Showing papers in "Health and Human Rights in 1997"

The Next Plague: Stigmatization and Discrimination Related to Hepatitis C Virus Infection in Australia.

Abstract: A recently discovered hepatitis C virus is a common cause of chronic liver disease in industrialized countries. Because it is basically blood-borne and because blood donors are systematically screened, the only major group now at risk of infection are injecting drug users. There are increasing reports of stigmatization, affronts to dignity and discrimination as a result of the hepatitis C status of individuals, but little action is being taken to prevent or redress these. In an attempt to stimulate such action, we collected 37 reports of such incidents in Australia in 1994, in the domestic, work, recreational, day care and funeral settings, but the most common involved health care settings and health professionals. In general, action did not follow from such incidents, despite the fact that Australia has a very strong framework of anti-discrimination legislation and process. It is urgently necessary that these issues be addressed, both in themselves and as a necessary prerequisite for controlling the continued massive spread of hepatitis C among injecting drug users.

Health and Human Rights: If Not Now, When?

Abstract: his is clearly a very exciting and exhilarating time to be working in health and human rights-but it is necessarily also a difficult time. For we are creating, participating in, and witnessing an extraordinary moment in social history-the emergence of a health and human rights movement-at the intersection and at the time of two enormous paradigm shifts. Stimulated in the first instance by pressures within each field, both public health and human rights are undergoing major transformations, so that the linkages between them, and the outcomes of their association have now become dynamic and even more challenging than may have been evident just a few years ago. Fortunately, as the tectonic plates are shif ting in the domains of both public health and human rights, interest in health and human rights has intensified-a reality manifested in, and symbolized by, this 2nd International Conference. This extraordinary situation in which both the public health and the human rights paradigms-and the systems of thought and action which flow from them-are rapidly evolving has become evident during this Conference. The challenge of applying human rights concepts in analysis and response to health problems, such as violence, has helped reveal previously unrecognized difficulties and limitations in traditional human rights work; similarly, efforts to define, expand and protect human rights in health-relevant settings, such as sexual rights and health, uncover substantial gaps or inconsistencies in health thinking and practice.

Sexual Rights: Concepts and Action.

Abstract: Over the course of the past decade, the intersection between sexuality and health has become a central focus of attention for researchers and activists from a range of diverse fields. Scientific disciplines and social movements that, until quite recently, might well have seemed to have little in common with one another, have increasingly merged in seeking to address the complex range of questions that have linked sexuality to health in the late twentieth century. Yet in spite of intense research and activism in recent years, we have nonetheless largely failed to develop a more coherent framework for thought and action capable of resolving such questions-and this failure has been linked in important ways to our inability to develop a concept of sexual rights capable of serving as the cornerstone for a more progressive, global response to the relationship between sexuality and health. This paper briefly discusses the key challenge that currently confronts work on sexual rights. I begin by examining the complex intersections among a number of diverse fields that converge around questions related to sexual rights-and around the relationship between sexual rights and sexual health. Then I discuss the apparent difficulties encountered in seeking to elaborate a positive and empowering conception of sexual rights capable of providing a point of departure for the work carried out across such diverse fields. And finally, I would like to briefly suggest how such a conception, should we manage to build it in the future, might enable us to develop a coalition capable of working together both locally and globally not only against sexual violence, but in favor of sexual diversity

The Links between Legal Status and Environmental Health: A Case Study of Mozambican Refugees and Their Hosts in the Mpumalanga (Eastern Transvaal) Lowveld, South Africa.

Abstract: This article uses a case study of Mozambican refugees in South Africa to explore the connections between realization of human rights and health promotion and practice one of three concepts highlighted at the First International Conference on Health and Human Rights in 1994. The introduction acknowledges the difficulties in addressing the needs of vulnerable groups that arise from false assumptions of community homogeneity and from the transient nature of vulnerability. The article then provides a brief sketch of the history of the Mozambican refugee situation and the case study area. The research methodology is described as incorporating data from a household census an environmental health survey community discussions and field work. Results are presented in terms of the refugees lack of legal status settlement patterns access to water sanitation and waste disposal fuel use layout and accommodation of living space and standard of living. It is concluded that the demographic distribution of the refugees environmental health indicators and lack of legal status all point to the vulnerability of the refugees. The lack of certainty over their future has hampered refugee desire to invest in their domestic infrastructure and is prompting new refugee movements to areas where they are less easily identifiable. Human rights activists must demonstrate that the failure to grant refugees legal status does not stop people from seeking refuge and actually increases social and political costs.

