Comment Comment and Features

The plot to sterilise the world’s poor

A sterilisation ward in Chhattisgarh. Four million Indian women are sterilised each year (AP)

Last month, prosecutors in Lima reopened a criminal investigation into the part Peru’s former president, Alberto Fujimori, played in a state programme that sterilised close to half a million poor Peruvians in the late 1990s. At the time, Fujimori received plaudits from feminists, reproductive rights groups and progressive opinion around the world for his determination to bring his country’s birth rate under control and for his political courage in standing up to the Catholic Church, which opposed the policy.

Fujimori prepared the ground for his initiative by framing it as a liberalisation of Peru’s strict contraception laws. He was, he claimed, empowering women by allowing them to get their fallopian tubes tied without having to seek their husbands’ consent. Women’s organisations enthusiastically collaborated with the state in setting up family planning clinics. A travelling circus of outreach workers and doctors hosted colourful “tubal ligation festivals”, complete with dancing and bunting, in remote Andean villages. But very quickly what had been sold as giving women autonomy began to do the opposite. Under the weight of bureaucratic quotas and political expectations, the Voluntary Surgical Contraception Policy, as it was branded, became increasingly coercive.

Documents seized by human rights investigators detail how health workers were paid bounties to “capture” women, some as young as 20 and childless, for sterilisation. Some, speaking only indigenous languages with no words for “tubal ligation”, had no idea what was being done to them. Others were threatened and cajoled, told they would be denied food aid or disqualified from medical care if they refused. It is now apparent that the poor and the indigenous population were specifically targeted and that there may have been a national security dimension to the campaign. Peru was facing at the time a terrorist threat from the Maoist Shining Path guerrilla group, and military documents from the period advocate the sterilisation of “surplus beings” from “culturally backward and impoverished groups” as part of a strategy of terrorist prevention.

What exactly the president knew and when he knew it, whether Peru’s sterilisation programme was cynically conceived and motivated by racial, class and security considerations from the outset, or was a well-intentioned policy that went badly wrong on contact with practical realities, are matters still contested in Peru. The criminal investigation was abandoned last year, but has now been reopened just as Fujimori’s daughter Keiko has taken the lead in opinion polls ahead of the presidential election in 2016. Whether it turns up any new evidence to settle the outstanding questions may well hang on the result.

Despite so much remaining unresolved and the pervasive sense that justice has not been done, the story of Peru’s forced sterilisations nevertheless has the feel of something that belongs to the past. Although the late 1990s may not be that long ago, they are sufficiently distant for the scandal to cease to qualify as current affairs and become reclassified as recent history. Besides, those international agencies that were embarrassed by the initial revelations – USAID, which paid for the surgical instruments, and the UN, which also helped fund the programme – have moved on, haven’t they? Isn’t everyone now agreed that coercive sterilisation is a crime against humanity and taking pains to see it never happens again?

There will always be some event to jolt us out of complacency. Last November’s harrowing story from Chhattisgarh, among India’s poorest states, was one such. There, 15 women died and dozens more were hospitalised after undergoing laparoscopic tubectomies at a state-run sterilisation camp. The word “sterilisation” has a strong whiff of disinfectant about it, but where doctors are performing large numbers of procedures, with minimal budgets for nursing assistance, or where quality control of antibiotics is unreliable, serious infections can quickly take hold. Many of the operations are conducted with old, sometimes rusty, scalpels, inadequate anaesthetics in unhygienic, multiple-occupied operating theatres. Doctors typically spend three to four minutes on each patient. The 15 deaths in Chhattisgarh generated headlines round the world because they took place in the same spot and within a short time-frame. But for years, deaths ascribed to botched sterilisations have been running at over 200 per annum, occasioning little comment.

As in Peru, people have since come forward to testify that some of the women were coerced into having the procedure. And the financial incentives offered by the state can amount to more than a week’s income. In areas of poverty exacerbated by low standards of education, the bar for “informed consent” needs to be set higher, rather than lower, than it is in Western countries. But what was perhaps most astonishing about the reports of the Chhattisgarh tragedy was the sheer scale of India’s current sterilisation programme. It turns out that approximately four million women are sterilised in India each year. The country accounts for almost 40 per cent of all female sterilisations worldwide and the procedure has become the most commonly used method of contraception and the main focus of the nation’s population control activities.

This is all the more surprising in view of India’s past experience. In the mid-1970s, while civil liberties were suspended under a state of emergency, the Prime Minister’s son, Sanjay Gandhi, launched a campaign of compulsory sterilisation aimed at poor males. Police would seal off roads outside villages in preparation for sterilisation sweeps that saw desperate victims dragged, protesting, to the operating table.

