Category Archive for 'right to health'

Resources to build your Chapter, educate your community, and lead meaningful advocacy

The National Student Program has launched a website dedicated to resources for students, residents, and young professionals who are interested in advocacy based on PHR’s human rights investigations.

To educate your campus or community, refer to the PHR Student Chapter Toolkit for detailed information about how to plan and lead an advocacy campaign, host educational events, and more.

Use the issue-based PHR Toolkits to lead education and advocacy:

Access to Essential Medicines

The UN Working Group on Access to Essential Medicines opened its report on Essential Medicines with the assertion that “The lack of access to life-saving and health-supporting medicines for an estimate 2 billion poor people stands as a direct contradiction to the fundamental principle of health as a human right.”

Using clinical skills to defend human rights: Asylum and Detention

Physicians for Human Rights’ Asylum Network is a community of hundreds of health professionals who offer pro bono physical and psychological evaluations to document evidence of torture and persecution for men and women fleeing danger in their home countries. As mentioned in a recent post, the Asylum Network at Physicians for Human Rights conducted 317 evaluations during the 2010-2011 academic year. 10% of these evaluations were shadowed by medical students and residents through student-run asylum clinics.

Transforming health professional education: Health and Human Rights Education

Over the course of their careers, every health professional will be confronted with patients who have endured human rights violations. However, few medical and public health schools have mainstream courses to help prepare students to deal with this effectively. Students and faculty are working together to introduce new courses and promote Health and Human Rights Education.

Prioritzing the Patient: Medical Professionalism

Medical professionalism is the basis of medicine’s contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health. As discussed in a previous post, there is a strong human rights basis for the integrity of medical professionalism and for prioritizing the needs of the patient.

Domestic Health Equity and Ethnic Disparities: Access to Health in Massachusetts

This Toolkit examines health disparities and health reform through the case of Massachusetts’ health reform and its relationship to federal health reform.

Other recent resources that may be of interest:

What is medical professionalism?

Medical professionalism is the basis of medicine’s contract with society. It demands placing the interests of patients above those of the physician, setting and maintaining standards of competence and integrity, and providing expert advice to society on matters of health.

Medical professionalism prompts a thorough examination of the underlying causes of ill health in people and communities. The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national, and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities- the unfair and avoidable differences in health status seen within and between countries. For a more in depth look, visit the WHO-social determinants website.

The medical profession is confronted by an explosion of technology, changing market forces, problems in health care delivery, bioterrorism, and globalization. As a result, physicians find it increasingly difficult to meet their responsibilities to patients and society. These challenges center on increasing disparities among the legitimate needs of patients, the available resources to meet those needs, the increasing dependence on market forces to transform health care systems, and the temptation for physicians to forsake traditional commitment to the primacy of patients’ interests.

The human rights basis for professionalism in health care

The principles of patient welfare and social justice are central to the right to health and medical professionalism. The commitment to improving access and quality of care mirror the right to health’s fundamental “AAAQ” framework,  a notion that asserts that health services be available, accessible, acceptable, and of good quality. Finally, the commitment to science and the assurance of confidentiality are critical concepts to a human rights approach to health.

Health professional responsibilities can be met through a rights based approach to health utilizing human rights framework to achieve goals of accountability, participation, nondiscrimination, and universality. Examples of the use of a rights-based approach are improvement of patient care, building community health, and enhancing health policy.

Improve patient care

Employ the human rights principles of participation and non-discrimination to improve individual patient care, enhance cultural competency, recognize root causes of disease, and help people stay healthier longer.

Build community health

Apply the right to health principles of providing accessible, affordable, acceptable, quality care to build health systems that work, and recognize social determinants of health that can be addressed through programming that connects clinics with communities.

Enhance health policy

Use human rights as a platform to advocate for the closing of racial disparities by increasing funding for low income health care, to fight for immigrant health care, and to ensure that global health programs build systems that address fundamental health needs.

PHR Student Toolkit: Professionalism in Medicine

In conjunction with the American Board of Internal Medicine Foundation, which has released a Physician Charter that guides health professionals in medical professionalism, PHR has created a Medical Professionalism Toolkit for you to learn more.

