Joint Statement of the ERRC, the IHF and the Slovak Helsinki Committee on the Issue of Coercive Sterilizations of Romani Women

10 April 2003

Joint Statement of the European Roma Rights Center (ERRC), the International Helsinki Federation for Human Rights (IHF) and the Slovak Helsinki Committee (SHC) on the Issue of Coercive Sterilizations of Romani Women, on the Occasion of the OSCE Supplementary Human Dimension Meeting on Roma and Sinti

Early 2003 has been marked by widespread public debate surrounding the issue of coercive sterilizations and other extreme human rights abuses in relation to Romani women's health, following the publication of Body and Soul: Forced Sterilization and Other Assaults on Roma Reproductive Freedom in Slovakia, a report by the New York-based non-governmental organisation Center for Reproductive Rights and the Kosice-based Centre for Civil and Human Rights. In recent weeks, U.S government officials have stated that they have raised the issue "at the highest levels" with the Slovak government. In response to questions by the members of the European Parliament on the issue, European Union Commissioner responsible for the Enlargement of the European Union Mr. Günter Verheugen stated, on behalf of the European Commission:

"The Member of the Commission responsible for Enlargement has immediately addressed this issue in a letter to Slovak Prime Minister Dzurinda, underlining that these allegations are a matter of serious concern and if proved to be true, would constitute a serious breach of human rights. He has asked the Slovak authorities to vigorously carry out the necessary investigations, remedy possible discriminatory measures and keep the Commission informed about the proceedings."

Slovak officials have stated that they have opened criminal investigation into the matter.

Field research by the European Roma Rights Center conducted in 2002 and 2003 indicates that there is serious cause for concern with respect to allegations that sterilizations have in the recent past been performed on Romani women in Slovakia absent full and informed consent, as well as in relation to a number of other issues related to Romani women's health in Slovakia. Preliminary research undertaken with respect to Romani women's health issues in the Czech Republic and Hungary indicate that a number of the concerns raised in recent weeks with respect to Slovakia appear to be prevalent also in those countries. In a number of cases, we have established a failure to secure full and informed consent where sterilization or other invasive gynaecological procedure has been at issue. In some cases, women were simply told, after the operation, that they had been sterilized.

  • With respect to Slovakia, on the basis of research conducted throughout Autumn 2002 and in the early months of 2003, the ERRC believes that sterilizations absent full and informed consent continue to be performed on Romani women. The majority of the approximately 200 women whom ERRC interviewed have not been provided with key information of relevance to sterilization procedures to which they have been subjected. In most cases, some form of consent to sterilisation has been registered, but consent has not been to the standard of "informed": misinformation, manipulative information, and pressure have been applied by medical authorities. In many cases, no effort has been made to present clear and understandable explanation to patients referred for sterilization. The high levels of racist animosity documented generally in Slovakia -- and in particular anti-Romani sentiment -- appear to have played a role in the abusive or negligent treatment of women by doctors and nurses. On the basis of independent research, the ERRC believes that dozens of Romani women have in the recent past been victims of violations of their reproductive rights and their rights in the field of women's health. One Romani woman in Slovakia told the ERRC: "While I was on the operating table and under anesthesia, the doctor gave me some papers to sign. I asked what it was and he told me that it was 'something about the child'. I was not able to read what was on the paper because I was not fully conscious at the time. I only found out later that I had signed consent to be sterilised and now I cannot have any more children." ERRC documented dozens of similar statements in Slovakia.
  • With respect to the Czech Republic, on the basis of preliminary research conducted in early 2003 in some localities, the ERRC can discern no qualitative difference between issues raised with respect to Slovakia and preliminary results in the Czech Republic, with the possible exception being that public discourse on the necessity of curbing Romani birth rates appears to be less pronounced. During preliminary field research, ERRC interviewed thirty-six Romani women and documented twenty-seven cases of sterilisation, out of which, twenty-four cases seem to be cases of sterilisation conducted without proper, full and informed consent. Most of the women interviewed were sterilised in 1990s. The ERRC pilot research indicates further that there is significant cause for concern in the Czech Republic regarding other forms of abusive treatment of women by doctors and nurses on grounds of race.
  • ERRC field research in Hungary in recent weeks has documented a range of issues including sterilizations of Romani women absent full and informed consent, racial segregation in hospitals, and racially motivated physical and verbal abuse of Romani women in health care. In March alone, the ERRC interviewed forty-four Romani women and documented nine cases of sterilisation, out of which, four such operations appear to have been performed absent proper, full and informed consent. The ERRC, together with the Legal Defence Bureau for National and Ethnic Minorities (NEKI), is currently involved in litigation on behalf of one Romani woman who was sterilized after having been provided with misleading and/or incomplete information.

