00.00.03

Child playing. Song

Peru, the site of one of the world's oldest civilisations is witnessing what some have referred to as ethnic culling.  A government campaign for the mass sterilisation of rural women, is threatening to wipe out the future of the Andean people.

00.00.25

Interview with Hilaria Supa, peasant

HS: In our culture, women have always been fertile. There was never a woman who didn't have children. They all did.

00.00.40

Image of baby breastfeeding

A woman who has children is always respected, even by her husband.

00.00.53

And a woman who cannot bear children is looked down on.  In our community women have always been seen as good mothers.

00.01.10

TITLE:

SECRET STERILISATION

00.01.20

The campaign for sterilisation targeted certain groups of women. Those from poor Indian speaking communities. In the Andean towns and villages it's seen as a silent slaughter, the lives of future generations irrevocably severed.

00.01.45

It was in hamlets like this that government officials and health teams slowly began to implement their plan. In 1996 no one suspected their motives. After all this was a region founded on certain traditions.

00.02.02

image of a roof top

These Peruvian symbols of fertility are a testimony to what the family means to Peru's rural communities.

00.02.14

Despite the high rates of mortality Andean women have large families. They believe a family's size should not be determined by government policy.

00.02.33

Interview with Gregória Ribeiro

GR: That is up to God?

Int: How many children have you got?

GR: seven

Int: How many have died?

GR: two

00.02.42

Interview with Claudia Palomino

Int: Four died.

Int: How many are left?

CP: seven.

Int: Is this the youngest?

CP: yes

00.02.54

Interview with Marcela Huaman:

Int: Is that your last daughter?

Int: yes, she is

MU: and you can't have any more children?

MU: I don't know, the thread is forever.

00.03.03

The ‘thread' is the name women give for a hysterectomy.

Under the government's birth control program, which begun in 1996, over 250,000 women in Peru have received the thread, many without their consent. They were often forced or blackmailed into being sterilised.  It's a policy which has shaken Andean communities to their core.

00.03.33

Pampamarca, Ayacucho province

In the village of Pampamarca another funeral is taking place.

00.03.40

On a wooden stretcher, wrapped in a blanket, lies another dead child.

00.03.46

The baby died of asphyxia during birth.  A birth which also killed the mother.  At the delivery there was no medical assistance.  In the foothills and surrounding villages it's a growing trend that the locals are only too aware of.

00.04.08

Interview with Moises Mendonza, Peasant

MM: We are sad because the health centre is going to close. How many more dead are we going to have? We hope that the centre will reopen or we will die without any help.

00.04.25

But help was never the government's intention.  The health centre in the village has remained closed ever since it accomplished its mission to sterilise the local women. From day one the combination of regional and national campaigning coerced the women of Pampamarca into a terrifying situation.

00.04.50

Interview with Emiliano Huamani, Peasant

The ladies were told that once they had the thread done, they would not have any more children.

00.04.55

Interview with Teofilo Huaman, Mayor of Pampamarca

TU: The president gave a decree at a national level.

It seems it was compulsory to do the thread, to avoid big families.

00.05.22

Restricting the size of peasant families became a true obsession for the Peruvian Government.

Posters appealing for family planning were everywhere.  When that failed some women were involuntarily and indiscriminately seized from their homes and sterilised as mother of 5, Maura Quispe recalls.

00.05.44

Interview with Maura Quispe:

MQ: she told me that I already had too many children, that the government and President Fujimore had sent specialists from Lima.  She said that the injection and the pill were going to end and if it wasn't for the thread we would have too many children. It's been two years since I had the thread done.

00.06.26

Despite local protests the government saw the campaign for sterilisation as a necessary part of Peru's development and it continued.  They even set new targets for the health centres allegedly sending out further orders for enforced sterilisations.

00.06.48

Maria Cleofé worked as an assistant nurse at a health centre in Huancavélica. There she obeyed strict instructions to sterilise as many women as possible.

00.07.00

Interview with Maria Cleofé

The supervisors gave the orders, they forced us to have five patients for the hysterectomy per campaign and per health technician. There was a health centre in one village in which 15 patients had the operation in one day.

00.07.25

Street GV's

One high profile doctor refused to sterilise women against their will.  Hector Chaves claims doctors are only the messengers.

00.07.36

Interview with Hector Chaves, President of the Medical Federation of Ayacucho

HC: They're the orders from the Ministry. An order comes from the top and it has to be obeyed.

