1. Forced and Coerced Sterilization of Positive Women in Namibia AIDS 2008 International Community of Women Living with HIV/AIDS

2. Definitions Forced or coerced sterilization –When you don’t consent –When you were asked to sign a consent form and didn’t know that you are signing away your rights –You know that you are signing but you are under duress –You are forced to sign because your service provider made you do it Because of HIV status Potentially while you are seeking a related service (abortion, C-section) –“you have a big baby we won’t help you to delivery it unless you sign the consent forms”

3. Background of Project Young Women’s Dialogue –Women who were sterilized came forward ICW initiated this project to address these issues

4. Research and Investigation Approximately 300 women have been educated about sterilization. –Working mainly through support group networks –40 women have stated that they were sterilized –13 cases have been picked up by LAC –2 cases have filed in court Fact Finding Trip –Rural areas, talked to some doctors, spoke with support groups

5. Why is this happening? Stigma and discrimination against HIV positive women –all people in the hospital setting (doctors, nurses, receptionists) –Examples Being told to stand in a separate line Being told that you shouldn’t be pregnant Health passport are marked with big letters of HIV, no confidentiality STD clinic is isolated from the main hospital, hosptial set up is not conducive and discriminatory When you are HIV positive people always assume you are going to be sick and don’t help you

6. Specifics around Tubal Ligation and Coercion Stigma and discrimination Routine testing during pregnancy –Lack of counselling –Lack of time to make a decision –Misinformation –Language barriers Lack of information –No presentation of alternatives methods of family planning Consent forms which are not clear / explained / being told that they are not consent forms for sterilization Women are told that they are putting the health and well being of their fetus or future child at risk

7. Related Issues Lack of access to medical records –Women are denied access to their full medical records, what is recorded in medical passports is often incorrect Lack of services, information, and will power about reversal

8. Emotional and Social Context Anger of families and partners –Partners and husbands leave Distress on the part of the woman herself –Fear of not finding a husband or a boyfriend –Desire of wanting to have children –Having just found out your HIV status –Discrimination between women

9. Human Rights Framework Namibian Constitution Namibian HIV/AIDS Plan Various international human rights treaties that Namibia has ratified African Protocol on Human and People’s Rights African Charter on Human and People’s Rights of Women in Africa

10. Some of the specific rights violations Right to dignity Right to be free from torture, cruel, inhuman or degrading treatment Right to be free from discrimination (based on being a woman, being HIV positive, etc) Right to a family Right to reproductive self determination Right to health Right to non-interference in one’s privacy

11. Outcomes thus far 2 cases have been filed –The rest are being investigated by LAC Submission to the Deputy Minister of Health Several newspaper articles (which have prompted more cases) We are exploring the potential to use other human rights mechanisms

12. Recommendations Many recommendations, here are some: To Ministry of Health –Investigate and take action against hospital staff who have wrongly or coercively sterilized women –Offer sterilization reversal procedures for women who have been coercively sterilized where possible –Follow through with policy directives which mandate that women have full access to their medical records –Health care staff should be thoroughly educated about the principals of informed consent and the correct way to obtain consent. –Ensure that health services staff adequate knowledge about ARV regiments for pregantn women and educate women on options available –Provide family planning information in a non coercive manner allowing women to make fully informed and voluntary decisions about family planning –An appropriate and timply complaints procedure should place –All staff should undergo traning on stigma and discrimination related to HIV/AIDS and the rights of individuals living with HIV/AIDS

13. For more information Overview document available here or at ICW booth 246 in Global Village Or contact – Jennifer Gatsi Mallet Namibia@icw.org. Namibia@icw.org Veronica Kalambi 5529572998 (Mexico) / veronicakalambi@yahoo.com and Aziza Ahmed at 5530816556 (Mexico) aziza@icw.org. veronicakalambi@yahoo.com aziza@icw.org