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

(New York) – The United States government has proposed new rules for facilities administering antipsychotic drugs that would increase the risks to older people, Human Rights Watch said today. Human Rights Watch submitted formal comments to the Centers for Medicare and Medicaid Services (CMS), the government regulator for nursing facilities in the United States.

Under US regulations, a physician or prescriber must evaluate every 14 days a person who is being given antipsychotic drugs on an as-needed basis. The proposed rule would lengthen the review period for most residents to every 70 days, decreasing prescriber supervision for drugs that increase the risk of death when used for older people with dementia. 

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“Older people face a documented threat of overmedication with potentially dangerous drugs in US nursing homes,” said Bethany Brown, researcher on older people’s rights at Human Rights Watch. “The proposed rules appear to heighten the risk to older people and should be withdrawn.”

Human Rights Watch urged CMS to withdraw the proposed changes and instead improve enforcement of existing protections against overuse of antipsychotic medications. These drugs can be inappropriately used to control people’s behavior or for staff convenience – a practice known as chemical restraint – rather than to treat medical symptoms. They also pose special health risks to older people with dementia.

CMS should ensure that nursing home residents and their families are informed of treatment alternatives and have the right to refuse medication. The government should also ensure that  nursing  homes employ sufficient staff to provide supportive care to residents rather than using chemical restraint.

In a 2018 report, “‘They Want Docile’: How Nursing Homes in the United States Overmedicate People with Dementia,” Human Rights Watch documented US nursing facilities’ inappropriate use of antipsychotic drugs in older people as well as the administration of the drugs without informed consent. This practice occurred mostly as a result of inadequate enforcement of existing laws and regulations.

Nursing home residents who had been subjected to overmedication told Human Rights Watch about the trauma of losing their ability to communicate, think, and remain awake. Their family members described the pain of witnessing these losses in loved ones.

The US Food and Drug Administration (FDA) has never approved antipsychotic drugs for use in older people with dementia and warns against their use for symptoms of dementia. Clinical research has found that on average, antipsychotic drugs almost double the risk of death in older people with dementia.

CMS is facing scrutiny from the US House of Representatives Ways and Means Committee for  failing to enforce existing regulations regarding inappropriate antipsychotic drug use in nursing homes.

“The Centers for Medicare and Medicaid Services should improve protection for nursing home residents by enforcing existing rules, not look for ways to lower the bar,” Brown said. “Residents should have the support they need to live in dignity.”

Posted: January 1, 1970, 12:00 am

Hajar Raissouni (Via Facebook)

 

(Tunis, September 9, 2019) – The Moroccan authorities’ prosecution and jailing of a journalist on charges of having an abortion and sex outside of marriage flagrantly violate her rights to privacy, liberty, and numerous other rights, Human Rights Watch said today. The authorities should drop the charges and release her immediately.

Police in Rabat arrested Hajar Raissouni, 28, on August 31, 2019, and interrogated her about her intimate life. Two days later a prosecutor charged her with having an abortion and sex outside marriage, and a judge ordered her detained. Her trial is set to start on September 9. She faces up to two years in prison if convicted.

“Hajar Raissouni is being charged for alleged private behavior that shouldn’t be criminalized in the first place,” said Ahmed Benchemsi, Middle East and North Africa communications director at Human Rights Watch. “Moreover, by publicizing detailed allegations about her sexual and reproductive life, authorities trampled on her right to privacy and apparently sought to smear her reputation.”

In the same case, police forces arrested Raissouni’s fiancé, Sudanese scholar Rifaat Al-Amin; the doctor who is accused of having performed the abortion; and two of his aides. Al-Amin is charged with complicity in abortion and sex outside marriage, and faces up to two years in prison. The doctor and his aides are charged with performing an abortion and complicity in abortion, and face up to 10 years in prison.

At about 11:30 a.m. on August 31, six policemen in civilian clothes arrested Raissouni and Al-Amin on a street in Rabat’s Agdal neighborhood, near an obstetrics-gynecology office where Raissouni was a registered patient. The police took them to the office, where they arrested a doctor and two aides, then transported the five to a police station in Rabat for interrogation, Saad Sahli, a lawyer for Raissouni and Al-Amin, told Human Rights Watch.

