MORE THAN 250,000 poor Peruvian women have been sterilized in a three-year state-sponsored campaign in which officials used threats, violence and bribes of food to meet government quotas.

Many of the women in the far-flung Andean and Amazonian regions were illiterate, had never before seen a doctor and had no idea what was happening to them, according to a report to be released next month by a women's rights organization.

The campaign was launched in 1995 by President Alberto Fujimori in an attempt to reduce poverty by cutting family sizes. Officials were set regional quotas by the ministry of health and threatened with dismissal if they failed to meet them. When announcing the programme, Mr Fujimori said that state sterilisation, previously illegal, gave women in the overwhelmingly Catholic country "an opportunity to govern their own lives". He also set a recommended limit of two children per family.

Abortion is illegal in Peru and other forms of contraception hard to obtain. Initially women's rights groups welcomed the move, but the campaign quickly got out of hand, according to Giulia Tamayo, the lawyer who wrote the report. "The programme has been carried out in such an aggressive manner that rather than offering women a choice it quickly became an appalling abuse of humans rights," she said.

In some places fairs were held in village squares at which women were encouraged to have their tubes tied. "Some were told it would be good for their health and others that they wouldn't have access to food aid unless they were sterilised," said Kathy Hall-Martinez, a lawyer at the New York-based Centre for Reproductive Law and Policy, which is also compiling a report on violence against women at health facilities in Peru.

A draft copy of Ms Tamayo's report - which includes 250 interviews with slum-dwellers around the capital Lima and indigenous Quechua-speaking women in rural areas - says the women were systematically bribed by public health officials, usually with food from foreign donors, or misinformed. Medical staff were paid about £3 for every two patients they brought in and doctors were told that their contracts would not be renewed if they did not deliver their quotas.

In one case in the Andean state of Cuzco, Dolores Quispe and her husband were warned by a nurse that they would be arrested if they refused. She and 11 other women were locked in a clinic until they consented. Another woman, Felipe Cusi, claimed that she was threatened and taken by force to a health post where she was tied to a bed. In the northern city of Piura, Victoria Vigo was sterilised without consent during an emergency caesarean delivery. She discovered what had happened only when her premature baby died. "How many women are sterilised and don't know?" she asked. Some women had never had surgery before and were shocked by the anaesthetic. "One told me she thought she'd died and come back to life again," said Ms Tamayo. At least 15 died from complications or lack of aftercare.

Health workers made frequent home visits trying to persuade women as young as 19 to be sterilised. "I know of some health workers who even had themselves sterilised to meet targets and cases where women were told that sterilisation was just a kind of temporary contraceptive device," said Ms Tamayo. In 1997 alone, 110,000 women were sterilised.

The government claims that the numbers are so huge because of demand from woman who had no access to sterilisation in the past. It denies setting targets, claiming that doctors let the situation get out of hand. But the report contains documents from the Peruvian health ministry to public health posts clearly setting quotas.

The issue has been taken up by the US Congress, which sent a delegation to Peru to investigate and lobbied the American government to withhold aid which was apparently being misused. Congressman Joseph Rees, who led the delegation, testified to a committee investigating the misuse of aid, saying: "I don't think there is any question that women in Peru, especially very poor mestizo [mixed-race] women, have been misled into having sterilisations and in some cases lied to." The Peruvian government has indicated that in future there will no longer be targets for sterilisation. It will also institute a 72-hour period during which women can decide whether to give consent.

Last Wednesday, Mr Fujimori distanced himself from the sterilisation programme, sacking his health minister and appointing three female ministers in an apparent attempt to portray himself as pro-feminist. But women's groups were not impressed, pointing out that Mr Fujimori was accused of beating his wife, Susanna Higuchi, who recently divorced him, although a court threw out the charges. "This is an extremely macho country," said the lawyer representing the former First Lady.