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Slovakia Sterilization Practices Criticized

The history of ethnic discrimination against the Roma minority in Europe has taken many forms. Some, like the Nazi efforts to exterminate large segments of the Roma population during the Holocaust, have been brutal, calculated, and quite direct. Other manifestations of racial prejudice, from the segregation of Roma communities in sub-standard urban ghettos in Italy and Greece to the British government’s consistent reluctance to accept Roma refugee claims, are more subtle, yet still troubling. In the British case, many of the applicants for refugee status have been from Slovakia, which will be a European Union member in less than one year. While prejudice against the Roma and a desire to protect a fellow European Union member may motivate the British actions, it helps to mask Slovakia’s poor human rights record regarding its treatment of the Roma people within its borders.


In the 10 years since Slovakia became a separate, independent nation, the government has faced severe criticism that it has not done enough to prevent discrimination against the Roma. The charges have ranged from a failure to adequately investigate claims of police brutality against Roma citizens to an absence of any form of hate crimes legislation to protect Slovakia’s minorities, including Roma, Jews, Hungarians, and Germans. While Slovakia’s 2001 census only shows a population of 90,000 Roma, it is widely believed that the true number is closer to 500,000 (approximately nine percent of Slovakia’s population). The reason for this discrepancy is likely that many Roma are afraid of the racial prejudice attached to that label in Slovakia. But a much more sinister form of discrimination in Slovakia indicates the strong possibility of a widespread effort to control Roma population numbers. Recent reports of systematic efforts in Slovakian hospitals and clinics, particularly in the eastern provinces, to force or coerce Roma women into sterilization procedures have become a serious human rights concern. These procedures, if they are as prevalent as many human rights observers believe, could well represent a quiet genocide against Slovakia’s Roma minority.


In January 2003 American and Slovakian human and reproductive rights advocates released a report titled Body and Soul: Forced Sterilization and Other Assaults on Roma Reproductive Freedom in Slovakia. This report focused on 40 Roma communities in eastern Slovakia, including interviews with more than 200 Roma women. The authors concluded that there was strong evidence that at least 110 of those women had been coerced or forced into undergoing sterilization procedures, usually when in the hospital to give birth. The Slovakian medical professionals employed several different strategies in order to complete these sterilization procedures, some of which were ostensibly consensual. In at least six cases, doctors targeted young Roma women who were not of legal age to consent to such a procedure without the approval of their parents.


Doctors and nurses also often asked Roma women to sign consent forms while they were under the influence of sedatives during labor. In one of the most egregious cases, Agata, a Roma woman from the town of Svinia, claimed that she was given anesthesia before a Caesarian section procedure. While she was falling asleep, a nurse entered the room, put a pen in her hand, and helped her sign the consent form. When she woke up, she was told that she would no longer be able to have children. Agata is illiterate and could not have understood the form that she was signing even if she had not been under the influence of sedatives.


Agata’s story indicates a third tactic that hospital authorities often use in many of these cases—taking advantage of the rampant illiteracy in Roma communities to convince women to sign documents that, in many cases, they cannot fully comprehend. The fourth method, which has been used in several documented cases, is one that may in some cases be legitimate, but given the history of anti-Roma sentiment in Slovakia, could well be a form of false benevolence. In at least seven instances, Roma women were informed that if they did not undergo sterilization, their next pregnancy would, in all likelihood, cause either their own death or that of their newborn. Although one can argue that these procedures may be valid in cases where the life of the mother and child are in danger, further reports regarding the general treatment of Roma patients in hospitals and maternity wards in eastern Slovakia tend to give credence to the idea that these procedures are conducted under malicious pretenses.


One of the hospitals that received some of the strongest criticism in the report was the Krompachy Hospital. Alexandra, a Roma patient from Richnava, stated that the Roma were actively segregated from Slovakians in Krompachy; they were forced to use separate rooms, showers, and bathrooms (quite often of a lesser quality); and they were denied access to dining facilities. Krompachy became the target of the Slovakian government probe into the allegations. But because 10 hospitals were included in the study and the government has only focused on the Krompachy facility, it is unlikely that this probe will effectively curtail racial discrimination in medical treatment and forced sterilizations. Furthermore, the government inquiry is only studying cases from 1999 to 2002; many allegations were made well before that time period.


Indeed, there is an acknowledged history of coerced sterilizations of Roma women in Slovakia dating back to the years of Communist leadership, prior to 1989. The common practice then was for the local Communist authorities, in collusion with local doctors and nurses, to offer bribes to Roma women who underwent the sterilization procedure. Yet given the limited scope of the current Slovakian government’s study into the matter, both in time period and number of facilities, it will be impossible to determine the true extent of the problem, and therefore to be able to combat it effectively. This circumstance raises serious questions about whether Slovakia is more interested in saving face by simply appearing to address the problem as it prepares to enter the European Union in May 2004, or whether it actually wants to attack these claims of human rights abuses. Slovakia risks the potentially valid accusation that it tacitly supports these efforts to forcibly limit the Roma population. The United Nations Human Rights Committee, in a recent report on the subject, concluded that many Roma women likely did not give informed consent to these procedures. The report urged Slovakia to perform a more thorough investigation into the matter. While the combined pressure of international non-governmental organizations and inter-governmental organizations is welcome and may well reduce future discrimination against the Roma, Slovakians themselves, at the national, regional, and local levels, must be the ones who make the firm commitment to eradicate the practice of coerced sterilization of Roma women and the racial prejudice that makes it possible. Because these events have occurred at the local level and outside the national center, it will be difficult, even with concerned international and local human rights groups now taking notice, to eliminate this discrimination entirely unless there is a fundamental change in attitude among the Slovakian medical community and the population as a whole.


Dan Brame received a bachelor’s degree in international relations and religion from Syracuse University and is now pursuing a master's degree in international development at the University of Pittsburgh Graduate School of Public and International Affairs. In spring 2004 he will continue his research on the Roma population of eastern Europe with fieldwork in Skopje, Macedonia.

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