ROMA FACE COERCIVE STERILIZATION

"Verging on Genocide" in the Czech Republic?

by Gwendolyn Albert, WW4 REPORT

PRAGUE — For almost two decades now it has been possible for just about anyone from the outside world, including people from the formerly taboo democracies of the "West," to freely visit countries which were once satellites of the former Soviet Union. Indeed, the capital of the Czech Republic, Prague, has quickly become a favorite European tourist destination due to its millennium of preserved architecture. Former dissident Vaclav Havel, the playwright and one-time president, continues to be the main personality on the international stage associated with the country's peaceful transition to democracy.

But NATO and EU memberships notwithstanding, the "transition," as it is referred to here, has failed to correct a grim human rights legacy with regard to the Roma minority—a record which includes the still-unredressed crime of coercive sterilization.

The Roma minority, originally from India and visibly quite different from ethnic Czechs and other "white" Europeans, has been living on European territory for almost a thousand years. Their history is one of intense persecution, including a period of being owned as chattel slavery in what is now Romania from the 14th century through the mid-19th century. During the Nazi era, Czech Roma were 95% exterminated from the "Protectorate of Bohemia and Moravia," which covered roughly the same geographical area as today's Czech Republic. Today, open and proud "anti-Gypsyism," manifested by political leaders and the ordinary people who elect them is a fact of life in the Czech Republic which human rights advocates have been attempting to address for more than a decade now.

Where the Roma are concerned, "democratization" has yet to reach social welfare, child welfare or the housing policies of hundreds of towns across the country. Discriminated against in almost every area of life and all but completely sidelined from the prosperity the country enjoys, members of this community more than any other find themselves dependent on the state and on local authorities—which continue to subject them to the kind of invasive control of their personal lives for which totalitarian Czechoslovakia and other Soviet bloc states were once infamous. Tthe transition to democracy and a market economy has brought Roma in the Czech Republic little but further degradation. The 1990s saw a rush of Czech Roma emigration to Canada and the UK as a result.

Roma in the Czech Republic face pervasive racism—racially segregated housing and forced evictions; segregated education in which Romani children are disproportionately sent to schools for the mentally disabled, resulting in high illiteracy levels; and the disproportionate placement of Romani children into state care. Romani parents who are deprived of their parental rights, purportedly due to poverty, are still paradoxically required to bear the costs of maintaining their children in institutional care and can face prosecution for failing to meet their parental responsibilities. Roma face an exclusion from most employment even should they attain education, and are a frequent target of skinhead violence. Despite these abuses, there is no anti-discrimination legislation in place—for which the European Commission may soon sanction the Czech Republic.

This is the context for an ongoing campaign of coercive sterilizations of Romani women, which has been in place for decades—starting in the late 1950s, and with cases reported as recently as 2004.

Since the late 1970s, human rights advocates have been sounding the alarm that doctors in both the former Czechoslovakia and the present-day Czech Republic have been sterilizing Romani women without their informed consent. It was not until the year 2005 that an in-depth investigation into specific cases was conducted by the Czech Health Ministry. The results of the investigation were reviewed by the country's human rights oversight body, the Czech Public Defender of Rights (also known as the Ombusman), after coercive sterilization survivors complained to the body. On Dec. 29, 2005, the Public Defender issued its "Final Statement of the Czech Public Defender of Rights on the Matter of Sterilizations Performed in Contravention of the Law and Proposed Remedial Measures," which concluded that "the problem of sexual sterilization carried out in the Czech Republic either with improper motivation or illegally, exists, and Czech society has to come to terms with this."

Despite the Public Defender's ground-breaking acknowledgement of these human rights violations, Czech officials have yet to make any public statements on the matter.