Genocide by Attrition 1939­1993: The Warsaw Ghetto, Cambodia, and Sudan.

Abstract: Genocide by attrition occurs when a group is stripped of its human rights, political, civil and economic. This leads to deprivation of conditions essential for maintaining health, thereby producing mass death. Genocide by attrition is epitomized by the Warsaw Ghetto (1939­43), Democratic Kampuchea (1975­79), and Sudan (1983­93). Potentialities of response are considered, as well as state and international interests in overlooking genocide, and the inadequacy and misuses of humanitarian aid. Lastly, guidelines are offered for future policy to prevent genocide by attrition, involving governments, health professionals, and aid workers.

The synergistic relationship between health and human rights: a case study using female genital mutilation.

Abstract: This article explores the usefulness of the human rights paradigm for dealing with the legal, political, and social questions raised by health issues, with particular emphasis on the role of health professionals. Health and human rights, each ways of defining and advancing human well-being, have the individual as their major concern. The concept of health rights encompasses individual autonomy in decision making, access to the health care needed to implement one's decisions, and the influence of broader economic, social and cultural conditions-without which choice is unavailable to most individuals.

The relevance of human rights to health status in Australian Aboriginal and Torres Strait Islander communities

Abstract: Australian indigenous people have been, and in many instances continue to be, deprived of human rights and fundamental freedoms. Dispossession of their land, territories, and resources have prevented Australian indigenous peoples from realizing their rights to development in accordance with their needs and interests. This alienation and enforced impoverishment have contributed significantly to the poor health status of Aboriginal and Torres Strait Islander people and communities. While there have been some major improvements in health during the past 20 years, mortality rates are still far too high and life expectancy too low. Australian indigenous peoples have a fundamental right to expect improvements in their health status similar to that achieved in other countries throughout the world.

Common Strategies for Health and Human Rights: From Theory to Practice.

Abstract: M y task is to encourage the participants in this Conference to think about the ways forward, to devise a strategy to move from theory to practice. In offering some thoughts about a common strategy for health and human rights, I am starting from two assumptions. The first assumption is that the health and human rights communities that the Fran~oisXavier Bagnoud Center has brought together at these two Conferences share a growing awareness of a common agenda. There are numerous indicators of this trend. One is the increase in the number of participants from the first Conference to the second. It is truly extraordinary that five hundred people have come to explore a theme that, a few short years ago, might have appeared esoteric and marginal. A second indicator is the spectacular growth in subscriptions to Health and Human Rights, truly remarkable for a scholarly journal. There is something that is capturing the attention of people. A third sign of this shared perception is the extraordinary number of relevant projects under way around the world, about which participants have reported at this Conference. The second assumption behind a strategy for the future is that the problems to which we would apply a common strategy of action are both numerous and urgent. The substantive program of this Conference is an excellent indicator of the quantity and urgency of the issues. The program lists eight or nine different forms of violence and interpretations thereof; it focuses on several emerging and existing diseases and approaches to dealing with them; it deals with a considerable number of health and society issues. Taken together, that list is itself an agenda calling for a common strategy.

Challenges of Global Health: How Can We Do Better?

Abstract: I would like to say a few words, about what I consider to be the global health crisis of today, which is essential in order to speak about the future of global health collaboration. And in this context, we must consider a key actor in this field, which is, of course, the World Health Organization (WHO). I think it is relatively clear that we live in a world with large and growing inequities in health. There are vast disparities in health status across the globe. We see the gaps widening dramatically between the health "haves" and the health "have-nots," whether this occurs intercountry, intergender, interrace, interethnic group, or interso many things. We see a dramatic decrease in access to quality health care, making a significant contribution to mass-scale deprivation both in the pockets of the rich northern countries as well as on a massive scale in the poor, developing countries of the south. The statistics are all there, from vulnerable groups in Latin America, Central Eastern Europe, South Asia, and above all, sub-Saharan Africa. What are the factors behind this devolution? The full picture would take hours, but allow me to discuss two issues which are close to my heart. First, I see a frightening global laissez-faire mentality in our increasingly amoral world, which is allowing global casino economics to ride roughshod over political, civil, social, economic, and cultural rights. In turn, this laissez-faire approach has removed a good deal of the solidarity, a good deal of the caring attitudes, that existed in the wake of the World War II. In addition, I see that we are continuing, almost vehemently, to ignore the lack of insight into the intersectoral and synergistic nature of most health promotion and health

Strengthening Alliances for Sexual Health and Rights.

