Showing papers in "Health and Human Rights in 2006"

Human rights abuses and vulnerability to HIV/AIDS: the experiences of Burmese women in Thailand.

Abstract: We investigated human rights concerns related to migration, living and working conditions, and access to HIV/AIDS services and reproductive health services for Burmese women in Thailand. Vulnerability to HIV/AIDS for Burmese women stemmed from abuses they experienced: gender and ethnic discrimination, including violence; unsafe migration and trafficking; labor and sexual exploitation; and denial of health care. Despite having bound itself to human rights laws, the Thai government is failing to fulfill its obligations to Burmese women, with particularly devastating impacts for their well-being, including the risk of HIV/AIDS. Moreover, as our documentation shows, this failure to incorporate human rights concerns into its national response to the epidemic virtually guarantees that HIV/AIDS will continue to be a problem in Thailand.

Global recognition of human rights for lesbian, gay, bisexual, and transgender people.

Abstract: he interdependent relationship between health and human rights is well recognized. Human rights are indivisible and inalienable rights due to all people. Articles 1, 2, 3, 5, 6, 7, and 16 of the Universal Declaration of Human Rights (UDHR) address, respectively, the rights to equality; freedom from discrimination; life, liberty, and personal security; freedom from torture and degrading treatment; recognition as a person before the law; equality before the law; and the rights to marry and have a family.' Some people, specifically lesbian, gay, bisexual, and transgender (LGBT) individuals, are in many places and circumstances denied their claim to the full set of human rights. This puts LGBT people in many countries at risk for discrimination, abuse, poor health, and death the ultimate human rights violation. Denial of the recognition of human rights for any group of individuals is a denial of their humanity, which has a profound impact on health. For LGBT people, it may result in discrimination in housing and jobs (affecting the ability to purchase food, shelter, and health care); lack of benefits (affecting the ability to pay for health care and financial security); harassment and stress (affecting mental health and/or prompting substance abuse, smoking, overeating, or suicide);

Evaluating asylum seekers/torture survivors in urban primary care: a collaborative approach at the Bronx Human Rights Clinic.

Abstract: Primary care providers who evaluate torture survivors often lack formal training to identify and address their specific needs. We assessed 89 asylum seekers from 30 countries to evaluate the pattern, spectrum, and presentation of abuses and the outcomes of the medico-legal process of seeking asylum. Commonly reported reasons for abuse were political opinion/activity (59%), ethnicity (42%), and religion (32%). The most common means of abuse were punching/kicking (79%), sharp objects (28%), genital electric shock (8%), witnessing murder/decapitation (8%), and rape (7%). Persistent psychological symptoms were common; 40% had post-traumatic stress disorder. The high success rate of asylum approval (79%) in this sample highlights the need for physician witnesses trained in identification and documentation of torture, working in collaboration with human rights organizations.

THE PERUVIAN TRUTH COMMISSION'S MENTAL HEALTH REPARATIONS: Empowering Survivors of Political Violence to Impact Public Health Policy

Abstract: (TRC) put mental health on Peru's national agenda. Formed in 2001 to study the causes, consequences, and responsibilities of Peru's 20-year internal armed confliet, the TRC called special attention to the devastating pychosocial damage caused by the war. These findings led to the TRC's recommended Integral Plan of Reparations (PIR), which ineluded a mental health component. In particular, the TRC set the stage for creating a more expansive approach to mental health, recognizing that each rural community, deeply impacted and often divided by the war, faced unique challenges to mental health recovery. Thus, it proposed a communitarian approach that moved beyond an individualized clinical- and medical-based model and identified a diverse representation of local participants who needed to be involved in diagnosing and determining the most appropriate ways to attend to their own mental health needs. Given the challenges of introducing new innovations into conventional health care, however, victimssurvivors need to be empowered to demand that the gov

Developing a measure of dignity for stress-related health outcomes.

Abstract: Jonathan Mann asserted that violations of dignity serve as underlying factors that negatively impact the health of individuals. He called for the public health community to develop an empirical understanding of ill health through the fundamental concept of dignity. This article explores definitions of dignity and presents a model to demonstrate how violations of dignity may cause chronic stress and, therefore, poor health. By combining human rights, capabilities, and ecosocial approaches, it may be possible to develop a multi-dimensional instrument to quantify and measure dignity violations. The most promising testable hypotheses concerned with dignity violations are related to violent victimization, poverty and deprivation, and discrimination -each of which has been linked to chronic stress and poor health.

