In Zimbabwe, HIV-positive mothers and soon-to-be mothers were once forced to undergo sterilisation. In the name of saving lives, the procedure was seen as the only prevention of transmitting HIV to their unborn or newborn babies. Now the tides have turned. Thanks to new ways of preventing transmission, mothers have higher hopes for healthy babies. What's more, some sterilised Zimbabwean women are now seeking compensation from the government.
"When I fell pregnant, knowing that I was HIV-positive, I went to the doctor seeking counselling. But at that time, because I had no information and most probably my doctor did not have information, I was told the best way to go was sterilisation," says Tendayi Westerhof.
The woman was sterilised in the early 1990s. Today she feels duped and is seeking compensation from the government for what she has been through. "Now I cannot bear children anymore, unlike if I had been given choices," she says. "Even if I was HIV-positive, I had a right to give birth to a healthy child, and ... there were other choices that I could make."
Westerhof's case is not an isolated one, and it is believed that there are a lot of HIV-positive women who were sterilised without consent. Affected mothers were commonly told that if they gave birth, they would deliver HIV-positive babies. Most of the sterilisation cases occurred in Zimbabwe between 1985 and 2004, even well after the mid-1990s advent of the prevention of mother-to-child transmission (PMTCT) programme. The procedure was done in both private and public healthcare centres.
Westerhof, who is still using the surname of her ex-husband, Dutch football coach Clemens Westerhof, is involved in the Pan-African Positive Women's Coalition (PAPWC). The organization represents women living with HIV and is now documenting such cases in Zimbabwe to establish the actual number of sterilisation victims. The coalition plans to take their evidence to the courts, demanding compensation from the government.
"We have seen an increase of women leaving with HIV being coerced into sterilisations in the region and we assume that the same is happening to other poor women as well. To us this is a real challenge. We are assisting women in the region to make sure that their rights to giving birth despite being HIV-positive is observed and respected," says Promise Mthembu, regional coordinator of the International Community of Women Living with HIV/AIDS.
Her organization has been involved in documenting evidence of sterilised HIV-positive women, since 1998 when Mthembu initiated an investigation in Namibia. But not everyone supports the cause. The head of the HIV and AIDS and Tuberculosis in the Ministry of Health and Child Welfare, Owen Mugurungi, denies that the government adopted sterilisation as a method of eliminating HIV transmission from mother to child.
"As a country, we never at any point recommended sterilisation, never. Sterilisation was used as an option of family planning methods through the consent of the concerned part. For example, it was used in a situation where a mother has four or five children and later finds out that she has contracted HIV. The mother was asked to take it as a way of family planning," Dr Mugurungi told Radio Netherlands Worldwide.
Saying he was busy, Dr Mugurungi could not give further comments.
Meanwhile, prevention of mother-to-child transmission is proving very effective. The treatment involves a long course of antiretroviral drugs and the avoidance of breastfeeding, which reduces the risk to below 2 percent. According to the World Health Organization, since 1995, when PMTC was introduced, hundreds of thousands of children around the globe have avoided acquiring HIV infection because of antiretroviral prophylaxis.
"When married, I will use the PMTCT to deliver a healthy baby," says Judith Feremba, who lives with HIV and is planning a December wedding. "It is very possible for me to have a healthy baby because of the availability of information. Personally, I am confident that I can get pregnant and deliver a healthy baby. I appreciate that it was difficult for us to get pregnant before PMTCT was introduced as we had no information."
Rosa Chimbindi is another living example of the potential benefits. She recalls her experience with the programme, saying: "I am an HIV-positive mother who got pregnant and gave birth to a healthy baby in 2008. When I gave birth I did not breastfeed my baby, because of education on PMTCT which was given to me by health care officials. I did not breastfeed her, fearing that she might contract the virus. I got my baby tested for HIV and was found negative."
Chimbindi adds: "As we speak, my baby is healthy."