¿Family Planning? (english)2023-08-03T18:19:28+00:00

¿FAMILY PLANNING?

Attitudes toward family planning and population control

We present the results of the first national opinion survey on family planning, birth control and forced sterilizations carried out between 1996 and 2000.

Project Directors: Alejandra Ballón, Ana Muñoz, and Natalia Sánchez Loayza | Translator: Lucía Stavig | Graphics Editor: Alejandra Ballón | Editors: Alejandra Ballón, Ana Muñoz and Natalia Sánchez Loayza | Photographers: Tadeo Bourbon and Liz Tasa | Designer Gonzalo Gamboa

HERE you can read the complete edition that has been made based on the national survey of the Instituto de Opinión Pública of PUCP

–Foto de Tadeo Bourbon–

Little pills of Panadol/Tylenol

–By Alejandra Ballón–

In today’s Peru, women are fighting an arduous battle to have the right to decide over their own bodies. They are demanding that the state provide intercultural sexual education and that this education include a focus on gender to prevent violence against women. Even within this context, and despite the thousands of forced sterilizations that took place during the 1990s under the National Program of Reproductive Health and Family Planning (the PNSRPF 1996-2000), a little over 50% of those surveyed believe the Peruvian State should introduce a policy to limit the number of children a family can have. In 1997, Yolanda was the mother of seven children. Neither she nor her husband desired more children. Because of this, when Olga, the health promote from the town of Shumanza, told Yolanda that the Peruvian State was “supporting women,” through a free campaign to not have more children, she didn’t think twice. Yolanda had wanted to work and contribute to the family income. Olga explained, “when you decide you want more children you can. This surgery is just to tie your tubes, not to cut them.” Yolanda and her husband trusted Olga. Yolanda underwent surgery despite not having undergone any pre-operative exams. She was paralyzed after the operation and was bedridden in the Juanjuí Hospital in San Martin for 23 days. Olga never visited her again; once she met the State’s quota, she disappeared. Yolanda remembered painfully how the healthcare personnel only gave her “little pills of Tylenol” to help calm her pain.

–Foto de Tadeo Bourbon–

An unbearable question

–By Ana Muñoz–

The question is disquieting in and of itself. The need to ask whether “all couples should have the absolute freedom to decide how many children to have and when” should cause us the same discomfort as asking whether oxygen should continue to go untaxed or whether tomorrow will be a new day. When fundamental rights are placed under the microscope of public opinion it is time to sound the alarm, ring the bells, batten down the hatches, brace ourselves against the cold, and take to the streets to repeat, as many times as necessary, that our bodies belong to us women. Nevertheless, for some people, albeit only a few, this fact is not self-evident: 16% of those interviewed selected “disagree” or “strongly disagree” that a woman’s body belongs to her.

–Foto de Liz Tasa–

Because she’s a woman

–By Alejandra Ballón–

63% of those surveyed believe the burden of contraceptive use should not fall on women alone, and they are right. Nevertheless, according to Ombuds Report No. 69, the Peruvian State sterilized 272,028 women (at least 18 of which died), and 22,004 men during the PNSRPF. There can be no doubt that the program actively discriminated on the basis of gender. Of those sterilized, 93% were women while only 7% were men. There is no medical argument that could justify the flagrant prejudice evidenced by these statistics. The medical personnel charged with recruiting people to sterilize thought women would be easier to deceive. Moreover, they thought that come time for the procedure, women would be less likely to physically resist. This is precisely what happened in the Native community of Patria Nueva in Loreto. Nurses came to visit Norma and lied to get her to come with them. They took her to Pucallpa by boat and to the hospital by mototaxi. There, they spoke Spanish though Norma only understood Shipibo-Conibo. When they tied her hands, she bit through the rope and ran despite already having been anesthetized. But her efforts were to no avail. The nurses trapped her and injected her with more anesthesia until she fell unconscious.

Source: Public Opinion Institute | Instituto de Opinión Pública

–Foto de Tadeo Bourbon–

Equally

–By Natalia Sánchez Loayza–

Unlike the previous question, this one asks those surveyed to consider whether the State should have the power to impose the use of contraceptive methods. Almost half of respondents agree that the state ought to be able to exert control over all bodies. Between March and August of 1997, the ex-Minister of Health, Marino Costa Bauer, wrote letters to ex-President Alberto Fujimori updating him on the progress made toward realizing the goals of the PNSRPF. In his April letter, he asked forgiveness for not having met the monthly goal of Surgical Sterilizations set in March. In May, he informed Fujimori that the number of procedures in April represented a 120% increase over the 1996 figures. In June, Costa Bauer reported that in one month alone, they had increased the number of Contraceptive Surgeries (CS) by 36%. In July he wrote, “in keeping with what we predicted,” the increase in procedures was holding steady and that the “ongoing coordination/cooperation” with the armed forces and police was making this possible. How is it possible to “predict” the decision of thousands of individuals whether or not to have children, when to have them, how many to have, using what medical tradition? That preexisting quotas and goals foreclosed the possibility of choice evinces this program’s criminal nature.

