Ultrasound Machines India China And A Skewed Essay Example for Free

Ultrasound Machines India China And A reorient EssayGeneral Electric Co. and other companies deport sold so m any(prenominal) ultrasonography machines in India that tests ar now available in small towns like Indergarh, where there is no drinking water, electrical energy is infrequent, and roads turn to mud after a March rain shower. A scan typically costs $8, or a weeks wages.GE has waded into Indias market as the field grappleswith a difficult social issue the abortion of female fetuses by families who want boys. Campaigners against the practice and both(prenominal) authorities officials are linking the countrys widely reported skewed sex symmetry with the interpenetrate of echography machines. Thats putting GE, the market leader in India, under the spotlight. It faces legal hurdles, government scrutiny, and bristled business problems in one of the worlds fastest-growing economies.Ultrasound is the main reason the sex ratio is comingdown, says Kalpana Bhavre, who is i n charge of women and barbarian welfare for the Datia district government, which includes Indergarh. Having a daughter is often viewed as incurring alifetime of debt for parents be arouse of the dowry payment at marriage. Compared with that, the cost of an ultrasound is nonhing, she says.For more than a decade, the Indian government has tried tostop ultrasound technology from being used as a tool to determine gender. The devices use sound waves to produce images of fetuses or internal organs for a paradigm of diagnostic purposes. India has passed righteousnesss forbidding doctors from disclosing the sex of fetuses, required official alterations of clinics, and stiffened punishments for offenders. Nevertheless, some estimate that hundreds of thousands of girl fetuses are aborted severally year. GE, by far the largest seller of ultrasound machines in India through a joint venture with the Indian outsourcing giant Wipro Ltd., introduced its own safeguards, even though that means f orsaking sales. We stress emphatically that the machines arent to be used for sex determination, says V. Raja, chief executive of GE healthcare South Asia. This is non theroot cause of female feticide in India. only the efforts gain failed to stop the problem, as a growing saving has made the scans affordable to more people. The skewed sex ratio is an example of how Indias strong prudence has, in unpredictable ways, exacerbated some nagging social problems, such as the traditional preference for boys. most activists are accusing GE of non doing enough to prevent unlawful use of its machines to boost sales. in that location is a demand for a boy thats been completely exploited by multinationals, says Puneet Bedi, a new-sprung(prenominal) Delhi obstetrician. He says GE and others market the machines as an essential pregnancy tool, though the scans often arent necessary for mothers in lowrisk groups. Prosecutors in the city of Hyderabad brought a criminal case against the G E venture with Wipro, as considerably as Erbis Engineering Co., the medical-equipment distri thator in India for Japans Toshiba Corp. In the suits, the district government supposed that the companies knowingly supplied ultrasound machines to clinics that were not registered with the government and were illegally performingIndia has been a critical market to GE. Its outsourcing trading operations have helped the Fairfield, Connecticut, giant cut costs. The country also is agrowing market for GEs heavy equipment and other products. The company wont disclose its ultrasound sales, but Wipro GEs overall sales in India, which includes ultrasounds and other diagnostic equipment, reached round $250 one thousand million in 2006, up from $30 million in 1995.Annual ultrasound sales in India from all vendors also reached $77 million last year, up nearly 10 percent from the year before, according to an estimate from consulting firm rime Sullivan, which describes GE as the clear market le ader. Other vendors include Siemens AG, Philips Electronics NV, and Mindray International Medical Ltd., a new Chinese entrant for Indias pricesensitive customers. India has commodious struggled with an inordinate bit of malebirths, and female infanticidethe violent death of newborn baby girlsremains a problem. The abortion of female fetuses is a more recent trend, but unless urgent action is taken, its poised to escalate as the use of ultrasound services expands, the get together Nations Childrens Fund give tongue to in a report. Indias alarming decline in the child sex ratio is likely to exacerbate child marriage, trafficking of women for prostitution, and other problems, the report said.The latest official Indian census, in 2001, showed a steep decline in the relative number of girls aged 0 to 6 years compared with the decade earlier 927 girls for every 1,000 boys compared with 945 in 1991. In much of northwest India, the number of girls has move below 900 for every 1,000 bo ys. In the northern state of Punjab, the figure is below 800.Only China straightaway has a wider gender gap, with 832 girls born for every 1,000 boys among infants aged 0 to 4 years, according to UNICEF. GE sells close three times as many ultrasound machines in China as in India. In January, the Chinese government pledged to improve the gender balance, including tighter monitoring of ultrasounds. Some experts predict China give be more effective than India in enforcing its rules, given its success at other populationcontrol measures. Boys in India are viewed as wealth earners during life andlighters of ones funeral pyre at death. Indias National Family Health Survey, released in February, showed that 90 percent of parents with twain sons didnt want any more children. Of those with two daughters, 38 percent wanted to try again. Although there are restrictions on abortions in this Hindu-majority nation, the rules offer enough allowance for most women to get around them.GE took the lead in selling ultrasounds in the early mid-nineties soon after it began manufacturing the devices in India. It tapped Wipros extensive distribution and service network to deliver its products to near 80 percent of its customers. For more remote locations and lower-end machines, it used sales agents.The company also teamed with banks to help doctors paythe purchase of their machines. GE now sells about 15 different models, ranging from machines costing $100,000 that offer sophisticated change images to basic black-and-white scanners that retail for about $7,500.To boost sales, GE has targeted small-town doctors. Thecompany has kept prices down by refurbishing old equipmentand marketing laptop machines to doctors who travel frequently, including to rural areas. GE also offered discounts to buyers inclined to boast about their new gadgets, according to a former GE employee. Strategically, we