On Monday, July 30th, a Namibian court made a historical ruling protecting the reproductive rights of its women, as well as paving the way to establish more agency for patients in hospitals.

The case was brought to court two years ago by three women who were all sterilized while undergoing a caesarean section during childbirth. They had opted for a C-section because the women, aged 22 to 47, were all HIV positive and did not want to transmit their disease to their children.

The women were treated in an unethical manner during their entire hospital stay. They were faced with staff who could not speak Oshiwambo, their native language. They were also given consent forms that were extremely technical and required a thorough medical knowledge to comprehend. There were a number of unexplained acronyms found on the forms, including BTL which stands for the sterilization method of bilateral tubal ligation. To add insult to injury, these forms were given to the women at the height of labor, sometimes minutes before they were expected at the operating table. One of the women claimed that she was in labor for four days before she was given the consent form, and the hospital staff member who handed it to her said that she would not receive a caesarean if she did not sign the form.

The judge who presided over the case ruled in favor of the women. He stated that the timing of the consent forms was criminal at worst and impractical at best because the women would not be able to seek counsel of any kind when they were in the climax of labor. He also told the Namibian government that it was essential for them to provide information about contraception methods in every language necessary. The judge agreed that the Namibian women should be compensated in some way for what they suffered, but he did not allot a particular sum to them.

Although the judge agreed with the women about the injustice of their sterilization, he did not go so far as to state that the hospital’s motive for sterilizing them was their HIV positive status. Despite this setback, the victims’ lawyer Amon Ngavetene said the verdict was a victory for women all over Namibia as well as the rest of Africa. He said that the case brought up the issue of keeping accurate medical records and always seeking knowledgeable and comprehensive consent from the patient. There is a paradigm shift occurring where the responsibility for educating a patient about the procedure they are going to undergo is not in the hands of the patient themselves, but rather the duty of a medical practitioner.

This case is not the only one on the African continent dealing with women’s health and patient’s rights. In South Africa, a lawyer by the name of Sanja Bornman has taken on a case involving two women who claim that they were sterilized in 2009 without giving consent. Another 22 women are making similar claims with the Woman’s Legal Centre in Cape Town. Some cases involved complete fabrications on the part of the health staff, with women being told that if they weren’t sterilized they would die giving birth to another child.

The right to reproduce has been very culturally significant in Africa, and being unable to give birth carries an immense social stigma with it. Many women are divorced or abandoned by their husbands if they are unable to have children. If a woman cannot bear children and is HIV positive she faces the most stigmatization of all.

In many African nations, it is standard procedure to sterilize a woman if she is HIV positive whether or not she comprehends what she is consenting. However, the recent ruling in Namibia is paving the way for more awareness and action against this shocking practice.

For more information:

Harvard Report on Women’s Reproductive Rights in Namibia: http://www.law.harvard.edu/news/2012/07/related-content/namibia_final.pdf

HIV: http://en.wikipedia.org/wiki/HIV