The right to health and the privatization of national health systems: a case study of the Netherlands.

Abstract: Many countries have national health systems that cover all or part of the population. An aging population and advances in medical technology are making health insurance increasingly expensive, and governments are left seeking cost-effective options. The Dutch government is reorganizing its health care system and seeking to combine economic competition with a right to health in order to improve the health of its population. This article addresses privatization in terms of a right to health and asks whether governments can privatize their health care systems while also guaranteeing the availability, accessibility, acceptability, and quality of health care services. It is suggested that a "right to health impact assessment" can be a useful tool applicable also to the privatization processes in other countries.

Protecting Children's Rights in the Collection of Health and Welfare Data

Abstract: Program managers and researchers promoting children's rights to health, education, and an adequate standard of living often gather data directly from children to assess their needs and develop responsive services. Gathering information within a participatory framework recognizing children's views contributes to protection of their rights. Extra precautions, however, are needed to protect children because of the vulnerabilities associated with their developmental needs. Using case studies of ethical challenges faced by program implementers and sociobehavioral researchers, this article explores ways in which data collection activities among children may affect their rights. We suggest ways in which rights-based principles may be used to derive safeguards to protect against unintentional harm and abuses, based on a multidisciplinary consultation with researchers and service providers.

Selective adaptation and human rights to health in China.

Abstract: This article advances an alternative paradigm for making judgments about China's compliance with its international obligations in the realm of health and human rights, grounded on the reality that non-local rule regimes are interpreted and applied according to the extent of commonality between the norms underlying these international rule regimes and local cultural norms. This paradigm, "selective adaptation", allows us to determine that China complied with its international obligations in the case of SARS, but not HIV/AIDS. It makes visible how during SARS China eventually complied with the spirit of the international sanitation regulations but the lack of commitment to improving access to health care for persons living with HIV/AIDS reflects a failure by China to guarantee the right to adequate health care.

Balancing protection and pragmatism: a framework for NGO accountability in rights-based approaches.

Abstract: In the classic understanding of human rights obligations, the state is considered the primary duty-bearer. Governments, however, are increasingly handing over their function of delivering health services to NGOs. This article argues that because of these new and increasing responsibilities, NGOs should also be seen as duty-bearers required to uphold rights through their services, activities, and principles of operation. Translating human rights norms into practical, measurable activities remains a challenge. We worked with organizations delivering HIV-related services to prisoners and injecting drug users in Malawi and Pakistan. The aim was to develop a simple, practical framework of activities and indicators to provide accountability standards against which NGOs could be held accountable for progressively realizing the rights of their clients.

Health, human rights, and malaria control: historical background and current challenges.

Abstract: Malaria, a parasitic infection, causes hundreds of millions of disease episodes and more than a million deaths every year, nearly all of them occurring in the poorer and more vulnerable sectors of the world's developing countries. In spite of the great burden of suffering caused by malaria, the human rights implications of this disease have not been well described. This article summarizes important associations between the spread of malaria and human rights abuses (such as those associated with slavery and armed conflict) and between poverty, socio-economic inequity, and access to malaria-control measures. The author concludes that malaria control merits inclusion as a core element in global strategies to achieve progressive realization of the right to health.

Identifying the links between violence against women and HIV/AIDS: ecosocial and human rights frameworks offer insight into U.S. prevention policies.

Abstract: While US government-sponsored HIV prevention initiatives have achieved notable successes, challenges remain to serving women effectively. Intimate partner violence hinders women's efforts to decrease their HIV risk behaviors. The global HIV/AIDS epidemic is often viewed as a human rights crisis. An analysis of US HIV prevention strategies based on ecosocial and health and human rights frameworks clarifies women's HIV risk practices and suggests opportunities for progress. These two frameworks help to (1) demonstrate how HIV/AIDS is a clinical manifestation of violence against women, (2) identify safety from violence as a human right necessary for well-being, and (3) suggest ways in which HIV prevention initiatives can more effectively improve women's health and fulfill their basic human rights.

Water and sanitation in the context of HIV/AIDS: the right of access in resource-poor countries.

