Sterilisation: Peru's darkest secret

Victoria Vigo shows no flicker of emotion as she recounts how she discovered – by chance – that she had been surgically sterilised against her will. Heavily pregnant, she was admitted to a public hospital in the city of Piura, on Peru's northern coast, in April 1996 to undergo a Caesarian section. Within hours of the procedure, her ailing new-born child had died and Ms Vigo, 32 at the time, was being consoled by two doctors.

"I was exhausted and just wanted to go home," Ms Vigo says. "The doctors were trying to comfort me and one told me I was still very young and could have more children. But then, afterwards, I overheard them talking and the other said that it would not be possible for me to conceive as he had sterilised me."

Not only had Ms Vigo never given her permission for the procedure. The doctor had omitted it from her clinical records and failed to inform her. "I felt totally violated and brutalised. I still cannot understand what motivated him," Ms Vigo says. "He sterilised me and then hid the evidence. I could have tried for years to have another child without even knowing I could never conceive."

Doubly traumatised, Ms Vigo went home without confronting the doctor. But she eventually sued him and, in 2003, won damages of approximately £2,000. During the trial, Ms Vigo says, the doctor claimed that he had been following instructions and that the practice of sterilising patients – with or without their knowledge or consent – was standard among Peru's public healthcare providers.

That allegation may now finally be tested in court, after Peru's Attorney General last month reopened an investigation into the alleged forced sterilisations during the government of Alberto Fujimori, President from 1990 to 2000, who is currently serving a 25-year prison term for embezzlement and directing death squads during the crackdown against the Maoist Shining Path.

The investigation will look at the entire issue of forced sterilisations while focusing on one sample case, of Mamerita Mestanza, a 33-year-old, Quechua-speaking mother-of-seven, from the Andean region of Cajamarca. She died in 1998 from complications from sterilisation surgery that health officials allegedly harassed her into accepting.

According to human rights groups, there may have been as many as 300,000 victims, overwhelmingly women, the majority of them poor and often indigenous, Quechua-speakers with limited Spanish. "They were the weakest and most vulnerable," says Ms Vigo, whose case remains the only one to have reached the courts in Peru.

According to the New York-based Centre for Reproductive Rights, Fujimori's Peru is one of only two instances of forced sterilisations being adopted as state policy since the Third Reich.

The case had previously been shelved in 2009 after it was deemed to have lapsed under the statute of limitations. However, prosecutors have now reclassified the sterilisations as a crime against humanity, meaning there is no time limit for perpetrators to be brought to justice.

That could pave the way for high-profile trials of Fujimori and his three health ministers Eduardo Yong Motta, Alejandro Aguinaga and Marino Costa Bauer.

Although they have conceded there were problems in individual cases, all four have denied ordering forced sterilisations. Silvia Romero, a lawyer representing the Association of Women Affected by Forced Sterilisations, which has approximately 2,000 members, mainly from the Cusco region, retorts: "This was a state policy that came from the highest spheres of power."

But Ms Vigo also wants to see the doctors who carried out the sterilisations in the dock. She believes recent allegations by Peru's medical association, that its members were pressured into carrying out sterilisations, including with the threat of losing their jobs, is too little, too late. "They had a choice," she says. "If more of the doctors had spoken out at the time, the sterilisations might never have taken place."

Fujimori first unveiled the policy of providing free sterilisations for men and women in 1995 as a way of tackling Peru's entrenched poverty and rising population. It initially received a warm reception, including from the United Nations, which provided financial support. The United States' international aid agency, USAid, donated $35m (£22m).

But word quickly spread about doctors being pressured to meet sterilisation targets, and patients being tricked or bullied into undergoing the procedure. Human rights groups even reported alleged cases of medical personnel and members of the armed forces being ordered to undergo sterilisations simply to allow clinics to make up the numbers. As the scandal mushroomed out of the Fujimori administration's control, the Inter-American Commission on Human Rights stepped in and oversaw a settlement in 2001 between the Peruvian state and the family of Ms Mestanza, including a compensation payment of $100,000. The Commission also instructed Peruvian authorities to bring the perpetrators to justice and provide reparations to all the victims – a ruling yet to be fulfilled.

The sterilisations remain highly controversial and arguably swung the result in June's presidential elections away from Mr Fujimori's 36-year-old daughter, Keiko. She had apologised to the victims while insisting the procedures were the work of individual "bad" doctors.

According to Ms Romero, the sterilisations remain "the most forgotten crime of the Fujimori government". That is partly because of the sheer scale of the alleged practice. But it is also down to the fact that, unlike the human rights abuses carried out on Fujimori's orders in the fight against the Shining Path, the sterilisations were never considered by Peru's Truth and Reconciliation Commission.

All of which leaves Ms Vigo wondering: why her? In many ways, she was an atypical victim. Qualified as a teacher, she worked as the administrator of her family's construction business, making her an unlikely target for a practice aimed at reducing poverty.

She now believes she was chosen for the procedure as a result of random misfortune, the confluence of the fact that she already had two children and the pressure on the doctors at the hospital to meet quotas: "I was not a candidate for sterilisation," she says. "I did not fit the profile.

"Of course it has changed my life. I am lucky to have already had two children but I wanted more, including a second and possibly third child with my husband [her first child was with an earlier partner]. The instinct to be a mother is so powerful. Having that snatched away from you takes away your whole purpose in life, your reason for being."

Of Fujimori, she says: "I voted for him twice. As President, he did many good things. I looked up to him, like a daughter to a father. What he did to me was the worst kind of abuse of trust."

Shining Path terrorists plead for an amnesty

The Shining Path has been militarily defeated and its few remaining members would be willing to lay down their arms, one of the terrorist group's leaders has admitted for the first time.

From his jungle hideout in the eastern Andean foothills, Comrade Artemio said the group wanted an amnesty to come out of hiding. But President Ollanta Humala has promised to wipe out the Shining Path, and most Peruvians were sickened by their numerous atrocities, including dynamiting victims' corpses in front of families.

In the late 1980s and early 1990s, inspired by a Khmer Rouge-style ideology, the group plunged Peru into a civil war that claimed 70,000 lives. But they have been on a downward spiral since founding leader Abimael Guzman was captured in 1992.

The few left still attack soldiers patrolling remote mountain areas, occasionally even downing helicopters, but now seem more interested in cocaine-trafficking than revolution.

Simeon Tegel