Forced sterilisation of Indigenous women in Peru

A tubal ligation involves cutting into a woman's abdomen, locating her fallopian tubes, and severing, burning, or blocking them, a permanent procedure that, performed without sterile conditions or proper aftercare, carries serious risks of haemorrhage, infection, and death. In rural Peru in the 1990s, it was being done in mud-floored health posts, commonly without anaesthesia, often on women who had no idea what was happening to them.

This was government policy.

Between 1996 and 2000, Alberto Fujimori's administration ran a family planning campaign (PSRPF) that focused heavily its efforts on Voluntary Surgical Contraception Programme, AQV in Spanish, the acronym offering a bureaucratic tidiness to what was, in practice, a state-organised mutilation campaign. Health workers were assigned numerical quotas. Miss your target, lose your job. The women they were sent after were overwhelmingly Quechua-speaking, poor, rural, and Indigenous, the population that Peru had always treated as expendable.

According to data released by Peru's own Health Ministry, over 290,000 women underwent tubal ligations between 1996 and 2000. Rights group CLADEM estimates that as few as 10% gave genuine consent. A subsequent study of the broader programme, covering 1993 to 2000, found that approximately 220,000 women were deprived of basic information about alternative contraceptives, the risks involved, or the fact that the procedure was permanent. 26,000 were not even told they would never be able to have children again.

Some were taken for sterilisation immediately after giving birth, still on the delivery table. Others were coerced at routine medical appointments. Some were offered food, bags of rice, tins of oil, in exchange for agreeing, incentives impossible to refuse for families already in poverty. These were not incidental details of implementation. They were made possible by postcolonial structures that have long denied Indigenous people equal footing, in land, in law, in labour markets, compounding disadvantage across generations and making communities like these acutely vulnerable to exactly this kind of state coercion.

The monetary poverty rate among indigenous people was running at nearly double the national figure, 35.9% against 20.8%. Indigenous applicants needed to send 80% more job applications than white candidates with equivalent qualifications just to get a callback. The women targeted by AQV were not random. They were chosen because the state had spent decades constructing them as people whose fertility was a problem to be managed.

The programme was framed internationally in the language of women's empowerment. USAID and UNFPA were funding it. Fujimori's government dressed it in reproductive rights rhetoric while running forced sterilisation quotas on the ground. Professor Ñusta Carranza Ko, Associate Professor of Global Affairs and Human Security at the University of Baltimore and a scholar of Quechua descent, is precise about what this combination achieved: it insulated the programme from international scrutiny long enough to start it. By the time international partners had documented the coercion well enough to threaten funding cuts, the damage, hundreds of thousands of women, permanently, without consent, was already extensive.

Peru's fertility rate did drop over this period, from 3.83 in 1990 to 2.93 in 2000. What Fujimori never acknowledged is that the decline was already happening before he touched it, the rate had been falling at the same pace since 1970, when it stood at 6.31. The programme accelerated nothing demographically. Nor did it touch poverty. Indigenous poverty in Peru stood at 62.3% in 1994 and 62.8% in 2000, statistically indistinguishable, across the entire span of the programme, which rather exposes the stated rationale for what it was.

What followed, across two decades, has been a masterclass in the performance of accountability without its substance. Peru's Truth and Reconciliation Commission concluded its work in 2003 without acknowledging the sterilisations, a silence that has haunted every subsequent attempt at justice, leaving survivors without the institutional foundation that formal recognition might have built.

A victims' registry, REVIESFO, exists on paper, but registering requires survivors to produce medical documentation and formal testimony that many, in rural and Indigenous communities with threadbare access to healthcare records, simply cannot obtain. Criminal investigations into Fujimori and his health ministers ran for over 20 years before being definitively archived. No one has been convicted domestically. No reparations have been paid.  As Professor Ko and Indigenous leaders like Ketty Marcelo Lopez noted have documented, this is not aberration, it is pattern. The state's violence against these communities did not begin with AQV, and its impunity did not end there either.

Professor Ko describes the institutional pattern as both failure and intention. ‘The state doesn't want to recognise and give reparations for as long as they can avoid it,’ she says. This year, the Inter-American Court of Human Rights found Peru responsible for violations including discrimination, a legal landmark that human rights advocates celebrated and that Peru has yet to act on, distracted, officially, by electoral politics.

Professor Ko is sceptical about what compliance will look like even if it comes. Symbolic reparations, a plaque, a commemorative date, a public apology, are the most likely concession, gestures designed to close the file without opening the prison doors. She draws a comparison that lands hard: the Japanese government's management of the comfort women case, prolonging engagement until the survivors die.

The survivors of AQV are now in their fifties, sixties, and seventies. What they want, consistently and clearly across decades of organising through groups like IAMAMC, is what they have always wanted: the people responsible jailed, a genuine apology, and medical support for the lifelong health consequences of procedures performed in conditions that should never have been permitted. What they have received is registries that don't work, investigations that close, and court victories that Peru is too busy to honour.

Reproductive violence against Indigenous women, Professor Ko argues, sits at the intersection of every axis along which Peruvian society has historically decided whose suffering counts. Indigenous, female, rural, Quechua-speaking, poor. Formal acknowledgement has not changed that calculus. The files are open. The names are written down.

Reparations remain rhetorical.

Further information and opportunities to engage with organisations working in this area are listed below:
https://www.ampaefperu.org/
https://demus.org.pe/
https://interactive.quipu-project.com/#/en/quipu/intro

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