Indian sterilization clinics under scrutiny after doctor used bike pump on patients

New Delhi (CNN) -- Conditions in Indian sterilization clinics are under renewed scrutiny after a doctor was removed from his job for using a bicycle pump to inflate women's abdomens during the procedure.

Health officials in Odisha state have launched an investigation after reports that bicycle pumps were used on 56 women undergoing sterilization surgery at a government-run community health center in Banarpal, Angul district, Friday.

The physician was identified as Dr. Mahesh Chandra Rout, a retired surgeon who carried out work when required for the clinic, said Odisha Health Secretary Arti Ahuja.

She said he would no longer be called on to work for the clinic, and could face charges as a result of the inquiry.

When contacted by CNN, Rout refused to comment.

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Equipment missing

Ahuja said the medical equipment that should have been used in the procedure -- a carbon dioxode insufflator -- had been provided to the clinic, and investigators would try to determine why it was not used.

But Sachin Ramachandra, a health official in the district where the procedures took place, said inquiries revealed the insufflator was missing, which is why the bicycle pump had been used instead.

A health official who did not wish to be named told CNN that the use of bicycle pumps in sterilization surgery was widespread.

In the wake of the incident, state health officials issued a directive that all sterilizations must be carried out according to correct protocols.

'Might burst abdomen'

In sterilization surgery, the patient's abdomen needs to be inflated to allow room to move surgical instruments.

Dr. Naresh Trehan, the chief medical officer at the Medanta medical institute in New Delhi, told CNN that using a carbon dioxide insufflator allows a doctor to measure and calibrate the amount of pressure placed on the abdomen.

Using a bicycle pump -- a method Trehan said he was alarmed to hear about -- is highly dangerous.

Medical staff use a bicycle pump to inflate a patient's abdomen during surgery.

"If you use a bicycle pump, you don't know how much air you're pumping in and you might burst the abdomen," he said.

Dr. Vidhyadhar Sahu, the chief medical officer for Angul district, said none of the 56 women who underwent surgery on Friday reported any problems.

Deaths 'almost inevitable'

For decades, in a bid to curb population growth, the Indian government has run a nationwide sterilization program.

Particularly in poorer, rural areas, where access to other forms of contraception is limited, sterilization is a popular option.

Women are paid to have the operations, and doctors are given incentives to perform them.

But health advocates claim that conditions at the mobile clinics where the procedures are often performed, known as sterilization camps, are sometimes unsanitary and dangerous.

Patients wait outside the medical center where the bicycle pump was used.

Last month, a surgeon was arrested on charges of negligence and attempted culpable homicide in the deaths of a dozen women who had undergone sterilization operations at a mobile clinic in Chhattisgarh, one of India's most impoverished states, which borders Odisha.

Dr. R. K. Gupta, assisted by a team of fellow medical professionals, operated on 83 women in a span of six hours, including 12 who subsequently died.

Government guidelines stipulate doctors should conduct no more than 30 sterilization surgeries a day.

Gupta blamed the deaths on drugs given to the women after the surgeries.

Kerry McBroom, a New Delhi-based advocate with the Human Rights Law Network, told CNN at the time of the deaths that they were "almost inevitable... given the unsafe, unethical and unhygienic conditions that persist throughout India in these camps."

"You might find that there is no electricity, there is no running water, there is not enough staff in these facilities," she said.

READ MORE: India's sterilization program under fire after patient deaths

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CNN's Sugam Pokharel, Kunal Sehgal and Omar Khan contributed to this report.