Yesterday, the Obama administration released a ten-year budget plan. Despite numerous cuts, the President’s FY2012 budget proposes an increase in Global Health and Child Survival allocations of $887 million, a 10% increase over the President’s FY2011 request. How will Congress respond? Please call your Senators and Representatives and urge them to support funding for health.

In January, I asked you to call your Senator to urge them to support funding for health programs. The House of Representatives had approved a resolution to reduce non-security spending to 2008 levels, which would undermine progress towards better health outcomes – both domestically and globally. The federal budget is currently running on a Continuing Resolution that expires March 4, 2011. If the Senate fails to sustain or increase funding, this will have a direct impact on health outcomes in 2011 and for years to come. On Friday night, House republicans revealed a spending plan for the next seven months that contains that “largest spending cut in modern history,” according to House Majority Leader Eric Cantor, R-Va, despite continued needs.

Since the House and the Senate are making budget decisions about both this fiscal year right now, and very soon will make decisions about the next fiscal year, PHR asks you to give your member of Congress a clear message: Don’t cut health funding.

Dramatic cuts in health care funding are dangerously short-sighted.  I suspect that Bill Gates agrees with me.  He appeared on The Daily Show with Jon Stewart recently and mentioned the importance of continued funding for health interventions:

The US government has been very generous, over a billion to (polio eradication). They’ve been the most generous government…. So I’m a little concerned.  I hope the US government, even with all the challenges, wants to see the polio campaign through….

It’s in the foreign aid budget… We hope it doesn’t get cut. There’s a lot of things that help children. The UK government actually kept their humanitarian stuff even as they were balancing their budget, and I hope to make the case that we should do the same….

You want to have aid that, at the end of the day, people feel helped them.  Helped them with their childhood health, or disease.  That’s the stuff I think has the best chance of showing people we’re very generous.   You know, we want to help. Some aid can backfire.

In other words, when done right, humanitarian aid can be an effective investment in global health diplomacy.

You can view the interview here.

Please call your Senators and Representatives this week to urge sustained funding for domestic and global health programs. Remind them that these cuts will not adequately address the federal deficit. For example, foreign aid is a very small fraction of the US budget. The International Affairs budget makes up about 1% of the overall federal budget, yet was able to fund the treatment of AIDS, TB, and malaria for millions of people. This investment is humanitarian, diplomatic, and economically sound, as it allows people to continue working and reduces the likelihood of transmission, and hence avoids increased health care costs. Also – as Bill Gates points out – these investments can be very effective “global health diplomacy.”

When you call, address these points:

  • I am a health professional (student) in your state and a member of Physicians for Human Rights.
  • Sustain or expand funding for global and domestic health because it’s a smart investment. When it comes to health, short-term funding cuts will have long-term repercussions.
  • The right to health implies that health care must be affordable, accessible, acceptable, and of good quality. My hospital can’t do this if it can’t pay its bills.
  • Funding health is a cost-effective investment. We can’t neglect global or domestic health without serious consequences. On the other hand, cutting these programs will not balance the budget or substantially reduce the deficit.

You can find your Senators and Representatives here.

Please report your call here.

Federal funding for health is in jeopardy.

In the recent State of the Union address, President Obama announced a five-year freeze on domestic spending (aka non-security discretionary spending). On Jan. 25th, the House of Representatives approved a resolution to reduce non-security spending to 2008 levels.

We cannot balance the budget on the backs of the most vulnerable.

To avoid losing the progress that targeted spending has made in saving lives and improving health outcomes, the Senate should pass an omnibus bill that provides slight increases to FY10 levels for the majority of global health accounts. Last year’s efforts to pass an omnibus bill died in December when it became clear that 60 votes were not available to overcome a threatened Republican filibuster, the Washington Post reported. The federal budget is currently running on a Continuing Resolution that expires March 4, 2011. If the Senate fails to sustain or increase funding, this will have a direct impact on health outcomes in 2011 and the years to come.

