Several of my colleagues from the International
Community of Women Living with HIV/AIDS (ICW) and I were crammed into an
SUV with our luggage and food driving through the northern regions of
Namibia. It was a trek familiar to
Jennifer Gatsi-Mallet, ICW Namibia Country Officer, and Veronica Kalambi, an ICW
member. This was a journey they had made
many times while visiting the many women and girls who come to positive women’s
support group meetings throughout the country.
For the rest of us, it was our first time to rural Namibia and the
The trip we
were making was in response to a shocking discovery by Jennifer during a
Namibian Young Women’s Dialogue that
several HIV positive women in Namibia had been sterilized against their
consent. More inquiry into the situation
by ICW Namibia and the Namibian Women’s Health Network determined that there
was a need to do a fact-finding mission to gather data and take steps to demand
justice from those individuals and entities that had violated the sexual and
reproductive rights of women. These
fundamental rights include the rights of HIV positive women to have a safe,
healthy, and fulfilling sex life and to determine whether and when to have
children. They also include the right to
access health services free of stigma and discrimination; the right to full
information about health services and conditions; the right to give full
informed consent before any medical procedure; and the right to access to
prevention of mother-to-child transmission services.
Members of ICW know all too well the terrible and
traumatic experiences faced by HIV-positive women as they attempt to access
care, treatment, and support in general, and with specific regard to sexual and
reproductive health services. However,
knowledge and awareness is never preparation enough for the traumatic and
extreme rights violations that we were now documenting in Namibia.
As we asked questions: have you ever been mistreated in a
hospital? Have you been forced to accept a procedure you did not want? Women
raised their hands time and time again, speaking of poor treatment by nurses and
physicians, telling of being kept in separate waiting areas because they were HIV
positive, and being identified as HIV positive in front of other patients. Alongside stigma and discrimination, women spoke
of being made to feel that because they are HIV positive they should not be
pregnant, and about receiving misinformation about pregnancy and HIV. Positive women
spoke of their rights to information and informed consent being violated: For example, some were encouraged to take birth control
despite desiring more children, others were forced and coerced into sterilization while
in labor or while having a caesarian section.
We visited hospitals and spoke to staff that admitted the mistrust they
have for women when it comes to caring for their own bodies. One physician even spoke of the women who
visit his clinic as being unclean and poor and unable to make the best decisions
for themselves, their bodies, and their communities.
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ICW has partnered with several domestic and international
NGOs in order to seek justice for the women who have been sterilized and demand
that necessary changes be made to stop the violations of women’s sexual and
reproductive health and rights. All are
rights protected by the Namibian Constitution as well as regional and
international human rights agreements.
For HIV positive women who need to access health services
for their survival, a hospital should be a place of safety, a place where one
recuperates, and where one can fully understand and address the health issues
that affect them. In other words, hospitals and health care facilities are a
place where rights should be realized, not violated. As
documented by ICW, health care facilities as sanctuaries of health and human
rights for HIV positive women in Namibia remain far from reality.