Developments Related to the Coercive Sterilisation of Romani Women in Slovakia, Including Government Failure to Provide Redress to Victims

07 February 2004

On October 17, 2003, the Council of Europe's Commissioner for Human Rights published a "Recommendation of the Commissioner for Human Rights Concerning Certain Aspects of Law and Practice Relating to Sterilisation of Women in The Slovak Republic". In the Recommendations, the Commissioner concluded that: "on the basis of the information contained in the reports referred to above, and that obtained during the visit, it can reasonably be assumed that sterilisations have taken place, particularly in eastern Slovakia, without informed consent." The Commissioner also found that:

The issue of sterilisations does not appear to concern exclusively one ethnic group of the Slovak population, nor does the question of their improper performance. It is likely that vulnerable individuals from various ethnic origins have, at some stage, been exposed to the risk of sterilisation without proper consent. However, for a number of factors, which are developed throughout this report, the Commissioner is convinced that the Roma population of eastern Slovakia has been at particular risk.

The initiative of the authorities to investigate into the sterilisation practices in the country is welcomed. The Slovak Government engaged in an open and constructive dialogue with the Commissioner concerning this difficult issue. It is also encouraging to note that the Government is considering ways of improving the country's health care system in general, including reproductive health care, and access to it for vulnerable persons, including Roma women in particular.

The Commissioner is concerned about what appears to be a widespread negative attitude towards the relatively high birth rate among the Roma as compared with other parts of the population. These concerns are often explained with worries of an increased proportion of the population living on social benefits. Such statements, particularly when pronounced by persons of authority, have the potential of further encouraging negative perceptions of the Roma among the non-Roma population. It cannot be excluded that these types of statements may have encouraged improper sterilisation practices of Roma women."

On the basis of a lengthy report, the Commissioner recommended the following:

"1. The Commissioner recommends the rapid adoption of new legislation introducing and sufficiently specifying the requirement of free and informed consent for medical acts, including sterilisations, in line with the requirements of international law.
2. The Commissioner recommends the rapid adoption of specific regulations on the patient's right to access his or her medical files, including rules on the delegation of that right.
3. The Commissioner recommends that adequate resources be allocated for measures aimed at improving the health care system, including gynaecological and obstetrical medical services and counselling, and that equal access to health care be ensured for everybody.
4. In the light of the specific circumstances set out in this report, the Commissioner recommends that the Government of the Slovak Republic accept clearly its objective responsibility for failing to ensure that no sterilisations were performed without free and informed consent, as required by international human rights instruments. The Government of the Slovak Republic ought, consequently, undertake to offer a speedy, fair, efficient and just redress.
5. To establish the modalities and criteria for the remedies to be offered to the victims, consideration should be given to the creation of an independent commission. The redress should include compensation and an apology.
6. It should be up to each woman to decide whether she wishes to introduce, continue or, to the contrary, give up the individual claim she may have before the courts, in the light of any alternative resolution mechanism proposed by the Government."

The full text of "Recommendation of the Commissioner for Human Rights Concerning Certain Aspects of Law and Practice Relating to Sterilisation of Women in the Slovak Republic" which was based on a visit to Slovakia and discussions with various stakeholders, including government officials and non-governmental organisations, is available at: Recommendation of the Commissioner for Human Rights Concerning Certain Aspects of Law and Practice Relating to Sterilisation of Women in the Slovak Republic. The Commissioner's investigation was originally undertaken as a result of allegations throughout 2003 by the ERRC and other groups - most notably the Center for Reproductive Rights and the Kosice-based Centre for Civil and Human Rights - that coercive sterilisations of Romani women had been undertaken recently.

On October 29, the Slovak government issued a "Statement by the Government of the Slovak Republic to the Report on the Developments in Allegations of Forced Sterilisations of Roma Women in the Slovak Republic and on Steps and Measures Adopted". This states, inter alia: "[...] a thorough investigation of some sterilisations of women, indeed, confirmed procedural shortcomings. (emphasis added). Therefore the Government has initiated a review of the relevant Slovak medical legislation with a view to its compliance with EU legislation and international obligations of the Slovak Republic. The Government is prepared to organise further training of health care, police, social sector and also public administration staff in order to deepen the humanisation of services provided by them." The statement was issued appended to the "Resolution Of The Government Of The Slovak Republic No.1018 of 29 October 2003 Concerning The Report on Developments in Allegations of Forced Sterilizations of Roma Women in the Slovak Republic and on Steps And Measures Adopted", which includes instructions to the Slovak Minister of the Interior, Minister of Health, Minister of Foreign Affairs, and the Plenipotentiary of the Government of the Slovak Republic for Roma Communities. Notably, the government has not, however, indicated that it is prepared to offer victims of coercive sterilisations redress. The Slovak Government has also failed to provide redress to Romani victims of coercive sterilisation in 2001 and 1992 - following previous official complaints about the practice.

On December 11, 2003, the ERRC sent a letter of the Slovak Government, noting inter alia that the recently concluded official criminal investigation into allegations of coercive sterilisations of Romani women in Slovakia was fundamentally flawed on grounds that: (i) it was conducted almost exclusively into the practices of one hospital; (ii) the investigators focused on the crime of genocide to the exclusion of other crimes related to violations of the right to health care and bodily integrity/autonomy; (iii) the investigation failed to evaluate whether consent, when given, was indeed informed; (iv) human rights activists and possible victims were threatened with criminal charges for speaking out; (v) documented violations were ignored (e.g. even in situations where the Slovak Government expressly confirmed that sterilisations had indeed been performed without any consent, it regardless failed to proceed and provide the victims with redress); and, (vi) finally, the Slovak authorities did nothing in order to address the inherent conflict of interest that exists whenever a Government investigates the wrongdoing of its own agents. The ERRC letter (again) provided the Slovak Government with the relevant international standards on the issue and urged the Slovak Government to re-open the criminal investigation into all allegations of coerced steriliszation of Romani women in Slovakia, to an internationally acceptable standard for a prompt, impartial and effective official investigation. The ERRC letter also urged the Slovak Government to instruct hospitals, by a government resolution or regulation, to allow patients, together with their authorised legal representatives, to have access to their medical files, in-line with international law, and encourages swift amendment of Slovakia's legal order, such that it is brought into line with international standards in the field of reproductive rights and provides all necessary guarantees that the right of the patient to full and informed consent to procedures undertaken by medical practitioners is respected in all cases.



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