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Archive for the ‘Health and Human Rights’ Category

By Anjali Oberoi

A man on the Madrid Metro with a toddler on his lap shifted, listening to the unfamiliar dialect as I recounted the events of my week to my mom over the phone in whispered Hindi. When the train entered the station, he shot me a glare before standing up to leave. As he rushed past me he pulled his toddler tightly closer to his chest. I don’t look like a Spaniard.

His marked disapproval reflects a shift throughout Europe as humanitarian crisis sweeps the continent. The world currently faces the largest refugee crisis since World War II, as conflicts around the globe continue and worsen1. (more…)

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By Dominique Baker

Have you ever had the unpleasant experience to walk past a landfill? The noxious fumes can really knock you off your feet. For most of us, trash is a nuisance but once it is out of sight, it is out of mind. In Lebanon’s capital, Beirut, trash is becoming a real problem.

In the middle of a war torn region, Lebanon provides shelter to about 1.8 million refugees, almost equal to half of the country’s current population. According to the United Nations, Lebanon has “the highest per capita concentration of refugees worldwide”. With the influx of refugees comes an increased strain on the country’s waste management system. CNN calls it a “stinking river of trash” which extends from the site of an old landfill through the city’s suburbs.

It not only smells awful but is toxic especially to the already crowded areas where refugees reside. Public health officials cite multiple concerns over the growing heap. The biodegradation of uncontained waste is extremely dangerous; it poisons the air giving rise to various respiratory diseases and contaminates sources of drinking water. Doctors fear the spread of typhoid, cholera, jaundice, dysentery and diarrhea with cholera being a primary concern. According to a UNICEF report, the cholera outbreak in Iraq has spread to Syria and other Gulf countries as Shiite pilgrims return home and the fear is that a case will reach Lebanon in time for the rainy season.

According to Basel al Yousfi, director of WHO’s Center for Environmental Health Activities, the piles also present fantastic breeding sites for all kinds of vectors of disease. Some of the vectors include mosquitoes, flies, and mice all of which are capable of spreading disease. In trash ridden areas of nearby Syria, Leishmaniasis is becoming an increasingly serious health concern. Leishmaniasis is a parasitic disease that can cause a leprosy-like lesion when it appears in it’s cutaneous form. This opens the door to more opportunistic infections in an already unsanitary and overcrowded environment.

In response to the growing heaps, citizens and refugees in Beirut have started a protest with the moniker “#You Stink”. They hold the government accountable for its inability to provide proper waste disposal, something that is very basic to the health of the capital city.

The issue with waste disposal in Beirut is a graphic display of the crucial role that the government plays in public health. In other cases, the role of government is not so clearly defined as is the case of the government in Beirut. Universal healthcare is a reality considered to be the responsibility of the government in some states but in other countries it is not considered a prerogative. It is interesting to contemplate where this line is drawn and what citizens can demand of their government in the interest of health.

In the case of Beirut, officials are looking for alternative landfill sites and have even contemplated sending the trash to Russia. I would argue that they should also look into providing relocation of refugees to areas outside of the capital area in order to decrease their contribution to the waste as well as addressing the problem of overcrowding, which is straining the systems currently in place. The goal of public health is to achieve the greatest good for the greatest number. Beirut is sheltering millions of refugees from the hostilities of war but it is also exposing them as well as inhabitants of Beirut to deadly diseases. My question is: Would it be more compassionate to welcome excessive amounts of refugees into the country or maintain the health of the nation? I would argue for the health of the nation but what do you think?

 

Works Cited

 

Buchanan, Elsa. “Lebanon: Doctors Warn of Spread of Cholera in Refugee Camps as Rubbish Crisis Intensifies.” International Business Times RSS. N.p., 15 Sept. 2015. Web. 26 Feb. 2016.

 

Conlon, Kevin, Raja Razed, and Tamara Qiblawi. “Army Deployed to Beirut after Street Protests.” CNN. Cable News Network, 30 Aug. 2015. Web. 26 Feb. 2016.

 

Hume, Tim, and Mohammed Tawfeeq. “Lebanon: River of Trash Chokes Beirut Suburb.” CNN. Cable News Network, 25 Feb. 2016. Web. 26 Feb. 2016.

