KRISHNAGIRI: It did not begin with a raid, a court order, or a headline-grabbing arrest. It began with a number on a chart that refused to make sense. In a routine review meeting, as sex ratios were read aloud like ordinary statistics, one figure lodged itself in Dr G Ramesh Kumar’s mind and refused to let go. What followed was not a moment of outrage, but a decade of persistence.
From that single point of reckoning, Kumar’s work as District health officer (DHO) evolved into a sustained campaign against sex determination and selective abortions. Across Namakkal, Coimbatore, Thanjavur and Krishnagiri, numbers that once told a story of loss were steadily rewritten through relentless inspections, decoy operations and an unyielding pursuit of those profiting from illegal scans, turning quiet resolve into statewide vigilance.
It all began in 2016, when Kumar joined as the DHO in Namakkal. During a district visit, Darez Ahamed — then mission director of the National Health Mission and now managing director and CEO of Guidance Tamil Nadu — reviewed the area’s sex ratio. Kumar’s follow-up actions earned accolades for the Namakkal collector, as well as those from Thanjavur and Coimbatore.
Ramesh Kumar recalls the time when Namakkal’s sex ratio stood at a dismal 826 females per 1,000 male births in 2016. Through intensified reviews and visits to scan centres, authorities warned violators and cracked down on qualified doctors running illegal sex-selective abortions. Scan centres were sealed, driving the ratio up to 967 by 2019. This achievement won then-Namakkal Collector M Asia Mariam the Beti Bachao Beti Padhao (BBBP) award from the union government. Coimbatore and Thanjavur collectors also received state government honors.
“When I joined as DHO in Krishnagiri in 2022, the sex ratio was 918. It has reached 987 as of December 2025,” he added. Over the past three years, with support from then-collector KM Sarayu and incumbent collector C Dinesh Kumar, a special team conducted 13 decoy operations. These teams have busted sex-selective abortions and determination rackets in Krishnagiri, Tirupattur, Salem, and Chittoor (Andhra Pradesh) and also supported three decoy operations in other districts.
The crackdown also led to 25 arrests across districts. Seven village health nurses and two government doctors were suspended, five scan machines were seized, and the Goondas Act was invoked against seven suspects. Antenatal mothers seeking illegal scans were booked as well.
“Low sex ratios fuel underage marriages and teenage pregnancies, creating societal imbalance. These issues increase infant and maternal deaths. While registered medical practitioners once dominated in Namakkal, quacks now run networks from Tirupattur, spanning Krishnagiri, Tiruvannamalai, Dharmapuri, Salem, Namakkal, and Kallakurichi districts,” Ramesh Kumar said.
A health department staffer from Kumar’s team explained the decoy process. “Each decoy operation requires identifying an antenatal mother. Quacks only accept referrals from prior clients and insist on visits after four months of pregnancy. Fees for illegal scanninng and abortion range from Rs 15,000 to Rs 35,000.”
Illegal scans typically happen during daytime at mango groves, isolated spots, or near government hospitals and rarely at night. Recently, repeat offenders have shifted to nighttime operations, complicating cooperation from pregnant women and families. Decoy costs vary, and team safety remains paramount, the DHO noted.
Last month, Kumar’s team pulled off a gruelling decoy near Vazhapadi in Salem where they waited at a bus stand late at night, trailed suspects until dawn, and arrested three.
What started as one review meeting has rippled into statewide vigilance. Kumar’s team has united police, revenue, school education, and anganwadi workers to drive awareness against sex determination and selective abortions. For Dr Ramesh Kumar, this mission to balance sex ratios and curb child marriages continues to endure as a beacon of public health resolve.