You make an interesting point there, Richard, when you say, "we need to be proud of our profession." This is something I strive to drive among youngsters at the agency I work for in India.

I noted with interest you are scheduled to visit India this week and that's the reason why I write this. I am also sure you wont be hearing this for the first time. One of the major problems that plague the profession in India is a clear lack of respect amongst media for PR professionals and I frequently hear from colleagues in the industry how thankless this profession is. We still have a long way to go before media can appreciate PR professionals for the role they play and the PR folk, including some self proclaimed media specialists stop acting subserviant to the media, ruining it for everybody in the process. In India, the industry itself could do with a little PR. And I hope stalwarts like you do your bit in educating the vital links that form the PR chain on the value we add to organisations and media alike.

I hope your stay here is pleasant. Happy holidays!

I would like to respond to Mr. Sachin Talwar’s remarks defending GE in Richard Edelman’s blog. For last 21 years been concerned with protecting girl child rights in India. In the first decade I worked on growth of pre-school children and female infanticide in villages in TamilNadu. I left the villages and started working on sex selection when ultrasound machines started appearing in urban TamilNadu in 1995. I was among the 3 petitioners in the Indian Supreme Court (2000-2003) and also successfully lobbied for amendments in the Indian Parliament to the PNDT Act which forbid the sale of ultrasound machines to non-registered Clinics (December 2002). I emphasise this as a short message sent on Jan. 3 morning was not posted in the blog & having put Mr.Talwars comments in full I hope you will post my comments.
The trivialization of the issue of female foeticide which is an outcome of widespread access to foetal sexing by increasing number of ultrasound machines by comparing its abuse to auto car companies is a matter of grave concern. If comparisons have to be made then we would compare ultrasound machines to WMD (Weapons of Mass Destruction) particularly given the ongoing genocide of girls eliminated before birth.
Part A talks about the enormity of the issue of female foeticide. The enormity and impact has major bearing on culpability. Part B considers the commitment made by the legendary Jack Welch before GE started the joint venture in India with WIPRO to manufacture ultrasound machines. Part C describes the outcomes of GE sales in India based on documents submitted by their partner WIPRO to the Honourable Indian Supreme Court in 2001-2 at the time of our litigation against Government of India and all State Governments for non-implementation of PNDT. Therefore, my submission is not misinformed opinion but based on facts. Other responses are included in Part D.
PART A
Data from different sources are consistent about the estimates of missing girls. The Census which is conducted every ten years counts the numbers of surviving boys and girls up to the village/ward level. From Census 2001 also we also get a direct estimate of sex ratio at birth (SRB) from the number of births occurred in the last year (2000 to 2001, based on 19.2 million live births). This was 906 girls per 1000 boys, which implies 5% of girls were eliminated before birth in the year preceding the Census. The latest estimate of SRB is from the Sample Registration System (SRS) for the years 2002-2004. SRS covers over 1.3 million households and estimates are pooled for three years to get valid numbers at the State level. SRB is 882 girls per thousand boys for India. Thus in India we have nearly 930,000 missing girls every year (at least 2500 girls per day!). Note in USA 2,000,000 girls are born every year! Therefore we are dealing with a genocide unprecedented in the history of the country. The foetal stage has become the riskiest time in a woman’s life cycle and in areas like Delhi where foetal sexing by ultrasound is extensive, a girl is likely to be eliminated several times in mother’s womb than die of all causes in the first year of life! And each missing girl is an outcome of at least two foetal sexing. Millions of illegal scans have been done by misuse of ultrasound. Estimates are that about 8 million illegal scans were done using ultrasound since the PNDT law was enacted in 1994 till 2001. And another two million per year from 2002 onwards! So the birth data is evidence of what a gold mine foetal sexing has been for the manufacturers. We do not deny that ultrasound has several uses but nobody can deny that illegal foetal sexing had been a significant use in India. In fact since there are millions of abortions of female fetuses, sex selective abortion is becoming a increasing part of induced abortions. And since a lot of these abortions are done illegally, maternal mortality due to unsafe abortions is also increasing. Thus sadly, ultrasound has become a weapon of mass destruction of Indian women (before and after birth)! So much for life saving technology!!
PART B
GE announced in 1993 that it will manufacture ultrasound in India with WIPRO. Jack Welch, the legendary CEO of GE assured the American business media that GE was not coming to India to exploit the market for sons. Note this apprehension was because both in South Korea and China where GE had a major share of the ultrasound market, there was significant abuse of ultrasound for foetal sexing.
