Centre for Health and Resource Management v. State of Bihar and Others (2011)
CHARM v. State of Bihar and Others
is a public interest litigation petition filed in March 2011 by the Center’s
partner in India, Human Rights Law Network. It seeks legal accountability from
the state government of Bihar for its failure to provide essential maternal
health care, including safe abortion services, in public health facilities,
leading to shockingly high rates of maternal mortality. In 2011, at the request of our partner, the
Center for Reproductive Rights prepared a supplementary brief in the case
discussing the legal obligations under international human rights law for the
state government to ensure the right to survive pregnancy and childbirth.
Filing Date: March 2011
Country:
Bihar, India
Plaintiff(s):
Centre for Health and Resource Management (CHARM)
Center
Attorney(s): Melissa Upreti and Payal Shah
Co-Counsel/Cooperating
Attorneys: Human Rights Law Network (HRLN)
Summary:
In March 2011, the Center’s partner in India, the Human
Rights Law Network (HRLN), filed
a public interest litigation petition before High Court of Judicature at Patna (High Court) seeking accountability for denials of maternal health care, including safe
abortion services, in the state of Bihar in India. This case, CHARM v. State of Bihar and Others C.W.J.C. No. 7650/2011, focuses on the district of Munger, where health conditions
are emblematic of the poor quality of medical services available to pregnant
women throughout the state of Bihar. The
CHARM petition argues that the Bihar
government is obligated to ensure access to maternal health services under the
Indian Constitution as well as international human rights law, and cites the
recent decision by the Delhi High Court establishing the right to reproductive
health in two other maternal health cases brought by HRLN. HRLN has requested the Center to submit a
supplementary brief in this case discussing the international human rights
commitments that obligate the Bihar government to take steps to reduce maternal
mortality and ensure access to safe abortion services.
The CHARM petition
is based on violations of the right to survive pregnancy and childbirth
documented by HRLN during a fact-finding mission in Munger, including explicit
non-compliance with the Indian Public Health Standards and the National Rural
Health Mission’s service guarantees. Some examples of the government’s failure
to ensure these guarantees cited in the petition include collection of fees by
health officials for referral and registrations of pregnancy, even though such
services should be free for pregnant women, dilapidated and unsanitary health
facilities that lack electricity, toilets, running water, and blood supplies,
failure to provide transportation for pregnant women needing to reach health
facilities, and the unavailability of safe abortion services. Further, women in
Munger are routinely unable to obtain cash payments guaranteed to them under
national maternal health policies. The petition also alleges that the absence
of a grievance redressal system denies women due compensation for violations
suffered, and leaves no mechanism to provide feedback to the government that
could result in reform.
Notably,
this petition argues for the first time that the failure to ensure access to
maternal health care and safe abortion services constitutes a violation of the
right to be free from cruel, inhuman and degrading treatment (CIDT) due to the
foreseeable pain and suffering caused to pregnant women. HRLN’s attorneys argue that this right is
particularly violated for poor women seeking maternal health care in Munger’s
government health centers, as they are effectively “imprisoned” by poverty.
Like pregnant women held in state custody, poor women in Bihar are also left
without an alternative to relying on the government for reproductive health
care, and as such, the denial of life-saving maternal health care to poor women
in Munger’s health facilities constitutes a violation of the right to be free
from CIDT.
The approach taken in this case is part of a broader
undertaking to seek legal accountability for violations of the right to survive
pregnancy and the right to safe abortion in India. The
Center has also contributed supplementary briefs in, among others, Sandesh Bansal v. Union of India
&, Ors., W.P. No. 9061/2008 and
in Snehalata Singh v. The State of Uttar Pradesh &, Ors., W.P. No.
14588/2009, both maternal health
cases,. Like
in many states in India, maternal mortality and morbidity is an ongoing crisis
in Bihar, and the Center hopes that in filing this brief, which contains
undeniable evidence of reproductive rights violations, much-needed justice will
result.
On March 20, 2012 the High Court issued an interim order requiring the Bihar Health Secretary to provide an expense report that accounts for every
rupee spent under the National Rural Health Mission. The state government now has less than three weeks to produce receipts for expenses totaling close
to $680 million, a task which aims to highlight the shortcomings of the government in implementing the program and subsequently address existing gaps.
This order affirms the obligation of the government to respect, protect, and fulfill the right to access to maternal health care.