The international community has long criticized the government of Uzbekistan for its poor human rights record. Yet the silence has been deafening about one egregious problem: forced sterilization.
Every year tens of thousands of women of reproductive age throughout Uzbekistan are sterilized, according to a new report by journalist Natalia Antelava. This is done without their informed consent—and often even without their knowledge. Any woman who has had two or more children is at risk for sterilization; however women of lower socio-economic status and ethnic minorities are disproportionately affected.
Doctors interviewed for the report indicated that government sterilization quotas put pressure on professionals throughout the medical establishment to produce results. Local administrators compete with one another to gain favor with the central administration. Doctors and nurses are held responsible for fulfilling quotas, and often must do so without the use of necessary equipment, a stable environment, or the ability to perform proper medical examinations.
Antelava quotes Kulkaroi Abudllaeva, a woman from Oltinkul who was forcibly sterilized after delivering her third child: “They tied a sheet around my stomach and started pulling on it until it tore. They tormented me and I lost consciousness.” Her baby was stillborn, and Abdullaeva only discovered the doctors had performed a hysterectomy after returning home from the hospital. “Why did they make me an invalid?” she asked. “I wanted to have more children.”
The aim of the nationwide sterilization program appears to be population control. Uzbekistan is the most populous country in Central Asia, and this puts a strain on dwindling land and water resources.
Another incentive for the sterilization effort appears to be the way in which perceived success in women’s reproductive health has helped the country’s generally negative image abroad. The international community has applauded President Islam Karimov for his efforts to reduce maternal and infant mortality rates without any questions as to how Uzbekistan was able to lower the figures.
What we see in Uzbekistan is part of a larger disturbing trend. The notion of population control has provided the impetus for forced and coerced sterilizations in a number of countries around the world. While the mechanisms vary, the common ground is governments and medical professionals who assume they are working for the good of the people but who ignore the rights of the specific women involved.
A recent report by the UN Special Rapporteur on torture describes forced sterilization as “an act of violence, a form of social control, and a violation of the right to be free from torture and other cruel, inhuman, or degrading treatment or punishment.” Given this strong condemnation, it is inexcusable that the international community has not given forced sterilization in Uzbekistan greater attention.
In its 2012 report on human rights practices in Uzbekistan, the U.S. State Department acknowledges allegations of forced sterilization as well as confirmation of these allegations by contacts in both the human rights and health care communities. However, rather than condemn the practice, the report simply refers to the Uzbek government’s strong denials of any wrongdoing.
Uzbekistan’s isolation, the government’s iron grip on information, and the lack of a paper trail have made it difficult to document precisely what was happening in the country. But Antelava’s report, complete with first-hand accounts of women and doctors, makes clear the extent of the problem and the need for the international community to respond more strongly.
The United States should speak out against the treatment of women in Uzbekistan. International agencies that fund women’s reproductive health programs in Uzbekistan should be cautious when praising reproductive health measures taken by the country, and institute monitoring of how Uzbekistan’s medical professionals are safeguarding the rights of women.
Beyond Uzbekistan, we must closely examine the global relationship between state policies and how the gynecological profession carries out its mission to serve women, no matter how challenging and politically inconvenient that may be.