It isn’t an apology or an acceptance of responsibility. But for the first time, an Israeli government official has told doctors to stop injecting Ethiopian women – or any other women – with long-acting birth control medication known as Depo-Provera without the informed consent of the women. The effect of the shots lasts for months and the practice effectively sterilizes women for that period of time. Many Ethiopian women have reportedly received these shots for years with little or no say in the decision to receive them.
Corrected 3-11-2013
Israel Orders Doctors To Stop Administration Of Depo-Provera Shots To Women If There Is Any Doubt That They Do Not Understand Their Purpose
Shmarya Rosenberg • FailedMessiah.com
It isn’t an apology or an acceptance of responsibility. But for the first time, an Israeli government official has told doctors to stop injecting Ethiopian women – or any other women – with long-acting birth control medication known as Depo-Provera without the informed consent of the women. The effect of the shots lasts for months and the practice effectively sterilizes women for that period of time.
Many Ethiopian women have reportedly received these shots for years with little or no say in the decision to receive them.
The Director General of Israel’s Ministry of Health Professor Roni Gamzu issued an order to Israel’s four health maintenance organizations to stop routinely administering Depo-Provera to Ethiopian Jews or any other women unless it is clear that the women really understand what Depo Provera does and how long its effects last, Ha’aretz reported yesterday. Gamzu instructed all HMO gynecologists "not to renew prescriptions for Depo-Provera for women of Ethiopian – or any other origin – if there is the
slightest doubt that they have not understood the implications of the
treatment.” He also ordered the gynecologists and other physicians to use Amharic translators when necessary to make sure the Ethiopian women understood their various treatment options and their side effects.
The Ministry of Health and other government ministries and agencies deny knowledge or responsibility for the alleged practice, which made international headlines when it was exposed by investigative journalist Gal Gabbay on the Israel Educational Television’s Vacuum news magazine in early December but which was first reported in a small Israeli print news publication five years ago.
“They told us people who frequently give birth suffer. We took it every three months. We said we didn’t want to,” one of the Ethiopian women interviewed by Gabbay on Vacuum said.
Gamzu’s letter to the HMOs was issued in response to a letter from the Association of Civil Rights in Israel. The Association, which is representing several women’s rights and Ethiopian immigrants’ groups, demanded the injections cease immediately. It also insisted that an investigation be launched to determine how and why the near-blanket administration of Depo-Provera shots to Ethiopian women became the standard practice.
There has been an almost 50% decline over the past 10 years in the birth rate of Israel’s Ethiopian community. It is feared that a significant part of this drop has come from coercive administration of Depo-Provera.
Ziva Mekonen-Dego, an Ethiopian-born Israeli social worker who is the CEO of the Israel Association for Ethiopian Jews, said Gamzu’s letter was the bare minimum that should be done by the government to redress the wrong. She called the policy of coercive administration of Depo-Provera shots to Ethiopian women racist and said she was outraged by the idea these shots were given for the women’s own good because they could not be trusted to use more normal types of birth control, according to a report in the Los Angeles Times.
“The suggestion Ethiopian women can't be trusted with responsibility for their own health is outrageous,” she said.
Isha L’Isha, an Israeli feminist group, reportedly researched Depo-Provera prescriptions and found that 60% of the Depo-Provera injections in one HMO were prescribed to Ethiopian women. The other high-use group found was women in various forms of custody, including those in mental institutions.
Hedva Eyal, who headed that research project, said the Isha L’Isha report was commonly met with disinterest and, in some cases, with slammed doors.
"The ease with which a woman's testimony is dismissed -- certainly that of a black woman and a poor black woman at that -- is shocking," she reportedly said.
Gal Gabbay’s Vacuum report also alleged that the Depo-Provera shots were administered coercively in Ethiopia by American Jewish Joint Distribution Committee (JDC) medical personnel there and by personnel sent from Israel to help them. Women were allgedly told that they had to agree to the shots. If they refused to do so, they were allegedly told, they would not be allowed to immigrate to Israel.
The JDC’s chief medical officer in Ethiopia, Dr. Rick Hodes, strongly denied those charges last month when asked to comment via email on the Vacuum report by FailedMessiah.com.
“…JDC runs the medical program in Gondar for potential immigrants to Israel. As part of this, we offer voluntary contraception to our population. Our clinic offers both birth control pills and injectable contraception. If a woman prefers another method of contraception such as implantable or tubal ligation, we send them to facilities down the
road in the city of Gondar for this.
“Women come to the program because they desire family planning. We present the various options to them and they choose. So women both choose to use contraception and choose their method. And choose when to discontinue contraception. It has always been that way in our
program.
“Right now we’re caring for about 4500 potential immigrants to Israel. We average about 85 family planning visits each month.
“We do not inform the Israeli authorities who is on family planning, and I have no idea what happens once they arrive in Israel.
“…[W]e offered family planning to the population at a time when it was less available to the general public, and our population chose to use it.…
“Injectable contraceptives are the most desired throughout the country. They are easy, culturally preferred, and offer the ability to be on birth control without a woman informing her husband, which is an issue here.…
“Neither myself nor my staff have ever told any women in our program that they should take Depo-Provera for any reason. 100% of Depo-Provera shots are purely voluntary, and may be discontinued (or changed to another method) at any time.…we don't have JDC workers from Israel come and tell women [that they have to submit to the Depo-Provera shots in order to immigrate to Israel],” Hodes wrote.
Update 3-11-2013 – on March 6, Ha'aretz corrected its report. It now contains the following quote and the correction below it is appended to the bottom of its article:
"Without taking a stand or determining facts about allegations that were made," [Director General of Israel’s Ministry of Health Professor Roni] Gamzu wrote, "I would like to instruct, from now on, all gynecologists in the HMOs not to renew prescriptions for Depo-Provera for women of Ethiopian – or any other – origin, if there is the slightest doubt that they have not understood the implications of the treatment."
CORRECTION: This article, which was updated on March 6, 2013, reported on Health Ministry director-general Prof. Roni Gamzu's instruction to gynecologists not to renew prescriptions for Depo-Provera if there is any doubt that recipients did not understand the implications of the treatment. The original version failed to state that this instruction was issued "without taking a stand or determining facts about allegations that had been made," and referred to all women and not just women of Ethiopian origin.