A team of doctors have rushed to central India after at least 12 women died and dozens of others fell ill after undergoing botched sterilisation surgery, officials have said.
A total of 83 women, all villagers under the age of 32, had the operations on Saturday as part of the federal government's free sterilisation campaign in Bilaspur district of Chhattisgarh state. But scores were later rushed in ambulances to private hospitals after falling ill.
More than 50 are still in hospital while 25 of them are reported to be in critical condition, according to the Indian Express newspaper.
If the facts are confirmed, then a grave human tragedy has occurred
"Their condition is very serious. Blood pressure is low," said Dr Ramesh Murty at CIMS hospital, one of the facilities where the sick women were taken after the ill-fated surgeries held as part of a free, nationwide programme aimed at limiting births in the world's second-most populous nation.
The Chhattisgarh state government sent a plane to New Delhi overnight to pick up a team of four doctors "to ensure no time is lost" in treating the patients, Indian Health Secretary Lov Verma told local Press Trust of India.
The state government has suspended four officials, including Dr RK Gupta, who supervised the surgeries.
"It appears the incident occurred due to negligence" by doctors, Chhattisgarh Chief Minister Raman Singh said, before urging patience for the autopsy results. He also said the victims' families would each receive a compensation payment of about $6,600.
The state chief minister has also ordered for a police case to be filed against Gupta, who was awarded by him earlier this year for conducting 50,000 laparoscopic tubectomies.
The apparent cause of death was either blood poisoning or hemorrhagic shock, which occurs when a person has lost too much blood, state deputy health director Amar Singh said, though the preliminary results from autopsies were expected to be released later on Wednesday.
India's government - long concerned about its rapidly growing 1.3 billion population - performs millions of free sterilisations to both women and men who want to avoid the risk and cost of having a baby.
The vast majority of patients are poor women who are usually paid a one-time incentive fee to undergo the surgery of about $10-$20.
India has one of the world's highest rates of sterilisation among women, with about 37 percent undergoing such operations, compared with 29 percent in China, according to 2006 statistics reported by the United Nations. About 4.6 million Indian women were sterilised in 2011 and 2012, according to the government.
Activists blame the incentive payments, as well as sterilisation quotas set by the government, for leading health authorities to pressure patients into surgery rather than advising them on other forms of contraception.
"These women have become victims because of the target-based approach to population control," said Brinda Karat of the All India Democratic Women's Association, who has demanded that the state's health minister resign.
India has one of the world's worst records on maternal health care, with 200 women dying during pregnancy or childbirth for every 100,000 patients, compared with China's 37 deaths for every 100,000 women who give birth.
The women who underwent surgery on Saturday were each paid about $10, and all 83 surgeries were performed within six hours, the state's chief medical officer, Dr SK Mandal, told The Associated Press by phone.
Prime Minister Narendra Modi, who is in Myanmar on a state visit, said that he had spoken with Singh and urged a thorough investigation.
The UN has also expressed concern over the deaths.
"If the facts are confirmed, then a grave human tragedy has occurred," Kate Gilmore, deputy executive director of the UN Population Fund, was quoted as saying by Reuters.