More than 13,500 asylum seekers remain trapped on the Greek islands in deplorable conditions as winter begins on December 21, 2017. Greece, with support from its European Union partners, should urgently transfer thousands of asylum seekers to the Greek mainland and provide them with adequate accommodation and access to fair and efficient asylum procedures.

Author: Human Rights Watch, Human Rights Watch
Posted: January 1, 1970, 12:00 am

(New York) – The latest revisions to China’s Criminal Law impose up to seven years in prison for “spreading rumors” about disasters, Human Rights Watch said today. The revised law, which took effect November 1, 2015, does not clarify what constitutes a “rumor,” heightening concerns that the provision will be used to curtail freedom of speech, particularly on the Internet.

“The revised Criminal Law adds a potent weapon to the Chinese government’s arsenal of punishments against netizens, including those who simply share information that departs from the official version of events,” said Sophie Richardson, China director at Human Rights Watch. “The authorities are once again criminalizing free speech on the Internet, which has been the Chinese people’s only relatively free avenue for expressing themselves.”

The National People’s Congress Standing Committee approved the addition of a provision to article 291(1) of the Criminal Law (Criminal Law Amendment Act (9)), which states that whoever “fabricates or deliberately spreads on media, including on the Internet, false information regarding dangerous situations, the spread of diseases, disasters and police information, and who seriously disturb social order” would face prison sentences – with a maximum of seven years for those whose rumors result in “serious consequences.” The vagueness of the provision means that individuals doing nothing more than asking questions or reposting information online about reported local disasters could be subject to prosecution.

In the past, the Chinese government has detained netizens who questioned official casualty figures or who had published alternative information about disasters ranging from SARS in 2003 to the Tianjin chemical blast in 2015, under the guise of preventing “rumors.”

The revision was made in the context of a wider effort to rein in online freedom since President Xi Jinping came to power in 2013:

  • In August 2013, the authorities waged a campaign against “online rumors” that included warning Internet users against breaching “seven bottom lines” in their Internet postings, taking into custody the well-known online commentator Charles Xue, and closing popular “public accounts” on the social media platform “WeChat” that report and comment on current affairs;
  • In September 2013, the Supreme People’s Court and the Supreme People’s Procuratorate (the state prosecution) issued a judicial interpretation making the crimes of defamation, creating disturbances, illegal business operations, and extortion applicable to expressions in cyberspace. The first netizen who was criminally prosecuted after this took effect was well-known blogger Qin Huohuo, who was sentenced to three years in prison in April 2014 for allegedly defaming the government and celebrities by questioning whether they were corrupt or engaged in other dishonest behavior;
  • In July and August 2014, authorities suspended popular foreign instant messaging services, including KakaoTalk, claiming the service was being used for “distributing terrorism-related information”;
  • In 2015, government agencies such as the State Internet Information Office issued multiple new directives, including tightening restrictions over the use of usernames and avatars, and requiring writers of online literature in particular to register with their real names;
  • In 2015, the government has also shut down or restricted access to Virtual Private Networks (VPNs), which many users depend on to access content blocked to users inside the country and also help shield user privacy;
  • In March 2015, authorities also deployed a new cyber weapon, the “Great Cannon,” to disrupt the services of GreatFire.org, an organization that works to document China’s censorship and facilitate access to information;
  • In July 2015, the government published a draft cybersecurity law that will requires domestic and foreign Internet companies to increase censorship on the government’s behalf, register users’ real names, localize data, and aid government surveillance; and
  • In August 2015, the government announced that it would station police in major Internet companies to more effectively prevent “spreading rumors” online.
     

Activists in China are regularly prosecuted for speech-related “crimes,” Human Rights Watch said. The best known of these crimes is “inciting subversion,” which carries a maximum of 15 years in prison. But authorities have also used other crimes such as “inciting ethnic hatred,” as in the case of human rights lawyer Pu Zhiqiang, who has been detained since May 2014 for a number of social media posts questioning the government’s policies towards Uighurs and Tibetans.

While providing the public with accurate information during disasters is important, the best way to counter inaccurate information would be to ensure that official information is reliable and transparent, Human Rights Watch said.

Above all, journalists should have unimpeded access to investigate and inform the public about these events, and the wider public should have the freedom to debate and discuss disaster response.

“The casualties of China’s new provision would not be limited to journalists, activists and netizens, but the right of ordinary people and the world to know about crucial developments in China,” Richardson said. “The best way to dispel false rumors would be to allow, not curtail, free expression.”

Posted: January 1, 1970, 12:00 am

The Dominican Republic’s total ban on abortion threatens women's health and lives and violates their rights. Abortion is illegal in the Dominican Republic in all circumstances, even when a pregnancy is life-threatening, unviable, or the result of rape. Women and girls facing unwanted pregnancies have clandestine abortions, often at great risk to their health and lives. Many experience health complications from unsafe abortions, and some die. Some women and girls face abuse, neglect, or mistreatment by healthcare providers. The ban does not stop abortion but drives it underground and makes it less safe. As a starting place toward meeting the country’s human rights obligations, Congress should decriminalize abortion in three circumstances, Human Rights Watch said.

Posted: January 1, 1970, 12:00 am

Video

Dominican Republic: What happens when abortion is totally banned?

The Dominican Republic’s total ban on abortion threatens women's health and lives and violates their rights. Abortion is illegal in the Dominican Republic in all circumstances, even when a pregnancy is life-threatening, unviable, or the result of rape. 

(Santo Domingo) – The Dominican Republic’s total ban on abortion threatens women's health and lives and violates their rights, Human Rights Watch said in a report released today. Abortion is illegal in the Dominican Republic in all circumstances, even when a pregnancy is life-threatening, unviable, or the result of rape.

The 78-page report, “‘It’s Your Decision, It’s Your Life’: The Total Criminalization of Abortion in the Dominican Republic,” documents that women and girls facing unwanted pregnancies have clandestine abortions, often at great risk to their health and lives. Many experience health complications from unsafe abortions, and some die. Some women and girls face abuse, neglect, or mistreatment by healthcare providers. The ban does not stop abortion but drives it underground and makes it less safe. As a starting place toward meeting the country’s human rights obligations, Congress should decriminalize abortion in three circumstances.

“Women and girls in the Dominican Republic have always defied the abortion ban, but they have been forced to put their health and lives on the line to end pregnancies clandestinely,” said Margaret Wurth, senior women’s rights researcher at Human Rights Watch and the author of the report. “Congress should decriminalize abortion and ensure that women and girls have access to safe and legal abortion by trained providers, instead of leaving them to use dangerous underground methods.”

