In South Africa, the forced sterilization of HIV positive women is part of the plan

In March of this year, we wrote: “In South Africa this week, 48 women living with HIV and AIDS responded to the indignity and abuse of forced sterilization. Represented by Her Rights Initiative, Oxfam, and the Women’s Legal Centre, 48 women who had suffered forced sterilization in Gauteng and KwaZulu-Natal came forward and lodged a formal complaint. These 48 `cases’ were from 1986 to 2014. These 48 women are the tip of a rumbling volcano.” Yesterday, the volcano rumbled, as a report indicated that, of 6719 HIV positive women interviewed, 498 said they had been forcibly sterilized. “It is the largest number of reported forced sterilisation cases ever uncovered in the country.”

The report, The People Living With HIV Stigma Index: South Africa 2014, noted, under Sexual Reproductive Health: “Of concern is that 7% of respondents reported that they were forced to be sterilized. In addition, 37% of the respondents said that access to ARV treatment was conditional on use of contraceptives.” Sindisiwe Blose, a research project manager and a member of the Treatment Action Campaign, elaborated, “We heard from people living with HIV who had refused marriage due to stigma, had avoided work promotion, or had been coerced into undergoing sterilization. Behind the figures lies a depth of suffering that struggles to be addressed.”

Close to 500 women forcibly sterilized doesn’t just happen. In this instance, the incidents were distributed all over, with the hotspots in three provinces: Eden, in the Western Cape, accounted for 22%; Buffalo City, in the Eastern Cape, 20%; and Sedibeng, in Gauteng, 19%.

Sethembiso Mthembu, of Her Rights Initiative, responded to the numbers: “The data of 498 cases basically confirms the practice is widespread. It is systematic. It is not a few rotten apples.” The Women’s Legal Centre also described the sterilization as systemic, with Jody-Lee Fredericks, of the Centre, adding, “This is horrific.”

The horrific this is the banality of the policy. As Helen Rees of the Wits Reproductive Health & HIV Institute recently explained, the biggest concern right now is young women, ages 15 to 24, and women sex workers. Many of the young women who are “placed in this situation” are poor, vulnerable and “prey to sexual exploitation.” In other words, none of this is surprising.

Yesterday, Nkhensani Mavasa, the Chairperson of the Treatment Action Campaign, addressed the opening session of the South Africa Aids Conference 2015. She spoke of a new denialism among the leadership of the nation, and she warned, “If you choose to ignore the crisis in the healthcare system, this crisis that is a fact of our daily lives, you may, like those other denialists in the past, end up on the wrong side of history.”

The forced sterilization of HIV positive women is an integral part of that new denialism. In the complaint filed in March, 48 women and their supporters rejected the double stigma of being HIV positive and being unable to have children. They also rejected the third stigma of having failed the nation-State. Women who are HIV positive are viewed as failed citizens. That’s why they can be treated this way, despite Constitutional and legal protections to the contrary. The Department of Health says forced sterilization is not department policy, but it is practiced, in the open, regularly. The forced sterilization of HIV positive women is an integral part of State violence against women, and it is never accidental or incidental. It is part of the plan.

 

(Photo Credit: The Star / Chris Collingridge)

In Namibia, the women say, “Non negotiable: my body, my womb, my rights”

 

In 2009, three Namibian women sued the State. They claimed they had been forcibly sterilized and that they had been sterilized because they were HIV positive, and so were victims of discrimination. This week, the High Court of Namibia decided the case. Judge Elton Hoff ruled in the plaintiff’s favor in the first claim and dismissed the second, due to insufficient evidence. The case is widely viewed as a landmark case.

Three separate women, ranging in age from 20s to 40s, at the height of labor, were presented with the sterilization `option’. In one case, the woman had been in labor for over four days and was in severe pain. She was led to believe that her caesarean could only take place if she signed the form. In such circumstances, what is the gender of informed consent?

In a decision that took Judge Hoff two hours to read, the Judge said there was no informed consent. He further noted that the women were Oshiwambo-speaking and that none of the health staff spoke Oshiwambo. He also noted that the forms the women signed were filled with acronyms no one, other than a specialist, could be expected to understand. Finally, in all three cases, the women only discovered the meaning of “BTL”, bilateral tubal ligation, long after they had undergone the surgery.

As the judge said: “There could not have been counselling in those circumstances.” When Judge Hoff looked up from his papers, he saw a courtroom, packed with women in black t-shirts that read, “Non negotiable: my body, my womb, my rights”.

This is a story, on one side, about how women at their most vulnerable are treated. Violently. It’s equally a story about how women organize and turn men’s swords into women’s ploughshares.

The three women are members of the Namibian Women’s Health Network. During a routine inspection of post-treatment papers, Network members started noticing BTL on members’ treatment cards. When the women were asked about it, no one knew what BTL was, and absolutely no one knew that this had happened to them. The women then hooked up with the Southern Africa Litigation Centre, and in particular with Priti Patel, deputy director and HIV program manager, who managed the case.

Though mixed, the decision is a step forward, and it’s a step that women Namibian women took, as they are doing in South Africa, in Kenya, in Swaziland, in Zambia. In South Africa, for example, Promise Mthembu went through a similar torture. At 22, she discovered she was HIV positive. She went to hospital and was told she had to sign a paper and undergo sterilization if she wanted treatment. And so she signed. Now, 16 years later, she says she is `haunted’ by having signed that form.

In response, Promise Mthembu has organized, among other groups, Her Rights Initiative, HRI: “Her Rights Initiative (HRI) was formed in 2009 by a group of feminist South African women. The Initiative is building from the knowledge and experience of its founding members who all identified the gap between HIV/AIDS policies and HIV positive women’s experiences and the potential HIV positive women represent in improving existing policies or recommending new ones to ensure women living with HIV/AIDS are able to access their sexual and reproductive rights in South Africa with a potential for improvement for all women.”

Last year, HRI researchers, feminist researchers, produced `I Feel Like Half a Woman All the Time. The researchers interviewed HIV positive women in Gauteng and KwaZulu-Natal. They found cases, and not just a few, of explicitly coerced sterilization and other cases of sterilization performed without informed consent. More to the point, they listened closely and intently to what the women were saying. It’s what feminist researchers and activists do.

Feminist South African women, feminist Namibian women, feminist African women are moving the State and the continent.  It’s non negotiable.

(Photo Credit: socialgoodmatters.tumblr.com)