In the central European nation of Slovakia, women from poor Roma, or gypsy, communities are entering hospital to give birth, only to find that when they return home that they’ll never have children again - sterilised, they claim, without their consent. Slovakia’s doctors angrily reject the charge, but when Bronwyn Adcock visited the Roma communities, she found the practice was widespread.
This is where the Roma of Hermanovce live. Like Roma everywhere in eastern Slovakia, they live on the edge of town, in crowded, squalid conditions. Here, a dirty river separates them from where the white Slovaks live. From the time they are born, Roma are at a disadvantage. Babies born in this part of town, for example, are twice as likely to die as babies born to whites just up the road. It's a cold Saturday morning and some of the Roma have come to church in the white part of town. They've come for the wedding of Rozalia and Radislav. Just as soon as the white Slovaks leave the church, the wedding will begin. Rozalia and Radislav have been together for eight years and have two young daughters. To their great sadness and disappointment, this marriage will not be blessed with any more children. Rozalia's youngest child Jitka was born six years ago. Rozalia clearly remembers the day when her labour began and she was taken to hospital.
ROZALIA (Translation): They didn't say much. They asked how many children I had. I said I had one and this was my second. And then they just told me I would have a Caesarean.
As far as Rozalia knew, there were no problems with the birth, both she and her baby were healthy. However as the years wore on, Rozalia became increasingly perplexed as to why she never fell pregnant again. The mystery ended when this woman came into her life. Barbora Bukovska is a lawyer based in Prague in the Czech Republic. She's one of the authors of a report that has rocked Slovakia. This report confirmed longstanding claims that Roma women are being sterilised without their full consent.
BARBORA BUKOVSKA, CENTRE FOR CIVIL & HUMAN RIGHTS: Usually, it's happening on the delivery table, when woman is brought into the hospital, she's in delivery and for whatever reason she has to have a Caesarean section, they give her anaesthesia and then she's undergoing Caesarean section and during the Caesarean section her fallopian tubes are tied.
Last year, Barbora Bukovska led a team of researchers to some of the Roma settlements in Slovakia. From an extremely small sample, they found over 100 cases of women who'd been sterilised in questionable circumstances. It's believed that these 100 cases are just the tip of the iceberg.
BARBORA BUKOVSKA: This forced sterilisation, we found out that it's not isolated incident. It's not an incident that would be limited to one hospital or one doctor - it's a practice, and it's a practice that's been continuing in Slovakia for decades.
On behalf of some women, Barbora gained access to their medical files.
BARBORA BUKOVSKA: This is how they mark the files, with the 'R'. So, for instance, this one - so, 'R', that's she's Romany. It was in these files that Barbora discovered the answer to the question haunting women like Rozalia.
REPORTER: So there were cases where women told you they didn't know why they couldn't conceive, and then you checked their files...
BARBORA BUKOVSKA: Yep, and it was written that she requested sterilisation, like this one.
This is Rozalia's file. With Rozalia's permission, Barbora had checked her medical records at the hospital where she last gave birth. Barbora came to Hermanovce to deliver the bad news.
ROZALIA (Translation): Barbora came and took me to one side. She said that from my file she'd found out that I'd requested that something be done so that I wouldn't have any more children.
Rozalia then had to pass on the news to her partner Radislav.
RADISLAV (Translation): I was surprised when she told me. I only knew after Barbora came.
ROZALIA (Translation): He would have been happy for us to have more kids, but when I said we wouldn't, he was surprised. He didn't say anything. He was sad.
While Rozalia's file says she consented to being sterilised and has a signature that purports to be hers, she says this is not true.
ROZALIA (Translation): The doctor never explained anything to me. He asked what name to put. I said Robert for a boy and Jitka for a girl. I don't remember anything else. I went in. They give me anaesthetic. They gave me an injection. I remember nothing after that.
INTERPRETER (Translation): Did you sign anything before or after the operation?
ROZALIA (Translation): Nothing. I didn't sign anything. They just asked me about the name I was going to give. There was nothing else.
Veronica is 23 years old. She did sign a consent form for sterilisation, but under extreme conditions. Veronica was 19 when she went into labour with her second child. She arrived at the hospital alone and in pain. The doctor told her she would be having a Caesarean and that she needed to be sterilised because it would be dangerous for her to ever have another baby.