Human Rights Watch interviewed 50 women and girls ages 15 to 43, in four provinces, all of whom had been pregnant at least once, and dozens of health and social service providers and other experts.

The country’s criminal code imposes prison sentences of up to two years on women and girls who induce abortions and up to 20 years for medical professionals who provide them. Prosecutions are rare, but the criminal penalties create pervasive fear and harmful stigma. The penalties leave medical providers unable to terminate a pregnancy when it is medically advisable without risking their careers and possible prison time. The ban disproportionately harms women and girls from poor and rural areas, who are less likely to be able to travel to another country where abortion is legal or locate safer clandestine abortion providers.

Research shows that restrictive laws and criminal penalties do not reduce the incidence of abortion. Expert bodies charged with interpreting international human rights law have determined that denying women and girls access to abortion is a form of discrimination that jeopardizes a range of human rights.

Rosa Hernández stands in her home below a photo of her daughter, Rosaura Almonte Hernández, who died in 2012 at age 16. Rosaura, known as “Esperancita,” had leukemia. Doctors initially denied her chemotherapy treatment because she was pregnant, and the Dominican Republic’s abortion ban prohibited her from terminating the pregnancy.

© 2018 Tatiana Fernández Geara for Human Rights Watch
Public Health Ministry data suggests that nearly half the pregnancies in the country are unplanned or unwanted. Many women and girls said they felt “depressed,” “terrified,” “desperate,” or “trapped, with no future,” when they discovered they were pregnant. Some continued unwanted pregnancies, due to personal beliefs or fear of unsafe abortion.

Others tried to end pregnancies, including by taking or inserting pills; using home remedies; trying to induce poor health, for example by denying themselves food or water; taking prescription medications contraindicated during pregnancy; or trying to induce physical trauma. One woman said she beat her belly with a concrete block.

At least 8 percent of the country’s maternal deaths are caused by complications from illegal abortion or miscarriage, according to the Public Health Ministry. “We’ve always recognized that unsafe abortion is an important health problem because women have to appeal to clandestine methods to find an answer to their situation,” said Dr. José Mordán, head of the ministry’s Department of Family Health.

Interview: Defying the Dominican Republic’s Abortion Law

Interview: Defying the Dominican Republic’s Abortion Law

The Dominican Republic is one of the few countries left that bans abortion under all circumstances. This means that women and girls resort to secretly taking pills or herbs and drinking certain teas, all potentially dangerous ways to end unwanted pregnancies. Researcher Margaret Wurth talks to Amy Braunschweiger about what this means for women’s lives.

Complications can include heavy bleeding and infection. The use of misoprostol – a medication used to induce labor and to treat stomach ulcers – for medical abortion has reduced the risk of complications in countries where legal access is restricted. But 25,000 women and girls still seek medical attention for complications related to abortion or miscarriage in the public health system each year.

Some women and girls said they faced negligence, mistreatment, or abusive behavior by health personnel when they sought care for urgent sexual and reproductive health concerns, including being turned away, facing unreasonable delays, and being treated without anesthesia or pain management. Fear of prosecution or abuse by health care professionals led some to delay or go without seeking care following complications from clandestine abortions or during miscarriages.

For over two decades, legislators in the Dominican Republic have debated a new penal code. President Danilo Medina and women’s rights groups have urged lawmakers to decriminalize abortion when the life of the woman or girl is in danger, when the pregnancy resulted from rape or incest, and when the fetus has serious complications incompatible with life outside of the womb. President Medina has twice vetoed revised penal code versions that maintained the total abortion ban, but the National Congress has resisted reform.

Historic votes in Ireland and Argentina in 2018 and a landmark decision to partially decriminalize abortion in Chile in 2017 are just a few examples of global progress toward expanding legal access to abortion. Between 2000 and 2017, 27 countries expanded access to abortion. The Dominican Republic should join the countries affirming that access to abortion is a human right, Human Rights Watch said.

“Congress has an opportunity to enact long-awaited reforms to the Dominican Republic’s penal code and decriminalize abortion, or at least liberalize access,” Wurth said. “Women and girls should not have to wait any longer for the government to guarantee their sexual and reproductive rights.”

Quotes from the report

“I was terrified. I was going crazy, thinking if I can’t even find food for these two babies [I already have], how will I feed a third?”
– “Juliana,” a 16-year-old mother of two, on learning she was pregnant unexpectedly in early 2018. She used home remedies to end the pregnancy but was still experiencing pain and dizziness from complications.

“I started thinking I was not going to survive it…. It was really intense. I suffered a lot.”
– “Melina,” a 26-year-old mother of four young children, on her experience having a clandestine abortion.

“When I went to see her, she had a fever, and she was shaking…. She was afraid to say she had an abortion…. When we went to the doctor, I stayed outside.… I dropped her off and left. And I went back for her. But I didn’t stay because it’s illegal, and I didn’t know if there could be consequences.”
– “Alejandro,” 24, on helping a 28-year-old friend get medical care for complications from an unsafe abortion in 2017.

“It was the first time I had intercourse. I didn’t want to have sex. I didn’t agree. [When I learned I was pregnant,] I was crying and desperate…. A friend gave me a tea, and I had an abortion. …My friend told me to stay at home and endure to the pain. Going to the hospital would mean going to jail.”
Dayelin, 22, describing a clandestine abortion when she became pregnant at age 12 after she was raped by a 25-year-old man.

“Sometimes you have your hands tied. You don’t know what to do. You have the law telling you that you can’t do it [perform an abortion]…. But it doesn’t work like that. The pregnancy can put a woman’s life at risk…My job is to preserve the woman’s life. If I have to violate the law, I will.”
– A doctor in the Dominican Republic.

Posted: January 1, 1970, 12:00 am

Venezuelans wait to vaccinate their children at a post administered by the Pan American Health Organization at the Colombian side of the border with Venezuela. July 28, 2018.

© 2018 Human Rights Watch
(Washington, D.C.) – Venezuela is facing a devastating health crisis whose extent its government continues to deny, Human Rights Watch said in a report published today.

As the crisis continues to spiral out of control, Human Rights Watch researchers traveled to the Colombian and Brazilian borders to assess the extent of the humanitarian crisis Venezuelans are fleeing. Human Rights Watch traveled with a team of public health and medical professionals from John Hopkins University’s Center for Humanitarian Health and its Center for Public Health and Human Rights, based at the Johns Hopkins Bloomberg School of Public Health.