 

Kaprealian, Avo. “Clearing Rubbish in Syria: A Life-saving – and Life-threatening – Job.” IRIN. N.p., 01 July 2013. Web. 26 Feb. 2016.

 

Kechichian, Jospech. “Cholera Emerges as New Health Concern in Lebanon.” Cholera Emerges as New Health Concern in Lebanon. Gulf News, 6 Dec. 2015. Web. 26 Feb. 2016.

 

“Parasites- Leishmaniasis.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 10 Jan. 2013. Web. 26 Feb. 2016.

 

Sarhan, Afif. “Garbage Accumulation Causes Health Problems.” IRIN. N.p., 07 Aug. 2006. Web. 26 Feb. 2016.

 

Stel, Nora, and Rola El-Husseini. “Lebanon’s Massive Garbage Crisis Isn’t Its First. Here’s What That Teaches Us.” Washington Post. The Washington Post, 18 Sept. 2015. Web. 26 Feb. 2016.

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By Devika Nadkarni

On October 3rd, 2015, a Médecins Sans Frontières’ (MSF) Trauma center was bombed during an airstrike in Kunduz, Afghanistan (1). Ten patients and twelve staff members were killed at the facility – the only medical center operating in north-east Afghanistan that treated all people in need of trauma care regardless of political affiliation and ethnicity. MSF mobilized and launched a campaign for an independent investigation of the attacks that overtly thwarted the Geneva Conventions set forth to protect civilians and prisoners of war in regions of conflict. The organization drew attention to the patients that burned in their beds in the hospital, to the medical personnel that were forced to operate on their colleagues, to the MSF staff that had to carry on with their work while their team members died. They demanded nothing less than a transparent investigation without involvement from NATO, nor from Afghan and US forces to find an answer for their losses. The tragedy faced by MSF in Afghanistan shows the worst possible outcome of military intervention interfering in global health initiatives and emergency medical care (1).

The United Nations Security Council uses “humanitarian intervention” as a legitimate justification for armed intervention. The use of foreign military force (including unilateral state troops deployed on behalf of the United Nations) in conflict areas has had mixed effects on medical humanitarian initiatives – ranging from improvement to severe exacerbation of an already dire situation. In 2002, British troops were able to facilitate an end to the civil war in Sierra Leone – eventually allowing for elections to be held in the long divided nation. However, for every Sierra Leone there are countless genocides and civil wars where allegedly humanitarian troops encouraged and supported the perpetrators of violence (2). In his book, An Imperfect Offering, former MSF president Dr. James Orbinski highlights in excruciating and consuming detail instances of this occurring in Rwanda, Cambodia, and Kosovo, among many others (3). A telling excerpt from the book, detailing intervention by French forces in the Rwandan genocide in 1994, reads as follows:

“Some French officers were so disgusted by what their force was doing and not doing that they saw themselves as accomplices to a genocide that they had been told did not exist.”

France had provided arms and military training to the Hutu-led Interhamwe – the perpetrators of the genocide. Medical personnel from MSF and the Red Cross, among aid workers from other non-governmental organizations, witnessed the Interhamwe systematically slaughter 800,000 Tutsis and the mutilation of countless others – all of whom required medical treatment by increasingly small medical teams. When French troops were deployed to establish a safe zone – the Turquoise Zone – to end the genocide, they established a means of escape from justice for the Interhamwe and their supporters (3). It is clear that veiling armed force as humanitarian intervention can not only further war crimes and conflict fueled by states seeking out their own interests, but also hurt and overburden humanitarian operations that are already stretched to their limits. The purpose of the military is to put the interests of the state first – a purpose that in times of war can directly conflict with the purpose of humanitarianism – which is to put the basic needs and safety of people first. This difference in purpose is why unilateral military interventions are not humanitarian. It is time that states and inter-governmental organizations – including and especially the United Nations Security Council – stopped allowing states to use armed force under the guise of humanitarianism.