focused on those customers who had big mouths, said Manish Vora, who thus sold ultrasoun ds in the western Indian state of Gujarat for the Wipro-GE joint venture.Without discussing specific sales tactics, Raja, of GE health care South Asia,acknowledges the company is aggressive in pursuing its goals. But he points out that ultrasound machines have broad benefits and make childbirth safer. As the machines become more available, women can avoid making long trips into cities where healthcare typically is more expensive, he says. Indian authorities have tried to regulate sales. In 1994, the government outlawed sex selection and empowered Indian authorities to search clinics and seize anything that assisted sex selection. Today any clinic that has an ultrasound machine must register with the local government and come through an affidavit that it will not conduct sex selection. To date, more than 30,000 ultrasound clinics have been registered in India.GE has taken a number of steps to ensure customers complywith the law. It has educated its sales force about the regulatory r egime, demanded its own affidavits from customers that they will not use the machines for sex selection, and followed up with periodic audits, say executives. They line of descent that in 2004, the first full year it began implementing these new measures, GEs sales in India shrank by about 10 percent from the year before. The sales decline in the low-end segment, for black-and-white ultrasound machines, was curiously sharp, executives say. Only in 2006 did GE return to the sales level it had reached before the regulations were implemented, according to Raja.Complying with Indian law is often tricky. GE cannot tell if doctors sell machines to others who fail to register them. Different states interpret registration rules differently. GE also is under close scrutiny by activists battling the illegal abortion of female fetuses. Sabu George, a 48-year-old activist who holds degrees from Johns Hopkins and Cornell universities, criss-crosses the country to spot illegal clinics.The crimi nal case in Hyderabad against Wipro-GE, a companyrepresentative, three doctors, and an ultrasound technician followed an inspection that found one clinic could not produce proper registration and had not kept complete records for two years. A team of inspectors seized an ultrasound supplied by Wipro-GE. The inspection teams report said it suspected the clinic was using the machines for illegal sex determination.The owner, Sarawathi Devi, acknowledged in an interviewthat her clinic, Rite Diagnostics, was not officially registered at the time of the inspection. She said the ultrasound machine was owned by a freelance radiologist who had obtained proper documentation for the Wipro-GE machine but was not there when the inspectors had arrived. She denied the clinic has conducted sex determination tests. Later, Dr. Devis records show, she registered the clinic with the government and bought a Wipro-GE machine, a sale the company confirms.The speak to case was part of a wider dragnet spe arheadedby Hyderabads top civil servant, District Magistrate Arvind Kumar. During an audit last year, Kumar demanded paperworkfor 389 local scan centers. Only 16 percent could furnish complete address information for its patients, making it almost impossible to track women to kibosh if they had abortions following their scans. Kumar ordered the seizure of almost one-third of the ultrasound machines in the district due to registration and paperwork problems. A suit also was lodged against Erbis, the Toshiba dealer.GEs Raja says that, in general, if theres any doubt about the customers intent to comply with Indias laws, it doesnt make the sale. in that respect is no winking or blinking, he says.A Wipro-GE representative is scheduled to appear at theHyderabad court hearing. An Erbis spokesman said he was unaware of the case in Hyderabad. A court date for Erbis had not been set. A visit to the clinic in Indergarh, a town surrounded by fields of tawny wheat, shows the challenges GE fac es belongings tabs on its machines. Inside the clinic, a dozen women wrapped in saris awaited tests on GEs Logiq 100 ultrasound machine. The line snaked along wooden benches and down into a darkened basement. On the wall, scrawled in white paint, was the message We dont do sex selection.Manish Gupta, a 34-year-old doctor, said he drives two hours each way every week to Indergarh from much larger Jhansi City, where there are dozens of competing ultrasound clinics. He said even when offered bribes, he refuses to disclose the sex of the fetus. Im just against that, Dr. Gupta said.But he is not complying with Indian law. Although the law requires that clinics display their registration certificate in a clamant come out of the closet, Dr. Guptas was nowhere to be seen. When Dr. George, the social activist, asked for the registration, he was shown a different document, an application. But the application was for a different clinic the Sakshi X-ray center. Dr. Gupta said the proper docu ment wasnt with him, adding I must have forget it at home.Asked by The Wall Street Journal about the clinic, the local chief magistrate of Datia district called for Dr. Guptas dossier later in the day. When a local official arrived, Sakshi X-Ray center had been crossed out on the application. In blue pen was written the correct name, Sheetal Nagar, the part of Indergarh where the clinic is located.Its not clear how Dr. Gupta procured the GE machine. Dr.Gupta said he bought it from a GE company representative, but he declined to show documents of ownership. GE says it does not comment on individual customers.Like the rest of India, the Datia district government hastaken a number of steps to try to boost the number of girls in the district. For girls of poor families, the local government provides a place to live, free school uniforms, and books.When they enter ninth grade, the government buys bicycles for them. Yet the low ratio of girls born had not budged much over the past decade , according to Bhavre, the district government official.Ultimately, says Raja, head of GE Healthcare in South Asia, its the job of the government, not companies, to change the prevailing preference for boys. Whats really involve is a change in mindsets. A lot of education has to happen and the government has to do it, he says.Indias Ministry of Health, which is now pursuing 422 different cases against doctors accused of using ultrasounds for sex selection, agrees. Mere legislation is not enough to deal with this problem, the ministry said in a statement. The situation could change only when the daughters are not treated as a burden and the sons as assets.Most recently, both Siemens and GE have introduced handheldultrasound machines, only slightly larger than an iPhone. Initially they will sell for under $10,000.