The police took Raissouni later that day to Rabat’s Ibn Sina hospital, where staff subjected her to a gynecological examination without her consent, one of her lawyers, Mohamed Sadkou, told Human Rights Watch. Such examinations, when performed without the person’s consent, amount to cruel and degrading treatment under international human rights standards.

Raissouni was kept in detention at the police station for 48 hours, during which the police asked her invasive questions about her intimate life, and about whether she had an abortion.

On September 2, Raissouni was taken before a prosecutor in Rabat’s Court of First Instance and then charged with having an illegal abortion and sexual relations outside marriage, offenses punishable respectively by up to two years and one year in prison, under articles 454 and 490 of the penal code. The same day, a judge in the same court refused her petition for pretrial release, set the trial to September 9, and sent her to Al Arjat prison in Salé, a town near Rabat.

The court also rejected pretrial release for Al-Amin, the doctor and his two aides, who are in Al Arjat prison pending the September 9 trial. Al-Amin is accused of sex outside marriage and complicity in abortion under articles 490, 129 and 454 of the penal code, and could be sentenced to up to two years in prison. The doctor and his aides are accused of performing or complicity in performing an abortion, under articles 449, 450 and 451, and could be sentenced to up to 10 years in prison.

On September 5, Abdeslam Al-Imani, a prosecutor in Rabat, issued a communiqué, widely distributed to the media, detailing the allegations against Raissouni. The communiqué included deeply personal details pertaining to her sexual and reproductive health, in violation of her right to privacy.

The prosecutor’s communiqué stated that Raissouni’s arrest was “not connected in any way” to her being a journalist, and happened “incidentally,” after she visited a medical office that was “under surveillance because the judicial police had received reports that abortions were routinely conducted there.”

However, in a “letter from prison” published by Al Yaoum 24, a website associated with Akhbar Al Yaoum, the daily for which Raissouni works, she says the police asked several questions about her work as a journalist, and her relatives, including a prominent religious scholar and the editor-in-chief of Akhbar Al Yaoum. She also said that police interrogators asked specific questions about her relations with her fiancé that revealed to her that the couple had been under surveillance.

Akhbar Al Yaoum is one of the country’s few remaining critical newspapers. The authorities have taken severe measures against it several times since its creation in 2009. In 2018, a Casablanca court sentenced Taoufik Bouachrine, the daily’s founder and publisher, to 12 years in prison on charges of aggravated sexual assault in a trial that the United Nations Working Group on Arbitrary Detention concluded was marred by due-process violations. Akhbar Al Yaoum extensively covered the trial of protest leaders in the Rif region of Morocco, who were sentenced to up to 20 years in prison, largely based on statements that they said were made under police torture.

Raissouni is a member of a well-known dissident family. Her uncle, Ahmed Raissouni, a leading Islamist thinker, is the president of the International Union of Muslim Scholars, a theological organization based in Qatar. Another uncle, Suleiman Raissouni, is the editor-in-chief of Akhbar Al Yaoum and is known for his critical columns. Her cousin Youssef Raissouni is the secretary general of the Moroccan Association of Human Rights, the country’s biggest independent human rights organization, which has a long history of being targeted by the government.

According to Chafik Chraibi, president of the Moroccan Association to Combat Clandestine Abortions, between 600 and 800 clandestine abortions a day take place on average in Morocco, about two- thirds of them by licensed doctors. Chraibi told Human Rights Watch that abortion-related arrests usually involve the practitioners but almost never the patients.

Authoritative interpretations of international law have determined that countries that, like Morocco, deny access to legal abortion endanger numerous human rights, including to life;, health;, freedom from cruel, inhuman, and degrading treatment;, and privacy. Human Rights Watch research in countries that criminalize abortion has shown that it drives women and girls to have clandestine abortions that can risk their health and lives. Human Rights Watch believes that decisions about abortion belong to a pregnant woman without interference by the state or others.

Morocco should also decriminalize consensual sexual relations among adults outside of marriage, in respect for the right to privacy as guaranteed under the International Covenant on Civil and Political Rights (ICCPR), which Morocco has ratified.

