Some time ago Helena Ferencikova, a Romany woman, claimed she had been forced to undergo sterilization. Her case set off many more complaints from Romany mothers who said they'd received similar treatment. Many of them wrote to the Ombudsman Otakar Motejl for help and several have since taken their case to court.
As the complaints piled up the Ombudsman's Office launched its own investigation into the matter. Its conclusion was shocking: the Ombudsman said his office had collected sufficient evidence to suggest that at least 50 Romany women living in the Czech Republic and formerly communist Czechoslovakia, were forcibly sterilized in the years between 1979 and 2001. Kumar Vishwanathan has been working for several years to mediate between Roma and the authorities. He explains what went on:
"During the process of childbirth they were given a paper to sign saying that they consent to a C-section and, at the same time, to sterilization. In some cases the women were informed that they were going to be sterilized and that they had to sign a paper and the women signed it, but they didn't have any time to think over things, to discuss it with their partners. Some of the women thought it was a temporary arrangement, something like an intra-uterine device, that it was reversible. They never thought in terms that they would never ever have any more children."
This means of controlling the Romany population was allegedly done on the grounds of a communist directive that remained in force up until 1991 - that is two years after the fall of communism. Social workers were actively involved in the practice. Kumar Vishwanathan again:
"The social workers would come to the hospital and get the women to sign, the social workers would threaten the families that if the woman didn't get sterilized they would take away their money /social benefits/. During the communist regime the Czechoslovak government had a programme, a law, for the control of the Roma population. It was a eugenically motivated law and the monetary incentive was part of the communist government's plan to limit the Roma population."
The first court ruling on enforced sterilization was awaited with anticipation since it was expected to set an important precedent. Helena Ferencikova from Ostrava won her case and the court ruled that the maternity hospital in question should acknowledge malpractice and apologize to her. Mrs. Ferencikova says this is not enough, and is demanding a million crowns in compensation. Several other women have followed her example and the enforced sterilization suits will be settled on a case-by-case basis. Roma rights advocates think there should be a blanket form of compensation for all Roma women who can prove their case.
By far the most disturbing aspect of this story is that there are some who suggest the practice of enforced sterilizations may not have been completely eradicated. Kumar Vishwanathan again:
"We are convinced that there has been no significant change in medical practice over the past decade. We are convinced that the medical practice in this country is still paternalistic, that doctors have a paternalistic attitude to a patient rather than a partner-like approach, and as long as that doesn't change we will remain wary that enforced sterilization can still happen."
So when is sterilization performed in the Czech Republic and what precedes it?
According to Jaroslav Fajrajzl, the head of the Podoli Maternity Hospital, the currently valid law, which dates back to the 1970s, stipulates that doctors can perform sterilization for health reasons or at a patient's request. In either case, the matter is discussed by a "sterilization commission" made up of several leading experts, the patient must request to undergo sterilization in writing and sign two separate sets of papers, on different occasions, to confirm that she understands what the procedure entails. She is free to change her mind up until the last minute in the operating theatre. The only case where a surgeon may perform this without a patient's approval is if the woman's life is in danger, for instance if he finds extensive tumours during an operation. Dr. Fajrajzl says that possibly the most controversial part of the law - and one that relates to the Roma cases - is the recommendation that sterilization is advisable for health reasons following a second or third Caesarian section :
"As regards the practice of sterilization after a second Caesarian section, yes, that is recommended by the present health law. This legislation is thirty years old and needs to be amended, because it does not reflect the progress medicine has made in the past three decades. Some maternity hospitals abide by this recommendation - which I do not fully agree with - but even so, sterilization cannot be undertaken without all of the steps I mentioned - explaining it to the patient, getting her approval and getting approval from the sterilization commission. Hospitals usually perform this six weeks after the birth of the child."
The thirty year old law on health care is about to be amended. Meanwhile, the Ombudsman's Office has put forward a series of recommendations as regards sterilizations. They are that: a woman should have at least seven days to make up her mind whether or not to undergo sterilization and that the hospital should provide an easy-to-understand brochure which explains the procedure and all its implications.
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