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Archive for the ‘Violence and Public Health’ Category

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 Michelle Leon

Although many may argue that women’s rights have made significant improvements and has led to a more equal society, I think people often ignore populations across the globe that are still behind in women equality. And when specifically looking at populations at risk for HIV, women are at higher risk than men. And I think the most important factor for women’s HIV risk across the globe is women subordination to men that is still seen today. And it doesn’t just occur when contracting HIV but subordination also affects women’s chance to treat HIV.

I came across a NY Times article speaking about a new vaginal ring that will reduce HIV rates in African Women. According to Denise Grady, this new vaginal ring slowly releases an antiviral drug (dapivirine) thus protecting women from HIV sexual transmission 1. Studies on African women and this vaginal ring resulted in a 27% reduction in infection rates 1. The ring can stay in the vagina for a month and it is cheap. But while I read these results I could only help but wonder why such a device is needed. In the United States, contraceptives and condoms are so prevalent and accessible that I couldn’t understand why such a device was necessary. And then I thought… women in parts of the world don’t have access to contraceptives and can’t protect themselves from sexual transmission of HIV.

Of the 37 million people who are infected with HIV, half of them are women, and most are from the sub-Saharan region of Africa 1. The reason this vaginal ring is important is because men don’t have to find out that women are using it. With this ring, women do not need to ask for permission or ask their partners to wear a condom and even when men deny women the ability to take contraceptive pills, the ring helps protect them from HIV transmission. Additionally, once placed inside, neither she nor her partner will feel it, preventing the possibility it might disturb the sexual experience 1. But such a ring would be irrelevant in a world where women were equal to men in various aspects of life. But the reality is that, women suppression is still common today and I think it is the driving force for why women are at higher risk for HIV. There are various reasons why women subordination leads to higher rates of HIV infection and decreases their rates of survival for those living with the disease.

First off, marital violence and gender-based violence prevent women from protecting themselves from sexual transmission 2. In a study conducted in South Africa, women who experienced partner violence were 50% more likely to get infected with HIV than those who do not experience such violence 3. Secondly, women in countries with high rates of HIV (e.g. sub-Sahara Africa) have less access to healthcare services or have none 2. Lack of access to sexual health services indicates that women have less ability to look out for their health and even when women have access to some services, stigma against women can result in refusal. Consequently, when pregnant, women infected with HIV may not receive the appropriate care to reduce transmission to her child. And lastly, girls’ lack of access to education also drives their higher rates of HIV infection. According to UN’s 2004 publication on women and HIV/AIDS, one study of 32 countries found that women who had some secondary education were five times more likely than illiterate women to have knowledge of HIV 4. Additionally, illiterate women were four times more likely to believe that HIV could not be prevented.

So as you can tell by now, most of these factors that increase women’s risk for HIV infection, are intertwined with women suppression. And I think that is what needs to be addressed and be top priority in developing countries and regions of the world that continue to have high rates of HIV. Women suppression needs to be dealt with through education and spread of knowledge. Women in countries known to have women subordination need better HIV testing, better antiretroviral treatment for pregnant women, better school-based interventions to reduce stigma against women and help change cultural norms about the role of women.

 

 

 

References

 

1 Grady, D. (2016, February 22). Vaginal Ring With Drug Lowers H.I.V. Rates in African Women. Retrieved February 26, 2016, from http://www.nytimes.com/2016/02/23/health/vaginal-ring-hiv-aids-drug-dapivirine.html

 

2 Women and HIV/AIDS | AVERT. (n.d.). Retrieved February 26, 2016, from http://www.avert.org/professionals/hiv-social-issues/key-affected-populations/women

 

3 Jewkes, R. et al (2010) ‘Intimate partner violence, relationship power inequity, and incidence of HIV infection in young women in South Africa: a cohort study‘ The Lancet 376(9734):41-48

 

4 United Nations Population Fund (UNFPA) (2004) ‘Women and HIV/AIDS: Confronting the Crisis

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-By Isabel Park

In this post, allow me to take you to Guatemala.

From the remains of Mayan civilization to beautiful European buildings laden with luscious Central American botanics, the streets of Guatemala flow with riches of culture and history. But these very same streets are where many girls and women are stripped off of their future and their fundamental human rights. (more…)

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-By Nina Misra

In mid-December 2013, violence erupted in South Sudan, the world’s youngest country. The president, Salva Kiir, accused his former vice-president Riek Machar of planning to upstage the presidency. Kiir had eleven people associated with this planned coup arrested. Fighting first started in the capital, Juba, amongst Presidential guards. This conflict between Kiir and Machar turned into a war between ethnic groups. Kiir is somewhat followed by the Dinka people, while Machar is fully supported by the Nuer.  Machar says that “the conflict is not yet over”, and refuses to stop fighting until the eleven politicians are released from detention.  Machar says, “these are events of war”- events that include “extrajudicial killings, sexual violence, and massacres committed by both sides”. The death toll is unknown, and the violence unspeakable. The effects of the fighting are felt by all the citizens of South Sudan, even those who are not directly in the line of fire.  (more…)

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Gathers_Syria after

By Erin M. Gathers

As the crisis in Syria builds, images of the destruction and carnage continuously flood news sources. Telling as these pictures may be, they capture but one moment. They are stagnant, and it is the viewer’s responsibility to carry the story forward, we are the ones who must inquire: “What happens next? Where do these wounded civilians go?” (more…)

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By Janina Colavita

In 2010, the Department of Justice estimated that 25 percent of college women “will be victims of rape or attempted rape before they graduate a four-year college period,” and also that schools with more that 6,000 students “average one rape per day during the school year.” According to New York University’s “National Statistics about Sexual Violence on College Campuses,” fewer than 5 percent of such cases are reported to law enforcement. [1] (more…)

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By Lisa Anammah

The Democratic Republic of Congo has been labeled as the worst place on earth to be born a woman. Each day women in the Congo live with the constant fear of being victims of brutal and often sexual assaulted. This fear is propounded by the fact that being a married woman, teenage girl or even an infant child doesn’t provide security from victimization. The plight of these women is so great that experiencing rape just once in a lifetime is considered as ‘lucky’. (more…)

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