“Morocco’s arrest, prosecution, and brutal violation of Hajar Raissouni’s private life illustrate the country’s lack of respect of individual freedoms, and apparently the selective enforcement of unjust laws to punish critical journalism and activism,” Benchemsi said. “Raissouni and all her co-defendants should be freed immediately, and all charges against them dropped.”

 

 

 

Posted: January 1, 1970, 12:00 am

An external view of the EFSA (European Food Safety Authority) headquarters in Parma, Italy, February 16, 2018.

© 2018 ANSA via AP Images

In several European countries, pregnant women risk consuming food contaminated with the pesticide chlorpyrifos, a neurotoxin that could be harmful to the fetus.

Last month, the European Food Safety Authority (EFSA) stated that the pesticide does not meet the safety criteria for renewed approval by the European Union. The agency joins eight EU member states and a growing number of children’s rights and environmental advocacy groups around the world pushing back against the use of this dangerous chemical.

Chlorpyrifos, a pesticide commonly used on food crops, has garnered international media attention in recent months due to its links to neurotoxic health issues. The pesticide belongs to a class of chemicals called organophosphates – a group of compounds that alter the structure and function of the human nervous system. Scientists have coupled chlorpyrifos exposure with neurodevelopmental challenges, as well as an array of symptoms including dizziness, confusion, respiratory paralysis, and even death. Many of these outcomes are particularly hazardous to children because their bodies and nervous systems are still developing – and because they may absorb toxic chemicals more easily than adults.

The EFSA’s finding that there does not exist a safe exposure level for chlorpyrifos comes at a critical time. The approval period for chlorpyrifos use in the EU expires in January 2020 and the manufacturer’s application to renew this approval is currently under review by the European Commission.

Earlier in July, the United States missed a similarly critical opportunity to protect public health when the Trump administration ruled against enacting a 2015 EPA proposal to ban chlorpyrifos. Still, environmental and public health advocates in the US are rallying, particularly at the state and local levels. Most recently, Human Rights Watch joined over 80 organizations in signing a letter urging New York Governor Andrew Cuomo to approve a bill banning chlorpyrifos in New York state.

Come January, the EU has an opportunity to act where the US has failed. Failure to protect against known dangerous pesticide exposures violates the right to health. EU officials should seek to better protect Europeans’ health – and uphold human rights – by not renewing the approval of this neurotoxic pesticide.

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

The damage done by Hurricane Maria was far worse than Alvarez, or anyone, could have imagined. With broken roads, and hospitals overwhelmed as blackouts roiled the island, she gave birth at home a few weeks later. She relied on her doula skills and a friend to stem her own bleeding which, like the first two births, was excessive.

Video

Mariel Alvarez, Doula and mother

What was it like to be seven months pregnant during Hurricane Maria?

Last week, Puerto Rico was again under threat, as Hurricane Dorian tore across the Caribbean, almost exactly two years since Hurricane Maria made landfall. Heavily pregnant women, and those who have recently given birth, will have no doubt watched the news with same deepening sense of dread experienced by Alvarez and others two years ago.

Puerto Rico was lucky. Gathering hideous strength, Hurricane Dorian veered away from the island. But the hurricane did massive damage to the Grand Bahama and Abaco islands, leaving residents homeless and authorities scrambling to find missing people and provide water and food. And Dorian will doubtlessly expose – as did Maria – the unique vulnerabilities of particular groups, including pregnant women and those who have recently given birth.

While Hurricane Maria spared no one, pregnant women and those who had recently given birth were vulnerable to the storm’s wrath in unique ways. Their stories have been lost in anger and finger-pointing over the flawed emergency response and slow disbursement of recovery funds by US President Donald Trump’s administration. But they need to be heard: global warming climate crisis means Caribbean islands (and other areas like the eastern US seaboard) will face increasingly severe hurricanes with increased precipitation, like Maria.

In 2018, a year after Hurricane Maria, Human Rights Watch interviewed 30 doctors, nurses, lactation consultants, and NGO staff, and 16 women who were pregnant or had recently given birth when Hurricane Maria hit Puerto Rico in September 2017. Each of these women faced unique and extraordinary challenges, but taken together their testimonies paint a picture of the distinct challenges pregnant women and new moms faced. New mothers and pregnant women struggled for months after Maria hit with the healthcare system in shambles, and difficulty knowing how and where to access the scant services that were available to them.