Following the outcry raised by MSF, the United States admitted to the airstrike in Kunduz – dismissing it as collateral damage before attempting to write it off as the responsibility of the Afghan government. MSF no longer operates the hospital in Kunduz, at a time when “the medical needs are immense”. The relationship between humanitarian agencies and the military forces is a complicated one (1). Indeed, the efforts of military forces have also had incredibly positive impacts on certain global health initiatives – most notably during the Ebola crisis, where the intense training of United States’ and British military personnel to withstand extreme conditions and in logistical command was essential to streamlining efforts to tackle the crisis (4). However, even in cases such as these it must be noted that while the military may provide for support existing humanitarian efforts, military interventions themselves are not humanitarian.

 

Works Cited

  1. “Kunduz Hospital Airstrike Share.” Médecins Sans Frontières. Médecins Sans Frontières, 05 Nov. 2015. Web. 22 Feb. 2016.
  2. “Intervention That Worked.” The Economist. The Economist Newspaper, 2002. Web. 22 Feb. 2016.
  3. Orbinski, James. An Imperfect Offering: Humanitarian Action for the Twenty-first Century. New York: Walker, 2008. Print.
  4. Lancet, The. “National Armies for Global Health?” The Lancet 384.9953 (2014): 1477. Web.

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By Aarthi Chezian

Over 117 million girls are missing in the world today, lost to femicide, the murder of women simply because they are women. [1] These 117 million girls do not exist because of cultural systems that deem them as worthless or unnecessary burdens. Every minute, four baby girls are lost to sex-selective abortion and female infanticide [2]—that’s 2.1 million girls who never had a chance to live just because they made the mistake of being female. Of these 117 million girls, 43 million are from India. [3] In India, the state of Tamil Nadu was a surprising addition to the list of areas where female infanticide drastically affected the sex ratio. Tamil Nadu, like most other South Indian states, is considered one of the better states in regard to women’s rights and social support. However, researchers found a 4% decline in the sex ratio over only two decades. [4] Why were girls in a relatively progressive part of the country disappearing?

It’s A Girl

A major motivation behind sex-selective abortion and female infanticide in Tamil Nadu is the cost of raising a daughter. Culturally, daughters come with a price tag that many families either cannot afford or would prefer not to waste on a child that was meant to leave and marry into another family. However, sons are culturally viewed as the inheritors of the family’s assets, the ones who take care of the family as the parents age, and continue the lineage. Historically, this created a culture that encouraged the devaluation of women. The pattern of skewed sex ratios began to show in the 1980s due to the neglect of female children through malnutrition, lower quality of care, and restricted access to healthcare. This grew into infanticide and, with the appearance of sex-determining technology, foeticide, over the next two decades. [5]

Soon after the Forum against Sex Determination and Sex Pre-selection (FASDSP) began in Mumbai, researchers discovered reports of female infanticide at levels that affected sex ratios at the taluk, or county, level in the rural districts of Madurai, Salem, and Dharmapuri in Tamil Nadu. [1] They found that the killing of newborn baby girls was concentrated in the low-caste Kallar communities and the high-caste Gounder communities. One community could not bear the cost of a female child and the other did not want the burden or expense of raising a daughter within upper caste restrictions. As the Tamil Nadu government began to notice these increasing trends of female infanticide; they created the Pre-Natal Diagnostic Techniques (Prohibition of Sex Selection) (PNDT) Act of 1994, which became the PC (Pre-Conception)-PNDT (Regulation and Prevention of Misuse) Act of 2003. [1] The legislation made sex-determination and subsequent abortion illegal and made both the physicians and the family liable. Unfortunately, it was not effective, and sex-determination tests are still performed just with more secrecy and at a higher price.

Tamil Nadu also instituted two programs to address the crisis: the Girl Child Protection Scheme and the Arasu Thotil, or Cradle Baby program, in 1992. The Girl Child Protection Scheme involved placing Rs 100 into a state fund for every baby girl enrolled into the program, and, as the child grows and attends school, more money would be added to the fund. At 21, if the girl remains unmarried, she would receive Rs 20,000. [1] In theory, this program sounds incredible. It relieves parents of the financial burden they fear, facilitates higher education for women, and discourages child marriage. However, the participation in the program came with restrictions: in order to qualify one must have no sons, be sterilized, and must fall below the poverty line. [1] Not the easiest criteria to fill, nor the most appealing incentives. It also failed to address the loss of female children from wealthier communities.

