NEWS女性 避妊不妊手術不妊手術 強制

インドの集団不妊手術で女性13人死亡　6時間で83人にずさんな処置

インドで、不妊手術を受けた後に60人ほどの女性が体調の悪化を訴え、12日までに13人が死亡するという事件があった。1人の医師が6時間ほどの間に女性83人に対して手術を行っていたという。
Charlotte Alfred
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Indian women who underwent sterilization surgeries receive treatment at the District Hospital in Bilaspur, in the central Indian state of Chhattisgarh, Wednesday, Nov. 12, 2014, after at least a dozen died and many others fell ill following similar surgery. The surgeon who performed the operations at the government-run
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インド中部にあるチャッティースガル州で現地時間11月8日、不妊手術（卵管結紮）を受けた後に60人ほどの女性が体調の悪化を訴え、12日までに13人が死亡するという事件があった。ニューヨークタイムズによると、この不妊手術は集団不妊手術用の「キャンプ」（移動式医療施設）で起こったもので、1人の医師が6時間ほどの間に女性83人に対して手術を行っていたという。

ロイターの記事によると、被害女性たちには毒素性ショック症候群の症状が見られるという。古い医療器具あるいは薬品の汚染が原因のようだ（また、同記事によると、2009年から2012年に同様の死亡事故が600件近くあったという）。

このニュースによって、インドにおける避妊法としての不妊手術の普及や、本当に自主的な手術と見なすことができるのかどうかに注目が集まることになった。

国連の最新の統計によると、15～49歳のインド人女性は、避妊する場合、約65％が不妊手術を受けるという。

実際、女性の不妊手術は世界で頻繁に利用されている避妊法であることが、避妊動向に関する国連報告書で明らかになっている。これによると、先進国の多くでよく使われているのが避妊用ピルであるのに対し、途上国の多くでは女性の不妊手術が普及しているという（世界全体で見ると、最も多い避妊法は女性不妊手術（20.3％）、次に、特に中国で多く利用されるIUD（14.2％）となっている。世界各国の避妊法の違いをグラフ化したページはこちら）。

国連報告書によると、女性の不妊手術の割合が最も多いのはドミニカ共和国で、47％の女性が避妊法として不妊手術を利用している。ブラジルの40％、プエルトリコの39％、インドの37％、中国の33％がそれに続く。

インドは人口が多いので、不妊手術の件数は世界で2番目に多い。世界で行われている女性の不妊手術全体の約37％が、インドで行われている。インド政府の統計によると、2011～2012年には、国内で約460万人の女性が不妊手術を受けたという。

これとは対照的に、2006年のインド政府の調査によると、男性が不妊手術（精管結紮切除）を受けた割合は、1％前後となっている。

「女性は、避妊法の選択肢について情報を与えられていない」と指摘するのは、ニューデリーを拠点に活動する非営利団体「インド人口財団」（PFI：Population Foundation of India）で、政策提言およびコミュニケーション担当の共同ディレクターを務めるソナ・シャルマ氏だ。同氏は「Associated Press」の取材に対して、「女性たちには、他の方法も存在することを知る権利がある」と述べている。

複数の報道によると、11月8日に不妊手術を受けた女性たちは、全員が貧しい村の出身で、手術を受けるのに10ドルから23ドルを受け取っていたという。

一方で、暗黙の罰則もある。インドの一部の州では、不妊手術を拒否する人には行政サービスが提供されなかったり、子供が2人以上いる人が公職に立候補することを禁止するケースもあると、ニュースサイト「Quartz」は指摘している。

国際人権団体「ヒューマン・ライツ・ウォッチ」が公開した2012年の報告書によると、医療従事者は、女性の不妊手術において地元政府が定めたノルマを達成しないと罰則が科されるので、脅迫という手段に訴える場合も多いという。

インドは、公式には1996年に女性不妊手術のノルマを廃止したが、各州では今も、医療従事者たちに目標達成を求めているとの指摘が根強くあるという。

今回の乱暴な不妊手術が行われたチャッティースガル州の医療当局責任者は、これらの手術を行った医師について、州政府の目標を達成しなければというプレッシャーにさらされていたと述べた。

インドには、「半強制的な不妊手術」をめぐる長い困難な歴史がある。1970年代初頭、当時のインディラ・ガンディー首相は、子供が2人以上いるインド人男性を対象に、集団不妊手術プログラムを導入した（当局の家族計画担当者にはノルマが割り当てられたため、一部の州では、避妊手術を受けないと住宅などの公的補助が受けられなくなったり、貧しい人々に強制的に避妊手術を受けさせるといったことも生じた）。このプログラムは、暴力的な抗議行動を引き起こした。ガンディー元首相が1977年に政権から引きずり下ろされると、それに伴ってこのプログラムも廃止された。

この記事はハフポストUS版に掲載されたものを翻訳しました。

[日本語版：湯本牧子、合原弘子/ガリレオ]

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