Forced Sterilization and Romani Womens

Resistance in Central Europe

By Gwendolyn Albert
Editors Note: Recent years have seen a disturbing increase in violence against Romani people in Europe,
along with other groups of people considered socially marginalized. Police brutality and forced reloca-
tions of Romani communities have received some coverage in the United States but far less attention
has been paid to the issue of forced sterilization. In this issue of DierenTakes, human rights activist Gwen-
dolyn Albert writes about the history of reproductive violence against Romani communities in the Czech
Republic, Slovakia and Hungary, and shares new International Federation of Gynecology and Obstetrics
(FIGO) guidelines on sterilization for reproductive justice activists to publicize and use.
Co-editors Katie McKay Bryson and Betsy Hartmann
most accurately represents the power dynamic
involved when individuals are manipulated to
produce an outcome they did not desire. The
experience of Romani women in Europe is a case
in point.
With a conservatively estimated population of 10
million people,
4
the Romani are Europes largest
ethnic minority. Their forebears are posited to
have come to Europe from India more than a mil-
lennium ago, when they were defeated in war-
fare against the Ghaznavid rulers of Persia around
1000 CE. After being brought to Armenia and
Anatolia as soldiers and servants, they migrated
further west and were enslaved between the
14th and 19th centuries in present-day Romania.
The Roma also emigrated to the Americas and
Australia with other Europeans.
5
Tubal ligation, a surgical technique rst proposed
in early 19th century England, has been pro-
moted as a permanent birth control method ever
since.
1
While voluntary sterilization is an impor-
tant contraceptive option, tubal ligation has also
been forcibly performed upon women in margin-
alized populations worldwide, motivated all too
often by frankly eugenic considerations.
2
Ster-
ilizations performed against the will or without
the knowledge of the patient go by many names:
forced sterilization (when a patient is never
consulted or informed about the sterilization); co-
ercive sterilization (when patients are threatened
or oered incentives to undergo sterilization);
and involuntary sterilization, which is sometimes
used to speak about both forced and coerced
sterilization.
3
I prefer the term forced steriliza-
tion to describe all of these circumstances, as it
NO. 71
SUMMER
2011
A publication of the
Population and Development Program
CLPP tHampshire College t Amherst, MA 01002
413.559.5506 t http://popdev.hampshire.edu
Opinions expressed in this publication are those of
the individual authors unless otherwise specied.
Think. Act. Connect.
For people, environment
and justice.
DIFFERENTAKES http://popdev.hampshire.edu No. 71 - Summer 2011
The 20th century saw them racially targeted by Nazi
Germany for annihilation, and many perished during the
Holocaust. In the postwar period, most Romani people
in Europe lived under communist rule throughout the
Soviet bloc. Since 1989, when most countries in that re-
gion began a transition to democratic governance and
market economies, members of the Romani minority
have experienced a profound degradation in life expec-
tancy, social status, and standard of living.
6
They have
also been the targets of deadly pogroms committed by
neo-fascist and neo-Nazi groups, and forced evictions
involving police brutality throughout Europe.
7
Forced
sterilizations occurred during and after communist rule
in the Czech Republic and Slovakia and during the past
decade in Hungary.
Czech Republic
In communist Czechoslovakia, Romani women were
forcibly sterilized beginning in the 1970s, a practice
continuing after the 1989 transition to democracy
and the 1993 breakup of the country into the Czech
Republic and Slovakia.
8
The Czech ombudsman has
estimated that, since the 1980s, as many as 90,000
women may have been aected throughout the former
Czechoslovakia.
9
During communism, tubal ligation was disproportion-
ately promoted to Romani women by social workers
to address what was ocially termed their high,
unhealthy reproduction rate compared to non-Romani
women using either the promise of nancial incen-
tives or the threat of various sanctions to coerce or force
compliance.
10
After the Czechoslovak Prosecutor-Gen-
eral reviewed these incidents post-1989, incentive pay-
ments for sterilizations were discontinued.
11
Subsequent
instances of forced sterilizations didnt involve social
workers; instead, doctors sterilized Romani women
during C-section deliveries, often telling them that not
only the C-section but the sterilization itself had been
emergency, life-saving measures.
12
In November 2009, the Czech Government expressed
regret for individual failures in the performance of
sterilizations by tubal ligation.
13
The practice had been
described as genocidal by dissidents with the Charter
77 organization in communist Czechoslovakia, and fol-
lowing 1989, complaints about the program were led
with the ombudsman (the Public Defender of Rights).
