Iithete testified that the issue of elective hysterectomy was raised because of the plaintiff’s previous history of severe bleeding. [63] Dorothea Maria Krönke, a witness called by the defence qualified as a medical doctor in 1985 in Germany. She started to work in Namibia at the State Hospital from 1987 until 1992. She returned to Germany where she qualified as a specialist gynaegologist and thereafter returned to Namibia where she worked at the Central Hospital as well as Katutura State Hospital. [64] She testified that in 2005 the antenatal clinic was run by sisters and nurses who were specially trained for antenatal care and that there were regular group counselling. During the group counseling different forms of contraception are discussed including sterilisation. When she has a discussion with a patient who does not understand English she would make use of an interpreter. The third plaintiff arrived at the hospital on 13 October 2005 at 18h50 when she was in early labour. The plaintiff previously requested a termination of pregnancy on medical grounds. The plaintiff has previously been observed by Dr Kheiseb, the Head of the Department. The pregnancy was too advanced for the termination thereof. The plan was to have an elective caesarean section and a sterilisation. Her experience was that the maternity ward at Katutura State Hospital was very busy with around six thousand deliveries annually. In respect of the antenatal care record of the plaintiff it was indicated in front of the document: “wants BTL”. The third plaintiff was seen by Dr Fong the previous evening who still had the hope that she might deliver normally. The next morning this plan was reviewed and it was decided that she had to undergo a caesarean section. It was recommended to the plaintiff that a sterilisation be done simultaneously and that this was discussed with the plaintiff. She testified that a patient should not be counselled for the first time while she is in active 32 labour regarding the option of sterilisation. She testified that in her capacity as a consultant she herself was not involved in obtaining informed consent from the plaintiff. [65] Dr Krönke, in response to a statement during cross-examination that when it comes to sterilisation counselling it must be done on a one-on-one basis, stated that such sterilisation counselling is being done during group counselling where all types of contraception are discussed, where each and every contraception method is presented and this is regarded as sufficient if a patient understands what has been conveyed to her. Should a patient need further individual counselling that would be arranged. She testified that there are simply too many patients at the antenatal care clinic to counsel each and every one on a one-on-one basis. Dr Krönke, in response to a statement during cross-examination that the people who attend the group counselling and the antenatal clinic would be at different levels of education and experience, stated that at these group counselling sessions the health officials presume that the patients are at a low educational level (since that was their experience) and