MOSCOW – A human rights group and a think-tank alleged Tuesday that Uzbekistan's government has instructed health workers to surgically sterilize women as part of a campaign to reduce the birth rate of the authoritarian ex-Soviet nation.
Uzbek health officials did not answer repeated telephone calls from The Associated Press to seek their comment about the allegation.
However, previous human rights, United Nations and U.S. State Department reports also have alleged that women in the central Asian country have been forced or duped into sterilization.
Uzbekistan's government retains strict Soviet-style control over health institutions in the predominantly Muslim nation of 27 million, whose population has been growing quickly.
The Expert Working Group, an independent think-tank based in the Uzbek capital, Tashkent, said Tuesday that a Health Ministry decree issued in mid-February orders district doctors to recommend hysterectomy as an "effective contraceptive." The procedure requires partial removal of the uterus and makes women irreversibly sterile.
Uzbek law does not prohibit forced sterilization or removal of reproduction organs.
The decree orders each district physician to persuade "at least two women" a month to have the procedure, the group's coordinator, Sukhrobdzon Ismoilov, told The Associated Press in a telephone interview. Physicians who don't follow the decree face reprisals and fines from their superiors, he added.
"We're talking about at least tens of thousands of women," Ismoilov said.
Uzbekistan has an estimated 80,000 physicians, each overseeing several hundred patients in cities, towns and villages across the nation.
Ismoilov said his group reached its conclusion after interviewing dozens of health workers throughout Uzbekistan in the weeks following the publication of the decree.
A human rights group in western Uzbekistan supported the claim.
Khaitboy Yakubov of the Najot group in the Khoresm region told the AP that his group learned about "numerous" cases of forced sterilization even before the decree was issued.
The group said in a report in 2009 that doctors in hospitals often sterilize women after their second child without their consent. Many women, alarmed by rumors about the procedure, opt to give birth at home, the group said.
Sometimes, the group said, doctors force women to have the surgery, alleging they have serious gynecological pathologies.
The Expert Working Group and Najot have both faced official pressure amid a perennial crackdown on government critics and opposition in Uzbekistan.
Their claims reflect similar allegations made in 2005 by Gulbakhor Turayeva, an Uzbek human rights activist and medical doctor. He claimed surgeons were instructed to secretly perform hysterectomies on women treated for minor gynecological disorders in the densely populated Ferghana Valley in eastern Uzbekistan.
Turayeva was later convicted of anti-government actions and possession of banned literature, and he spent six months in jail.
In 2006, a U.S. State Department report on Uzbekistan said: "Torture and abuse were common in prisons, pretrial facilities, and local police and security service precincts. Several cases of medical abuse were reported, including forced psychiatric treatment on political grounds and alleged sterilization of women without notification or medical need."
In 2007, the U.N. Committee Against Torture reported a "large number" of cases of forced sterilization and removal of reproductive organs in Uzbek women, often after cesarean sections. Some women were abandoned by their husbands as a result, it said.
Most of the Uzbek population is concentrated in impoverished rural areas, where inefficient economic reforms, official pressure on farmers, and deterioration of Soviet-built irrigation systems have contributed to widespread unemployment and a mass exodus of Uzbek labor migrants to neighboring countries.
The practice of forced sterilization dates back to 1999, said Ismoilov of the Expert Working Group, when Uzbek President Islam Karimov expressed his dissatisfaction with high birth rate of about 4 to 5 children per woman and ordered measures to curb it.
Ismoilov claimed the ministry suspended the practice in 2003 after independent media reports and spreading rumors, but the February decree allegedly renews it.
In 2008, Uzbekistan reported the birth rate of 2.3 children per woman. Demographers say a fertility rate of only 2.1 children per woman is needed to maintain the existing population of developed countries.