Forced sterilization in Peru
Under the administration of President Alberto Fujimori, Peru implemented a forced sterilization campaign as part of the National Population Program, primarily targeting impoverished and Indigenous women in rural Andean regions. This effort, regarded as the largest state-sponsored sterilization initiative in the Americas, was publicly presented as a progressive strategy for promoting reproductive health and economic development. However, it has been broadly denounced for its coercive methods and associated human rights abuses.
The program drew on long-standing eugenic doctrines and neo-Malthusian theories, which linked excessive population growth to poverty and national instability. These concepts were encapsulated in Plan Verde, a military strategy conceived during the Peruvian Civil War. Under Fujimori, these ideas were transformed into a systematic policy purportedly designed to reduce poverty and high birth rates.
Women were frequently sterilized without informed consent, sometimes under pressure or in exchange for basic necessities such as food or healthcare. Medical personnel received monetary bonuses—typically ranging from four to ten dollars—for each sterilization they conducted, and promotions were tied to achieving specific targets. Failure to meet these quotas could negatively affect a health worker's career. Between 1996 and 2000, an estimated 300,000 sterilizations took place, disproportionately impacting Indigenous communities.
Numerous international and domestic organizations have condemned the campaign as a crime against humanity, with some categorizing it as ethnic cleansing or genocide. Efforts to prosecute those responsible have encountered legal and political barriers, resulting in limited accountability. In recent years, victims and advocacy groups have sought formal recognition and justice, though significant hurdles remain in obtaining comprehensive reparations and ensuring full responsibility for those involved.
Background
Radical eugenic measures, though previously proposed, were not enacted in Peru until the government of then-Peruvian President Alberto Fujimori. The systematic targeting of Indigenous women for sterilization, often without their informed consent during the Fujimori regime, affected peasant populations in the Peruvian highlands and reflected the belief that they were 'unfit' for reproduction according to the "imperatives of racial hygiene" and their perceived role as a barrier to national advancement.Eugenics in Peru
In the 20th century, population control measures in Peru were closely tied to ethnicity. Public discourse on the so-called "Indian problem" portrayed Indigenous populations as obstacles to national progress while associating racial improvement with increased whiteness.Eugenics, a theory that aims to improve the genetic quality of a human population, gained influence in Peru during the first half of the 20th century, reaching its apogee in the 1920s and 1930s. The government introduced pre-marriage examinations designed to prevent unions between individuals deemed "unfit".
Although concerns over population control persisted after the decline of the eugenics movement in the 1930s and 1940s, practices such as forced sterilization and eugenic abortion were not formally implemented during this period. However, there were also Peruvian authors who supported them, inspired by the policies applied in the United States and Nazi Germany. By the 1970s, after the atrocities of World War II, eugenics had largely fallen out of favor in both scientific and political discussions in Peru, becoming a taboo subject.
Demographic changes and population control
In post-colonial Peru, public health interventions primarily targeted marginalized groups, including women, the poor, and Indigenous populations. This focus led to a perception of the health system as catering mainly to these disadvantaged groups. Early pro-natalist policies in the republic emphasized mother-child health, viewing population growth as beneficial to the economy. Women were often seen in terms of their reproductive roles, with their contribution to economic progress tied to their potential as mothers and caregivers.However, by the 1970s, large families were increasingly seen as "culturally primitive", harmful to women's health, and a threat to democratic stability. At that time, Peru was a deeply divided society, with a powerful oligarchy ruling over a largely impoverished majority. Rapid urbanization occurred, healthcare improved, and mortality rates declined, but the birth rate remained high—around six children per woman in 1972.
As the sexual revolution unfolded globally, calls for better access to birth control grew in Peru, particularly among middle-class urban women. Feminist movements advocated for reproductive health services, but access remained unequal, with middle-class women enjoying more resources compared to poor, rural, and predominantly Indigenous women.
Following the collapse of the military regime in the 1980s, the government of Fernando Belaúnde made the first attempts to expand access to birth control. The 1981 census indicated that women in regions with high birth rates did not desire more children. In response, the government created a national population council and introduced family planning services in hospitals, though these efforts were largely confined to urban areas and did not reach rural Indigenous populations.
