Josefina Quispe, mother of five, was sterilised at the age of 33. But it wasn’t something she volunteered for. Like 300 000 other Peruvian women, she was sterilised against her will in the 1990s as part of a government initiative, led by ex-president Alberto Fujimori, to lower birth rates and reduce poverty.
Speaking to BBCNews, she recounted the day she was forcibly taken to a hospital.
“Some were pushing my back, others were pulling me. The nurses who had brought me from my village were pulling my two arms. They put me in a room and started to ask me questions… They said to me: ‘How many children do you have?’ I have five, I said. They said, ‘How long are you going to keep giving birth? How many children do you want to have? You’re giving birth like a pig, like a guinea pig.’”
Then they put her on a hospital bed and gave her an injection. “I don’t know how, I went to sleep. That’s the last thing I knew. Later in the afternoon, about 4.30pm, I woke up. When I woke up, all of my body was hurting,” she said.
“I was crying. I was saying, ‘What have you done to me, señorita? What have you done to my stomach?’ Nobody gave me an answer. Nobody even responded.
“They pushed me into another room. As I went in, I heard women crying and shouting… All the women were saying, ‘They have cut our stomachs so we can’t have children.’”
The Peruvian government's sterilisation programme was meant to be voluntary, but thousands of women say they didn’t consent. Most were indigenous women from poor families who didn’t speak Spanish. Official data says that 18 died after procedure.
“Almost 20 years on, all the women are suffering," says Josefina. "Some are dying now, some with cancer, with infections, with illnesses… Nobody is recognising this.”
Several inquiries have failed to satisfy campaigners, but charges are set to be re-issued against Fujimori and three ex-health ministers. Alberto Fujimori has served time in prison for human rights abuses but was previously cleared of wrong-doing linked to forced sterilisations.
“We are asking for justice. Justice and compensation, is what we’re asking for, but they are not taking any notice of us. So we are going to continue struggling.”
When is it consent, when is it coercion?
All medical procedures must be undertaken voluntarily and with full consent of the patient. That means that the patient understands what the procedure entails, and that they give their full permission to proceed.
According to the Open Society Foundation, “Forced sterilisation occurs when a person is sterilised without her knowledge or is not given an opportunity to provide consent.
“Coerced sterilisation occurs when financial or other incentives, misinformation, or intimidation tactics are used to compel an individual to undergo the procedure. Additionally, sterilisation may be required as a condition of health services or employment.”
Just to be clear, the Foundation states: “Forced and coerced sterilisations are grave violations of human rights and medical ethics and can be described as acts of torture and cruel, inhuman, and degrading treatment.”
In South Africa
Under Apartheid South Africa, a clandestine government project aimed to create an “anti-fertility weapon” by ways of a vaccine administered to black women. At the Truth and Reconciliation Campaign, testimonies were heard of how Wouter Basson’s Project Coast included plans to sterilise black women en masse, without their knowledge or consent.
But this gross human rights violation isn’t confined to pre-1994. 20 years later, in 2015, the SA National Aids Council released the Stigma Index, revealing that 7% of the 10 500 HIV-positive women surveyed were sterilised either unwittingly, by force or by coercion. A further 40% said they had to accept contraception at the clinics in return for access to ARVs.
In March 2015, a complaint was lodged with the South African Commission on Gender Equality by Her Rights Initiative (HRI), on behalf of nearly 50 HIV-positive in Gauteng and KZN who had tubal ligation performed during their C-sections – without their consent – or they were given consent forms to sign while they were in advanced stages of labour, not realising what they were signing or afraid that they wouldn’t receive the necessary medical care during labour if they refused. Some of these cases happened as recently as 2014, in certain public and private hospitals.
A 1998 law prohibits sterilisation without consent in South Africa. But The American Medical Association Journal of Ethics wrote in 2015 that despite South Africa’s “highly progressive laws” aiming to protect women’s sexual and reproductive rights, enforcement was sorely lacking.
The situation in the rest of Africa, Asia and Latin America is even worse.
In Chile, 42% of HIV-positive women have been sterilised without consent or under coercion.
In Kenya, an anti-tetanus vaccine programme was hijacked in 2014 and 2015 to administer the hormone hCG to 2.3 million young women of child-bearing age. When not pregnant, this hormone builds up immunity against pregnancy, causing the woman to miscarry when she does fall pregnant. APA News in Kenya reported that 500 000 women are completely sterile following the vaccines.
- Why I chose to get sterilised
- Contraceptives: All you need to know
- The ability to choose the size of your family is a basic human right: family planning
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