JOHANNESBURG, February 24, 2020— “Women living with HIV who brought this complaint have shown tremendous bravery in standing up to the pervasive stigma and discrimination they experience in healthcare settings and claiming their rights to bodily autonomy and to choose whether and when to have a family”, said Sharon Mashamba, Regional Director, ICW Southern Africa.

The International Community of Women Living with HIV (ICW) welcomes the findings of the South African Commission for Gender Equality (CGE) in their report released today which confirms that women living with HIV in KwaZulu-Natal and Gauteng were sterilized without their informed consent in public hospitals on the basis of discrimination related to their gender and HIV status, as they have long claimed was the case. The CGE concluded that the women experienced a range of human rights violations rights to equality; to dignity and bodily integrity; to the highest attainable standards of health including sexual and reproductive rights; and that ultimately they were “subjected to cruel, torturous or inhuman and degrading treatment.” The CGE’s findings represent an important step forward in the recognition of this grave human rights violation experienced by women living with HIV and its devastating impacts on their lives and well-being. 

“The Commission’s findings take us one step closer to justice for the women living with HIV whose lives have been devastated by this violation of their human rights. We call on the National Department of Health to take responsibility and be accountable to women whose rights they have violated, provide them with redress and take concrete steps to ensure that nothing similar ever happens again”said Jody Lee Fredericks, Attorney, of Fredericks & Associates. 

ICW in partnership with Her Rights Initiative lodged the complaint in 2015 on behalf of 48 (forty-eight) women living with HIV who suffered forced or coerced sterilization in state hospitals.^[1]The CGE’s investigation focused on 15 hospitals in KwaZulu-Natal and Gauteng and included meetings with the NDOH and onsite inspections. In 2018, ICW commissioned Fredericks and Associates to collect medical records consent forms and affidavits from the complainants for submission to the CGE.

ICW’s documentation detailed the harrowing experiences of women, who endured humiliating and degrading treatment from healthcare workers. Women were asked to sign consent forms while in labor and some while they were being prepared for Cesarean section surgery. In most cases signing the consent forms was a pre-condition to receiving medical treatment. The women reported that they were misled by doctors who told them they should not have children because they were HIV positive. The women described being powerless due to being in labor and the unequal power dynamics characteristic of healthcare settings.

“Justifications for these violations of rights are often based on a lack of respect for the autonomy of women, misinformation, discriminatory attitudes and stigma which are completely unacceptable as public health rationales.”  said Olena Stryzhak, Interim Chair, International Steering Committee, ICW.  

The CGE’s findings specify that “medical staff breached their duty of care to the patients” and that the women living with HIV who were parties to the complaint were “not provided with adequate knowledge on the sterilisation procedure before being asked to consent, thus violating their right to information”; nor were they were “not advised on other alternative methods of contraception.” The report highlighted significant problems with the informed consent procedure provided by the National Department of Health (NDOH) and concluded that the women “could not reasonably be said to have consented to the procedure. They were therefore forced and/or coerced into being sterilised.” 

“Women living with HIV continue to be subjected to egregious forms of reproductive oppressionin healthcare settings. Until these practices are ended everywhere and until women who have experienced these violations have justice, we must keep fighting” said Sophie Brion, Human Rights Lawyer.

The consequences of forced or coercive sterilization are devastating for women living with HIV and have life-long impacts, undermining their self-worth and sense of identity and increasing their vulnerability to intimate partner violence. In all of the cases the women’s fundamental right to control their own bodies was taken away by healthcare workers who wrongfully made life-changing decisions on behalf of women. The women living with HIV who brought the complaint, report experiencing depression and persistent physical complaints stemming from their sterilisation. Further, the women continue to experience harm and severe emotional distress due to the violation of their bodily integrity and due to the permanent loss of their ability to have children.

The forced and coerced sterilization of women living with HIV has been documented in over 31 countries around the world including 9 countries in Eastern and Southern Africa. Women and girls who face discrimination, including on grounds of HIV status, have been disproportionally targeted by the practice. Critically, the practice violates established international human rights law, including the rights to bodily integrity, full, free and informed consent and the right of women living with HIV to marry, to have a familyand to decide freely on the number and spacing of their children as enshrined in the Convention on the Elimination of all forms of Discrimination against Women (CEDAW),^[2]The sterilization of women living with HIV violates governmental obligations to respect, protect and fulfill the right to the highest attainable standard of physical and mental health. Forced and coerced sterilization has also been recognized by the Committee on Economic, Social and Cultural Rights as both a form of violence against women and as a form of torture, violating women’s rights to be free from cruel, inhumane, or degrading treatment or punishment.[3]Forced and coerced sterilization is under no circumstances a legitimate method of prevention of vertical transmission and sterilization is never an emergency procedure that justifies suspension of an individuals rights to informed consent.

ICW calls on the South African government to ensure justice and remedies including reparations to survivors and their families. ICW also calls on the South African government to explicitly prohibit sterilization without free, full, and informed consent. Lastly, ICW calls on the South African government to take swift action to hold accountable medical providers who forcibly sterilized the complainants in this case as well as any other health care professional who violates their professional code of conduct and carries out procedures that violate the policies of the National Department of Health. We look forward to working with the CGE and the NDOH to achieve justice for women who have been forced or coerced into sterilisation.

The full report is available on the Commission’s Website: http://www.cge.org.za

About the International Community of Women Living with HIV  

Established in 1992, The International Community of Women Living with HIV (ICW) is the only global network for and by women living with HIV. ICW networks exist throughout the globe. ICW envisions a world where all women living with HIV live free of gender oppressions, realizing and claiming our sexual, reproductive, legal, social, economic and health rights. We lead efforts towards securing and improving the quality of life for women living with HIV. We do this by mobilizing, organizing, advocating, mentoring and raising consciousness on the issues that directly impact our lives.  ICW Southern Africa is a regional network of women living with HIV and is part of the global family of women living with HIV–led networks forming ICW.ICW member networks around the world including in Southern Africa have been actively documenting and working to address the widespread nature of the practice of forced and coerced sterilization.

Learn more about ICW:

https://www.facebook.com/internationalcommunityofwomenlivingwithhiv

CONTACT:

Jody Lee Fredericks

Lawyer 

Representative of ICW

Tel: +27745321437 Whatsapp Only

Email: jody@frederickslaw.co.za

Sophie Brion, MPP, JD

Human Rights Lawyer

International Community of Women Living with HIV  

Tel: (202) 470-3245

Email: sophieicwglobal@gmail.com