Category Archive for 'torture'

“Wisdom, compassion, and courage are the three universally recognized moral qualities of men.” – Confucius

The PHR National Student Program would like to recognize the wisdom, compassion and courage of Mount Sinai medical students Hana Akselrod, Cedric Bien, Brendan Milliner , Matthew Spinelli, Uma Tadepalli, and Jamie Zimmerman. Based on their collaborative work, Hana, Brendan, and Jaime recently published “Restoring Our Professional Integrity: Perspectives on Torture from U.S. Medical Students,” in The Lancet Student. The authors condemn the torture violations by American physicians and offer a very compelling argument for upholding the Hippocratic tradition and respecting the universality of human rights:

“Physician-assisted torture is so egregious a violation of medical ethics, that it justifies a definitive response. As medical students and young physicians, we are compelled by beneficence and pride in our chosen profession to help end this shameful practice for good. We hope that other states in our country will follow New York’s example with their own laws and measures, and that we will see medical educators rise to the occasion, by placing a greater emphasis on professional ethics and human rights.”

Hana, Brendan and Jamie are members of the New York Medical Student Coalition Against Torture (NYCAT) and wrote the article on behalf of this group of concerned doctors, psychologists, lawyers, students and citizens. The Coalition has mobilized medical professionals and fellow students across New York State to support the Gottfried-Duane Anti-Torture Bill (S. 4495-A/A. 6665-B), introduced into the New York State Assembly and State Senate in February 2010. This bill is an innovative law proposed in New York that seeks to hold medical professionals accountable for enabling torture and to ease pressure on doctors working in dual-loyalty situations to assist in torture. If passed, it would be the first law of its kind in the nation.

According to Hana Akselrod, publishing the article was a rather straight-forward process. The three co-writers originally envisioned that the article would be posted online as a professional blog post for the Lancet Student blog and/or the American Medical Student Association (AMSA) Global Pulse Journal blog. However, upon submitting the blog post, the Lancet staff liked it so much they requested that Hana, Brendan and Jamie refine it according to professional publication standards. Hana explains that while this made it a much lengthier process, it also became a much more rewarding one as well. The article was published approximately six months after writing the original blog draft; however, as an official publication, it carries extra weight (both recognition and respect) within the greater medical community. Additionally, Hana underscores the very real value in the collaborative process in which she and Brendan and Jamie engaged – especially learning how to properly reference one’s work.

Medical students have a unique voice and there is pressing need for more students to articulate their opinions in formal publications such as the Lancet Student. As Hana, Brendan and Jamie can attest, engaging in professional blogging is a great way to get started.

Please join PHR in congratulating these students and their fellow Coalition members on this impressive accomplishment. They are, without question, compassionate and wise students who have courageously raised their voices and mobilized their peers to advocate for respecting the greater good – that of human rights.

Mount Sinai has been doing other noteworthy things as well. They launched a Human Rights Clinic for asylum seekers and refugees. The clinic has trained over 120 students, including 60 students involved in clinical sessions and affidavit writing. They recently began an elective –Health, Human Rights, and Advocacy” – inspired by the 2010 PHR National Student Conference, Health and Human Rights Education. You can see more of their work on their Chapter website. This blog contains information about the events that they’ve hosted, as well as a page for our new student elective. The student elective page has a discussion board as well as links to readings for each session.

Having engaged, supportive faculty has been key for the Chapter. As director of Mount Sinai’s Human Rights Clinic, Dr. Ramin Asgary has ensured opportunities for students to translate what they learn in the classroom into clinical practice, to the benefit of asylum seekers in the New York City area. Dr. Holly Atkinson, former PHR Board member and advisor to the Mount Sinai chapter, has nurtured in her students a passion for pursuing their professional roles within a health and human rights framework, and she serves as an exceptional resource for students. Both Dr. Asgary and Dr. Atkinson were at the 2010 Conference, and will speak at the 2011 Conference this Saturday. The students of Mount Sinai will present at the Conference as well, to give other students a sense of how they’ve been able to accomplish such remarkable achievements – even as busy med school students.

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.

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The New York Coalition Against Torture (NYCAT) — a group of concerned doctors, psychologists, lawyers, students and citizens — was formed in response to the shocking human rights abuses and gross violations of health professional ethics that have taken place during the “war on terror.” The well-documented participation of doctors, psychologists and other health care professionals in the torture, abuse and interrogation of prisoners in US custody raises serious concerns about the integrity and the future of health care professions in this country.

Working in conjunction with the Center for Constitutional RightsThe Bellevue/NYU Program for Survivors of Torture, and Physicians for Human Rights, NYCAT has been at the forefront of education and advocacy efforts intended to address this issue at the state level.  One of the group’s primary goals is to see the passage of the Gottfried-Duane Anti-Torture Bill (S. 4495-A /A. 6665-B), which is pending in the New York State Legislature. This bill is the first of its kind in the nation and explicitly addresses the role of health professionals in the abusive treatment of prisoners.

The bill explicitly states that NY-licensed health professionals’ duty to do no harm applies to their relationships with all patients and employers, and affirms that they are prohibited from any involvement in torture or other abuse of prisoners. This can be a way to help health professionals resist unlawful instructions that may expose them to risk of criminal prosecution and civil damages lawsuits.

