By IPS Correspondents
LIMA, May 31 1998 (IPS)

Delia Zamudio, the head of a neighbourhood women’s shelter in the Peruvian capital was admitted to a public hospital for a simple operation to have a cyst removed. She and came out sterilised.

“The doctor looked at me and said ‘black! How many years old, how many kids?’ When I told him I was 40 and had two kids he said ‘we have to conduct an AQV’ – which they proceeded to do against my will,” Zamudio said.

“AQV” is an acronym for the government’s Voluntary Surgical Contraception campaign, which sets sterilisation quotas for public hospitals, health clinics and doctors, and provides incentives and rewards – as well as threats of dismissal.

Zamudio’s testimony had provided evidence to back allegations by the Roman Catholic Church and local women’s groups that the programme is not strictly voluntary.

“I thought that since I said ‘no’ to the operation they wouldn’t do it. But while I was under the effects of anesthesia they just went ahead…And on top of that they did it poorly, leaving a gauze inside that caused an infection which almost killed me,” Zamudio declared.

Conservative sectors and the Catholic Church have been calling for an end to the government’s family planning programme after denouncing the surgery-related deaths of 10 of the 130,000 women sterilised in 1997.

“While using the pretext of fighting one of the factors of poverty, the government has unleashed a war against poor women, because the AQV programme is carried out in the most depressed social and geographical areas,” said Rafael Rey, a parliamentarian with ties to the conservative Catholic organisation Opus Dei.

Health Minister Marino Costa responded that “there is always a risk of death in any surgery. The number of deaths was minimal, and the 130,000 surgeries carried out in 1997 prevented many deaths, because in Peru, 254 women die for every 100,000 births.”

Publicity won by the anti-birth control sector forced civil organisations in favour of family-planning programmes to back off, for fear of being linked to what appeared to be a policy of widespread forced sterilisation.

Women’s groups, however, took a stance this week. While not opposing the birth control programme – which includes information and educational campaigns on contraceptive methods and the distribution of condoms and insertion of intrauterine devices (IUDs) free of charge – feminist groups demanded that the rights of those who use public health services be respected.

The Broad Women’s Movement, comprised of a number of institutions and women’s rights activists, joined the fray this “to lay down guidelines” – in the words of one of its leaders – and demanded that human rights be given top priority.

“In the past few months we have been shocked and indignant at seeing the series of abuses that has occurred in the application of the government’s reproductive health policy,” said Maria Esther Mogollon. “We demand that the programme be reformulated, and that it no longer be based on sterilisation quotas.”

The movement wants women’s groups to be involved in discussing, drawing up and monitoring government policies on reproduction, she added. “Women are directly involved in the problem, and the manner in which the programmes are carried out affects us. In the 1980s, women’s organisations waged a battle against domestic violence, and we obtained satisfactory laws, whose correct enforcement we will continue to monitor. Now we are facing violence among public officials who are applying a compulsive sterilisation programme.”

Guilia Tamayo, an official of the Latin American and Caribbean Committee for the Defence of the Rights of Women (CLADEM), stressed that women’s groups were not against the setting of family planning targets, but rather the system of quotas established by the current government to reach those targets.

“Last year’s target was 130,000 sterilisations, and the government aims to carry out 160,000 this year. To reach that figure, quotas have been set for each hospital, health clinic and doctor of the National Health System, with incentives, rewards and threats of dismissal,” she said. “Sterilisations must not only be voluntary, but also endowed with all the necessary safeguards, and must be carried out in adequately equipped establishments.” Women’s freedom of choice must also be respected, Tamayo declared.

“To facilitate forced sterilisations and perhaps also to cut costs, unsuitable general anesthesia is used, like Ketina, which is not recommended because it causes hallucinations, against which the women are not warned,” she said.

Maria Isabel Rozas, with DEMUS, a women’s legal advocacy office, criticised the Health Ministry’s lack of response to the charges that the sterilisation programme has entailed excesses, and that it is compulsory rather than voluntary.

“There is a total lack of self-criticism. They have only responded by promising a new regulation, but this year’s target of 160,000 sterilisations remains standing – a target they won’t be able to reach because the denunciations have frightened off women and alerted their families,” said Rozas.

Tamayo commented that women’s organisations were concerned with the loss of credibility of the government’s reproductive health programmes.

“If the government fails to reformulate the programme and curb the excesses, the programme’s credibility will go down the tubes, women from the poorest sectors will stop visiting public health services, and not only the birth rate, but maternal mortality as well, will rise,” she said.

CLADEM launched a campaign against the quota system Thursday, the World Day on Women’s Health. Some 2,000 activists from women’s groups and soup kitchens in poor neighbourhoods visited a number of public hospitals in Lima, handing out informational pamphlets.

The leaflets, designed to help women users of public health services demand respect for their rights, contained information on Peruvian legislation and international recommendations.

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