8 Apr 2025 | Czech Republic, Europe and Central Asia, News and features, Slovakia, Volume 54.01 Spring 2025
This article will appear in Volume 54, Issue 1 of our print edition of Index on Censorship, titled The forgotten patients: Lost voices in the global healthcare system, which will be published in April 2025.
Jana Husárová was in labour with her second child when the doctor presented her with a document. “I didn’t want to sign it,” she said. So she didn’t.
“When I got home, I visited my doctor in Sabinov. He told me that my [fallopian tubes] were tied.”
She went back to the hospital and asked how that could be possible when she had not signed a consent form.
It was 1984, and Husárová was 15 years old. She is one of many Roma women who have undergone forced sterilisation, as she described in a video for the Slovakian Centre for Civil and Human Rights (known as Poradňa).
Since then, she has fought for justice and compensation, and to stop this happening to other women.
In Soviet-era Czechoslovakia, Roma women underwent forced sterilisations, just as they had done under the Nazi regime.
They were offered money by visiting social workers, pressured into agreeing to the procedure and told that their other children would be taken away if they did not comply. Others were made to sign consent forms while in agony during childbirth, often with no idea what they were signing. When a caesarean section was performed, they were sterilised at the same time.
Then came the Velvet Revolution in 1989 – which marked the end of Soviet rule in Czechoslovakia – and, in 1993, the creation of the Czech Republic and Slovakia as sovereign nations.
Sterilisation was no longer state policy, but the doctors who had implemented it were never punished, and racism towards Roma communities continued to thrive.
And for Roma women, the practice was far from over.
In 2003, a grim reality was uncovered in a report by the global human rights organisation Centre for Reproductive Rights and Poradňa. The organisations interviewed about 110 Roma women across eastern Slovakia who had been (or had likely been) sterilised since the fall of communism. They found that doctors and nurses gave women “misleading or threatening information” to “coerce them into providing last-minute authorisations for sterilisations” when they were undergoing caesareans. C-sections were sometimes given unnecessarily, partly as a pretext for sterilisation.
In some cases, women were not told about the procedure until after the event – if ever.
Alongside forced sterilisation, Roma women faced physical and verbal abuse by medical providers. They were segregated in maternity wards and sent to Roma-only rooms. If they complained, they were insulted by doctors and nurses.
During the course of the research, hospital authorities stopped Roma women accessing their own medical records, denying them the opportunity to get to the truth. The government failed to condemn any of these practices or put an end to them. The report writers urged the government to examine the issues and make things right with the survivors.
In 2004, Slovakia adopted new legislation around informed consent, requiring women to wait 30 days before sterilisation could be performed. It also gave more protection to patients seeking access to their medical records.
Soon after the report was published, lawyer Vanda Durbáková started working with Poradňa on a plan to bring some of the cases to court while urging the government to introduce a compensation scheme.
At the time, Slovakia was scheduled to become a member of the European Union (EU), and all eyes were on the state of human rights in the country. The reaction to the report from the state was not welcoming, and it initiated criminal proceedings against the report’s authors.
But a group of Roma women felt empowered to take their stories to Parliament.
“They not only submitted their cases in the courts but were also really active, communicating with the media and starting as a group to fight for justice,” Durbáková said.
With little luck in the Slovakian courts, they took their cases to the European Court of Human Rights (ECtHR) in Strasbourg.
Between 2011 and 2013, the ECtHR made rulings in three cases, finding that Roma women who had been forcibly sterilised had had their rights violated. The women were granted financial compensation, and the Slovak courts began to make their own rulings in favour of other women, but it was a slow process.
“The women were not really encouraged to take their cases to the courts, because the [Roma] community was afraid of any victimisation,” Durbáková said, explaining that they were worried that suing hospitals would lead to further discrimination.
But the women who spoke up told her they believed their actions eventually led to them, and their daughters, getting better treatment.
