Norplant Sterilisation Third world guinea pigs
BBC Television: Horizon
THE HUMAN LABORATORY
AIR DATE 5 November 1995
NARRATOR (CHARLOTTE CORNWELL): The 60s, the age of contraception, heralded a
whole new era of liberation for women. But contraceptives have not always meant
liberation.
SYBIL SHAINWALD: They have been used as a human laboratory. They're just
expendable. Who cares if a Third World woman dies?
NARRATOR: When Norplant was released in the West recently, it seemed to be every
woman's dream. Hassle-free sex, no daily pill, and extremely reliable
protection. Six implants are surgically inserted under the skin of the arm,
where they stay for five years, releasing a hormone to inhibit ovulation. Its
developers claimed it was the most widely-studied contraceptive to arrive on the
market. But some women have had problems. Patsy Smith had Norplant inserted
after the birth of her second child.
PATSY SMITH: Three months after having Norplant inserted I started getting
horrible headaches like gosh, it was like somebody was just grabbing my head and
just squeezing it together as tight as can be squeezed like someone had put a
bomb in there and it was going to go off. I'd noticed that being kind of blurry
and after the months it got a little bit more blurry and things started looking
like they were on top of each other and...
NARRATOR: Doctors thought there was nothing wrong at first, but over the next
year her eyesight deteriorated. Her symptoms became unbearable and she was taken
to hospital.
PATSY SMITH: I knew something was wrong rightaway when residents and students
and people started coming in and saying can we look at your eyes, you know, can
we take a look at your eyes. They did all kinds of tests and pictures and X-rays
and ultra-sounds and odds and ends and, oh I was scared, I was really, really
scared, and then they tell me this big word and I'm like whoa. I then asked if I
would go blind and Dr. Tang told me she couldn't make any promises that she
couldn't make me any guarantees at all, so we're just waiting.
NARRATOR: They found Patsy had pseudo-tumour cerebri, a condition where
increased fluid pressure in the brain crushes the optic nerve. The pale circle
shows a cross-section through a normal nerve, but in Patsy's case, the fuzzy
white circle shows where the nerve has been crushed and permanently damaged.
DR. ROSA TANG: Patsy has blindness in one eye already, for practical purposes.
What damage she has now is not going to improve. She is blind in that eye
permanently and partially blind in the other. If she has another episode this
may further damage the vision she has left and she could go completely blind.
NARRATOR: Could the Norplant have caused this? Dr. Tang became so concerned that
she wrote to every eye specialist in Texas to find out if other women on
Norplant had eyesight disorders. Out of 100 women referred to her, over 40 had
blurred vision. Of these 8 had the same condition as Patsy.
ROSA TANG: It was very surprising for me because I had not seen any reports in
the literature at this time of such a link between Norplant and pseudo-tumour
cerebri and I was surprised of the fact that there were so many patients that
seemed to be having the condition related to Norplant. I think that there is
enough out there that there is a possibility of a link between the two that a
larger-scale study should be done if Norplant is to be continued.
PATSY SMITH: What hurts me the most is the possibility that I may go blind and
not see my children grow up. It's really scary. It's more precious to me now
than it was before. I take a lot of the things that she does and I hold them
near so that way I can remember them if anything happened.
NARRATOR: Eyesight disorders, strokes, persistent bleeding, problems with
removal - many women have no such side-effects, but thousands are now taking
legal action in the West. Norplant was studied for 20 years in the West, but
mostly in developing countries. After standard clinical trials of Norplant had
been completed, pre-introductory clinical trials were held to assess the drug's
safety, efficacy and acceptability in local conditions. Horizon went to
Bangladesh to investigate one such trial. In the mid-80s, stories had begun to
emerge from women's health campaigns. In the slums of Dhaka, Farida Akhter heard
of women with Norplant in their arms who were desperate to get it removed. She
realised she had stumbled on a drug trial.
