RIGHTS-VENEZUELA: Sterilisation Workshops Spark Controversy

Estrella Gutierrez

CARACAS, Mar 3 1999 (IPS) - Nearly 700 women asked to be sterilised in just one Venezuelan hospital during the first day of the civic- military social emergency plan, but only 22 of them fulfilled all the necessary requisites and actually had the operation.

The offer of sterilisation within the plan implemented on February 27 drew criticism from conservative groups and only conditional support from non governmental organisations (NGOs) dealing with women and children.

Carmen Gonzales, a 34 year-old mother of four, was one of the 22 women who had their tubes tied in the Concepcion Palacios Maternity Hospital, in Caracas.

Gonzales said she was satisfied with the outcome; “I am relieved because the current situation isn’t right for having more children and I waited nearly two years for this chance.”

“There is no sterilisation policy or programme in itself, it is not a specific nor mass objective,” said health minister, Gilberto Rodriguez, but “a great deal of scandal has been raised over the issue,” he said critically.

Gisela Diaz, executive director of the private Family Planning Organisation (Plafam), agreed with the minister saying there had been both scandal and manipulation.

But she also stressed her concern that the Maternity Hospital, the biggest health care centre in the country for pregnant and recently delivered mothers, had classed the sterilisations offered under the six month emergency plan as being “voluntary and for the indigent.”

“Poor women or women have the same rights as any other person, and their freedom of choice cannot be taken away,” Diaz told IPS.

The Plafam executive thus criticised declarations made by director of the hospital, Carlos Cabrera, who had suggested a doctor or other authority could be granted the power to prescribe sterilisation in the case of beggars, alcoholics or the insane, should they be considered unfit, without permission from either the patient or their next of kin.

She also said sterilisation should form part of an integral health and social care policy. “It is not a matter of ‘sterilise them and leave them to their fate’,” she said, summing up the stance of the NGOs, most of whom offered to support the emergency plan.

The controversy surfaced when it became public that the social emergency plan, operated by 70,000 military personnel, 80,000 civil servants and tens of thousands of volunteers, would include sterilisation amongst the backlogged operations hospitals would try to clear in 120 days.

Catholic Church representative, Bishop Hernan Sanchez, classified the sterilisation workshops as “an assault on human dignity,” stating that the tying of the fallopian tubes “is contrary to moral law” when carried out voluntary.

Provive, the antiabortion organisation, stated efforts were being made to drag the country “into anti birth campaigns which include plans for mass sterilisations,” taking advantage of the socio-economic crisis. Abortion is illegal in Venezuela.

This organisation which spreads across several countries, funded by a multimillionaire Venezuelan liquor selling family, classed sterilisation as “mutilation of the poor” and “unacceptable social profilaxis.”

Meanwhile, Diaz, director of Plafam, the leading family planning NGO, said sterilisation is only one more method of birth control – something women have a right to – although as it is permanent, they must fulfil the prerequisites.

Diaz cited the fact that more than 20 percent of pregnancies in Venezuela occur in adolescents (aged 18 and younger) and that the State only offers help or guidance to around 14 percent of women of child-rearing age.

This means more than four million adolescent girls and grown women are given no information on sex, reproductive health or birth control, most of them falling in the class of the socially marginalised in cities and rural areas.

Of the 23 million Venezuelans, 80 percent live in poverty, 35 percent suffer from critical poverty, and 14 percent survive by begging. Around 60 percent of the poorest homes have no father, while in general, a quarter of all families are headed by a woman alone.

Cultural heritage, irresponsible fatherhood, a machist tradition where women are valued by “how much they produce” in terms of children and women’s attempts to keep their partner by having babies, all feed the problem along with the reluctance of the State to change values and promote family planning.

Venezuela’s birth rate is 3.3 children per woman, but this rises to seven in rural areas, while the infant mortality rate is amongst the highest in Latin America, with 27 deaths per 1,000 live births.

One sign of how machismo affects official levels is seen in the fact that the Maternity Hospital demands a husband’s consent in sterilising a woman, irrespective of the woman’s rights or the type of family predominant in the social strata dependent on public health care.

Diaz explained there is no specific legislation on family planning in the country, and the law on children and adolescents, approved in 1998, is the first to include the right to receive information on reproductive health.

Each institution sets its own rules for sterilisation. In the Maternity Hospital this means a minimum age of 26 years old, two births and approval of the partner throughout the emergency plan, when it expects to deal with 50 women per week.

Plafam, with its four centres in the metropolitan area of Caracas, and links with other NGOs dealing with women and children and giving day to day care to a hundred people, said current standards are for three children in women aged between 20 and 29, two for women up to 35 years old, and one from that age on.

An interdisciplinary Bioethics Committee is in charge of updating the rules and dealing with cases not fitting in with general guidelines. “The woman is always listened to and a decision made with her,” explained Diaz.

Plafam has carried out 14,800 voluntary sterilisations in its ten years of operation, and on the basis of this experience, Diaz said it would be a mistake to leave the decision up to only one player, or to make rules of any sort on absolutely exceptional cases, where free will would be difficult to achieve.

Diaz pointed out that Plafam’s experience is that the pill and sterilisation are the most commonly used contraceptives. Plafam also offers vasectomies, a male sterilisation cheaper and quicker than the female version, and not included in the emergency plan.

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