African women fight back against forced, coerced sterilizations
NAIROBI, November 15, 2012, (LifeSiteNews.com) – A group of HIV-positive women in Kenya have launched a series of lawsuits in five countries after they were sterilized against their will following childbirth. Cases are pending before the courts in Zambia, South Africa, Malawi, and Namibia.
In many of the cases the women were told by government-sponsored health facilities that sterilization was mandatory for HIV-positive women. Some were threatened with the withdrawal of antiretroviral drugs, treatment that prolongs the life of HIV-infected patients.
A report has been published by an independent NGO interviewing women who had experienced coerced or even forced sterilizations.
It shows that 75 percent of the forced sterilizations were conducted in public hospitals where women were often presented with consent documents to sign while in the midst of labor pains. Some said they were unconscious at the time and never signed any forms, while others say they were illiterate and could not understand what was being presented to them.
Some say that the consent forms were presented to them but that they were told that sterilization was mandatory for HIV-positive births.
According to the report “Robbed of Choice: Forced and Coerced Sterilization Experiences of Women Living with HIV in Kenya” by the African Gender and Media Initiative, forced sterilization is unnecessary, since mother-to-child transmission of HIV can be prevented using antiretroviral drugs and “modified obstetric and infant feeding practices”.
The study, which was conducted between October and November 2011 in Nairobi and Kakamega, interviewed about 40 women.
The group, which fully supports voluntary sterilization and the use of condoms to prevent HIV infection, said, “Forced and coerced contraceptive sterilization violates numerous rights guaranteed under the Kenyan constitution and multiple regional and international obligations that Kenya is signatory to.”
The women interviewed for the report said they had undergone “non-consensual tubal ligation when they visited health facilities to give birth through cesarean section. Others, who had normal delivery, were also later taken to the operating room for the procedure to be done”.
Among the groups cited by women in the report and in news investigations are Medicin Sans Frontiers and Marie Stopes International.
Marie Stopes issued a statement saying that informed consent is “fundamental” to its practice and that the report sampling was “a very small and…unrepresentative”.
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Most of the women were in their mid-twenties, and said that after sterilization men would not consider marrying them.
“Most of the men who have approached me for marriage want children. The moment they realize l cannot have babies, they leave,” Ruth Achieng, a survivor of the coerced sterilization who lives in Nairobi, told AllAfrica.com.
Others described the disintegration of their marriages after the procedure. Jones Imbwanga, one of the plaintiffs, described her loneliness CBC Radio in an interview, “I feel like the whole world wants to swallow me.”
In some cases, the women, most of whom were poor, were told that sterilisation was required as a condition for receiving free or reduced-price medical treatment or receiving food and medical aid for their children, especially milk and anti-retroviral medications. Some were told by doctors that they already had too many children and therefore permanent and irreversible contraception was necessary. Others were threatened with having their supply of antiretroviral drugs stopped if they did not consent to the procedure.
The report quotes the United Nations Human Rights Committee that calls “sterilization of women without their consent as a violation of the right to be free from torture and other inhuman and degrading treatment”. “Women living with HIV have a right to a family planning method of their choice and right to be sexually active and bear children,” they said.
Winfred Lichuma of the National Gender and Equality Commission described what happened to the women as “atrocious an infringement of their human rights and contrary to medical ethics”. The group also says that forced sterilisation is considered a crime against humanity under the Rome Statute and is prosecutable by the International Criminal Court.
The prevalence of involuntary sterilisation of HIV-positive women was highlighted this summer when Namibia’s High Court ruled in July that government health facilities had violated the rights of three women who had been sterilized without their free, full, and informed consent. The women had launched their suit in 2009.
One woman told the judge that she had been approached with consent forms while she was in extreme pain from labour. The judge called it “inappropriate” to seek consent while a woman is in active labor. The plaintiffs had not received sufficient counseling about the sterilization procedure in a language they could understand, according to a report by the group Stop Torture in Health Care.
Nicole Fritz, from the Southern Africa Litigation Centre (SALC) in Johannesburg, which brought the Namibian suit, said the three cases were only “the tip of the iceberg”.
Namibia has one of the highest rates of HIV prevalence, with about 13 percent of adults infected.
The fight-back has started over international and national groups pushing sterilization on African women. A project in western Kenya was blasted by human rights groups last year when it was discovered they were offering HIV-positive women cash for sterilizations. Project Prevention, a US-based NGO, was offering US $40 to be fitted with IUDs, which can prevent pregnancy for over a decade.
Agnes Odhiambo of New York-based Human Rights Watch blasted the NGO for “pushing women with HIV to take up long-term birth control irrespective of their reproductive needs”. James Kamau, coordinator of the Kenya Treatment Access Movement, called the project “wrong, immoral and unethical”.
A Project Prevention operative told local news sources, “Why should you give birth to a child who will remain an orphan, or who is likely to die before his or her fifth birthday because the mother had infected them…Prevent the suffering before it occurs.”
In November 2011, Citizen TV ran a story about an HIV-positive widow in Mbita who had received a grant to start a fish farming venture from the American NGO. The sole qualification to receive the money was her agreement to be fitted with an IUD.
The Minister for Medical Services, Peter Anyang’ Nyong’o, responded to the reports, saying, “We can’t say as a government we have been good at providing family planning needs of women or even men but we are putting measures in place. But it is important to stress that even HIV-positive women have the right to have children if and when they desire. HIV doesn’t take that right way, not at all”.