remains a priority. Dowry although illegal, is still prevalent, although among Christians it assumes more subtle forms -- "If the girl's family wants to give us something how can we say 'No'?"

For the Catholic church in India, its missing daughters throw up a number of questions. Has the Indian church challenged its faithful sufficiently with Christ's radical relationship with women? Has it taken concrete steps to counter gender discrimination in society? What is its pastoral response to domestic violence? Has the pro-life movement in the Indian Church made the link between abortion and the low status of women? What does our negative child sex ratio have to reveal about the impact of the Christian understanding of the sacredness of life? What are the priorities of the Church's healthcare and development programmes? In the answers to these questions lie clues to the Christian witness of the Indian Church.

Conclusion
From newspaper reports it is apparent that religious communities in India have already begun using the results of the census to analyse trends in their communities with a view to taking effective corrective measures where necessary. The government itself has recognised the value of the support of religious communities in chalking out its development plans based on the Census Report. Thus, the Minorities Commission of the Government of India has convened a meeting of religious leaders to discuss the data. It remains to be seen whether the Churches in India will similarly use the Census Report as a baseline for implementing their pastoral plans.

And while they are about it, perhaps the Churches could use the data to introspect on what it means to be Christian in India today. The census is after all a lens through which Christians are being viewed. Two thousand years ago they said of the followers of Christ: "See how they love." What do they say today?