An arbitrary freeze on spending is short-sighted and ineffective. The money saved will not adequately address the federal deficit. For example, foreign aid is a small fraction of the US budget. The International Affairs budget makes up about 1% of the overall federal budget, yet was able to fund the treatment of AIDS, TB, and malaria for millions of people. This investment is humanitarian, diplomatic, and economically sound, as it allows people to continue working and reduces the likelihood of transmission, and hence avoids increased health care costs.

A return to 2008 levels would dramatically reduce funding for the Global Health and Child Survival USAID Account (USAID-GHCS). January marked some milestones that offer a glimpse of the urgency of the need for continued investment in global health.  This month was the one year anniversary of the earthquake in Haiti and the six month anniversary of the floods in Pakistan. Yesterday, the WHO Director General, Margaret Chan, commented that increased funding is necessary and asked,

“Will progress stall? Will powerful innovations, like the meningitis vaccine, like the vaccines for preventing diarrheal disease and pneumonia, like the new diagnostic test for tuberculosis, fall short of reaching their potential? Public health has been on a winning streak. But will we still have the resources to maintain, if not accelerate, these gains?

Domestic health is also at risk. Most insiders anticipate a healthcare reform repeal vote in the Senate before long.

Please call your Senator to share your opinion. You can use this script:

I am a voter in your state. I urge you to sustain or expand funding for global and domestic health because it’s a smart investment. When it comes to health, short-term funding cuts will have long-term repercussions. We need to continue the work to make health care affordable and accessible, make prevention a priority, and ensure that women have access to the reproductive and other health care services they need. As a member of Physicians for Human Rights, I will be keeping an eye on how you vote on this issue.

You can find your senator here.

Please report your call here.

Jack Geiger, founding member and past president of PHR.

Why do you go to Conferences? I go to be inspired by the speakers, informed about issues, and energized by the other participants. Given the speakers who have agreed to present, the 2011 PHR National Student Conference promises to be truly inspirational.

I’m thrilled to announce that Jack Geiger, MD, M Sci Hyg – a pioneer in human and civil rights, a founding member and past president of PHR, and the creator of the model of Community Health Centers, which now serves millions of low- and middle-income patients – will speak. He has graciously agreed to accept the Leon and Carola Eisenberg Award for a lifetime of dedication to health and human rights education.

Throughout the day, the speakers will offer thought-provoking insight into how to design a career that will make a difference. Join us to hear presentations from these physicians, public health practitioners, researchers, human rights activists, media analysts, and policy specialists:

  • Howard Zucker, MD, JD, LLM – A senior advisor to the Division of Global Health & Human Rights at Massachusetts General Hospital; formerly  Assistant Director-General of the World Health Organization (WHO) and U.S. Deputy Assistant Secretary of Health.
  • Jennifer Leaning, MD, SMH – The Director of the FXB Center for Health and Human Rights, Harvard University and former PHR Board member who revealed the mass grave at Dasht-e-Leili, Afghanistan, and investigated systematic rape in Darfur, Sudan.
  • Khassan Baiev, MD – As a wartime trauma surgeon, Dr. Baiev treated thousands of civilians and combatants in Chechnya.
  • Mohammed Ahmed Eisa, MD – Awarded the 2007 Robert F. Kennedy Human Rights Award for his clinical and humanitarian work in Darfur, Sudan.
  • Gloria White-Hammond, MD – As a pediatrician, minister, and activist, Dr. White-Hammond has worked with marginalized communities in the U.S. and overseas.
  • Richard Sollom, MPH, MA – PHR Deputy Director and public health researcher whose reports on Zimbabwe, Bangladesh, and Burma are redefining how human rights violations are tracked.
  • Susannah Sirkin – As PHR Deputy Director since 1987, Ms. Sirkin has led the fight against genocide, violence against women, and incarceration of prisoners of conscience.
  • Parveen Parmar, MD, MPH – A physician with a background in humanitarian response who uses her clinical skills to demonstrate human rights violations in Bangladesh and Burma.
  • Nathaniel Raymond – A human rights investigator at the new Satellite Sentinel project initiated by George Clooney; former Director of PHR’s Campaign Against Torture and lead investigator on the Dasht-e-Leili case.
  • Christy Fujio, JD, MA – PHR’s Asylum Program Director oversees the network of health professionals who use their clinical skills to validate the claims of asylum seekers and survivors of torture.
  • Sarah Kalloch – A policy advocacy and education specialist; currently leads campaigns at Oxfam America.