As future doctors, we are committed to restoring trust in our profession and respect for the rule of law. We look forward to garnering additional support for the bill and to raising awareness about this critical ethical and human rights issue,” says Hana Akselrod, medical student and member of PHR’s active student chapter at Mt. Sinai School of Medicine

Today, NYCAT and interested medical students will go to Albany to meet with legislators to advocate for the Gottfried-Duane Anti-Torture Bill. They have been gathering signatures for the petition to demonstrate widespread support for the legislation, including at the PHR National Conference in February, and will present the petition today.

Show your support by sign the petition now.

Note: There is a file embedded within this post, please visit this post to download the file.

Physicians for Human Rights, Amnesty International, and the International Campaign for Human Rights in Iran sent a letter to Iranian authorities on November 25 to ask for a full, transparent and independent investigation into the suspicious death of Dr. Ramin Pourandarjani, a physician who had examined prisoners wounded and killed during the 2009 Iranian election protests. Dr. Pourandarjani, 26, reportedly died of a heart attack in his sleep at police headquarters in Tehran on November 10.

The letter states:

We strongly urge that this investigation be thorough, impartial and independent and we also urge you to ensure that internationally respected forensic experts be invited to assist in such investigations. We respectfully draw to your notice that experienced forensic specialists from Physicians for Human Rights, would be willing to assist in the investigation.

Dr Pourandarjani graduated with distinction from the University of Tabriz and was doing his two-year national service at the Kahrizak detention center in Tehran during the June 2009 protests.

Many protestors were held in Kahrizak where they were allegedly tortured and ill treated. At least three detainees reportedly died of their injuries, including Mohsen Ruholamini, the son of a senior conservative politician. Following his death, Iran’s supreme leader, Ayatollah Ali Khamenei, ordered the closure of Karhizak. Although Iranian authorities have promised to investigate the ill treatment of detainees at Kahrizak, no prosecutions have yet been announced.

The Washington Post reported on November 18:

A parliamentary committee plans to issue a report soon on the Kahrizak prison, the state-run Islamic Republic News Agency said. The makeshift detention center was closed in July on the orders of Iran’s supreme leader, Ayatollah Ali Khamenei, because of substandard conditions.

The prison became the focus of a rare investigation into police conduct after the death of Mohsen Rouholamini, the son of a former senior Health Ministry official. Authorities said he and two others died of meningitis, but Rouholamini’s father said his son was tortured to death.

Former presidential candidate Mehdi Karroubi, a Shiite cleric, publicly accused security forces in August of having tortured and raped detainees in Kahrizak, an allegation that government officials denied. In a raid on Karroubi’s office in September, security forces confiscated witness reports, names and addresses.

Dr. Pourandarjani had reportedly examined Mr. Ruholamini two days before he died. The doctor reportedly stated to Iranian MPs: “He was brought to me after being physically and severely tortured. He was in a grave physical condition and I had limited medical supplies, but I did my best to save him. It was then that I was threatened by the authorities of Kahrizak that if I disclose the cause of death and injuries of the detainees, I will cease to live.”

Defending colleagues at risk is at the core of PHR’s work. Physicians for Human Rights was founded in 1986 after Dr. Jonathan Fine and a group of US physicians visited Chile to advocate for the release of imprisoned health professionals. Since then, PHR has rigorously defended health professional colleagues and pressured governments for their release, supplementing secondary material with firsthand research and investigation.

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PHR News Updates

Check out the latest news from Physicians for Human Rights:

Visit PHR’s Health Rights Advocate blog and the PHR Press Room for more recent health and human rights-related news updates. You can also set up a Kaiser Health News personal RSS account to regularly receive major health care news stories.

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PHR News Updates

Check out the latest news from Physicians for Human Rights:

Also, you can set up a Kaiser Health News personal RSS account to regularly receive major health care news stories.

Washington Director, John Bradshaw, was recently interviewed by PressTV about PHR’s new report, Aiding Torture: Health Professionals’ Ethics and Human Rights Violations Demonstrated in the May 2004 CIA Inspector General’s Report.

A team of PHR doctors authored the white paper, which details how the CIA relied on medical expertise to rationalize and carry out abusive and unlawful interrogations. It also refers to aggregate collection of data on detainees’ reaction to interrogation methods. Physicians for Human Rights is concerned that this data collection and analysis may amount to human experimentation and calls for more investigation on this point. If confirmed, the development of a research protocol to assess and refine the use of the waterboard or other techniques would likely constitute a new, previously unknown category of ethical violations committed by CIA physicians and psychologists.

Avatar Image

PHR News Updates

Check out the latest news from Physicians for Human Rights:

A team of PHR doctors authored the new white paper, “Aiding Torture: Health Professionals’ Ethics and Human Rights Violations Demonstrated in the May 2004 Inspector General’s Report.”

Note: There is a file embedded within this post, please visit this post to download the file.