Since the 1970s, when the practice was official policy in what was then totalitarian Czechoslovakia, hundreds of Romani women have been coercively sterilized. In some cases, the patient's consent was never provided to the sterilization at any time. There are also cases in which signed "consent" was obtained from a patient who was in an advanced stage of labor or shortly before Caesarian delivery of a child—i.e., under circumstances in which the patient was under intense stress. There are cases in which "consent" was provided without a real understanding of the terminology used, or absent explanations of the permanent consequences of sterilization. There are cases in which social workers pressured Romani women to undergo sterilization either by offering financial incentives or threatening sanctions (withholding of benefits, taking children into state care, etc.).

In short, the sterilizations have occurred either entirely without the consent of the person concerned, or by applying standards of consent divergent from those required under international law as "fully informed." The European Convention on Human Rights and Biomedicine (ECHRB), Article 10 (2), states that "Everyone is entitled to know any information collected about his or her health." This right is reinforced in the World Health Organization (WHO) Declaration on Patients' Rights, Article 4 (4), which states that "Patients have the right of access to their medical records and technical records and to any other files and records pertaining to their diagnosis, treatment and care and to receive a copy of their own files and records or parts thereof."

As the European Roma Rights Center (ERRC) noted in its March 2007 "Shadow Report" on the issue to the United Nations Committee for the Elimination of Racial Discrimination: "These practices potentially implicate the Genocide Convention and are to be regarded with the utmost gravity." Article 2 of the Genocide Convention states: "In the present Convention, genocide means any of the following acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such:… (d) Imposing measures intended to prevent births within the group."

Under the Communist regime, the sterilization of Romani women in order to bring their rate of reproduction to parity with the Czech birth rate was part of a larger state policy promoting sterilization as a birth control method. Following the termination of this policy in 1991, a number of doctors have apparently acted illegally to continue the practice. At a press conference releasing the Ombudsman's Final Statement, Deputy Ombudsman Anna Sabatová, (herself a Charter 77 signatory and former dissident who was periodically imprisoned by the communist regime along with most of her family members) said the investigation had revealed "fully deformed praxis in the Czech medical community" with regard to these procedures.

With only rare exceptions, all of the persons who have come forward to complain of this treatment so far have been Romani women. Pages 23-58 of the Ombudsman's Final Statement note that "a group of Charter 77 signatories had pointed out the use of sterilization…as early as 1978, at the time of the most active implementation of the state assimilation policy towards the Romani minority, labeling it without hesitation as a technique on the verge of meeting the attributes of genocide."

The Statement also notes: "It would be wrong to believe that the relation of the pre-November [1989] Czechoslovakian state [policy on the] Roma was random, uncontrolled, and lacking co-ordination." Further: "What should be primarily condemned … is that the state-controlled social services set itself controlled birth rate curbing in the Romani community as one of its socio-prophylactic and unconcealed eugenic measures (see the constant references to improving the quality of population) and that for this purpose it developed practical administrative procedures leading in individual cases as far as the legally and morally dubious persuading of women to undergo sterilization, i.e. a virtually irreversible intervention..."

So far the perpetrators of these crimes have enjoyed total impunity. This is due both to the high level of contempt for the Roma in the Czech Republic and to the fact that Czech officials have failed to adopt necessary safeguards for patients' rights in general.

The Ombudsman also requested criminal investigations into the coercive sterilization complaints. To date most of the criminal charges filed have been dismissed by the police out of hand—including cases which require no particular "expertise" in order to decipher the nature of the illegality concerned. After all, when the law requires a hospital sterilization commission to pre-approve sterilizations, and a sterilization is performed before approval, there should be no doubt that the law has been broken. The Czech police, however, can't quite see it that way.

In another case, an "expert" on medical procedure who was contacted by the police to evaluate the evidence characterized the victims as having been "irresponsible" for not voluntarily agreeing to the sterilization.

The Ombudsman recommended the state institute a reparations procedure for persons who were sterilized up until 1991, when the state policy promoting sterilization was rescinded, and that those sterilized since 1991 try to access justice through the courts (this in a country with no state-supported legal aid system).

Most human rights advocates see the matter differently and believe all of the victims, regardless of the point in time at which they were sterilized, should be apologized to and compensated by the state—and at least one UN committee agrees with them.

