Harvard Law School’s International Human Rights Clinic has co-released a report documenting the Namibian health care system’s maltreatment of women living with HIV.

A joint product of HLS’s International Human Rights Clinic, the Namibian Women’s Health Network and Northeastern Law School, the 49-page report, entitled “At the Hospital There Are No Human Rights,” (pdf) was released on July 26 during the International AIDS Conference, in Washington, D.C.

“We often assume that hospitals are healing places, where people living with HIV receive medical services in a safe facility, from trustworthy health practitioners,” Aziza Ahmed, an assistant professor at Northeastern Law School said. “While this can be the case, women living with HIV in Namibia often report serious mistreatment in hospital settings.”

In the report, based on interviews conducted in Namibia in 2010, women describe being unable to give their informed consent (or make an informed refusal) to medical treatment either because information was withheld, or categorically denied to them. Time and again, they said, their HIV status exposed them to mistreatment and discrimination.

“No one wanted to touch me,” said one woman, describing her birthing experience at the hospital.

Women interviewed for the report described experiencing forced or coerced sterilization. The majority of reported cases involved the failure of medical personnel to provide women living with HIV with a description of the nature of the sterilization procedure, as well as its effects, consequences, and risks. In some cases, medical professionals obtained consent under duress or based on misinformation, and demanded consent to sterilization in order for female patients to access other necessary services—including abortion and child delivery. In other cases, medical professionals demanded or obtained consent for sterilization without providing information about other contraceptive options.

Additionally, women reported that medical professionals recorded misinformation on medical passports and denied them access to medical records.

One woman living with HIV put it plainly: “At the hospital there are no human rights.”

The Government of Namibia has been aware of the practice of forced or coerced sterilization since at least 2008, when the International Community of Women Living with HIV released a seminal study on the topic. The issue has drawn international attention. In a landmark HIV ruling on July 30, a court in Namibia ruled that the southwest African country’s government violated the human rights of three HIV-positive pregnant women who were forcibly sterilized while giving birth.

Prior to the court’s decision, Jeni Gatsi-Mallet, executive director of the Namibian Women’s Health Network said: “The court must decide in favor of all the women who have been forcibly sterilized, but even that will be insufficient to bring justice. The government must review its policies to ensure that the sexual and reproductive health of women living with HIV is protected, including issuing clear guidelines for informed consent for sterilization and legal abortion.”

The report makes several recommendations to the Government of Namibia, the donor community, and civil society on how to redress the situation.

“The Government of Namibia has ratified many of the relevant international human rights instruments and reflected these rights guarantee in its national laws, policies, and programs,” said Mindy Jane Roseman, of the International Human Rights Clinic at Harvard Law School. “The time has come for the Government to implement its guarantees, and for the donor and international communities to support women living with HIV in their struggle for non-discrimination, equality, and rights to access sexual and reproductive health care, free from coercion and violence.”

For more on the IHRC’s ongoing work related to the decision, read “The Day After Victory: More Work Needed to Protect Rights of Namibian Women Living with HIV,” a post written by Roseman on the IHRC’s blog.