Abstract: Sexual health and, more broadly, the field of reproductive health, has been the focus of my work for the past ten years. I know my 73-year-old mother will be very proud of me because my talk is on an issue that she has spent the past 10 years of her life educating adolescent girls and their mothers in rural India about-that healthy sexuality and the right to sexual health are fundamental to community health and development. Up to the International Conference on Population and Development in Cairo, the term \"reproductive health\" had been used synonymously with family planning, and family planning referred specifically to the use of contraceptives to contain population growth. Because of this narrow definition, family planning programs worldwide somehow managed to function without fully acknowledging the central role that sexual behavior played in conception. As absurd as this may sound, it is a fact that sexuality and sexual health have remained outside the purview of family planning programs and policies worldwide for the past four decades. It took infection and death-the AIDS pandemic-to force public health officials to focus on human sexuality. Even so, the focus has not been so much on human sexuality in general as on risky individual sexual behavior, without recognition of the complex societal context within which such behavior occurs or its social, cultural, political, or economic determinants. Public health messages to prevent HIV therefore stressed individual responsibility, with messages such as abstain from sex, use a condom, reduce the number of partners and be faithful, without acknowledging that, for many people worldwide, the course of sexual actions and lives is shaped by forces outside individual control.

Health and the Environment: A Human Rights Agenda for the Future.

Abstract: Linkages between health and the environment are increasingly recognized, but human rights law still does not provide an adequate framework for dealing with those connections. Environmental health issues now are seen as involving many institutions, processes, actors, and causes that are not immediately obvious. This reality requires changes in the human rights agenda. Practitioners should not take an overly legalistic and norm-based approach to health and the environment. While the right to a healthy environment is a useful concept, it is more effective to focus on how to implement the right to health from a policy perspective. Practitioners need to think about how human rights approaches can pressure decision-makers and social institutions to consider the environmental causes of ill health. Finally, it is hoped that human rights and environmental movements will work together more effectively in the future.

Inequity as Violence: Race, Health and Human Rights in the United States

Abstract: By every conventional index, the United States is the most violent society among industrialized nations. Consequently, violence and its effects have become a national preoccupation, the repetitive staple of the media, the subject of a broad spectrum of concern (ranging from sociological conferences to electoral politics), and a key factor in the ongoing American divisions of race and class. Yet paradoxically, in every venue from public discourse to congressional debate, our definitions and discussions of violence are strikingly restrictive, diverting attention from injuries more massive than those conventionally defined. With few exceptions, our concerns refer only to violence as the use of physical force by individuals to cause injuryand so we talk of guns and gangs, and domestic battering, rape and murder, militias and bombs. Of course these phenomena are serious and deserve our urgent attention. But there are other kinds of violence-actions and policies which, by intent or omission, result in predictable harm to the physical and mental health of large populations and, further, are a major stimulus to conventionally defined violence. There is, for example, what has been called constructive violence: to overcome or prevent resistance by threat or (more pertinently in the United States) by systematic deprivation. There is violence by failure to observe established restraints: in Mississippi at this moment, for example, a district attorney is seeking the death penalty for a 13-year-old child marginally involved in a car-jacking.

Juveniles and psychiatric institutionalization: toward better due process and treatment review in the United States.

Abstract: The United Nations Convention on the Rights of the Child (CRC) can be used as a framework to examine issues regarding psychiatric institutionalization of juveniles in the United States. The current U.S. system allows children diagnosed with relatively mild, non-psychotic disorders or exhibiting delinquent behaviors to be placed in institutions. Failure to regulate treatment in these faciltities also results in abuses by the treatment providers. Parents can institutionalize a child under the guise of mental health "treatment" because they disapprove of the child's lifestyle choices. In some states, parents can waive the child's right to an impartial hearing before institutionalization. The serious social, mental, and physical health consequences of erroneous deprivation of liberty are discussed. Recommendations include that the U.S. ratify the CRC, guarantee due process for juveniles faced with institutionalization, conduct systematic treatment reviews, and correct institutional abuses.

Activism for Sexual and Reproductive Rights: Progress and Challenges.

