María Mamérita Mestanza, a rural, indigenous woman and mother of seven children, was pressured to accept sterilization by a nearby public health center. Prior to her sterilization, Ms. Mestanza and her husband were subjected to various forms of harassment, including several visits in which health personnel threatened to report her and her husband to the police, and told them that the government had approved a law requiring anyone who had more than five children to pay a fine and go to jail. Finally, under coercion, Ms. Mestanza agreed to have tubal ligation surgery. The procedure was performed at the regional hospital, without any pre-surgery medical examination. Ms. Mestanza was released the next day, although she had serious symptoms including nausea and sharp headaches. A few days later, Ms. Mestanza died at home and the death certificate specified a “sepsis” as the direct cause of death and bilateral tubal blockage as a precedent cause. A criminal case was dismissed against the Chief Doctor at the health center for insufficient grounds to prosecute. A petition was filed before the Inter-American Commission on Human Rights, alleging that the case of Ms. Mestanza was one among a large number of women affected by a massive, compulsory, and systematic government population control policy aimed specifically at altering the reproductive behavior of poor, indigenous, and rural women. The petition alleged violations of the rights protected by Articles 1 (obligation to respect rights), 4 (right to life), 5 (right to humane treatment) and 24 (right to equal protection) of the American Convention.
In 2003, a Friendly Settlement agreement was entered into in this case. Through the Friendly Settlement, the government acknowledged international legal responsibility, agreed to compensate Ms. Mestanza’s surviving husband and children, and agreed to modify and implement recommendations made by Peru’s Human Rights Ombudsman concerning sterilization procedures in Peru’s government facilities.