In Namibia, a victory for HIV-positive women, for all women, everywhere

 

Pushed by women’s organizations, by women organizing, courts and legislatures around the world are forcing the end to coerced sterilization of women. A little over a month ago, the California legislature finally outlawed the forced sterilization of women prisoners. This month, Namibia’s Supreme Court upheld a 2012 High Court ruling that health workers sterilized HIV-positive women without their consent. As Michel Sidibé, UNAIDS Executive Director, noted, “This is a great victory for all women in Namibia and the world. This decision reinforces the right to sexual and reproductive health for all women, irrespective of their HIV status.”

This latest chapter began, formally, in 2009, when 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. 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 2012, Judge Elton Hoff took two hours to read the decision. He argued there was clearly no informed consent. He noted that the women were Oshiwambo-speaking and that none of the health staff spoke Oshiwambo. He further noted that the forms the women signed were filled with acronyms no one, other than a specialist, could be expected to understand. In all three cases, the women only discovered the meaning of “BTL”, bilateral tubal ligation, long after they had undergone the surgery. Judge Hoff concluded, “There could not have been counselling in those circumstances.” When, after two hours, Judge Hoff looked up from his papers, he faced a courtroom packed with women in black t-shirts that read, “Non negotiable: my body, my womb, my rights”.

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. No one knew what BTL was, and absolutely no woman knew that this had happened to her. The women then hooked up with the Southern Africa Litigation Centre, and in particular with Priti Patel, then deputy director and HIV program manager, who managed the case.

According to Jennifer Gatsi-Mallet, Director of the Namibian Women’s Health Network, “The three women at the heart of this case are just the tip of the iceberg. We have documented dozens of similar cases of women living with HIV being sterilised without their informed consent. This judgment presents the strongest possibility that the Government of Namibia will be held to account for subjecting HIV-positive women to coerced sterilisation,” said Mallet.

Priti Patel added, “Monday’s decision will have far-reaching consequences not only for the three women at the heart of this case, but for the dozens of other HIV-positive women who have been subjected to coerced sterilisation in Namibia and throughout southern Africa.”

This victory in the Namibian Supreme Court extends beyond hospitals and prison and before human rights to women everywhere organizing to sustain their dignity as women, and in so doing, pushing the State to do more than pay lip service to women’s rights and equality. This is a victory for women’s autonomy and power, everywhere. The State, and not just Namibia, did more than fail to stop forced sterilization. The State engaged for decades, and centuries, in medical pogroms against women. It’s way past time for the State to be held to account for violence committed against women across the African continent and around the world.

 

(Photo Credit: Namibian Women’s Health Network)

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)