Roma activist Veronika Cibriková, who was forcibly sterilised in 2000 during a caesarean section, told Poradňa: “I don’t want other women – and my daughter, who is now pregnant – to end up like I did. We fight for each and every woman so that they do not suffer as we have suffered.” She eventually got justice at the ECtHR.
Following a call for an inquiry by the UN Human Rights Committee, the Slovak government finally apologised in 2021. It promised to pass legislation to allow for financial compensation, but this has not yet come to fruition.
In 2017, CRR and Poradňa published another damning report, documenting Roma women’s experiences of reproductive healthcare in Slovakia. Women reported abuse, discrimination and physical restraint in childbirth. Almost all the women interviewed reported being segregated in maternity units – something the Commissioner for Human Rights condemned during a visit in February 2025.
One woman, Viola, said: “When I was giving birth…they were yelling at women during childbirth… They tied some women’s legs or jumped on their bellies. One woman [jumped on my belly] with all her weight, pressed it and yelled, ‘Push, push! You were fucking and so now you have to deliver’.”
Durbáková said that sometimes Roma-only rooms were so overcrowded that the women had to share beds. Poradňa is now litigating a case against one state-run hospital.
The fight for Roma women has roots that go back decades. The first documentation came in 1978 through the campaigning organisation Charter 77, with signatories including dissident writer (and, later, Czech president) Václav Havel.
It outlined how Roma women were not truly consenting to sterilisation, saying: “Czechoslovak institutions will soon have to answer charges that they are committing genocide.”
The Czech Republic is facing this ugly truth, too.
“During the 1990s, we began to hear stories of [Roma] women claiming that they were still being forcibly sterilised,” said Gwendolyn Albert, a human rights activist and journalist from the USA who now lives in the Czech Republic. Albert has campaigned for Roma women who have allegedly been sterilised as recently as 2017.
The woman she’s worked with the longest is Elena Gorolová, who became the face of the movement to seek justice in the Czech Republic.
Many Roma women felt ashamed that the decision to choose to have a family had been taken away from them, said Albert: “[These women] went to the hospital fully believing that the doctors had their best interests at heart and were going to do what was best for their health and what was best for their children. And instead, they’ve been tricked into becoming infertile, and so they feel stupid.”
Kumar Vishwanathan is the director of Life Together, an NGO working with Roma communities in Ostrava in the Czech Republic. When he found out that he knew many of the women impacted, he brought them together in his office. At first they were tentative to talk but they soon started opening up.
“They were suppressing it within themselves all their lives,” he said, adding that some women had faced physical abuse at home after it transpired they could no longer have children. “So that is a taboo which was broken around that table in 2003.”
In 2005, the Czech ombudsman published a report showing that there was significant reason to believe that forced sterilisations had continued until at least 2001.
Vishwanathan said that while there was a lot of support for the women during debates in Parliament’s Lower House, the problem came in the Upper House.
“A lot of them were doctors, former doctors, who felt threatened that if they agreed to the fact that these women were forcibly sterilised and have to be compensated… they will be challenged as people who violated the law,” he said.
The Czech government apologised in 2009, becoming the first in the region to do so. In 2021, Gorolová and others won the fight for women to receive compensation, although the government set a time limit for making a claim. Women had until the end of 2024 to apply, and they had to prove that they had been forcibly sterilised, even though many medical records had allegedly been destroyed or falsified.
The government is now debating a two-year extension of the process, and there are calls to remove the “burden of proof” from the victims and place it on the state instead. However, many women had already been rejected under the earlier rules, had not applied in the first place, or died before they had the chance to seek compensation.
There is likely more yet to be uncovered. Vishwanathan said that many Roma people have told him they still face segregation in Czech hospitals.
The issues in reproductive care for Roma women are not unique to the Czech Republic and Slovakia. Ana Rozanova from the ERGO Network, a group of pro-Roma NGOs across Europe, told Index that women in these two countries have simply been more vocal.
