Doctors in the Indian state of Chhattisgarh have been performing hysterectomies that weren’t medically warranted on poor village women in order to claim money from a national insurance scheme, according to the state’s health minister.
 

"The women were deliberately ill-advised by doctors who removed their uterus to get money," Amar Agrawal, Chhattisgarh's health minister, recently told Reuters. Under the program launched four years ago, doctors can charge up to $540 dollars for the surgery.

The vast majority of these women, many under age 40, said they felt coerced into surgery by doctors who claimed cancerous or pre-cancerous cells were present. However, in a majority of cases, that diagnosis was made strictly on the basis of an ultrasound. This scan doesn’t justify a decision to operate, according to independent doctors.

“It seems that private doctors see this as an opportunity to make a fast buck. They’re making money on ailments which could be treated in a simpler, less invasive way.” Dr. Narendra Gupta, affiliated with the health charity Prayas, told the BBC.

Gupta, a gynecologist and one of many activists trying to shed light on the malpractice, told the BBC that she sees up to eight women a week from villages in the region outside Jaipur who’ve been told they need hysterectomies, but want a second opinion.

“In rural areas, doctors give a diagnosis of cancer very readily,” Gupta said. “That’s very wrong. When patients come to me, I tell them that an infection doesn’t cause cancer. We’ll cure the infection, I tell them, and you will be completely all right. Some are convinced but some are not convinced because they’ve been told: ‘If you don’t get your uterus removed you will get cancer and die.’”

The cause of the recent uptick in hysterectomies performed may be the rapid expansion of small private clinics and hospitals in rural areas that are poorly served by the government health system.

Critics of the health system say this has led to the exploitation of poor women by unscrupulous private physicians as a way to tap into government funds.

An independent evaluation by government doctors found that roughly 12 percent of 2,606 women who were examined for the presence of cancer in their uteruses agreed to have them removed, although it was unnecessary surgery.

"I think there was basically a mad rush to earn as much money as possible to do unwarranted surgery," Samastipur district magistrate Kundan Kumar said.