David Smith in Johannesburg guardian.co.uk, Monday 22 June 2009
Women in Africa are being sterilised without their consent after being told the procedure is a routine treatment for Aids,
a lawsuit will claim.
Forty HIV-positive women in Namibia have been made infertile against their will, according to the International Community of Women Living with HIV/Aids (ICW). The group is preparing to sue the Namibian government over at least 15 cases.
Campaigners also report coerced sterilisation in the Democratic Republic of Congo, Zambia and South Africa, where according to one report a 14-year-old girl was told she could have an abortion only on condition that she agreed to sacrifice her reproductive rights.
The ICW has documented cases in Namibia where HIV-positive women minutes from giving birth were encouraged to sign consent forms to prevent them from having more children. Jennifer Gatsi-Mallet, its co-ordinator in the country, said : "They were in pain, they were told to sign, they didn’t know what it was. They thought that it was part of their HIV treatment. None of them knew what sterilisation was, including those from urban areas, because it was never explained to them.
"After six weeks they went to the family planning centre for birth control pills and were told that it’s not necessary : they’re sterile. Most of them were very upset. When they went back to the hospital and asked, ’Why did you do this to us ?’ the answer was : ’You’ve got HIV’."
Gatsi-Mallet said that some women were now afraid to go to hospital in case they are sterilised, and infertile women were often rejected by their husbands and communities : "In African culture,
if you are not able to have children, you are ostracised. It’s worse than having HIV."
African women aged between 20 and 34 have a higher prevalence of HIV than any other social group ; in South Africa one in three is infected.
On average an HIV-positive mother has a one in four risk of transmitting the virus to her child. With the latest antiretroviral drugs, the probability can be cut to less than one in 50.
But such medical interventions are underfunded and inaccessible to millions of women across the continent.
The ICW accuses the Namibian government of encouraging state doctors to sterilise HIV-positive women as a means of preventing the spread of the virus. Its request to see the government’s official guidelines has been refused. It hopes to bring 15 or more cases to court later this year.
A media report from Namibia last week highlighted the plight of Hilma Nendongo. A few weeks after giving birth, she was asked by a nurse : "Oh, did they tell you that you had been sterilised ?"
Nendongo, 30, who is HIV-positive, suddenly remembered that hospital staff had told her to sign some papers as she entered the operating room for a caesarean section.
"It was a very big shock," she told Canada’s Globe and Mail newspaper. "I was very emotional … I wanted a sister for my three boys, and now I can’t have one."
In South Africa, cases are being referred to the Women’s Legal Centre with a view to a possible action. Promise Mthembu,
a researcher at Witwatersrand University, said coerced sterilisations were happening in "very large areas" of the country.
Many patients were forced to undergo the operation as the only means of gaining access to medical services, Mthembu told the Mail & Guardian newspaper.