Tuesday, June 15, 2010

Poverty Drives "Google Baby" Boom in India

Cost arbitrage that began with call center outsourcing from the West to India has now found its way into the low-rent wombs of poor Indian women! This new growing business has created a global supply chain with low-cost human babies as the final product brought to the West. This business can cut the cost from over $100,000 in the U.S. to less than $6000 per baby in India. It is explained in an Israeli documentary "Google Baby" scheduled to be aired on HBO in the United States tomorrow. The movie follows an Israeli gay man who decided to have low-cost test-tube babies by outsourcing the job to India.

Wealthy Americans and Europeans, gay or straight, can now shop online for an egg from an egg donor in the West, use their sperm or from sperm another western donor, and implant the embryo into a surrogate mother in India. These people don't want their European genes to be mixed with those of the poor women in India, but the Indian women are acceptable as cheap surrogate mothers.

On NPR Talk of the Nation show aired today, the show host Neal Conan and Google Baby producer Zippi Brand Frank introduced the basic idea of surrogacy in India in the following exchange:

"CONAN: And essentially your film follows a young man from Israel who has been -he and his partner have adopted a baby, has gotten a surrogate baby themselves from the United States. And he says in the end it ended up costing him $140,000. And he thinks, wait a minute, everything else is being outsourced to India. Why not this?

Ms. FRANK: Exactly. That's what - that's exactly his start-up(ph). I mean he did it - he did his first baby through 100 - he paid 140,000 U.S. dollars and he decided he's going to find the cheapest way to do the other babies. And now his business is really growing rapidly, I would say. And it costs, if you go to India and you still want to have a Western egg donor but you can, you know, you can compromise for an Indian surrogate mother, so you pay only 40,000 U.S. dollars, and that's the maximum you can get for a baby."

The NPR radio show featured a couple of soundbites from an Indian obstetrician Dr. Nayna Patel in Anand, Gujarat, who is actively promoting her India-based surrogacy business in the West.

"Dr. NAYNA H. PATEL (Akanksha Infertility Clinic): Hello? Yes. I'm so sorry, Doctor, but you know it's not an easy procedure. It's a very complicated procedure, surrogacy, and they should understand all the implications before they go into it. Yeah? So that - yes. The husband and wife themselves should come, understand the whole procedure, and then decide whether they would want to go for it or not, okay? When they come personally we can discuss it, okay? Okay. Welcome. Bye-bye. No, no, no, most welcome. Bye-bye."

"Dr. PATEL: I am Dr. Nayna Patel, and I'm practicing in vitro fertilization (unintelligible) in Gujarat, India. And (unintelligible) started practicing surrogacy. And these are a few of my surrogates who work with me. All of my surrogates are very humble, simple, nice females. And they are very committed, they are very dedicated, they're very religious. And they want to do their job in a very dedicated manner. These surrogates are (unintelligible) and they always deliver under my care and supervision. And this, as a clinic, we try to supervise as a whole procedure."

Dr. Nayna Patel's IVF and cheap surrogacy business has dramatically picked up since her appearance on Oprah Winfrey Show back in 2006.

It is common in the United States for IVF children to know and maintain contact with their surrogate birth mothers. However, the poor Indian mothers do not want to acknowledge their surrogate status in public, nor do they want any connection with the babies they carry to term because of social taboos. Critics argue that the surrogacy practice in India is not only exploitation of poor women, but it is also a violation of the UN Convention on the Rights of the Child which states that all children have a right to know their parents.

Here is a video on ethical and moral implications of legalized commercial surrogacy in India:

Related Links:

Haq's Musings

Status of Women in India

Gender Inequality Worst in South Asia

Grinding Poverty in Resurgent India

Women's Status in Pakistan

A Tale of Tribal Terror

WEF Global Gender Gap Rankings 2009

India, Pakistan Contrasted 2010

Female Literacy Through Mobile Phones

Pakistan's Woman Speaker: Another Token or Real Change

Female Literacy Lags Far Behind in India and Pakistan

Female Genocide Unfolding in India

Honor Killings in India


Mayraj said...

I wonder when the lawsuits will start:
Test-tube babies 'twice as likely' to suffer birth defects
World's oldest mother reveals she is dying... just 18 months after IVF birth aged 70

Anonymous said...

Hmm perhaps you could mention something about poor pakistanis selling their kidneys in the aftermath of the Kashmir earthquake and this grotesque trade being masqueraded as a boom in 'medical tourism' by the then Pakistan government.

Riaz Haq said...

anon: "perhaps you could mention something about poor pakistanis selling their kidneys in the aftermath of the Kashmir earthquake"

Pakistan did have a small illegal kidney trade in the aftermath of Kashmir quake, and it continues. However, such illegal transactions in Pakistan really pale in comparison to the scope and scale of illegal poverty-driven organ trade in India masquerading as medical tourism.

