Kenya: MSF reviews patient allegations of coerced sterilisation

MSF reaffirms its commitment to ensuring that all patients provide informed consent prior to receiving any medical treatment. MSF has never encouraged sterilisation as a preferential family planning method. MSF will cooperate fully with the Kenyan authorities on this matter.

NAIROBI / PARIS – Médecins Sans Frontières (MSF) has been notified that four individuals, including three former MSF patients, have filed suit against five health organisations, including MSF, in Kenya. In particular, the former patients allege that they were either sterilised without their consent at third-party Kenyan health structures or, in what concerns MSF, felt pressured by staff at MSF’s former Mathare HIV care project to undergo surgical sterilisation to avoid losing access to medical treatment or nutritional support.

“MSF takes these allegations extremely seriously and is reviewing them carefully,” said Dr. Alexandra Vandenbulcke, MSF’s current Medical Coordinator in Nairobi. “As a medical humanitarian aid organisation, MSF is committed to ensuring that all of our patients are fully informed about their medical options and that all of our patients provide full and informed consent prior to any medical treatment they receive.”

From 2008 to 2013, MSF’s health promotion activities in Mathare involved providing HIV-positive patients with family planning information. In accordance with MSF’s policies, patients were informed of a full range of contraception methods and the benefits, risks and consequences of each method. MSF has never encouraged surgical sterilisation as a preferred contraceptive method. Surgical sterilisation (bilateral tube ligation) was one contraceptive measure described to patients. In accordance with Kenyan Ministry of Health policies, women who chose surgical sterilisation as their preferred family planning option were referred by MSF to third-party Kenyan health structures. MSF has never performed surgical sterilisations in Kenya.

According to an internal MSF audit conducted in 2012, out of more than 1,100 patients who received family planning information from MSF, only twenty-one women were referred by MSF to Kenyan health structures for surgical sterilisation procedures. On three occasions, women told MSF’s internal auditor that they felt they needed to choose sterilisation to maintain the relationships they had with their healthcare providers. None of the other patients interviewed by MSF’s auditor said that they felt under any pressure to select a particular family planning methodology.

Nonetheless, following the completion of its internal audit, MSF reinforced its internal procedures with respect to providing information about surgical sterilisation. MSF’s practices now go beyond Kenyan national recommendations and ensure that all patients are provided with multiple opportunities to discuss their family planning choices, including with at least two different healthcare providers. Patients are now also required to take a minimum of three weeks to consider any non-reversible family planning option.

“It is never easy to investigate the confidential and private exchanges between a healthcare practitioner and a patient,” noted William Hennequin, MSF’s current Head of Mission in Kenya. “MSF once again reaffirms that we will collaborate fully with Kenyan authorities with respect to these serious allegations.”

MSF has been working in Kenya since 1987. In 2001, MSF provided the first free access to life-extending antiretroviral treatment for HIV infected patients in Kenya. MSF is currently providing needed health care services in Homa Bay County, Kibera, Mathare and Dadaab.