Symphysiotomy is a procedure that cuts the symphysis pubis, the joint that holds the pelvis together. It was performed on hundreds of women in Ireland from the 1940s to 1980s. A few cases of symphysiotomy have been recorded in more recent years. Ireland is the lone country in the West to have the practice continue after it was rejected for its dangers in the 18th century. Irish doctors reemployed the procedure to make their mark on the medical world, to export to the missions and to prevent women from having caesarean sections which could only be performed an estimated four times. That would have provided a restriction on the number of children a woman could have. Survivors experience a myriad of side effects including incontinence, severe orthopaedic issues, acute pain and psychological trauma.
The women mostly did not know what was done to them, let alone why. In Ireland talking about your body, particularly a female body, was rare. Complaining was not done. Doctors were experts and trusted accordingly. It is only in the last decade that survivors have come together and began to make sense of what happened to them. The state has had to catch up.
After years of advocacy and dozens of impending cases against the state for allowing the procedures to happen in its hospitals, the Irish government responded. A payment scheme was devised to stem the flow of litigants. It was rejected by the group representing 99% of survivors, Survivors of Symphysiotomy. The absence of an investigation, apology and individualised awards for the survivors as well as the indemnifying of religious orders and perpetrators received condemnation from the Irish Council of Civil Liberties, the Irish Human Rights and Equality Commission and Amnesty International Ireland. In July of 2014, the United Nations Human Rights Committee held that the payment scheme was in contravention of international law. The scheme proceeded as planned.
Once the scheme had been implemented the number of news stories declined. A decisive government action appeared to have extinguished the media curiosity; the problem had been solved, the issue concluded. It is at this point that the media is particularly needed. There remains a general ignorance of symphysiotomy despite the government response. It’s tricky to pronounce and defies belief.
This adds to the need to have it in the spotlight. Every time there is press coverage at least one new survivors sees it, realises what happened to her and comes forward. Without broad public knowledge of symphysiotomy there is a limit to the opposition that survivors’ advocacy group, Survivors of Symphysiotomy, can rally. When awareness is low, so too is political will to take action. Without intense media pressure there is no impetus for the government to provide an effective remedy. Symphysiotomy remains a political non-issue. TDs will not have to answer questions on its handling, it will not be mentioned on the doorsteps or referred to in manifestos. As survivors are elderly women and the problem is gynaecological there is a limit to the political capital they can garner without media reporting. Media reporting is essential to get justice for survivors.
Survivors of Symphysiotomy attempt to keep the plight of survivors and the payment scheme failures in the public arena. This is only possible through generating news stories themselves. Where Irish media outlets have been minimal and non-investigative, Al Jazeera has stepped in. In the last year they have compiled four reports. Each one has interviewed survivors, given an overview of the struggle and been critical of government action.
BBC Radio 4, CNN and The Guardian have featured similar reports. The few Irish media reports have been when the Scheme Assessor, Judge Maureen Harding Clark, has passed comment on the large number of refusals or on the couple of occasions when a TD has questioned the Minister for Health. It is plausible that without the legal challenge against symphysiotomy the issue may have entirely gone off the radar of the Irish media.
What does that say of Irish media and of legacy abuse? If there is not unrelenting agitation by a survivor group, an issue will be forgotten about. If it were not for Survivors of Symphysiotomy making an issue of all of the scheme’s failures and publishing press releases the issue could never have been taken up. Certainly without the agitation there would be no assessor’s response or TD questions and the few media reports would not have occurred. It leads you to believe that our media reporting system may not be fit for purpose; it requires sensationalisation. The tragedy of the Magdalen Laundries seems to be more widely heard of. While a greater number of women were impacted, it is questionable whether the story would have reached as large an audience were it not for the film, The Magdalene Sisters. Does institutional abuse depend on dramatisation to garner media coverage?
There are plenty of stories to be written. Stories that Ireland needs to hear and needs to address: Retired judge, Yvonne Murphy, is doing the report into Mother and Baby Homes, yet her report into symphysiotomy has been heavily criticised by the United Nations Human Rights Committee; Mary Daly, independent historian for the Mother and Baby Homes report, was called as an expert witness for the state in defending symphysiotomy litigation; Dr Peter Boylan of the National Maternity Hospital has featured in the Sunday Independent saying “patients need to be embraced as partners,” yet will defend the use of symphysiotomy in court.
Serious flaws with the payment scheme have not been addressed. The scheme was not advertised in any local media nor in countries such as the UK, Australia and America where survivors live. This was at least done in the (albeit flawed) Magdalen Laundry McAleese scheme. Survivors are still coming forward having realised what was done to them was a symphysiotomy and that it was wrong. Those women are left out by the scheme.
GP records from up to 50 years ago are requested by the assessor. Non-treating doctors or specialist evidence of injuries is not admissible. The awards are paltry. In most cases they will not cover the decades of expense a symphysiotomy has resulted in. If you want to accept the award you must sign a form indemnifying not only the state but also, bizarrely, religious orders. There has been no investigation into the practice nor an attempt to prosecute anyone who is still alive and performed the operations. It seems to fit in with the broader Irish trend of allowing religious institutions to evade accountability that was seen with the Church’s’ child abuse.
The role of religion in symphysiotomy has been ignored. The state’s response is the only one. Yet there is no apology or admission of wrongdoing from the state. The lie that the operations were necessary is promulgated. Leo Varadkar’s defence of the procedure has gone unchallenged in the media.
Without media reporting we can never come to terms and take account of what happened, get justice and make sure it never happens again. Specifically, without Irish media reporting, survivors do not feel like their own story has been listened to and heard by the society that was complicit in the atrocity.
This government has done nothing to improve the lives of survivors. They want you to think the issue is solved and they did a good job. Nothing could be further from the truth but the average Irish citizen could be forgiven for their ignorance.