For the first time since allegations were made five years ago, the Israeli government has admitted that Jewish Ethiopian immigrants were coerced into taking the birth control injection Depo-Provera. This common form of birth control has many long-term effects, including loss of bone mineral density, heightened risk of osteoporosis, and a high risk of blood clots. The shot, which is administered every three months, leaves women infertile during this time, and often women who take it have more far reaching fertility issues even after discontinuing its use.

In early December the plight of these Ethiopian immigrants came into focus yet again when investigative journalist for Israel Educational Television’s program Vacuum Gal Gabbay aired a special report on the issue. Thirty-five women were interviewed, claiming that during their stay in transit camps in Ethiopia they had to attend family planning programs where they were coerced into taking the injections as a prerequisite to entering the country, and that the injections continued even after entering Israel. Emawayish, one of the women interviewed, had this to say of her experience:

“We said we won’t have the shot. They told us, if you don’t you won’t go to Israel and also you won’t be allowed into the Joint (American Joint Distribution Committee) office, you won’t get aid or medical care. We were afraid… We didn’t have a choice. Without them and their aid we couldn’t leave there. So we accepted the injection. It was only with their permission that we were allowed to leave.”

On Sunday, January 27th, the Health Ministry Director General Professor Ron Gamzu issued a letter to Israel’s four health maintanace organizations, instructing HMO gynecologists “not to renew prescriptions for Depo-Provera for women of Ethiopian origin if for any reason there is concern that they might not understand the ramifications of the treatment.” The use of Amharic translators has also been recommended when necessary to ensure that Ethiopian women understand their options and their effects.

Gamzu’s letter came in response to a letter from Sharona Eliahu Chai, a lawyer of the Association of Civil Rights in Israel (ACRI), an organization that represents several women’s rights and Ethiopian immigrant groups. The letter demanded the immediate cessation of the injections and that an official investigation be launched.

In the past decade, Israel has witnessed a near 50% decline in the birthrate of its Ethiopian population, and many suggest that this decline is due in large part to the birth control policy that is allegedly forced upon these immigrants if they want to enter the country.

This sharp decline in birthrates was first brought to the attention of women’s groups in Israel in 2008, when the director of a daycare center for 120 Ethiopian children outside Tel Aviv noted that she had only received one new care in the past three years. Rachel Mangoli, the daycare center director, went to a local health care center for Ethiopian families to look for answers. She was informed that they had been instructed to administer Depo-Provera injections to women of childbearing age, but was not told who gave the order. After talking to some of the women, Mangoli said, “They had not been told about alternative forms of contraception or about the side effects or given medical follow-ups.”

In 2009, the Israeli feminist group Isha L’Isha looked into Isreal’s prescription policy and found that 57% of the Depo-Provera injections administered in Israel were prescribed to Ethiopian women, while Ethiopians make up only 2% of the population. This targeted administration of birth control has some suggesting that racist policies are being enforced to reduce the number of black babies in Israel. Hedva Eyal, the head of Isha L’Isha’s Women and Medical Technologies project, suggested that their report was given little attention, noting that, “The ease with which a woman’s testimony is dismissed—certainly that of a black woman and a poor black woman at that—is shocking.”

Close to 100,000 Ethiopians have immigrated to Israel since the 1980’s under the Law of Return, but these immigrants have faced near constant suspicion of their Jewishness, a requirement for entry. In 2012 Prime Minister Benjamin Netanyaho said that illegal African immigrants “threaten our existence as a Jewish and democratic state.”

Racism against Ethiopians has long been suspected in Israel. In 2006 these suspicions began to gain credit when it was discovered that for years Ethiopian blood donations had been rejected out of fear that they carried disease. Additionally, reports of Ethiopian children being turned away from certain schools or put in separate classes have been discovered, and in November 2010, 53% of employers reported that they preferred not to hire Ethiopians.

This racism is no more prominent than in the government’s dealings with Ethiopian women. Yaacov Ben Yezri, the health minister in 2008, was questioned about the administration of Depo-Provera and responded that the high representation of Ethiopian’s among its users simply reflected a cultural preference. However, according to the World Health Organization, nearly three-quarters of women in Ethiopia who use birth control take an oral pill.

“The answers we received from officials demonstrated overt racism. They suggested that Ethiopian women should be treated not as individuals but as a collective group whose reproduction needs controlling,” said Eyal of her organization’s investigations into these policies.

That such overt racism by a government organization has gone on for so long is in and of itself disturbing, but when you also consider the ramifications these policies have on women’s health and on the future of an entire ethnic group, the possibilities are truly horrifying.

While Gamzu’s new policies are in no way satisfactory, nor do they make up for the decades of discrimination Ethiopians have faced in Israel, they are a step in the right direction. The guidelines demonstrate a change, if only a small one, in the government’s attitude towards these immigrants. While they will undoubtedly face hardships and continued racism elsewhere in their lives, the fact that they will (hopefully) no longer face the equivalent of a silent genocide is reassuring. And by voicing its changed opinion of Ethiopians, it is possible that the government will be the catalyst for a shift in the cultural attitudes of Israel.

Birth control and family planning are wonderful tools that can truly enrich the lives of women, but these tools should never be used as weapons. The fact that Israel’s government is only now realizing this is worrisome. Close monitoring of its treatment of Ethiopian women needs to continue, and we hope that the women’s groups who brought this issue to light will do just that.

Written by Kelsey Bain