Video

Dr Yari Vale Moreno, ObGyn

What problems do women face because of lack of access to clean water and electricity?

Adli, 25, said that she began having sporadic contractions at home during the 2017 hurricane, and worried that she might go into labor months before she was due to give birth. She said she could not locate her doctor and was unsure whether her hospital would be open. “It was a very precarious situation,” she remembered.

Yulisa, 23, recounted how her sister missed prenatal appointments following Hurricane Maria, and when she was able to make it to a hospital, they were unable to do a prenatal exam. She said that soon after her attempt to access care at the hospital, her sister had a pre-term birth, and the baby died the next day. Gabriela was six months pregnant when Hurricane Maria struck. She said she could not attend prenatal check-ups for two months afterward because “after the hurricane everything was closed, the roads were covered in trees,” even though she was suffering from such acute gastritis that she could not sleep lying down during this time. One woman named Carolina could not find a way for her premature baby, born four days before Maria, to get her vaccinations.

Video

Lourdes Santaballa, CASICA

How did you deal with infant care after Hurricane Maria?

The lack of water also meant keeping caesarean section or vaginal wounds clean was harder, women told us. Dr. Yari Vale Moreno, an obstetrician, worked in a mobile clinic that went out to find patients in places where the clinics were not functional. She found widespread vaginal infections because many had little or no clean water.

Other women faced a myriad of other problems: no electricity meant nowhere to store pumped breast milk even if you could find a generator to pump. Some interviewees said lack of clean water made them feel more dehydrated and making formula an acute problem on top of many others. New mothers struggling to breastfeed couldn’t find help. Supporting mothers with breastfeeding, which provides babies with both the nutrients and safe water, is recognized as a lifesaving intervention in disasters, including in the US

Video

Lenulisy Rosado Estradam, Oxfam

What was the impact of Hurricane Maria on how women perform domestic tasks?

An Oxfam report also showed how women and girls carried the burden of washing houses, clothes, and the soiled sheets of bedridden relatives by hand without electricity and running water.

Epidemiologists who calculated the excess mortality after the storm found that almost 3,000 additional people died in the months after the storm. It’s not known how many of these deaths were maternal deaths, or what maternal morbidity (serious injury connected to pregnancy or giving birth) was like after Maria. Most people died two to three months after Maria hit, and people in poorer areas died in higher numbers, often where electricity was restored last.

Video

Tania Rosario, Taller Salud

What matters in how a disaster is responded to?

After Maria, community organizations, including women’s rights groups, like Taller Salud in Loiza municipality, stepped in to take on some responsibilities of the state including by running large aid distribution efforts, feeding thousands with donations from the Puerto Rican diaspora. They made sure domestic violence victims had housing so they didn’t have to move back in with abusers, that pads and tampons were included in their distributions. They saw first-hand the importance of considering gender in disaster response. So far, no government authorities have sought their reflections and expertise nor, as far as they know, has it been incorporated in disaster planning.

The insights from groups like Taller Salud should help guide and be included in Puerto Rico’s disaster plan. This plan is still not finished; in May this year its drafters said that they had not consulted with women’s rights groups while drafting an emergency action plan, which, two years after Hurricane Maria, has still not been made public.  

Video

Maria Fernos, InterMujeres

What needs to happen now that we are in hurricane season again?

The epidemiological study found the failure of planning and communication, as well as disparities between communities in wealth, were all key reasons why Hurricane Maria’s aftermath led to a secondary public health disaster far more deadly than the high winds and water that killed 76 people. Adaptation policies – plans for how Puerto Rico will cope with the impacts of the climate crisis – and hurricane readiness are critical and can mean the difference between life and death for thousands.

There will always be pregnant and postpartum women in disasters. Their needs and vulnerabilities will be different, as Maria showed, and as Dorian will very likely show us again, and need to be seen and prepared for long before the next devastating storm hits.

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

Trump administration policies threaten to worsen the already dangerous conditions for meatpacking workers in the United States. The Trump administration is weakening oversight of chicken, hog, and cattle producers, and lifting limits on production speeds.

