Raipur (India) (AFP) - Furious protesters took to the streets in central India on Wednesday, smashing cars and demanding the resignation of the chief minister as the death toll from a government-run mass sterilisation programme rose to 13.
Another 14 women are seriously ill in Chhattisgarh state following the surgery that women are paid 1,400 rupees ($23) to have under a government scheme to reduce population growth.
"Preliminary examinations suggest septic shock may have caused the deaths," said local government official Amar Thakur.
"It looks like the equipment that was used was probably infected. We are waiting for the report," he told AFP by telephone from Chhattisgarh's Bilaspur district, where around 80 women had the surgery over the weekend.
The victims had suffered vomiting and a dramatic fall in blood pressure after undergoing laparoscopic sterilisation, a process in which the fallopian tubes are blocked.
As the death toll rose to 13 on Wednesday, a local official said women who attended a second sterilisation camp in the area on Monday had also fallen ill.
"Six women from Gorella camp developed complications and they have been brought to Bilaspur for treatment," district commissioner Sonmani Borah told AFP.
Shops and businesses shut their doors in the Chhattisgarh capital Raipur on Wednesday as scores of demonstrators took to the streets to demand the resignation of state Chief Minister Raman Singh.
Television footage showed the protestors, many of them opposition party workers, shouting slogans and smashing up vehicles.
- 'Abysmal' care -
Sterilisation is one of the most popular methods of family planning in India, and many state governments organise mass camps where rural women can undergo the usually straightforward procedure.
Although the surgery is voluntary, rights groups say the target-driven nature of the programme has led to women being coerced into being sterilised, often in inadequate medical facilities.
Under pressure to meet targets, some local governments offer additional incentives such as cars and electrical goods.
In the latest case, one doctor reportedly operated on 83 women in just five hours, using the same instruments on all of them. Some of the women also said they had been forced to attend the camps, according to local media.
Sona Sharma, joint director at advocacy group the Population Foundation of India, said the quality of care provided to women undergoing sterilisation is "abysmal".
"It is about time we woke up to this problem. The quality of care to women can't be compromised at any cost," she told AFP.
"The government has laid out standard protocols, but they exist only on paper," she said, urging the government to adopt a "more choice-based voluntary system" of family planning.
Authorities are keen to curb the growth of India's population with the latest census carried out in 2011 showing that India had 1.2 billion people.
Last year, authorities in eastern India came under fire after a news channel aired footage showing scores of women dumped unconscious in a field following a mass sterilisation.
Prime Minister Narendra Modi has ordered an investigation into the latest deaths, and state chief minister Singh on Tuesday suspended four top health officials.
The National Human Rights Commission (NHRC) also demanded a detailed report on the incident, giving the state government two weeks to submit it.
"It (NHRC) has issued a notice to the Government of Chhattisgarh... for a report into the incident within two weeks," the notice posted on its website said.
A police complaint has also been lodged against the surgeon who performed the operations.
Reports said the doctor had been given a government award earlier this year for performing tens of thousands of such sterilisations.