Jan 30, 2013

Depo Provera injections given to Ethiopian women in Israel: accusations of racism

Ethiopian women in Israel given Depo Provera injections

The recent admission by an Israeli government official that women of Ethiopian origin have been receiving injections of the long-lasting contraceptive Depo Provera confirms allegations that have been around for a number of years. In the past Israeli government officials have always denied the practice. The story got greater exposure recently following coverage on Vacuum news magazine - an Israeli TV show.

Jewish women of Ethiopian origin interviewed for Vacuum talked about pressure from representatives of the Joint Distribution Committee (JDC). The women were warned about the hardships of raising large families... warned that if they had large families employment would be tough to find in Israel and that landlords wouldn't rent to them.

According to Haaretz a woman who received the injections was cautioned as she was preparing to move to Israel: "They told us, if you don't you won't go to Israel. And also you won't be allowed into the Joint (American Joint Distribution Committee) office, you won't get aid or medical care. We were afraid ... We didn't have a choice."

Back as far as 2008 a woman named Rachel Mangoli who runs a day care center for Ethiopian children in the Tel Aviv suburb of Bnei Braq, noticed that she had received only one new child in the previous three years. She is quoted in Jonathan Cook's article in The National saying:  "I started to think about how strange the situation was after I had to send back donated baby clothes because there was no one in the community to give them to."

The Cook article provides more info about Ms Mangoli's inquiries and the health risks associated with Depo Provera use:

She [Ms Mangoli] approached a local health clinic serving the 55 Ethiopian families in Bnei Braq and was told by the clinic manager that they had been instructed to administer Depo Provera injections to the women of child-bearing age, though he refused to say who had issued the order. Ms Mangoli, who interviewed the women, said: "They had not been told about alternative forms of contraception or about the side effects or given medical follow-ups." The women complained of a wide range of side effects associated with the drug, including headaches, abdominal pain, fatigue, nausea, loss of libido and general burning sensations.

Depo Provera is also known to decrease bone density, especially among dark-skinned women, which can lead to osteoporosis in later life. Doctors are concerned that it is difficult or impossible to help women who experience severe side effects because the drug is in their system for months after it is injected. The contraceptive's reputation has also been tarnished by its association with South Africa, where the apartheid government had used it, often coercively, to limit the fertility of black women.

The point about the use of Depo Provera in apartheid South Africa is worth noting. An academic study - Patterns of Human Rights Violations - noted the following about Depo Provera use during the apartheid era:

Black women were injected with the controversial contraceptive Depo Provera, often without their consent, counseling, or being given another birth control option. White women weren't even told about Depo Provera. Factories coerced black women to be injected.

The Cook article points out official inconsistencies that add weight to the view that Depo Provero use on Ethiopian women was highly suspect. In 2008 then health minister, Yaacov Ben Yezri, said the use of Depo Provera by Ethiopian women in Israel reflected a "cultural preference" for injections - a statement that is quite simply incorrect. World Health Organization stats show that around 75% of women in Ethiopia favor the oral pill, not injection.

Investigations into Depo Provera use mentioned in the article further suggests a racist motive:

"The answers we received from officials demonstrated overt racism," Ms Eyal said. "They suggested that Ethiopian women should be treated not as individuals but as a collective group whose reproduction needs controlling." When Woman to Woman conducted an experiment by sending five non-Ethiopian women to doctors to ask for Depo Provera, all were told that it was prescribed only in highly unusual cases.

Ethiopian women were reportedly injected at transit camps. Some were informed that they were receiving "inoculations." On arrival in Israel, the Depo Provera treatments continued.

It seems likely that the admission by the Ministry of Health was hastened by increased media scrutiny and exposure of the treatment. The Ministry instructions went out after the Association of Civil Rights - speaking on behalf of women's rights and immigrant groups - fired off a letter demanding that the Depo Provera treatments end immediately. 

Haaretz reports that the Israeli Ministry of Health director, Roni Gamzu, issued a letter to Health Maintenance Organizations (HMO's) telling them to stop injecting Ethiopian women with Depo-Provera. The Ministry now also requires that medical personnel have Amharic translators available so that the treatment is clearly understood. A service that by the most basic medical standards should have been in place long ago to ensure informed consent.

The treatment these Ethiopian women were subjected to is totally outrageous. Even though the treatment has been going on for years without their properly acquired and informed consent and even though there are known health risks associated with the ongoing administration of Depo Provera... the MOH didn't offer any apology or admission of responsibility.

A number of commentators have said that the practice amounts to a form of undercover eugenics... an attempt to lower the birth rate of African women in order to preserve Israel's preferred "ethnic face" that an article in Peter Beinart's Open Zion typifies as Ashkhanezi. In a very insightful article Emily Hauser writes that "Israel has always had a problem with Jews who differ in some way from the Ashkenazi culture of the founding generation." She goes on to say:

When Sephardi Jews began to pour into the newly established country from all across the Middle East and North Africa, they were called primitivim, and they and their children were treated as such for decades. Many Yemenite families still believe their children were kidnapped and adopted; official inquiries have found that while that didn’t happen (with 56 possible exceptions), possibly hundreds of children died and were buried without their parents being informed. Newly arrived Sephardi children were routinely treated poorly by the Ashkenazi schools to which they were sent, marriages were forbidden by angry Ashkenazi parents, and home-seeking Sephardi families were shunted to disadvantaged development towns. The establishment and meteoric rise of Shas in Israeli politics came largely in response to this reality.

We have witnessed other examples of Israeli intolerance towards migrants of African origin over the past year. In reference to African asylum seekers, PM Binyamin Netanyahu engaged in some highly inflammatory rhetoric. He described them as "illegal infiltrators" and said they threatened "the social fabric of society, our national security and our national identity." He described them as nothing less than a threat to 'the Jewish and democratic character of the country.'

Around 50,000 Ethiopian Jews have moved to Israel in the last decade under the Law of Return. They exist in Israel as a community on the fringe, with many Israelis including rabbis casting doubt on their claim to be Jewish.

Ethiopians favor large families but the birth rate of the community has fallen by half. Stats suggest that over 50% of Depo Provera users in Israel are Ethiopian - remarkable seeing that they account for less that two per cent of the Israeli population. It's difficult not to draw conclusions over and above medical malpractice.