These efforts were continued by President Alan García, with support from both the political left and the Catholic Church. However, while the Church endorsed population control, it opposed modern contraceptive methods, promoting instead "responsible parenthood" through traditional means. Due to the Church's influence, the 1985 National Law on Population did not legalize voluntary sterilization or abortion, a decision that disappointed many feminist activists.
Plan Verde and National Population Program
Elaboration of Plan Verde
In the 1980s, the Peruvian Armed Forces grew increasingly frustrated with President Alan García's inability to address the country's political crises, including the civil war. In response, the military began drafting a plan to overthrow his government and implement a neoliberal economic system under an authoritarian regime. The military saw overpopulation of ethnic Others as a possible cause of social problems, as in neo-Malthusian theory, and shaped this thought into Plan Verde.Business elites, who maintained close relations with military planners, supported this agenda, providing economic ideas that aligned with the military's goals. One key aspect of this plan, detailed in a volume titled Driving Peru into the 21st Century, involved a population control strategy aimed at impoverished citizens. According to extracts from Plan Verde, the authors expressed concern over what they termed "epidemic" demographic trends. They argued that the growing population would strain resources such as food, education, and housing by increasing demand by approximately 500,000 people each year.
The plan advocated halting demographic growth through the "widespread use of sterilization" among groups described as "culturally backward" and "economically impoverished". It proposed making tubal ligation the standard procedure at health centers, urging compulsory methods "on an experimental basis" and calling for discrimination against "surplus population", which were deemed detrimental to Peru's progress. Peruvian analyst Fernando Rospigliosi likened these ideas to those of the Nazis, noting the extreme language used in the plan, including references to the "total extermination" of certain populations due to their perceived incorrigibility and lack of resources.
Recognizing the growing influence of Vladimiro Montesinos – Fujimori's advisor and future head of the National Intelligence Service – senior military commanders transferred the Plan Verde to him. Rospigliosi suggested that an agreement was reached between Fujimori, his intelligence chief Montesinos, and key military officers involved in Plan Verde prior to Fujimori's inauguration. As a result, many of the policies outlined in Plan Verde were later adopted during Fujimori's administration.
Implementation of sterilization policies
In the 1990s, the government of Alberto Fujimori implemented a state-led sterilization program as part of broader population control efforts under the National Population Program. This initiative, framed as a tool for economic development, disproportionately targeted impoverished and Indigenous women, particularly in rural areas. A media controversy orchestrated by Fujimori during his first term created a conducive environment for his future sterilisation campaign.The sterilization campaign stemmed from earlier military plans, including Plan Verde, which advocated for population control measures to alleviate economic burdens. By 1991, Fujimori's administration had integrated these ideas into its policies. In 1992, following Fujimori's self-coup, a civilian-military regime was established, and many of the objectives outlined in Plan Verde were set into motion. The Family Planning Program was initially supported by national and international organizations due to the historical neglect of comprehensive reproductive health policies in Peru.
In 1993, the government advocated for such a program, citing the need for population control to ensure the provision of basic social services. Reports from the Presidency and the Prime Minister's Office influenced the direction of the sterilization campaign, emphasizing sterilization for the poor as a critical element of economic recovery. The program director, Eduardo Yong Motta, demanded increased quotas for sterilizations, and Fujimori, known for his micromanagement, personally pressured regional leaders to comply.
Before the program's expansion, fewer than 15,000 sterilizations were performed annually, primarily for women with specific health risks or those with multiple children. However, after 1995, sterilizations were increasingly performed on people without prior medical conditions, targeting women from poor and marginalized communities. By 1996, the number of sterilizations had increased to 67,000, and by 1997, it reached 115,000.
The program was presented using progressive rhetoric, with Fujimori framing population control as essential for modernization and economic growth. He criticized the Catholic Church, which opposed the use of modern contraceptive methods, as an obstacle to family planning efforts. Notably, many of the rural areas targeted by the program were not overpopulated, but were located in inaccessible, poor and marginalized areas.
Between 1996 and 2000, an estimated 300,000 Peruvians were sterilized, the vast majority of whom were Indigenous, poor, and illiterate women. The program's use of intimidation and coercion led to severe medical complications for many women, social ostracism, and in some cases, death. Fujimori's government used feminist discourse to legitimize the campaign, framing it as a progressive step toward women's empowerment and family planning, even as human rights violations occurred.