“Venezuela’s public health system has collapsed, putting at risk the lives of countless Venezuelans,” said Shannon Doocy, associate professor at Johns Hopkins Bloomberg School of Public Health, who was part of the team that traveled to the Colombia-Venezuela border. “The combination of a failing health system and widespread food shortages has produced a humanitarian catastrophe, and it will only get worse if it’s not addressed urgently.”

In the last few years, the Venezuelan government has sought to suppress data on the country’s epidemiological situation, in an apparent attempt to hide the extent of the health crisis. In 2015, the Health Ministry abruptly stopped publishing its weekly updates on relevant health indicators, a key source of public health information, although it still reports some data to the Pan American Health Organization.

When the health minister at the time briefly resumed their publication in 2017, she was promptly fired. The government has also retaliated against physicians who have publicly expressed concern about the crisis or attempted to report data on it.

Existing data points to a troubling picture of outbreaks of diseases like measles and diphtheria, spikes in malaria and tuberculosis cases, and a nearly absolute unavailability of anti-retroviral treatment for people with HIV. Increasing levels of malnutrition compound this health crisis, making Venezuelans both more susceptible to infectious diseases and more prone to complications when sick.

Vaccination

Venezuela is now routinely experiencing outbreaks of diseases that are preventable through vaccination and had been eliminated in the country. These outbreaks suggest serious problems with vaccination coverage. According to the Pan American Health Organization:

Malaria

The number of suspected and confirmed malaria cases in Venezuela has consistently increased in recent years – from nearly 36,000 in 2009 to more than 406,000 in 2017, according to the World Health Organization. Malaria is currently an ongoing epidemic in nine Venezuelan states, according to an official document by the Pan American Health Organization, UNAIDS, and the Venezuelan Health Ministry. Health experts attribute this to reductions in mosquito-control activities, shortages in medication to treat the disease, and illegal mining activities that promote mosquito breeding by creating pools of water.

Tuberculosis

The number of reported tuberculosis cases in Venezuela increased from 6,000 in 2014 to 7,800 in 2016, and preliminary reports indicate that there were more than 10,000 cases in 2017. The 2017 tuberculosis incidence rate (32.4 per 100,000) was the highest seen in Venezuela in 40 years.

HIV

Venezuela is the only middle-income country in the world where large numbers of patients with HIV are forced to discontinue their treatment as a result of widespread shortages of anti-retroviral medicines. Eighty-seven percent of the more than 79,000 people living with HIV registered to receive anti-retroviral treatment from the Venezuelan government are not getting it. The number of newly identified HIV cases in Venezuela increased 24 percent between 2010 and 2016, with 6,500 new diagnoses in 2016. The real number of new HIV infections is undoubtedly higher, particularly given that many health centers are no longer able to perform HIV tests.

Maternal and Infant Mortality

The latest official statistics available from the Venezuelan Health Ministry indicate that in 2016, maternal mortality rose 65 percent and infant mortality rose 30 percent in just one year.

Malnutrition

The medical complications patients in Venezuela experience are further compounded by severe shortages of food and limited access to an adequate nutrition. Many of the dozens of Venezuelans the Human Rights Watch and John Hopkins team interviewed at the border said they had lost weight and were eating one or two meals per day back home, which for some consisted solely of yuca or sardines.

The Venezuelan government has not published nationwide nutrition data since 2007, but available evidence suggests malnutrition is increasing:

  • A nationally representative survey by three prestigious universities in Venezuela concluded that 80 percent of Venezuelan households are food insecure, meaning they don’t have a reliable source of food, and that people surveyed had lost an average of 11 kilograms in 2017.
  • Cáritas Venezuela, a Catholic humanitarian organization that monitors the nutritional situation and provides nutritional aid to children in low-income communities in Caracas and several states, reported that moderate and severe acute malnutrition among children under age 5 increased from 10 percent in February 2017 to 17 percent in March-2018a level indicative of a crisis, based on World Health Organization standards. In July 2018 Cáritas Venezuela reported the average had dipped to 13.5 percent, but figures exceeded crisis levels in Caracas (16.7 percent) and Vargas state (nearly 20 percent).
  • A 2018 Cáritas survey found that 48 percent of pregnant women in these low-income communities had moderate or severe acute malnutrition.
  • Hospitals in various locations across the country are reporting increases in the number of children admitted with moderate or severe acute malnutrition, and the proportion of children being admitted to hospitals who are acutely malnourished is alarmingly high, ranging from 18 to 40 percent, according to information provided by Venezuelan health professionals to Human Rights Watch.
Posted: January 1, 1970, 12:00 am

A health worker prepares a syringe with a vaccine against measles. Health authorities in Thailand are trying to contain a measles outbreak in the country's southern provinces, where at least 13 deaths and more than 1,500 cases have been reported since September.

© Creative Commons

Sometimes it’s incredibly easy to save a child’s life. Two doses of the measles vaccine into a child’s arm or thigh is almost 100 percent effective at preventing a disease that starts with a simple fever, but can rapidly progress and have deadly complications. Since 2000, the safe, inexpensive, and effective measles vaccine has prevented more than 20 million deaths.

But sometimes words can be enough to kill a child. That’s happening now in southern Thailand, where a 9-month-old girl has become at least the 13th measles fatality in the past six months. The cause of the disease outbreak that has infected thousands isn’t poverty, neglect, or a poor health system. It’s because certain local Islamic teachers are preaching the vaccine is somehow un-Islamic, leading to a drop in vaccination rates and a quick revival of the deadly disease.

The Chularatchamontri – Thailand’s top Muslim spiritual leader – rejects that vaccinations are contrary to Islamic principles. The Central Islamic Council of Thailand has said that even if vaccines contained religiously prohibited items, the medical benefit to a person and the community would take precedence. Globally, imams and other Islamic leaders have repeatedly issued statements and fatwas describing how immunization is consistent with Islamic principles.

The disinformation campaign opposing vaccinations is likely linked to local leaders who support separatist movements in Thailand’s Muslim-majority southern provinces. Separatist insurgents have burned down public health centers, murdered public health volunteers and hospital staff, and used a hospital for military purposes – all violations of international humanitarian law. They target the public health system as symbolic of what they consider to be the Thai Buddhist state’s occupation of their homeland. But it’s a tactic that kills children in their community. 

