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Reprinted with permission of the author, this article appeared in the Summer 2000 issue of NATIVE AMERICAS, pp. 38-42.
While coerced sterilization of Native American women seems to have largely ended in the United States (see "Reprise/Forced Sterilization: Native Americans and the `Last Gasp of Eugenics,'" Winter 1998), sterilization continues to be practiced as a eugenic prescription for the reduction of indigenous populations in Latin America. At least some of this is funded by the U.S. Agency for International Development (USAID). The largest such program to date has stirred protests in Peru.
PERU: STERLIZATION AS COUNTERINSURGENCY
Until 1995, sterilization for contraceptive purposes was illegal in Peru, a country with a Catholic majority, where tampering with reproductive processes is considered a violation of God's will. The year President Alberto Fujimori was elected, the legal ban on sterilization was lifted and a sterilization program aimed at poor, mainly rural, indigenous women was organized by the government.
Described as one of the largest and most aggressive "family planning" efforts in the world, the Peruvian program grew into a bureaucracy with an astoundingly effective internal reward system that increased the number of tubal ligations in Peru from 10,000 in 1996 to roughly 110,000 in 1997. Peru quickly became USAID's largest "population assistance" program in Latin America. The sheer aggressiveness of the program caused international protests and congressional pressure threatened to halt USAID support during 1998. The program has also been criticized extensively by an unusual Peruvian alliance that includes the Catholic Church, conservative political opponents of Fujimori, feminists and Native rights groups.
Government workers canvassed poor neighborhoods, offering gifts of food and sometimes clothing in exchange for agreement to undergo tubal ligations. Sometimes this form of contraception was offered at "Ligation Festivals" sponsored by the government health ministry. Ministry of Health workers trained by instructors from the United States government took to the field in Peru armed with statistics: the number of babies born to each woman averages 3.5 in Peru, compared to two in the United States; Peruvian women with little or no education average 6.2 children; women in rural areas average seven children: the goal was to reduce Peru's rural birth rates.
Magna Morales and Bernadina Alva were two women, among many, who accepted the offer of free sterilization. The operation was performed without complications on Alva, age 26, who was given clothes for her son and daughter as gifts for her participation. However, Morales died of complications ten days after surgery, one of at least seven deaths related to the surge in Peruvian sterilizations.
Records compiled by Alianza Latinoamerica para la Familia, opponents of the sterilization program, contain accounts of several other deaths:Juana Gutierrez Chero [of] La Quinta, Piura, Peru... Died at home approximately ten hours after being sterilized. According to her husband, she did not want to be sterilized, but the health workers kept coming to their house repeatedly... Once she even hid from them. They came for her one day after her husband had left for work. He found her very ill and in bed; he went off to the clinic to see if he could get help, but no one was there. Juana died that night at home about 2 A.M.Health workers sometimes visited individual women several times as the hard sell for sterilization became steadily more aggressive. If offers of food and clothing did not bring about the women's consent, health workers would threaten to withhold government-provided foods from their children. The health workers usually were under instructions to meet quotas.
Celia Ramos-Durand, [of] La Legua... Died about two weeks after undergoing a sterilization to which both she and her husband consented after being told it was a simple operation. According to the family, when she did not return home from the clinic, the family went to look for her and were told she had been transferred to a hospital. They later found out [that] she had gone into a coma as a result of the operation.
Women who have been sterilized told investigators for Peruvian human-rights groups that doctors and nurses -- who were sometimes paid bonuses of $10 to $30 per surgery -- performed as many as 20 to 30 tubal ligations a day. Conditions were described as unsanitary, resulting in post-operative problems that numbered in the hundreds. Before the operations, the women, many of whom could not speak or read Spanish, were directed to sign forms that waived their right to sue for malpractice. The forms also stated that the government was not responsible for expenses including hospitalization or medicines that might be required as a result of complications from the tubal ligations.
The dramatic rise in the number of poor women being sterilized led human rights groups and other opponents of sterilization to organize a campaign that trimmed the program, but that did not end it. The protests reached the United States House of Representatives, where a subcommittee report recommended that the United States stop providing funding and expertise for the program.The Peruvian program grew into a bureaucracy with an astoundingly effective internal reward system that increased the number of tubal ligations in Peru from 10,000 in 1996 to roughly 110,000 in 1997.
Peruvian opponents of sterilization point to U.S. aid for such programs as an outgrowth of a report, then classified secret, which was prompted by Henry Kissinger for the National Security Council in 1974. This report supported advocacy of worldwide population control by the United States because U.S. industry was increasingly relying on materials from Third World countries. The report reasoned that lowering birth rates among the poor in the rural Third World would put a cap on smouldering unrest caused by rapid increases in the size of discontented lower classes. Che Guevara had made the same point more concisely years earlier when he said it is "easier to kill a guerrilla in the womb than in the mountains."
Joseph Rees, the staff director for the Congressional subcommittee on International Operations and Human Rights that oversees USAID, visited Peru for a week during January of 1998. Returning to Washington, Rees testified in hearings convened by the subcommittee in February, that U.S. aid should be withheld from Peru until abuses of sterilization stopped.