This is just a snapshot into the wider discrimination faced by Roma women across Europe, based on both ethnicity and gender.
It is the women who have put an end to forced sterilisation in the Czech Republic and Slovakia by fighting for justice – but there is further to go. The rest must now come to light and be eradicated.
25 Mar 2022 | Czech Republic, Opinion, Russia, Ruth's blog, Ukraine, United States
“We will not be intimidated or pushed off the world stage by people who do not like what we stand for, and that is, freedom, democracy and the fight against disease, poverty and terrorism.” — Madeleine Albright (1937-2022)
This week one of those special people passed away. A woman who broke glass ceilings, whose leadership inspired so many others, a woman who knew what she stood for and was determined to fight for what she knew to be right. She had a life well lived and has left her mark on the world. The reality is our society is lessened by her passing, but we were lucky to have her, and we so nearly didn’t.
Former US Secretary of State Madeleine Albright. Photo: Fiona Hanson/PA Images
Madeleine Albright was born Marie Jana Korbelová, in Prague in 1937, to a Jewish family. Her family fled to London in 1939 when the Nazis invaded. They converted to Roman Catholicism and hid their true identity for decades. The first female US Secretary of State only discovered the truth and the fact that 26 members of her family had been murdered in the Holocaust as an adult. At the end of the war her family chose to return to Czechoslovakia, but this proved short-lived and they were forced to flee the Communist regime in 1949 and seek asylum in the States.
As traumatic as her early life was, Marie Jana Korbelová did more than most to shape the future, to find hope and to cherish the democratic values that were stolen from her and her family. Her personal story and her impact were exceptional. But reflecting on her life has caused me to think a lot about the Children’s Memorial at Yad Vashem, Israel’s Holocaust Museum.
There is a single candle surrounded by mirrors. The reflection of each flame represents a life not born – a story not told. It highlights, in simply imagery, the lives that were extinguished, the families that were destroyed and, heartbreakingly, the children never born because their parents had been murdered. We have no idea of what the world lost because of the Shoah. The poetry and books not written, the art not created, the scientific discoveries not made.
Which brings me to the horrors we see every day on our news. The images of the death and destruction in Ukraine. Lives of every Ukrainian citizen have been turned upside down. We see daily reports of war crimes. Of children being killed, of journalists being kidnapped, of humanitarian aid being blocked.
In Ukraine today, the daily horrors shock and upset us all but for me it is also the devastation of the lives not lived. The talent that is being brutally removed from our world. Our collective society is being lessened because of their deaths and those that will now never be born. We will never know what we have lost. We can only hope that among those that survive there will be someone as inspirational as Madeleine Albright.
22 Oct 2021 | Opinion, Ruth's blog
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On 15 October 1971, in the depths of the Cold War, the feted British poet Stephen Spender wrote an impassioned appeal for the Times Literary Supplement in which he highlighted the threat of a world without creativity or impartial news as repressive regimes sought to silence dissent.
Writers, academics, journalists and artists were subject to state sanctioned persecution on a daily basis, threatened, arrested and in too many cases murdered as authoritarian leaders moved against their citizens. Watching was no longer enough, letters to the Times and statements of solidarity were no longer sufficient for Spender and a group of his contemporaries.
It was time to act, to provide an international platform for dissidents to publish their work and importantly it was time to make a positive argument for the liberal democratic values of free speech and free expression. It was time to launch Writers and Scholars International and its in-house journal Index on Censorship.
Spender concluded: “The problem of censorship is part of larger ones about the use and abuse of freedom.”
In the 50 years since Spender wrote in the TLS, Index has published the works of thousands of dissidents, their words, their art and their journalistic endeavours. From Havel to Rushdie, from Zaghari-Radcliffe to Ma Jian, their works have found a home in our publication. Their stories have been told and their works published for posterity – a recognition of their plight.