Vaccination programs have been successful elsewhere in Thailand in saving children from this uniquely contagious disease. Dissuading vaccinations for preventable diseases is less direct than burning down public health centers or placing a bomb outside a school, but it can lead to equally devastating consequences. The work of the doctors and public health officials to ensure all children in southern Thailand are vaccinated should be allowed to proceed without interference. Children’s lives depend upon it.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

A nurse prepares an insulin shot for a diabetes patient.

© Creative Commons

Last week, a Russian group in Saratov, that for three decades has helped people living with diabetes, announced it was shutting down. According to the group’s leader, Larisa Saygina, its board members are “no longer willing to be involved in public/social activities.” That’s hardly surprising once you know the backstory.

At the end of 2017, the prosecutor’s office petitioned a court to designate the group a “foreign agent.” The request was based on a complaint from a local student, who apparently read online that the group was receiving foreign funding. In May, a local court fined the group 300,000 rubles (about US$4,500) for failure to register as a foreign agent. On October 30, the court ruled that the group should be added to the register of “foreign agents.”

Many Russian groups live in constant fear of being designated a “foreign agent,” whether they work to protect the environment, support people with disabilities, or provide information and services to people who use drugs.

A 2012 law requires independent groups to register as such if they receive any foreign funding and engage in broadly defined “political activity.” In Russia, “foreign agent” is widely understood to mean “traitor” or “spy.” The law’s aim is to publicly discredit such groups and make them seem disloyal. The government’s list of foreign agents currently has 73 entries. Many more have shut down rather than wear the “foreign agent” label.

Authorities also find other pretexts to target groups, especially those working on controversial issues.

Days before the Saratov group was fined, the Andrey Rylkov Foundation – a grassroots organization providing harm reduction and other services to drug users – was fined 800,000 rubles (about US$12,000) on charges stemming from an article it published on harm reduction. Transparency International (TI) Russia was recently fined one million rubles in connection with a 2016 corruption investigation.

While Andrey Rylkov’s Foundation and TI Russia have been raising money to cover the fines, the Saratov group decided it was time to pull the plug. “Firstly, we have 300 000 rubles in fines…Secondly, most of our group’s members are leaving it. People don’t want to do this anymore,” Saygina explained.

One can’t blame the group for its decision: they have little choice. The saddest part is that those who will be hit the hardest are those who need the group’s help most.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

People protest U.S. President Donald Trump's announcement that he plans to reinstate a ban on transgender individuals from serving in any capacity in the U.S. military, in Times Square, in New York City, New York, U.S., July 26, 2017.

© 2017 Reuters

The Trump administration is urging key US federal agencies to stop protecting the rights of transgender people, according to a New York Times article. The Department of Health and Human Services is leading an effort to adopt a narrow interpretation of sex discrimination under US civil rights law that does not include “sexual orientation” or “gender identity.” This could roll back protections for transgender people at work, at school, and at the doctor’s office.

The federal government’s protection of transgender rights under major legislation such as Title VII (employment rights), Title IX (education rights) and the Affordable Care Act is largely rooted in interpretations adopted by the Obama administration. An inclusive interpretation of sex discrimination has been upheld by an increasing number of federal courts weighing in on the question.

The Trump administration’s proposal will likely be challenged in court. In the meantime, however, it threatens to do serious harm to transgender people who face discrimination that threatens their access to employment, housing, education, and healthcare. Its proposal that any definition of “sex” be restricted to “male” or “female” as indicated on birth certificates could also have a severe impact on intersex people whose sex characteristics may not neatly align as "male" or "female," and whose sex assigned at birth may not match their gender identity.

From attempts to exclude transgender soldiers from the military, to expanding permission for health care providers to deny care on religious or moral grounds, the administration has relentlessly undermined the protections from discrimination transgender people depend on under federal law. But there is a way forward.

Without delay, Congress should pass the Equality Act, which would amend federal legislation including the Civil Rights Act, Title VII, Title IX, and the Affordable Care Act to explicitly provide protection against discrimination on the basis of “sex” to explicitly include “sexual orientation and gender identity.” This would clarify for the courts and for all federal agencies that all Americans – including transgender people – have equal access to employment, education, health care, and other essential services.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

A syringe used for injecting the opioid heroin. 

© Chaiwat Subprasom / Reuters

As we approach 2019 – the year set out by the UN a decade ago as the target date by which to “eliminate or reduce significantly and measurably” illegal drug markets – the International Drug Policy Consortium, a global coalition of 170 nongovernmental organizations working on drug policy issues, argues that this goal has been “spectacularly missed.”

The Consortium’s report, drawing on data from government and nongovernment sources, provides a comprehensive evaluation of the 10-year UN drugs strategy and concludes by urging UN member states to conduct their own honest and thorough assessment of the strategy, something that has so far not happened.

According to UN data analyzed in the report, illegal cultivation of opium poppy and coca bush increased by 130 and 34 percent respectively between 2009 and 2018; the number of adolescents and adults who had used drugs at least once in 2016 grew by 31 percent compared to 2011; and drug-related deaths surged by 145 percent from 2011 to 2015. Meanwhile, the global drug market continues to flourish with annual turnover estimated at US$426 to US$652 billion. More than half of the gross profits from the drug trade are laundered, with law enforcement seizing less than one percent of that money.

Overly punitive drug policies have exacerbated violence in countries like Afghanistan, Colombia, and Mexico, the report said, resulting in countless deaths, enforced disappearances, and displaced persons.

UN data shows that one in five prisoners worldwide is behind bars for drug offences, the overwhelming majority for mere drug possession. In some countries, as many as 80 percent of women in prison are there for drug offences.

Rates of HIV, hepatitis C, and tuberculosis infection among people who use drugs continue to be far higher than in the general population as most countries lack prevention and health services, or people are reluctant to use health services because drug use is criminalized.

At the UN General Assembly, US President Donald Trump recently called for member states to sign a document supporting “action on the global war against drugs”. Sixty-three countries did not sign, saying the document was too narrow, without enough focus on health, human rights, and appropriate punishments.

The report recommends that the next global drug strategy focus not on creating a “drug free world” but on improving health outcomes, compliance with human rights norms, and promoting development, peace and security.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am
Video

Lebanon: Burning Trash Poses Serious Health Risk

Lebanese municipalities are endangering the health of residents by openly burning waste despite the passage of a national solid waste management law banning the practice. 

