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TALES OF POOR women being pressured and even forced to submit Pera^s plan to sterilization operations that have killed at least two women have emerged from small towns and vil to sterilke lages across Peru in recent weeks. Critics of the program, which was THE GOVERNiV3ENT has vehe begun in 1995, charge that state mently rejected charges that it is con poorwomen health-care workers, in a huny to ducting a campaign to sterilize poor meet government-imposed steriliza women and says that all its steriliza tion quotas that offer promotions and tion operations are done with the pa criticized, cash incentives, are taking advantage tient's consent, as required by law. of poor rural women, many of whom Health Ministry officials, who are illiterate. spoke on condition of anonymity, The critics, who include many of said that in the last year the program Reports of deaths the program's early supporters, say had suffered from "lapses in judg health workers are not telling poor ment" by individual health-care shock supporters women about alternative methods of workers and doctors, who had been contraception or the fact that tubal li reprimanded. But the officials said ByCALVIN SIMS gation is nearly always irreversible. They also charge that many state that such cases were isolated inci The New York Times dents that had been blown out of doctors perform sloppy operations. proportion. LIMA, Peru —For Magna Morales "They always look for the poorest Three years ago, when President and Bernadina Alva, peasant Andean women," said Gregoria Chuquihuan- Alberto Fujimori announced plans to women who could barely afford to cas, another Tocache resident. "They promote birth control as a way to re feed their families, it was a troubling make them put their fingerprint on a duce family size and widespread pov offer but one they found hard to re sterilization paper they don't under erty in Peru, family-planning experts, fuse. Shortly before Christmas, gov stand because they can't read. If the women refuse, they threaten to cut feminists and even many opposition ernment health workers. promised politicians expressed broad support. giftsof food and clothing if they un off the food and milk programs." The government denies there are But the mounting criticism of the derwent a sterilization procedure sterilizations has tarnished the image called tubal ligation. sterilization quotas, though it ac knowledges having goals. of the family-planning program, one X The operation went well for Alva, of the most ambitious in the Third m 26, who received two dresses for her "The government's program is morally corrupt because nurses and Worid. O daughter and a T-shirt for her son. Health Ministry officials estimate O But Morales, 34, died of complica doctors are under pressure to find c; women to sterilize, and the women that the 1997 stenlizations will result go tions 10days after the surgery, leav in 26,000 fewer births in 1998. This is ing three young children and a hus- are not allowed to make an informed S decision," said Luis Solari, a medical good news, they say, in a country iDand. She was never well enough to where the fertility rate — the average Catholic church leaders have vigor "When you don't have anything ously opposed the program because and they offer you clothes and food it promotes artificial forms of birth CO for your kids, then finally you agree control, which the church disavows. d to do it," said Alva, a neighbor of Cardinal Augusto Vargas Alzamora z Morales in the village of Tocache. of Lima has warned Catholics that "Magna told them that her husband they will be committing a "grave sin" i if they resort to sterilization. was against the idea, but they told m her, 'Don't worry, we can do it right 00 now, and tonight you will be back ZD home cookingand your husband will never realize what happened.' " I

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