After ordering a Czech Health Ministry investigation,
he critiqued the ministry for failing to conclude that
the documented procedures violated not only human
rights, but the law.
The ombudsmans report became the basis for interna-
tional human rights bodies
14
recommendations that the
Czech state take urgent action to redress the victims of
forced sterilization. Yet criminal investigations into these
incidents were shelved and none of the perpetrators
have been subjected to civil, criminal or professional
sanction. Civil lawsuits brought by individuals have only
rarely resulted in compensation awards due to statutes
of limitations.
Slovakia
Romani women were also forcibly sterilized in the
Slovak part of Czechoslovakia starting in the 1970s.
Dissidents monitoring these incidents reported that in
the region of East Slovakia, more than 1,000 Romani
women and girls were sterilized during a single year in
the 1980s.
15
By 2002, Romani women were still being
sterilized without their informed consent, according to
human rights activists.
16
The government investigated
for genocide and found no evidence of it; yet inter-
national observers, including the U.S. Commission on
Security and Cooperation in Europe, called the investi-
gation awed because human rights activists and po-
tential victims were threatened with criminal charges for
speaking out. In that same year, the Council of Europes
Commissioner for Human Rights said he found the al-
legations credible, recommending that the government
oer a speedy, fair, ecient, and just redress to the
victims.
17
The Slovak Government has yet to act upon
these recommendations, though they have revised the
conditions under which sterilization may be performed
and instituted high fees for tubal ligations meaning
this birth control method is now eectively out of reach
for low-income women who desire it in Slovakia.
In 2006, the Slovak Constitutional Court ruled that the
governments report had not adequately claried the
facts and ordered the investigation into forced steriliza-
tion re-opened. However, in 2007, after interrogating
the alleged perpetrators and victims, the Slovak Pros-
ecutor announced no crime had been committed or
rights violated, and discontinued the proceedings. Var-
ious international human rights bodies are still calling
on the government to investigate the allegations, com-
pensate the victims, and punish the perpetrators. A case
is also currently pending before the European Court for
Human Rights.
Hungary
Compared to the Czech and Slovak examples, far
fewer forced sterilizations of Romani women have
2
DIFFERENTAKES http://popdev.hampshire.edu No. 71 - Summer 2011
3
been reported in Hungary. The apparently anomalous,
isolated nature of these incidents may be why demands
for redress were eventually met in the case of A.S., a
Romani woman who was sterilized without her consent
by tubal ligation during emergency obstetrical ser-
vices in a public hospital in 2001. The Hungarian courts
acknowledged that the surgery had been performed
without her informed consent, but claimed that her
reproductive capacity had not been harmed, as the ster-
ilization was purportedly reversible. In 2004, A.S. led
a complaint with the Committee for the Elimination of
Discrimination against Women (CEDAW), and two years
later it found Hungary in breach of the Convention. In
2009, the state compensated A.S. after extensive civil
society pressure.
18
As of this writing, the European Roma Rights Centre
reports that Hungarys Public Health Act still maintains
that sterilization by tubal ligation may be performed
on the basis of a doctors medical indication alone.
There is no requirement for informed consent. The law
also requires that patients receive information about
tubal ligations chances of reversibility phrasing
that suggests doctors in Hungary view sterilization as
potentially reversible. The European Roma Rights Centre
is currently litigating another case of a Romani woman
sterilized in Hungary without her consent, which came
to light in 2008.
Romani Womens Resistance
Romani survivors of forced sterilization have played a
key role in bringing it to light and building a movement
for justice. In the Czech Republic, Elena Gorolov, spoke- , spoke-
sperson for the Group of Women Harmed by Forced Ste-
rilization, has been an outspoken advocate for Romani
victims.
19
Sterilized during the C-section delivery of her
second child in 1990, Gorolov cannot bring a civil suit
because the statute of limitations has expired, as it has
for many other women. This has not stopped her and
other survivors from pursuing justice locally, nationally
and internationally. Survivors of forced sterilization in
the Czech city of Ostrava demonstrated outside the hos-
pital most known for having sterilized Romani women
in their community. They have also raised these viola-
tions in face-to-face meetings with maternity ward sta,
courageously confronting some of the very doctors who
sterilized them against their will.
Such public activism by survivors is an exception, and
local tabloid publications have attempted to smear
many of the women who have come forward. Some
Romani members of Gorolovs community have
warned her that her cause is in vain, but she has not
given up hope that one day the government will com-
pensate the survivors of forced sterilization.