More than six million men were sterilised in a single year, but the programme prompted a vigorous political reaction. It is significant that today’s sterilisation campaign is overwhelmingly targeted on women, who are doubtless seen as a ofter touch. Nor is India the only country where sterilisation – forced, unforced or ambiguous – is creeping back into fashion. Across Africa human rights groups report cases of sterilisation, often associated with HIV infection, and in China local officials were mounting vigorous campaigns of compulsory sterilisation in support of the country’s one-child policy, despite disapproval from the political centre. In a campaign launched in 2010 in Guangdong, it was reported that family members were seized and held as hostages against women surrendering to family planning workers and agreeing to being sterilised.

In the West, including the US and even Britain, we are once again seeing the occasional moral panic over benefits fraud prompting some daft populist legislator or airhead newspaper columnist to call for bringing back sterilisation of the poor.

And “bring back” is the correct formulation, for this was once a policy that disfigured the Western political landscape, too. In the United States it was the brainchild of the eugenics movement, which hoped to improve the quality of the national gene pool by limiting the rate at which the poor and the feckless (eugenicists barely distinguished between the two) were able to breed. This saw the enforced sterilisation of 70,000 poor Americans over a period stretching from the 1920s to the 1970s, with round-ups of Appalachian mountain men conducted by the police in much the same way as in 1970s India. Native Americans were targeted in Vermont; and in the Deep South, predictably, poor blacks were the focus, with sterilisation so common it was known within the medical profession as “the Mississippi appendectomy”.

But if America’s practice of sterilising the poor grew out of the junk science of eugenics, what sustains it around the world today? It seems far-fetched that there is some global conspiracy of unreconstructed eugenicists at large. What does seem to be the case, though, is that the idea of sterilising the poor attaches itself to any passing concern or enthusiasm. Thus, at the height of the Cold War, when international security was the big issue, alarmists would warn darkly of the wars, conflicts and uncontrollable migrations that would result from population growth unrestrained by sterilisation. As international development rose up the agenda, junk economics would tell us that sterilising the poor in the global south was the only way to sustainable growth. Nowadays junk ecology tells us that sterilising the poor is the appropriate response to the challenge of climate change.

The marriage of alarmism over anthropogenic global warming with misanthropic population control is the most toxic combination of all. In 2006, Dr Eric Pianka, a leading evolutionary ecologist, former Fulbright and Guggenheim scholar and a professor at the University of Texas, gave a speech stating that the world could not survive unless its population was reduced by 95 per cent, and that the planet might be “better off” after a disease such as Ebola had made this a reality. After a public outcry, Dr Pianka had to row back and bring his rhetorical boat within bounds. But perhaps more worrying than the lecture was the response of the audience. The massed ranks of the Texas Academy of Sciences gave it a standing ovation.

It is rapidly becoming the scientific orthodoxy in climate alarmism circles that human beings are the real problem. We are forever consuming scarce resources, breathing out CO2 and leaving our carbon footprints all over the planet. We are the cause of global warming and sterilising large numbers of us is the only long-term solution. Another related theme asserts that climate change will degrade agricultural production in the south, making it impossible to feed a growing population. This is the “conspiracy against life” of the kind that Pope John Paul II warned against in his 1995 encyclical Evangelium Vitae, where a person “just by existing compromises the wellbeing or lifestyle of those who are more favoured” and so “tends to be looked upon as an enemy to be resisted or eliminated”.

Population alarmism is, of course, nothing new. Paul Ehrlich, a Stanford University academic with a claim to being once regarded as the world’s greatest expert on population issues – and whose 1968 book The Population Bomb introduced the idea of the “population explosion” – predicted: “The battle to feed all of humanity is over. In the 1970s hundreds of millions of people will starve to death in spite of any crash programs embarked upon now. At this late date nothing can prevent a substantial increase in the world death rate.”

Such pessimism has characterised population studies ever since Malthus, despite the worst predictions never being borne out. The same kind of pessimism is already being repeated among climate commentators. In 1989, the director of the New York office of the United Nations environment programme warned that entire nations would be washed away by rising sea levels if global warming was not reversed by the year 2000. In 2009 the Prince of Wales gave us 96 months to save the planet in his Dimbleby Lecture.

Al Gore’s deadline is fast coming up. It is this too-little questioned urgency of “tomorrow morning” concerning climate change and its threatened effects that fuels the demand for population control, and consequently the botched and bloody sterilisation schemes that pervade around the world.

Dennis Sewell is the author of The Political Gene: How Darwin’s Ideas Changed Politics (Picador)

This article first appeared in the latest edition of the Catholic Herald magazine (19/6/15).

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