Dublin, Ireland – Women who had their pelvises broken in Irish hospitals have been failed by a state redress scheme, according to lawyers and activists.
Symphysiotomy, a brutal procedure that involved slicing through the cartilage and ligaments of a pelvic joint during childbirth, and pubiotomy, an even more extreme form in which the bone of the pelvis was sawn apart, was carried out in Ireland centuries after it was abandoned elsewhere, leaving women with lifelong disabilities, incontinence and chronic pain.
An estimated 1,500 women are thought to have unknowingly undergone the procedure without giving consent since its practice was revived in Irish hospitals in the 1940s. It officially ceased in 1984, but there are unconfirmed reports of its having taken place up until 2012.
The fact that these decades also witnessed a rapid increase in Irish emigration to Britain and the US means that there may have been countless more women who had the procedure but were possibly never made aware of it. In fact, many of the women were never informed of exactly what had been done to them and only found out decades later after media reports on the topic.
In 2014, the UNHRC recommended that Ireland conduct “a prompt, independent and thorough investigation into cases of symphysiotomy” and create channels to “prosecute and punish the perpetrators”.
Today, Irish survivors of the procedure are faced with a no-blame payment scheme that fails to meet the recommendations of the UNHRC, but which most feel they must now accept because of their old age and ailing health.
The Irish government announced its Symphysiotomy Payment Scheme in November 2014. It offered quick, limited payments, from €50,000 (around $55,000) to €150,000 (around $165,000) and forced the participating women to sign an ex gratia waiver which barred them from seeking to “prosecute and punish” the hospitals, doctors and religious orders responsible for the practice.
The scheme has been widely condemned by activists, lawyers and the women themselves, who claim it prevents them from seeking justice and offers inadequate compensation.
Critics say that the scheme failed to hear oral testimonies from those women who were unable to locate medical documents, often 50 years after the event, and that, subsequently, many of these women received the minimum payout despite suffering decades of pain and disability.
Noelle Higgins, who is a senior law lecturer at the National University of Ireland, Maynooth, says the scheme is an attempt by the state to erase its part in this horrific chapter of Irish history.
“They are doing this – the redress scheme – because it’s cheaper,” she said. “These women have suffered awful trauma, yet they get payments of only €50,000 (around $55,000) – which is what someone with whiplash would get.
“They can also say they are dealing with this,” she added. “No state wants to be accused of torture.”
Writing in the Irish Examiner in 2015, Mark Kelly from the Irish Council for Civil Liberties (ICCL), described the scheme as forcing women “to choose between indemnifying their abusers in exchange for cash and fighting High Court actions to vindicate their rights”.
Still, the Irish government defended the scheme, with the country’s health minister, Leo Varadkar, describing it as “simple, straightforward and non-adversarial”.
Marie Therese O’Connor is the chairwoman of Survivors of Symphysiotomy (SOS), a group that represents more than 400 of the 578 women who had their applications accepted. She says the scheme is a calculated attempt to buy off women who might otherwise have pursued legal cases.
“Its draconian terms and conditions were equalled only by its adversarial administration,” O’Connor said.
“The scheme’s insistence on medical records showing injury from symphysiotomy also led to older women, whose doctors were deceased, being denied the payment for significant disability given to younger women with the same injuries, who could produce records from doctors who were still alive.”
But what many consider to be a dismissive attitude on the part of the government seemed to reach its peak on January 19 of this year, when a small notice on the scheme’s website informed the women that their documents would be destroyed at the end of the February if they did not specifically request that they be returned. For most, these records, including old x-rays, were difficult to obtain, and as many survivors do not use the internet they would have had little or no knowledge of the state’s intention to destroy them.
Fred Logue, a data lawyer based in Dublin, says the onus is on the scheme to return the medical records to the women and that practices like this could be in breach of data protection.
“In my view, placing an advertisement on the internet with a short deadline is not only unreasonable but also a breach of the terms of reference which are crystal-clear on this point,” Logue said. “Any unauthorised destruction of documents containing personal data is in breach of the terms of reference and would likely be also a breach of the Data Protection Acts, and aggrieved applicants would have remedies in that respect.”
Al Jazeera raised the scheme’s handling of personal data with Judge Maureen Harding Clark, the scheme’s assessor, who declined to answer, after criticising media coverage of the scheme.
Clare Daly, an independent member of the Assembly of Ireland, said the scheme’s failure to engage with public representatives reflects a general sense of hostility towards inquiry.
“The manner in which the symphysiotomy board has responded to requests for information from me has been nothing short of abrupt, rude and defensive,” said the politician. Daly has sent countless parliamentary questions to the minister for health, questioning the names of consultants hired by the scheme and whether or not Clark considered oral testimonies from the women. She criticised the scheme’s lack of transparency.
“I have found it quite astonishing in terms of how a public body should behave and, in that sense, believe that if that’s the way in which elected representatives are being treated, it is indicative of an aggressive attitude which is being imposed on the women themselves.”
Although Varadkar described the scheme as “person-centred” when questioned about it in parliament, SOS says Clark has met only a fraction of those who applied for the scheme.
“Our understanding is that the assessor has met around half a dozen … of the over 700 [women] who applied,” said O’Connor. “The scheme’s policy of not hearing oral evidence has led to grave injustices. We know that 95 percent of [the victims] suffered lifelong disability from symphysiotomy, yet more than 50 percent of applicants to date have been denied the disability payment, and more than 150 women have had their claims dismissed in their entirety.”
As the scheme prepares to destroy the women’s documents – some of which date back 60 years or more -, many in Ireland question the historical consequences of the scheme.
Higgins believes it is an effort by the state to rewrite history.
