On 29 January 1998, the last day of his investigative trip to Peru, PRI Review editor and investigator David Morrison was given an interview with Eduardo Yong Marta, President Fujimori’s health advisor and former head of the Ministry of Health during the beginning of the campaign. The following is a paraphrase of that interview.
Eduardo Yong Motta is on the short side, somewhat pudgy, balding and wears no wedding band. He is one of ten children and, while favoring children generally, reminded the interviewer that many children bring many problems too. He described at some length how tired his father, a doctor, had been all the time and of how hard he had to work merely to provide his children an education and how sad Yong Motta considered this situation to be.
According to Yong Motta, the sterilization campaign had been in the works since 1999, but other political considerations (terrorism, for example) prevented the government from following up on its commitment until 1995. He said that the mission of the Ministry of Health on family planning was to steer a middle course between the Church, which he called Holy Mother Church and which he claimed wanted no family planning at all, and feminist groups that wanted abortion made legal. In his view the program has been a great success except for the denunciations in the press which he read, but discounted as exaggerations or outright lies.
Yong Motta said that he knows these things [the abuses] could not have happened because health workers are like educators. They are with the people, he said. They know what the people think and what the people need. They care about the people.
At this point the interviewer asked specifically about the consensus among so many different parts of the society that these abuses and problems are occurring widely. The interviewer even listed some of the diverse groups that make up the consensus. Yong Motta’s response was that all these different groups had biases that disqualified their protests. The human rights and feminist groups were disqualified because they look at things very closely and then blow what they find out of proportion; the Church was disqualified by being the Church; USAID was disqualified from objecting because they have been helping in the family planning program from the first.
The interviewer asked about the campaigns, why did they need to be house to house? Yong Motta replied that if the Ministry of Health did not do the campaign house to house people would not come. The interviewer asked if that did not make the Ministry of Health want to rethink whether sterilization was an idea with broad appeal. Yong Motta replied that the interviewer misunderstood Peruvian culture, which is very home-based. Communication is done in the kitchens he said, in the homes. And he speculated that all such campaigns in the developing world would have to be done house to house.
The interviewer asked why the women needed to be pressured so. Was there a need for health promoters to go back to the houses time and time again? He replied with a long discussion of a hypothetical male patient with a hernia. A man might not want to get the hernia operation for any number of reasons, Motta said. It’s too expensive or it might hurt, or it might interfere with his sexual function later. But, Mona said, it was a doctor’s responsibility to convince the patient to do what was best and have the operation. It’s exactly the same with ligation, he said. Women in Peru have many children.
The interviewer asked about the lack of freedom to choose a method and used some of the examples of women who had been pulled off Depo-Provera. Why were women being pulled off Depo and sterilized? Depo costs too much, Yong Motta said. If the state is giving both methods for free the State should be able to choose which method it offers. In addition, he pointed out, a woman might forget to come in for her shot or might not want to [emphasis added].
The discussion of the State brought up the discussion of targets and the campaign. Did the campaign have targets and, if so, why?
Of course the campaign had targets; if not how would we know how we are doing, Yong Motta asked. How does the Ministry of Health measure the success of the program, the interviewer asked bluntly. Yong Motta answered, through many methods. Numbers of acceptors versus non-acceptors, numbers of complications both simple and serious were among the examples he used.
The interviewer asked if the ministry recognized the danger that the targets set to evaluate the policy at one level might be understood as targets for sterilization at the local level and he replied that this was quite possible but that the campaign had been a success.