Posted: January 1, 1970, 12:00 am

Watch: US Meat Workers Under Threat

Video

US: Meatpacking Workers' Rights Under Threat

Trump administration policies threaten to worsen the already dangerous conditions for meatpacking workers in the United States. 


Posted: January 1, 1970, 12:00 am

How did you first become aware of the problem in Kabwe?

We learned about it from an environmental group several years ago but became interested in doing our own research after seeing a young person from Kabwe speak at a United Nations event. Lead is in the soil and dust, and children in Kabwe have some of the most severe cases of lead poisoning in the world. About a third of Kabwe includes lead-contaminated neighborhoods that are home to roughly 76,000 people.

How do you know that Kabwe has one of the most severe contamination levels in the world?

Human Rights Watch isn’t a scientific group, but a number of reputable academic and scientific studies from as recently as this year have already been done by others in Kabwe that show the lead levels in soil, and also in children’s blood.

Why are children specifically at risk?

Lead contamination can be toxic for both children and adults, but it has particular effects on children because their bodies are still growing and their brains are developing. Their bodies absorb as much as four to five times more lead than adults.

Children are also much more likely to be playing in the ground or in the soil, and that’s where the lead is. They are more likely to ingest lead if it is on their fingers or if they are eating food outside.

What are the symptoms?

According to medical experts, symptoms can be as severe as coma, seizure, or even death. Short of that, symptoms include severe stomach pain, severe headaches, memory issues, concentration issues, and learning difficulties in school. Lead poisoning can also lead to stunted growth.

When you went to Kabwe, did you meet children and adults displaying these symptoms?

We met a number of people who wanted to speak to us, including some children who had severe stomach pain, headaches, and memory and concentration issues. Many of those children had been tested by the government in the past and found to have high lead levels in their blood.

Does that mean they had lead poisoning?

Those symptoms are consistent with lead poisoning, but because we are not medical doctors or experts, we can’t say whether they are from lead poisoning.

The most important thing is that existing studies show large numbers of children in Kabwe – more than 50 percent – have extraordinarily high lead levels in their blood, which means regardless of their external symptoms, they could be experiencing severe internal effects that are invisible.

What difficulties did you face doing this research?

There is a lack of good public records showing what percentage of Kabwe is affected by lead. There has been periodic testing by the government since the 1990s, but that only included hundreds or maybe a few thousand people. There are likely tens of thousands of people who have been affected by lead. It was hard for us to access documentation on the scope of the problem.

That said, the World Bank – which recently provided funding to the Zambian government to further address this issue – notes in its documents that there are over 76,000 people living in contaminated areas, so that’s the benchmark we use.

What is life like for children in Kabwe?

There are children playing throughout the neighborhood, sitting on the ground, playing games, eating outside. There is really very little parents can do to protect them from the threat in the environment.

We met one father who wouldn’t let his baby play outside or crawl on the ground because he wanted to protect him.

One girl, who was about ten years old, had extraordinarily high lead levels when she was tested by the government during a previous World Bank project. She also had such severe stomach pain that she had to miss school.

Families throughout Kabwe have to live with this uncertainty, seeing that their kids are sick without knowing if the symptoms are from lead poisoning or if they can help them.

Can you talk more about the World Bank project?

In December 2016 the Zambian government launched a new World Bank-funded project designed to address cleanup of the mining site as well as testing, treatment, and education of people in the areas. This is a follow-up to a previous project that ran from 2003 to 2011 that didn’t sufficiently address issues.

What has been done so far?

Families throughout Kabwe have to live with this uncertainty, seeing that their kids are sick without knowing if the symptoms are from lead poisoning.

Joanna Naples-Mitchell

Children's Rights Researcher

Not a lot that community members have seen. We have been in touch with several government ministries, and they said the cleanup project faced a lot of bureaucratic obstacles to get off the ground, which is part of the reason it had been delayed.

They say that there will be visible results by the end of the year.

Does the government understand the extent of the issues?

It does seem that the government takes this issue seriously. But they have also indicated they don’t have sufficient resources to address the scope of the problem.

We would say that the government has a responsibility to fully address the contamination because this is a human rights issue. If it does not currently have sufficient resources, it should prioritize making a concerted effort to secure them.