After years of researching Lebanon’s waste crisis, I was horrified to find out it had come to my family’s village. Open waste burning at unregulated dumps across Lebanon creates serious health risks for people living nearby. Mine and other Lebanese families regularly go to our ancestral villages to escape the crowds, noise, and pollution of the cities. Learning that the local government is polluting our villages by burning trash has brought the crisis and my own research home for me in a critical way.

According to a 2017 Ministry of Environment and UNDP report, there are more than 941 open dumps across Lebanon, including 617 municipal waste dumps, more than 150 of which are being burned on a weekly basis. Open burning poses serious health risks like heart disease, cancer, skin diseases, asthma, and respiratory illnesses. Despite the recent passage of a law clearly banning the practice, open burning continues.

The most recent analysis available indicates that open burning of waste is taking place in some of the poorest areas of the country. In other words, those populations least equipped to manage the health impacts of open burning or to escape from sites near open dumps are among those most negatively affected.

We have to protect ourselves and our neighbors. Residents can call on officials within the Ministry of Environment, Environmental Police, and Public Prosecutor Offices to stand up for our health. If you see open burning or dumping of waste call the Ministry of Environment on 1789 and file a complaint. Together we can #StopTheBurning.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am
Video

Lebanon: Burning Trash Poses Serious Health Risk

Lebanese municipalities are endangering the health of residents by openly burning waste despite the passage of a national solid waste management law banning the practice. 

(Beirut) – Lebanese municipalities are endangering the health of residents by openly burning waste despite the passage of a national solid waste management law banning the practice, Human Rights Watch said today. Following decades of mismanagement of solid waste, Lebanon’s parliament passed the law on September 24, 2018, during the first parliamentary session since elections in May.

Municipalities are flouting the law, which bans open dumping and burning of waste and sets penalties for violations. The law gives the Environment Ministry an oversight and monitoring role and mandates the ministry to develop a national waste management strategy within the next six months.  

“Now that parliament has passed the long overdue solid waste management law, the Lebanese government needs to carry it out,” said Lama Fakih, deputy Middle East director at Human Rights Watch. “Unless violators are held accountable, Lebanese will continue to suffer devastating impacts on their health and their environment.” 

Signs of burning at the al-Qantara dump, including soot from recent burns and ash deposits, October 11, 2018, Qantara, Lebanon. 

© 2018 Lama Fakih for Human Rights Watch

Lebanon’s waste crisis gained international recognition in 2015, when garbage overflowed in the streets of Beirut. But Lebanon’s mismanagement of its waste, including by burning it at dumps, is decades-old. Human Rights Watch found in a December 2017 report that burning waste at more than 150 open dumps was risking the health of nearby residents. The practice violates Lebanon’s obligations under international law, including the government’s duties to respect, protect, and fulfill the right to health.

Human Rights Watch researchers visited two villages in south Lebanon, al-Qantara and Qabrikha, on October 11 and spoke with residents in al-Qantara who had witnessed the open burning of waste in the municipal open dumps in both villages in previous days. Media have reported that the practice continues in other towns and villages across the country.

Signs of burning at the al-Qantara dump, including soot from recent burns and ash deposits, October 11, 2018, Qantara, Lebanon.

© 2018 Lama Fakih for Human Rights Watch

The dump at Qabrikha was still smoking when Human Rights Watch researchers were on the site and there were clear signs of burning at the al-Qantara dump, including soot from recent burns and ash deposits. Residents said that municipal open dumps in neighboring al-Ghandoriya, Rab Thalatine, and Beni Hayyan were also still burning waste in spite of the new law, but Human Rights Watch was unable to verify these claims through site visits.

One resident said that, despite repeated requests to the head of the Qabrikha municipality about the burning over the past week, the burning persisted. “We got to a point where we can’t sleep anymore,” he said. “It [the Qabrikha dump] is continuously on fire and affecting us…The smell would get stuck in your nose. It’s a problem. My son is 6 years old, he has a cough…Two days ago, when they burned in the morning, you couldn’t see the surrounding towns.”

Scientific studies have documented the dangers that smoke from the open burning of household waste pose to human health. Children and older people are at particular risk.

Human Rights Watch interviewed the deputy head of the Qabrikha municipality, Imad Fahes, on October 12 by phone. Fahes admitted that the municipality was open burning nonrecyclable waste on a monthly basis. He said that while he was aware of the new waste management law and the penalties associated with open dumping and burning of waste, the municipality was waiting for instructions from the Jabal Amel union of municipalities on how to proceed.

“Perhaps we can adopt sanitary landfilling,” he said. “But we need expertise and to know whether it would affect groundwater. There’s also the funding issue…But the principal thing we need is instructions and technical guidance.”

Guidelines to municipalities and unions of municipalities on solid waste management were however already circulated by the Ministry of Environment in November 2017. 
 
Human Rights Watch tried unsuccessfully multiple times to reach the head of the al-Qantara municipality but did interview an employee from the al-Qantara municipality responsible for picking up the waste. He denied that the municipality was burning trash. When researchers told him there was evidence of burning at the dump site, he said this must be from old burning at the site. But visible ash deposits and black soot at the dump, and a noticeable absence of piles of trash, suggested that this was not the case. Residents also said the burning at the al-Qantara site was continuing and one resident provided photos to Human Rights Watch taken on September 24 that appeared to show smoke from the burning of trash at the al-Qantara dump.

Signs of burning at the al-Qantara dump, including soot from recent burns and ash deposits, October 11, 2018, Qantara, Lebanon.

© 2018 Lama Fakih for Human Rights Watch

The Environment Ministry should urgently begin monitoring compliance with the solid waste management law and ensure that violators are appropriately penalized, Human Rights Watch said. The ministry has set up a complaints process to receive information about environmental offenses like open dumping and burning of trash, including a hotline that residents can call by dialing 1789. The cabinet should consider the ministry’s budget requests to ensure it can carry out monitoring. The government should ensure that everyone in Lebanon who suffers a violation of their right to health through action or failures by state bodies has an effective remedy.

The environmental public prosecutor in each governorate should also be adequately resourced to investigate complaints received from the Environment Ministry and others and ensure that violators are held accountable. The Justice Ministry should publish the names of the environmental public prosecutors in each governorate to facilitate the reporting of violations, Human Rights Watch said.

In January, Human Rights Watch opened a campaign calling on parliament and the cabinet to pass a waste management law and develop a strategy on waste management for the entire country and comply with environmental and public health best practices and international law. Over 12,000 people signed a petition in support of the campaign.

The new law requires the Environment Ministry to establish a national strategy within six months. In January, the cabinet passed a a summary policy on Integrated Solid Waste Management, and the environment minister formed a committee on waste management, which includes a civil society representative.

