Ultrasound Machines India China And A Skewed Essay Example for Free

Ultrasound Machines India China And A Skewed EssayGeneral Electric Co. and other companies have change so many ultrasound machines in India that tests are now available in small towns like Indergarh, where there is no drinking water, electricity is infrequent, and roadstead 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 country grappleswith a difficult social issue the abortion of female fetuses by families who want boys. Campaigners against the practice and almost regime officials are linking the countrys widely reported skewed call down ratio with the spread of ultrasound machines. Thats putting GE, the market leader in India, under the spotlight. It faces legal hurdles, government scrutiny, and thorny business problems in one of the worlds fastest-growing economies.Ultrasound is the main reason the evoke ratio is sexual climaxdown, says Kalpana Bhavre, who is in charge of women andchild welfare for the Datia district government, which let ins Indergarh. Having a daughter is very much viewed as incurring alifetime of debt for parents because of the dowry payment at marriage. Compared with that, the cost of an ultrasound is nothing, she says.For more than a decade, the Indian government has tried tostop ultrasound technology from being used as a pawn to determine gender. The devices use sound waves to produce images of fetuses or internal organs for a range of diagnostic purposes. India has passed laws forbidding doctors from disclosing the sex of fetuses, required official registrations of clinics, and stiffened punishments for offenders. Nevertheless, some estimate that hundreds of thousands of girl fetuses are aborted each year. GE, by far the largest seller of ultrasound machines in India through a joint venture with the Indian outsourcing monster Wipro Ltd., introduced its own safeguards, even though that means forsaking sales. We stress emphatically that the machin es arent to be used for sex determination, says V. Raja, chief executive of GE health care sulphur Asia. This is not theroot cause of female feticide in India. still the efforts have failed to stop the problem, as a growing economy has make the scans affordable to more people. The skewed sex ratio is an example of how Indias strong economy has, in unpredictable ways, exacerbated some nagging social problems, much(prenominal) as the traditional preference for boys. Some activists are accusing GE of not doing copious to prevent unlawful use of its machines to boost sales. There is a demand for a boy thats been completely exploited by multinationals, says Puneet Bedi, a New 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 GE venture with Wipro, as well as Erbis Engineering Co., the medical-equipme nt distri simplyor in India for Japans Toshiba Corp. In the suits, the district government alleged that the companies knowingly supplied ultrasound machines to clinics that were not registered with the government and were irregularly performingIndia has been a critical market to GE. Its outsourcing operations have helped the Fairfield, Connecticut, giant cut costs. The country also is agrowing market for GEs lowering 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 just astir(predicate) $250 million in 2006, up from $30 million in 1995.Annual ultrasound sales in India from all vendors also reached $77 million endure year, up about 10 percent from the year before, according to an estimate from consulting firm Frost Sullivan, which describes GE as the clear market leader. Other vendors include Siemens AG, Philips Electronics NV, and Mindray Intern ational Medical Ltd., a new Chinese entrant for Indias pricesensitive customers. India has long struggled with an inordinate number of malebirths, and female infanticidethe killing of newborn baby 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 United Nations Childrens Fund tell in a report. Indias alarming mitigate 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 congress 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 fallen below 900 for every 1,000 boys. In the northern state of Punjab, the figure is below 800.Only China today 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 about 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 will be more effective than India in enforcing its rules, given its triumph 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 two 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 leeway for most women to get around them.GE took the lead in selling ultrasounds in the early 1990s short after it began manufacturing the devices in India. It tapped Wipros extensive distribution and service network to deliver its products to about 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 financethe purchase of their machines. GE now sells about 15 diametric models, ranging from machines costing $ speed of light,000 that offer sophisticated color images to sanctioned 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 then interchange ultrasounds in the western Indian state of Gujarat for the Wipro-GE joint venture.Without discussing s pecific sales tactics, Raja, of GE Healthcare 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 aided sex selection. Today any clinic that has an ultrasound machine must register with the local government and provide an blasphemy 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 go to ensure customers honorwith the law. It has educated its sales force about the regulatory regime, 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 note 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 especially 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 criminal case in Hyderabad against Wipro-GE, a companyrepresentative, three doctors, and an ultrasound technician follow ed an critical review 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 revue 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 court case was part of a wider dragnet spearheadedby Hyderabads top civil servant, District Magistrate Arvind Kumar. During an audit last year, Kumar demanded p aperworkfor 389 local scan centers. Only 16 percent could furnish complete address information for its patients, making it almost impossible to track women to check 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 stick with with Indias laws, it doesnt make the sale. There 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 faces keeping tabs on its machines. Inside the clinic, a dozen women wrapped in saris awaited tests on GEs Logiq 100 ultrasound m achine. 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 conspicuous place, 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 document wasnt with him, adding I must have forgotten it at home.Asked by The Wall Street Journal about the clinic, the local chief magistrate of Dat ia 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. just 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 govern ment, not companies, to change the prevailing preference for boys. Whats really needed is a change in mindsets. A lot of information 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. to the highest degree recently, both Siemens and GE have introduced handheldultrasound machines, only slightly larger than an iPhone. Initially they will sell for under $10,000.