By Marina Denysenko
BBC News, Ostrava, Czech Republic
"I was sterilised when I was 21", says Elena Gorolova, an ethnic Roma (Gypsy) woman living in Ostrava in the east of the Czech Republic.
Elena Gorolova (right) says the operation was not explained to her
She is one of 80 Roma women in this pretty and quiet Czech town who claim they were coerced into sterilisation in the Czech health system.
Elegant and articulate, 37-year-old Elena describes how her stay in the maternity ward 16 years ago left her emotionally and physically scarred for life.
She had just delivered a boy and joked to the doctor: "I won't bother to take the baby home, because I wanted a girl".
The doctor's answer still reverberates in her ears: "You'd better take it, because you will not have any more children. We have sterilised you."
For years these women stayed silent, and some were even ashamed to tell their own husbands. Only a few years ago did the shocking details start to emerge.
There are allegations that coercive sterilisation was used to curb the traditionally high fertility rate among the Roma.
Roma girls danced at an exhibition dedicated to sterilised women
Many were offered money, though that was not official policy. Similar cases have been reported in neighbouring Slovakia.
The practice officially ended in 1990 after the collapse of communist Czechoslovakia, but a number of doctors are said to have continued the operations on their own initiative.
The complaints sparked an official inquiry. The Czech ombudsman - Public Defender of Rights Otakar Motejl - investigated the cases and issued a report in December 2005.
"The problem of sexual sterilisation carried out in the Czech Republic, either with improper motivation or illegally, exists," he said, recommending state compensation for women affected between 1973 and 1991.
During that period social services had offered some Roma women financial incentives to undergo sterilisation "even though the state issued no instruction," he concluded.
The communist authorities had practised an assimilation policy towards Roma which "included efforts by social services to control the birth rate in the Romani community," he said.
Pressure for action
But human rights groups say the last recorded case happened as late as 2003.
"Sterilisation was used as a means of birth control," says Kumar Vishwanathan, head of Life Together, an Ostrava-based NGO for Roma rights.
Like many other Roma women, Elena Gorolova signed a consent form without realising what the operation entailed.
Some women say they had been administered drugs, others simply did not understand what the word "sterilisation" meant.
Czech doctors disagree. "Sterilisation is conducted on purely medical grounds," says Richard Spousta, head of the gynaecological unit at an Ostrava hospital. "We don't keep any statistics on Roma and non-Roma sterilised women. I don't know why you are making such claims."
An investigation by a Czech health ministry advisory committee concluded that procedural mistakes had been made in a number of cases.
But the Czech embassy in London told the BBC that "sterilisation is in no way a national policy targeted on a specific ethnic or any other group in the Czech Republic".
"We've suggested to the government that it issue an apology to the victims," says Ceslaw Walek, director of the Roma Community Affairs Council, which advises the government on Roma-related policies. "But I cannot see this happening."
Earlier this year the Czech high court did uphold a lower court's decision obliging an Ostrava hospital to apologise to one of the victims, Helena Ferencikova, sterilised in 2001.
"This is the first decision of its kind in Central and Eastern Europe," says Lucie Fremlova from the Life Together NGO.
The hospital has not yet complied with the court's decision. Helena Ferencikova is still waiting.