Where is the lead coming from?

The mine has contaminated the soil. Because Kabwe is very dry for much of the year there’s a lot of lead in dust that blows around and gets in people’s homes. Lead contamination has been found in homes and back yards, in at least one school, in roads which in some parts are unpaved, and in a health center.

A full cleanup effort would have to address all of these sources of contamination.

What about the mine that caused the contamination?

The mine closed in 1994 but was never properly sealed off and piles of waste are still there. There’s not even a wall or fence around the mine. It continues to be a source of contamination, since the wind blows more lead dust into the community. People with no other way to make money also go there and work as small-scale miners, and this leads to more exposure as they can bring lead dust back on their clothes and shoes.

The government is aware this mining is taking place and the new World Bank project includes creating new livelihood opportunities for people.

How should the contaminated neighborhoods be cleaned up?

Cleanup isn’t simple, but there are different models that have been tried in Kabwe and elsewhere.

In one neighborhood an NGO [nongovernmental organization] put a cloth membrane on the contaminated soil and then put new soil and grass on top. They also used a special vacuum in homes to remove lead particles and put cement doorsteps in place. This seems to have been pretty effective, but it can’t eliminate the threat of road dust or people bringing the lead dust from their clothes into their home. It’s not a long-term solution without parallel measures to address other sources of lead exposure.

We leave it to the government to determine what the best model is.

Who should be tested?

Children under five are the greatest priority and should all be tested. But then everyone in Kabwe also has the right to testing. Lead can be transmitted through the placenta or breast milk so pregnant women and new mothers also should be a priority for testing.

Does everyone who has lead in their blood need treatment?

According to medical experts and various studies, different lead levels require different treatment. Anyone with extremely high levels of lead should be considered for a treatment that removes lead from the blood stream, called chelation therapy. That can be in the form of pills or injections.

Below that level, the best treatment would be nutritional supplements and monitoring.

Also, no matter what the level is, someone who receives treatment for lead poisoning should not be returned to a lead-contaminated environment.

In an ideal world, what should happen now?

All homes, schools, health centers, and public spaces should be cleaned. The old mine dump should be fully closed and sealed, and the waste properly disposed – as has been done in some old lead mines elsewhere. The roads should be paved and maintained to contain the lead dust, and the government should set up a permanent system of testing and treatment.

This interview has been edited for length and clarity.
Melanie Hung contributed to this interview.

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

Elaine Pearson, Australia Director at Human Rights Watch, speaking at the Parliamentary Joint Committee on Human Rights hearing on the Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019.

© 2019 Human Rights Watch
Human Rights Watch is an independent, nongovernmental, human rights organization that conducts research and advocacy in over 90 countries on a range of human rights issues, including on the rights of older people and the rights of people with disabilities.

Through extensive research on overmedication of older people living in nursing homes in the United States, we have documented how nursing facilities give antipsychotic drugs to residents with dementia to control their behavior out of convenience, despite rules against the misuse of drugs as chemical restraints. The use of antipsychotic drugs on older people with dementia is associated with a nearly doubled risk of death and other adverse reactions including stroke, falls and the inability to stake awake long enough to eat or spend time with loved ones.

Based on our experience documenting these harmful practices, we have written to this Committee to share our concerns regarding F2019L00511, the Quality of Care Amendment (Minimising the Use of Restraints) Principles 2019, registered on April 2, 2019. We have urged this Committee to recommend the disallowance of this regulation.

This legislation, which aims to regulate the use of restraints in aged care facilities, is inconsistent with Australia’s obligations under several core human rights treaties that Australia has ratified, including the International Covenant on Civil and Political Rights,[1] the International Covenant on Economic, Social and Cultural Rights,[2] and the Convention on the Rights of Persons with Disabilities.[3]

The use of physical or chemical restraints for control, punishment, retaliation, or as a measure of convenience for nursing facility staff should be prohibited. This regulation does not prohibit such measures.

Medicines should only ever be used for therapeutic purposes and with the free and informed consent of the person receiving them.

Informed Consent

The regulation does not require informed consent for chemical restraint, although it is required for physical restraint.

