HIV-positive women sue Kenya government and NGOs over sterilisation – The Guardian

Five HIV-positive women in Kenya are suing the government and two top international NGOs, claiming they were sterilised without their consent.

The group this week filed a legal action against parties including the Kenyan health ministry, Médecins sans Frontières (MSF) and Marie Stopes International.

Meanwhile, activists protested in the capital, Nairobi, arguing that forced sterilisation is still widespread and should be be banned. The women marched from the high court to Uhuru Park with T-shirts that said: “Enforced and coerced sterilisation of women living with HIV”.

Lawyer Allan Maleche said his five clients were sterilised in health facilities in Nairobi county through a procedure known as bilateral tubal ligation. The various circumstances allegedly included: threats to withhold food portions and baby formula milk; inducement with the promise to pay medical and maternity fees; lack of provision of essential information to enable the women to make informed decisions; lack of provision of choices of other forms of family planning methods for the women.

Maleche said that one of the women was given two discount vouchers to reduce the cost of delivering her baby in hospital: one was for a caesarian but she did not realise the other was for tubal ligation.

“They have been psychologically affected, they have found it difficult when their spouse has left them for another spouse who can have more children,” the lawyer said on Thursday. “There is depression because something so valuable in their lives had been taken away from them. Their spouses wanted more children.”

MSF and Marie Stopes International did not directly carry out sterilisations, Maleche added, but allegedly referred the women to government hospitals where the operations were performed.

The lawsuit asks the court to make declarations including “the sterilisation of these women in these circumstances violated their human and constitutional rights” and “women living with HIV have equal reproductive health rights as all women including the right to freely and voluntarily determine if, when and how often to bear children”.

One of the group, Teresia Otieno, told the BBC: “I went in for an operation to give birth to my first child. By the time I was leaving the operation the doctor told me I had been sterilised.”

MSF said it had never encouraged surgical sterilisation as a preferred contraceptive method. Bilateral tube ligation was one contraceptive measure described to patients.

Dr Alexandra Vandenbulcke, MSF’s medical coordinator in Nairobi, said: “MSF takes these allegations extremely seriously and is reviewing them carefully. As a medical humanitarian aid organisation, MSF is committed to ensuring that all of our patients are fully informed about their medical options and that all of our patients provide full and informed consent prior to any medical treatment they receive.”

Faustina Fynn-Nyame, country director of Marie Stopes Kenya, said: “We are currently investigating the stories, but would be deeply concerned about any possibility that any woman had the kind of experience outlined in the report while under our care.

“If the accounts are accurate, they are wholly inconsistent with our principles of voluntarism, informed choice, and informed consent which are fundamental to our values, policies, and practices in all of the 38 countries we work in around the world.

“We will be working with government, private and NGO family planning providers in Kenya to determine the facts of these historical claims, and to reinforce our shared commitment to informed choice and informed consent.”

In 2012, a landmark report entitled Robbed of Choice, produced by the African Gender and Media Initiative, contained powerful testimonies from 40 Kenyan women who said they had been affected. Its author, Faith Kasiva, described the forcible and coerced sterilisation of poor, HIV-positive women as “systemic in public health facilities”.

She told TrustLaw: “We live in an African cultural setting where having a child or motherhood is glorified in a way that probably it’s not in other societies. A lot of these women, because they cannot give birth, they have been chased away from their homesteads. Others have been disinherited.”

The report quoted Selina, a 23-year-old woman, who said she was admitted to the Kenyatta national hospital in 2000 with tuberculosis and pre-term labour pains. She told how she underwent a caesarean section and, in the process, was sterilised after her husband signed the consent forms without her knowledge.

Her husband sent her away and married another woman because he “could not live with a woman who cannot give birth”, she was quoted as saying. “The sterilisation ruined my life.”

The women’s campaign received a boost in 2012 when a court in Namibia ruled that state hospitals illegally sterilised three HIV-positive women. The women had not given informed consent as they were presented with sterilisation forms just before or after giving birth, without being told what they were signing.
However, the judge did not feel there was sufficient evidence to prove that it was a discriminatory practice against women living with HIV.