PHR Student Blog

Robert S. Lawrence, MD, a founding member of PHR and the Chair of PHR’s Board of Directors, has been awarded the Sedgwick Memorial Medal at the 137th Annual Meeting of the American Public Health Association (APHA). The medal, considered the APHA’s most prestigious award, was presented at a ceremony in Philadelphia on November 10, 2009. The Medal recognizes Dr. Lawrence as

an individual who has demonstrated a distinguished record of service to public health while tirelessly working to advance public health knowledge and practice.

Upon learning of the award, PHR’s CEO, Frank Donaghue, said:

Physicians for Human Rights warmly congratulates and applauds our Board Chair, Robert Lawrence, MD, the recipient of one of the highest honors bestowed by the APHA. The 2009 Sedgwick Memorial Medal — a true accolade of the profession — signals colleagues’ recognition of Dr. Lawrence’s exemplary accomplishments in the field of public health. His leadership has helped PHR bring a human rights perspective to vital issues such as fighting global AIDS, strengthening the health workforce, addressing inequities faced by women and children, and promoting accountability and governance in health systems.

The Sedgwick Medal honors Dr. Lawrence’s long and remarkable career in public service. As Professor and Director of the Center for a Livable Future at The Johns Hopkins University Bloomberg School of Public Health, Dr. Lawrence has worked to eliminate racial and income-based disparities in health-care access across the United States. Educated at Harvard College and Harvard Medical School, Dr. Lawrence has taught at top US universities, served as a director of health sciences at the Rockefeller Foundation and has been a principal force for establishment of human rights programs in schools of public health. He is a member of the prestigious Institute of Medicine and is a past recipient of the Albert Schweitzer Humanitarian Prize.

Dr. Lawrence co-founded PHR, and has participated in human rights investigations with PHR and other organizations in countries including Chile, the former Czechoslovakia, Egypt, El Salvador, Guatemala, Kosovo, the Philippines, and South Korea and South Africa.

Homeland Security official Beth Gibson tried to put a kinder face on immigration detention health care in a November 9 talk to health professionals at the American Public Health Association annual meeting in Philadelphia. Instead of making detention center health staff pre-clear, and therefore pre-justify, every medical procedure that is referred to health professionals outside the prison walls, Homeland Security policy under consideration, according to Gibson, would devise a list of treatments that are “pre-approved.” Only more unusual services — such as CAT scans — would require special advance approval.

This is welcome news from Ms. Gibson, who, as Senior Councilor to the Assistant Secretary of Homeland Security John Morton, surely appreciates the human costs of unjustified delays in detention health care that have been reported in the press and by human rights groups.

Still, the policy doesn’t go far enough in the opinion of a number of health professionals who attended the APHA session, chaired by detention health expert Homer Venters, MD, at which Ms. Gibson spoke. One participant called for health professionals to support comprehensive immigration reform, which would decrease the number of persons in the US who are amenable to detention in the first place. Leaders in the Jail and Prison interest group of APHA also called on health professionals to become much more involved in supporting reforms to immigration detention policy.

Today marks a victory for PHR and all of you who have been working to lift the US HIV travel ban. This morning, while signing the fourth reauthorization of the Ryan White CARE Act, President Obama  vowed to “publish a final rule that eliminates the travel ban effective just after the New Year.”

Obama said:

Twenty-two years ago in a decision rooted in fear rather than fact, the United States instituted a travel ban on entry into the country for people living with HIV/AIDS.  Now, we talk about reducing the stigma of this disease — yet we’ve treated a visitor living with it as a threat.  We lead the world when it comes to helping stem the AIDS pandemic — yet we are one of only a dozen countries that still bar people from HIV from entering our own country. If we want to be the global leader in combating HIV/AIDS, we need to act like it.

The final rule will remove the HIV infection from the list of “communicable disease of public health significance,” no longer require HIV testing as part of the US immigration screening process and eliminate the need for a waiver to enter the country as an HIV carrier.

Please read Obama’s statement, his first public address about HIV/AIDS where he illustrates his commitment to make the United States a global leader in tackling HIV/AIDS and erasing its stigma.  Also check out PHR’s press release on this important victory.