Int: and what are the orders?

HC: that we need to have women sterilised.

00.07.51

Although the plans for mass sterilisation were taken at the highest level of national office, there's very little documented proof of the campaign.  The only evidence was in a press statement issued by a regional Health Department in 1997 which states  that health technicians were not to be paid for rounding up women for hysterectomies, because it was compulsory. Some doctors such as Hector Chavez argue this was not the case.

00.08.18

Interview with Hector Chavez

HC: For those professionals who went out campaigning there was extra payment. 

00.08.32

Interview with Maria Cleofé

MC: At the end of the year there was a competition to see which health centre had performed the best and prizes were given out.

00.08.45

However the head of Huancavélica's Health Department is adamant that no sterilisation programme exists.

00.08.52

Interview with Juan Carlos Cusicanqui,

JCQ: We have a program of reproductive health and family planning which includes all methods. But there is no such "thread  programme"

00.09.01

Interview with Hector Chavez

HC: It's much easier to sterilise than to educate, to provide jobs or better health conditions. They opted for the easiest option.

00.09.18

The catholic church was also opposed to the sterilisations. Father Hermida was sure that incentives were indeed a factor.

00.09.28

Interview with Father Mariano Hermida

Father ME: some of those who work in family planning tell us that they received incentives in money and electrical utensils.  They make reference to other doctors who have received more than they did ... it seems pretty clear to me.

00.09.43

Music, people: man's voice saying:

If some rural communities had so far escaped the campaigning, the government radio broadcasts put paid to that. This one declares that that for your children to be born strong and healthy it's necessary to have at least a two years between births. Let's avoid putting lives at risk, the announcer says.

00.10.16

Ritual dancing

As the tradition of fertility in Peru is gradually eroded it's anticipated that by the year 2050, the government will have halved the number of children born to women in rural areas.  Festivals like this one will only have historical value.

00.10.35

As the campaign gathered momentum word spread through the hamlets of a travelling 'thread' festival where doctors performed thousands of free hysterectomies. The government message was unashamedly direct.  You're too poor already to have more children and because it's not catholic to use other forms of birth control you need to be sterilised.  As pressure mounted to secure hysterectomies some women were being humiliated to force them to consent.

00.11.09

Interview with Claudia Palomino

CP: The nurses told me that I had too many children.  They asked me if I was an animal to have so many children.  That's why I had the thread.

00.11.33

Interview with Filipa Cusci

FC: The nurse came to my house 3 times. Once in the morning, in the afternoon and in the evening.  She said to me, "Why do you have to think twice when you can think only once.  Have the thread done, it's not going to harm you. 

00.12.03

By now the health workers were under pressure to fulfil their quota of sterilisations.  If they failed their own jobs could be at risk. Like many of her colleagues Maria Cleofé struggled to convince many women.

00.12.22

Interview with Maria Cleofé

MC: It was a requirement, an obligation. At the time we were told that if we didn't achieve a certain number of patients they would terminate the contract and we would all have to go.

00.12.42

Street GV's

But if some medical teams were finding it heavy going, the government had found another way of drawing in more patients.  They used their own food aid scheme PRONAA as a means of coercing women into sterilisation. At was at these food distribution centres that many women heard about sterilisation for the first time and succumbed to being sterilised in exchange for food.

00.13.13

Interview with Teofania Haussi

TH: The PRONAA ladies went from door-to-door throughout the community inviting us to go to the program. There they gave a lecture and told us to get sterilised and stop using our own methods of contraception.

00.13.28

Interview with Benedicta, former health worker

There was a health centre where porridge was distributed and where mothers were told,

"If you don't get the thread we won't give you any food".

Some agreed thinking maybe it was true, others refused.

00.13.52

Socos, Province of  Ayacucho

The food aid program was designed to ensure that even in the poorest communities, young children didn't go hungry.  Often the reward many women received for becoming sterilised was a lousy bowl of soup.  Even so many mothers took up the offer.

00.14.15

Interview with Ester Aquino, President of PRONAA Canteen

Q:  How many women have been sterilised?

EA: I don't know how many, but there are many.  This is a big village and there are a lot of mothers. They are a very needy people. It's a pity.

00.14.36

Interview with Hector Chavez

It's a sad reality but we are an over-populated country.  We need to have fewer births, so the government will do it with or without causing harm.