In August 2006, the United Nations Committee for the Elimination of Discrimination Against Women issued the following recommendations as part of its regular periodic review of the Czech Republic's compliance with the CEDAW Convention:

Recommendation 23: The Committee is particularly concerned about the report, of December 2005, by the Ombudsman (Public Defender) regarding uninformed and involuntary sterilization of Roma women and the lack of urgent Government action to implement the recommendations contained in the Ombudsman's report and to adopt legislative changes on informed consent to sterilization as well as to provide justice for victims of such acts undertaken without consent.

Recommendation 24: The Committee urges the State party to take urgent action to implement the recommendations of the Ombudsman/Public Defender with regard to involuntary or coercive sterilization, and adopt without delay legislative changes with regard to sterilization, including a clear definition of informed, free and qualified consent in cases of sterilization in line with the Committee's general recommendation 24 and article 5 of the European Convention on Human Rights and Biomedicine; provide ongoing and mandatory training of medical professionals and social workers on patients' rights; and elaborate measures of compensation to victims of involuntary or coercive sterilization. It also calls on the State party to provide redress to Roma women victims of involuntary or coercive sterilization and prevent further involuntary or coercive sterilizations. The Committee requests the State party to report on the situation of Roma women pertaining to issue of coercive or involuntary sterilization, in its next periodic report, including a detailed assessment of the impact of measures taken and results achieved.

The UN Committee for the Elimination of Racial Discrimination, which reviewed the Czech Republic in March 2007 issued its own recommendation:

The State party should take strong action, without further delay, to acknowledge the harm done to the victims, whether committed before or after 1991, and recognize the particular situation of Roma women in this regard. It should take all necessary steps to facilitate victims' access to justice and reparation, including through the establishment of criminal responsibilities and the creation of a fund to assist victims in bringing their claims. The Committee urges the State party to establish clear and compulsory criteria for the informed consent of women prior to sterilization and ensure that criteria and procedures to be followed are well known to practitioners and the public.

Despite the urgent tone of these communications and the relatively large media impact in the Czech Republic of the CEDAW recommendations in particular—which were preceded by testimony at the UN from one of the victims—the Czech government has maintained silence on this issue. There is therefore no guarantee whatsoever that right now, in some medical facility in the middle of Bohemia or Moravia, another Romani woman is not being subjected to this very same treatment at the hands of the medical professionals to whom she has entrusted her health.

It is tempting, when trying to place this disturbing information in context, to associate this behavior on the part of the Czech medical profession with the legacy of the Nazi era and the country's communist past, but this would be an oversimplification. The fact is that state-sanctioned sterilizations of minorities (whether based on ethnicity or disability) are not unique to the Czech Republic. In the post-WW II era, complaints of such practices have been made in Australia, Canada, China, Estonia, Finland, Hungary, Iceland, India, Japan, Norway, Panama, Peru, Slovakia, the former Soviet Union, Sweden, Switzerland, the UK, and 33 of the United States of America.

In other words, regardless of political regime, culture, or geographical location, the medical profession itself seems to have regularly become the willing instrument of what can only be considered eugenics of the crudest sort. In the context of the "fourth world," such practices have had a profound impact on indigenous and minority communities worldwide.

International recognition of the global reach of these crimes, performed upon anaesthetized victims in the silence of the operating theater and leaving no easily discernible traces, has yet to be properly achieved. Coercive sterilization victims have rarely if ever been compensated, and the perpetrators of these crimes have been punished even less frequently. To date, only Norway and Sweden have instituted reparations programs for coercive sterilization victims.

The human rights community needs to review the facts of the last 60 years, recognize the worldwide scope of this ongoing practice, and hold medical practitioners and the states that oversee them accountable for these violations of human dignity.

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Gwendolyn Albert, a US citizen, is a permanent resident of the Czech Republic, a member of the Czech Government Human Rights Council representing civil society, and Director of the Women's Initiatives Network at the Peacework Development Fund.

http://www.peacework.org