Arasu Thotil allows parents to leave unwanted children in empty cradles located in hospitals, welfare centers, and government offices. The children are then sent to orphanages where other families can adopt them. This program provided a home and a life to the newborn baby girls being left to die abandoned in the streets and in trashcans. Yet, data has shown that while there is an increase in female children being taken up by the program, the killings are continuing. In a way, the program has legitimized the abandonment of female children. [6] The problem with both programs is that neither attacks the root of the problem. The primary cause of female infanticide and foeticide in Tamil Nadu is the culture that perpetuates the devaluation of women. Government initiatives should be tackling how to redefine women’s value in Tamil society. If women are no longer viewed as burdens, they will be treated with the humanity they deserve.

 

References:

 

  1. “Gender-biased Sex Selection.” United Nations Population Fund. UNFPA, 31 July 2015. 8-21 <http://www.unfpa.org/gender-biased-sex-selection&gt;.
  2. Bare Branches, pp. 112-113, 157.
  3. Christophe Z. Guilmoto, Sex Imbalances at Birth: Current trends, consequences, and policy implications; UNFPA Asia and Pacific Regional Office, 2012, p. 47
  4. John, Mary. “Sex Ratios and Gender Biased Sex Selection: History, Debates, and Future Directions.” UN Women. <http://asiapacific.unfpa.org/sites/asiapacific/files/pub-pdf/Sex-Ratios-and-Gender-Biased-Sex-Selection.pdf&gt;.
  5. Srinivasen, Sharada. (2012) Daughter De cit: Sex Selection in Tamil Nadu. New Delhi: Women Unlimited.
  6. Ball, Nita. “India’s Cradle Baby Scheme Hopes to End Female Infanticide.” Reuters. Thomson Reuters, 03 Dec. 2013. <http://www.reuters.com/article/us-india-cradlebabies-idUSBRE9B206P20131203&gt;.

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By Madeleine Kelly

The hot topic at every girl’s sleepover in high school; how many kids their going to have, at what age their going to have them, and what their names are going to be. Unfortunately family planning turns out much better in your imagination than it does in real life.  The fight for access to sexual education and contraceptives makes it hard for women to control their bodies and lives. Living in a developed country we are lucky to have the minimal access that we have. Unfortunately those living in still developing countries are not as lucky.

In 2012, the United Nations declared access to contraception a “universal human right.” This was quite a step in allowing women to take control of their bodies. This declaration is by no means a law, it stands with no legal emphasis, but it opens doors to future legal movements towards much needed help. As of 2015 it was found that only 40% of married or in union women of childbearing age in developing countries were using some form of contraceptive (Department of Economic and Social Affairs, 1). Keep in mind this only pertains to the percent of society married or in union. Family Planning is so vital to this century, with our high abortion and unsafe abortion rates, infant mortality rates, skyrocketing fertility rates coinciding with the poverty levels in underdeveloped (and developed) countries, and economic turmoil for so many countries.

With abortion as controversial as ever, it should not even be considered as a type of contraceptive or family planning. However because of lack of accessibility here we are in 2016 still abusing abortions. An amazing example of how family planning, access and education on contraceptives can impact abortion rates is Europe, which holds both the highest and the lowest incidence rates of abortion. The lowest, 12 per 1,000 women, is in Western Europe, and the highest is in Eastern Europe, with a rate of 43 per 1,000. The difference between the two is that Eastern Europe has low contraceptive use and dependence on outdated methods like the withdrawal and rhythm method (Guttmacher Institute, 1). Countries outside of the US and Europe haven’t been as lucky with family planning.