In Hungary and Slovakia, while survivors have taken legal
action, they have been very careful to keep their identi-
ties private for a number of reasons. In the A.S. case, there
were fears that publishing the amount of any eventual
compensation could expose her to violent extortion
attempts. In Slovakia, women who were pregnant and
sterilized before reaching ocial adult status were thre-
atened that they or their partners would be criminally
prosecuted for statutory rape if they came forward.
New Guidelines On Sterilization
The International Federation of Gynecology and Obstet-
rics (FIGO) has recently adopted new ethical guidelines
on female contraceptive sterilization as a result of these
cases and numerous others around the world involving
imprisoned women, Indigenous women, women of
color, and transgender people in the Americas; women
with disabilities in Australia; HIV positive women in
Chile and Namibia; and lower-caste men and women
in India.
20
The guidelines are innovative because they
emphasize that:
- Sterlllzatlon should be consldered lrreverslble and
patients must be so informed.
- Consent to sterlllzatlon should never be a condltlon
for access to medical care, HIV/AIDS treatment, natural
or cesarean delivery, abortion, or to benets such as
medical insurance, social assistance, employment or
release from an institution.
- Sterlllzatlon for preventlon of future pregnancy
cannot be ethically justied on grounds of medical
emergency and is not an emergency procedure.
- Artlcle 23(l) of the UN Conventlon on the Plghts of
Persons With Disabilities imposes the duty upon
states to ensure that persons with disabilities, in-
cluding children, retain their fertility on an equal basis
with others.
Reproductive justice activists can strengthen these
guidelines by spreading knowledge about them. Bring
them to the attention of local, regional and national
governments, and demand the institution of safeguards
to prevent forced sterilizations from being perpetrated.
Bring them to the attention of medical associations,
hospital administrators, and other providers, and ask
that medical professionals join lobbying and publicity
eorts. Bring them to the attention of academics and
policymakers, and encourage research into current
DIFFERENTAKES http://popdev.hampshire.edu No. 71 - Summer 2011
4
sterilization practices and procedures in health care
facilities, particularly those operating in low-resource
settings or in institutions such as prisons.
Forced sterilization is a serious human rights abuse
that has gone unacknowledged and underreported for
over a century. It represents an ultimate violation of a
womans right to determine her own reproductive des-
tiny. The women of the world deserve doctors who will
protect their rights as well as their health. Reproductive
justice activists are crucial in holding doctors account-
able to the professions ethical standards, and govern-
ments accountable to their human rights obligations.
Gwendolyn Albert is a human rights activist and ally
of Romani survivors of forced sterilization in the Czech
Republic in their ght for redress of these human rights
violations. She is a consultant to the Council of Europe
Commissioner for Human Rights, the European Roma
Rights Centre, and the Open Society Institute as part of
its Campaign to Stop Torture in Health Care. Her work
includes direct outreach to the medical profession
through the International Federation of Gynecology and
Obstetrics (FIGO).
Notes
1. For a history of the development of tubal litigation, see Medscape
Reference, Tubal Sterilization, by Robert K Zurawin, MD, (22
April 2011), http://emedicine.medscape.com/article/266799-
overview#a0101.
2. Matthew Connelly, Fatal Misconception, (Cambridge, MA/London,
England: Belknap Press of Harvard University, 2008)
3. Men have also been targeted for vasectomy in some Asian
countries, notably India, where incentive programs promoting
tubal ligations and vasectomies still continue; see The Times of India,
Get sterilized in Rajasthan, drive home a Nano, Ali, Syed Intishab,
Syed Intishab AliJune 30, 2011, http://timesondia.indiatimes.
com/india/Get-sterilized-in-Rajasthan-drive-home-a-Nano/
articleshow/9045645.cms, For more on the global nature of this
abuse, see www.stoptortureinhealthcare.org
4. According to the Council of Europe Roma and Travellers Division,
the average estimate of the Romani population in Europe (i.e., the
47 member states of the Council of Europe area, which includes
most of the CIS countries, Russia and Turkey), is 11,256,900, with
a maximum estimate of 16,118,700 (August 2009 update). The
World Bank provides a map with Romani populations listed as
a percentage of country populations based on data from 2007,
but this does not include any of the CIS countries; see http://web.