In its 2013 Concluding Observations on Australia, the United Nations Committee on the Rights of Persons with Disabilities (CRPD Committee) expressed concern that “under Australian law a person can be subjected to medical intervention against his or her will, if the person is deemed to be incapable of making or communicating a decision about treatment.” The committee called on Australia to repeal all legislation that authorizes medical intervention without the free and informed consent of the persons with disabilities concerned.[4]

Similarly, the UN special rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health has stated that informed consent “is a core element of the right to health, both as a freedom and an integral safeguard to its enjoyment.”[5]

For persons who may require support in making decisions and giving their informed consent for medical treatment, support should be provided and can take different forms. These can include:

  • accessibility measures and reasonable accommodation in understanding medical interventions, their consequences and side effects, as well as alternatives;
  • advance directives; and
  • the appointment of one or more support persons chosen by the person concerned.

The CRPD Committee has acknowledged that in some cases, even after serious and sustainable efforts have been made, it may not be possible to determine a person’s will and preferences, due to communication barriers or for other reasons. This may be the case with some people with dementia. In such situations, every effort should be made to make the best interpretation of an individual’s will and preferences. [6] Consideration should be given to all forms of verbal or nonverbal communication, as well as a person’s relevant previously manifested preferences, values, attitudes, and actions.

Prohibition on restraints in social care institutions

In a 2013 report, the UN special rapporteur on torture stated that “it is essential that an absolute ban on all coercive and non-consensual measures, including restraint and solitary confinement of people with psychosocial or intellectual disabilities, should apply in all places of deprivation of liberty, including in psychiatric and social care institutions.”[7]

The CRPD Committee has stated in numerous concluding observations that laws that condone the practice of restraining persons with disabilities or using other coercive measures to control them should be repealed.[8] It criticized the use of restraints in its 2013 review of Australia, expressing  serious concern that persons with disabilities are “subjected to unregulated behaviour modification or restrictive practices such as chemical, mechanical and physical restraints and seclusion, in various environments, including schools, mental health facilities and hospitals.” The Committee called on Australia to take immediate steps to end such practices.

The Joint Parliamentary Human Rights Committee itself stated in a December 2018 report on the National Disability Insurance Scheme,[9] which sought to regulate restraint in National Disability Insurance Scheme-funded services, that “Australia's obligations in relation to the prohibition on torture, cruel, inhuman and degrading treatment or punishment are absolute and therefore cannot be limited.”[10]

And, “[t]o that extent, a nationally consistent approach which prohibits restrictive practices that could amount to torture, cruel, inhuman and degrading treatment or punishment would be desirable from a human rights perspective.”[11]

Australia should be working to end the use of all forms of restraints, including physical restraints, sedatives (chemical restraints), forced isolation, and forced psychiatric treatment as a means of managing or disciplining older people in aged care. They should develop support and interventions for persons experiencing crises and emotional distress, including in nursing homes, that do not involve restraints. Any new law should also ensure informed consent for all treatment or interventions and ensure independent monitoring and effective, accessible, independent complaints mechanisms, including for individuals in aged care and their families. 

In the United States, the US Code of Federal Regulations, Title 42, Section 483.13 (a) states that, “The resident has the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience, and not required to treat the resident’s medical symptoms.”[12]

In closing, Human Rights Watch urges you to recommend disallowance of this legislation that seeks to regulate practices that are incompatible with Australia’s international human rights obligations. This regulation should be repealed and replaced with a robust prohibition on such practices, and requirements for:

  • supportive interventions, including training for aged care facility staff;
  • informed consent for all interventions;
  • independent, immediate, external review of complaints;
  • rights of access for advocates and inspectors to investigate potential restraint to ensure drugs are being used for therapeutic purposes only;
  • meaningful, regular monitoring by health practitioners;
  • sanctions for health practitioners found to be engaging in restraint;
  • clear lines of enforcement from inspectors for facilities found to be in breach; and
  • increased scrutiny of affiliated facilities with repeated violations. 

Thank you for your consideration.

--------------------------------------

[1] Implicates Article 6, the right to life; Article 7, the right to be free from torture and cruel, inhuman or degrading treatment or punishment; Article 26, equality before the law and to the equal protection of the law.