Said PHR CEO Frank Donaghue:

Today is a great day for human rights and for people living with AIDS, their friends and their families. The HIV Travel Ban made the United States a pariah in human rights circles, and harmed our reputation as a world leader of HIV/AIDS prevention, treatment and care. Starting in 2010, people living with HIV will no longer be prevented from entering this country, no longer turned away at customs, no longer forced to hide their condition and interrupt medical treatment, and no longer be treated by our government with contempt.

We’re celebrating in Cambridge and DC; we hope you are too. This is an amazing victory for all of you who have worked so hard to promote and protect the human rights of people living with AIDS!

During his campaign, President Obama promised to end the ban on federal funding for syringe exchange programs.

Call President Obama TODAY at (202) 456-1414 or (202) 456-1111 and tell him to keep his promise to save lives.

This summer, the House of Representatives took a historic step by removing the ban on federal funding for needle and syringe exchange programs (SEPs).  Now, the Senate must act, but they are not making this policy a priority.

Senators need to hear from President Obama that his Administration supports syringe exchange. Now is the time to urge President Obama to fulfill his campaign promise to end the ban and to urge the Senate to act.

SEPs promote health and human rights. More than a dozen scientific reviews of SEPs have shown that when implemented as part of a comprehensive HIV/AIDS prevention strategy, SEPs help reduce HIV transmissions without increasing drug use.

Indeed, SEPs do more than provide clean syringes and properly dispose of used ones; they link people into the health care system and drug treatment programs that save lives.

President Obama’s leadership is key to moving this issue forward in the Senate. His support could help save the lives of thousands of people. 20 years is too long—help us end the ban today!

Call The White House Comment Line TODAY at (202) 456-1414 or (202) 456-1111 and tell Obama to fulfill his promise and END THE BAN.

Phone Script:

Tell the operator where you are from and if you are a health professional and/or have any specific expertise relevant to needle exchange, AIDS, and/or harm reduction. It is okay if you don’t have specific expertise—Obama needs to hear from everyone, in every state, about this issue!

Ask the operator to tell President Obama:

• The research is clear – syringe exchange programs work. The presence of syringe exchange programs in communities does not increase rates of drug use, nor does it lead to a rise in crime. What it does do: decrease transmission of HIV, Hepatitis C and other diseases.
• Now is the time for the President to make good on his promise to support lifting the ban on federal funding for syringe exchange. We are calling on President Obama to let key congressional members know that the White House supports Chairman Obey in fully revoking the ban on federal funding for syringe exchange.
• The President must also urge the Senate to refrain from adding any language or amendments to the Senate bill that would place undue restrictions on SEPs. The detrimental “1,000 Foot Rule” contained in the House bill may seem innocuous, but in reality it severely and unnecessarily limits the locations of SEPs. In some cases, the rule makes it impossible for urban communities to have needle exchange programs at all.

Leon Eisenberg, MD

Physicians for Human Rights mourns the loss of child psychiatrist, medical educator, and human rights advocate Leon Eisenberg, MD, husband of PHR founding board member Carola Eisenberg, MD.

PHR CEO Frank Donaghue said:

The board and staff of Physicians for Human Rights express our appreciation for Leon’s lifelong commitment to the advancement of human rights, and extend our deepest sympathies to his wife, Carola, and his family and friends. We will all miss our dear friend and colleague.

PHR Deputy Director Susannah Sirkin added:

Leon was a towering figure in advancing social medicine and passionate about human rights and dignity. He will be deeply missed.

The American Academy of Arts Sciences captured many of  Dr. Eisenberg’s accomplishments in a death notice published in the New York Times:

To the medical community, he contributed pathbreaking work in child psychiatry and an abiding concern with the relation between the practice of medicine and the lives of patients. As the Communications Secretary of the Academy for seven years, he informed our work with his gentle humor and his wide-ranging knowledge and interests. He helped to ensure that merit and diversity were the hallmarks of our membership and that the communication of information and ideas across fields and professions was our responsibility to society.