Register today to hear these inspiring speakers on February 12 at Tufts University School of Medicine in Boston!

Avatar Image

Tomorrow, December 10, is International Human Rights Day.  This year marks the 62nd anniversary of the adoption and proclamation of the Universal Declaration of Human Rights (UDHR) by the UN, a watershed moment in establishing an international consensus that we are each entitled to certain inalienable human rights.

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

- Article 25 of the Universal Declaration of Human Rights.

According to Louis Henkin, the UDHR is said to be one of the most important international instruments of the twentieth century, second only, perhaps, to the United Nations Charter. The significance of the Universal Declaration lies in four achievements:
  1. It helped convert a discredited philosophical idea (“natural rights”) into a dominant political ideology
  2. It defined a vague colloquialism (“human rights”) in an authoritative code, a triple “decalogue” of thirty articles of fundamental rights.
  3. It universalized human rights, promoting a constitutional ideology accepted in a few countries into a standard of constitutionalism for all countries.
  4. It internationalized human rights, transforming matters that had been subject to exclusive domestic jurisdiction – “sovereignty” – into matters of international concern, putting them permanently on the international political agenda, and providing the foundation for a sturdy edifice of international norms and institutions.
This year, the UN High Commissioner for Human Rights (UNHCHR) has chosen the theme “human rights defenders who act to end discrimination.”  This theme notes the achievements of human rights defenders and emphasizes how governments must enable and protect their role. The Day is also intended to inspire a new generation of defenders to speak up and take action to end discrimination in all of its forms. Students have a critical role as “human rights defenders,” and I invite you to join PHR to defend human rights and demand justice.

A demonstration in Uganda.

This week, students across the US will use the new National Action Toolkit to educate their communities about why patients are denied access to life-sustaining medicines and lead their communities to take action. Join PHR and Chapters across the US in advocating for better access to essential medicines in resource-poor settings through UNITAID’s new Medicine Patent Pool. Our new National Action Toolkit offers analysis, resources to educate your community, and easy advocacy projects. This week of action spans from World AIDS Day (December 1) to International Human Rights Day (December 10). This National Action is dedicated to our friend and colleague, Sujal Parikh, in recognition of his leadership in this area. Let us know about your Chapter’s National Action! Send the National Student Program Coordinator, Hope O’Brien, an update with photos and flyers, and we’ll feature your Chapter on the blog.

Every summer, I promise myself that I’ll make the time to time to read the books that I’ve been meaning to get to all year. Whether I’m parked in front of the air conditioning or in the last light of dusk on the porch, there’s just something great about reading that’s not assigned. Summer is my chance to choose what I want to read: something fun, something that will deepen my understanding of the world, or something that will inspire me to return to work with renewed commitment, awareness, and energy. I want to read something that is indulgent, informative, and inspirational.

The PHR National Student Program is busy this summer, expanding and improving the resources available to Chapters. Among other things, we’re creating lists to help you discover new resources and opportunities. In honor of summer reading lists, I wanted to give you a glimpse of our new Recommended Reading list.

Here’s a list of some excellent books, articles, and blog posts that will appear on the Recommended Reading list. Most were suggested by PHR staff and interns. Although Laurie Garrett’s 800-page Betrayal of Trust: The Collapse of Global Public Health might not be everyone’s idea of an ideal beach read, it might be just what you’ve been looking for.

Have a favorite that you didn’t see here? Maybe something that inspired your interest in health or human rights, or offered a new perspective on a topic near and dear to your heart? Post it in the Comments section below, and we might include it in the final version of the Recommended Reading list.

