June 2003


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"S. E. Anderson" <[log in to unmask]>
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Science for the People Discussion List <[log in to unmask]>
Mon, 16 Jun 2003 06:14:00 -0700
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NOTE: This news report does not mention the underlying genocidal
racist policy of sterilization of Brazil's poor. And where's
Lula's ruling party standing on this?

June 13, 2003
In Paying for Votes,
Politicians In Brazil Reduce Future Rolls

Free Sterilization for Poor Is Common Bargaining Chip

CABO DE SANTO AGOSTINHO, Brazil -- During the last local
election in this northeastern Brazilian town, Sarah da Silva
and her sister accepted a curious favor in exchange for
their votes. Instead of offering cash or medicine, a
candidate paid for the two mothers to be sterilized.

In parts of Brazil, arranging for operations to tie women's
fallopian tubes is a proven vote getter. "This is a perverse
market in which sterilization has become just another
commodity to trade," says Ana Paula Portella, head of SOS
Corpo, a nongovernmental organization here in the
northeastern state of Pernambuco. In some cases, politicians
make it known that they will finance tubal ligations in
exchange for votes; in others, women who want to be
sterilized approach candidates.

In the slums of this town of 160,000 in a sugar-cane region,
many women in their late twenties report nonchalantly that
they are sterilized -- and most say they got a politician to
pay. Mrs. da Silva's family of four lives on about $100 a
month; she couldn't afford to pay $90 for a tubal ligation
at a private clinic. Nor did the 27-year-old want to deal
with the long wait and red tape at a municipal hospital that
performs the surgery free of charge. Like most Brazilian
men, her husband wouldn't countenance a vasectomy,
a simple outpatient procedure.

Cabo's town council has 21 members, who each earn nearly
$3,000 a month, a lot by local standards. Isaias Jose, an
affable councilman in his fourth term, was an ambulance
driver before he entered politics. He doesn't hide the fact
that he uses his connections in the medical establishment to
help voters get urine tests, blood work and surgery. Mr.
Jose evades the question of how many sterilizations he has
facilitated. "It's a financial issue," he says. "These women
can't afford to have their tubes tied, so they go looking
for politicians to pay for it."

According to Brazil's latest official figures, as of 1996,
40% of all married women of reproductive age in this Roman
Catholic country were sterilized. Demographers believe the
figure is now close to 50%. The procedure is a big reason
for the plunge in Brazil's fertility rate over the past 20
years. In 1980, Brazilian women had an average of 4.3
children each. Today, women in Brazil have just 2.2, and the
birthrate is projected to decrease further.

Academics point to several factors behind the trend: widely
viewed soap operas, where small families are the norm; the
rise of consumerism; and a high level of urbanization and
women's education. In one generation, communities such as
Cabo have seen a marked change in family size. Mrs. da
Silva's mother gave birth to 11 children. But Mrs. da Silva,
who shares a tiny shack with another family, says two kids
are enough. "I want to give them a better future."

Contrary to 20th-century predictions, population growth is
slowing in many parts of the developing world. In some
countries, such as Mexico and Iran, government initiatives
have induced couples to have fewer children. In the absence
of government family-planning policies in Brazil, private
doctors have responded to the high demand for contraception
by encouraging women to tie their tubes, a procedure that
became the preferred method of birth control.

Some feminist and human-rights activists decry the
phenomenon, saying that poor, uneducated women are duped
into surgery without being informed about the full range of
contraceptive options. The Catholic Church, too, is
officially against the procedure, but it is more focused on
wiping out abortion than sterilization. For millions of
Brazilian women, already inured to invasive medical
procedures, including Caesarean sections and cosmetic
surgery, tubal ligations are the most practical solution to
unwanted pregnancies.

This mentality has bred a mutually beneficial relationship
between women and local politicians used to doling out petty
bribes in the northeast, an impoverished region that is home
to 25% of Brazil's 170 million people.

Rosilene Maia, 25, knew where to go in the 2000 election.
Saddled with three young mouths to feed and an unemployed
husband, she contacted a councilwoman named Maria de
Zequinha who was seeking re-election. Mrs. Maia says that
she showed up at a local clinic on the time and day
designated by Ms. Zequinha's aide. At first, an obstetrician
on duty told her that he didn't have any knowledge of her
case. But after a phone call, he declared, "We're all set"
and operated, Mrs. Maia recalls.

Sitting in a rocking chair on her porch, Ms. Zequinha says
that she sponsors sterilizations "because there is so much
deprivation out there. I don't do it for political reasons."
Asked whether she might benefit at the polls, the portly
woman with a warm smile replies: "Voters see my deeds and
they decide how to reciprocate." Carlos Fonseca, an
obstetrician who performs sterilizations for Ms. Zequinha at
a private clinic, won't disclose how much he earns from the
procedures. But in election years, he concedes, "it rains
tubal ligations."

In Brazil, voting is obligatory for anyone 18 or older.
Politicians who exchange favors for votes have no way of
checking whether someone actually voted for them, although
sometimes they ask for a voter's identification number as a
form of intimidation. Some women get the best of the
candidates. "I got my tubes tied, and then I didn't vote for
him," says Angelica Erica of one candidate.

In recent years, the Brazilian government has improved
family-planning services. Birth-control pills, intrauterine
devices and condoms are distributed free at public clinics.
But often demand outstrips supply. One day recently, Cabo's
main clinic didn't have a single pack of contraceptive
pills, and the pharmacist said she didn't expect a new stock
for two weeks.

The government has also taken steps to regulate tubal
ligations. In 1997, it began paying for the procedure at
public hospitals for women with at least two children. But
applicants must wait no less than 60 days to have the
operation to ensure they receive professional counseling and
information about other forms of birth control. The
bureaucracy, coupled with high demand, means that most
applicants fail to get sterilized at public hospitals, says
Elza Berquo, a leading Brazilian demographer. That opens
the door for politicians to pay for private procedures.

Since she was sterilized in September 2000, Mrs. Maia has
divorced and remarried -- and now regrets having had the
difficult-to-reverse procedure. "My current husband is dying
to have a child," laments the mother of three. "I made a big

Still, other women are just waiting for next year's
municipal election to end their reproductive life. "I've
already done my part for Brazil," says Rosilene Santana,
who has two children. "Next election, I'm going to find a
politician who will get my tubes tied."

Write to Miriam Jordan at [log in to unmask]

Updated June 13, 2003