Complaints sent to UN Bodies on Obstetric Violence in Croatia
Following a month of public debate and discussion on obstetric violence (lack of anaesthesia) during reproductive healthcare procedures, Roda has submitted the following complaint to three UN human rights bodies:
- Special Rapporteur for Violence Against Women
- Special Rapporteur for the Right to Health
- Working Group on the issue of discrimination against women in law and in practice
Below please find the text of the complaint, while the full complaints can be found in PDF format at the end of this article.
On Thursday, October 11th, 2018, Croatian Member of Parliament Ivana Ninčević Lesandrić, stood up and told her very personal story of obstetric violence to the House and Minister of Health.
"I had a miscarriage. They tied my hands and feet and began the curettage procedure without any anesthesia. They scraped my uterus without anesthesia. Those were the most torturous 30 minutes in my life. I can describe every second to you because they were the worst 30 minutes of my life. Thirty minutes of degradation for every one of the thousands of women who have signed petitions to end this type of care.”
The Speaker of the House reprimanded her for going over her allotted time and told her that she had put him in a very uncomfortable position telling such an intimate story in the Parliament. The Minister of Health, who was also present, responded to her statement by saying: "Croatian hospitals don't do things like that. Give me your medical documentation so I can explain why anesthesia was contraindicated."
Sadly, MP Ninčević Lesandrić’s experience is not an outlier that can be explained away, but rather one of thousands of similar horror stories of unnecessary denial of access to pain control, substandard care, humiliation and discrimination of women by medical staff during standard reproductive health procedures in Croatia. In 2014, Roda sent an open letter to then Minister of Health Dr. Siniša Varga calling for an end to this type of discriminatory and inhumane treatment of women accessing reproductive health services in Croatia. The authorities’ response to both the campaign in 2014 and MP Ninčević Lesandrić’s testimony in Parliament in 2018 was one of indifference to the suffering of women, discreditation of women’s experiences and showed a complete lack of political will to take effective measures to eliminate discrimination against women in healthcare and ensure women’s equal access to comprehensive health services, including access to pain relief during standard reproductive health procedures. Thus, the Ministry is ignoring Croatia’s commitments under the Convention on the Elimination of All Forms of Discrimination against Women, Article 12(1) to take all appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services.
As a response to the official attempts to discredit MP Ninčević Lesandrić’s story, Roda - Parents in Action, a large Croatian parents’ organization, called for women to send their testimonials of procedures in reproductive health conducted without anaesthesia, using the hashtag #PrekinimoŠutnju, or #BreakTheSilence. In only two and a half days, Roda collected 400 handwritten stories of procedures ranging from biopsies, medically assisted reproduction treatments, surgical miscarriages and surgical removals of placenta as well as suturing after vaginal birth being conducted without anaesthesia. In the weeks that followed, hundreds more stories flowed in from all over the country, spanning all regions and over two decades of women experiencing discrimination, misogyny, denial of access to pain relief, and unethical treatment when accessing reproductive health care services in Croatia. Some of these stories are attached to this communication, with translations in English.
The reactions of leaders of some of the most important Croatian healthcare institutions and professional organisations during this period have shown an overall lack of concern, denial of the existence of a problem, questioning the credibility of the women’s stories and women’s perceptions of pain in general, to blaming the problem on a deficit of anesthesiologists. Instead of reacting with alarm to testimonials of discrimination, human rights abuses and denial of access to pain relief, and insisting immediate and effective measures be taken to protect women's reproductive health, leaders of public health institutions and organisations were among the first to demean and question the truth of thousands of women's stories of pain and suffering, questioning their intelligence and credibility.
The stories women have sent clearly show that legislated mechanisms for protecting patient's human rights do not function in practice in Croatia. Years of attempts and requests made by various stakeholders to the Ministry of Health have not resulted in any improvements, but have instead repeatedly demonstrated a lack of political will inside the health sector to adequately respond to these egregious abuses of women’s health rights. Indeed, the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, on his visit to Croatia in 2016 noted the “strong opposition among policymakers and within society at large towards well-established standards, instruments and mechanisms for the promotion and protection of women’s sexual and reproductive health rights.” The Special Rapporteur went on to recommend that priority be given to women’s and children’s rights in the area of sexual and reproductive health, and set out recommendations, which the Ministry of Health has not yet addressed with any specific measures. There are concerns that gynaecologists would like to handle the problem within a closed circle of professionals, having the profession monitor itself, without including stakeholders from other sectors.
For this reason, and after many years of women’s suffering being ignored, and patient representatives’ and women’s rights advocates recommendations being denied, on October 24th, Roda wrote a letter to Prime Minister Andrej Plenković calling on him to begin urgent procedures for the preparation of an Action Plan for Women's Health for 2019-2021 by International Human Rights Day 10 December 2018 and to express concern about announcements that inspection teams will be visiting Croatian healthcare facilities, consist only of physicians and do not include other stakeholders or patient representatives. More specifically, similar inspections to date have sought to bury problems instead of addressing them, and have led to no improvements in the protection of women’s health rights. Indeed, RODA’s concerns about the aims and effectiveness of such measures were only buttressed by the Minister of Health Mr. Kujundžić’s statement on October 26th, that all those who are found guilty will face punishment, including women whose testimonials turned out to be untrue. Such a statement is clearly geared towards silencing any more women from coming forward out of fear of punishment, and does On October 29th, RODA expressed its concerns with the Minister of Health and called again on the Prime Minister to begin urgent procedures for the preparation of an Action Plan for Women's Health, to show that his Government protects the dignity of women and their right to life without violence, including reproductive and institutional violence. To date, there has been no response from the Prime Minister’s Office.
We are calling on you to monitor this process closely, and to consider launching an investigation on the systemic and institutional violations of women’s rights to health and dignity in healthcare in Croatia.