The report details how the CIA relied on medical expertise to rationalize and carry out abusive and unlawful interrogations. It also refers to aggregate collection of data on detainees’ reaction to interrogation methods. PHR is concerned that this data collection and analysis may amount to human experimentation and calls for more investigation on this point. If confirmed, the development of a research protocol to assess and refine the use of the waterboard or other techniques would likely constitute a new, previously unknown category of ethical violations committed by CIA physicians and psychologists.

In a statement today, Scott Allen, MD, PHR’s Medical Advsisor and lead author of the report, said:

Medical doctors and psychologists colluded with the CIA to keep observational records about waterboarding, which approaches unethical and unlawful human experimentation. Interrogators would place a cloth over a detainee’s face to block breathing and induce feelings of fear, helplessness, and a loss of control. A doctor would stand by to monitor and calibrate this physically and psychologically harmful act, which amounts to torture. It is profoundly unsettling to learn of the central role of health professionals in laying a foundation for US government lawyers to rationalize the CIA’s illegal torture program.


Steven Reisner, PhD, PHR’s Psychological Ethics Advisor and report co-author, said:

The required presence of health professionals did not make interrogation methods safer, but sanitized their use, escalated abuse, and placed doctors and psychologists in the untenable position of calibrating harm rather than serving as protectors and healers. The fact that psychologists went beyond monitoring, and actually designed and implemented these abuses — while simultaneously serving as ’safety monitors’ — reveals the ethical bankruptcy of the entire program.

The Inspector General’s report documents some practices — previously unknown or unconfirmed — that were used to bring about excruciating pain, terror, humiliation, and shame for months on end. These practices included:

  • Mock executions;
  • Brandishing guns and power drills;
  • Threats to sexually assault family members and murder children;
  • “Walling” — repeatedly slamming an unresponsive detainee’s head against a cell wall; and
  • Confinement in a box.

Co-author and PHR Senior Medical Advisor Vincent Iacopino, MD, PhD, said:

These unlawful, unethical, and ineffective interrogation tactics cause significant bodily and mental harm. The CIA Inspector General’s report confirms that torture escalates in severity and torturers frequently go beyond approved techniques.

Co-author Allen Keller, MD, Director of the Bellevue/NYU Program for Survivors of Torture, said:

That health professionals who swear to oaths of healing so abused the sacred trust society places in us by instigating, legitimizing and participating in torture, is an abomination. Health professionals who aided torture must be held accountable by professional associations, by state licensing boards, and by society.  Accountability is essential to maintain trust in our professions and to end torture, which scars bodies and minds, leaving survivors to endure debilitating injuries, humiliating memories and haunting nightmares.

PHR has called for full investigation and remedies, including accountability for war crimes, and reparation, such as compensation, medical care and psycho-social services. PHR also calls for health professionals who have violated ethical standards or the law to be held accountable through criminal prosecution, loss of license and loss of professional society membership where appropriate.

Being involved in the Physicians for Human Rights Student Program was one of the most rewarding and career-shaping experiences of medical school. I chose to study medicine because of a desire to improve access to and systems of care for the most vulnerable populations around the world. However, typical medical education does little to prepare students for such a career, which requires an understanding of human rights, policy-making, and advocacy. PHR, however, connected me and other students with the leading experts in the field of health and human rights, providing us with training and engaging us in crucial advocacy activities.

In 2003, we started a student chapter at Emory University. That year, PHR connected us with internationally renowned advocates and clinicians in the field of aiding survivors of torture. Through their training, and with guidance from PHR’s student coordinator and Asylum Network coordinator, we were able to start the Atlanta Asylum Network (AAN) for Torture Survivors, within the Emory Institute of Human Rights. The AAN is an entirely student-run, volunteer organization that trains and coordinates health professional to provide expert medical and psychological testimony for survivors of torture seeking political asylum. Working with these survivors has given me tremendous appreciation for the strength and passion of political activists and others who have suffered through torture. My experiences with these inspiring survivers of such egregious human rights violations have reinforced my dream of working in the field of health and human rights. PHR’s ongoing support and guidance has provided me with the mentorship and skills I needed to realize this dream.

Thanks to PHR’s training and support, I have not only worked with survivors of torture in Atlanta, but I was also well prepared to conduct research on the health issues and human rights conditions of child soldiers in Nepal, many of whom have witnessed or suffered torture. I went on to get a PhD in medical anthropology, studying the effects of political violence and other human rights violations on the mental health of conflict survivors in Nepal.

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Brandon Kohrt discussing human rights violations and community rebuilding projects with leaders Hari Bahadur Sijuwal and Puru Regmi in Dhading, Nepal.

Now in a psychiatry residency program, I am combining my interests in human rights, global health, and clinical mental health care to work with others developing a community-based mental health program in Atlanta for refugees, asylees, and other immigrants, many of whom are survivors of political violence. It was only through the support and guidance of PHR that such work was made possible. And, through the Student Program, I not only have the mentorship of PHR members to guide me in this work, but I also have a national network of other students and young human rights professionals with whom to collaborate and discuss novel ways to improve health and protect human rights around the world.

Brandon Kohrt, MD, PhD, is a resident at Emory University School of Medicine, Department of Psychiatry, in Atlanta, GA.