At the 1999 Istanbul Summit, the OSCE Heads of State declared that: "We deplore violence and other manifestations of racism and discrimination against minorities, including Roma and Sinti. We commit ourselves to ensure that laws and policies fully respect the rights of Roma and Sinti and, where necessary, to promote anti-discrimination legislation to this effect." In addition, in the Charter for European Security adopted at the same Istanbul Summit the OSCE participating States declared: "We recognise the particular difficulties faced by Roma and Sinti and the need to undertake effective measures in order to achieve full equality of opportunity, consistent with OSCE commitments, for persons belonging to Roma and Sinti. We will enforce our efforts to ensure that Roma and Sinti are able to play a full and equal part in our societies, and to eradicate discrimination against them." In the 1992 Helsinki Document the CSCE participating States "express[ed] their concern over recent and flagrant manifestations of intolerance, discrimination, aggressive nationalism, xenophobia, anti-semitism and racism" and "reaffirm[ed], in this context, the need to develop appropriate programmes addressing problems of their respective nationals belonging to Roma and other groups traditionally identified as Gypsies and to create conditions for them to have equal opportunities to participate fully in the life of society, and will consider how to co-operate to this end."

In line with these commitments and in connection with the issues of coercive sterilizations in Slovakia, a first and most important step is for Slovak government officials to acknowledge the existence of widespread practices of coercive sterilizations of Romani women, and to establish an independent commission of inquiry into the issue. In this undertaking, Slovak officials would be able to draw on experience from other participating OSCE states. Any commission established should include international experts, Roma, and NGOs along with Slovak governmental officials, and its work should be based on the principles of independence, professionalism, and transparency.

In the Czech Republic and Hungary, authorities should thoroughly investigate reported cases of coercive sterilization, and make widely available -- and widely publicised -- procedures for women who believe they may have been abusively sterilized to report the issue. These procedures should ensure privacy rights, as well as rights related to effective remedy.

The ERRC, IHF and SHC are of the view that while the criminal investigations opened by Slovak authorities are necessary, they are by no means sufficient to address the human rights and race issues concerned. Indeed, due to an extreme dependence on the formal existence of a signature as evidence of consent in the legal systems of Central and Eastern Europe, in a number of the cases documented by the ERRC, it is entirely possible that, guided by existing practice, criminal investigation authorities may -- even if investigations are carried out in good faith -- rule that prosecution is unwarranted. The ERRC, IHF and SHC believe that any investigations undertaken should focus not merely on the formal existence of a signature, if the latter exists at all, but also on the circumstances under which it has been obtained, as well as the quality of information provided in order to secure consent.

While justice requires prosecution of all those culpable for coercive sterilizations, it is unlikely that there can be any meaningful change with respect to the issue of coercive sterilisation of Romani women without a range of measures going well beyond criminal prosecution of perpetrators. The ERRC, IHF and SHC are of the view that thoroughgoing policy measures are also required in all three countries to:

  • Establish, in accordance with international human rights standards, adequate safeguards against abuses of the patient's right to informed consent, particularly with regard to medical procedures which may have grave human rights implications;
  • Promote rights culture in health care, among medical practitioners as well as among the public at large.

In the contexts of the recent publicity on the issue of coercive sterilizations in Slovakia, the ERRC, IHF and SCH are also concerned about the role of civil society in documenting and protecting Roma rights.

