The forced sterilisation of a deaf woman in Lesotho has flagged how families are secretly and illegally  sterilising disabled daughters, giving them no say over their sexual and reproductive health rights. This is being done no matter how mild or severe the disability in the name “protecting” them from unwanted pregnancies, including rape-related conception.

20 October 2023 by Pascalinah Kabi

This investigative reporting was supported by the International Women’s Media Foundation’s Howard G. Buffett Fund for Women Journalists.

‘Matsepiso Likopo Mokhoromeng (in red jacket) says parents of a deaf woman sterilised her to prevent future rape related pregnancies. Mokhoromeng is seen her with interpreter, Mafusi Lenonya, at the media briefing on Disability Council. Credit: Pascalinah Kabi. 

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In a shocking revelation, MNN can confirm that a deaf woman who has spoken up about her forced sterilisation is not alone in Lesotho where the reproductive rights of disabled women of all ages are violated with little consequence. Parents and guardians are secretly engaging doctors who will sterilise daughters with disabilities. Families make the decision, no matter how mild of severe the disability.

 Lesotho’s National Federation of Organisation of the Disabled (LNFOD) Gender Officer , ‘Masenono Letsie, told MNN that  that girls and women with disability in Lesotho are hardly ever involved in discussions around their sexual and reproductive health rights (SRHR).

“Their families make decisions on their behalf. They do not even care whether the disability is mild or severe, they just want to sterilise them,” Letsie said.

She says reasons for sterilising girls and women with disability border around families viewing disability as a curse and as such, they fear disabled women will also give birth to disabled children. Families believe that this, according to Letsie, would be a disgrace to such families.  

“And as such, parents decide to remove wombs of their mentally impaired children. Secondly, there are many abuses meted on disabled persons, including rape. To prevent these disabled women from falling pregnant from rape-related incidences, their guardians and parents force them to sterilise,” Letsie said.

LNFOD has since discovered that forced sterilisation remains closely guarded family secrets because communities believe that this unlawful practice “is a form of protection” for disabled girls and women.

“What they fail to understand is that they are denying them (disabled girls and women) their sexual and reproductive health rights. Although they are disabled, they have to be informed about each and every decision made on their bodies. You cannot just wake up in the morning and say I am going to have her womb removed because I am her guardian,” she said.

Section 25 of the Persons with Disability Equity Act, 2021 mandates that persons with disabilities must receive “non-discriminatory attendance and service provision by medical personnel and health

professionals.”

‘They sterilised me after I was raped’

In April this year, two local families approached the National Association of Deaf Lesotho (NADL) to mediate in their family dispute. One of the family members was ‘Matokelo Tsuinyane* (not her real names) – a woman with hearing and speech impairment.   

Tsuinyane and her in-laws had not been seeing eye-to-eye and believed that they were having challenges understanding Tsuinyane’s sign language. Her in-laws also believed that a mediation overseen by NADL would help them resolve their family disputes.

NADL official Matšepiso Mokhoromeng says Tsuinyane was raped twice as a girl. Of the two rape cases, Tsuinyane fell pregnant. She is a mother of one child. To prevent this from repeating itself, Mokhoromeng says Tsuinyane’s maiden family sterilised her without her consent around 2015.

“One lady was sterilised after being raped twice. She is less than 30 years and her case is very sensitive,” Mokhoromeng said in an interview with MNN.

Mokhoromeng says Tsiunyane shared her story with NADL during a closed meeting between NADL officials, her maternal family and in-laws.  

“It was during that meeting that the woman shockingly revealed that she was sterilised without per permission after being raped twice. She was not married at the time her family sterilised her,” Mokhoromeng said.

Although Mokhoromeng could not reveal more details surrounding Tsuinyane’s case in a bid to protect her, she says Tsuinyane is not the only Mosotho woman with hearing and speech impairment that has been sterilised without her consent.

Many cases of forced sterilisation targeting women with hearing and speech impairment happened between 1994 and 1998, according to Mokhoromeng. Sterilisation is sealing a fallopian tube of a woman and when done without her knowledge or consent, it is referred to forced or involuntary sterilisation.

Health experts say sterilisation can be done just after a vaginal delivery or caesarean delivery. “Non-surgical procedures use devices placed in the fallopian tubes to seal them. The devices are inserted through the vagina and uterus, and the placement doesn’t require an incision.”

Another procedure – Bilateral salpingectomy (BS), also known as tubectomy, is having a woman’s fallopian tubes completely surgically removed. If not the whole tube is removed, it’s called a partial bilateral salpingectomy. 

While there is evidence that women in key groups of HIV+ and disability are being sterilised without their consent in Lesotho, MNN has not been able to independently identify which type of sterilisation is commonly used in Lesotho.