Here's an excerpt from a recent Time magazine story about India's illegal organ trade:

Shocked but not surprised. That might be the best way to sum up India's reaction to the revelation this week that a black market organ transplant ring had been harvesting kidneys from poor Indian laborers, sometimes against their wishes, and using them in foreigners desperate for transplants. Police who busted the ring last week say doctors paid as little as $1000 for the kidneys and then sold them for as much as $37,500. The racket, based in Gurgaon, a business center close to the capital, New Delhi, drew victims from as many as eight Indian states and lasted for almost a decade. Police say the black market doctors may have illegally transplanted as many as 500 kidneys. The ring, according to the police, was run by two Indian brothers, neither of whom had any medical training but who oversaw the surgery. One of the brothers has been arrested in Mumbai, but the other, Amit Kumar, who police say was the racket's kingpin, is now the focus of an international manhunt and may have fled to Canada.

But while the details of this particular case are appalling, and the scam is the first — or at least first to be exposed — involving foreigners from as far away as the U.S. and U.K flying in for transplants, Indians are sadly all too familiar with organ rackets. In 2007, police in southern India uncovered an illegal kidney trade involving fishermen whose jobs had been destroyed by the Indian Ocean tsunami. A massive transplant ring in Punjab was also uncovered in 2003. Police there believe at least 30 of the donors, who as in this latest case were poor, illiterate workers promised riches for their organs and bused in to be operated on, died, despite promises that they would receive excellent post-operation medical care and that they had nothing to worry about.

Zen, Munich, Germany said...

There is nothing surprising in it. Everything, done at enough scale by a dominant civilization(ie, West in our time) will be counted as civilized and ethical. So those women who stay at home to breastfeed are considered backward or oppressed while those who outsource and go to work are modern. Those Indian women - let them earn a few bucks, better than selling kidneys(I'm not referring to previous comments from Anon, rather just from a medical safety point of view). This could even be developed as tourism - will have to find a marketing term.

Riaz Haq said...

Poverty is one of the factors that drives IVF surrogate business in India.

A recent ODI report highlighting India's progress toward MDGs and putting India in the top 20.

Looking at the detailed report, however, it clearly highlights Pakistan along with China in the top 10 in achieving poverty reduction goal MDG1, the most important of MDGs. There is no mention of India on this list in table 4.


Riaz Haq said...

Much has been written about India's skilled doctors providing health care to "medical tourists" from the West. Here's a BBC story that makes you think about all the hype:

A US surgeon convicted of manslaughter after botching a series of operations has been jailed for seven years by an Australian court.

Jayant Patel, an Indian-born US citizen dubbed "Dr Death" by Australian media, worked at a Queensland hospital between 2003 and 2005.

He was found guilty at the Brisbane Supreme Court earlier this week of the manslaughter of three patients.

He was also convicted of causing grievous bodily harm to a patient.
Patients hidden

Patel had pleaded not guilty to the manslaughter of Gerry Kemps, James Phillips and Mervyn Morris, and causing grievous bodily harm to Ian Vowles.

Prosecutors argued that Patel's operations were well below the standard of a competent surgeon.

During the 14-week trial, the court heard that he had botched operations, misdiagnosed patients, removed healthy organs and used sloppy surgical techniques during his time at Bundaberg Base Hospital.

Nurses used to hide patients from him because of their concerns about the quality of his work, the court heard.

Prosecutors had requested a 10-year sentence.

Before arriving in Australia, Patel had been banned from conducting surgery in the US states of New York and Oregon.

Riaz Haq said...

Here's a BBC report on pregnant women's deaths in Rajathan due to tainted UV fluids:

..The (three) doctors have been charged with negligence and irregularities in purchases of medicines.

The women died after they were given infected intravenous (IV) fluids at two hospitals in Jodhpur city.

Laboratory tests had confirmed that IV fluids supplied by a local company were "tainted", officials said.

The women died after severe haemorrhaging after they were administered with the IV fluids, authorities say.

India accounts for the highest number of maternal deaths in the world, with tens of thousands of women dying every year due to pregnancy-related problems.


Here's a Deccan Herald story on tainted medicines in India:

It is said that roughly 10 per cent of the medicines available in the market are counterfeit, contaminated or substandard. Profits are huge in the trade. This is a massive racket that involves not just illicit manufacturers but a long chain that includes distributors and then, of course, the shops and hospitals through which these spurious medicines are pushed. It is alleged that pharmacists selling counterfeit drugs profit from doing so. If manufactures are able to push their contaminated drugs easily, it is because hospital authorities are not vigilant. They prefer to purchase medicines from those who grease their palms rather than trusted manufacturers. The problem of contaminated medicines is not one that is confined to allopathic medicines. Testing of some samples of ayurvedic or homeopathic medicines has revealed presence of toxic metal.

Indian pharmaceutical companies export medicines to Africa and Latin America. Therefore, the manufacture of substandard drugs and contaminated fluids poses a grave public health threat that extends far beyond India’s borders. Stern action against those responsible for Jodhpur tragedy is welcome. But it must not stop there. The government must act against other manufacturers of counterfeit and contaminated medicines. The crime they are engaging in is not a minor one. It cannot be brushed aside as mere negligence as they are causing the death of people. They cannot be allowed to play with people’s lives. It is undermining the legitimacy of our medical system.