1. In official documents, the surgeries used to sterilize both men and women were called Voluntary Contraceptive Surgeries (VCS). However, this is neither a technical term nor does it reflect the reality faced by thousands of men and women who did not submit to sterilization voluntarily.

–Foto de Liz Tasa–

Will

–By Alejandra Ballón–

Conclusive evidence indicates that more than 80% of those surveyed believe the Peruvian State should introduce policies that enable families to voluntarily plan the number of children they desire to have. Here we run into a problem, for this is exactly what ex-president Alberto Fujimori and his ex-ministers say the PNSRPF did. However, thousands of affect campesinas know very well that reality is not the same as discourse. The scars on their bellies are evidence of the abysmal gulf between word and deed, choice and quotas. So how can the Peruvian State introduce a series of public policies addressing reproductive health and family planning with the social tragedy of forced sterilization still weighing heavy on its shoulders? If the public were aware of the disquieting details of the PNSRPF, a program that took a genocidal turn in indigenous communities, would they trust the State?  Many of the women sterilized without their rightful consent never trusted again, especially those women who are descendants of First Nations and who lived in Native communities or communities far away from modern conveniences. These women’s first exposure to state hospitals was their sterilization. This has been their only experience of the public health system. These women bear witness to the fact that the same doctors and nurses who destroyed their life projects continue to work in the health centers where their fundamental rights were violated with impunity.

–Foto de Tadeo Bourbon–

A concise analysis

–By Ana Muñoz–

Eight of every ten people interviewed believe the Peruvian State ought to carry out campaigns to disseminate information on the proper use of multiple contraceptive methods among both men and women. However, to “disseminate” does not mean to impose. Likewise, “to ensure proper use” implies to make something serve its proper purpose. It does not mean to modify our bodies against our will. “Diverse contraceptive methods” suggests the availability of a variety of methods to prevent conception, and that no one method will be privileged over another. Finally, “among men and women” implies that all people are to be equal recipients of these informational campaigns. The National Program of Reproductive Health and Family Planning (the PNSRPF 1996-2000) failed to fulfill each and all of these premises.

Source: Public Opinion Institute | Instituto de Opinión Pública

–Foto de Tadeo Bourbon–

Hypocrisy

–By Ana Muñoz–

“Thus, the State will promote (policy?) which enables poorer families with lower levels of educational attainment to have the same access to family planning options as higher-class families. It would be hypocritical to ignore the fact that different methods are offered based on class,” said Fujimori in 1995. He continued, “The just thing to do is to distribute, I said thoroughly distribute, family planning methods.” It is striking, if not chilling, to realize that after calling attention to this hypocrisy, Fujimori went on to commit an even bigger one. “Thoroughly distribute” not in some far of future but immediately. And it is alarming—though not as much after having read the previous questions—to observe that six out of every ten people believe that poor families should have fewer children than more affluent ones.

–Foto de Tadeo Bourbon–

To Form a Familiy

–Por Natalia Sánchez Loayza–

The question is a geographic one and the results are diametrically opposed: 44% agree and 37.2% disagree.  Does getting to have a family depend on where one lives? Reviesfo enrolled 7,022 people between January 2016 and November of 2018. Even if the Reviefso does not specify which victims come from urban areas and which from rural, it does disaggregate results by region. Of the 7,022 people who denounce having been sterilized against their will, 4,868 are from the Andes, and 1,360 are from the Amazon. Of the more than seven thousand sterilized, only 11.3% come from the Coast. In the 19990s, being sterilized or not was undeniably determined by where one lived.