FARIDA AKHTER: This started with the slum woman very secretly. They just did not
tell anybody, there was no announcement and these are poor women, we are not
meeting them every day so nobody knew.
NARRATOR: Farida Akhter was concerned about the vulnerability of slum women and
wanted to know how the tests were being run, but no-one could tell her.
FARIDA AKHTER: We found that the family planner would just come to them and say
that you can't talk about these things to any outsider woman, and they were
afraid to talk to us, you know. They were so afraid that sometimes they were not
even sure that because we look educated woman we might be from the government,
or from the family planning clinic itself, maybe we are just pretending to know
them, so they were not sure what they could tell us. You know, it took us time
to even get their trust to be open and they were so much afraid, you could see
in their face that they were really afraid.
NARRATOR: An earlier trial had been dropped because of public outcry over the
way Norplant was being promoted as a safe drug when it was still under test.
While Farida Akhter was investigating this trial, her offices were raided by
military government officials.
FARIDA AKHTER: They just gave me an impression that if I don't answer questions
in the right way they will do something. It was like a frightening thing you
know. They entered the gate, asked where is the Executive Director and you know,
two men coming in you know and entered my room and sat down and there was a file
and you can see the government file, you know it's a red tape and they have
Ubinig written on it you know, and they said where do you get the money from,
what are you doing you know. They were just frightening me, asking me look, you
have the file, we have information about you.
NARRATOR: Undeterred, she continued her investigation.
FARIDA AKHTER: I really had to find out in a detective way. We went to the
villages, we went to the slum areas. It was more than 100 woman we talked to.
NARRATOR: She found the side-effects were having a dramatic effect on their
lives.
WOMAN [SUBTITLED]: Suddenly my body became weak, quite suddenly. I couldn't get
up, couldn't take care of my children, couldn't cook. I was bedridden.
WOMAN [SUBTITLED]: It was unbearable.
INTERVIEWER: Did you feel weak?
WOMAN: Yes, my limbs felt like collapsing, as if they were being wrenched apart.
I couldn't work or eat even. I had to lie in bed for three months. I couldn't do
anything.
INTERVIEWER: And the bleeding?
WOMAN: I was bleeding all the time.
FARIDA AKHTER: Severe bleeding makes her so weak and she even does not have two
meals a day. Many of them fainted quite often, you know which was not the case
before, so these woman were telling us we were supposed to be very happy after
taking this Norplant, but why our life is like hell now.
NARRATOR: Then she heard of women being coerced to stay in the trial. Once
Norplant is inserted, a woman cannot remove it by herself.
WOMAN [SUBTITLED]: I went to the clinic as often as twice a week. But they said:
'This thing we put in you costs 5,000 takas. We'll not remove it unless you pay
this money.' Of course I feel very angry. I went to several other doctors and
offered them money to take those things out, but they all refused. I went to
three or four of them and they said these can only be taken out by those who put
them in. They said that, if they tried they might go to jail.
INTERVIEWER: If they ask you to take Norplant again, will you?
WOMAN: That thing! Even if 14 generations of my ancestors asked me, I shall
refuse.
INTERVIEWER [SUBTITLED]: How many times did you go to the clinic and ask them to
take it out?
WOMAN: In 6 months about 12 times. Yes, about 12 times. I went to the clinic and
pleaded 'I'm having so many problems. I'm confined to bed most of the time.
Please remove it.' My health broke down completely. I was reduced to skin and
bone I had milk and eggs when I could, but that did me no good.
WOMAN [SUBTITLED]: I felt so bad, my body felt so weak, even my husband told me
it was all very inconvenient.
INTERVIEWER: How is your relationship with your husband?
WOMAN: What else could it be? He says he'll get another wife tomorrow. I told
the doctors, 'Please take it out, I'm having so many problems.'
INTERVIEWER: How many times did you ask to get it removed?
WOMAN: Oh, about 15 times. One day I was so desperate. I gave up hope. I felt
like throwing myself under the wheels of a car.
