Four HIV-positive Kenyan women recently won a nine-year legal battle and have been awarded $20,000 (£16,000). The women filed the case after being sterilized without their informed consent, according to the report by BBC News.

“It has ruined my life,” noted one of the women. The statement was given by her after she underwent surgery shortly after having twins at a state-owned Pumwani Maternity Hospital in Nairobi.

The women stated that they aren’t concerned about the compensation but are glad that the High Court Judgement has “validated their demand for justice,” reported BBC.

According to the reports, their lawyer, Nyokabi Njogu, stated, “They just wanted an acknowledgment that this happened. They don’t want women who have suffered like them to continue in that suffering.”

What heart-wrenching procedure did they actually undergo?

The procedure is called ‘bilateral tubal ligation, also known as BTL.’ Commonly, the procedure is termed as tubes tied. Under this procedure, a woman’s fallopian tubes are cut, tied, burned, clipped as well as partly removed from their body to prevent future pregnancies.

The major intention behind BTL is to prevent sperm from meeting the egg. The procedure doesn’t affect the menstrual cycle of a woman, yet it may result in problems like pain in the belly, a swollen belly, a change in bowels, and shoulder or back pain.

Poignant tale of the woman’s journey

One of the four anonymous women had no one as the father of her twins left before the delivery; her husband was no more as he scummed to HIV-related complications. While having a conversation with BBC News, she expressed grief and asked who would become her partner as she can’t give birth following the procedure.

It is to be noted that the woman was aware that she is HIV positive; however, she was advised to give birth by cesarean section (C-section). However, she was advised not to breastfeed her children so that the virus is not transmitted from mother to child. After giving birth, she fed her baby formula milk, according to a report by BBC News.

While expressing her pain, she stated, “As a single mother, that shocked me. I was already struggling with stigma. I didn’t know what else to do.”

Which path led the woman to BTL?

In the midst of this struggle, the woman was suggested to visit Marie Stopes – the largest and most-specialized sexual reproductive health organization in Kenya. Here, she met a community worker who asked her to fill out and sign a form (which was about BTL surgery).

However, it is reported that the surgery was performed without her consent as she was unable to read and write.

What happened with the other three women?

The second woman had a similar experience at the largest public maternity hospital in Kenya in Pumwani. The reports have suggested that she was aware of her condition and her suffering from HIV by the time she was pregnant with her fourth child.

According to the reports by BCC News, she underwent the procedure because she was told that if she did not, then she would not receive the portions of cooking oil, porridge, and maize-meal flour. She was threatened that her medical bills would not be paid.

One of the nurses suggested her family planning and asked her to undergo a BTL, along with cesarean delivery. She signed a form without actually knowing what exactly it was for.

“I didn’t know what it meant. I thought it was ordinary family planning,” the second woman told the BBC. “If they had explained the procedure properly to me, I wouldn’t have signed that paper,” she added.

The third woman expressed that she only remembered saying yes to a cesarean section so that her newborn baby was not infected with HIV. However, when she woke up, she was suffering from unbearable pain. Then, a nurse explained to her that she had undergone the sterilization procedure.

While expressing about her condition, she mentioned, “I was too afraid to tell my husband what happened. I kept it to myself.”

She further added, “When he found out, he became a total drunkard. He died after he was hit by a moving vehicle. These organizations destroyed my home.”

The fourth woman expressed that she underwent the BTL after two months of delivering her third child. She outlined that she was pressurized. She asserted that she was unable to get free baby formula milk. “I was desperate. My husband had left. My rent was due. What could I have done?” she said.

Following this, the woman knocked on the doors of the Kenyan High Court, where they won the case because health professionals did not explain the procedure they were actually undergoing.

What orders by the High Court support such women?

In the month of September, the High Court of Kenya stated that if a woman is forced to opt for the bilateral tubal ligation procedure, then it will be a violation of women’s fundamental rights.

According to the reports by BBC, the damages will be fulfilled by Marie Stopes International and the Pumwani Maternity Hospital as well as the medical charity Médecins Sans Frontières (MSF).

Very significant decision for HIV-positive women!

The four women were represented by the executive director of Kelin Kenya – an HIV-rights group – Allan Maleche. He underscored that this latest judgment by the High Court is essential for the women who are HIV-positive and are forced to undergo sterilization.

During the conversation with BCC, Maleche noted, “For a very long time, cases that were filed in South Africa, in Namibia, had the difficulty making the link between the tubal ligation and the HIV status. The significance of this case is that it reaffirmed the fact that it is wrong.”

What insights do spokespersons from Marie Stopes, MSF France, and Pumwani Maternity Hospital bring to table?

BBC interacted with a spokesperson of Marie Stopes via email and stated that this resolution is welcomed wholeheartedly, nearly after a decade.

“Informed consent has always been integral to everything we do. As a member of the global reproductive rights community, we understand the stigma that people living with HIV continue to face. We will continue to undertake rigorous training and monitoring to ensure that the highest standards are adhered to, and we will never be complacent about the care we deliver,” the email read.

On the contrary, MSF France outlined that they have not ever performed the BTL procedure in Kenya. MSF’s country director in Kenya – Dr Hajir Elyas, told the news organization that if any woman shows interest in sterilization, then their duty is to counsel, inform and then refer them to selected facilities.

Elyas stated, “We acknowledge the part of the responsibility for what happened to the women and restate, as a medical organization, our commitment to the patient informed consent process.”

Although, no comment was given by the Pumwani Maternity Hospital.

BTL without consent is a serious issue in Kenya!

It is to be noted that no data confirms the number of cases of HIV in Kenya about sterilization without informed consent. Research conducted back in the year 2012 studied 40 women who had been sterilized without their information. However, only five (5) were able to file a petition.

The research was published by the African Gender and Media Initiative – Robbed of Choice.