Righting the Wrongs of Forced Sterilization in Namibia

It may be one of the last places you would expect to feel unsafe, but for many Namibian women living with HIV the hospital is as scary a place as it could be comforting. For many women in this southern African nation, particularly pregnant women, health care professionals can sometimes seem like wolves in sheep’s clothing. Add HIV into the mix, and things get even more complicated.

“We often assume that hospitals are healing places,” explained Aziza Ahmed, an assistant professor at Northeastern Law School, “where people living with HIV receive medical services in a safe facility, from trustworthy health practitioners. While this can be the case, women living with HIV in Namibia often report serious mistreatment in hospital settings.”

According to recent reports, Namibian women living with HIV are often times neglected proper healthcare when and where they need it most. A combined effort from Harvard Law School’s International Human Rights Clinic, Northeastern Law School and the Namibian Women’s Health Network has found that some government hospitals are doing more harm than good for these HIV-infected women.

The report, which based its findings off of interviews from 2010, found that women were forced (or heavily coerced) into granting their permission to be sterilized. In these instances, medical personnel withheld important information concerning the procedure including its effects, risks, and ultimate consequences. Other times, women were forced to assent if they wanted access to other medical services like a child delivery or abortions, and even access to their own medical records. “At the hospital there are no human rights,” explained a Namibian woman living with HIV.

Fortunately, positive change may soon be on the way. Already made aware of the crisis, the Namibian government was found guilty by a Namibian court of violating the human rights of three pregnant women who are HIV-positive. The women, while seeking care at government hospitals, had unwittingly signed release forms which gave permission for doctors to sterilize them. Each of the women was giving birth at the time their consent was given. The recent ruling is a true progress.

While these three women can expect monetary compensation from their government, the country can expect some changes in the future. This landmark ruling has made the point that women need to, and have a right to, access information concerning these decisions. They also have a right to decide whether or not this procedure is what they want.

It is estimated that up to 210,000 Namibians are currently living with HIV—out of a country that has a population of approximately 2.1 million, which is almost 1 in every 10. While sterilization is seen as a method to help decrease this number, especially the mother-to-child transmission, it is incredibly drastic and impedes upon human rights.

“The time has come for the Government to implement its guarantees, and for the donor and international communities to support women living with HIV in their struggle for non-discrimination, equality, and rights to access sexual and reproductive health care, free from coercion and violence,” said Mindy Jane Roseman, of the International Human Rights Clinic at Harvard Law School. Non-discriminatory healthcare must now be enforced so that women no longer need to fear being defiled by health professionals.

To urge the Namibian Ministry of Health to protect the rights of women living with HIV by providing equal rights and access to healthcare free of coercion, sign the petition here.


Photo Credit: usaid.gov/sites/default/files/styles/505_width/public/nodeimage/Namibia%20OW_0.jpg

Biohazard: Surgeries Performed with Soiled Instruments

For John Harrison, the surgery he underwent in order to repair his rotary cuff on his right shoulder was anything but routine. It was 2009, and Harrison was 63.  The complications were not immediate, but in the weeks that followed the surgery Harrison became worried about the condition of his new scar. Hot to the touch and beaming in bright red color, the scar began excreting what was referred to as a substance that resembled “butter squeezed from a bag.”

After being advised by the staff of Methodist Hospital of Houston, Texas, to return to the hospital immediately, Harrison and his wife headed back to the hospital where he underwent the initial surgery.  His shoulder, it turned out, had become severely infected with parts of his shoulder bone eaten away, and the metal devices implanted during the surgery had been pulled loose.  And it did not end there–today, Harrison still has trouble doing simple tasks like raising his arm and getting dressed.

Harrison was not alone either, but rather among several other patients who experienced similar post-surgery complications from the same hospital.  Based on this outbreak, the Methodist Hospital was forced to call off knee and shoulder surgeries and close down operating rooms when the Centers for Disease Control and Prevention (CDC) intervened in order to launch an investigation.  Through their efforts, the agency was able to trace the problem to arthroscopic shavers used in surgeries like that which Harrison had went through. 

On closer inspection of the device, it was discovered that remnants of bone, blood, and flesh had not been properly washed away in the sterilizing process and was directly responsible for Harrison’s and the other’s ailments.  While Harrison pursues a lawsuit against Stryker, the manufacturer of the device (for providing inadequate cleansing instructions to hospital employees), this issue is hardly confined to this one hospital.  Instead, the problem of dirty surgical instruments extends much further across the country; and is now shedding a light on gaps in training processes at hospitals nationwide.  The issue may stem from the pressure to deliver clean tools to the operating room quickly; or the fact that the low wage position has a high turn-over rate.  Inefficient cleaning instructions may be yet another concern. 

Mary Olivera, former president of the New York State Association of Central Service Professionals  and current director of sterilization at a New York City medical facility, believes it comes down to job preparedness.  When it comes to those tasked with cleaning up medical equipment and leaving them ready for future use, there is no defined training. “The people who do your nails, they have to take an infection control course before they can apply for a license,” explains Olivera.  “Same with a dog groomer.  Yet the people who deal with lifesaving equipment, they are required to have zero education.”

In order to ensure that all aspects of a surgery and its recovery process are safe, devices used during the procedure need to be safe and clean from the very start.  Workers must complete specific job training that would qualify them to handle and sterilize medical devices before each and every procedure.  For more information, and a chance to put the pressure on government health officials to administer this change, sign the petition here.

Photo Credit: defense.gov/photos/newsphoto.aspx?newsphotoid=6415