On January 23, 2003, the Office of Human Rights and Minorities in Slovakia filed a criminal complaint under Articles 221-224 of the Slovak Criminal Code (offences against health) to investigate the coercive sterilization of Romani women. The complaint was based on the allegations contained in the report Body and Soul: Forced Sterilization and Other Assaults on Roma Reproductive Freedom in Slovakiai, published by the Center for Reproductive Rights and the Centre for Civil and Human Rights, and included a conditional clause to investigate the possible "spreading of false rumours" (an offence under Article 199 of the Criminal Code). Although no formal charges have been brought against the authors of this report, this threat against human rights defenders, whether followed by actual prosecution or not, is wholly unacceptable and puts at risk the exercise of fundamental rights such as that of freedom of expression.

The space for political debate and the voice of civil society are both placed under threat when a government acts to silence its critics. As an OSCE member state, Slovakia is committed to "respect the right of everyone, individually or in association with others, to seek, receive and impart freely views and information on human rights and fundamental freedoms, including the rights to disseminate and publish such views and information and respect the rights of everyone, individually or in association with others, to study and discuss the observance of human rights and fundamental freedoms and to develop and discuss ideas for improved protection of human rights and better means for ensuring compliance with international human rights standards" (Copenhagen 1990). This commitment is also in line with the Declaration on the Rights and Responsibilities of Individuals, Groups and Organs of Society to Promote and Protect Universally Recognised Human Rights and Fundamental Freedoms. In addition, in Istanbul in 1999 OSCE member states pledged themselves to enhance the ability of NGOs to make their full contribution to the further development of civil society and respect for human rights and fundamental freedoms.

We urge the Slovak government to publicly ensure that the authors of the report will not be criminally prosecuted in relation to the publication of Body and Soul, and in so doing demonstrate its commitment to respecting the voice of civil society and the contributions of civil society to identifying and ending human rights violations and seeking justice for victims.

By the nature of their work, human rights defenders encounter highly sensitive information that could put themselves, victims or witnesses of abuse or others at risk. Efforts to employ effective safeguards in the handling and dissemination of this information are legitimate and form part of professional conduct of human rights field research. Research of human rights violations is based on the ethical rule that victims' names will not be released without their consent, and that human rights defenders will protect the victims' right to privacy. Victims and witnesses should be protected, as far as possible, from threats and intimidation that could result from disclosure of their names.

Since the release of the report Body and Soul, Slovak government officials have allegedly urged the authors of the report to provide the names of the victims and witnesses whose testimony is included in the report. However, a breech of confidentiality may harm the victims and witnesses interviewed, compromise the professional integrity of the NGOs concerned, and jeopardise trust in the capacity of human rights NGOs to be effective defenders of human rights. In addition to safety concerns, protecting the confidentiality of respondent identity is part of the right to privacy, provided by Article 8 of the European Convention on Human Rights and Article 17 of the International Covenant on Civil and Political Rights. Human rights researchers and other civil society actors may co-operate with official investigations, including by disclosing certain identities, if they are formally constituted as witnesses by a competent authority, where the interests of justice require such co-operation and adequate provisions have been made for the security of those involved or implicated. Particular care is exercised with respect to releasing the identities of victims who are minors.

In view of the foregoing, the ERRC, IHF and SCH urge the Slovak government to refrain from demanding that the authors of the report Body and Soul release the names of their sources.

In Central European countries including Slovakia, the Czech Republic and Hungary, racism and paternalism interact to produce outcomes wherein Roma are treated by medical practitioners as individuals not fully capable or deserving of taking meaningful decisions about their own lives. Romani women's reproductive rights are affected in particular. Given the entrenched and systemic nature of anti-Romani bias in Europe, it falls to the governments of Slovakia, the Czech Republic and Hungary to undertake rigorous, thorough-going and proactive policy measures to end the legacies of intense paternalism and racism in health care, and in particular to stop and redress coercive sterilization practices.


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