Fifty years later Spender would have hoped for us to be irrelevant, that the fundamental freedom of free expression was not just respected but embraced throughout the world. If only that was the case. Every week there is an attack on academic freedom at home or abroad, a new debate about our online rights and a new report of a systematic attack on those that embody the very principle of free speech.
In 1971 over a third of the world’s population lived under Communist rule with still more living under other forms of totalitarian regime. Today 113 countries, representing 75 per cent of the global population, completely or significantly restrict core human rights.
These aren’t just statistics, there are real people behind each headline.
In Belarus 811 people are currently detained as political prisoners by Lukashenka, including Andrei Aliaksandrau one of Index’s former staff members. In Egypt more than 60,000 people are imprisoned, including our award-winner Abdelrahman Tarek – detained and regularly tortured since the age of 16 for attending democracy demonstrations. In Afghanistan three young female journalists were brutally assassinated as they left work earlier this year. In Hong Kong the 50 leading democracy protestors have been arrested by the CCP and their families threatened.
These brave journalists and campaigners represent millions of people who cannot use their voices without fear of retribution. Every day they face a horrendous choice between demanding democratic rights or being silenced.
Index seeks to be a platform for them – providing a voice for the persecuted, ensuring that no tyrant succeeds in silencing dissent.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][three_column_post title=”You may also wish to read” category_id=”41669″][/vc_column][/vc_row]
16 Sep 2019 | News and features, Volume 48.03 Autumn 2019
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Arthur Miller, American playwright (Photo: U.S. Department of State / Wikipedia)
It is always necessary to ask how old a writer is who is reporting his impressions of a social phenomenon. Like the varying depth of a lens, the mind bends the light passing through it quite differently according to its age. When I first experienced Prague in the late 60s, the Russians had only just entered with their armies; writers (almost all of them self-proclaimed Marxists if not Party members) were still unsure of their fate under the new occupation, and when some 30 or 40 of them gathered in the office of Listy to ‘interview’ me, I could smell the apprehension among them. And indeed, many would soon be fleeing abroad, some would be jailed, and others would never again be permitted to publish in their native language. Incredibly, that was almost a decade ago.
But since the first major blow to the equanimity of my mind was the victory of Nazism, first in Germany and later in the rest of Europe, the images I have of repression are inevitably cast in fascist forms. In those times the communist was always the tortured victim, and the Red Army stood as the hope of man, the deliverer. So to put it quite simply, although correctly, I think, the occupation of Czechoslovakia was the physical proof that Marxism was but one more self-delusionery attempt to avoid facing the real nature of power, the primitive corruption by power of those who possess it. In a word, Marxism has turned out to be a form of sentimentalism toward human nature, and this has its funny side. After all, it was initially a probe into the most painful wounds of the capitalist presumptions, it was scientific and analytical.
What the Russians have done in Czechoslovakia is, in effect, to prove in a western cultural environment that what they have called socialism simply cannot tolerate even the most nominal independent scrutiny, let alone an opposition. The critical intelligence itself is not to be borne, and in the birthplace of Kafka and of the absurd in its subtlest expression absurdity emanates from the Russian occupation like some sort of gas which makes one both laugh and cry. Shortly after returning home from my first visit to Prague mentioned above, I happened to meet a Soviet political scientist at a high-level conference where he was a participant representing his country and I was invited to speak at one session to present my views of the impediments to better cultural relations between the two nations. Still depressed by my Czech experience, I naturally brought up the invasion of the country as a likely cause for American distrust of the Soviets, as well as the United States aggression in Vietnam from the same detente viewpoint.
That had been in the morning; in the evening at a party for all the conference participants, half of them Americans, I found myself facing this above-mentioned Soviet whose anger was unconcealed. ‘It is amazing,’ he said, ‘that you – especially you as a Jew – should attack our action in Czechoslovakia.’ Normally quite alert to almost any reverberations of the Jewish presence in the political life of our time, I found myself in a state of unaccustomed and total confusion at this remark, and I asked the man to explain the connection. ‘But obviously,’ he said (and his face had gone quite red and he was quite furious now) ‘we have gone in there to protect them from the West German fascists.’