At the hearings, Victoria Espinoza, mother of three, testified that a Peruvian doctor had sterilized her without her knowledge. "When I heard that, something deep in my heart broke," she told the committee, "Now there is a hole inside." Avelina Nolbreto told the committee that when she put off a decision on a tubal ligation, health workers made an appointment for her anyway. "I came back from an errand and there they were, with a taxi, waiting for me. They took me practically by force."
In the interests of friendly relations with the Fujimori government, the State Department took no known action to implement Rees' recommendations.
BRAZIL: STERILIZATION AS CAMPAIGN STUNT
A politician in northeastern Brazil who is also a medical doctor, is using sterilization of a small Native tribe to garner votes among non-Indian Brazilians who have taken much of their highly coveted, diminishing land.
At least 80 indigenous women of the Pataxuhe band in the Brazilian state of Bahia have been sterilized by Ronald Lavigne, medical doctor and politician. Lavigne offers sterilization to women who are unable to obtain other types of birth control every time he runs for office. Many of the women are desperate to reduce the size of their families because many children in the area die of malnutrition. Some women complained after the fact that the finality of tube-tying was not explained to them. Lavigne's activities were described in the London Sunday Telegraph, September 13, 1998. "This is genocide," said Roberto Liebgott, activist with Native peoples in Bahia. In some villages, every woman of child-bearing age has been sterilized, leading to the probable demise of entire peoples within one or two generations.
For Lavigne, sterilizations are paid back at the ballot box, where a study by the Brazilian Congress estimates that the candidate snags between seven and 25 extra votes for each operation from non-Native land owners -- many of them recent arrivals -- who fully understand their stake in reducing Native populations in the area. Within a few years, Pataxuhe land holdings have been reduced from 50,000 to 20,000 hectares. Lavigne is a leading figure in Brazil's right-wing Liberal Front, the party favored by new rich landowners in the Amazon Basin.
Blood also has been spilled over the colonizers' insistence that the land's original inhabitants not challenge their title. Last year, a local Pataxuhe leader took his people's complaints to Brasilia, the federal capital. Galdino Jesus dos Santos was jumped by a gang of youths at a bus stop in the capital. They beat him, then dumped gasoline over his bruised, battered body and lit a match.
Lavigne's advocacy of sterilization for poor indigenous women is hardly unique in Brazil. The Brazilian poor peoples advocacy group Servico Brasileiro de Justica e Paz reported that two-thirds to three-quarters of women of child-bearing age have been sterilized in the poorest regions of the country, in or adjacent to Amazonia's shrinking indigenous populations. Three-quarters of the women in Maranhao state have been sterilized, according to the group; 71.9 per cent have been sterilized in Goias; 63.3 percent in Mato.
MEXICO: STERILIZATION AND IMMIGRATION
Far from Brazil -- in Omaha, Neb. -- medical personnel at local clinics caring for an influx of Mexican and other Latin American immigrants report that many women come to them complaining of having trouble getting pregnant. The Omaha care-givers are left to tell the women, many of whom are of Mexican Indian ancestry, that they have been sterilized or implanted with IUDs by Mexican doctors. Most of the women express great surprise and shock at this, indicating that any form of consent they may have been given was not given knowingly.
The flood of immigration to Omaha has come about as a result of a combination of factors: a vibrant labor market, with state unemployment at about two percent, and economic hardship from the Rio Grande south. The influx is so heavy that local Immigration and Naturalization Service officials estimate that a quarter of the workers in Nebraska's meat-packing plants are undocumented. The INS has set up a special program, "Operation Prime Beef," to catch them.
As sterilization abuse declines on U.S. Indian reservations, the U.S. government continues to fund sterilization abuse on indigenous lands in Latin America -- and forcibly repatriate migrants back to these very lands.
- Brian Carrell, "This is Genocide? Dr. Lavigne Patuxuhe," Overpopulation.Com. Population News. April 26, 1999, Vol. 3, No. 6. [http://overpopulation.com/population_news/1999/popnews_04_26_1999.html]
- Galdina Jesus dos Santos, U.S. Department of State, Country Report on Human Rights Practices for 1998, released by the Bureau of Democracy, Human Rights, and Labor, February 26, 1999. [http://www.state.gov/www/global/human_rights/1998_hrp_report/brazil.html]
- The Peruvian Situation: Magna Morales/Bernadina Alva, Alianza Latinoamericana para la Familia, Press Release, February 11, 1998, U.S. Government Asked to Withdraw Population Control Funds from Peru Following Reports of Massive Human Rights Abuses. [http://www.africa2000.com/INDX/alafa.html]
- Bruce Johansen, Reprise/Forced Sterilizations, Sterilization of Native American Women Reviewed by Omaha Master's Student, 1998. http://www.ratical.org/ratville/sterilize.html
- Edward J. Spriggs, Jr. "Involuntary Sterilization: An Unconstitutional Menace to Minorities and Poor," Review of Law and Social Change 4 (Spring, 1974):127-151.
Bruce E. Johansen is a Robert T. Reilly Professor of Communication and Native American Studies at the University of Nebraska at Omaha.