Posted on | April 12, 2012 by Annalee Seath, J.D. |
Uzbekistan is allegedly running an under-the-table program to sterilize women, sometimes without their knowledge or consent. A report by Natalia Antelava of BBC World Service reveals a disturbing trend of forced sterilizations and mandatory quotas for women, gynecologists, and other medical providers. The news comes despite claims by Uzbekistan’s government that sterilizations may not be performed without informed consent of both parents.
“Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilised,” says a gynaecologist from the Uzbek capital, Tashkent. . .
. . .”There is a quota. My quota is four women a month,” she says.
Two other medical sources suggest that there is especially strong pressure on doctors in rural areas of Uzbekistan, where some gynaecologists are expected to sterilise up to eight women per week.
The stories exhibit the ease of crossing the line from informed consent to force and coercion at the hands of a government known for its human rights abuses and population control agenda:
“On paper, sterilisations should be voluntary, but women don’t really get a choice,” says a senior doctor from a provincial hospital, who wished to remain unnamed.
“It’s very easy to manipulate a woman, especially if she is poor. You can say that her health will suffer if she has more children. You can tell her that sterilisation is best for her. Or you can just do the operation.”
Women reported not even knowing that they had been sterilized until facing unexpected complications after pregnancy or later trying – and failing – to get pregnant. Doctors are capitalizing on lax Caesarean section rules to meet quotas and sterilize unsuspecting mothers.
Several doctors I spoke to say that in the last two years there has been a dramatic increase in Caesarean sections. . .These doctors dispute official statements that only 6.8% of women give birth through C-sections.
“Rules on Caesareans used to be very strict, but now I believe 80% of women give birth through C-sections. This makes it very easy to perform a sterilisation and tie the fallopian tubes,” says a chief surgeon at a hospital near the capital, Tashkent.
This is not the first time the Uzbekistan government has come under fire for its family planning policies. The sterilization policy dates back to 1999 when iron-fisted Uzbek President Islam Karimov sought control over the country’s birth rate.
Beyond the horror of government-perpetuated forced sterilization, the real mystery is why the government perpetuates the policy.
According UNICEF, Uzbekistan’s total fertility rate fell from 6.5 children per woman in 1970 to 4.2 in 1990. Today, the CIA World Factbook estimates a mere 1.86 born children per woman, well below replacement levels of 2.1 children per woman.
In addition to a low fertility rate, the country is also experiencing a population decline due to emigration. With a population of about 28 million, Uzbekistan experienced a net loss of 779,200 people in 2010.
There’s another theory. Doctors and international human rights activists speculate that sterilization measures are taken as a bizarre tactic to lower maternal and infant mortality and boost Uzbekistan’s international ranking in these areas.
“Uzbekistan seems to be obsessed with numbers and international rankings,” says Steve Swerdlow, Central Asia director at Human Rights Watch.
“I think it’s typical of dictatorships that need to construct a narrative built on something other than the truth.”
The country’s maternal mortality currently ranks at 113th at 30 deaths per 100,000 live births. Infant mortality rates are at 21.2 deaths per 1,000 live births, placing it at 93rd in the world rankings. Ironically, when the statistics are expressed as percentages, a decline in absolute number of maternal or infant deaths alone will not affect the rankings.
Regardless of the reasons, diminishing the specter of maternal and infant mortality does little to soothe the heartbreak of women deprived the chance to have future children, as Ms. Antelava recounts:
Nigora is among many for whom forced sterilisation is a reality. She had an emergency C-section. A day later she was told she had been sterilised. On the same day, her newborn died.
Nigora is 24 and will never have children.