Smoke rising from the smoldering dump at Qabrikha, October 11, 2018, Qabrikha, Lebanon.

© 2018 Lama Fakih for Human Rights Watch

In keeping with its obligations under the new law, the Ministry of Environment should build on the summary policy by developing a long-term strategy for waste management. It will need to detail plans for reduction, sorting, collection, transfer, storage, processing, and disposal of solid waste in a manner that takes into account the perspectives of the public health and environmental experts and local communities, Human Rights Watch said.

“The next six months present an opportunity for the community to work with the Environment Ministry to build on the summary waste management strategy that was passed in January,” Fakih said. “For the long-term strategy to be effective, it should take into consideration the concerns and expertise of local communities and public health and environmental experts.”

The dump at Qabrikha is adjacent to a recycling facility. Human Rights Watch researchers visited the facility and spoke with an employee there. He said waste that was not recyclable and non-organic was returned to the municipalities whose trash was processed at the facility. He said that Qabrikha municipality moved this waste into the nearby open dump, where he saw them burn it. He said trash at this dump included plastic bags and diapers. Human Rights Watch researchers also observed clothes and other household waste at the dump. Qabrikha is in the Wadi Hujeir Nature Preserve.

Residents could not specify when burning at the dumps began but estimated that it had been going on for years and said that burning in the past week had been particularly intense.

One woman who moved to al-Qantara in May 2017 said the municipalities have been burning the al-Qantara and Qabrikha open dumps since she arrived:

We can’t breathe at night. The smoke builds up and it moves towards us like fog. I can’t recover from the flu…There’s smoke every day. And the smell is strong at night. It’s the smell of nylon, it’s heavy and odd, something you can’t handle. I didn’t see a doctor or pharmacist regarding the symptoms. I take medicine for blood pressure and diabetes, why add to all this? I drink tea with lemon… The maximum I can do is close the windows, what more can I do?... And not just me, others, even my grandsons, they’re always sick.

Another woman, who has lived in al-Qantara for two and a half years with her husband, said:

The smell of trash, the burning, it’s unbearable. Especially the 2-3 days we went through last week…The smell is usually from Qabrikha…The latest incident was 3 or 4 days ago. I woke up at night suffocating. Smoke was filling the house. This is a village. There’s no pollution. Why would we have to wake up feeling like this? It was from Rab Thalatine. I knew because of the direction of the wind, which was from the east...The smoke smelled like trash… The main symptom was difficulty breathing and chest pressure…My husband had a surgery in the lungs. This smoke isn’t good for him. And of course he was irritated. He had difficulty breathing.

An older man also described his symptoms during the trash burning: “The symptoms are usually difficulty breathing. And some symptoms the next day, like black phlegm, from all the polluted air that gets into you. I experience this only when the burning takes place, otherwise no.”

Posted: January 1, 1970, 12:00 am

A group of Doctors meet in the University of Mississippi Medical Center in Jackson, Mississippi October 4, 2013. 

© 2013 Reuters

On September 13, Lambda Legal and interACT Advocates for Intersex Youth published a detailed guide on how to make hospitals compassionate, affirming, and evidence-driven centers for intersex health care. It is very badly needed.

I have interviewed dozens of doctors, surgeons, and mental health providers who care for intersex children in the US, and who work with parents of children born with genital differences.

Every practitioner I met across the United States told me they needed more data and guidance. Every parent told me they just wanted the information and advice they needed to raise a healthy and happy child. Every person with intersex traits whose story I heard spoke of the deep desire to make informed decisions about their own body. A 40-year-old intersex woman in California told me about the medical care she received as a child: ““I felt like I was being treated like I was on fire, and they were going to throw water on me because I was on fire.” She said: “But all that time, they didn’t realize I was drowning.”

Unfortunately, affirmative and respectful care for intersex people is not the norm — far from it.

“Intersex” refers to the approximately 1.7 percent of the population born with a range of bodily traits that do not fit conventional expectations of female or male. Their sex characteristics, such as chromosomes, gonads, or genitals, may differ from social expectations. These variations are medically benign.

But in the 1960s, American surgeons popularized cosmetic operations to “normalize” intersex children. These children generally have no medical problem. And no data has ever demonstrated that the operations help children “fit in” or “function in society,” which some surgeons say is the aim of the procedures. The operations, such as clitoral reductions, vaginoplasties, and gonadectomies, carry high risks of scarring, incontinence, sterilization, and psychological trauma.

I heard from parents who felt coerced — even bullied — into going ahead with cosmetic surgeries to which their children are not old enough to consent. Some surgeons, under the protection of anonymity in our interviews, described to me how they told parents that surgery could prevent their kid’s suicide — which is flagrantly untrue and deeply unfair to confused and distressed parents.

But most of the doctors I spoke with acknowledged the shortcomings of intersex health care, even in their own practice over the years. They wanted guidance and policy to help them do better, as a community of physicians who took an oath to “Do No Harm” by their intersex patients.

Now that guidance exists.

Lambda and interACT’s new guidelines make it clear: Intersex patients need specialized care, but above all, they need honesty and support from their doctors. There are parallels in transgender health care issues and good basic standards for informed consent that should be applied to all patients. Intersex people aren’t asking for anything groundbreaking or special — just respect and transparency, and an end to the coercive early surgery that has damaged so many lives.

The document outlines how hospitals should include variations in sex characteristics in their non-discrimination policies, establish and uphold policies ensuring that their surgeons will not perform medically unnecessary surgeries on intersex children who are too young to give their own informed consent, support parents of intersex infants, and refrain from stigmatizing intersex children.

Doctors have in recent years increasingly acknowledged that they need guidance on intersex issues to avoid repeating past mistakes.

In 2017, Dr. Ilene Wong, a urologist in Pennsylvania, acknowledged the harm in which she took part when she operated on an intersex child without her consent. She wrote in Newsweek: “Eight years ago, I did irrevocable damage to the first intersex person I ever met.” Dr. Wong, who has become a staunch intersex patient advocate, knows that her field of surgery has stuck stubbornly to an outdated and harmful paradigm.

“The psychological damage caused by intervention is just as staggering, as evidenced by generations of intersex adults dealing with post-traumatic stress disorder, problems with intimacy and severe depression,” she said.

Other doctors agree.