I admit that I was struck dumb. Imagine! The marching of all the Warsaw Pact armies in order to protect the few Jews left in Czechoslovakia! It is rare that one really comes face to face with such fantasy so profoundly believed by a person of intelligence. In the face of this kind of expression all culture seems to crack and collapse; there is no longer a frame of reference.
In fact, the closest thing to it that I could recall were my not infrequent arguments with intelligent supporters or apologists for our Vietnamese invasion. But at this point the analogy ends, for it was always possible during the Vietnam war for Americans opposed to it to make their views heard, and, indeed, it was the widespread opposition to the war which finally made it impossible for President Johnson to continue in office. It certainly was not a simple matter to oppose the war in any significant way, and the civilian casualties of protest were by no means few, and some – like the students at the Kent State College protest – paid with their lives. But what one might call the unofficial underground reality, the version of morals and national interest held by those not in power, was ultimately expressed and able to prevail sufficiently to alter high policy. Even so, it was the longest war ever fought by Americans.
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The sin of power is to not only distort reality but to convince people that the false is true, and that what is happening is only an invention of enemies
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Any discussion of the American rationales regarding Vietnam must finally confront something which is uncongenial to both Marxist and anti-Marxist viewpoints, and it is the inevitable pressure, by those holding political power, to distort and falsify the structures of reality. The Marxist, by philosophical conviction, and the bourgeois American politician, by practical witness, both believe at bottom that reality is quite simply the arena into which determined men can enter and reshape just about every kind of relationship in it. The conception of an objective reality which is the summing up of all historical circumstances, as well as the idea of human beings as containers or vessels by which that historical experience defends itself and expresses itself through common sense and unconscious drives, are notions which at best are merely temporary nuisances, incidental obstructions to the wished for remodelling of human nature and the improvements of society which power exists in order to set in place.
The sin of power is to not only distort reality but to convince people that the false is true, and that what is happening is only an invention of enemies. Obviously, the Soviets and their friends in Czechoslovakia are by no means the only ones guilty of this sin, but in other places, especially in the West, it is possible yet for witnesses to reality to come forth and testify to the truth. In Czechoslovakia the whole field is pre-empted by the power itself.
Thus a great many people outside, and among them a great many artists, have felt a deep connection with Czechoslovakia – but precisely because there has been a fear in the West over many generations that the simple right to reply to power is a tenuous thing and is always on the verge of being snipped like a nerve. I have, myself, sat at dinner with a Czech writer and his family in his own home and looked out and seen police sitting in their cars down below, in effect warning my friend that our ‘meeting’ was being observed. I have seen reports in Czech newspapers that a certain writer had emigrated to the West and was no longer willing to live in his own country, when the very same man was sitting across a living-room coffee table from me. And I have also been lied about in America by both private and public liars, by the press and the government, but a road – sometimes merely a narrow path – always remained open before my mind, the belief that I might sensibly attempt to influence people to see what was real and so at least to resist the victory of untruth.
I know what it is to be denied the right to travel outside my country, having been denied my passport for some five years by our Department of State. And I know a little about the inviting temptation to simply get out at any cost, to quit my country in disgust and disillusion, as no small number of people did in the McCarthy 50s and as a long line of Czechs and Slovaks have in these recent years. I also know the empty feeling in the belly at the prospect of trying to learn another nation’s secret language, its gestures and body communications without which a writer is only half-seeing and half-hearing. More important, I know the conflict between recognising the indifference of the people and finally conceding that the salt has indeed lost its savour and that the only sensible attitude toward any people is cynicism.
So that those who have chosen to remain as writers on their native soil despite remorseless pressure to emigrate are, perhaps no less than their oppressors, rather strange and anachronistic figures in this time. After all, it is by no means a heroic epoch now; we in the West as well as in the East understand perfectly well that the political and military spheres – where ‘heroics’ were called for in the past – are now merely expressions of the unmerciful industrial-technological base. As for the very notion of patriotism, it falters before the perfectly obvious interdependence of the nations, as well as the universal prospect of mass obliteration by the atom bomb, the instrument which has doomed us, so to speak, to this lengthy peace between the great powers.
