A little over two weeks before Ireland’s historic abortion plebiscite, another story was dominating the country’s news outlets: a radio interview with 37-year-old mother of five Emma Mhic Mhathúna that was aired the morning of May 10th on RTÉ, the country’s national broadcasting service. Speaking to journalist Audrey Carville, Mhic Mhathúna, who had recently been diagnosed with terminal cervical cancer, described the immense pain of explaining to her sons (one of whom, she said, is so young that he probably won’t have any memory of her) that she is going to die. At several points during the short but agonizing-to-listen-to interview, both Mhic Mhathúna and Carville break down and cry.

Mhic Mhathúna, who publicly announced on July 4th that the tumor had metastasized to her brain, rose to national prominence because she is one of at least 221 Irish women to have been diagnosed with cervical cancer despite receiving all-clear results from CervicalCheck, the country’s official screening program. At the time of writing, 18 of these women have died.

The genesis of the misdiagnosis scandal goes back to 2008, when the Health Service Executive (the government body in charge of health-related programs) awarded contracts for processing the results of cervical cancer tests to two Irish labs and two American ones. Health professionals who raised concerns about American labs’ lower rates of pre-cancerous cell detection at the time were ignored. After attempts to dissuade Tony O’Brien, then CEO of the National Cancer Screening Service, from going ahead with the outsourcing were unsuccessful, a number of scientists resigned from their government positions. But a 2014 audit conducted by CervicalCheck of Irish cancer diagnoses found a high number of cervical cancer patients who had earlier received false negatives, confirming the warnings raised back in 2008.

Faced with evidence that its plan had reaped exactly the consequences that the clinicians who resigned had predicted, the government sat on the audit for years amid squabbles about whose responsibility it was to inform the women affected, or even whether to inform them at all. Gráinne Flannelly, the former clinical director of CervicalCheck, resigned after emails came to light in which she counseled that “a balance needs to be struck,” arguing that some patients simply should not be told of their results. The government’s attempts to respond to the concerns of Irish women after this story came to light, meanwhile, have frequently been bungled: an HSE helpline established to field questions about CervicalCheck proved woefully understaffed upon opening, failing to respond to almost three-fourths of the nearly 11,000 calls it received.

The crisis facing Ireland’s healthcare system today is the result of a disastrous governmental decision to outsource labwork, compounded by equally disastrous years-long government silence. During this time, cancer cells divided and spread until, for some, the eventual revelation came too late. That the HSE is now being held accountable for its actions and inactions is due not to any sudden desire for transparency on the agency’s part but to the tireless efforts of the affected women — some balancing an exhausting schedule of media and court appearances with end-stage medical treatment and final time with loved ones — to make the stories of their mistreatment known. As Mhic Mhathúna said in her interview with Carville, “If my smear test was right in 2013, I wouldn’t be where I am today. I’m dying when I don’t need to die.”

Despite the scope of this tragedy, the jubilation that followed the victory of pro-choice campaigners’ effort to repeal Ireland’s draconian abortion laws has eclipsed media attention on the cervical cancer story, especially on the international stage. Combined with the vote to legalize same-sex marriage just a few years prior and the election of Leo Varadkar, the first openly gay Taoiseach (prime minister), these events lend themselves to a triumphalist narrative in which a secularizing Ireland is steadily (if belatedly) excising itself of its gravest social ills. According to this view of things, the cervical cancer crisis is an outlier on an otherwise upward trajectory. But for Irish citizens, government secrecy at the expense of women’s bodily autonomy is very simply nothing new; it is less a statistical anomaly than a grim confirmation of past trends. If Deputy Leader of the Fianna Fáil party Dara Calleary was right when he said on the national assembly floor that Mhic Mhathúna’s radio interview had “seared the soul of our country,” so too was the darkly sardonic response one reader gave in the comments section of an article covering Calleary’s speech: “The soul of our country has been seared so often and for so long that it must be well cooked by now.”

The cynicism intertwined with the public outrage that has greeted each new development in the cervical cancer story is a testament to just how far back Ireland’s history of exercising both extreme control over women’s bodies (particularly as far as sexuality was concerned) and extreme negligence regarding the immense harm such control exacted. Not until 1996 was the last Magdalene Laundry closed, by which time thousands of women had been through its system. Magdalene Laundries were institutions, typically run by religious orders, that attempted to reform “fallen women” by imprisoning them and forcing them to work without pay, often in degrading conditions.

Magdalene Laundries are hardly the only example of institutional callousness in Ireland. Historian Catherine Corless’s 2017 research into burials at a home for unwed mothers in Tuam, Co. Galway led to the horrifying revelation that almost 800 children had been taken from these women and buried in unmarked graves on the property. This discovery launched nationwide inquiries into the appalling conditions at so-called mother and baby homes, where fatality rates for the “illegitimate” children forcibly separated from their mothers was six times above average. Investigations into the degree of government complicity in the running of these institutions has been damning: the army relied on Magdalene Laundries for cheap cleaning services, while the state referred an estimated 25% of all Laundry inmates and the police force actively sought and returned women who had managed to escape. Perhaps, then, it is unsurprising that the government has never prosecuted any individuals involved in running Magdalene Laundries. Similarly, despite official inspectors reporting the health issues endemic at the Tuam mother and baby home as far back as 1944, the facility was permitted to remain in operation until 1961.

Given this history, the paternalistic silence that so defined the official response to CervicalCheck’s failings is disturbing evidence that secularization is not enough to cure Ireland of its attitudes towards women’s bodies. While successive governments have presided over changes that at last unmoor Irish law from Catholic religious dicta, the inability or unwillingness of the state either to safeguard women’s rights to life and health or to reckon honestly with its own failings in this respect has remained undiminished. The roots of Ireland’s often fatal disregard for its citizens’ bodily freedoms, it seems, are deeper and more knotted than previously thought. And pulling them out from the earth at last will prove far more difficult and far more painful than many would have liked to believe.