Books

Health and Human Rights: A Reader, Jonathan Mann, Michael A. Grodin, Sofia Gruskin, and George J. Annas.  (1999)

Perspectives on Health and Human Rights, Sofia Gruskin, Michael A. Grodin, George J. Annas, and Stephen P. Marks.  (2005)

These texts are often used in health and human rights courses.  Both are comprehensive anthologies of foundational essays on health and human rights, and examine issues from ethnic cleansing to women’s reproductive rights.

The Oath: A Surgeon Under Fire, Khassan Baiev and Ruth Daniloff. Dr. Baiev was caught in the the struggle between Chechnya and Russia. Regardless of their nationality or whether civilian or military, he treated everybody under extraordinarily difficult circumstances.  Considered a traitor to both sides, he was called a “bandit-doctor” (for treating Chechens) and a “pig-doctor” (for treating Russians). For years, PHR has worked to protect Colleagues at Risk – clinicians who are targeted for adhering to their Hippocratic Oath, despite the political situation.

The Spirit Catches You and You Fall Down, Anne Fadiman. Described by various PHR staff as “fantastic,” “riveting,” and “devastating and totally addictive,” this describes the clash of two cultures over a child’s health. Anne Fadiman writes with the insight of an anthropologist and the compassion of a friend. I worked with refugees for years, and I also saw heartbreaking conflict between people who each had a patient’s best interests at heart, but had very different beliefs about illness and health.

Betrayal of Trust: The Collapse of Global Public Health, Laurie Garrett.  As in another of Garrett’s massive tomes, The Coming Plague, Garrett uses investigative reporting to analyze public health preparedness.

The Bone Woman: A Forensic Anthropologist’s Search for Truth in the Mass Graves of Rwanda, Bosnia, Croatia, and Kosovo, Clea Koff. Koff takes the reader inside her life as a forensic anthropologist to see what it’s like to excavate mass graves and build evidence of human rights violations. PHR’s International Forensic Program relies on these skills in Afghanistan, Central America, and elsewhere.

The Dark Side: The Inside Story of How The War on Terror Turned into a War on American Ideals, Jane Mayer. This dramatic narrative reveals the decisions behind the controversial excesses of the war on terror and considers the impact of these choices. For more background and an update, visit PHR’s reports on torture of US detainees.

PHR Reports

From Persecution to Prison: The Health Consequences of Detention for Asylum Seekers. Asylum seekers who come to the U.S. to escape torture, persecution, violence or abuse are often locked up in inhuman conditions. PHR conducted the first systematic and comprehensive study about the impact of detention on asylum seekers’ mental health.

Achieving the MDGs by Investing in Human Resources for Health and The Right to Health and Health Workforce Planning. Access to healthcare depends in large part on the ability and distribution of a country’s health workforce. Investments that sidestep the training, payment and supervision of healthcare workers do not build the overall health system.

Stateless and Starving: Persecuted Rohingya Flee Burma and Starve in Bangladesh. In recent months Bangladeshi authorities have waged an unprecedented campaign of arbitrary arrest, illegal expulsion and forced internment against Burmese refugees. In this emergency report, PHR presents new data and documents dire conditions for these persecuted Rohingya refugees in Bangladesh. PHR’s medical investigators warn that critical levels of acute malnutrition and a surging camp population without access to food aid will cause more deaths from starvation and disease if the humanitarian crisis is not addressed.

Articles

Health and Human Rights is published by the FXB Center for Health and Human Rights at Harvard University. The original editor-in-chief was Jonathan Mann, succeed by Sofia Gruskin and then Paul Farmer, all pioneers in the field. By posing the question, “What is a rights-based approach to health and why should we care?” this issue began a series that dealt with fundamental concepts regarding health as a human right.  Subsequent issues tackle accountability (10:2), participation (11:1), and non-discrimination and equality (11:2). The series concludes with the most recent issue on international assistance and cooperation, edited by Jennifer Leaning, the new FXB director and a former PHR Board member. All material is freely available online.

