Editorial: the collapse of the Peruvian program

At last the Peruvian government’s brutal campaign to force poor mothers into dangerous, unsanitary and criminal medical procedures is drawing to a close. Sources in the (inappropriately) named Ministry of Health in Lima told reporters at the Peruvian paper La Republica that the sterilization campaign has “collapsed.”

“Sterilizations have decreased 68%,” La Republica quoted officials as saying, because “of a dramatic lack of confidence both in the method and in health agents.” An unprecedented alliance of Peruvian Church groups, feminist non-governmental organizations, pro-life groups and human rights groups coalesced to oppose the campaign. The groups alleged and documented how the campaign’s coerced poor women and failed to follow even minimal medical guidelines and killing at least 18 mothers who had been forced into undergoing the surgery.

“I am not usually given to public optimism,” said Steven Mosher, President of the Population Research Institute (PRI). “But I would have to say that the news from Peru is very welcome. It would have been good to hear that the Peruvian government had come to its senses and rethought this war on it own people,” Mosher said, “but in a way it’s even more gratifying to hear that the campaign collapsed because it was rejected by its intended victims.”

PRI sent an investigator and camera crew into Peru in late January to document abuses in the campaign. PRI’s reporting later helped generate sufficient interest for the US Congress to hold public hearings featuring witnesses from Peru.

Speaking for the record Jorge Parra, new director of the Ministry of Health’s Reproductive Health and Planned Parenthood program said the government “‘obviously” would fail to reach the “goal” of 78,000 tubal ligations and 22,000 vasectomies in 1998. Parra’s statement marked the first time a Peruvian government official had both admitted the government had set yearly goals for the program and volunteered a figure for those goals. Parra also announced that the Ministry had to cease its “sterilization festivals,” who’s whose existence the government had also previously denied.

PRI and other human rights groups documented that the campaigns began after the government of President Alberto Fujimori forced the Peruvian legislature to change the long-standing law against using sterilization or abortion as a means of “family planning” in the country. Although the ban on abortion remained on the books, the part of the National Population Control Law prohibiting sterilization was removed. The government then began to organize campaigns based, at least partially, on similar campaigns run in nations like Columbia and India, using the expertise of officials and doctors flown in to the to train Peruvian officials and doctors for that purpose.

The campaigns usually began in Lima, where officials would use primarily economic and social criteria to select a part of Peru for a campaign. Areas targeted were almost universally poor and were often populated primarily by Peruvians of native ancestry. The Ministry would then alert local officials in the region about the campaign and they would begin to round up women to be sterilized. As critics documented, the tactics used to get women to accept the procedure ranged from offering food. and sometimes clothing, to desperately poor and hungry families in exchange for sterilization; repeated harassment from Ministry workers in women’s homes, threats, bullying and other intimidation and deception. None of the women PRI interviewed as part of its investigation reported being offered anything like informed consent about the procedure.

PRI also documented cases of women who were already cooperating with the population control program by consenting to shots of Depo-Provera every three months only to be told that the shots were being “discontinued” and that they must accept sterilization. When asked later about this particular policy Dr. Eduardo Yong-Motta, former Minister of Health during the campaign’s beginning and now Presidential Health Advisor told PRI investigators “Depo-Provera is too expensive.” Further, he said, the government was concerned that women might “forget” to come in for their shots or even decide they didn’t want it any longer.

Government officials who support the program have been widely quoted as blaming a the Roman Catholic Church in Peru for running a “subtle guerilla war” against the campaign, but the Peruvian media has been widely reporting the campaign abuses for over a year. The Public Defenders office, which serves in Peru as something of an official inspector general, has a growing list of abuse cases against the government that it is investigating.

But at bad as the Peruvian campaign was (and it ranks as among the worst in recent memory) we must continue to make the point that it was only one example. A growing list of nations around the world has chosen to violate their citizens’ human rights in the effort to dam their fertility. This year marks the 50th anniversary of the United Nations Universal Declaration on Human Rights and marks an appropriate time to ask whether authentic human rights really do belong to everyone or merely to the wealthier few.

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