RIGHTS-PERU: Sterilisation Outcry Stirs Family Planning Debate

By IPS Correspondents Reprint | | Print |

Abraham Lama

LIMA, Jul 26 2002 (IPS) - Peru’s Health Minister Fernando Carbone said Thursday that the family planning programme of the Alberto Fujimori administration (1990-2000) should be closely investigated, as a recent ministry report accuses the former president of supporting the forced sterilisation of more than 200,000 people, mostly from poor indigenous communities.

According to the report Carbone presented to Congress, 10 percent of 506 women interviewed acknowledged they had submitted voluntarily to the sterilisation procedure, but the rest said they did not clearly understand the explanation they were given about the surgical intervention.

The family planning programme under the Fujimori government won praise in 1998 from the World Health Organisation and was backed by the World Bank and the U.S. Agency for International Development.

The initiative curbed Peru’s population growth, reducing it from more than three percent to 1.7 percent, the target reached in 1998.

The demographical decline was greatest in the rural areas where the family planning initiative was most heavily promoted, and took its toll in social terms because with fewer children, families had fewer sources of income.

According to the investigation that Carbone released, between 1996 and 2000, some 215,000 women underwent fallopian tubal ligations and more than 16,000 men had vasectomies under the government programme, which targeted rural, predominantly indigenous communities.

Health Ministry officials carried out the survey of the 506 women after Prime Minister Luis Solari said compensation was being considered for women who reported that they had suffered physical or psychological damage as a result of the surgical procedures that left them unable to have children.

“The survey involved the numerous women who voluntarily stepped forward to testify, and we have the reports on each one of their cases. Many said they did not file complaints before because they feared losing the food aid provided by the government,” Carbone said in an interview Thursday on Peru’s television Channel 6.

“Fujimori’s family planning programme utilised negative mechanisms, such as turning the National Health System’s contraceptive surgical intervention goals into sterilisation quotas,” stated the official.

The quotas imposed on the Health Ministry by pressure from the Fujimori administration were distributed among the system’s doctors, many of whom used irregular means to meet the targets.

The report by the current Health Ministry states that the upper echelons of the Fujimori government, including the former president himself, were involved in drafting, promoting and monitoring the sterilisation programme.

Carbone, a conservative Catholic, admitted that he is personally opposed to birth control programmes, but assured that his ministry would not obstruct the dissemination of contraceptive methods, another policy the Alejandro Toledo government inherited from the Fujimori era.

Many of the national and international media reporting on Carbone’s presentation of the study Wednesday before a parliamentary subcommittee investigating Fujimori’s “responsible parents project”, suggested that the former president, now exiled in Japan, had committed genocide through forced sterilisation of reproductive-age adults.

But Carbone said, “I did not utilise the term ‘genocide’, nor did I say that the women were forced to undergo surgical sterilisation. It was a word used by lawmaker Héctor Chávez. But I do believe that the way the family planning campaign Fujimori promoted was carried out.”

The health minister during Fujimori government, Marino Costa Bauer, told IPS that the idea behind the responsible parents project was to reduce infant-maternal mortality, and that it proved successful in that sense.

“The accusation of genocide is very serious. It implies an extermination policy against an ethnic community, when the result was quite the opposite because we reduced the infant-maternal mortality rate,” said Costa Bauer.

“It is an accusation with a dual political motive: on one side, to incriminate Fujimori and his ministers, and on the other, to demonise contraceptive programmes in order to reverse them,” added the former official.

“All of the surgical interventions were conducted in hospitals and official health centres by responsible personnel,” said a doctor who worked for the Voluntary Surgical Contraception Programme.

“If the accusation were honest and did not involve political intentions, those of us who participated in the programme would have to be charged with criminal complicity,” said the doctor, who did not give his name.

“The Health Ministry’s statements are incorrect. It mentions 200,000 women affected, a figure that is not corroborated by any serious study conducted on the matter,” said the Flora Tristán Peruvian Women’s Centre on Thursday.

The organisation, which denounced irregularities in the government’s sterilisation programme in 1997, expressed concern that “within the recommendations set forth in the ministry’s document, it mentions withdrawing voluntary surgical contraception from the list of contraceptive methods provided.”

Voluntary sterilisation is “a scientifically proven and harmless alternative, and its elimination as an officially recognised contraceptive method would adversely affect the poorest population… making it a procedure for the privileged, performed only in the private sector,” says the communiqué issued by the Flora Tristán Centre.

Minister Carbone said “the state should not promote birth control practices, nor impede them. The Health Ministry continues providing information and services on procedures for family planning.”

“More than 200,000 surgical sterilisations were conducted and only 18 deaths from subsequent complications were reported, a very low number in international terms,” said Rosa María Palacios, women’s rights activist and Channel 6 journalist during the Carbone interview.

Palacios pointed to a 1998 survey of 5,600 sterilised women — a poll conducted by the Fujimori government and monitored by the People’s Defender (Ombudsman) and “some international organisations” — showing that “more than 90 percent of the women consulted had voluntarily agreed to the procedure.”

“We should look at how that poll was conducted. And whether food and gifts were offered the women of the poorest populations to convince them to be sterilised. Perhaps they were convinced with similar promises to respond in that survey that they were in favour of those sterilisations,” responded the minister.