Thursday, November 26, 2020
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The struggle for women’s reproductive rights
Annalise Falck-Pedersen*
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Emergency contraceptives and forced sterilizations continue to be under investigation.

Peru is struggling to improve the access and safety of modern contraceptives, especially emergency contraceptives (ECs), otherwise known as “the morning after pill”. Benefits of using ECs include preventing pregnancy-related health risks in women, reducing infant mortality, reducing adolescent pregnancies, enhancing sexual education, and slowing population growth.

According to The World Health Organization (WHO), ECs are included on the Model List of Essential Medications- basic medicines needed for a functional clinic. However, many countries in Latin America do not recognize ECs as an essential medicine and therefore are not widely available, such as in Argentina, Brazil, Chile and Costa Rica. The use of ECs are completely banned in Haiti and the Honduras. Haiti in particular has an absolute ban; even spreading information about ECs is illegal.

Peru does have ECs included on their Essential Medicines List, but that doesn’t necessarily mean it’s easily accessible. In 2009, the Peruvian Constitutional Court banned the free distribution of ECs in public health facilities because it violates the right to life of the unborn, protected by the constitution, and ordered the laboratories that produce, commercialize and distribute ECs include a warning that the product could inhibit implantation of the fertilized egg.

Peru’s Ministry of Health stated that EC was not an abortifacient, providing medical and scientific evidence supporting this. However, in 2010 the constitutional court maintained the ban to the free distribution of ECs in public health services and in 2011 published new guidelines. Today, ECs are only available in the commercial sector.

Regulations of ECs are also a major issue. As recently as 2014, an investigation carried out by the NGO Prosalud Interamericana discovered pharmacies in Lima were found to be selling falsified ECs; almost a third of the batches tested were ineffective (28%) and one batch didn’t even contain the drug levonorgestrel, the hormone used to prevent ovulation. It was instead replaced with a cheap antibiotic used for urinary tract infections.

“Many of the EC products on the market in Peru are of unknown quality and have not received approval from a Stringent Regulatory Authority (SRA),” said the International Consortium on Emergency Contraception.

Female Sterilization
According to the United Nations Department of Economic and Social Affairs, female sterilization is most common in nine of the countries or half of the total region: Belize, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Guatemala, Honduras, and Nicaragua. Latin America accounts for the highest percentage of female sterilization in the world at 26%. Female sterilization is the fourth most used contraceptive in Peru.

One of the major issues with female sterilization is that in many cases it has been forced; women are coerced into tubal ligation, either because the operation is explained in a language they do not understand (in Spanish vs. Quechua) or are told incorrect information about the procedure. In some cases, women were abducted from their homes to receive the operation. The women targeted are mostly indigenous populations and living in rural areas, or are infected with the HIV virus, according to research done by the Women and Health Initiative and Open Democracy.

This was a major issue in Peru during the presidential reign of Alberto Fujimori (1990-2000), where between 200,000 and 350,000 women were forcibly sterilized under the “Voluntary Surgical Contraceptive Program, which physicians were given monthly sterilization quotas and health workers were trained to “capture” as many women for sterilization as possible. This was carried out in an effort to control Peru’s population growth rate. Many of these women now suffer from health complications and some have even died from the poorly performed operations. Only five perpetrators (physicians and health workers) have been prosecuted, with the majority of the cases being dismissed.

The procedure, made legal in 1995, became under investigation by the Peruvian government of President Alejandro Toledo (2001-2006) in 2002, which considered banning female sterilization due to its controversial history, but nothing came of it. In 2011 the Peruvian government recently reopened the investigation only to be closed again in January 2014 with no progress, despite the thousands of testimonies. The courts claimed “forced sterilization does not constitute a crime against humanity”.

“The problem here is that the attorney general considered these crimes to be serious violations against human rights under the form of ‘delitos culposos’ [criminal negligence], which is a contradiction, because you cannot have human-rights violations without intent. In other words [if it is deemed negligence], you cannot commit a serious human-rights violation. He also stated that these are not crimes against humanity because no organized state apparatus was used to violate human rights,” explained María Ysabel Cedano, director of Demus, a women’s group in Lima, in an interview for Pass Blue information service.

Peru reopened the investigation for the fourth time in May, specifically targeting Alberto Fujimori. It is believed to be one of the “largest government-sanctioned involuntary sterilization programs in recent history.”

18 years without justice
On July 9, the Association of Women Affected by Forced Sterilizations (AMAEF) from Cusco, along with the Defense Committee for Human Rights of the Sterilized Women of Huancabamba Province, Piura, met in the National Congress for a forum called “Forced sterilization: 18 years without justice”. The purpose of this forum was to come together and share ideas and form a strategy so their case is not denounced once again.

The president of AMAEF, Rute Zúñiga, hopes to help the cause by giving the parliament updated data and more testimonies of the victimized women.

Human rights activist and Andean Parliament representative Hilaria Supa has supported this issue since the beginning. “It is time to fix the acts of injustice”, she said.

Victimized women and families still are not receiving any reparations from the government. Fujimori, 76, is serving a sentence of 25 years in prison, to be completed in 2032, for human rights violations and corruption, but was not tried for the Voluntary Surgical Contraceptive Program and the thousands of forced sterilizations. Organizations like Demus and AMAEF continue to fight for the recognition of the seriousness of these crimes.

Today, both ECs and female sterilization continue to be a battle to become safer and providing more power to women. It is a long and bumpy road ahead fighting for women’s reproductive rights.
—Latinamerica Press.

*Annalise Falck-Pedersen, US citizen recently graduated in English Rhetoric and Spanish Business, is doing an internship at Comunicaciones Aliadas in communications.


Forced sterilization is a crime against humanity, claim the women victims of this practice, who met in the National Congress. (Photo: Office of the Andean Parliament representative Hilaria Supa)
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