worldbank.org/WBSITE/EXTERNAL/COUNTRIES/ECAEXT/EXTROMA
/0,,contentMDK:20339787~menuPK:904252~pagePK:64168445~piP
K:64168309~theSitePK:615987,00.html
5. Hancock, Ian, The Heroic Present: Romani History and
Chronology, in The Romani Diaspora in Canada, course reader
for News 343H1: Section 5101, instructor Ronald Lee, Canadian
Scholars Press: Toronto (2010)
6. World Bank, Roma in an Expanding Europe, 2005, available at
http://siteresources.worldbank.org/EXTROMA/Resources/roma_in_
expanding_europe.pdf
7. Cahn, Claude and Guild, Elspeth, Recent Migration of Roma in
Europe, Council of Europe and OSCE, 2008, http://www.osce.org/
hcnm/78034
8. Final Statement of the Public Defender of Rights in the Matter of
Sterilisations Performed in Contravention of the Law and Proposed
Remedial Measures, Oce of the Public Defender of Rights of
the Czech Republic (ombudsman), 2005, http://www2.ohchr.org/
english/bodies/cerd/docs/ngos/Public-defender-rights.pdf
9. According to the ombudsmans estimate, from the 1980s until
today, as many as 90,000 women may have been sterilized
throughout the territory of the former Czechoslovakia. (Authors
translation.) Lidovky.cz, Ministr Kocb: Politovn sterilizovanch
en je prvn fze (24 November 2009), http://www.lidovky.cz/
ministr-kocab-politovani-sterilizovanych-zen-je-prvni-faze-pld-/
ln_domov.asp?c=A091124_184921_ln_domov_tai
10. Sokolova, Vera, Cultural Politics of Ethnicity: Discourses on Roma in
Communist Czechoslovakia, ibidem-Verlag, Stuttgart, 2008
11. Final Statement of the Public Defender of Rights in the Matter of
Sterilisations Performed in Contravention of the Law and Proposed
Remedial Measures, Oce of the Public Defender of Rights of
the Czech Republic (ombudsman), 2005, http://www2.ohchr.org/
english/bodies/cerd/docs/ngos/Public-defender-rights.pdf
12. Ibid.
13. Czech Prime Minister Apologizes to Victims of Coercive
Sterilization, 24 November 2009, Decade of Roma Inclusion press
release, http://www.romadecade.org/czech_prime_minister_
apologizes_to_victims_of_coercive_sterilization
14. For the Czech Republic at CEDAW, see UN Committee on the
Elimination of Discrimination against Women, Forty-seventh
session, 4-22 October 2010, Concluding observations of the
Committee on the Elimination of Discrimination against Women,
http://www2.ohchr.org/english/bodies/cedaw/docs/co/CEDAW-C-
CZE-CO-5.pdf
15. Final Statement of the Public Defender of Rights in the Matter of
Sterilisations Performed in Contravention of the Law and Proposed
Remedial Measures, Oce of the Public Defender of Rights of
the Czech Republic (ombudsman), 2005, pg. 27-28, http://www.
ochrance.cz/leadmin/user_upload/ENGLISH/Sterilisation.pdf,
16. Center for Reproductive Rights, Poradna pre obcianske a ludsk
prva in consultation with Ina Zoon, Body and Soul: Forced
Sterilization and Other Assaults on Roma Reproductive Freedom in
Slovakia, 2003, http://reproductiverights.org/sites/crr.civicactions.
net/les/documents/bo_slov_part1.pdf
17. RECOMMENDATION OF THE COMMISSIONER FOR HUMAN RIGHTS
CONCERNING CERTAIN ASPECTS OF LAW AND PRACTICE RELATING
TO STERILIZATION OF WOMEN IN THE SLOVAK REPUBLIC, 17
October 2003, CommDH(2003)12, https://wcd.coe.int/ViewDoc.jsp?i
d=979625&Site=CommDH&BackColorInternet=FEC65B&BackColorI
ntranet=FEC65B&BackColorLogged=FFC679
18. Reproductive Health Reality Check, Coercively Sterilized Romani
Woman Will Receive Compensation, Wilkowska-Landowska, Anna,
June 12, 2009, http://www.rhrealitycheck.org/blog/2009/06/11/
coercively-sterilized-romani-woman-will-receive-compensation
19. The story of Elena Gorolov, April 2009, http://www.ohchr.org/EN/
NEWSEVENTS/Pages/ElenaGorolova.aspx
20. Female Contraceptive Sterilization, available at http://www.go.
org/les/go-corp/FIGO%20-%20Female%20contraceptive%20
sterilization.pdf