Aasia Khan, a 27-year-old mother of three who lives in a Mumbai slum laughs with disbelief when she first hears of surrogacy. "A child without a man? How can that be?" she asks. "There has to be some kind of a 'relationship,' right?"
Across the world, in San Antonio, US, middle-aged couple Lisa and Brian Switzer have sold their home and risked their savings on a medical tourism firm that once promised them an affordable solution after seven years of infertility. Hiring an Indian surrogate like Khan is their only chance of experiencing parenthood, they say.
Infertile couples in the US pay up to $100,000 for a domestic surrogate mother to carry and deliver their child. The same procedure costs them roughly $25,000 in India (includes clinic charges, lawyer's bills, travel and lodging, and the surrogate's fee), often raising questions of exploitation. "Walk a mile in my shoes before you judge me," Lisa says, in a scene from Made in India, a 96-minute 2011 documentary by Vaishali Sinha and Rebecca Haimowitz.
Using a fly-on-the-wall approach and intimate interviews, the filmmakers present a complex portrait of Khan and her commissioning parents in a film that won them jury awards at the Florida Film Festival and San Francisco Int'l Asian American Film Festival.
As Khan and the Switzers' stories grow increasingly tied, the docu reflects on the globalisation of the reproductive industry valued at more than $450 million in India. Ironically, India has no laws governing surrogacy; only suggested guidelines. Thus, questions of citizenship, global corporate practices, choice, commodification of the body, reproductive rights and notions of motherhood are raised.
Having seen the film, Professor Michel Anteby, who teaches a course titled, Managing Human Capital to students in the second-year elective curriculum at Harvard Business School's MBA programme, decided last month to make the film a case study in their syllabus on Ethics.
While most human capital discussions in business school settings deal with higher echelons of the labour market, this case introduces a 'view from below' or what human capital might look like at the base of the pyramid. "By the 'base of the pyramid', we are primarily referring to the poorest four billion people on earth as compared to the 'top of the pyramid,' which refers to the top 2.5 billion consumers in developed economies," reads the course abstract on the HBS website.
Their groundwork, says Mumbai-born Sinha over the phone from New York where she is currently based, started in 2007 when Haimowitz read an article about American couples looking to India to rent a womb. "Research included speaking to surrogates in Gujarat, Pune, and Mumbai, before we decided to focus on Aasia's story," she recalls. Officials from the US Consulate, the Indian Council of Medical Research, and Sama, a women and health resource group in Delhi feature in the film.
The absence of negotiating power came through clearly in the surrogates' voices, says Sinha. In her film, the Switzers' contract mentions a payment of $7000. Khan is made to sign a separate contract where she is told she'll receive $2000, most of which will be paid post-delivery. Raising your voice is a double edged sword, of course. Vocal agents and surrogates are seen as 'difficult' if they do, and stand to be ostracised or lose their jobs if they decide to make demands.
"In one instance of miscarriage in the sixth month, the woman only received Rs 5,000. We should receive payment upon miscarriage," said one surrogate. Another complained of misinformation. "We sign the contract but nobody reads it to us. And if there's a literate person in the room, they ask them to wait outside," she said.
"Through the making, it was clear that this is a territory fraught with complexities," reflects Sinha. "But in my opinion, there's no other way of arriving at conclusions about the business without first listening to the voices of those at the heart of it."
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