Abstract: Because the HIV/AIDS epidemic in resource-poor countries is concentrated in the most productive age group, it affects all development sectors and threatens the protection and safeguarding of human rights. While access to safe water and sanitation is a human right, it is particularly important for people infected and affected by HIV/AIDS that these rights are respected, protected, and fulfilled. Yet, the impact of the epidemic jeopardizes the ability of the water and sanitation sectors to fulfill these duties. This article reviews the linkages between these sectors and HIV/AIDS from a rights perspective and gives suggestions for strategies to be undertaken by state and non-state actors to promote access to water and sanitation as a right in an HIV/AIDS context.

Woman-centered post-abortion care in public hospitals in Tucumán, Argentina: assessing quality of care and its link to human rights.

Abstract: Unsafe abortion is a major public health and human rights problem in Argentina. Implementation of a woman-centered post-abortion care (PAC) model is one strategy to improve the situation. The quality of PAC services was measured in three public hospitals in Tucuman, a province with high levels of poverty and maternal mortality due to unsafe abortion. Overall, the quality of PAC services was found to be poor. Women do not receive services in a manner that respects their human rights, in particular their rights to health and health care, information, and to the benefits of scientific progress. Findings from the evaluation are being used to develop collaborative NGO/hospital/policy-maker efforts to improve PAC services through better training of health care providers.

INVOKING HEALTH AND HUMAN RIGHTS TO ENSURE ACCESS TO LEGAL ABORTION: The Case of a Nine-Year-Old Girl from Nicaragua

Abstract: rights and national laws are invoked both to support and to challenge the provision of abortion services.' In such situations, ideological political forces and subjective understandings of law- rather than concern for human rights or health may determine access to legal abortion services.2 We analyze how political actors and health and human rights standards influenced the fate of "Rosa," a nine-year-old Nicaraguan girl, who in 2003 was raped in Costa Rica, became pregnant, and sought a legal abortion. Laws in both Costa Rica and Nicaragua can be interpreted to allow abortion to preserve a person's health.3-6 Their interpretation and application in Rosa's case, however, were contested by individual health care providers, government representatives, and institutions, ranging from hospitals to national ministries, who obstructed her family's quest for information and abortion services. Rosa's parents petitioned the government of Nicaragua to satisfy the positive duty of providing a legal abortion and,

The anti-prostitution policy in the US HIV/AIDS program.

Abstract: T here is much to applaud in the legislation authorizing US foreign assistance for HIV/AIDS (the US Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act -hereafter the Leadership Act). President George W. Bush and Congress passed this landmark legislation in a laudable effort to address the catastrophic HIV/AIDS pandemic. The law has vastly increased US funding for HIV/AIDS programs and helped hundreds of thousands of people gain access to HIV treatment. The prevention strategies in the Leadership Act have proven controversial. This Commentary reviews the health and human rights implications of one of the HIV prevention policies in the law -the "anti-prostitution policy" (APP) -

The global gag rule - an antithesis to the rights-based approach to health

Abstract: F amily planning assistance in the US has directly advanced, supported, and helped to build the infrastructure of family planning services in over 50 countries around the world since 1965. Family planning funds, channelled through the United States Agency for International Development (USAID), have allowed women and families around the world to improve their quality of life.2 Tragically, in recent years, it has become harder for USAID to achieve successes in family planning. Restrictions placed on US family planning funds have created lasting damage to family planning programs around the world that rely on US support. On his first day in office in 2001, President George W. Bush reinstated a controversial policy (first instituted by the Reagan Administration in 1984) that infringes on the rights to health and life of women living in developing countries.3 The policy in question, officially known as the Mexico City Policy,

The right to health of indigenous peoples in the industrialized world: a research agenda.

Abstract: he international community has made great strides in developing a coherent body of international human rights law principles. Far less attention, however, has been focused on the extent to which such principles have been implemented within countries and the processes involved in their implementation. This is particularly evident in relation to economic, social, and cultural rights, not least within wealthy nations. It is often overlooked that most wealthy countries include minority populations that suffer from poor standards of living by any comparison. Such minority populations include Indigenous peoples in Australia, Canada, New Zealand, and the United States. These populations still experience relatively poor standards of living, including in the area of health.l Australia, Canada, and New Zealand are parties to the International Covenant on Economic, Social and Cultural Rights (ICESCR), the Convention on the Rights of the Child (CRC), and the Convention on the Elimination of Discrimination Against Women (CEDAW), and all four countries are parties to the Convention on the Elimination of Racial Discrimination (CERD). These treaties incorporate elements of the right to the highest attainable standard of health.2 These countries are also parties to the International Covenant on Civil and Political Rights (ICCPR), which in-

Models of resistance: "victims" lead.