FARIDA AKHTER: One woman when she begged to remove it, they said 'I'm dying,
please help me get it out'. They said 'OK, when you die you inform us, we'll get
it out of your dead body', so this is the way they were treated. In a slum area
people are living in a very small, like 5ft by 7ft where at least five family
members are living and these woman are working outside. The most important
resource they have is their own healthy condition.
NARRATOR: In Bangladesh if a woman can't work, often her family can't eat.
FARIDA AKHTER: We have many information where these woman have told us that they
have sold their cow or the goat which was the only asset they had for treatment
because she had to get well, otherwise the family can't survive, so in order to
save her, they had to, you know, sell the cow or if they didn't want to treat
her then she suffered, so the family was suffering either way. In every sense
these people were totally torn. Their economic condition were torn, their family
happiness was totally gone.
NARRATOR: By now, news of the Norplant testing had spread. Nasreen Huq, who has
recently represented the Bangladeshi government on women's health issues, found
more disturbing aspects to the trial.
NASREEN HUQ: Participation in a clinical trial requires that the person who is
participating in that trial understands that it is a trial, that the drug they
are testing out is still in experimental stages. This requires informed consent.
This was categorically missing.
INTERVIEWER [SUBTITLED]: When they implanted this device, did they say it was an
experimental thing that they were testing?
[WOMEN RESPONDING]: No.
NARRATOR: Perhaps most worrying of all in the drug trial, potentially serious
side-effects appeared to have been ignored.
NASREEN HUQ: Many of them told us that they had problem with eyesight which is
not recorded by the clinics which were doing the trial on their bodies.
WOMAN [SUBTITLED]: I couldn't see. I couldn't look at things at a distance. I
had trouble focusing. You know in the village we light oil lamps. I couldn't
look at them. They looked like the sun, as red and large as the sun. If I looked
into the distance, my eyes would water.
INTERVIEWER [SUBTITLED]: What do you mean by this dimness of the eyes?
WOMAN: If I went out of doors, my eyes became absolutely dark. I couldn't see
anything at all as if my eyes had become affected by blindness.
NARRATOR: In 1993 a report of the first phase of this trial concluded: Norplant
is a highly effective, safe and acceptable method among Bangladeshi women.' It
stated less than three per cent of women reported significant medical problems,
no mention of eyesight disorders or women being refused removal.
NASREEN HUQ: I think the Norplant trials were bad science, really shoddy
science, because they were not recording the side-effects. They were scolding
women when they wanted to report side-effects, they were scolding women if they
came in at a time when they were not scheduled to come in for a follow-up check.
Their request for removal were disregarded, were not even recorded during the
trial. So how can they tell us that it was an acceptable method for women and
that this has been scientifically tested out, you know? When continuation rates
reflect caution, reflect refusal to remove, reflect disregard of women's
concerns, reflect disregard for women's health, how can they even accept that
this has been the work of scientists?
FARIDA AKHTER: If you look at the trial, it looks like as if this woman are no
better than a guinea pig and a guinea pig perhaps is more expensive in the West,
that's why our woman are cheaper here, so they're easily available, they can be
easily controlled and their bodies can be easily tested.
NASREEN HUQ: When you conduct a trial in this sort of setting, you are simply
taking advantage of them being poor. You've access, cheap access, to subjects,
and you can write it up as a successful trial. You're not in any way advancing
science, you're taking advantage of a situation in which women are poor and they
don't want to have more children, and by providing this method, or conducting
this trial, you are not in any way letting them out of their desperate
situation. I mean, I have been trained in science and I'm sorry, this is not
science.
NARRATOR: The trials were developed with funds from the US Agency for
International Development.
DR NILS DAULAIRE: We have very strict rules at AID in terms of any
experimentation that's done that certain ethical standards in terms of human
subjects have to be met, and informed consent is a critical part of that. I've
not been made personally aware of any serious lapses in terms of informed
consent of any of the AID trials. If there are cases where women were not
accorded the opportunity to have Norplant removed, that would be a very serious
breech and if this was done with US aid funds, we would take that extremely
seriously.