In developing countries, abortion rates are high, but unsafe abortion rates are even higher. What the World Health Organization is calling, a “preventable pandemic,” unsafe abortions are the result of fear of childbirth but also fear of shame. Defined by the WHO as  “abortions done by individuals without the requisite skills, or in environments below minimum medical standards, or both,” they claim 19-20 million abortions annually (World Health Organization, 1). This is nearly half of the 43 million global abortions that took place in 2008, according to the Guttmacher Institute (1).  They also show that an estimated 68,000 women die annually world wide due to complications from unsafe abortions (1). These are complications that can easily be fixed, with more access to contraceptives and access to legal and available abortions when absolutely necessary.

Another issue with limited access to contraceptives is infant mortality. For those who decide to come to term with pregnancies, despite not being ready emotionally, physically, or financially for a child, put themselves and their newborn in a risky position. As of 2015, the top three countries with the highest infant mortality rates, Afghanistan, Mali, and Somalia, are all developing countries with roughly 10% of their infants dying. There are 36 countries losing more than 5% of their infants, all developing countries (Central Intelligence Agency, 1). These high death rates are correlated with high birth rates, correlated with a lack of control over birth.

The UNFPA goes as far as saying that family planning will boost the economy, stating that for every dollar invested in contraception leads to a reduction in the cost of pregnancy-related care by $1.47 (UNFPA, 1) They also comment on the annual GDP of growing countries, giving the example, “If adolescent girls in Brazil and India were able to wait until their early twenties to have children, the increased economic productivity would equal more than $3.5 billion and $7.7 billion, respectively” (UNFPA, 1).  As you can see, family planning is as important, if not more important in still developing countries than in already developed countries. It is a public health issue that is in desperate need for more attention, with the ability to decrease need for abortion, decrease infant mortality and population problems, and potentially increase economic productivity, family planning needs to be of higher concern to nations with these problem areas.

 

Beadle, Amanda Peterson. “United Nations Declares Access To Contraception A ‘Universal Human Right’.” Center for American Progress Action Fund, 14 Nov. 2012. Web. <http://thinkprogress.org/health/2012/11/14/1189161/un-contraception-human-right/&gt;.

 

“Facts on Induced Abortion Worldwide.” Facts on Induced Abortion Worldwide. Guttmacher Institute, Nov. 2015. Web. 23 Feb. 2016. http://www.guttmacher.org/pubs/fb_IAW.html

 

“Family Planning/Contraception.” World Health Organization, May 2015. Web. <http://www.who.int/mediacentre/factsheets/fs351/en/&gt;.

 

“Family Planning | UNFPA – United Nations Population Fund.” Family Planning | UNFPA – United Nations Population Fund. United Nations Population Fund, 20 Apr. 2015. Web. <http://www.unfpa.org/family-planning#&gt;.

 

“Increased Contraceptive Use Worldwide.” Reproductive Health Matters. Department of Economic and Social Affairs 11.21, Integration of Sexual and Reproductive Health Services: A Health Sector Priority (2003): 198. Web. <http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf&gt;.

 

“The World Fact-book: Country Comparisons: Infant Mortality.” Central Intelligence Agency, 2015. Web. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

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-By Michelle Tagerman

The Patient Protection and Affordable Care Act (ACA), commonly known as ‘Obamacare,’ was recently implemented with the goals of making health insurance coverage more affordable by expanding coverage, controlling the spiraling costs of health care and making health care delivery more efficient (KFF, 2013). To do so, state health exchanges were created where people are able shop for health insurance. In addition, government subsidies to purchase insurance are available for the poor. By lowering the cost of health insurance, the law was aimed at making health care accessible to all uninsured or under-insured American citizens by providing government subsidies. Unfortunately, the act has failed to eliminate several health disparities, (Davis & Walter, 2011) as will be discussed. (more…)

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-By Katherine Storer

Video: 4 Shocking Facts about US Healthcare http://www.youtube.com/watch?v=dqLdFFKvhH4

As someone with a chronic illness the healthcare system is something I’ve had a lot of experience with. Since I was 9 years old I’ve never walked away from a doctor’s appointment feeling anything other than frustration. I was always met with endless hours waiting for late doctors, copious amounts of obscure tests, and never-ending stares of disbelief. I had large co- pays for each useless visit, expensive prescriptions, uncovered tests, and never any answers. I always knew it was a flawed system, but I never quite understood why. (more…)

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