“It is harmful to make sex assignments based on characteristics other than gender identity,” said Dr. Deanna Adkins, the director of the Duke University Center for Child and Adolescent Gender Care, when she testified in a North Carolina court against the state’s notorious anti-transgender “bathroom bill.” Infants too young to walk or speak cannot express their gender identity. So the surgeries in question should be deferred until they can express their gender identity and give their informed consent for procedures that will alter how their bodies look and feel.

Alice Dreger, a bioethicist who served on a National Institutes of Health (NIH) intersex research project before resigning in protest in 2015, wrote of her two decades of engagement on the intersex surgery controversy: “While many clinicians have privately shared my outrage about these activities, in public, the great majority have remained essentially silent.”

The new guide from Lambda Legal and interACT gives those physicians footing to make a difference by creating policies that will make their intersex patients feel welcome in their clinics — and ensure they receive care that affirms them and their choices about their bodies, rather than subjecting them to other people’s ideals.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

Maria Gabriela Silva Alves (“Gabi”), age 2, with her mother, Maria Carolina Silva Flor (“Carol”), at their home in Esperança, Paraíba state, Brazil in 2018. Gabi was one of thousands of children born with disabilities caused by exposure to the Zika virus in utero during the 2015-2016 outbreak.

© 2018 Joselito Alves dos Santos
Listening to the candidates running for president in Brazil, one would never know that just three years ago the Zika epidemic radically changed the lives of thousands of Brazilian families.

Maria Carolina Silva Flor (“Carol”) and Maria Paula, who asked us to identify her only by her first name, are two women who gave birth to children with congenital Zika syndrome during the 2015-2016 outbreak in northeastern Brazil. The very serious effects of the virus were not well known back then, and they could not imagine how their lives would change. Today, as their children grow, and their needs evolve and change, both mothers struggle to raise their children without adequate support from the government.

Carol’s municipality, Esperança, does not offer the services her daughter, Gabi, needs. So three times a week, she travels half an hour each way to Campina Grande, a larger city in Paraíba state, for appointments with doctors and specialists.

In Recife, Maria Paula has a wheelchair to help move her daughter, Mariana, who now weighs 13 kilograms, to her medical appointments twice a week. But the buses she takes are not accessible, so she leaves the wheelchair at home and carries Mariana in her arms.

I first met Maria Paula and Carol in late 2016 while doing research for a Human Rights Watch report on the impacts of the Zika outbreak in Brazil. We found that families raising children with congenital Zika syndrome don’t have the support they need, much less services that protect their basic human rights to life and health. People in the area have limited access to clean water and sanitation services, and women and girls lack comprehensive reproductive health information and services.

Over the last few months, I spoke to some of the mothers again, including Maria Paula and Carol. While their children have been able to get some health care, many of them found it difficult to get all the services they need, and in many cases, they worried about the quality of that care. They also reported difficulties in scheduling surgery, getting to health appointments, and buying expensive medicine. Recently, mothers of children with Zika syndrome in Campina Grande protested against the lack of beds in intensive care units for their children, which contributed to the death of one baby born with disabilities linked to the virus. 

According to Ministry of Health data, as of June one-third of the children who have confirmed cases of congenital Zika syndrome have not been able to get primary pediatric care and two-thirds have not been able to get the specialized early stimulation that will be especially important for their development.

Caring for a child with congenital Zika syndrome is a strenuous routine without an adequate network of support services, such as personal assistance for parents. Some mothers described feeling emotionally exhausted, or said they faced discrimination or prejudice against them and their children at health centers or on public transportation. One mother told me that a bus driver initially refused to open the door for her and her daughter with Zika syndrome and then told her to “shut up” when she defended her daughter’s right to free transportation. The mother filed a complaint with local authorities, but after the hostile encounter, she developed panic attacks and felt unable to ride the bus and face the driver for several months. She couldn’t take her daughter to the therapy programs and medical appointments she needed. “I didn’t have the emotional state to take care of her,” she said.

Caregivers need support. One way of helping them is through providing day care centers with staff trained to work with children who have Zika syndrome. As one mother of a two-year-old boy with Zika syndrome told me, having day care that she trusted to meet her son’s special needs would enable her to look for a job that would help her support her son and get the services he needs.  

The lack of community-based services and support could have devastating consequences for children with congenital Zika syndrome. A recent Human Rights Watch report found people with disabilities living confined in institutions under inhumane conditions, with little contact with the community. Many enter institutions as children and remain there for their entire lives. Without the proper support, children with congenital Zika syndrome could end up in the same institutions.

At the height of the outbreak, Zika was all over the news, and authorities felt pressure to respond. But now, the families affected by the virus are in danger of being forgotten – by the public and the authorities. The decreasing number of children born with congenital Zika syndrome might give the impression that the Zika outbreak no longer requires attention from the state. Nothing could be further from the truth. For families with children affected by the epidemic, its consequences will last their whole life.

Maria Paula and Carol are trying to do the best for their kids, to give them the best quality of life they can have. Federal and local authorities should not leave them to struggle alone. These children need the best medical and developmental care available, and they need care within reach. Providing these services will not only help them and their families but will strengthen their entire communities. 

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

Gangashree walks through the village to manually clean human excrement from dry toilets in Kasela, Uttar Pradesh, which she will collect in her basket and carry to the outskirts of the village for disposal.

© 2014 Digvijay Singh

“We don’t get any other job no matter where we go. I have tried. I know this is discrimination, but what can I do?” In June 2014, when I met 18-year-old Bablu, he was working through a contractor for the government, cleaning garbage and excrement from drains in Bharatpur city in Rajasthan state.

Bablu is a Dalit. His parents were cleaners. After he completed eighth grade, more schooling than his parents had, he said he looked for a job that could lift him out of the status accorded at birth by the caste structure. He wanted something that better matched his skills.

Bablu says he was thrilled when he secured a job interview in a hotel because he wanted to train as a waiter. But as soon as the manager heard his caste, Bablu was hired instead to clean toilets. Others with a similar education who were not Dalit, got the waiter jobs.

Bablu quit the hotel job soon after. He is now among thousands of Indians who are “manual scavengers,” manually cleaning human excrement from private and public dry toilets, open defecation sites, septic tanks, open and closed gutters and sewers.

They are forced into this work because they are usually from caste groups customarily relegated to the bottom of the caste hierarchy and confined to livelihood tasks viewed as deplorable or too menial by higher caste groups. Bablu, like most people who do this work, is from the Valmiki caste, a sub-caste discriminated against even by other Dalits. They usually work without protective gear, not even gloves. For generations, women working as manual scavengers would carry baskets of human waste on their heads.