INTERVIEWER: Well it has been done with US funds it appears, and we have
interviewed many women who had problems getting it removed. How can this be,
with a clinical trial which you're running with American taxpayers' money?
NILS DAULAIRE: Well I can't answer that specific clinical trial because that's
one that I'm not personally familiar with. I can't tell you how it can be, I can
tell you that if it is, there will be severe consequences. The organisations
that would be responsible for monitoring and overseeing these would have to
clarify how any such activities took place under their oversight.
NARRATOR: Family Health International oversaw some of the trial for US AID. They
confirmed their officials were in Bangladesh regularly, but told Horizon: we do
not believe this was very poor science. The study was well designed and
implemented in an ethical way. They admitted there were problems with removal,
but say they acted upon them and that these were not as widespread as claimed.
Yet their own data reveals that out of 1300 women from the expanded trial, over
100 reported being refused removal. And Horizon found evidence of problems with
other US AID studies of Norplant. Testing was also carried out in Cité Soleil in
Haiti, the poorest community in the poorest country in the western hemisphere.
Since the mid-80s, there have been 14 coups d'état and 8 changes of government.
CATHERINE MATERNOWSKA: Danger's a difficult concept to define in Haiti. It can
come from any direction at any moment. People who stand up and indicate that
they have been abused are often punished, attacked at night, raped, hundreds of
women in Cité Soleil have been raped by the para-military forces. Often entire
neighbour-hoods are razed and burned down. This political instability makes the
climate for doing good research absolutely impossible. For many years now I've
had copious field notes on side-effects with the Norplant method, but I've had
to work essentially in secret and covertly with Haitian women listening to their
stories and their difficulties and unable to publish it. The participants in my
study could have been in grave danger had the information been let out, the fact
that they were talking to me about their woes, about their difficulties with the
Family Planning Centre and the Norplant method. Many of the women that I
interview come from the countryside where they've lost their land, where they've
lost their income, where they've basically taken off in search of life and
within months most of them tell me, the little saying (FRENCH) takes a turn and
they say (FRENCH), which means in searching for life the essence of life is
destroyed. They can't find food, they can't find water, they have no access to
health care, so essentially they're looking for life but they find misery.
NARRATOR: It was while studying this community that Catherine Maternowska came
across US AID trials of Norplant and was worried at what she found.
CATHERINE MATERNOWSKA: Side-effects in the context of Haitian women's lives are
horrible. With the Norplant users they were extremely severe. Bleeding could go
on for 18 months and what this means in a Haitian woman's life has enormous
impact. In Haiti, women don't have cotex or tampons. That means that they have
to use rags. She needs to wash them every morning. Washing is not a simple task
at all in Haiti. She has to buy soap which cuts into her finances for her food.
To purchase water. A woman who can't actually purchase the water needs to find
the water in the nearby gutters which are filthy, polluted and used for
defecation among other things. Another bad side-effect was headaches. A Haitian
woman is not able to buy aspirin. They live in very noisy, active, polluted,
intense communities and the headaches on top of all this were intolerable. Many
women collapsed from this method in sheer exhaustion. They couldn't go to work,
they felt so ill, they were unable to function.
NARRATOR: Just as in Bangladesh, a pattern emerged where it was sometimes
difficult for the women to get the Norplant removed. Catherine Maternowska
believed local clinics were under pressure to keep women in the trial to make
the data look good.
