Families being sterilised against their will

Czech hospitals have been accused of tricking women from gypsy communities and so called "problem" families on low incomes into being sterilised against their will.

From the 1950s until the fall of communism in 1989 in what was then Czechoslovakia a birth control programme, tacitly supported by the state, was reportedly run on Roma women who were encouraged and coerced into sterilisation. They were offered financial incentives to undergo the procedure.

But the latest claims are far more recent, and the country's health ministry which is taking them seriously has ordered a special enquiry to deal with the allegations.

Several dozen women have come forward to say that even as recently as this year doctors in Czech hospitals had been getting them to sign token consent forms - usually when they were either on medication or under anaesthesia. Every week new women come forward.

Most of the women involved are from gypsy communities or low income families from problem estates, but in at least one case doctors are accused of a sterilisation on health grounds - apparently believing further pregnancies were a risk.

At least four hospitals have been named in official complaints lodged with the country's Ombudsman. The papers say the women were asked to agree with sterilization even though they were given the documentation shortly before giving birth and were in most cases in great pain from labour. All said they were unable to read the document thoroughly or clearly.

NGOs backing the women say the original programme under the Communists was a way of keeping a population cap on an "undesirable" minority. Birth rates among the Roma are still today higher than in the rest of the population.

In many Roma communities across Eastern Europe families with five, six or seven children are not uncommon. Women of fertile age who cannot produce children are often looked down on in Roma communities, and usually shunned even by their husbands.

In the industrial city of Ostrava in the north-east of the Czech Republic, three women who are lodging complaints with the Ombudsman over claims they were sterilised without their consent said their cases were typical and are going public to see it does not happen again.

Roma woman Natasa Horvathova, 38, sitting in her two-room flat in a former communist tower block of flats, explains that she was less than five months pregnant in 1996 when she complained of strong pains. She was taken to hospital, but lost her baby.

She said: "The nurse came to me after and said that they would sterilize me. I didn't know what it was and told her I wanted to discuss it with my husband, but they said there was no time and she gave me some medicines."

After she was given her medicine a nurse came and asked her to sign a document. She signed, saying: "I thought they were documents regarding my miscarriage."

She added: "The hospital staff asked me how many children I had and when I said three, they said 'And that is not enough for you? You've had so many children, and you want even more? We will sterilize you'."

She said she did not realise what it meant and the doctors had been no help. She said: "The doctors talked their own language - I didn't understand them."

Her family fell apart after the operation, she said.

Her husband became an alcoholic and they came close to divorce and her children, Jana, 19, Alois, 17, and Filip, 13, had problems at school because of their parents' fighting. She said that she still has problems with her health following the operation and claims it was not carried out properly.

Another Roma woman, Helena Bandyova, 37, was also sterilized. She has four children, three girls and an 11-year old son called Dusan. All her births went smoothly, she says, until one day after her son was born a nurse came to her and told her: "Don't get up, you're going for sterilization".

She says: "I didn't know what it meant, and she said it was like a small cut."

Mrs Bandyova signed an agreement for the procedure, and is now also among those lodging a complaint with the Ombudsman.

Her friend Natasa Botosova, 39, says she was sterilized without her consent when she was 26. "The doctors said they didn't stitch me well, so they gave me an injection and said they would have to stitch me again," Mrs Botosova said.

She said she was told to sign a document agreeing with the stitches, but in fact she signed a document consenting to sterilization. She said her husband then announced he was no longer interested in her because she could not have children. They divorced a short while later.

"When they tie your ovaries like they would with a pig, then your man doesn't respect you anymore because you can't have children, you are not a real woman," she said.

Mrs Botosova said she was so frightened that the same thing could happen to her daughter, Jolana, 20, when she gave birth that she was present throughout the delivery and for several days afterwards to make sure that doctors did not sterilize her.

She said: "I stayed awake all the time and never left her alone until she was out of the hospital."

The women deny that they are after money and say that by raising these complaints they hope to draw attention to what is happening in some hospitals and make sure it does not happen again.

The Health Ministry has refused to comment on the complaints specifically or confirm their number, only confirming that there is an investigation. It has said that it expects the investigation to take months - and that it will pass on the results to the Ombudsman's Office directly.

The Ombudsman's Office that investigates civil rights breaches and has the power to order compensation has also refused to comment on the case - but has confirmed that complaints have been lodged.

"The complaints say that the women were not sterilised according to the law as they did not give their informed consent," deputy ombudsman Anna Sabatova said.

Czech Television however has carried reports suggesting the women filed complaints hoping to be paid money rather than being keen to bring the issue to the public eye.

Dr Richard Spousta, head of the Obstetrics-Gynecology Department of Ostrava-based hospital Fifejdy, said he had never heard of any cases where a woman would be sterilized without her consent.

He said: "The women complaining about forced sterilization have little chance of winning a lawsuit. If they didn't understand what they were told they shouldn't have signed any documents."

He said that, for example, one woman who has complained about her forced sterilization was given, and signed, a document, which was also seen by the Sunday Telegraph, which read: "I have six children and I ask for sterilization because I don't plan to have another child."

Dr Spousta said that many hospitals, like his own, also no longer carried out sterilizations straight after birth, when women may still be tired or partially under the effects of medication, but instead did it at six weeks. "We no longer carry out sterilization right after birth as it is not as effective as performing the procedure six weeks after birth," he said.

And he admitted that at times communication between patient and doctor at his hospital was not ideal. He said: "Communication between the patient and the doctor isn't always what it could be - and we could inform them about some things in a better way."

Under Czech law a woman can be sterilized if she has had more than three children and the mother is over 35 years of age or if another pregnancy could threaten her health. But in all cases the woman's consent must be given.

But organisations working with women who claim to have been sterilized without their consent have accused doctors of playing God and making decisions on women's health without informing their patients.

Director of the Ostrava-based Life Together organization, Kumar Vishawanthan, said: "At first we thought it was a racial problem but we can't say that anymore since non-Roma women have also made complaints. But there is a communication problem between the doctor and the patient. At best what we have here is a matter where the doctors don't consult with their patients and make a decision on their own."

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