Abstract: This author has found through professional and personal experience that throughout the world, women directly affected by injustice have led demands for accountability. The purpose of this article is to challenge mainstream human rights groups to create a different type of partnership between themselves and the people for whom they advocate by seeking the involvement of "victims", including leaders of successful "victim-led" initiatives. This approach will result in more appropriate policy recommendations and will enhance both entities' capacity for outreach. Moreover, it will bring mainstream human rights organizations into greater compliance with their own stated values, as well as exemplifying the same respect, flexibility, and accommodation that these groups often recommend to governmental, political, and institutional entities. Language: en

Making the grade: a first attempt at a health and human rights report card.

Abstract: We propose a methodology to evaluate fulfillment of the human right to health, using eight health indicators as proxies. Each health indicator was plotted against purchasing power parity US dollars gross domestic product (GDP)/capita to control for wealth. Generalized linear regression was used to derive a "best fit" curve. An "expected" value for each variable was calculated based on the GDP/capita of each country. The observed (reported) value was then divided by the "expected" value to give a score for that variable. Scores for each variable were averaged to give an overall health-related human rights score for each country. We believe that this report card is an initial step in the development of an effective means of monitoring health and human rights and can become a useful tool to quantify the fulfillment of the right to health. We invite comment on the approach.

Health and human rights education in academic settings.

Abstract: lhe Program on International Health and Human Rights at the Harvard School of Public Health and the University of New South Wales' Initiative for Health and Human Rights jointly hosted a one-day meeting in Boston to discuss health and human rights education in academic settings. Representing major research universities, government agencies, and some of the largest NGOs in the field, twenty-five prominent educators from around the globe came together to determine the various approaches, opportunities and challenges in Health and Human Rights education; establish the content specificities of teaching health and human rights courses; facilitate information exchange and communication processes to strengthen health and human rights teaching within and across institutions; and examine the interface between teaching and research in this fast growing field.

Children's rights and the MDGs: the right to health within Vietnam's transition towards a market economy.

Abstract: In Vietnam, the transition towards a market-based economy has contributed greatly to poverty reduction, but there are also signs of rising inequalities. This article discusses the consequences of internal and external economic liberalization on children's right to health. It describes how the right of the child to adequate health care is fulfilled in Vietnam and analyzes challenges health policy-makers face during the transition. Policy options are recommended, including increased public expenditures on health, introduction of health insurance, development of culturally sensitive health care programs for ethnic minority children and women, and negotiation of conditions for World Trade Organization (WTO) accession that do not jeopardize Vietnam's successes in implementation of the Millenium Development Goals (MDGs).

Accountability for the health consequences of human rights violations: methodological issues in determining compensation.

Abstract: Compensation for victims of human rights violations is a crucial developing area of international jurisprudence that demonstrates the need for collaboration among experts in the fields of public health and international law in the pursuit of effective rights-based approaches to health. The numerous methodological and ethical dilemmas raised through the emerging system of compensation reflect the complex nature of human rights abuses themselves. The myriad harms engendered by such violations can be successfully addressed only through methods that involve a marriage between normative and quantitative spheres of thinking. The right to compensation derives from both the right to an effective remedy, which is set out in numerous human rights instruments, and the struggle against impunity.l In this context, compensation has emerged as an attempt to help victims of human rights violations reclaim aspects of their former health and to dissuade future acts of wrongdoing. An examination of legal precedent, however, illustrates that the framework for compensation lacks an equitable, consistent, and transparent methodology for valuation. Economic theory has developed techniques for assigning monetary value to changes in health status that may be ap

Meeting the challenge of injection drug use and HIV in Armenia.

Abstract: Injection drug use (IDU) rates and HIV rates in some countries of the former Soviet Union (FSU) are skyrocketing.1 The epidemic of injection drug use is an epidemic of the young.23 These young people deserve attention and care, irrespective of how society feels about drug use. Stigmatizing them could risk the survival of a generation on which the promise of transition depends. Their drug use, the reasons behind it, and its consequences must be addressed with effective evidence-based methods - even if those methods may make some people uncomfortable.