VERONICA (Translation): He told me to sign it because if I had another one, it would be risky. If I came back, it would be at my risk.
INTERPRETER (Translation): For how long, in minutes or seconds did the doctor discuss the sterilisation with you?
VERONICA (Translation): I don't remember. He just brought me the form and said what my case was. He just washed his hands and I went in.
Such was Veronica's naivety, she wasn't even sure what sterilisation meant. Once the operation was over, she asked the doctor when she could have children again. She now deeply regrets signing.
VERONICA (Translation): They should have told me to be calm. They should have told me about what can happen. Maybe they could have done something so I could have children in 5 or 10 years. They never did that. They gave me a big piece of paper to sign, saying if I had a third one, I could die. That having a third operation was risky. And I signed it. I was crying because I was afraid, seeing my second birth was a Caesarean. I was afraid so I signed it.
According to Barbora, the majority of cases are like Veronica's - women who did sign but under duress, usually on the delivery table.
BARBORA BUKOVSKA: The women are told that the next pregnancy would be endangered, that during the next pregnancy, she or her baby would die and that's why she has to sign this paper, and the paper is consent for sterilisation.
Veronica already has two children, but wishes she could have more. So does her mother.
VERONICA (Translation): Mum asked me why I signed it.
VERONICA’S MOTHER (Translation): What can I say? We would like her to have more children. She's young.
Her inability to have more children has also affected Veronica's relationship with her husband.
VERONICA (Translation): Now that my children are older, this one is seven and the other four, their father went off to have other children. He wasn't happy not to have any more. While they were small, things were fine. When they got bigger, we started having problems.
This is Presov New Maternity Hospital. Both Rozalia and Veronica were sterilised here, and, according to Barbora Bukovskas's report, this hospital is one of the worst offenders. Dr Kysely is the head physician in the gynaecology department.
DR KYSELY (Translation): I think it's a fabrication on the part of the researchers for their own financial benefit and that of the Rom. Mrs Bukovksa has made the whole thing up. I don't want her here again. If she comes back, we'll start legal proceedings against her.
Dr Kysely says sterilisations are only ever performed because of medical necessity.
DR KYSELY (Translation): We haven't had anyone who didn't consent to sterilisation. It was for medical reasons after two or three Caesareans when there was the danger of further damage, we would recommend sterilisation as a possibility seeing that a further Caesarean would be dangerous. Every single one signed. We have it well documented.
Critics argue it's not necessarily a risk for a woman to have more than two Caesareans, but even still, this is not the real issue.
BARBORA BUKOVSKA: This is not about it - this is not whether the sterilisation was necessary or not. This is about the consent. This is about the situation when woman gave the consent and whether it was informed consent.
There is a long history of racism and institutional discrimination against the Roma in Slovakia. Here in Kosice, the regional capital of eastern Slovakia, you won't see many Roma faces. This is despite the fact the east is where the majority of Roma live. But drive just a few kilometres out of town and you'll come to Leunik 9, central Europe's biggest Roma ghetto. The deputy mayor tells me that around 5,000 Roma live here, the majority in abject poverty.
MAN (Translation): It's not true that Roma don't want to work. When they ask about a job on the phone they're told to come, the job is there. When they get there in person, they're told the job is gone. It's been taken.
JUD NIRENBERG, CARPATHIAN FOUNDATION: So, the communist period did not treat everyone equally. And come 1899 Roma were living apart from whites in slums, Roma were doing the most menial labour. Since the end of communism, this country has had a segregated school system, employment discrimination is absolutely the norm and nobody does anything about it.
Jud Nirenberg works for the Carpathian Foundation, an NGO that deals mainly with development. He's American but of Romany descent and has lived and worked in the region for nearly a decade. He's been deeply involved in Roma projects and issues.
JUD NIRENBERG: I think that most Slovaks, including those that I would call left-of-centre politically, including those who I think are very intelligent and open minded, including lots of different types of people, pretty much all seem to believe that Roma are culturally inferior, that Roma don't respect work as much as whites, that Roma don't believe in education the way whites do. By the way, if this doesn't go without saying, I think all this is false and it's dumb bigotry, but for the Slovaks this doesn't go without saying.
The discrimination faced by the people in this ghetto extends to health care. Roma women are only allowed to visit the local doctor one day a week. The other days are reserved for white women. Vilma knows the health care system well. Little Eloise is her eighth child.