00.14.48

Huayatará, Huancavélica Province, 29 October 1996

And with such a policy there are inevitable tragedies.  At least 15 women have died from complications while undergoing sterilisation. This video, made by a medical team shows the  suffering of a woman who becomes conscious when the anaesthetic stops working. The doctor ignores her cries and continues with the operation.  The woman died two days later.

00.15.19

Woman and child

Others like Madalena Reginaldo survived just such an experience.

00.15.26

Interview with Madalena Reginaldo

MR: I felt pain.  They were cutting into me and I wanted to get up.  I said,

"Dr it's hurting.  What are you doing to me?" and he just told me the anaesthetic wasn't working.

00.15.42

Madalena lives in Huancavélica, one of the poorest provinces in Peru. On average women here will have 9 children each.

00.15.57

Jessica is Madalena's youngest daughter and although she would have liked two more children she was sterilised against her will soon after Jessica was born.  Angry at the way she was treated she still carries both the physical and the mental scars.

00.16.16

Interview with Madalena Reginaldo

MR: I didn't want to be sterilised. Neither did my husband, because when a woman is sterilised she stops being useful.

00.16.26

Fire being stoked

At Jessica's birth the doctor told Madalena she was a woman of 'high reproductive risk' and for her long term health it was vital that she should have a hysterectomy.

00.16.44

Interview with Madalena Reginaldo

MR:  The Doctor said to me, "We can give you the thread".  I said "no" because I thought it would make me ill.  He said that was only psychological, that the thread didn't hurt.  I told him I was scared.  But He replied that I was at high risk and that I could die. I said, "It doesn't matter If I die doctor".

00.17.10

Madalena surrounded to the doctor after her husband signed a consent form.

00.17.18

Interview with Madalena Reginaldo

MR: The doctor arrived for my check up and told me, "tomorrow you'll have a surprise".  I said,  "What surprise?"

"Tomorrow we'll give a hysterectomy.  Your husband has already given permission and you have to sign as well. To accept that you'll have no more children. Sign so that we can sterilise you tomorrow."

Int: and you signed?

MR: yes

Int: why?

MR: I was told to do so: my husband signed so I had to sign as well.

00.17.50

The pressure on doctors to achieve more sterilisations took a new twist when they began targeting their own colleagues for sterilisation.

00.18.00

Maria Cleofe

Maria Cleofe had failed to reach

her sterilisation targets and was now being singled out.

00.18.07

Interview with Maria Cleofé

MC: The doctors told me that I already had children and that it would be better if I had a hysterectomy. That it might save my job.  "You have nothing to lose.  You didn't find any patients in 3 campaigns, you are going to leave anyway.  If you have the thread you'll keep your job".

00.18.32

Faced with an ultimatum - the right to motherhood or the right to work for the survival of her family? Maria Cleofé made a difficult choice.

00.18.45

Interview with Maria Cleofé

I took the decision myself.  I didn't consult my husband.  I needed to work for the family, so to keep my job I had the thread.

00.19.08

In the end it was a pointless sacrifice. Two months after her hysterectomy, Maria Cleofé was sacked.

00.19.16

But the Peruvian press now began to focus on the sterilisation campaign and under mounting pressure eventually the government could not deny its existence.

00.19.28

The organisation, Defence of the People, condemned the government for these acts of brutality. A denouncement which seemingly forced them into making changes. Official Figures indicate sterilisations dropped by more than 50% during the next 12 months. 

00.19.47

However, according to Father Hermida, the mass sterilisations have not stopped. Doctors have now found new subtle ways of achieving their aims.

00.20.00

Interview with Father Mariano Hermida

I know of several women who were sterilised against their will,  some without even knowing it.  They were conned into signing blank pieces of paper, the consent forms, without the doctor stating what it was for.

00.20.23

Gregória and Alfonso are devout Catholics.  They have nine children and have never accepted any form of artificial contraception. When Gregória became a mother again at 40 the doctors recommended sterilisation.  She refused.

00.20.41

Interview with Gregória Riveros

GR: They demanded I should be sterilised but I didn't want it and immediately refused.  Then they told my husband,  "if you don't want your wife to be sterilised you must have a vasectomy". He also refused.

00.20.57

But a few hours after giving birth, Gregória was taken to the local hospital where she was sterilised, without her knowledge or consent.

00.21.11

Interview with Gregória Riveros

GR: They told me that a piece of the placenta was still inside and it needed to be cleaned. I signed a blank piece of paper. After I signed they took the details from my documents.

