The Case of Celia Ramos: Seeking Justice for Women Forcibly Sterilized Under Peru’s Fujimori Regime

In Peru during the 1990s, thousands of women—primarily Indigenous women, rural peasants and women living in poverty—were forcibly sterilized as part of a State policy implemented by the regime of Alberto Fujimori.

Among those women was Celia Ramos, who died in 1997 after undergoing surgical sterilization without her valid consent at a local medical outpost in Peru.

On May 22, the Center for Reproductive Rights and its partners will be arguing the case of Celia Ramos at a public hearing before the Inter-American Court of Human Rights (IACtHR) in Guatemala City. It will be the first-ever case addressing Peru’s forced sterilization policy brought before the IACtHR, which is the highest human rights court in the Americas.

“Forced sterilizations were acts of power against the bodies of the most vulnerable women in Peru,” said Catalina Martínez Coral, the Center’s Vice President for Latin America and the Caribbean. “But above all, they were a form of reproductive violence that, through action or omission, nullified the freedom of thousands of women to make individual and deeply personal decisions about their motherhood, and replaced it with the dictates of state power.”

The Center and its partners are seeking recognition by the IACtHR that forced sterilization is a violation of human rights as a form of reproductive violence and gender-based violence.

Specifically, the Center and its partners are asking the IACtHR for:

• Truth, justice and reparations for Celia Ramos’s family.
• The establishment of a concrete reparation program for all the victims and families  of Peru’s forced sterilization policy, as well as non-repetition measures.
• The strengthening of  States’ obligations regarding the right to prior, free, full and informed consent, particularly regarding reproductive health.
• Recognition that forced sterilization is a form of reproductive violence and, as committed by the Fujimori regime, constitutes a crime against humanity.
• The inclusion of forced sterilization in transitional justice processes for victims of the armed conflict in Peru.

“In Peru today, there are thousands of Indigenous and impoverished women who were forcibly sterilized under a deliberate state policy of discrimination,” said Nancy Northup, Center President and CEO. “The Court can stop this from happening again by formally recognizing these women and belatedly condemning Peru.”

Co-litigating the case with the Center are Study for the Defense of Women’s Rights (DEMUS) and the Center for Justice and International Law (CEJIL).

Taking Place During Peru’s Internal Armed Conflict, Sterilization Program Targeted Impoverished and Vulnerable Women

Throughout the 1990s under Alberto Fujimori’s regime, a large part of Peruvian territory was under military control and lacked constitutional guarantees. Civilians lived in fear of violence committed by illegal armed groups as well as by the State.

Peru’s sterilization policy was part of the National Reproductive Health and Family Planning Program (PNSRPF), implemented by the State from 1996-2000. While the government promoted the program as a way to supposedly increase access to family planning for low-income families, it actually functioned as a forced sterilization program.

Under the PNSRPF:

• More than 272,000 tubal ligations were performed from 1996 to 2001. Of medical records analyzed, 59% showed missing or incomplete prior and informed consent.
• Almost 7,000 women were subjected to forced sterilization—and 97% of those victims were from the poorest regions of the country, according to Peru’s Registry of Victims of Forced Sterilizations (REVIESFO), created in 2015.

The PNSRPF targeted impoverished, vulnerable women from rural and indigenous areas and was characterized by:

• Misinformation and manipulative advertising campaigns.
• Sterilizations without valid consent.
• Goals and quotas imposed on medical personnel.
• Unsafe medical conditions for performing the operations.
• Impunity and lack of redress in reporting rights violations.

Celia Ramos’s Story

Celia Ramos was a 34-year-old woman with three daughters living in poverty in a rural area of Piura. The local medical post had been “adapted” to perform sterilizations under the PNSRPF, despite lacking the necessary resources to carry out surgical procedures such as sterilization.

In 1997, after seeking medical care at the post, Celia was repeatedly pressured by healthcare personnel to undergo surgical sterilization. Despite expressing her refusal, health personnel visited her home multiple times, providing her with misleading and incomplete information about the procedure.

Weeks later, Celia underwent surgical sterilization, during which she experienced respiratory arrest. Due to the lack of resources and equipment, the staff at the medical post failed to provide her with adequate treatment. Celia died 19 days after the procedure.

While Celia’s family reported her death to the local authorities, and despite evidence presented, no charges were filed.

Photo credit: Lina Gasca / Trineo Comunicaciones

IACtHR Action Needed to Address Peru’s Lack of Progress

In 2010, DEMUS submitted Celia Ramos’s case to the Inter-American Commission on Human Rights—a regional human rights body that monitors human rights in the Americas—which in 2021 concluded her rights were violated and recommended that Peru adopt measures of reparation and non-repetition.

In 2023, due to lack of progress by Peru, the Commission referred the case to the Inter-American Court of Human Rights (IACtHR), with the Center and CEJIL joining to provide legal representation to the victims.

Peru’s failure to meet its obligations demonstrates the need for the IACtHR to take strong action.

“Celia Ramos’s case presents the Court with the opportunity to set clear standards for States to follow in finally addressing Peru’s history of forced sterilization and reproductive violence,” added Martínez Coral. “Reproductive violence remains invisible, even though many women, like Celia, died, and thousands more still must cope with the devastating consequences that forced sterilizations left on their bodies and their lives. All these women deserve truth, justice and reparations—and we are hopeful the IACtHR will, once and for all, recognize that.”