On September 15, Prime Minister Narendra Modi opened a nationwide movement, Swachhata Hi Seva (Cleanliness is Service), as part of his flagship program Swachh Bharat or Clean India Mission focused on ending open defecation and sanitation. He called on people to participate in the drive, describing it as a service to the nation and picked up a broom himself to set an example. But he didn’t address manual scavenging.

India reiterated the ban on manual scavenging in 2013 with the Prohibition of Employment as Manual Scavengers and Their Rehabilitation Act. The law recognises a constitutional obligation to correct the historical injustice and indignity suffered by manual scavenging communities by providing alternate livelihoods and other assistance.

However, as Human Rights Watch and others have found, the practice is prevalent throughout India not just in homes but perpetuated by governments. Urban municipal corporations hire men and women for this work, both directly and through contractors, as in Bablu’s case, based on discriminatory caste-based hiring practices. They work without regard to labor or occupational safety standards or protections.

The authorities continue to bury the problem by grossly underreporting it. The government reports only 53,000 “manual scavengers,” but has figures from only 121 of the more than 600 districts in the country. This also excludes most of urban India, those engaged in cleaning sewers and septic tanks, and data from the state-owned railways, the largest employers of manual scavengers, to wash the tracks.

A Dalit woman removes excrement from dry toilets in Kasela village in Uttar Pradesh, India, where the state has failed to enforce laws prohibiting the practice of “manual scavenging.” 

© 2014 Digvijay Singh

A Job With Fatal Consequences

The sanitation workers face serious consequences, even a risk of death. Government data shows that since January 2017, 123 people have been killed while they were engaged in this occupation. In September alone, 11 sanitation workers died while cleaning sewers or septic tanks without adequate protective gear. In one incident, five men died when cleaning a sewer in Delhi. The latest deaths prompted hundreds of people to protest in New Delhi on September 25, demanding an end to the practice and compensation for victims’ families.

The government data on these preventable deaths, based on newspaper reports and numbers provided by a few state governments, are far from complete. Safai Karmachari Andolan, a rights group working to rehabilitate sanitation workers, says that at least 300 people have died since 2017.

The government figures do not include those who continue the outlawed work of cleaning dry toilets by hand, overwhelmingly Valmiki women. They face severe health consequences, including constant nausea and headaches, respiratory and skin diseases, anemia, diarrhea, vomiting, jaundice, trachoma, and carbon monoxide poisoning.
 

‘Swachh Bharat’ Ignores Manual Scavenging

The government says that in the last four years, it has built 90 million new toilets.

But ending the use of dry toilets and open defecation is not sufficient to address manual scavenging. There has been little progress to end the caste-enforced practice of manual scavenging or rehabilitate those previously forced to do this work. A robust effort is needed to modernise sewage systems and regularise the sanitation workforce, with proper labor and occupational safety protections.

Instead, the Swachh Bharat Mission has at times ended up reinforcing or further perpetuating caste-based discrimination. Recent reports from Delhi, Uttar Pradesh, Gujarat, Madhya Pradesh and Uttarakhand show that some state governments are still hiring people directly or through contractors to clean human waste manually, in violation of the law.

Even in states like Gujarat and Uttarakhand, which have declared themselves upgraded, the use of dry latrines and open defecation persist. And thus, so does manual scavenging, raising serious concerns over reliability of government data.

In rural areas, the government subsidises affordable toilets – often two-pit latrines – but has failed to counter abusive practices that are still immersed in age-old notions of purity, caste and untouchability. Unlike more modern forms of sanitation, these latrines need to be emptied manually. In rural communities, clearing manual pits remains the job of the Dalits, a study by New Delhi-based Research Institute for Compassionate Economics shows.

In November 2017, the United Nations special rapporteur on the human rights to safe drinking water and sanitation, at the end of his India visit, expressed concerns that Swachh Bharat may fail to eliminate manual scavenging and “may involuntarily contribute to violating the fundamental principle of non-discrimination.”
 

Ending Caste-Based Discrimination

The Indian government has taken a step in the right direction toward universal access to sanitation, and removing health risks associated with widespread open defecation. But process is plagued by lack of accountability, unreliable government data, and a focus on building infrastructure that does not take into account or work to reverse the realities of entrenched caste prejudice.

It is in fact causing new abuses as officials rush to meet targets. Some district officials have even used public shaming or denied access to public services to check open defecation or coerce people to build toilets.

For Bablu and others like him to end this “most degrading surviving practice of untouchability in the country.” the government will need to do much more. In addition to mechanising sanitation systems and supporting a professional sanitation workforce, it should strictly enforce the anti-manual scavenging law, including against local government officials who engage in caste discrimination in the workplace.

Everyone engaged in manual scavenging should be properly identified to ensure that they receive entitlements provided by the 2013 law, including financial assistance, scholarships, housing, alternative livelihood support and other important legal and programmatic assistance.

There has been an outpouring of support from India and abroad for the Swachh Bharat Mission. Individuals, companies, international financial institutions such as the World Bank and concerned governments should insist that the government’s Clean India Mission includes abolishing caste-based practices that impose sanitation-related tasks on Dalits.

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am

Corridor in a care facility for older people. 

© Flickr

The Australian government is taking an important step to investigate potential abuses against older people in care facilities and beyond. This week, Australian Prime Minister Scott Morrison announced a Royal Commission to investigate the industry responsible for providing support and health services to older people. Terms of reference are being drawn up now.

Sadly, the commission appears quite timely. The day after it was announced, a leading television news program exposed serious concerns in care facilities for older people, including lack of informed consent for the use of antipsychotic drugs. Another news story this week carried the claim by a geriatric specialist that 80 percent of people with dementia in nursing facilities in Australia are being given those drugs.

Human Rights Watch has found similar abuses in private nursing facilities in the US, concluding that people in such nursing facilities are often at heightened risk of neglect and abuse. This is frequently due to their physical or mental disabilities, and isolation from friends, family and the community. Often, they are unable or not allowed to leave the facility alone. Human Rights Watch determined that in the US, many people are forced to depend entirely on the institution’s good faith and have no realistic avenues to help or safety when that good faith is violated.

The experiences of older people should help shape the terms of reference for the commission. Older people who are most at risk will not have their perspectives included unless the government actively seeks them out. This investigation is about the daily lives of older people, and the Royal Commission has the chance to do this right by including the voices and perspectives of older people using aged care. 

Author: Human Rights Watch
Posted: January 1, 1970, 12:00 am