When Victoria lost her new-born baby in 1996, she was
"What kept me going was the thought that next year I could
try again," the Peruvian woman says. "I was so sad but I had the
hope that I'd have another chance."
That hope evaporated when she overheard a doctor saying that
she had been sterilized by a tubal ligation. She says no one had
ever discussed the operation with her or her husband nor asked for
her consent. "I wanted another child," Victoria says in almost a
Victoria's case is only one of a string of allegations that
have emerged over the past few months in connection with
sterilizations performed by the Peruvian Ministry of Health through
its Family Planning Program.
In 1995, the government launched what was widely regarded as
an extremely progressive family planning program.
It promised all women access to any family planning method
they chose, free of charge.
But mounting allegations and investigations are raising
serious questions here. Instead of the progressive program
described in its glossy brochure, critics claim that the Ministry
of Health actually has been waging a massive sterilization campaign
in which women - especially poor and indigenous women - were
pressured, bribed, or deceived into receiving the surgery.
In 1997, state doctors performed 110,000 tubal ligations - up
from 30,000 the year before. Among them were some atypical
candidates: women with no children, 15-to-19-year-olds, and
menopausal women, according to various inquiries.
According to Maria (not her real name), a woman who has
worked as an obstetric nurse for the health department for five
years, health department employees were under pressure to fill
quotas - between eight and 36 per month - for tubal ligations.
"They imposed quotas on us and they made it clear that our
job stability depended on filling them," says Maria, adding that
this pressure came directly and explicitly from the highest levels
of the Family Planning Program.
Maria says the pressure was accompanied by financial
incentives: Doctors and obstetric nurses, herself included, were
paid roughly $10 to $30 for every tubal ligation client they
Problems began when pressure was transferred to clients. "In
order to try to maintain their job, many people pass on the
incentives they receive to the patient in an attempt to convince
them to agree to the surgery," Maria says. "This is going on in the
poorest sectors of the country where people are capable of doing
anything for money."
Both newspaper reports and investigations have revealed
numerous accounts of women who were promised food for undergoing