The daughter of disgraced ex-president Alberto Fujimori had until the very last week of campaigning managed to dodge accusations that linked her to the corrupt and abusive regime of her father.
Many remained undecided until the last week, and she held a slight edge thanks to the backing of the media and the elite fearing the possible election of a left-leaning former army commander accused of being financed by Hugo Chávez. According to pollsters, Keiko Fujimori lost crucial support because of her dismal response to the issue of the mass sterilisation programme carried out during her father's regime.
Between 1996 and 1998, some 300,000 women were sterilised in Peru. All came from the poorest backgrounds, most from the Andean and Amazonian areas where Spanish is still not widely spoken. Some days before the election, vice-presidential candidate Rafael Rey declared the women had not been sterilised "against their will", but "without their consent". This came hot on the heels of Keiko Fujimori's assertion during the presidential debate that she, "as a mother", understood the plight of the women that had been sterilised, while defending the man who as health minister had carried out her father's policies.
Humala lost no chance to remind voters of his opponent's faux pas and women's rights activists took the issue to the forefront of symbolic fighting by parading in Lima's streets with placards of mutilated genitalia during the marches held against Fujimori. The issue was taken up by Peruvians of all social classes and while it was not uncommon to hear taxi drivers argue that "only educated women should have children", many of the women who had so far favoured Keiko Fujimori for her promises of providing school uniforms and lunches had second thoughts about supporting her after her defence of controversial population control policies.
As far as Keiko Fujimori and her advisers were concerned, the sterilisation campaign was executed with the best intentions at heart, although some regrettable errors were made. Thirty women died, and several others were scarred for life, as some of those sterilised had, in fact, never had children. The sterilisation program came about as a poverty reduction strategy. In the early 90s Peru had, under Fujimori, put in practice one of the most aggressive structural adjustment policies ever implemented. It was so forceful that even the World Bank advised the Peruvian government to slow down. As a result of prolonged economic crisis and neoliberal reform, 50% of Peruvians lived under the poverty line and population control was an ideal to aspire to. The UN population conference in Cairo in 1994 and the women's Beijing conference of 1995 provided Fujimori with inspiration, and his government received funding from USAid to undertake the ambitious project.
The programme was designed using the rhetoric of women's empowerment but – as Adrian Lerner, researcher at Instituto de Estudios Peruanos, has shown – Fujimori did let references to Malthusian economics slip. The Catholic church accused the government of blindly following the programme, under the advice of the IMF. Fujimori retaliated, branding the church an obsolete institution. Accustomed to fighting the church for its opposition to family planning – and believing this was a genuine movement for the empowerment of women – the medical establishment and feminist groups backed the programme. Thus the voices which could have expressed dissent were silent.
After his re-election in 1995, Fujimori had complete control over the state apparatus, making it possible for him to ensure the passing of legislation that would obscure the chain of command and diffuse responsibility over the programme. Its implementation showed the darkest side of neoliberalism, as those working in the health sector saw on one side their labour rights disappear, while on the other hospitals and health centres were given quotas of a number of sterilisations they had to conduct; they were given bonuses if the numbers were achieved and threatened with firing if they were not.
The result was tragic. It was only when the victims organised themselves and took their protests to the press that a real backlash began. The church and the newly created ombudsman's office took the accusations seriously and by 1998 Fujimori realised the policy could not continue. It was not, however, until the end of his regime that real investigations began and the first official reports were issued in 2002. It recommended that the responsible parties be investigated and the victims compensated.
Thus far, however, no one has faced justice and only one family received compensation. The 2011 elections have finally brought the sterilisation programme back to the discussion, and have probably cost Keiko Fujimori the chance of presidency.
An investigation conducted by a human rights group alleges that 250,000 women have undergone forced sterilisation in Peru in the last three years.
This investigation is not due to be presented until February but already its main findings have become clear.
Details of the report carried out by the Latin American and Caribbean Committee for the Defence of Women's Rights have been published in the Spanish newspaper, El Pais.
The report alleges that since 1996, President Alberto Fujimori's government has conducted a policy of forced sterilisation among women in poor areas of the country.
It says that many women have been sterilised without their knowledge or consent, while others only agreed to sterilisation after threats were made against them and their families.
In the last three years, Peru's Ministry of Health has issued a series of sterilisation quotas to doctors working in poor areas of the country, the report says.
It alleges the pressure has been exerted on the doctors to achieve their quotas.
The issue of sterilisation has caused serious controversy in Peru in the last few years.
When President Fujimori was re-elected in 1995, he said that one of his main aims was to achieve a substantial reduction in the country's birth rate by the end of the century.
Despite objections from the church, Mr Fujimori went on to adopt a policy of voluntary sterilisation in order to achieve this aim.
This report backs up concerns raised by human rights groups in Peru that the policy of voluntary sterilisation has given way to one of forced sterilisation but the government denies that this is the case.