Abstract: his Conference represents a particular moment in the history of the health and human rights initiative, an opportunity to bring together the many different strands of our work, in collaboration with friends and colleagues from all over the world. I am a representative of many sectors of the world's population that are most deeply and intimately concerned with issues of health and human rights: a woman, a South Asian, a feminist, a human rights defender, a member of the so-called developing world, an activist from the nongovernmental sector, and part of a minority community that stands for secular and democratic principles in the midst of societies that are rapidly falling prey to the most reactionary and violent forms of economic, social, and political control. I would like to sketch some of the broad parameters of our discussions, while acknowledging the pioneering work done in the fields of health and human rights by many women's activists throughout the world, especially in the years following the World Conference on Human Rights in Vienna in 1993, through the Conference on Population and Development in Cairo in 1994, to the Fourth World Conference on Women in Beijing in 1995. In this regard the link and relationship between the issues of health and human rights represents one of the most critical and dynamic areas of our contemporary activism. In making this connection, we reaffirm the universality and indivisibility of human rights and we work toward the inclusion of socioeconomic and cultural realities in our conceptualization of what constitutes a human right. We also Sunila Abeyesekera is Executive Director of INFORM, a human rights

Reconceptualizing human rights language: gender and violence.

Abstract: The international human rights language that emerged after World War II was crafted with men in mind and failed to consider the impact of gender. Since that time a new human rights language has been created that attempts to encompass a more diverse and egalitarian view of humanity. This language has been partly affirmed at UN Conferences and the 1993 UN Conference on Human Rights made significant contributions that also furthered the concept of the indivisibility of human rights. The changing scenario is also marked by the World Health Organizations designation of "health" as a human right. A gap remains however between the international recognition of rights and their adoption by national governments. Power relations and values in each society dominate perceptions about violence crime and punishment. Thus in Brazil the laws that privileged White middle- or upper-class men obscured gender violence. However the new political culture that emerged in Brazil in the 1970s and 80s demanded that formerly marginalized citizens be afforded all of the rights of democracy. An analysis of existing social apartheid that denies citizenship rights to some citizens in some countries could result in a valuable map of the world. Recent events resulting from activism give rise to hope that the balance of power in national-international arenas is changing in a way that will enlarge the scope of the concept of human rights to include health and gender violence.

Promoting Child Health and the Convention on the Rights of the Child.

Abstract: I want to fashion a thesis which will not commend itself to some, because there is a kind of breezy dismissal, underscored occasionally by an unwarranted contemptuousness, insofar as the rights of children are concerned, there is also some considerable jaundice and skepticism about international conventions generally-a tendency to see them as a kind of intellectual rigor mortis of the multilateral system. Nevertheless, I will make an argument. Let me use the Cold War as the context. It was impossible during the Cold War period to talk thoughtfully and rationally about rights. The western world promoted civil and political rights; the Eastern Bloc promoted economic, social, and cultural rights, and individual liberties were juxtaposed to the collectivist impulse. It was impossible to harmonize them; the positions were just too intransigent. Then the Cold War ended, and suddenly there emerged, full-blown in 1990, the Convention on the Rights of the Child. It is the only binding international convention which fully embraces the principle of indivisibility. That is to say, every single right is equal: traditional economic, social, cultural, political, and civil. The rights to health and to education are equal in every respect to the rights to freedom of religion or freedom of speech. And these rights pertain to all children up to the age of 18, given the definition within the Convention itself. For an agency like UNICEF, the Convention was a kind of godsend. We had embraced the goals which emerged from the World Summit for Children in 1990, goals which were largely appropriate for health and largely generic: health, nu-

Health and human rights: The equity issue

Abstract: I confess to some trepidation about entering a discussion on human rights and particularly in relation to health, as I sometimes have had a vigorous reaction to my perspectives on some of the common current notions. I grew up with the conviction that the Universal Declaration of Human Rights was a credo that could guide my own actions. I considered the basic human rights to be those of life, liberty, and the security of person. Later, I came to be concerned when I saw the proliferation of needs and attributes that were also said to be basic or fundamental human rights. I often took comfort in the words of the American Declaration of the Rights and Duties of Man, which, in relation to health, affirmed:

A Personal Perspective on Human Rights and Health.