In India before 1993, GE hardly had a presence in the ultrasound market. By 1996 the sales of the domestically produced GE machines started picking up and by late 90s GE-WIPRO captured the largest market share. GE-Finance gave cheap credit while GE-WIPRO sold the machine with vigorous marketing often not applying due diligence It is important to recognize that in America, FDA regulations mandate that medical devices like ultrasound be sold to only MDs. While in India, the company had different standards! The portability of some of the GE ultrasound models also enabled it to be easily taken around in the Doctors’s car for promoting foetal sexing! (in the earlier era the bulky ultrasound was carted to rural areas and peripheral towns of North West India in Ambulances).
PART C
The Supreme Court in December 2001 directed that the companies only sell machines to registered Clinics (in our Public interest litigation). The data of sales submitted to the Court by GE’s partner WIPRO revealed that, generally, wherever there was large number of machines, in those areas child sex ratios were low (against girls)! This was of course no coincidence but a reflection of what the machines were used for. Similar patterns were also revealed when Government of India undertook survey of machines two years ago.
We also need to understand the process of the implementation of the PNDT Act which was enacted by the Parliament in 1994. The Rules were framed only in January 1996 but these exempted almost 95% of the ultrasound machines. Only those machines which were used for invasive tests like amniocentesis and CVB were brought under the purview of the Act. The Act therefore remained in the law books till we challenged the implementation in the Supeme Court (Feb. 2000). After many hearings and dialogues with the Government in the Court, the first major judgment was pronounced in May 4, 2001. At this time barely 600 clinics were registered and 500 of the 600 was in TamilNadu (thanks to our efforts in the TamilNadu Assembly in May 2000). Today over 30,000 Clinics are registered. Note therefore, the claims of Mr. Talwar about GE’s compliance to the Law is difficult to accept. “It is also unfair to a manufacturer like GE who makes every effort to ensure strict compliance with a law (the Pre-Natal Diagnostics Techniques Act, or PNDT Act) that is very stringent”. The claim that “In fact, even before the amendment to the PNDT Act came into effect, Wipro GE Healthcare had taken pro-active measures including cautioning customers through terms and conditions of sale, product manuals and stickers on the equipment” does not have substantial merit given the terrible outcomes & impacts. Therefore, if GE indeed was true to Jack Welch’s commitment not to use ultrasound for sex determination it would have made proactive efforts to ensure that the PNDT law was implemented right from September 1994 when it was enacted.
The reality about the proliferation of ultrasound machines also needs to be highlighted. Ultrasound machines were used in India right from the early eighties but the numbers were fewer. The Government of India started publishing records of sales only from 1988 when barely a few hundred were being sold. The numbers increased 33 times between 1988 and 2003. However, it was after the economic liberalisation of the early 1990s that the annual production increased strikingly from a few hundreds to thousands, starting from 1994 (1314 during 1988–91, 5651 during 1992–95, 11290 during 1996–99, and 19581 during 2000–03). The ultrasound boom in India has a lot to do with GE’s entry and aggressive marketing. Thus India may have had a law in 1994 but the proliferation of machines from mid nineties coupled with the indifference of manufacturers to ethics has caused the genocide of ‘millions of missing girls’. How many more millions of girls will have to disappear from India before companies such as GE will recognize their responsibility? A copy of the paper describing GE’s practices was published in the medical journal Reproductive Health Matters, London in 2002 and a copy was also given to the CEO of GE last year by Amita Joseph. GE USA had chosen to not to respond.
PART-D
Regarding the assertion by Mr. Talwar that “The facts show that GE's sales in the North of India where gender discrimination is most rampant, are actually down following the PNDT Act because of strict compliance with the law” if backed with evidence is indeed welcome sign. Today new competitors are entering into the Indian market. Aloka’s decision to manufacture ultrasound in Chennai is indeed a great concern. Aloka is the largest dedicated ultrasound company in the world with substantial market shares in China and Japan. MNCs must be sensitive to public opinion, must practice due diligence & refrain from double standards. Korean Medison has emerged in the last few years in the Indian sub-continent. Home grown Chinese company, Mindray Medical has become aggressive in Europe after listing in New York Stock Exchange last year. Civil Society organizations & the media will be now regulating the impact of (potential) new entrants into the Indian market strengthened by the law & the courts. We look forward to GE’s assistance to ensure that the new market entrants respect ethics and law.
The Kerala high court interim order or a judgement is subservient to the judgement of the Supreme Court. Supreme Court is supreme as far as interpretation of the law is concerned. Therefore, the caution of sales in Kerala was necessitated by law & in fact if GE did not comply with the Supreme Court orders after its partners counsel WIPRO submitted affidavits, it would amount to grave contempt of the Court.

Sabu M. George, MA(Johns Hopkins), PhD(Cornell)
Consultant, Business & Community Foundation, New Delhi.