By Anastasia Moloney
BOGOTA (Thomson Reuters Foundation) - Government health workers spent hours going from door to door to coax, cajole and bully women in a farming community in Peru's highlands to come with them for free medical treatment.
Esperanza Huayama, then three months pregnant, was one of scores of women who clambered onto buses that morning 20 years ago for the three-hour ride to a clinic.
Lying in a hospital bed, Huayama soon realised something was wrong - but it was too late.
Moments later doctors administered anaesthetic and when she woke up, Huayama had been sterilised - victim of a birth control campaign targeting mostly indigenous women in the South American country's poor, rural areas.
"I didn't sign anything. They tricked us. Nurses told us we had to go to the clinic where we would be given a free health check-up, medicine and food. They said it was for our own good and well-being," Huayama, now 59, recalled.
"They threatened us and said those who refuse to go wouldn't get medical care in the future," she told the Thomson Reuters Foundation in a telephone interview from Peru's northern Huancabamba province.
Some 350,000 women and 25,000 men were sterilised as part of the mid-1990s programme, pushed through by former president Alberto Fujimori who argued that a lower birth rate was crucial to eliminating poverty in Peru.
Women were often threatened with a fine or prison if they refused to be sterilised, according to activists who view the campaign as one of Peru's biggest human rights scandals.
"Women were crying and shouting because of the pain. We were cut quickly. They treated us like animals," said Huayama, whose child was born dead weeks after the surgery.
"We were given no free medicine, nothing, after the surgery. When the doctors finished, they just shut the door and returned to Lima."
CRIMINAL INVESTIGATION
Last month, top state prosecutor Luis Antonio Landa Burgos ordered a criminal investigation to be re-opened into the forced sterilisations - the third time such an investigation has been re-opened since 2009.
The prosecutor said the enquiry would be widened to include new oral statements from other alleged victims of forced sterilisation in other parts of Peru.
The announcement is likely to put Fujimori, cleared in 2014 of any wrongdoing and crimes against humanity, under renewed scrutiny as the three-month probe proceeds, activists said.
Fujimori, in prison since 2007 for corruption and human rights abuses, has said the sterilisations were voluntary.
Huayama is one of more than 2,000 women who gave statements to Peruvian and international rights groups and prosecutors saying they underwent sterilisation without consenting to it or being informed of what would happen.
The women who did sign consent forms in Spanish before undergoing the operation often did not know what they were agreeing to because they were illiterate and spoke only Quechua, rights groups say.
"Justice for us would be for the government to ensure that this never happens again. They need to say sorry. We're waiting for an apology," Huayama said.
The scandal may be an election issue again in the run-up to Peru's presidential vote next year, experts say.
Incumbent President Ollanta Humala exploited the controversy during his 2011 presidential bid, in a run-off vote against Fujimori's daughter, Keiko Fujimori, a move that experts say helped him garner support among women.
Keiko Fujimori, who is yet to announce if she will run again for the presidency, leads the potential candidates for the 2016 vote, recent polls show.
"President Humala had criticised his opponent, Keiko Fujimori, for doing nothing but no progress has been made on the issue during his government," said Maria Cedano, head of DEMUS, a Peruvian rights group seeking compensation and high-level prosecutions for the 2,074 women who say they were coerced into sterilisations.
MENTAL SCARS
Two decades on, Huayama's experience has left both physical and mental scars.
"I and other women never felt the same again. We're still suffering," she said, adding that she can no longer do heavy farming work or carry wood.
"I was depressed for months after the tube-tying operation. Some women felt that if their bodies are dry, infertile, then the land is too."
The memory spurs Huayama, who leads a local women's rights group, to press on with the fight for justice.
One way to do that is to ensure more people know about what happened to them, she said.
As a result, she and some 60 other women have spoken about their forced sterilisations on a free phone line.
Run by Quipu, a multimedia documentary project, the phone line allows women to record, and share, their experiences.
"We'll continue to defend our human rights so that people inside and outside Peru can hear, and know, that our rights were violated, that we suffered, and that this really did happen," Huayama said.