Abstract: Pk ter having experienced the worst of barbarities, could the twentieth century nonetheless be remembered for its defense of human rights? For it is clear, that the debates generated by the protection of human rights are now among the most important in our societies, taking the place of general debates around political issues. In addition, for several years, the United Nations has placed human rights issues at the center of its international conferences on specific themes: whether environment in Rio, population in Cairo, social development in Copenhagen, women in Beijing or habitat in Istanbul. The importance attached to human rights is a critical factor in mobilizing the younger generation and the work of many nongovernmental organizations. While some may forget that only democratic institutions are able to guarantee a favorable environment for respect of human rights, there is increasing recognition that human rights norms may offer concrete answers to the tragedies perpetrated during this century by totalitarian or authoritarian r?gimes founded on hate. Democracy itself is too abstract a concept to protect against violations of all human rights, discrimination and to ensure dignity for all. Whereas the Universal Declaration of Human Rights gives a broad definition of human rights, political priority has long been given to civil and political rights. This is largely the result of nineteenth century political liberalism, and its associated moral values impacting on the concerns of Western democracies. More recently, increased political attention to social and economic rights, such as the rights to education, health, work, and shelter have helped broaden our understanding of the content of these, increasing efforts to react to situations of

Human Rights and Natural Laws

Abstract: \"Gravity; it's not just a good idea-it's the law,\" goes an old quip. Indeed, the laws that underpin ecosystem integrity are not just to be admired, they are necessary for maintaining life-support systems, and our health. In this context, environmental health, basic needs, and human rights-as considered by the United Nations-become barely distinguishable. It is the human role in undermining or rescuing nature's regulatory strategies that is the subject of this editorial. Self-regulatory mechanisms are active at all levels in living systems. Within the nucleus of DNA-containing organisms, regulatory genes deactivate abnormal cells, while others perform \"spell-checking\" functions-excising mismatched base pairs from mutated structural genes. In the cytoplasm, harmful oxygen-derived free radicals are neutralized before they disrupt DNA. And at the organismic level, T-cells and Natural Killer cells carry out active surveillance to expunge malignant cells. It is this diversity of regulatory responses that maintains informational stability over time-among the networks of genes critical for generating form and body plans, and for ensuring flexibility of immunological responses to insults and invasions. Within ecosystems, biodiversity is the primary buffer, assuring resilience in the face of perturbations and resistance

The Prevention of Institutionalized Intergroup Violence.

Abstract: rJ'he Postmodern Predicament A wit once defined \"irony\" as buying a suit with two pairs of pants and then burning a hole in the coat. This nicely captures the sense of pride punctuated by tragedy that characterizes our postmodern mood as the twentieth century slouches towards it conclusion. The irony of the historical experience of the twentieth century arises from the recognition that the long string of successes in many fields of science and technology that have occurred in this century have taken place alongside an equally long string of human rights violations, mass killings, wars, and genocides. If we measure human progress solely in terms of scientific and technological discovery and innovation, it has been a fabulously progressive century indeed. But if we measure human progress in terms of increased social and economic justice and greater security from war and other forms of social violence, then any objective appraisal of our century must conclude that we have failed tragically to solve the problem of man's inhumanity to man.' I want to focus my remarks on the phenomenon of institutionalized intergroup violence (IIV) and to discuss how an approach to this problem through the framework of health and human rights can point the way towards more effective responses to this source of human suffering in the twentyfirst century.2 My proposal is essentially that we ought to view outbreaks of IIV as an epidemiologist would view outbreaks of disease-as threats to public health. Furthermore,

Women's Human Rights and Health in Developing Countries.

Abstract: he improvements in development in Latin America and the Caribbean observed from the 1950s through the early 1970s have started to decline. Principal factors include growing external debt, the world trade imbalance due to the increase in the price of oil and manufactured products and the decrease of primary products. This deterioration of socioeconomic conditions has increasingly and primarily affected women. Recognition of women's status improved alongside restitution of democratic governments in Latin America. Recognition of human rights norms improved as the economic crises deepened. The rise of democratic governments and the renewal of respect for human rights created a friendly context for improving women's rights in the 1980s. Many advances occurred through legal and constitutional reforms and through the development of a strong women's movement. Feminist women even attained governmental and parliamentarian positions and contributed to changes in some countries. Yet, from the beginning of the 1990s, due primarily to the globalization of the world economy, new patterns of consumption and production also emerged. In developing countries, structural adjustment programs were applied which led to increasing inequalities, unemployment and social exclusion. The gap between rich and poor widened within and among nations. In 1995, 20 percent of the richest people in the world held 85 percent of the global income, while the poorest 20 percent of people had only 1.4 percent according to the United Nations Development Program (UNDP) Report on Human Development. Imbalances and inequities