International Human Rights Settlement Expected to Improve Women’s Access to Reproductive Health Care in Peru

Policy Changes Come After Coerced Sterilization Case that Ended in Death

Yesterday, the government of Peru signed an agreement before the Inter-American Commission on Human Rights (IACHR) that should bring about sweeping changes in Peru's reproductive health policies, and improve women's access to family planning and reproductive healthcare. In a landmark settlement involving the case of a woman who died after being coercively sterilized, Peru agreed to modify discriminatory legislation and policies including those that fail to ensure women's rights as autonomous decision-makers. Though settlement negotiations were concluded last year, former Minister of Health Fernando Carbone refused to sign the agreement. During his tenure, Carbone was heavily criticized for refusing to provide poor women with contraceptives, opposing emergency contraception and spreading misinformation about condom use. He resigned as Minister of Health earlier this summer.

"This agreement has broad implications for the reproductive freedom of Peruvian women," said Luisa Cabal, Legal Adviser for Latin America and the Caribbean at the Center for Reproductive Rights, a co-petitioner in the case. "By signing this agreement, Peru has committed itself to immediately improving the quality of reproductive health care. We hope the government will take this obligation seriously," added Cabal.

The agreement comes after an international legal battle against the Republic of Peru involving the case of Maria Mamerita Mestanza Chavez, who died in April 1998 from complications after being coercively sterilized. The Peruvian government agreed to the settlement on October 14, 2002, which recognized its international responsibility for violating the victim's human rights. The rights violated included, among others, the right to life, to physical integrity and humane treatment, to equal protection of the law, and to be free from gender-based violence.

"This agreement is very important for international human rights law, helping create precedent for future cases where reproductive rights violations occur in Latin America and around the world," said Maria Clara Galvis, Staff Attorney with the Center for Justice and International Law.

The Mestanza case was filed with the IACHR in 1999 after domestic legal remedies in Peru had failed. Mrs. Mestanza, a low-income, indigenous Peruvian woman, was coerced into agreeing to sterilization by government officials and was repeatedly denied follow-up medical care when complications ensued. She died from post-surgical medical complications seven days after her surgery.

In the settlement agreement signed today, the Peruvian government agreed to pay moral damages to Mestanza's husband and seven children, as well as significant compensation for their health care, education and housing. The government also agreed to conduct an in-depth investigation and to punish those responsible for the violations of Peruvian and international legal standards.

Of most significance to the women of Peru, the government agreed to modify discriminatory legislation and policies and to promptly implement the recommendations made by Peru's Human Rights Ombudsman. The Ombudsman's recommendations include:

  • improving pre-operative evaluations of women being sterilized;

  • requiring better training of health personnel;

  • creating a procedure to ensure timely handling of patient complaints within the health care system; and

  • implementing measures to ensure that women give genuine informed consent, including enforcing a 72-hour waiting period for sterilization.

Mestanza's case was part of a pattern of coercive sterilizations-a few leading to death, as in this instance-that occurred primarily between 1996 and 1998 during the regime of President Alberto Fujimori. The Center for Reproductive Rights, the Latin American and Caribbean Committee for the Defense of Women's Rights (CLADEM), and the Flora Tristan Women's Center first documented various forms of violence against women perpetrated in Peru's public health care facilities in 1996-97 in Silence and Complicity, a report released in 1998. The Human Rights Ombudsman subsequently investigated and affirmed that such violations were occurring as a result of governmental policies. In July 2002, the current Peruvian government apologized for the violations of the predecessor government.

Joining the Center for Reproductive Rights in the petition to the IACHR on the Mestanza case was Estudio para la Defensa de la Mujer (DEMUS), CLADEM, the Asociación Pro Derechos Humanos (APRODEH), and the Center for Justice and International Law (CEJIL).