Health and Human Rights Education in U.S. Schools of Medicine and Public Health: Current Status and Future Challenges, L. Emily Cotter et al.  PHR’s Senior Medical Advisor Vince Iacopino and the other authors evaluated obstacles to health and human rights education at schools of medicine and public health across the country.

Health and Human Rights, Jonathan Mann et al. A close look at the complementary ways that health and human rights define and advance human well-being:

  • The Impact of Health Policies, Programs and Practices on Human Rights
  • Health Impacts Resulting from Violations of Human Rights
  • The Inextricable Linkage Between Health and Human Rights

The Challenge of Global Health, Laurie Garrett. Garrett’s critique of misdirected investment in global health got a strong reaction from the media and the global health establishment. Don’t miss the exchange between Paul Farmer and Laurie Garrett. Although the funding and policy environment has evolved since this was published, it’s a glimpse of a critical moment in global health.

Blog posts

The Right to Health: A Conversation with Helen Potts, PhD on the Physicians for Human Rights site. An informative and comprehensive look at the history and meaning of the right to health.

Refugees in America: Faces and Stories Behind the Refugee Protection Act. This post by Erin Hustings, PHR’s Asylum Advocacy Associate, on the PHR blog Health Rights Advocate, offers a personalized look at the refugees who are denied asylum in the United States because of unnecessary obstacles and technicalities.

(.)

It’s official: the Global Health Week of Action is here!  The GHWA is a chance to move from education to advocacy on your campus.

The Chapters we’ve talked to so far are doing a range of activities – from direct advocacy with their Representatives, to speaker’s panels, a health fair, fundraisers, film screenings, and a blood drive! World Health Day is April 7, so April 4-10 is the official week of action – but your school might choose a different week in April to accommodate your campus calendars.

This year we’re encouraging chapters to focus their GHWA on the global health workforce crisis and the 2010 Global HEALTH Act (HR 4933).  Rep. Barbara Lee (D-CA) has introduced the bill in the House!  For the Global HEALTH Act to be successful, the more co-sponsors, the better.

How can you tell your Representatives that you want them to co-sponsor?

These letters, petitions, phone calls and district meetings send a clear message to your Representative: We want you to support the Global HEALTH Act. You can also forward some friends the link to the petition, post it on FB, and tweet it!

PHR has put together a GHWA Toolkit that includes an Issue and Action Guide, ideas for great events, suggestions on how to fundraise and publicize, and resources to share with your community. If you’d like to brainstorm together or discuss what resources PHR has for you, just email or call me! This GHWA is a chance to energize your Chapter, build interest in health and human rights education (HHRE) – and make a real difference at the same time.

  PetitionTemplate-GHA-4-10.pdf

  Global_HEALTH_Act_health_professional_sign_on_letter.pdf

  Global_HEALTH_Act_Sign_on_Letter_Request_Email.doc

  GHA2010_fact-sheet.pdf

Every year, PHR’s National Student Program works with chapters across the country to organize and lead a Global Health Week of Action (GHWA). The GHWA is an opportunity to educate your campus about global health and encourage your colleagues to act on their new knowledge to make a difference.

Check out the new GHWA Toolkit for more information.

This year we’re encouraging chapters to focus their GHWA on the global health workforce crisis and the 2010 Global HEALTH Act, which will be introduced soon in the House of Representatives. You can raise awareness about the need for more health workers and better health systems in developing countries, and then take steps to address that need.

The first step: set your Global Health Week of Action date. Because April 7, 2010, is World Health Day, April 4-10 is the official week of action date. If you need to move the date because of spring break or campus calendars, go for it – just try to stay within 2-3 weeks of this date.

Please refer to the GHWA Toolkit to find resources for planning a successful week of events! The Toolkit includes an Issue and Action Guide, ideas for great events, suggestions on how to fundraise and publicize, and resources to share with your community.

We hope these resources – along with your creativity, energy, and education and advocacy skills – will help ensure that your GHWA has real impact.

Want more support? That’s what we’re here for. Email Hope O’Brien anytime at hobrien[at]phrusa[dot]org.