Riaz Haq said...

Girls being surgically changed into boys, reports Hindustan Times

Girls are being 'converted' into boys in Indore - by the hundreds every year - at ages where they cannot give their consent for this life-changing operation.
This shocking, unprecedented trend, catering to the fetish for a son, is unfolding at conservative Indore's well-known clinics and hospitals on children who are 1-5 years old. The process being used to 'produce' a male child from a female is known as genitoplasty. Each surgery costs Rs 1.5 lakh.

Moreover, these children are pumped with hormonal treatment as part of the sex change procedure that may be irreversible.

The low cost of surgery and the relatively easy and unobtrusive way of getting it done in this city attracts parents from Delhi and Mumbai to get their child surgically 'corrected'. http://www.hindustantimes.com/Images/HTEditImages/Images/26_06_pg1a.jpg

About 7-8% cases come from the metros, say doctors.

While genitoplasty is relatively common - it is used to correct genital abnormality in fully-grown patients - the procedure is allegedly being misused rampantly to promise parents a male child even though they have a female child.

The parents press for these surgeries despite being told by doctors that the 'converted' male would be infertile.

While genitoplasty experts of Indore say each of them have turned 200 to 300 girls into 'boys' so far, only one could cite an instance when a 14-year-old was converted into a girl. ...

Riaz Haq said...

Here's a Dawn newspaper story on India's rent-a-womb industry:

Commercial surrogacy in India has become a profiteering business with an annual earning of $1 billion.

Most pregnant mothers are kept in Shelter Homes during their days of confinement; critics have dubbed these homes as “baby factories”.

Why do women take such a step?

An 18-year-old surrogate mother Vasanti, said, “In India, relationships and family are very highly valued. One can do anything for one’s children. I have become a surrogate mother so that I can provide my children with all the very best in life, which I have only dreamed of.”

Vasanti is at present pregnant; but the child protected in her womb is not her own, instead it belongs to a Japanese couple. Vasanti shall be paid $8000 for her troubles.

Such a huge amount is like a dream to Vasanti, who can now build a new home and also educate her kids, who are seven and five years of age. With regards to the impending payment, Vasanti declared that she was extremely happy with the arrangement.

The “baby production” process

The procedure for injecting her womb with the embryo of the Japanese couple was undertaken in the Akanksha IVF Centre in Anand town of the Gujrat state. She has been moved to a nearby temporary shelter home provided by the centre, where she will continue to live for nine months.

This home houses a 100 other surrogate mothers just like Vasanti. All of these women are under the supervision of gynecologist, Doctor Nayana Patel.

Each room in the shelter home is allocated to 10 surrogate mothers, who are provided with food and vitamins. They are also instructed to rest regularly; Vasanti however does not rest that often.

“I keep roaming around here and there at night because I can’t sleep. As the child in my womb grows, I am beginning to get bored. I want to go home as soon as possible, back to my husband and children.”

According to the rules and regulations of the shelter home, pregnant surrogate mothers are prohibited from indulging in sexual acts. These women are also very explicitly told that in case of any complexities, the doctors, the parents who have donated the embryo(s) and the hospital will not be liable to pay for any damages.

If a surrogate mother carries twin embryos until the time of delivery she is paid $10,000 but if she suffers a miscarriage during the first three months, then she is only paid $600 for her troubles....


Riaz Haq said...

Federal prosecutors charged 11 Chinese nationals Thursday as part of a crackdown on the “birth tourism” industry in Southern California.

Those charged were allegedly “maternity house” clients who left the country earlier this month after being ordered to stay in the U.S. as material witnesses in a continuing probe into businesses that allegedly help foreign women give birth in the U.S. Federal officials say they are investigating the “multiple Chinese maternity operations,” which allegedly arrange for Chinese women to travel here and go back home with infants born as U.S. citizens, according to Thom Mrozek, a spokesman for the U.S. attorney’s office in Los Angeles.

Those charged include four sets of husbands and wives. Ten individuals are accused of obstruction of justice and contempt of court as well as making false statements on visa applications. An 11th defendant who hadn’t officially been ordered to remain in the U.S. was charged with visa fraud.

Charges haven’t yet been brought against any operators of the businesses. Federal agents executed search warrants at several Southern California sites in March. The search warrants cited suspected visa fraud, tax evasion and harboring illegal immigrants, among other accusations.

Mr. Mrozek said that the men and women charged Thursday left on planes to China, and acknowledged that it would be difficult to get them to return. But federal prosecutors hope the charges send a message to the 18 other alleged clients who are still here, and who also have been ordered to stay as material witnesses, he said.

Attorneys for those charged couldn’t be located immediately. Material witness proceedings were under seal, according to Mr. Mrozek.