CATHERINE MATERNOWSKA: One woman came in with an infection in her arm. She was a
market woman, she carried heavy loads on her head and when she came in asking to
get the insert out, the doctor complained and he complained and he looked at me
and he was used to having me in the clinic and he said, 'Oh Cathy, look at this
woman, she's an animal, she wants her Norplant out, she's an animal. She has to
be in the study and she wants it out now. What's her problem?' They proceeded to
throw her literally onto the table, lie her down so that they could do the, take
the Norplant insertion out. They threw her head to the side like this and they
gave her the anaesthesia but before the anaesthesia had actually taken effect in
her skin they started pulling the inserts out and making incisions and pulling
the inserts out. Because the infection in her arm it looked painful, it was red,
it was swollen, and the muscle and sinew tissue had grown over the implants,
they were pulling and she was wailing, she was why, why, and they continued
calling her an animal. I think it's a sham, it's disgusting, it appalled me that
this kind of research was going on. When someone's looking for help, looking for
a solution to their poverty and what they find is something that just makes
their poverty worse, it's a huge, huge sadness.
NARRATOR: For health workers in Cité Soleil Norplant is one of a long line of
contraceptives that have been tested in Haiti over several decades.
ROSE-ANNE AUGUSTE [SUBTITLED): It is important for us to expose how women in
poor countries are used as guinea pigs, especially in Haiti, so that they can
test their products. Developed countries may not even use these products because
the hormone levels are too high. But they use these in experiments on women in
poor countries so that they can regulate the levels. Fundamentally, what appears
to us in Haiti is that these people have found a laboratory here a slum
laboratory - to do whatever they want. And one of the biggest laboratories for
the American government is right here in Cité Soleil.
INTERVIEWER: Why would your research target the poorest and the most illiterate
and the least well able to defend themselves group?
NILS DAULAIRE: You'll find that the broad portfolio of research does not target
the poorest and the most illiterate and the least able to defend themselves.
That in fact the research that's carried out is over a broad spectrum of society
because it's important to understand the use effectiveness and the benefits, as
well as the disadvantages of certain contraceptive types among a wide variety of
groups.
INTERVIEWER: That maybe true for US AID as a whole, but I am talking about the
clinical trials of Norplant in the Third World which were in the slums of
Dhaka..
NARRATOR: At this point the interview was terminated by a State Department
official who asked for further information. Later, Horizon was told: US AID
categorically denies that poor Haitian women were being used as human guinea
pigs by the United States. They added they were proud of their programme in Cité
Soleil and that the clinic there had been widely praised for its quality of
care. Norplant was studied in over 40 countries and apart from Bangladesh, there
are reports of problems from Indonesia, Brazil and others, so how did the drug
get approved by America's Food and Drug Administration? Sybil Shainwald attended
the only public hearing in 1989.
SYBIL SHAINWALD: The FDA approve a process In the case of Norplant was
ludicrous. It was not the standard approval process. The auditorium was packed
and it was like a dog and pony show. There were blond women running around
saying I love Norplant, I'm satisfied with Norplant. On the other hand, the
advisory committee, which was hearing the testimony, took very little cognisance
of the fact that there were problems that had been reported throughout the
world.
NARRATOR: This application was later withdrawn due to problems with the data. It
was resubmitted and approved 8 months later with no further public hearing.
SYBIL SHAINWALD: This was the fastest approval process that I know of since I
have been dealing with the Food and Drug Administration and the purpose was to
market this overseas to control population.
NARRATOR: Many researchers do believe that Norplant is of great benefit, but
others are critical of the US government's promotion of a long-acting
contraceptive overseas.
PROF. BETSY HARTMANN: At the highest levels in Washington, population growth in
the Third World has long been perceived as a national security threat. During
the Cold War, of course, public fear and paranoia often focused on the nuclear
bomb and in the post-Cold War period we're having the population bomb
re-emerging as a threat. Now we're fearing these Third World peoples. Does this
mean that you promote Norplant like a weapon in the war against population
growth? Colleagues and I have looked through declassified documents and have
found, much to our horror, that at the highest levels of government this has
been an obsession. There is a national security memorandum, for example, which
talked about the great need to control population growth in places like Brazil
and the big countries and how this population was a definite national security
threat.
