Sex determination and female foeticide has emerged as a major money-spinner for medical practitioners in rural areas of Karantaka despite the PNDT Act. Doctors carry mobile ultrasound machines and provide illegal service at a heavy price.

The Karnataka government's efforts in curbing the misuse of ultrasound equipment for sex determination has not had much of an impact in the districts and more so in the rural areas.

The doctors residing in districts of Kolar, Hubli and Dharwad, Mysore, Chitradurga are openly conducting the sex verification tests of the foetus in these districts. Even qualified MBBS or MDs indulge in this practice after fully knowing it is illegal. Most of them have mobile ultrasound machines, which are used during their visits to remote rural areas. Many of them also run infertility centres where treatment is unsuccessful and exorbitant fees are charged.

Medical practitioners in the districts think that there was nothing wrong in determining the sex of the foetus despite the PNDT (pre-natal diagnostics techniques) Act.

Though Karnataka's sex ratio has increased from 960 females per thousand males in 1991 to 964 in 2001, the sex ratio among the child population in the age group of 0-6 years has gone down abysmally from 960 to 949, according to the Census of India 2001 report. Dharwad has a sex ratio of 948 females per 1,000 males, which is one of the three lowest places in the State. The other two being Haveri (942) and Bangalore (962).

The PNDT Act of 1994 provides for regulation of the use of prenatal diagnostic techniques for detecting genetic and metabolic disorder and for prevention of misuse of such techniques for pre-natal and sex determination tests leading to female foeticide. According to the Act, only registered clinics can use such techniques only for detection of certain abnormalities in the foetus.

The Supreme Court order in a directive last year ordered all the States to constitute appropriate authorities to curtail incidence of female foeticide. Despite this, a several gynaecologists and the sonologists in the districts of Karnataka are misusing the ultrasonography and other pre-natal diagnostic tests for sex determination resulting in killing female foetus.

The doctors make a fast buck by charging between Rs. 500 and Rs.5,000 or even more for the procedure. The irony is that while these doctors are practising pre natal sex determination, despite being informed of the directive, the poor patients are not even aware that this procedure is illegal, opined a government official.

The government of Karnataka has ordered and instructed officials across the State in the department of health and family welfare to take a tough stand on the unregistered clinics that have been given sufficient time and a final warnings. But what is gathered by senior government officials is that the clinics with ultrasound equipment are registered but doctors use the mobile ultrasound machines when they visit rural areas and there is no way to curb that. "We have not be able to identify these doctors who go the remote rural areas for sex determination tests," said Kagodu Thimmappa, minister for health and family welfare, government of Karnataka.

"It is seven years since the Act has been passed and we have done nothing about it," informed officials from the Karnataka Health and Family Welfare department.

Although, there is no particular funding for the PNDT, the Karnataka government has sanctioned Rs. 95 lakh for the RCH out of which 50 per cent is earmarked for PNDT activities which includes a comprehensive Information Education programme.

All medical centres conducting ultra sound scans come under the purview of an Appropriate Authority of State and Districts. Periodic inspections and surprise visits by a panel of inspectors are conducted on a regular basis where all the records of registrations are maintained. "This has helped us to achieve a significant number of registrations as hospitals and diagnostic labs with ultrasound machines are now bound by law," said Dr. K N Kumaraswamy, joint project director RCH, department of health and family welfare, Karnataka.

Bangalore has the highest number of PNDT centres. The department of health and family welfare has organised an extensive survey to keep tabs on unregistered clinics. The survey is conducted with the assistance of staff from the District Commissioner of Bangalore, Bangalore Mahanagara Palike and the District Health Department, Urban.

The reproductive child health division of the department of health and family welfare has an Approved Authorisation Advisory Board in the 27 districts and meetings are held regularly for keeping a tab on the registrations. The Advisory Board comprises a chairperson, paediatrician, a representative from the information and publicity department, Public prosecution along with two voluntary NGOs of which one is a woman.

Going by the instances of doctors practising PNDT, the law breakers are not punished, informed a source from the government who is still trying to find out how and where doctors are conducting sex determination in the rural areas.

According to the Task Force report on health and family welfare, the infant mortality rate for females in the State is 72 and is the highest in Kolar, Dharwad, Bellary and Bidar districts. "All these clearly indicate that the female foeticide is on a steady rise in the State", sources said.