PHR is deeply moved and grateful that Dr. Eisenberg’s family has requested that in lieu of flowers, donations may be made to Physicians for Human Rights or Partners In Health.

Last year, Harvard Medical School’s Focus Online profiled Dr. Eisenberg. The piece described Eisenberg’s difficult entry into medical school in the 1940s; he was a straight A student but most schools would not admit him because he was a Jew. He was eventually admitted to Pennsylvania School of Medicine, rose to the top of his class and graduated valedictorian. He was nonetheless denied an internship, along with the seven other Jews who applied, at the University of Pennsylvania School of Medicine.

He went to Mt. Sinai Hospital in New York, where he discovered psychiatry….  In 1952, after a two-year stint in the Army teaching physiology to military doctors, he began a residency in child psychiatry at Johns Hopkins University, where his doubts about psychoanalysis were encouraged by the great psychiatrist, Leo Kanner….

Eisenberg would join him in his exploration of the newly identified psychiatric disorder, autism, paying special attention to the social, and especially, the family setting of the children in which it appeared.

Though Eisenberg suspected a genetic basis to the then rarely diagnosed disease, it would be years before the tools existed to look at it. In subsequent years, he turned his attention to more common childhood problems, such as school phobia, looking once again at the social setting in which they occurred.

In 1962, Eisenberg launched the first randomized clinical trial of a psychiatric medicine. “As simple as it seems, as straightforward, child psychiatry had gone on for 40 years before somebody did a randomized clinical trial,” said Earls.

The Focus piece also noted Dr. Eisenberg’s role in increasing the number of Black students at Harvard Medical School.

“Since being Jewish was no longer an issue in medical school after about 1950, I had thought that my job was to fight for the people who were being excluded, which were blacks,” he said. He was asked to chair the HMS commission on black community relations and the HMS admissions committee for the first seven years of affirmative action. “It was a wonderful place to see to it that the plan was implemented.”

Dr. Eisenberg’s commitment to fairness was constant and always included a focus on the institutions that he worked in.

A case in point was a festschrift held on the occasion of his 60th birthday. Former students presented an extraordinary array of papers, each of which Eisenberg thoroughly critiqued.

“At the end, when you would have expected Leon simply to say, ‘I’m so delighted, and I want to thank you for what you’ve done,’ well, he said all those things, and then he said, ‘You know, I just want to be honest with you,’” said Kleinman. “‘You’ve all become professors now, and you’re all outstanding in what you do, but I want to ask you this—have you used your tenure to go up against the system that we’re in? Have you spoken out?’”

With great admiration for Dr. Eisenberg’s contributions to psychiatry, medical education and human rights, the entire PHR staff extends our condolences to his wife, Carola; to his family; and to all who have been his friends, colleagues and students.

It’s a script for a great horror story — or nightmare. Being:

1. mentally ill,
2. indigent,
3. jailed, perhaps indefinitely, and
4. without a lawyer or guardian or anyone to speak for you?

And it’s happening right now in America.

Indigent mentally ill persons are placed in immigration detention and ordered deported from the United States every day. They have no right to a free lawyer nor to a court-appointed representative to speak on their behalf. Many have stories like Xiu Ping Jaing: an immigrant who fled human rights abuse in her home country only to be caught in a system dubbed by one expert the “American gulag.”

Other mentally ill people in immigration detention are not immigrants at all: they’re US citizens who, without help, can be detained for years or deported away from family members who were never informed of the action taken and are frantic to find their missing loved ones.

For many human rights problems, the solutions are complex. This isn’t one of them. In July, PHR joined human rights groups across the United States in asking Attorney General Eric Holder to take common-sense steps:

1. appoint lawyers for mentally ill detainees who can’t afford them,
2. set up a fair process to determine individuals’ competency to face deportation hearings, and
3. appoint guardians ad litem for individuals found incompetent.

In ratifying the International Covenant on Civil and Political Rights, the US agreed that

all persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person (Art. 10(1)).

The Obama Administration can, and must, act now to ensure that the mentally ill in our immigration jails are treated with the dignity they deserve.