NARRATOR: Norplant is at least an officially approved contraceptive. But there
are other, less regulated methods already in use.
BETSY HARTMANN: It's not just in the United States case the government, but
there are also a whole range of private foundations that are funding the
building of a population control movement.
NARRATOR: One private organisation is run by two doctors from America's southern
states who believe they've found the answer for Third World women in a drug
called Quinacrine.
DR. STEPHEN MUMFORD: Quinacrine is the most important development in
contraception since the birth control pill. It has an enormous potential for
preventing births and we're talking about literally billions of births.
DR. ELTON KESSEL: We have trials of the Quinacrine method going in some 17
countries like India, China, Bangladesh, and the trials are going very well.
100,000 women have had this method without a single fatality being reported.
NARRATOR: Dr. Elton Kessel was the founding director of Family Health
International. He now researches Quinacrine in a worldwide operation,
masterminded from Dr. Mumford's basement in Chapel Hill, North Carolina.
Quinacrine is inserted into the top of the womb where it causes inflammation and
scarring in the Fallopian tube, in theory blocking the tube with scar tissue and
preventing the sperm from reaching the egg.
STEPHEN MUMFORD: It's a very simple procedure, takes only a few minutes. It can
be done in very primitive settings by people who do not necessarily have a lot
of clinical skills. Quinacrine is clearly the cheapest method available in the
world and in fact the second cheapest method would probably be more than 100
times as expensive as the Quinacrine method. For $10,000's worth of Quinacrine
pellets, 70,000 women can be sterilised.
INTERVIEWER: Is that a lot of women?
STEPHEN MUMFORD: That's a lot of women, and a lot of grateful women.
DR. AMY POLLACK: The story of Quinacrine is very unusual. It amazes many people
that, despite the fact that this drug has not been approved by any major
regulatory body for use in women, it's been used and distributed to over, you
know, 80,000, maybe 100,000 women around the world who've been told that it's a
safe and effective method and therefore agreed to use the method. How's it been
done? Just a couple of guys out there running around with suitcases full of the
drug who distribute the drug to doctors, primarily, and there's an appeal
because it's inexpensive and it's easy to use.
NARRATOR: But some scientists believe the drug could put women's lives at risk -
from cancer and ectopic pregnancy. And they question this entire approach to
sterilisation.
PROF. SHREE MULAY: This method of producing scar tissue is extremely barbaric.
to try to damage the tissue so that you produce inflammation and block the tubes
that way I think is extremely crude. It is imprecise for sure because one does
not know where exactly that is going to take place and it causes a tremendous
amount of pain because of the inflammation. There has been a long history of
chemical sterilisation research and this history is really an ugly one and it's
quite a shocking one because all kinds of agents have been used - sulphuric
acid, formaldehyde - all of these agents which actually burn the tissue and
cause production of scar tissue. Chemical sterilisation was first tried out by
the Nazis in their very first experiments in the death camps. That it has been
picked up in the 60s, 70s and the 80s and been promoted as rescue for the women
of the Third World I think is quite extraordinary.
STEPHEN MUMFORD: We're seeing 500,000 women die per year. Every day women die
because of unwanted fertility that could be treated with this method.
INTERVIEWER: And you're going to save them?
STEPHEN MUMFORD: That's... I'm not going to save them, they're going to save
themselves by electing this if the thing is made available, if the method is
made available. We know these women want this method.
AMY POLLACK: What kills women in childbirth is horrible obstetrical services
totally inadequate services that exist around the world. Not only are they bad
services, but they're services provided for women who want to have children, and
those women are not going to choose sterilisation. So women who don't choose
sterilisation and choose to get pregnant are not going to be saved by Quinacrine.
The numbers that are presented to us don't take that into account at all.
NARRATOR: The World Health Organisation has stated that no further Quinacrine
research in women is justified until further laboratory tests have been
completed.
