Uzbek Women Accuse State of Mass Sterilizations 
19 July 2010
Associated Press

Hundreds of Uzbek women have been surgically sterilized without their knowledge 
in a program designed to prevent overpopulation from fueling unrest.

GULISTAN, Uzbekistan - Saodat Rakhimbayeva says she wishes she had died with 
her newborn baby.

The 24-year-old housewife had a Caesarean section in March and gave birth to 
Ibrohim, a premature boy who died three days later.

Then came a further devastating blow: She learned that the surgeon had removed 
part of her uterus during the operation, making her sterile. The doctor told 
her that the hysterectomy was necessary to remove a potentially cancerous cyst, 
while she believes that he sterilized her as part of a state campaign to reduce 

"He never asked for my approval, never ran any checks, just mutilated me as if 
I were a mute animal," the pale and fragile Rakhimbayeva said through tears 
while sitting at a fly-infested cafe in this central Uzbek city. "I should have 
just died with Ibrohim."

According to rights groups, victims and health officials, Rakhimbayeva is one 
of hundreds of Uzbek women who have been surgically sterilized without their 
knowledge or consent in a program designed to prevent overpopulation from 
fueling unrest.

Human rights advocates and doctors say autocratic President Islam Karimov this 
year ramped up a sterilization campaign that he initiated in the late 1990s. In 
a decree issued in February, the Health Ministry ordered all medical facilities 
to "strengthen control over the medical examination of women of childbearing 

The decree also said that "surgical contraception should be provided free of 
charge" to women who volunteer for the procedure.

It did not specifically mandate sterilizations, but critics claim that doctors 
have come under direct pressure from the government to perform them. "The order 
comes from the very top," said Khaitboi Yakubov, head of the Najot human rights 
group in Uzbekistan.

Uzbek authorities ignored numerous requests by The Associated Press to comment 
on the issue. Most Western media organizations have been driven from the 
country, and government officials face serious reprisals for contacts with 
foreign journalists. However, the AP was able to interview several doctors, 
sterilized women and a former health official, some on condition of anonymity.

This Central Asian nation of 27 million is the size of California or Iraq, and 
population density in areas such as the fertile Ferghana Valley is among the 
world's highest.

Rights groups say the government is dealing with poverty, unemployment and 
severe economic and environmental problems that have triggered an exodus of 
Uzbek labor migrants to Russia and other countries.

Heightening the government's fears is the specter of legions of jobless men in 
predominantly Muslim Uzbekistan succumbing to the lure of Islamic radical 
groups with ties to the Afghan Taliban and al-Qaida.

Uzbekistan is not alone in coming under allegations of using sterilizations to 
fight population growth. Authorities in China's Guangdong Province were accused 
by Amnesty International in April of carrying out coerced sterilizations to 
meet family planning goals. But no other country is known to use that method as 
a government policy.

Uzbekistan once had one of the Soviet Union's highest birthrates ? four to five 
children per woman - and Communist authorities even handed out medals to 
"heroine" mothers of six or more. Young army conscripts from Uzbekistan and the 
four other Central Asian republics made up for a declining ethnic Russian 

Now, as Uzbek authorities try to unravel that legacy, the birthrate has dropped 
to about 2.3 children per woman - still higher than the rate of 2.1 that 
demographers consider sufficient to replenish a falling population.

The sterilization campaign involves thousands of government-employed medical 
doctors and nurses who urge women of childbearing age, especially those with 
two or more children, to have hysterectomies or fallopian tube ligations, said 
Sukhrobjon Ismoilov of the Expert Working Group, an independent think tank 
based in the capital, Tashkent.

The surgeon in Rakhimbayeva's case, a burly man in his 40s named Kakhramon 
Fuzailov, refused to comment on her claims and threatened to turn an AP 
reporter over to the police for "asking inappropriate questions."

In 2007, the UN Committee Against Torture reported a "large number" of cases of 
forced sterilization and removal of reproductive organs in Uzbek women, often 
after Caesarean sections. Some women were abandoned by their husbands as a 
result, it said.

After the 1991 Soviet collapse, Karimov, a former Communist functionary, 
remained at the helm and retained many Soviet features, such as strict 
government control of public health. Government-paid doctors and nurses are 
assigned to each district or village.

Family planning is far different from Western norms.

Instead of focusing on raising awareness of widely available condoms or 
birth-control pills, the Health Ministry has chosen to promote uterine 
resections nationwide as the most reliable method of contraception.

Some women do volunteer. Khalida Alimova, 31, a plump, vivacious sales manager 
from Tashkent, agreed to a resection in March, almost a year after her third 
child was born.

She said her husband, Alisher Alimov, 32, an occasional cab driver who spends 
days playing backgammon with his friends, refused to use condoms or allow her 
to take birth-control pills.

"Now I feel relieved," Alimova said over a cup of green tea in the kitchen of 
their shabbily furnished Tashkent apartment. She added, though, that she never 
told her husband about the operation.

Many other women, especially from poor rural areas, say they face coercion from 
health workers or even potential employers to agree to sterilization.

A 31-year-old mother of two from the eastern Uzbek city of Ferghana said the 
director of a kindergarten where she sought a job told her to show a 
certificate confirming that she had been sterilized.

After consulting her disabled husband, who receives a government pension of $40 
a month, she said she agreed to the procedure, produced the certificate and got 
the job.

"We just had no choice," the woman, who gave only her first name Matluba, said 
by telephone from Ferghana. She refused to provide her last name or identify 
the kindergarten for fear of being fired.

Several health workers, who spoke on condition of anonymity also because they 
feared dismissal or persecution, said the authorities are especially eager to 
sterilize women with HIV, tuberculosis or a drug addiction. Instruments often 
are not sterilized properly and can infect other women, they said.

Inexperienced medical workers can also cause serious health complications. "Any 
negligence can do a lot of damage," said Shakhlo Tursunova, a gynecologist from 

Health workers involved in the campaign are threatened with salary cuts, 
demotion or dismissal if they do not persuade at least two women a month to be 
sterilized, a former high-ranking Health Ministry official said on condition of 

Veronika Tretyakova, a 32-year-old doctor from Tashkent, said she came under 
pressure from health workers to be sterilized.

"The nurse said, 'They would hang me if I let you have another child,'" 
Tretyakova said. "I told her to think about her soul."

Tradition plays a strong role in this male-dominated society, where a large 
family is seen as a blessing from God, and women are often blamed for childless 

After checking out of the maternity hospital in Gulistan where she lost her 
son, Rakhimbayeva said she shared her anguish with her husband, Ulmas, a 
29-year-old bus driver who refused to be interviewed for this story. Their 
marriage was arranged by their parents in 2008.

Instead of consoling her, she said, he told her to move back to her parents' 
house and wait for divorce papers as he did not want to live with a barren wife.

"He never even questioned why the doctors maimed me, just blamed everything on 
me," Rakhimbayeva said, wringing her hands. "Now I have no hope of having 
children, no job, no future.

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