WUNRN
UZBEKISTAN - BBC ARTICLE ON
STERILISATION OF WOMEN
By Natalia Antelava
The BBC has been told by doctors that
The BBC has been told by
doctors that Uzbekistan is running a secret programme to sterilise women - and
has talked to women sterilised without their knowledge or consent.
Adolat
has striking looks, a quiet voice and a secret that she finds deeply shameful.
She
knows what happened is not her fault, but she cannot help feeling guilty about
it.
Adolat
comes from Uzbekistan, where life centres around children and a big family is
the definition of personal success. Adolat thinks of herself as a failure.
"What
am I after what happened to me?" she says as her hand strokes her
daughter's hair - the girl whose birth changed Adolat's life.
"I
always dreamed of having four - two daughters and two sons - but after my
second daughter I couldn't get pregnant," she says.
She went to see a
doctor and found out that she had been sterilised after giving birth to her
daughter by Caesarean section.
"I
was shocked. I cried and asked: 'But why? How could they do this?' The doctor
said, 'That's the law in Uzbekistan.'"
Sterilisation
is not, officially, the law in Uzbekistan.
But
evidence gathered by the BBC suggests that the Uzbek authorities have run a
programme over the last two years to sterilise women across the country, often
without their knowledge.
Foreign
journalists are not welcome in Uzbekistan, and in late February of this year
the authorities deported me from the country. I met Adolat and many other Uzbek
women in the relative safety of neighbouring Kazakhstan. I also gathered
testimony by telephone and email, and in recordings brought out of the country
by courier.
None
of the women wanted to give their real names but they come from different parts
of Uzbekistan and their stories are consistent with those of doctors and
medical professionals inside the country.
"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.
Like
all doctors I interviewed, she spoke on a condition of anonymity. Talking to a
foreign journalist could result in a prison term, in a country where torture in
detention is the norm.
"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.
"Once or twice a month, sometimes more often, a nurse from the
local clinic comes to my house trying to get me to the hospital to have the
operation," says a mother of three in the Jizzakh region of Uzbekistan.
"Now
it's free, but later you will have to pay for it, so do it now," the nurse
tells the mother.
Another
mother says she experienced months of mysterious pain and heavy bleeding
following the birth of her son. Then she had an ultrasound check and discovered
that her uterus had been removed.
"They
just said to me, 'What do you need more children for? You already have
two,'" she says.
The
BBC gathered similar testimony from the Ferghana Valley, the Bukhara region and
two villages near the capital Tashkent.
According
to a source at the Ministry of Health, the sterilisation programme is intended
to control Uzbekistan's growing population, which is officially held to be
about 28m people. Some demographers are sceptical, however, pointing to the
large numbers of people who have emigrated since the last census in 1989, when
the population stood at around 20m.
"We are talking
about tens of thousands of women being sterilised throughout the country,"
says Sukhrob Ismailov, who runs the Expert Working Group, one of very few
non-governmental organisations operating in Uzbekistan.
In
2010, the Expert Working Group conducted a seven-month-long survey of medical
professionals, and gathered evidence of some 80,000 sterilisations over the
period, but there is no way of verifying the number and some of the procedures
were carried out with the patient's consent.
The
first cases of forced sterilisation were reported in 2005, by Gulbakhor Turaeva
- a pathologist working in the city of Andijan who noticed that uteruses of
young, healthy women were being brought to a mortuary where she worked.
After
gathering evidence of 200 forced sterilisations, by tracing women from whom the
uteruses were removed, she went public with her findings and asked her bosses
for an explanation. Instead they sacked her.
In
2007 Turaeva went to jail, accused of smuggling opposition literature into the
country. Like many others, she refused to be interviewed for this report
because of fears for her and her children's safety.
In
2007, the United Nations Committee Against Torture also reported forcible
sterilisations and hysterectomies in Uzbekistan, and the number of cases of
forced sterilisation appeared to fall.
But
according to medical sources, in 2009 and 2010 the Uzbek government issued
directives ordering clinics to be equipped to perform voluntary surgical
contraception. In 2009, doctors from the capital were also despatched to rural
areas to increase the availability of sterilisation services.
There
is evidence that the number of sterilisations then began to rise again.
"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."
Several
doctors I spoke to say that in the last two years there has been a dramatic
increase in Caesarean sections, which provide surgeons with an easy opportunity
to sterilise the mother. 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.
Uzbekistan: Infant and maternal deaths
Several doctors and medical professionals said forced
sterilisation is not only a means of population control but also a bizarre
short-cut to lowering maternal and infant mortality rates.
"It's
a simple formula - less women give birth, less of them die," said one
surgeon.
The
result is that this helps the country to improve its ranking in international
league tables for maternal and infant mortality.
"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."
Swerdlow
believes foreign governments could do more. Until recently Uzbek President
Islam Karimov was a pariah in the West, but in recent years both the US and the
EU have lifted sanctions, including a US ban on arms sales.
This
is apparently related to America's worsening relationship with Pakistan and
Nato's increased use of routes through Central Asia, including Uzbekistan, to
get supplies and troops in and out of Afghanistan.
A
number of Western dignitaries have visited Uzbekistan in recent months, but few
have made any public comment on the country's human rights record.
"Karimov
has managed to get to the point in his relationship with the West when there
are no consequences for his actions and human rights abuses," says
Swerdlow.
"There
is a deafening silence when it comes to human rights. Reports of forced
sterilisation add urgency to breaking this silence."
In
a written reply to the BBC's request for comment, the Uzbek government said the
allegations of a forced sterilisation programme were slanderous and bore no
relation to reality.
The
government also said that surgical contraception was not widespread and was
carried out only on a voluntary basis, after consultation with a specialist and
with the written consent of both parents.
The
Uzbek government stressed that Uzbekistan's record in protecting mothers and
babies is excellent and could be considered a model for countries around the
world.
However,
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.