In La Ceiba, a port city in northern Honduras, a 22-year-old woman sat with her head in her hands. After a few moments, she took a breath, and recounted the time two years ago when she was forcibly sterilized.
Back then, she was pregnant with her first child. As someone living with HIV, she knew she would have a C-section, because a surgical delivery reduces the risk of transmitting it to the child – but she was shocked to be told by a physician during a checkup that she also had to be sterilized because of the disease. She wanted to have a large family and resisted, but she said they forced her to sign a piece of paper agreeing to the procedure.
The Globe and Mail is not naming this woman, or others in the story, because they fear retribution for speaking out.
After her ordeal, the young woman sought help from CEPROSAF, a non-governmental organization in Honduras dedicated to the promotion of family health – and which provides legal support for HIV-positive women who experience this type of coercion.
Forced sterilization, a human rights violation that involves involuntary or coerced removal of a person’s ability to reproduce, has historically been inflicted upon marginalized groups, according to the United Nations Human Rights Office of the High Commissioner. The office reports that those subjected to these abusive practices are commonly women in poverty, those living with a disability, or who are HIV-positive.
Staff at CEPROSAF approximates that last year the total number of HIV cases in Honduras since 1985 reached 41,000, but that the actual number could be higher since so many people with the disease do not seek treatment.
If someone has HIV, their baby can become infected, but treatment greatly reduce a baby’s risk of infection, according to the Canadian Pediatric Society.
In Honduras, there are no statistics that show how many women and girls with HIV have been involuntarily sterilized, but The Globe and Mail spoke with experts from CEPROSAF and another advocacy organization that has documented numerous cases. (The Honduran embassy in Ottawa did not respond to a request to comment.)
Lawyers without Borders Canada – a non-governmental organization that helps vulnerable people access legal representation – has been working with CEPROSAF and other groups tackling the issue. Lucas Valderas Martos, the country director for Lawyers without Borders Canada – which receives funding from Global Affairs Canada – said his organization assists CEPROSAF in analyzing and documenting cases of forced sterilization, and helps them support victims.
“This could be considered a practice of exclusion and discrimination against [victims],” said Mr. Valderas Martos, “and we believe it is extremely important to support the documentation and generation of knowledge about these facts so that the State investigates them from an intersectional approach, grants justice to the victims, establishes reparation measures for them.”
A lawyer who works with women with HIV who have been forcibly sterilized said she and her colleagues have identified 20 women who believe they have been victims, and some have documents to prove it.
They’re overseeing five formal complaints.
Some women who signed forms authorizing sterilization, she said, thought that term referred to something done to the surgery room.
“They are poor women, maybe their literacy does not allow them to understand this is something done to her body,” she said.
Sometimes, she said, women report being asked to sign a consent form while partially anesthetized, or that a family member signed without fully understanding what they were signing.
The Globe visited organizations in Honduras that support women with HIV who have been forcibly sterilized and spoke to three women who said this happened to them. Here are their stories.
At Fundacion Llaves, an organization in San Pedro Sula that seeks justice for women sterilized without consent, a Garifuna woman said she was seven months pregnant when she went to the hospital for a routine checkup.
A doctor told her he was having difficulty hearing the baby’s heartbeat and performed an emergency C-section. Her baby girl died three days later.
It wasn’t until years later that the woman, who is HIV-positive, found out that, following her surgery that day, she was sterilized against her will, denying her the chance of ever having children again at age 21.
She said she is still traumatized by what happened the day she went to the hospital and wound up having the emergency procedure.
“When they were taking the baby out, they started saying to me, ‘You have to have sterilization because you’re HIV-positive and you’re Black.’”
She said she was falsely accused of having sex with married men and spreading the disease to their wives. She lay there crying with her baby, she said, not understanding why they were saying these things.
They told her to quickly decide if she would agree to sterilization. She refused, telling them she wanted to discuss it with her partner. “They said, ‘Okay, let’s close her up,’” she recalled, adding that they took her baby girl to a room and separated her from the other babies.
Hospital staff then sent her to a lactation unit where, to her horror, a doctor later suggested her baby had died. “I felt like my heart stopped,” she said. She left immediately to look for her baby, but the newborn was no longer in the room she’d been taken to. At the end of a hall, a health care worker gestured toward her and said, “Come, come.”
“I didn’t want to go because it was going to be real. I said: ‘I’m just looking for the baby that was here,’ and they were saying, ‘Come, we’re going to tell you what happened to the girl.’”
Remembering that day, tears streamed down her face. She said she was told her baby died of a heart attack.
Four years later, her partner suggested they try for another. When she went for an examination to make sure she was in good health before trying to become pregnant, she learned she had been sterilized.
She turned to Fundacion Llaves, where she was provided support, psychological counselling and legal advice.
“I want to be heard, that’s the first thing,” she said. “Why wouldn’t I do this fight if this is still happening to other girls?”
She wants the physicians who did this to her to apologize. And she wants to be compensated, she said, because the aftermath of what happened has made it difficult to find a job.
It is a long, slow march to getting justice, she said.
“You know doctors see themselves as God who can decide over your body,” she said. “I know it was obstetric violence and how hard it’s been for me to overcome this. Life is hard for women with HIV, and Black it’s even more difficult.”
A 38-year-old woman in San Pedro Sula said the first time she gave birth, her baby died because she and the newborn didn’t get the attention they needed because she is HIV-positive.
“They said I was going to contaminate the other girls in labour,” she recalled.
After that, she was given a paper to sign and when she asked what it was for, they told her it was an agreement to be sterilized. “They said, ‘You’re a person with HIV, you shouldn’t have the right to have any more children.’”
She refused to sign the document.
She lost another baby a year later, before delivering a healthy baby in 2012. After that delivery, she signed the consent form for sterilization while still partly under anesthesia. Now, she wishes she could have another child.
“They did this when I was weak,” she said.
After the ordeal, she educated herself about the rights of people who are HIV-positive, started working in health and studying law.
“When I know a girl or woman with HIV is going into labour, I tell her mother, her partner: ‘Please even if you feel forced to sign a document, do not.’”
In La Ceiba, the 22-year-old woman at the CEPROSAF office shared the rest of her story.
When the physician told her she had to be sterilized because she is HIV-positive, she did it in a crowded room full of other women.
“All of them heard what she said about my condition of HIV, and I felt like I wanted to die,” she said.
After being forced to sign the sterilization agreement, she was brought to the surgery room, where she said she was ridiculed by the physician.
She gave birth to a baby girl and filled out paperwork for her daughter to go into neonatal care – but instead, she and her baby were brought to the public waiting room. The room was unsanitary and full of sick people. She was left there for days until a nurse recognized her and discharged her from the hospital.
Not long after returning home, her baby became sick and died.
The months that followed have been difficult and lonely for the young woman, who has not even been able to tell her mother what happened, too fearful of how she’ll react learning her daughter has HIV. Still, she wants justice for what’s happened to her. She’s filed a complaint against the physician who sterilized her with a local human rights organization and has lawyers following her case. She hopes that bringing more awareness to what happened will help others in the future.
“I don’t want any other girl to suffer from this.”
The trip to Honduras was partly funded by Bigger than Our Borders, an NGO-supported initiative urging the Canadian government to increase foreign-aid programs. They did not direct, review or approve the article.