Deputy Health Minister Yaakov Litzman is appointing a team to investigate the widespread administration of contraceptive shots to Ethiopian immigrant women, which came to light nearly three months ago.
The team will check the reports that the women were given Depo-Provera shots to prevent pregnancy – often against their will and without being informed of potential side effects – in what was an allegedly deliberate effort to reduce births in the Ethiopian immigrant community.
The contraceptive shots, which are administered every three months, are said to have contributed to the drop in the birthrate among Ethiopian women of close to 50 percent within a decade.
The committee is being set up at the instruction of Litzman, who had earlier denied that the phenomenon existed, after it was revealed by an Educational Television documentary by journalist Gal Gabai in early December. The committee is expected to include senior ministry officials and an independent physician to be chosen by Litzman.
There will also be a representative of the Ethiopian community on the panel, who will be chosen by Yesh Atid MK Penina Tamanu-Shata. The new MK recently met with Litzman and demanded that he “not abet a cover-up of the issue and have it quickly examined by an investigative committee.” The committee will try to determine who was involved in setting a policy, if any, of routinely injecting Ethiopian women with the contraceptive.
About a month ago, Health Ministry director-general Prof. Roni Gamzu instructed the four health maintenance organizations to stop administering Depo-Provera injections as a matter of course. The ministry and other state agencies had previously denied knowledge or responsibility for the practice.
"Without taking a stand or determining facts about allegations that were made," Gamzu wrote, "I would like to instruct, from now on, all gynecologists in the HMOs not to renew prescriptions for Depo-Provera for women of Ethiopian – or any other – origin, if there is the slightest doubt that they have not understood the implications of the treatment."
He called on the physicians to employ translators if necessary to explain the possible side effects. Side effects reported by users of Depo-Provera include menstrual irregularities, loss of bone mass, abdominal pain or discomfort, weight gain, headache, fatigue and depression.
The ETV documentary included interviews with 35 Ethiopian immigrant women, some of whom told of being coerced into taking the injections while still in transit camps in Ethiopia and later in Israel.
“They told us that we don’t have to have many births,” said one of the women. “They said who ever gives birth a lot suffers in life … that it would be difficult for us economically. So we took the shot. We got it every three months. We didn’t want it. We refused and objected. We said we didn’t want to.”
“An entire community has been shocked to discover that they encouraged many women to take the Depo-Provera shot without knowing the possible harsh health ramifications,” Tamanu-Shata told Haaretz. Tamanu-Shata, a longtime community activist, also advocated for the community in 2006 when it was revealed that Ethiopian blood donations were being discarded for fear they might be infected with AIDS or HIV, the virus that causes AIDS.
“The community is worried and upset over the question whether it’s possible that someone didn’t want Ethiopian children, and whether there was a systematic policy of exploiting the distress of women who were in transit camps en route to Israel,” Tamanu-Shata said.
“This case must be investigated thoroughly and it behooves the deputy minister to do it courageously, if only because of the fact that the number of Ethiopian children who were meant to be born was cut in half,” she said.
Though the ETV program sparked a public storm, it was not the first report about this alleged injection policy. In 2009, Hedva Eyal of the Woman to Woman organization published a report that made similar claims. In the course of preparing her report she contacted the Health Ministry, which in 2008 replied that Depo-Provera is only used “when there is a medical indication to do so and other methods [of contraception] cannot be used.”
Clalit Health Services told Eyal that the shots were used “when other contraceptive methods fail.” Nevertheless, the HMO’s statistics showed that of 10 defined ethnic groups, in 2008, 57 percent of the Depo-Provera injections were administered to women of African origin. Given that African asylum-seekers don’t use the HMOs since the National Health Insurance Law doesn’t cover them, it is apparent that the recipients in question were from the Ethiopian immigrant community.
Depo-Provera injections are most widely administered to women who are mentally retarded or institutionalized, as a way of preventing pregnancy without having to rely on the woman’s own desire or ability to take birth control pills or undergo the insertion of an IUD.
CORRECTION: This article, which was updated on March 6, 2013, reported on Health Ministry director-general Prof. Roni Gamzu's instruction to gynecologists not to renew prescriptions for Depo-Provera if there is any doubt that recipients did not understand the implications of the treatment. The original version failed to state that this instruction was issued "without taking a stand or determining facts about allegations that had been made," and referred to all women and not just women of Ethiopian origin.