00.21.30

Interview with Alfonso Paço, Gregória´s husband

The following day my wife had tummy pains and a relative who came to visit her saw the scar on her belly and told me she'd been sterilised.

00.21.50

Interview with Gregória Riveros

GR: I signed to be cleaned inside, not to be sterilised.

00.21.54

In such circumstances families have little come back. It's often their word against the hospital's.  But someone who is prepared to fight on their behalf is a lawyer, Giulia Tamayo.

00.22.06

She's trying to prove that the government has violated human rights.

00.22.14

Interview with Giulia Tamayo

GT: I believe that the sterilisation of women during birth, often without their knowledge, is  masked by the increased number of caesarians.  It's necessary that the real facts are known.

00.22.30

Rufina Escobar is only 23 years old.  This is her cesarean scar. She had it done when she was six months pregnant. It conveniently disguises the hysterectomy which took place at the same time as the caesarean.

00.22.50

Interview with Rufina Escobar

In the emergency room I was told, "Sign so that they can give you a caesarean.

Sign Sign."

"What for?"

"To have a Cesarian done."

 My hand was shacking.

Q: was it a blank paper?

A Yes a blank piece of paper.  I wasn't told it was for the 'thread'. They made me sign and I went into the operating theatre.

00.23.19

Rufina carrying child

The baby born by Caesarean eventually died. It was a shock for Rufina to find out that she couldn't have any more children.

00.23.30

Interview with Rufina Escobar

RF:  I wasn't feeling well so the obstetricians told me that they were going to consult my medical files. A lady explained I'd had a hysterectomy.  When the doctor came to assess me I asked him, "why did you give me the thread?". I threatened to take legal action against him but he said that he couldn't be arrested for what he'd done."

00.24.00

Rufina only has one child, a 2 year old boy.  She's never pressed charges against the doctor and like many Peruvian women, has remained silent about her ordeal. Peru's family planning program has been accused of consistently failing to gain signatures of consent.  This is despite the government promising in 1997 to present every signed document.

00.24.28

Interview with Lurdes Flores, MP, Christian Popular Party

LF: They were asked for the signatures of consent but these have never materialised.

Int: Up to now?

LF: Up to now. They said it was confidential.  We didn't want to know specific identities, only the documents that prove that there was consent for each operation.

00.24.48

As more women come forward health department officials under pressure are adamant they can prove their legal responsibilities.

00.24.55

Interview with Juan Carlos Cusicanqui

JC: I am a witness to how the program ran.  In Huancavélica, I performed around 300 sterilisations.

Int: all voluntary?

JC: of course.

00.25.13

Interview with Lurdes Flores

LF: The women who are sterilised against their will do not have a gun pointed at their heads.  They are however, put in a situation where they have thought too little about it.

00.25.28

Interview with Felix Campos, Doctor

Int:  Have you ever pressured a woman?

FC: No, all my patients did it voluntarily. Many times they asked that if I would perform the operation myself. I have never put pressure on a woman to be sterilised.

00.25.46

Giulia Tamayo aims to represent the women who were forcefully sterilised.  She believes they are living proof that human rights violations did take place.

00.26.00

Interview with Giulia Tamayo

GT: The Peruvian doctors and the health workers acted as though they were the police or the army. They did not follow the necessary ethical procedures of conscience.  They put many people at risk.  They are accountable, just like the police or the military, for following orders which go against human rights.

00.26.38

Father Ermida goes one step further in his criticisms.

00.26.44

Interview with Father Mariano Ermida:

Father: Obviously I can't read the mind of the government but the intention is very clear, "Go and achieve the goals." And the goals are hundreds, thousands. We have been depopulated by a mass sterilisation.  It is killing the people.  It's genocide.

00.27.11

00.27.11

Interview with Giulia Flores

JF: There is a serious contradiction here. On the one hand if we reduce the number of poor people we reduce poverty.  On the other hand we are told the population living in extreme poverty is not growing anyway.

00.27.29

Interview with Father Mariano Ermida

I believe the government has to decide whether to carry on with sterilising the region's women.  If it continues like this they will kill the Peruvian Mountains.

00.27.55

GV's children

Peru is a country founded on the splendid traditions and glories of the past.  But in their commitment to the new God's of modernisation and progress,  Peru's leaders are in danger of losing touch with this heritage. Their pursuit of western ideals could bring with it the loss of perhaps Peru's greatest treasure.

00.28.27

Ends