Sorry, Those Aren't Your Rights: HIV-Positive Namibian Women Face Coerced Sterilization

Several of my colleagues from the International Community of Women Living with HIV/AIDS (ICW) and I were crammed into an SUV with our luggage and food driving through the northern regions of Namibia.  It was a trek familiar to Jennifer Gatsi-Mallet, ICW Namibia Country Officer, and Veronica Kalambi, an ICW member.   This was a journey they had made many times while visiting the many women and girls who come to positive women's support group meetings throughout the country.  For the rest of us, it was our first time to rural Namibia and the Namibia-Angola border. 

The trip we were making was in response to a shocking discovery by Jennifer during a Namibian Young Women's Dialogue that several HIV positive women in Namibia had been sterilized against their consent.  More inquiry into the situation by ICW Namibia and the Namibian Women's Health Network determined that there was a need to do a fact-finding mission to gather data and take steps to demand justice from those individuals and entities that had violated the sexual and reproductive rights of women.  These fundamental rights include the rights of HIV positive women to have a safe, healthy, and fulfilling sex life and to determine whether and when to have children.  They also include the right to access health services free of stigma and discrimination; the right to full information about health services and conditions; the right to give full informed consent before any medical procedure; and the right to access to prevention of mother-to-child transmission services. 

Members of ICW know all too well the terrible and traumatic experiences faced by HIV-positive women as they attempt to access care, treatment, and support in general, and with specific regard to sexual and reproductive health services.  However, knowledge and awareness is never preparation enough for the traumatic and extreme rights violations that we were now documenting in Namibia.  

As we asked questions: have you ever been mistreated in a hospital? Have you been forced to accept a procedure you did not want? Women raised their hands time and time again, speaking of poor treatment by nurses and physicians, telling of being kept in separate waiting areas because they were HIV positive, and being identified as HIV positive in front of other patients.  Alongside stigma and discrimination, women spoke of being made to feel that because they are HIV positive they should not be pregnant, and about receiving misinformation about pregnancy and HIV. Positive women spoke of their rights to information and informed consent being violated: For example, some were encouraged to take birth control despite desiring more children, others were forced and coerced into sterilization while in labor or while having a caesarian section.   We visited hospitals and spoke to staff that admitted the mistrust they have for women when it comes to caring for their own bodies.  One physician even spoke of the women who visit his clinic as being unclean and poor and unable to make the best decisions for themselves, their bodies, and their communities.   

ICW has partnered with several domestic and international NGOs in order to seek justice for the women who have been sterilized and demand that necessary changes be made to stop the violations of women's sexual and reproductive health and rights.  All are rights protected by the Namibian Constitution as well as regional and international human rights agreements. 

For HIV positive women who need to access health services for their survival, a hospital should be a place of safety, a place where one recuperates, and where one can fully understand and address the health issues that affect them. In other words, hospitals and health care facilities are a place where rights should be realized, not violated.   As documented by ICW, health care facilities as sanctuaries of health and human rights for HIV positive women in Namibia remain far from reality.