Experiencing excruciating abdominal pain following the recent birth of your child and visiting your physician to find out that you no longer have a uterus would be an immense shock to any woman. Unfortunately, in Uzbekistan right now, women are sterilized often without their prior knowledge as part of a secret government plan to keep its population numbers down. This callous, largely covert practice which has left thousands of women without the possibility of deciding how many children they will have on their own was recently brought to light by a BBC report.
Some women in this Central Asian nation are cajoled by health officials to just agree to the sterilization procedure while others are not asked at all; after giving birth they are simply sterilized and not told of what has taken place. On paper, sterilization should be voluntary but in reality it is not. The woman mentioned above, who found out about her hysterectomy by accident, was told directly, after she inquired about why the procedure was done, that Uzbekistan’s law dictates such practices to doctors. Whether hysterectomies are performed on women unbeknownst to them or by doctors presenting them with inaccurate information about their reproductive health, very basic human rights are at stake. With the rise of Cesarean sections in the last years it has become extremely easy for surgeons to just incorporate the sterilization procedure into the post birth routine.
The BBC report quotes a doctor from Tashkent, the Uzbek capital “Every year we are presented with a plan. Every doctor is told how many women we are expected to give contraception to; how many women are to be sterilized.” The Expert Working Group carried out a survey in 2010 calculating how many sterilizations took place during the “seven-month-long survey of medical professionals…” pointing to around 80,000 sterilizations in that time frame but it isn’t possible to deduce from that number how many had the patient’s official consent. Given the experience of the women interviewed by the BBC though is it really relevant how many women of the 80,000 gave true consent? If consent is often given by women presented with false information about their reproductive system, the numbers from the survey are really not representative of the entire picture. Moreover, even a single woman undergoing sterilization without medical urgency or without her own informed decision sets a dangerous precedent.
Uzbekistan is not exactly a free country, with its authoritarian president who has immense power and who, under the guise of avoiding Islamic extremism, holds a firm grip on his people. Human rights violations including the use of torture or the inability by Uzbek citizens to exercise their basic civil rights are not unusual. Contact with a foreign journalist is illegal in Uzbekistan, so reporters of the cited BBC expose first met with people inside the country, keeping sources anonymous, and once the Uzbek authorities deported the journalists they interviewed Uzbek women affected by sterilization in a neighboring country. What comes out of the interviews is a gross overstepping of boundaries into citizen’s private lives by a government obsessed with control. What is even more outrageous according to the BBC is that “Several doctors and medical professionals said forced sterilisation is not only a means of population control but also a bizarre short-cut to lowering maternal and infant mortality rates. It’s a simple formula – less women give birth, less of them die.” In international rankings of maternal and infant mortality, improved scores benefit the nation’s public image. Foreign nations, which once shunned Mr. Karimov, the Uzbek president, now pay less attention to his draconian national policies and human rights abuses. This is a result of a wider, global fear of Islamic extremism, which makes various democracies look the other way even when questionable practices by Karimov are brought to surface; unsurprising really since a number of Western democracies are themselves overstepping their citizens’ rights for the sake of national security.
The stories of the women interviewed are heartbreaking on a personal level but also astonishing in terms of the paternalistic entitlement the government feels it has over women’s ability to make decisions about their reproductive health. It seems that all over the world governments feel safer in their obsession of dictating reproductive dos and don’ts to women instead of treating them like adult human beings, equipping them with education, opportunities and power, making them perfectly capable of making up their own minds about some of the most intimate aspects of their lives. A prescribed number of sterilization procedures dictated by the government to be performed by each gynecologist puts immense pressure on the doctors to choose anywhere between four and eight of their female patients monthly and take away their ability to bear children. Convincing many women to undergo the operation is often quite difficult, so making the personal decision for them has become easier. While a few of the women interviewed had two children already and were sterilized right after the birth of their second, others are not so lucky. A young woman of 24 years “…had an emergency C-section. A day later she was told she had been sterilised. On the same day, her newborn died.” Important decisions about childbearing made by doctors for the sake of government, in cases where a woman’s life is not threatened and without any prior consultation with their patient, is a frightening reality.
This story out of Uzbekistan is disturbing but not unbelievable given the various ways that governments and extremist groups across the continents have in the past, and in many instances, continue to treat reproductive freedom today. Whether it is China’s flawed one child policy, a refusal to make contraception available and affordable, making abortion unattainable, or forced sterilization of people who are deemed to be undesirable parents, the drive for narrow-minded methods of controlling individuals isn’t confined to any specific culture, creed or system of government. There is no doubt that empowering Uzbek women, providing them with adequate pre and post-natal care and making contraception easily available would help to advance the nation’s human development index rankings, while improving the quality of life for all its people.
Broad stroke government policies, official or unofficial ones, that do not take into account the greater good for each of its citizens serve only the oftentimes misguided interests of the ruling elite. A mostly secret sterilization campaign is irrefutably not the way to gain the trust of women, lift a nation’s image, develop towards prosperity or shield against extremism. Mr. Karimov’s government is unlikely though to care about those matters, instead focusing on absolute control and its personal interests. It is my hope that the international community and multinational organizations will now assert both economic and political pressure on the Uzbekistan’s government in order to bring an end to this shameful practice.