AMY POLLACK: We don't have answers to critical questions about the long-term
impact of Quinacrine on women, and until we have those answers, and we can find
those answers, we should not be using this drug in women, period.
NARRATOR: So who is funding the research?
BETSY HARTMANN: A student of mine was examining who was funding the
anti-immigration movement in the United States and searching through the tax
records of various foundations, when she chanced upon the tax records of the
Leland Fikes Foundation and found to her amazement that that Foundation was not
only funding the Federation for American Immigration Reform, which is very
anti-immigrant, but Mumford's work on Quinacrine. It's very scary that you have
a private foundation funding both an anti-immigration group and a form of
unethical contraception. I think there's a racial fear involved in this
politics.
STEPHEN MUMFORD: My God this is they call this an anti-immigrant organisation. I
think that the Federation of American Immigration Reform is a highly patriotic
institution, that is correct. I mean very few Americans agree that we should
have open borders and FAIR's position is that we should not have open borders
and that has been the focus of their efforts since they were created. I'm very
happy to identify with the Federation for American Immigration Reform.
ELTON KESSEL: You know, if you open the borders of the United States, the United
States will become a developing country.
STEPHEN MUMFORD: That's correct. Most Americans do not want to live in these
conditions, including myself.
NARRATOR: They've had sympathisers for their philosophy in high places.
STEPHEN MUMFORD: I've just completed a book and George Bush was just leaving the
directorship of the CIA at that time. George Bush read the synopsis again, which
said over-population is a graver threat to US security than the nuclear threat.
George Bush says I agree with everything you're saying here in this synopsis and
I can assure you that the people at the CIA agree with you too, so at that point
I knew that at the highest levels of our government this issue was being
discussed.
NARRATOR: The latest scientific research promises the ultimate in easy-to-use
and safe contraception. Contraceptive vaccines are being developed. In the
future, one jab may prevent reproduction for years. It offers great hope, but
how could it be used, and by whom? In the Philippines women believe they have
been tested with a contraceptive vaccine, secretly.
SISTER MARY PILAR VERZOSA: I first got suspicious of the vaccination programme
by the way it was being carried out. The government would announce one or two
days a year which they called national immunisation days. They made
announcements that only women of reproductive age, that is from 14 to
45-year-old, should come to the health centres for their tetanus immunisation
shots.
NARRATOR: Records show two-thirds of tetanus deaths in the Philippines are
amongst men, so why would they target the women? She was even more suspicious
when she discovered the jabs were to be given five times in three years, when
usually a tetanus is given much less frequently.
MARY PILAR VERZOSA: That really put a lot of questions in our minds. The
Department of Health would send their teams into the schools, they would just
tell the teacher in charge that this was a government programme, it's a service
being given, it's good for the girls.
NARRATOR: Then she started to hear disturbing reports from women when she was
working in the slums.
MARY PILAR VERZOSA: The women would say why is it that the tetanus shots that
we've been getting have had effects on us? Our fertility cycles are all fouled
up, some of the women among us have had bleedings and miscarriages, some have
lost their babies at a very early stage. The symptoms could come soon after
their tetanus vaccination - some the following day, others within a week's time.
For those who were pregnant on their first three or four months the miscarriage
was really frightening.
NARRATOR: There are several research programmes around the world testing the
contraceptive vaccine linked to tetanus which creates an immune response. The
vaccine contains Beta HCG, part of a hormone necessary for pregnancy. This Beta
HCG stimulates antibodies so that if a woman's egg becomes fertilised her own
natural HCG will be destroyed and pregnancy will not occur.
MARY PILAR VERZOSA: I began to suspect that here in the Philippines that's
exactly what's happening. They have laced the tetanus toxoid vials with the Beta
HCG. The only way I could make sure that they hadn't done that was to examine
the vials, and how to get a hold of those vials was going to be a problem. Who
was I to collect them from the health centres?