VILMA (Translation): When they see a gypsy with several children, they get angry. From the beginning, they spoke about the child in terms of money. Even when I went for a check-up in the morning, he told me I wouldn't get extra child allowance. I told him I wasn't having this baby for money. I asked if he thought the 270 crowns allowance covered the cost of this child.
The final insult from the doctor, though, was during labour.
VILMA (Translation): When the baby was coming out and I was in pain, he turned his back to me and started making faces. He said, "Yuck, dirty gypsy". He didn't want to touch me.
BARBORA BUKOVSKA: We heard complaints and it was not in one settlement and not by one woman but by many women who didn't know each other and who were having same complaints that they were mistreated in the hospitals, that they were beaten, um, and doctors and nurses are screaming at them racist slanders and there are special rooms, segregated rooms for the Roma women and segregated facilities as dining rooms or toilets, bathrooms.
Back at Presov Hospital, Dr Kysely denies Roma women are discriminated against. However, he does want to point out that Roma are different.
DR KYSELY (Translation): The main difference is that the ones from the settlements are very much behind in questions of hygiene, social, cultural and psychological development. Those from the cities are just like the whites. The ones who live in the communes aren't interested in anything, don't attend school - they haven't developed the habit of basic hygiene.
The doctor then offers to show me something to illustrate his point - a newborn Roma baby with a deformity.
DR KYSELY (Translation): They don't go to prenatal clinics. They’re sick and give birth to children like that. Take her to see the hydrocephaly case.
The head nurse, Adela Bednaricova, takes me to go and see this baby. She shares the doctor's assessment of Rom women from settlements.
ADELA BEDNARICOVA (Translation): As for the Rom women from the settlements... It's a degenerate race. I don't know how you'll translate that, but ... they in fact... They have sexual relations between brother and sister, father and daughter, mother and son, and so on. It goes from one generation to another and the latest one is now degenerate. We have the impression that they keep making these children more and more for financial reasons - because they might get extra family allowance. First, I'll show you the ward where the patients are.
From what I see, it's clear that there is segregation. There are rooms for the Roma and rooms for the whites.
ADELA BEDNARICOVA (Translation): They segregate themselves. We've tried to put them together with white patients, but they refuse to be with them. They'd rather share a bed than share a room with whites. This is the dining room. Rom women eat together with white women. We don't segregate them. They have their meals together.
Finally we reach our destination, the deformed Roma baby, and I'm passed on to the hospital's head paediatrician, Dr Maria Sinayova.
DR MARIA SINAYOVA (Translation): This is the baby of a mother who is not yet 16. She didn't go to prenatal clinic. It's hydrocephaly. She didn't go to the clinic because she didn't want to.
This baby is not expected to live for more than a few months. The doctor blames the mother.
DR MARIA SINAYOVA (Translation): It's their mentality. We can't understand it. Those who want to go, do go. Those who don't, won't.
Dr Sinayova claims the Roma won't do anything unless they get paid.
DR MARIA SINAYOVA (Translation): In the past, they had to go to the clinic a few times in order to get the childbirth and the family allowance. Now they get it anyhow so only a financial penalty would have an effect.
INTERPRETER (Translation): Is there a solution that would allow Roma women to take better care in order to have healthy babies?
DR MARIA SINAYOVA (Translation): A better approach, responsibility, and their maternal instinct. I don't know. The maternal instinct has to wake up inside them.
JUD NIRENBERG: I think the first thing to do is to admit the fundamental problem here is that we we've got nurses and doctors who don't think that Roma are human beings - apparently, they don't think that Roma are even mammals. Is there a mammal that lacks maternal instincts? I don't think we should try to address the problem by looking too deeply at the Romany community. I think we need to start by asking what can we do about the fact that a hospital is staffed by people that think that non-whites lack basic human characteristics, like the love for one's own children.
Apart from a general climate of racism, there are several possible explanations for the sterilisation of Roma women. A pressing concern for the doctors and nurses of Slovakia is the fear that their white race will be out-bred by the Roma.
ADELA BEDNARICOVA (Translation): If it really were true what they claim, then it wouldn't be the case that in 10 years, there'll be a many of them as us.