That a group of intellectuals should persist in creating a national literature on their own ground is out of tune with our adaptational proficiency which has flowed from these developments. It is hard anymore to remember whether one is living in Rome or New York, London or Strasbourg, so homogenised has western life become. The persistence of these people may be an inspiration to some but a nuisance to others, and not only inside the oppressing apparatus but in the West as well. For these so-called dissidents are apparently upholding values at a time when the first order of business would seem to be the accretion of capital for technological investment.
It need hardly be said that by no means everybody in the West is in favour of human rights, and western support for eastern dissidents has more hypocritical self-satisfaction in it than one wants to think too much about. Nevertheless, if one has learned anything at all in the past 40 or so years, it is that to struggle for these rights (and without them the accretion of capital is simply the construction of a more modern prison) one has to struggle for them wherever the need arises.
That this struggle also has to take place in socialist systems suggests to me that the fundamental procedure which is creating violations of these rights transcends social systems – a thought anathematic to Marxists but possibly true nevertheless. What may be in place now is precisely a need to erect a new capital structure, be it in Latin America or the Far East or underdeveloped parts of Europe, and just as in the 19th century in America and England it is a process which always breeds injustice and the flaunting of human spiritual demands because it essentially is the sweating of increasing amounts of production and wealth from a labour force surrounded, in effect, by police. The complaining or reforming voice in that era was not exactly encouraged in the United States or England; by corrupting the press and buying whole legislatures, capitalists effectively controlled their opposition, and the struggle of the trade union movement was often waged against firing rifles.
There is of course a difference now, many differences. At least they are supposed to be differences, particularly that the armed force is in the hands of a state calling itself socialist and progressive and scientific, no less pridefully than the 19th-century capitalisms boasted by their Christian ideology and their devotion to the human dimension of political life as announced by the American Bill of Rights and the French Revolution. But the real difference now is the incomparably deeper and more widespread conviction that man’s fate is not ‘realistically’ that of the regimented slave. It may be that despite everything, and totally unannounced and unheralded, a healthy scepticism toward the powerful has at last become second nature to the great mass of people almost everywhere. It may be that history, now, is on the side of those who hopelessly hope and cling to their native ground to claim it for their language and ideals.
The oddest request I ever heard in Czechoslovakia – or anywhere else – was to do what I could to help writers publish their works – but not in French, German or English, the normal desire of sequestered writers cut off from the outside. No, these Czech writers were desperate to see their works in Czech! Somehow this speaks of something far more profound than ‘dissidence’ or any political quantification. There is something like love in it, and in this sense it is a prophetic yearning and demand.
[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_custom_heading text=”Border forces: How barriers to free thought got tough” font_container=”tag:h3|text_align:left” link=”url:https%3A%2F%2Fwww.indexoncensorship.org%2F2019%2F06%2Fmagazine-judged-how-governments-use-power-to-undermine-justice-and-freedom%2F|||”][vc_column_text]The autumn 2019 Index on Censorship magazine looks how governments are using borders to restrict free speech and the flow of ideas[/vc_column_text][/vc_column][vc_column width=”1/3″][vc_row_inner][vc_column_inner][vc_single_image image=”108826″ img_size=”full” onclick=”custom_link” link=”https://www.indexoncensorship.org/2019/06/magazine-judged-how-governments-use-power-to-undermine-justice-and-freedom/”][/vc_column_inner][/vc_row_inner][/vc_column][vc_column width=”1/3″][vc_custom_heading text=”Subscribe” font_container=”tag:h3|text_align:left”][vc_row_inner][vc_column_inner][vc_column_text]In print, online. In your mailbox, on your iPad.
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