–Foto de Tadeo Bourbon–

Peniaphoia: Fear of the Poor

–By Alejandra Ballón–

Alberto Fujimori installed an autocratic, corrupt, and criminal government, a breeding ground for the neoliberal policy. Within the context of this new neoliberal economy, the government implemented neo-Malthusian population control programs to meet financial goals at the cost of human rights. His government had not even taken power when Fujimori declared 1991 the “Year of austerity and family planning.” His populist discourse fomented a fear of poverty, and by extension, the poor. Through this discourse, he was able to paint “family planning” as a “war against poverty.” The programs were announced and portrayed as “voluntary.” It was argued that the family planning program would help lift families out of poverty. The World Bank lent Peru $150 million to carry out the program, which they predicting that lowering the fertility rate by 2.5% would increasing the GDP. However, we now know that the departments most affected by the PNSRPF (Huancavelica, Ayacucho, Cusco, Apurímac, Puno, San Martín, Cajamarca, Piura y La Libertad), found themselves even deeper in poverty at the conclusion of the program. Many sterilized women stopped working their fields and were unable to fulfill their household duties as before due to the severity of the injuries sustained during their sterilization. They also had to bear the cost of these post-operative illnesses. Thus, the departments that saw the most Contraceptive Surgeries did not experience the favorable economic outcomes the program—which was designed to be a poverty alleviation scheme—promised.

Source: Public Opinion Institute | Instituto de Opinión Pública

–Foto de Liz Tasa–

Half

–By Ana Muñoz–

More than half of those surveyed believe that families should have the freedom to determine how many children they want to have. However, less than half believe families with sufficient economic resources should be the only ones to exercise this freedom. This would seem to indicate that almost all people surveyed think that families should have the freedom to plan their families. Nevertheless, when economic factors were introduced into the question, many of those surveyed put limits on that freedom. Not the majority of those surveyed, but close to it: four of every ten people surveyed. That is, almost one out of every two surveyed believe that only those people who can afford children should have them, a belief which inscribes capitalism into the body, specifically the bodies of women.

–Foto de Tadeo Bourbon–

Resistance in the Amazon

–By Natalia Sánchez Loayza–

The majority of those surveyed would be on board with implementing drastic population control policy in Native and First Nations communities in the Amazon. In her report entitled “Nothing Personal,” lawyer and researcher Giulia Tamayo recounts the details of a Contraceptive Surgery Campaign that took place in San Lorenzo in October of 1996.  During the campaign, health personnel were charged with capturing eight to nine people per month. “Our source testified that it was impossible to meet this goal. Even though they informed the authorities of this, they did not reduce the goal,” Tamayo reported. “We only were able to get one or two. Mostly mestiza women were sterilized, but some women from indigenous communities were also sterilized. The community fought back, which reduced the number of tubal ligations,” said Tamayo’s source. A sterilized woman from San Lorenzo corroborated the story: “The campaign took place from San Lorenzo to Saramiriza. Doctors from outside the community came and sterilized twenty women. During the campaign, health personnel made house calls to convince women to undergo tubal ligation. Because one or two people died as a result of the procedure, the community resisted.” According to Tamayo, the Native Organization confirmed these events, stating that the capture of women from their communities to be sterilized undercut the willingness/ability of health personnel to attend to the population’s most basic health needs.

–Foto de Tadeo Bourbon–

Drastic Control

By Natalia Sánchez Loayza–

In the previous questions, the majority of those surveyed agree that the poor families (47.7%) and rural families (44%)should have fewer children. These opinions seem to inform the following opinion: 57.2% of those surveyed agree or strongly agree that a drastic population control program should be implemented in the poorest regions of the Andes. The PNSRPF was of the same opinion. In Huancavelica, the poorest department in the Andes and all of Peru, 6.95% of all women in the target population were sterilized. By October 2017, only two years into its tenure, the Registry of Victims of Forced Sterilization (Reviesfo) had registered 766 women from Huancavelica, and another 896 awaited enrollment. These 1,662 women whom Reviesfo was able to interview represent more than 47% of all women sterilized in Huancavelica during the PNSRPF. That is, in only two short years, working with far more limited resources than those enjoyed by the PNSRPF, Reviesfo has been able to collect the testimonies of almost half of all women sterilized. All of these women have said that they were forced to undergo the procedure, that they didn’t know what was going to happen, or that they simply said “no”.

2 According the PNSRPF manual published in 1996, women over the age of 25 and within their fertile years (up to 49 years of age) could be sterilized. The number of women within this age range was determined from the 1993 census.

