Coercive Sterilisation in Uzbekistan

The authorities in Uzbekistan are pressing ahead with a concerted campaign to force sterilisation on women as a way of curbing the population. 

Human rights activists in the country say the campaign is into its second phase, which will continue until August 15.

The prosecution service, local government and "mahalla" or neighbourhood committees are playing a role by identifying women of childbearing age.

Phase one took place in spring, under a programme officially described as "intensified supervision of medical examinations for women of childbearing age", according to a healthcare worker who requested anonymity.

The Expert Working Group, a coalition of analysts in Tashkent, reported that the health ministry issued a special decree in February which spoke of "voluntary sterilisation", but required every doctor to persuade at least two women to undergo the surgical procedure, and 50 more to use contraception.

"At morning meetings every day, doctors are asked about sterilisation. Those who fail to reach the target are reprimanded," said the medic.

Uzbek families traditionally have many children, and the authorities clearly fear that the birth rate will lead to overpopulation.

Uzbekistan has the largest population of the five Central Asian states, reaching 28 million by April this year. Demographic experts predict that by 2015 the figure will grow to 33 million.

Sterilisation is seen as the solution. Many doctors agree with the policy, given high maternal and infant mortality rates and the state's lack of funds to pay out maternity benefits.

A gynaecologist in Tashkent, for example, insisted the procedure was being offered on a voluntary basis, if on a fairly massive scale.

This doctor said staff from the main clinics in Tashkent were going around the country and performing 40 sterilisation operations each a week.

"Some 40 to 50 per cent of women identified by the health ministry have been sterilised," says the doctor. "Many of them understand that sterilisation is better than abortion."

Others say there is a strong element of coercion by the state.

"Women who don't agree to it lose the benefits they get for having young children," said an observer in Tashkent. "To obtain this benefit, the woman needs a certificate from a doctor, but the doctor won't give her it until she is sterilised."

Some women say they were sterilised without their knowledge or consent.

When Nargiza, a 23-year-old from Kokand in the Fergana Valley of eastern Uzbekistan, went for a medical examination in Tashkent to find out why she was unable to get pregnant, doctors told her she had been sterilised after having her second child by caesarean section.

Nargiza and her husband were planning to take the matter to court, but doctors produced a signed document agreeing to the sterilisation. She insists, "When I signed the document before the delivery, the doctors told me it was just a letter expressing gratitude."

Khaitboy Yoqubov, head of the Najot human rights group in Khorezm in northern Uzbekistan, has come across similar cases, and says deception is quite common. For example, he says, "doctors trick women by saying they've found a serious disease that makes surgical sterilisation necessary".

Medical experts say the procedure carries significant risks.

"Some women develop health problems, many have menstrual disorders, and some have bleeding that lasts one or two months," said a local observer. "When they hear of this, many women fear being forcibly sterilised."

Human rights activists say coercing women into sterilisation and failing to obtain their consent amount to gross violations of their rights.

In 2007, the United Nations Committee Against Torture reported cases of forcible sterilisation and hysterectomies in Uzbekistan. The number of cases appeared to fall after that, but this year the practice has once again become state policy.

This article was produced as part of IWPR's News Briefing Central Asia output, funded by the National Endowment for Democracy.