“The government is trying to sanitise itself through this scheme, which is completely inadequate given the amount of suffering these women have experienced. They want this over as quickly as possible,” she said.
“They do not want to get an accurate historical record of what happened to these women.”
The women’s stories
Maebh’s* story – ‘They said my body was a war zone’
“I went into hospital on Sunday. I was in labour all day and on Monday evening the doctor came in and said ‘We will have that baby in a few moments’.
They put me under anesthetic and the first thing I remember when I came to was terrible pain. I’ll never forget it, it was horrific. My pelvis had been cut through. I had no control of my bladder and I couldn’t walk.
When I tried to go to the toilet, the doctor said there was nothing wrong with me, that it was ‘just my nerves’. I was only 26 years old.
I couldn’t walk afterwards; for six months I was in so much pain and completely incontinent.
A few months after that, I had a procedure called the Old Manchester Repair. It’s where they stitch the neck of your bladder. That just made things worse. I had no control over my bladder and no feeling; they had damaged all my nerves. To this day, 50 odd years later, I still have urinary tract infections from that operation.
I still had no control over my bladder so I went for another operation called a sling. That doctor was so horrible to me. The first thing he said was ‘Why do I have to fix someone else’s mistakes?’ That operation went wrong and I started to swell inside. It took the hospital 24 hours to find the doctor so I could have it removed. He sent me home on antidepressants, sort of saying it was all in my mind.
After that I met a kind doctor. After he saw my scans the first thing he said was ‘This should not have happened to you’. He was the first doctor who wrote on the records ‘as a result of symphysiotomy’. Thank God he managed to repair my bladder a bit and I managed to get by with – I’m embarrassed to say – pads made of terrycloth.
At that time I was having all sorts of procedures. At one stage they pushed a load of cotton wool with dye on it inside me, to try to find out what was wrong. In those days the procedures were very invasive. I wanted to have more children. A doctor in Limerick said he’d help me and I had three children by Caesarean without trouble until the last time, when the doctor said I would have to have another repair. I had a hysterectomy and an angle suspension – where they opened me up from hip to hip.
After that operation, I was in constant pain. It almost drove me out of my head. My own doctor was kind, but when I went to a consultant he said I would have to put up with it.
Finally, I was sent to a bladder specialist who was so kind. He redid the surgery and made me 60 percent continent. It was a great job, but by then I was walking with a stick as my back was bad.
I found out about the support group for survivors in 2003, when I was in my 60s. My son heard a lady talking on the radio and that’s when I linked in with others.
After we started to get some attention the government gave us a medical card. That was marvellous as I was broke from the chemists.
We were then sent for assessments. The first thing the urologist said after looking at my scans was ‘Such a warzone’.
But when I went to the orthopaedic consultant, he said ‘The first thing we’re doing is taking that stick’. When I told him I couldn’t walk without it, he didn’t believe me – he said there was something wrong with my ears.
The next time I saw him, after he had viewed my scans, he was different. He rushed towards me with a chair and told me ‘You’re finished walking’. I believe he thought we were pretending to be injured.
When they announced the scheme, we thought it was better than nothing. I only got €2,000 (around $2,200) for every year I was suffering, which wouldn’t even cover the chemist visits, and I still have solicitors and doctors to pay.
The Irish government has treated us shamefully. I took the scheme because I’m nearly 80 and I could do with the money. I am an old-age pensioner and I have a small income of €5,000 (around $5,500) a year. I need to replace the roof in my house and I don’t want to be any trouble to my children.
I felt sick when I signed the paper, when I signed away all my rights. It looked so horrific when it was all there. I can’t help but think about the time I was getting a scan and the man said ‘You’re cut asunder, turn around and I’ll show you what they’ve done to you’.
I just didn’t want to see it. I knew what happened was so awful.”
Vera McCarthy’s story – ‘One doctor held my hand as the other cut me. The nurse broke down and cried’
Received 50,000 euros (around $55,000) – the scheme’s minimum payment
“I was 31 and I’d never had health problems. They told me afterwards that was one of the reasons I was chosen.
When I first went to the doctor after finding out I was pregnant, he said I was very small but that he would manage it. I was referred to a maternity hospital with a letter from my local doctor.
I visited that hospital many times and on the last visit the doctor asked me what size shoe I wore.
I started to bleed and went to the hospital. I realise now that I went down too early. I was kept there for several days but had no contractions. Finally, I was sent to a room where women were in labour – lots of them were roaring and there was only one midwife.
I was starting to get contractions when the midwife came over to me. All of a sudden, she said ‘The baby’s head is down, the baby’s head is down’, and I was brought up to the delivery room where three doctors were waiting.
This is why I think I was set up – they must have been planning it because all those doctors became very important afterwards.
One doctor was nice to me – he held my hand as the other doctor was cutting me.
There was a nurse in the room. She asked the doctors if she had to be there. They said she did. She was helping me afterwards. I remember once when I was trying to breast-feed, she just broke down crying.
I thought I had cancer, something really bad to make her that upset.
Every time the doctor came to see me he said how great the operation had been and that I’d have no difficulty having the next nine babies; that they would ‘drop out’. I was told then that I was picked because I was in perfect health.
I went home to my mother’s house. I had to clean the wound myself every day; we had no nurses to help us back then. I didn’t find out I had a symphysiotomy until after it was in the news. I had back pains but I never knew it was coming from that operation.
I took the schemes like the other women because we could die next year – some women died without getting anything. I could go tomorrow and so I took it. I have a son who suffers from mental illness; I did it for him.
When I got my payment I got a letter from the judge saying ‘Congratulations’. The scheme never tried to meet me. I offered to meet them and even take a lie detector test so they would know everything I’m saying is the truth.”