- A landmark court case, alleging that HIV-positive women were forcibly sterilised in Namibian state hospitals began this week in Windhoek's High Court. Human rights groups claim the practice has continued long after authorities were notified.
The Windhoek-based Legal Assistance Centre (LAC) is litigating 15 alleged cases of forced sterilisation. Three women's cases will be heard initially. Each woman is demanding the equivalent of US$ 132,000 in damages.
The sterilisations were first uncovered by the International Community of Women Living with HIV (ICW). "The first cases emerged during community meetings in early 2008. In the months that followed we interviewed 230 women, 40 of whom were sterilised against their will," says the ICW's Veronica Kalambi.
"In August 2008 we formally alerted the Ministry during a meeting with the Deputy Minister," Ms Kalambi adds.
Although the state is arguing that consent forms were signed in all three cases, the women's lawyers maintain the process necessary for "informed consent" was not followed and the women were coerced, or did not understand the procedure.
"Closing women up"
Meanwhile new cases have emerged in a town 80 kilometres south of Windhoek, suggesting that the practice continued even after the health ministry was alerted to problems. "I never signed a consent form," claims Maria Oubaas (not her real name). "After I had given birth I was simply told that I would be 'closed up'," she explains.
"The operation took about fifteen minutes. There was a whole bunch of us. One woman who saw that I was in pain after the sterilisation refused to undergo the surgery, but the nurse promised her clothes - a red skirt and red shoes - if she went through with it."
The thirty-five-year old shows her scar. All of Ms Oubaas's six children were born vaginally, but a short, faded white line on her belly remains from a procedure that she says she underwent on 1 February 2006, a day after she had given birth to her youngest daughter in Rehoboth's St Mary's Hospital. "To this day I don't know the exact nature of the sterilisation and whether it is reversible," says Ms Oubaas, who fears losing her new boyfriend over the inability to conceive.
She is not alone. The ICW claims to have documented five cases of forced sterilisation in the underdeveloped town. 'IPS' has seen the medical passports of two of the Rehoboth women who claim to have been sterilised against their will.
One file records sterilisation by tubal ligation in 2005, but the woman was referred to Windhoek with a possible ectopic pregnancy in April 2010, after tests confirmed she was expecting - indicating the sterilisation may not have been carried out properly.
The other sterilisation took place in September 2008, which was after the Health Ministry was informed about the claims. "The Rehoboth cases took place between 2005 and 2009, but there are reports that involuntary sterilisations have continued as recently as this year," says Ms Kalambi.
Women's rights activists claim that at least 15 women have come forward who claim to have been sterilised in 2009 and 2010, after the Health Ministry was alerted to the practice. "We have documentation for five of these cases," Ms Kalambi says. "The most recent case took place in February 2010.
In the operating ward of St Mary's, scrub nurse Maria Shanyengange who assists during sterilisation operations shakes her head. "Such things do not happen here," she is adamant.
"We have about ten sterilisations a month," she tells 'IPS'. "Although lately that number has dropped to five. In each case the nurse or the doctor has informed the patient. When I get them from the ward I check the paperwork and confirm verbally whether they are aware of the procedure."
"Absolutely impossible." Dr Georg Judmann, principal medical officer at St Mary's is equally emphatic. "Consent forms are signed in every case. If the patient doesn't speak English a nurse will translate the form," he adds.
"There have been cases when we feel there is doubt on the side of the patient, or she is still young and might regret the decision later on. Then we intervene and stop the procedure. We advise people to go home and think about it, talk to their partner and consult the social worker at the HAART (Highly Active Anti-Retroviral Therapy) clinic," Mr Judmann explains.
According to the LAC's Mark Nonkes, the three cases in the Windhoek High Court - unique in Africa - are the first of fifteen that will be heard in the months to come, with women demanding compensation for violation of their civil rights.
"In a show of solidarity with the women, a coalition of civil society organisations from across Southern Africa are planning to lead several events to coincide with the dates of the court case. Hospital sit-ins, a mass march of support, a petition hand-over and demonstrations at Namibian embassies in Zambia and South Africa are intended," states the LAC in a press release.
Whether the courts find malpractice or not, Dr Judmann fears the damage has been done. "The accusations and the publicity they generate corner physicians into refusing to operate. Doctors might become more reluctant to perform sterilisations if they risk being dragged through the media. This will deprive patients of proper health care."
Ms Kalambi disagrees. "We are not saying don't operate, but make sure that women are properly informed long before the moment of giving birth, for instance at antenatal classes, so they have time to consider their options."
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