NARRATOR: Sister Mary was helped through the Catholic network. A friend who
worked in a health clinic removed the vials unnoticed. The nuns packed them with
ice and sent them to an independent laboratory.
MARY PILAR VERZOSA: Oh boy that was really something when this came out of my
fax machine. Report on HCG concentration in vaccine vials. Three out of those
four vials registered positive for HCG, so my suspicions are affirmed that here
in our country they are not only giving plain tetanus toxoid vaccination to our
women, they are also giving anti-fertility.
NARRATOR: Sister Mary was not alone. Many women and doctors reported similar
findings. Dr. Vilma Gonzaga became suspicious when she had two miscarriages,
both times after receiving the tetanus jab. She is now suing the government
since tests showed she had very high levels of antibodies to Beta HCG.
DR VILMA GONZAGA [SUBTITLED]: Women should have been told that the injection
would cause miscarriage and, in the end, infertility. The Department of Health
should have asked beforehand, so that only those who didn't want to have
children had the injection. I really hope and pray to God that I will still have
a baby and get a normal pregnancy. And I am still hoping that the Department of
Health will find an antidote to the antibodies in my body.
NARRATOR: But the government has denied any contamination of the tetanus vials
and their tests have led to different conclusions.
DR RAYMUNDO LO: We found insignificant traces of what the machine read us HCG
and I interpreted this as plain background noise, in other words anything could
have caused that signal which caused the machine to read it thus HCG, so I think
the notion of tetanus toxoid being laced with HCG to cause abortions is plain
hogwash.
NARRATOR: Medical practitioners in Manila do not accept this and have called for
further investigations.
DR REYNALDO ECHAVEZ: We in the Philippine Medical Association doesn't believe in
what the government is saying. The test that were made in both big medical
centres were all positive for HCG, Beta HCG, and they claim that this is
insignificant. To me this could not be insignificant because it can produce
anti-HCG. At the moment there is a presence of HCG in the vaccine. It can
produce anti-HCG and this can now neutralise the HCG that a woman will produce
during pregnancy and abortion will set in.
NARRATOR: So are the fears genuine, or does this fit a Catholic campaign to
discredit the population programme? While the science remains unresolved fewer
women are accepting any vaccinations, and this could damage public health. If
the claims are true, how could it have been done?
DR FAYS SCHRATER: If there is a conspiracy to immunise the women of the
Philippines with chorionic gonadotropin rather than tetanus, then it requires
the knowledge of some member of a government, or two. It requires the
participation of a manufacturer to link the chorionic gonadotropin physically to
the tetanus toxoid - you can't just throw it in the vial and expect it to do its
work. And it requires that it be mislabelled and that it be shipped then to a
centre who knows what's in it and who is going to distribute it in a guise of
tetanus vaccine. Of course it's plausible and in fact it's probably not all that
complicated. All it takes is money and desire and the willingness to lie. We
have this long history, we, as women, of been either lied to or coerced in terms
of contraception. We've been lied to in terms of either the dosage of hormones
like in the pill, we've been lied to about the effects of Norplant, we have had
Norplant coercively used and then refusal to remove it, women have been forced
into sterilisation camps. There's a long history of medical science being used
negatively on women's bodies and of women being lied to.
FARIDA AKHTER: We are for family planning, but this is not happening. External
agencies - the government, the international aid agencies - they decide what
method we should have, how many children we should have, and then they decide
even what kind of contraceptive we should have, and then they dump on us all the
rejected ones, new ones they test on our bodies and woman have no control over
it.
NARRATOR: Every year 13 million children under five die, half a million women
die in pregnancy, there are 50 million abortions worldwide. The need for family
planning and new contraceptives is overwhelming.
AMY POLLACK: If we fail to recognise the human rights of women in developing
countries in terms of testing contraceptives and using contraceptives, then we
will lose all of the methods around. Women will deny themselves family planning
methods because they will consider it all of the time an experiment, and they
will never trust the support that they're getting from outside of their own
country. That's a risk that we take.