Justice for Francisca

For many women, having a child is one of the best days of their lives.

For Francisca, a young Chilean woman, it was both the best and worst day of her life. After delivering a healthy baby boy, the unthinkable happened — the doctor performing her cesarean sterilized her without her consent, simply because she was HIV-positive.

It has been 15 years since that day and Francisca still wakes up every morning feeling a profound sense of loss for the large family she always dreamed of having but knows will never be.

Outraged by Francisca’s tragic story, which unfortunately is all too common in her home country, the Center and Chilean-based HIV/AIDS NGO Vivo Positivo filed a case on her behalf in 2009 before the Inter-American Commission on Human Rights after an earlier criminal complaint against the surgeon was unjustly dismissed.

In their petition, the Center and Vivo Positivo argued that the government failed to protect Francisca from being forcibly sterilized, and in a historic decision five years later the Commission agreed to hear the case — the first-ever forced sterilization case of a person living with HIV in Latin America that will be decided by an international human rights body. 

On Saturday March 18, 2017, reproductive health and human rights advocates from around the world gathered in Washington D.C. to finally hear Franscisca’s case. Together with Vivo Positivo, the Center presented testimony at the hearing reaffirming the incredible injustices she faced as well as the pervasive stigma and mistreatment of HIV-positive women living in Chile.

Francisca bravely shared her story at the hearing, which was peppered with details one more dreadful than the next. Like, for example, the fact that when she was first diagnosed with HIV she thought she had been handed a death sentence because no one, not even her doctor, gave her information about the disease or referred her for counseling.

Or how when she arrived at the hospital for her scheduled cesarean, a decision she made to avoid transmitting the virus to her baby, she was told she should be ashamed to be pregnant and that women like her shouldn’t have children — comments that made her feel like an incubator rather than a person, like an irresponsible parent rather than an excited, expectant mother.

And ultimately how she woke up and discovered that a surgeon had made the life-altering decision to sterilize her without ever having discussed the implications with her. Stripped of her ability to have any more children, Francisca was utterly devastated by the news.  Recalling the experience, she said:

“I might seem like a normal, healthy person, but I feel empty inside. The state had no authority to make a decision for my body, that decision was only mine to make.”

At the hearing, the Center demanded that the Inter-American Commission on Human Rights declare Chile responsible for the human rights violations perpetrated against Francisca and compensate her for the suffering she endured. The Center further called on the Chilean government to pursue criminal sanctions against those responsible for violating her rights and adopt policies to guarantee that all women living with HIV in Chile have the freedom to make reproductive health decisions without coercion.

In response to Francisca and the Center’s powerful testimony, Chilean officials acknowledged the government’s failure to protect her and expressed their intentions to enter a friendly settlement agreement. They also reiterated that sterilization is a voluntary procedure and that any coercive or forced procedures should be condemned.

“Every woman, regardless of her HIV status, should have the ability to decide what it best for her own health and life,” said Catalina Martinez Coral, regional director for Latin America at the Center. “We are glad to see that the Chilean government is prepared to take responsibly for this extreme human rights violation and implement legal and policy changes to ensure that no other woman suffers like Francisca did.” 

It is vital that the Commission now works to ensure that the Chilean government keeps its promise to address the appalling injustices women living with HIV face in their country because unfortunately Francisca’s story is not unique. In fact, in their report Dignity Denied: Violations of the Rights of HIV-Positive Women in Chilean Health Facilities,  the Center and Vivo Positivo found that abuse against women living with HIV by medical professionals runs rampant in the country.

The report, which shares the stories of 27 HIV-positive Chilean women like Francisca, found that misinformation and misconceptions surrounding the risk of HIV transmission are widespread and fuel discriminatory treatment. Such women are often pressured not to become pregnant and chastised or verbally abused if they do, despite the fact that with appropriate intervention the risk of transmitting the virus to a newborn can be reduced to less than two percent. Findings also revealed that HIV-positive women are often denied care altogether, given misleading and inaccurate information, or like Francisca, sterilized without their consent.

Francisca’s story represents a countrywide problem in Chile, where women living with HIV are systematically discriminated against and denied the right to make the very personal decision of whether or not to become a mother. With the support of the Chilean government, HIV-positive women can now begin on the road to justice, starting with Francisca.

Photo: Daniel Cima for the Comisión Interamericana de Derechos Humanos.