In Namibia and Beyond, Forced Sterilization is a Human Rights Violation

Last week, we blogged about the discrimination often experienced by women who are HIV positive. Specifically, we highlighted a case in Maine in which a judge issued an extended jail sentence for a pregnant, HIV positive woman in violation of immigration law.

This morning, we have a disturbing addendum to the list of rights violations experienced by HIV positive women: forced sterilization.

An article by Geoffrey York in today’s Globe and Mail  highlights the case of Hilma Nendongo, an HIV positive woman who found out she had been sterilized when she went back to the hospital to have stitches removed after giving birth to a baby boy by Caesarian section.

Hilma is not alone, according to York, who writes that “perhaps hundreds” of women in Africa alone “have been sterilized without their knowledge or consent in recent years because they were HIV-positive.” (Author’s note- this quote has been updated- see comments below.) York describes the experience of several HIV positive women who received bilateral tubal ligation, or sterilization, either unknowingly or forcibly amidst pressure from their healthcare providers. In these cases “consent” is often obtained by having illiterate patients sign forms that they are unable to  understand, without explanation of the procedure to which they’ll then be subjected, as well as incorrectly informing patients that the sterilization operation is mandatory if they want to stay alive, or if they want medical assistance in delivering their baby.

Unfortunately, there is plenty of evidence to indicate that Namibia is not the only country in which such rights violations are taking place. Cases have been reported in countries all over the world, from Congo and South Africa to the United States. Angela Castellanos reports on that in Chile, a woman living with HIV and sterilized without her consent filed a complaint against before the Inter-American Commission on Human Rights (IACHR) last February, charging that the government failed to protect her from being forcibly sterilized.

The pervasive nature of this tragic and infuriating global phenomenon confirms that this is more than a few cases of bad healthcare advice or doctor manipulation: this is an issue of women’s health and human rights being blatantly and consistently undermined, ignored, and violated due to the stigma, discrimination, and misinformation associated with HIV/AIDS.

And so, as tragic as the cases of forced sterilization of HIV positive women documented by York in Namibia are, we must remember that they are not just tragic. As outrageous, blatant, and infuriating as they are, they are not only these things. Forced sterilization of a woman- any woman, regardless of her HIV status- is a violation of every woman’s fundamental human right to sexual and reproductive autonomy. The right of women to control their sexuality—the basis for sexual rights—is an indivisible part of their human rights, and without it, women cannot fully realize their other human rights.

Doctors and healthcare providers- in Namibia and around the world- must be held accountable for delivering respectful and consensual healthcare. Stigma, discrimination, and misinformation cannot be allowed to continue to stand in the way of ensuring the basic human rights of women around the world.

Check out this report issued in March by the International Community of Women Living With HIV/AIDS (ICW) for more information on forced sterilization in Namibia.



5 responses to “In Namibia and Beyond, Forced Sterilization is a Human Rights Violation

  1. Your article is important, but did you have to sensationalize it by misquoting York? You said:
    Hilma is not alone, according to York, who writes that “perhaps hundreds” of women in Namibia alone “have been sterilized without their knowledge or consent in recent years because they were HIV-positive.”

    But York Wrote:
    Ms. Nendongo didn't know it at the time, but she was one of dozens of African women – perhaps hundreds – who have been sterilized without their knowledge or consent in recent years because they were HIV-positive. At least 20 such cases have been documented in Namibia, some occurring as recently as six months ago, and similar cases are believed to have occurred in Zambia, South Africa and Congo.

    1. Thanks Lili, I didn’t realize that York was referring to the whole continent of Africa and not Namibia specifically in that quote. I’ve updated the blog appropriately. That being said, I certainly don’t think this is a sensationalized or unrealistic figure for the number of forced sterilizations that have occurred in the country in recent years. The ICW Report I link to in the original post found that of the 230 HIV positive women on whom they conducted research between 21st January 2008 and 22nd of April 2008 in Namibia, most reported some form of discrimination in health services and 40 (nearly 20%) stated that they had been coerced or forced into sterilization. Namibia has a population of over 2 million, and a current HIV prevalence of 15.3% with women accounting for more than half of all HIV infections in (55%), which implies that there are well over 100,000 women living with HIV in Namibia. Plus many who experience sterilization fail to report the practice due in part to the kind of stigma York highlights. Unfortunately, it seems that “hundreds” of cases may in fact be a conservative estimate.

      1. Thanks for making the change Lori. I read and replied to your link as a Namibian citizen who has been closely following the case in the national media, both out of personal and professional interest. There is an ongoing lawsuit against the doctors who allegedly performed the sterilization, and health officials have come out against those doctors. I agree that discrimination occurs aginst people with HIV, but to suggest that sterilization is somehow instituitionalized in Nambia, as you do in your last sentence above, is false and not very conducive to the discussion on discrimination. You basically infer that every HIV-positive Namibian women is subject to sterilization, which is not the case; you just succeed in demonising a whole country. It also appears that you have not looked into the issue further than the York article, which is very careful in the assertions that it makes. Your knowledge of HIV in Namibia seems limited to a few recently acquired facts, but you make your assertions with such certitude. In pursuing justice for other, I think it is important that we exercise a little humility.

        1. I appreciate your unique perspective and by no means meant to suggest that I am an expert on sterilization of HIV positive women in Namibia. Rather, my point is that due to the international lens through which I have viewed and have worked on women’s health issues with IWHC, I see the issue as one that is part of a larger context of rights violations and discrimination against women living with HIV. I never once inferred that every HIV-positive Namibian woman is subjected to sterilization- simply that even if a small percentage of HIV positive women are subjected to this rights violation, as the ICW report documents, this is a significant number indicative of more than just a few cases of one doctor’s arrogance, but rather a systemic problem related to stigma and rights violations of HIV positive women that is occurring around the globe. I truly believe that for progress to be made on these issues, we must join in solidarity with other who experience discrimination, and connect the dots and highlight the commonalities in the global struggle for women’s rights from country to country and continent to continent. Surely the case of sterilization that you are following in your country of citizenship is related to the one in Chile I mention in my blog post?! The Chilean case and others like it was not mentioned in the York article or in the ICW report, and I thought the global nature of the issue was important to highlight. That was my purpose, and not to offend or pretend to have more knowledge than I do. Again, thank you for your input and your valuable viewpoint. I encourage you to continue to speak up in this forum and in the women’s health field at large!

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