These indigenous ladies have been forcibly sterilised in Peru – many years later they nonetheless search justice

Florentina Loayza remembers the knock on the door.

It was 1998 and the young mother-of-one was at her home in the Peruvian highlands, caring for her nine-month-old baby.

Free food was available at a nearby health clinic, said the nurse standing outside, and transport had already been arranged.

Florentina stepped into the van full of other indigenous women from the Huancavelica region, and was driven away.

Once inside the clinic – a simple wooden hut – she heard the doors lock.

“They said we had to receive some medication before we could leave. The doctor said he was going to give me some shots,” Florentina recalls, now 45. “He put a drip in my arm and I fell unconscious. That is when they mutilated me.”

The 19-year-old woke up vomiting and disoriented, and saw cuts across her lower belly. 

“I did not know what happened to me. The nurses said it was birth control and that it would only last five years. I realised it was permanent much later,” she says. “Since then, I have been living in hell.”

Florentina had been forcibly sterilised under Peru’s family planning programme, a scheme launched two years earlier which promised to improve access to birth control.

“Peruvian women should be the owners of their destiny!” the populist president Alberto Fujimori had declared at the time.

Officials said the policy would decrease poverty, reduce maternal and infant mortality rates, and lower fertility to the global average rate of 2.5 children per woman. 

What the scheme did not mention was that thousands of participants would be sterilised against their will.

Between 1996 and 2001, more than 272,000 women and 22,000 men were sterilised, with estimates suggesting less than 10 per cent gave consent.

“The forced sterilisations perpetrated in the 1990s represent a grave violation of the human rights of thousands of people whose bodies were violated against their will,” says Marina Navarro, director of Amnesty International in Peru.  

Today, those affected are still fighting for justice – but hope is fading that it will ever be achieved.

‘If I wanted to see my baby I had to be sterilised’

Victims were overwhelmingly poor, indigenous women.

Thousands have reported being harassed, threatened and blackmailed to undergo the procedures; others say they were tied down, blindfolded and knocked out with horse tranquiliser. 

Testimonies show many indigenous-speaking victims were tricked into signing forms in Spanish that they could not read. Some were told they were receiving short-term contraception, while others were sterilised unknowingly after giving birth.

Doctors were given obligatory sterilisation quotas and received monetary incentives for performing the operations, according to lawyers.

“The doctors obeyed a scale of orders that were controlled by the highest level of the country,” says María Ysabel Cedano García, a lawyer representing the campaign’s victims. “We have evidence of the goals and quotas.”

One woman interviewed by The Telegraph said nurses would not let her see her newborn baby until she consented to the operation. 

“After I gave birth the doctor took my son away,” says María Elena Carbajal, age 54. “He said if I wanted to see my baby I had to be sterilised. He said I wasn’t an animal and I didn’t need any more children. They wouldn’t bring my son to me; I had no other choice.”

In the aftermath of such procedures, the women were further victimised by their communities, ostracised and often forced to leave.

“Because I could not have any more children, my husband told me I was useless and abandoned me,” Florentina says. “People in my community said it was my choice, that I had the operation to be with other men. My mother blamed me too. I was seen as a bad woman and had to leave.”

Mavila Rios De Rengiro, who was sterilised aged 27 and is now 61 years old, was also cast out by her community. She went to the clinic believing she was having a smear test. 

“They told me I was having a pap smear, and then they locked us in,” she says. “I was afraid. The doctor didn’t speak to me. I woke up in terrible pain and with a lot of blood.”

A nurse told Mavila that she had been sterilised, and that the surgery was for the best. “My husband abandoned me – he said I was not worth it. He said I wasn’t even good for sex. I was insulted all the time, it was a small community, they said it was so I could be with many men,” she recalls.

Mavila says she – and the other victims in her village – were called ‘los castrados’, meaning the castrated. “They still say these words, they still hurt,” she says.

She also says she has suffered life-long complications, including infections and internal pain. “He wasn’t a doctor, he was a butcher,” she says. “One of the women in my village died from it.”

