Ostrava,

North Moravia

It's just before noon and Helena Ferenčíková is setting the plates for lunch in her small but tidy Ostrava apartment. Two plates for her sons, ages 5 and 6, one for her husband Jan and one for herself.

Although Ferenčíková is only 24 years old and would love to have more children, especially a girl, there will always be just four places around the dinner table.

Five years ago, Ferenčíková was sterilized. She says doctors did this without her knowledge, shortly after she gave birth to her youngest son.

"I was in pain because it was a complicated birth," she recalls today. "They just shoved some papers at me and told me to sign, so I did."

It was only the next day that Ferenčíková found out that she would never be able to have more children.

Ferenčíková says she thinks the reason why the doctors sterilized her was that she is Romany, or Gypsy.

She is not alone.

Over 80 Romany women have filed complaints to the Czech Republic's ombudsman since 2004, saying they were sterilized without giving informed consent.

Last November, Ferenčíková became the first Romany woman in the Czech Republic to win a court case against the hospital that sterilized her.

Human rights organizations applauded the ruling, saying it has given hope to other Romany women, who had been too afraid to speak out about their sterilization.

It was only a partial victory, however. The ruling, made by the Ostrava regional court, said that the Vítkovice Hospital in Ostrava, where Ferenčíková gave birth, must apologize. But because more than three years had elapsed since the sterilization, Ferenčíková had missed her chance to get financial compensation.

Now both the hospital and Ferenčíková are appealing the ruling.

Ferenčíková's lawyer, Michaela Tomisová, who is currently representing 40 other Romany women in a similar situation as Ferenčíková, says her client should have the right to receive financial compensation.

Tomisová says she has encountered hostility from some doctors, who accuse her of pushing her clients into suing. "The hospitals begin waving around forms that the patients filled out," says Tomisová. "But often these forms are incomplete and filled out at a time when the patient was under stress and unable to read, let alone understand, a hospital form."

In their defense, the doctors say sterilization is a recommended procedure after a woman has given birth through a caesarian section for the second time, as in Ferenčíková's case. But the Health Ministry says that not every complicated birth warrants sterilization and that each case must be judged on an individual basis.

The Vítkovice Hospital denies any wrongdoing. "We maintain that the patient was informed sufficiently and well in advance," says hospital spokeswoman Simona Součková. "The sterilization was done because the patient asked for it."

Ferenčíková says such a claim is ridiculous. "No one explained anything to me," she says. "I didn't even know what sterilization meant until they told me the next day."

A legacy of the regime

The sterilization of Romany women who had had difficult births was not an uncommon practice under the communist regime. The government tried to control the Roma population this way.

Czech Ombudsman Otakar Motejl acknowledged this in an extensive investigative report, published Dec. 29, 2005, and recommended the state give these women financial compensation.

The ombudsman's office began investigating unwanted sterilization cases after the European Roma Rights Center (ERRC) alerted it to the problem. According to the ERRC, cases also exist in countries such as Hungary, Romania, Slovakia and Bulgaria, where discrimination against the Roma is still common.

Sterilization without consent in this country didn't stop after the regime change in 1989. Some, such as in the case of Ferenčíková, happened as recently as 2001.

The ombudsman's deputy Anna Šabatová says, however, that the number of such cases seems to be declining. The big change is that the problem has become public, with more and more women willing to speak out.

Šabatová says about half of the women who sent complaints to the ombudsman had undergone sterilization before 1989.

Following the ombudsman's request, the Health Ministry set up a special committee whose task is to investigate each case of suspected sterilization without informed consent. The cases date between the years 1961 and 2004.

Kumar Vishwanathan, founder of Life Together, a civic organization that works to aid Roma communities, first started finding out about cases of unwanted sterilization three years ago.

"I was surprised at first," says Vishwanathan. "I lived with these people for many years, and no one told me anything.

"I later realized these women were often afraid to talk about it. For many, it's still something very difficult to talk about, even years after they had been sterilized," he says.

Vishwanathan helped organize a meeting of women who had undergone sterilization, and he says their gradual transformation was incredible. "They were reluctant at first, but eventually they became more relaxed and you could tell how relieved they were to talk about it," he recalls.

"Obviously it's a very personal, sensitive topic. It's harder to talk about than housing problems or unemployment."

The situation is different in Slovakia, he says, where the government is unwilling to face the problem of unwanted sterilization, and women lack the necessary support.

These days, the Group of Women Harmed by Sterilization meets once a month in Ostrava and offers women like Ferenčíková the chance to talk about their experiences and to support one another.