Disabled women twice burdened 

According to United Nations, women in Lesotho generally face discrimination based on their gender.

“Such discrimination is often justified on the grounds of custom and culture as stipulation in section 18(4)(e) of the Constitution of Lesotho,” reads a UN Women report on Mapping Discrimination against Women and Girls with disabilities in East and Southern Africa.

When it comes to women and girls with disabilities, they “suffer double the scourge because of their status as women and because of their disabilities.” 

“The discrimination leads to denial of sexual and reproductive rights, unemployment, lack of access to education and limited participation in politics,” UN said.

UN also argues that section 3 of the the country’s Sexual Offences Act 2003 is viewed by many as reinforcing stereotypes that persons with disability are asexual.  

The section provides that anyone who engages in sexual intercourse with a disabled person who does not have the capacity to consent to such an act, commits an offence.

It further provides that, anyone who engages in sexual intercourse in the presence of a person with a disability commits an offence.

“In as much as the rationale behind this section is described as protection of persons with disability from sexual assault and exploitation, the section has been viewed as prohibiting persons with disability from consensual sexual relations thereby reinforcing the stereotype that persons with disability are asexual,” read the report.

The stereotype that disabled persons are asexual has led to communities, including health workers, frowning upon pregnant women who are disabled.

Pascalina Letsau is physically disabled. She fell pregnant with her first child in 1990 and attended antenatal clinic classes at the now demolished Queen Elizabeth II Hospital.

“I attended my antenatal clinic classes at Queen II on my first pregnancy. Every time I entered the room, there was shock on people’s faces because of my pregnancy. They would even gossip about me and sometimes nurses would say “even you, you allowed yourself to fall pregnant in your condition, men are really dogs,” Letsau said.

She added: “My friend and I experienced a lot of discrimination while attending antenatal clinic classes at Queen II. Instead of enjoying the fact that one has sought help at the right place, it became a place of distress.”

National University of Lesotho Head of Department of Procedural and Adjectival Law Dr Itumeleng Shale says this entrenched belief by most Basotho, including healthcare professionals, that persons with disabilities are asexual can dangerously affect persons with disability’s right to information.

Dr Shale says this affects access to information relating to sexual health, family planning, treatment of sexually transmitted diseases and HIV/AIDS counselling and testing services by persons with disabilities.

“Women with disabilities constitute about 1,6 per cent of the population of Lesotho (about 32 000 people),30 yet despite these significant figures, their rights are often overlooked, neglected and violated,” Dr Shale said in her 2014 Sexual and Reproductive Rights of Women with Disabilities: Implementing International Human Rights Standards in Lesotho.

I called my mother out – Letsau

When Letsau saw her first menstrual period, she was away from her parents’ house because she lived at the Centre of Disabled Children in Quthing. Letsau and other disabled children at the centre were only allowed to visit home twice a year.

“When I got home, my mother realised that I was now menstruating and started asking questions around when I began seeing my monthly periods. She later said to me “I don’t even want you to get married. I don’t want people thinking you are dumping your struggles on their families. I really despise the idea of you getting married,” Letsau explained.

Her mother, who hails from Botha-Bothe, wanted Letsau to have a career in nursing as she strongly felt that a disabled child should not get married and have children.

As such, Letsau’s mother started making inquiries about sterilisation few days after her daughter shared news that she was menstruating.

“I heard from grapevines that my mother is making inquiries on how I could be helped with a permanent birth control. She did not discuss it with me but with our female neighbours and relatives,” Letsau explained.

While her mother was busy making inquiries on sterilisation, time came for Letsau to return to Centre for Disabled Children. A year later, Letsau fell pregnant.

“When my pregnancy was reported to my parents, my mother said to my brothers, “you see now, I told you that I don’t want this child to have children and you failed to help me to have her fallopian tubes blocked or sealed”.

I asked her whose tube was going to be cut and she said, “yours, what are we now going to do with a child?” I told her that this was my child, and she was not going to perform that procedure on me without telling me first. I told her that sterilising me without my knowledge would have been a grave mistake, cautioning her to never make decisions about me without involving me.  

“I told her that now I have a child, what will happen when I meet someone who would like to marry me because married women are expected to birth children? What is going to happen? She repeated that issue of her not wanting me to get married. I was a member of disability organisations and friends with older girls, so I knew my bodily autonomy rights, and this is why it was never a problem to tell my mother that she cannot do that to me,” Letsau said.

Today, Letsau is a mother of two children who voluntarily chose to tie her fallopian tubes.

“I was pregnant with my second child when I voluntarily told doctors that I wanted to have my fallopian tubes tied. I chose this procedure to ensure that in an event that I want to have a third child, I would still be able to. I told them that I am against the procedure of cutting my tubes,” Letsau said.

The procedure was performed by doctors at St Charles Hospital in Botha-Bothe.