Programa Nacional de Población

The Peruvian armed forces grew frustrated with the inability of the García administration to handle the nation's crises and began to draft a plan to overthrow his government.[4][5] According to Peruvian sociologist and political analyst Fernando Rospigliosi, Peru's business elites held relationships with the military planners, leaving an impression that a neoliberal economy must be adopted in Peru.[6]

Between 1988 and 1989, a coup d'état was initially planned to oust President García.[7] In October 1989, a group of the armed forces finalized plans to overthrow the García government with a volume of the plan titled Driving Peru into the XXI century.[8][9] The goals were to establish Peru as a developed country through the turn of the twenty-first century by establishing a neoliberal economy with policies similar to Chile's or those proposed by Mario Vargas Llosa.[10] This volume also details plans to sterilize impoverished citizens in what Rospigliosi described as "ideas frankly similar to the Nazis", with the military writing that "the general use of sterilization processes for culturally backward and economically impoverished groups is convenient", describing these groups as "unnecessary burdens" and that "given their incorrigible character and lack of resources ... there is only their total extermination".[10] The extermination of vulnerable Peruvians was described by planners as "an economic interest, it is an essential constant in the strategy of power and development of the state".[10]

Plan Verde was later redeveloped to include Alberto Fujimori as the head of a "civil-military" government.[11][12] Peruvian magazine Oiga reported that Fujimori was to be directed on accepting the military's plan at least twenty-four hours before his inauguration.[13] Fujimori would go on to adopt many of the policies outlined in Plan Verde.[14][15]

In 1991, a new National Population Program was developed, known as Programa Nacional de Población.[3] Although Fujimori was an avid public supporter of family planning, the new National Population Program and its specific goals and strategies seemingly counteracted the law's initial purpose of preserving individual human rights.

With the newly drafted version of the National Population Program (Programa Nacional de Población) under Fujimori, goals were specified in the context of demographics. The Peruvian Ministry of Health's program manager stated that impoverished indigenous women are "poor and producing more poor people. The President is aware that the government cannot fight poverty without reducing the poor people's fertility. Thus, demographic goals are a combination of the population's right to access family planning and the government's anti-poverty strategy."[3] The program was targeted towards poor women who had "little or no formal education".[3] Thus, the program intended to:

• reduce population growth rate from 2.1% to 2%
• reduce the total fertility rate from 3.5% to 3.3%
• reduce maternal and child mortality rates
• foster "equitable socio-economic opportunities" between men and women[3]

The National Population program called on both public and private sectors to assist in its strategic implementation. Furthermore, seven strategies were laid out as guidelines to reach the intended demographic goals:

• reproductive health and family planning
• communication and information dissemination
• decentralization of population policy
• education
• production of research and statistics
• advancement of women and youth
• environmental protection[3]

Because these strategies required the cooperation of various institutions, the program failed to be carried out with ease yet again due to the lack of coherence within the involved political sectors and agencies. Many agencies "lacked sufficient power to carry out [its] functions" and others were either "not interested" or opposed to working in agreement "due to inter-institutional rivalries".[3] Peru's internal conflict from decades past continued to work against the overall productivity of the institution and its ability to sufficiently serve constituents.

Funding was also a crucial issue that proved to be an additional setback to the National Population Program. In Peruvian government, as with many Latin American countries, the Catholic Church held significant power over issues both public and private. Essentially, the moral support of the distinguished members of the Church would result in financial support. However the Catholic community looked down upon the National Population Program due to its promise to provide modern contraceptives.[3] Knowing fully well that his program would not be a success without the Catholic Church's approval, President Fujimori "toned down" the program's focus on contraception.[3]

After the goals were defined and the funding for the National Population Program was in place, the number of annual sterilizations in Peru rose drastically. Prior to the program, there were less than 15,000 sterilizations performed per year and women could only have the operation performed "if they had a health risk, four or more children, or were above a certain age".[3] However, after 1995 when sterilizations began to be performed, there were no pre-existing conditions necessary for sterilizations other than that women had to be considered part of Peru's poor and disenfranchised community. In addition, the number of annual sterilization procedures rose after the program's implementation from 15,000 to 67,000 in 1996 and 115,000 in 1997.[3]

The program's implementation also brought up several issues in terms of the quality and care of the procedures. Most of the personnel hired to perform sterilizations were not properly trained and much of the equipment used was outdated and lacking in quality. The counseling services provided to patients were also backed by poorly trained staff and many women were not given "quality information prior to procedures".[3] When sterilizations were given, they were done so in a hurriedly manner. "Teams were dispatchd one day at a time to perform procedures" and therefore attempted to cover large masses of women in rural areas in very minimal amounts of time.[3] As a result, patients were denied sufficient and proper treatment and rarely received follow-up care.

Bribery, threats, and deception were methods used in the implementation of such procedures by medical personnel. A large number of the indigenous Peruvian population speaks Quechua and are unable to read, write, and sometimes even communicate in Spanish. Many women were deceived by personnel and told that the procedures were operations other than sterilization. There were also instances of men being told they would be fined or jailed if they did not order their wives to have the operation. A former physician for the Ministry of Health confirms these practices:

We were required to perform a certain number of sterilizations each month. This was obligatory and if we did not comply, we were fired. Many providers did not inform women that they were going to be sterilized - they told them that the procedure was something else. But I felt this was wrong. I preferred to offer women a bag of rice to convince them to accept the procedure and explained to them beforehand what was going to happen.[3]

The plan's forced sterilization of vulnerable groups through the Programa Nacional de Población has been variably described as an ethnic cleansing or genocidal operation.[18][19][20][21] According to Back and Zavala, the plan was an example of ethnic cleansing as it targeted indigenous and rural women.[18] Jocelyn E. Getgen of Cornell University wrote that the systemic nature of sterilizations and the mens rea of officials who drafted the plan proved an act of genocide.[19] The Centro Amazónico de Antropología y Aplicación Práctica non-profit stated that the act "was the largest genocide since [Peru's] colonization".[21] At least 300,000 Peruvians were victims of forced sterilization in the 1990s, with the majority being affected by the PNSRPF.[22] The policy of sterilizations resulted in a generational shift that included a smaller younger generation that could not provide economic stimulation to rural areas, making such regions more impoverished.[23]

In 1997, the newspaper La República reported on the human rights violations of the National Population Program and sparked a nationwide debate that brought the government's actions to the forefront of Peruvian media.[3] Because the procedures of the National Population Program went against Peru's constitutional law and violated human rights law, foreign donors threatened to suspend support for any aspects of the program that were sterilization related. Many public organizations, such as the Flora Tristán Peruvian Women's Center and the Comité de América Latina y el Caribe para la Defensa de los Derechos de la Mujer (CLADEM), began to voice their concerns for the program and attempt to obtain evidence against the Ministry of Health and the Peruvian government for their covert actions.[3]

Without full support from the Catholic Church, outside funding was required for the program's success. International pressure to meet population standards became evident when the International Monetary Fund suggested that the Peruvian government cut funding for social services to allow for more spending in areas called for by the program.[3] In addition, USAID (United States Agency for International Development) contributed US$85 million between 1994 and 1998. Because the financial support from foreign donors brought economic and political pressure upon Fujimori to meet international standards, the plan to decrease population growth consequently became more focused on quotas than individual rights and health issues.

In 1998 after facing pressure following investigations by the Population Research Institute, USAID ceased funding for sterilizations in Peru.[24] Sterilizations continued until President Fujimori fled to Japan in 2000.[25]