–Foto de Tadeo Bourbon–

Disdain

–By Alejandra Ballón–

The systematic and mass forced sterilization committed by the Peruvian State under the auspices of the PNSRPF constitutes the gravest violation of women’s rights on the continent since the Colonial era. The magnitude of the program was such that 80% of those surveyed had at least heard of it. However, it is surprising that only 9.5% report to know a lot about the issue. Disdain, however, perfectly explains this gap, along with a series of realities rooted in our social history. In our country, there is a femicide every 48 hours; racism is an everyday occurrence; poor women are stigmatized as mothers of future terrorists; and our corrupt politico-judicial system goes woefully unchecked. Decades have passed and up to now, not one military official has been charged/convicted of mass rights violations. Neither have any of the political masterminds behind the forced sterilizations that occurred during the internal armed conflict. So why should this statistic surprise us? What does startle us is the society we see peering through these statistics. On the one hand, urban dwellers’ indifference toward the predicament of rural women is monumental. On the other, their access to information is almost utopic. Because of this, it is likely that urban people know much more about the issue than rural folk, although the latter have been more broadly affected by it. What is really surprising, however, is that women know less about the issue than men. But again, we know that access to education and information is far more limited for women.

 

–Foto de Tadeo Bourbon–

House calls to Ancón and Paracas

By Natalia Sánchez Loayza–

In 2002, a Congressional sub-commission released a the “Final Report concerning the Voluntary Surgical Sterilizations between 1990-2000”. In this report, Joo Luck, ex-Regional Director of Health for the constitutional province of Callao recounted a story. At the beginning of his second term, Alberto Fujimori invited the directors from thirty-four Public Health Directorates to a beachfront dinner. After they finished their supper, Fujimori invited them to walk the beach of Ancón with him, which lies on the coast of Lima. All of them listened enraptured. They knew it was a unique situation, for it was quite rare for a president to meet with seventh or eight rung public functionaries. All of them knew, according to Joo Luck, that this was the perfect opportunity to lobby the Minister of Health, Dr. Yon Motta, who was also present on the beach that, for their region’s health needs. Testifying before the Peruvian Congress, ex-Congressman Roger Guerra García would go on to describe this meeting in almost the same terms. He testified that there were at least one hundred people present, among which were Regional Directors of Health, as well as officials from Social Security and the Armed Forces. He also testified that during this meeting, Fujimori announced that 200,000 women were to be sterilized every year henceforth. Guerra García further that a follow-up meeting was held the next year in Paracas to analyze the results of the program, and to honor and reward the most successful sterilization centers—that is, those centers that had realized the most sterilizations.

–Foto de Liz Tasa–

Sterilize, Help, Improve

–By Ana Muñoz–

On the one hand we have women’s bodies. On the other, the household economy, the smallest unit of patriarchal capitalism. “Women are the most important human resource   because they use all resources in the most rational manner. They are capable of managing small economies and micro-economies to produce goods and services with the greatest efficiency,” Alberto Fujimori announced to the nation on July 28th, 1995. Here he placed women and economics on a continuum. On one extreme, lay wombs that menstruated, conceived, and gave birth. On the other, lay minds that governed the household, paid off debts, mopped the floor, saved when they could, and made sure that family expenditures did not exceed income. On one side of the continuum lay the cause, on the other the problem, and in the middle an inhumane solution: “Sterilizing poor women would help improve their family’s economic situation.” This was a policy that sterilized women’s bodies instead of “helping” and “improving” the economy to nourish those bodies.  It’s a dystopic non-fiction in which the law of the market lords over the uterus. But wombs do not submit to the logic of economy. They have their own logic, their own cycles, once a month.

Motivation

By Natalia Sánchez Loayza–

The program that sterilized hundreds of thousands of Peruvian women took place during Alberto Fujimori’s second term, between 1995 and 2000.  From its inception, the program was criticized for attempting to reduce poverty through population control among the poor, which involved controlling women’s bodies.  Fujimori himself denied that this was so. During his swearing in ceremony on July 28th1995, he indicated that the program put forth would be based on informed family planning: “Peruvian women should be the owners of their destiny!”  Six days later, as the only male head of state to attend the International Women’s Conference in Beijing, Fujimori made the following proclamation:  “Ladies and gentlemen, we have been accused of wanting to mutilate and kill poor people because we recently passed a law that adds voluntary, v-o-l-u-n-t-a-r-y, vasectomies and tubal ligations to the legal forms of contraceptives. My government has decided, in conjunction with other social development policies in the war against poverty, to develop a holistic family planning program to allow women to decide what is best for them with total autonomy and liberty!”  Despite the existences of current and sufficient proof proving the massive effort undertaken to forcibly sterilized women, Alberto Fujimori has always denied that this was his motive. Unlike Fujimori, however, 50.8% of those surveyed openly admit that they would be in favor of sterilizing the nation’s poorest women in order to reduce poverty in Peru.

HERE you can read the full edition