Nationwide, 18 women died shortly from the operations, after the programme failed to ensure minimum health standards or provide proper pre- and post-operative monitoring, rights groups say.

Experts say the disproportionate targeting of indigenous people reflects Peru’s deep-rooted racial discrimination – with one academic arguing the policy could even be classed as a genocide.

“A genocide occurred – but the targeting of these ethnic groups has gone unnoticed and pushed aside,” says Dr Ñusta Carranza Ko, an associate professor of global affairs and human security, and an expert on indigenous Peruvians. 

“Officials held health festivals to promote the policy, but only in rural areas, not in the cities. In moments when health officials gave consent forms, they were in Spanish, not in any Indigenous language.”

Dr Carranza Ko says the policy reflects long-standing ideas of ethnic superiority which were first introduced by the Spanish conquistadors.

“In the colonial period, people from Europe were at the top of the chain, and indigenous people at the bottom – that class structure has carried forward to the present day,” she says. “Anything indigenous is considered negative.”

Dr Carranza Ko says the policies share similarities with those introduced in Canada and the United States in the 1970s, in which indigenous populations were also sterilised. 

In these countries, population control also revolved around control of “aboriginal peoples’ land and resources,” and the “denial of indigenous sovereignty,” she says.

‘A lot of women have lost hope’

It took years for the scale of abuse in Peru to become public knowledge, in part because it happened against the backdrop of a brutal internal armed conflict that left nearly 70,000 dead. 

“Some Peruvian congressmen pointed to irregularities with the scheme in 1997, but that was it. At that time it was hard for anyone to speak out – if you did, you faced death threats, let alone you might disappear. It was a very repressive time,” Dr Carranza Ko says.

Yet even now, while forced sterilisations are considered a crime against humanity under international law, the vast majority of victims have never received justice in their decades-long legal battle. 

The most significant victory was a 2003 settlement before the Inter-American Commission on Human Rights in which the state agreed to pay compensation to the family of a woman who died after being forcibly sterilised.

In fact, many on the right continue to deny that forced sterilisations ever happened, while perpetrators “practice denialism”, according to lawyer Ms Cedano García.

Marino Costa Bauer, one of the former health ministers, called the family planning campaign an “excellent” programme that reduced the maternal mortality rate. 

Mr Fujimori’s daughter Keiko – an influential Peruvian politician who held the role of First Lady during her father’s administration – blamed individual rogue medical practitioners for coerced sterilisations. “I condemn the attitude of these irresponsible doctors,” she said.

In 2015, one anaesthetist, Rogelio Del Carmen Martino, rejected claims that doctors had been over-zealous in their implementation, saying publicly that his team had been ordered to sterilise at least 250 women over four days in 1997. “It was absurd – an offence to the dignity of women and doctors,” Dr Martino told Peruvian paper La Republica. 

Mr Fujimori, meanwhile, has always maintained that the procedures were consensual. 

Although he has been cleared of any wrongdoing in relation to Peru’s sterilisation programme, in 2007 he was imprisoned for corruption and human rights abuses – including authorising a number of killings carried out by death squads. 

Yet in December 2023, Mr Fujimori was released 15 years into his 25-year sentence – a decision human rights groups have called a slap in the face to all of his victims.

Victoria Vigo, a sterilisation victim who has received refugee status in Canada after receiving death threats for campaigning for justice, says she feels “spit on and insulted by Fujimori’s freedom”. 

Another investigation that involves thousands of sterilised victims is ongoing, but has been “stalling and stalling,” says Dr Carranza Ko. 

“A lot of women throughout the years have lost hope. There was a momentum and that momentum has passed,” says Rosemarie Lerner, a documentarian who has followed the women’s cases since 2011. “People are dying without getting justice.”

Florentina continues to protest but says the numbers of those still willing to speak out has dwindled. 

“I can’t remember how many times I have given my testimony, but there has been no response, no justice,” she says. “I feel forgotten by the country. So many years have passed now, but we are still forced to protest on the streets and I am still forced to suffer.”

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