Fear of the Roma birth rate is common in Slovakia. It's discussed widely, even at official levels. A mayor in eastern Slovakia, for example, is proposing Chinese-style limits on the number of children Roma can have. The leader of an opposition political party wants Roma men to be paid to be sterilised.
BARBORA BUKOVSKA: Doctors also genuinely believe that Roma are going to outnumber the Slovaks in society so they should do something with that - and I think that what they do is within the framework of this societal fear, societal myth, and they are thinking that they are justified to do what they do because they are helping Slovakia.
It could also be the case that doctors in Slovakia are just continuing a long-established practice. Under communism, many Roma women were sterilised in questionable circumstances, because of a policy that offered financial incentives for sterilisation.
BARBORA BUKOVSKA: That stopped because the law was amended in 1990, early 1990, but nevertheless the practice continues and the doctors who are doing it, they are still continuing. Some of them were young doctors then and now they are chiefs of the departments of the hospitals.
The Slovak Government's response has been one of scepticism and hostility. Ingrid Ginova has been on the receiving end of this. She was sterilised two and a half years ago, when she was just 16. Since the report came out, she's spoken publicly about her ordeal and is one of only two women pressing criminal charges. Today she's meeting with her lawyer and a human rights activist.
INGRID GINOVA (Translation): I want everyone to know what I've been through and how I feel now that I can't - now that I'm empty and I can't give life to a child. I could have had the joy and the pain of it. I can't express myself.
Shortly after her name appeared in local and international media, Ingrid received a visit from the local police.
INGRID GINOVA (Translation): A policeman came in a car and pulled up where he's standing. From the car he called out the name of who was to go down and I was called. They asked me how much I was paid for bringing charges against the doctor. I told them I hadn't been paid any money. None at all.
Ingrid was then taken to the local police station with one other woman. They were told they would be sent to jail if their claims were not proven.
INGRID GINOVA (Translation): They took us there and they asked us whether we knew that a false declaration could mean three years in prison.
As well as threatening Roma women with imprisonment, the Slovak Government warned the authors of the report that they, too, could be charged if the complaints weren't proven. Government spokesman Peter Miklosi.
PETER MIKLOSI, GOVERNMENT SPOKESMAN (Translation): Our aim is to uncover the real truth in all this and, if we find that a law has been broken, to prosecute the persons responsible. If it's found that no law has been broken, we'll seek action against those responsible for scare mongering.
The Government has recently concluded the major part of an investigation into the report, finding the allegations are without factual basis. This investigation relied on reviewing the records of one hospital, essentially just checking that signatures were in place. Walking around the settlement where Ingrid lives, we discover that her village is now paying a price for her decision to speak out. People here tell us that the local hospital, the hospital against which Ingrid made her complaint, is venting its anger against the village. This woman did not want to be filmed.
WOMAN (Translation): You made problems for them and they're angry with us. They won't treat our kids, even at Emergency, but with your resident card, they have to. They say we belong to the Gelnica. They won't treat our kids.
The hospital in question denies it is refusing to treat Roma from Ingrid's village. But when I was filming outside, it became clear that the allegations of forced sterilisations have touched a raw nerve here. I'm approached by a doctor from the hospital. It's unclear whether he realises I'm filming him.
DOCTOR (Translation): Are you trying to make fools out of us? We're this much above you. This much. Don't make fools of us. We're not apes in trees. I'm a hard-working surgeon. I work incredibly hard. Aren't you ashamed? Look for the reasons where they lie and not here with us, hard-working people. The cause lies with the gypsies. They do bugger all. They're lazy and stupid, look at them, you call that work? They've never done a day's work. That's what you should look at. Not at the decent, hard-working people.
This is a sensitive issue for Slovakia, particularly at a time when it's preparing to enter the European Union and the country's human rights record is on display. Luckily for Slovakia, the reports of forced sterilisation have barely raised a murmur in Brussels.
JUD NIRENBERG: The State seems to have a stronger interest in punishing the victims for having embarrassed Slovakia by speaking out than in punishing the people who misbehaved. I think that's very concerning and I'm surprised that the European Union is as nonchalant about the whole matter as it is.
The women who've been sterilised have been left only with questions and the unfulfilled desire for more children.
ROZALIA (Translation): Everyone is angry. They'd all want more. What can they do? Where can they go? They don't know who to turn to to reverse it, to be like before. I don't even know if it's possible...