[2] Implicates Article 12, the highest attainable standard of physical and mental health.

[3] Implicates Article 12, Equal Recognition Before the Law; Article 14, Liberty and Security of Person; Article 15, Freedom from Torture, or Cruel, Inhuman or Degrading Treatment or Punishment; Article 16, Freedom from Violence, Exploitation and Abuse; Article 17, Protecting the Integrity of the Person; Article 25, Health.

[4] Committee on the Rights of People with Disabilities (CRPD Committee), Concluding observations on the initial report of Australia, adopted by the Committee at its tenth session (2-13 September 2013), 21 October 2013, CRPD/C/AUS/CO/1, https://tbinternet.ohchr.org/_layouts/15/treatybodyexternal/Download.asp..., para. 33.

[5] Human Rights Council, Report of the special rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Dainius Puras, A/HRC/35/21, March 28, 2017, https://documents-dds-ny.un.org/doc/UNDOC/GEN/G17/076/04/PDF/G1707604.pd..., para. 63.

[6] CRPD Committee, General Comment 1, para. 21.

[7] Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez A/HRC/22/53, para 63. February 2013. http://www.ohchr.org

[8] See, for example, CRPD New Zealand, Concluding Observations CRPD/C/NZL/CO/1 http://docstore.ohchr.org/SelfServices/FilesHandler.ashx?enc=6QkG1d%2fPP..., para. 32, “The Committee recommends that immediate steps be taken to eliminate the use of seclusion and restraints in medical facilities.”

[9] Restrictive Practice and Behaviour Support Rules 2018 [F2018L00632]

[10] Joint Parliamentary Human Rights Committee, Human Rights Scrutiny Report 13 of 2018, 4 December 2018 https://www.aph.gov.au/~/media/Committees/Senate/committee/humanrights_c....

[11] Ibid.

[12] United States, 42 CFR 483.13 - Resident behavior and facility practices.

https://www.govinfo.gov/app/details/CFR-2013-title42-vol5/CFR-2013-title... (accessed August 7, 2019).

Posted: January 1, 1970, 12:00 am

(Sydney) – Australia’s parliament should scrap a new rule that allows nursing homes to overmedicate and restrain older people, a group of organizations working for older people’s rights in Australia said today. On August 20, 2019 in Sydney, the Parliamentary Joint Committee on Human Rights will hold a hearing on human rights concerns relating to the new rule. Human Rights Watch, Aged and Disability Advocacy Australia (ADA Australia), and others will appear.

The group includes ADA Australia, Capacity Australia, Dementia Alliance International, and Human Rights Watch.

“The Australian government rule is trying to regulate abusive practices that harm older people rather than prohibit them,” said Elaine Pearson, Australia director at Human Rights Watch. “The opening of a parliamentary inquiry into this matter is a critical opportunity to address the regulation’s serious shortcomings.”

In April, the Australian government introduced a new rule to regulate both physical restraints and overmedication, also known as chemical restraint, in aged care facilities. The use of physical or chemical restraints as punishment, control, retaliation, or as a measure of convenience for staff should be prohibited, in line with Australia’s international human rights obligations.

Authorities should instead make sure that any medical intervention takes place only with free and informed consent, and that medications are administered only for therapeutic purposes. The government should prioritize positive support and intervention for people with dementia, including in aged care facilities.

On May 23, Human Rights Watch sent a letter to the Australian parliament, urging its joint committee on human rights to move to disallow the Quality of Care Amendment (Minimising the Use of Restraints) Principles 2010.

In 2013, the United Nations Committee on the Rights of Persons with Disabilities criticized Australia for allowing practices that would subject people with disabilities, including older people with dementia, to “unregulated behaviour modification or restrictive practices such as chemical, mechanical and physical restraints and seclusion.” The committee called on Australia to end these practices.  

In addition to the physical, social, and emotional harm for older people restrained with antipsychotic drugs, the use of such drugs in older people with dementia is also associated with a nearly doubled risk of death. It also limits their ability to eat, communicate, think, and stay awake.

“Older people in nursing homes are at serious risk of harm if this new aged care regulation is allowed to stand as is,” said Geoff Rowe, CEO at ADA Australia. “Australia’s parliament should act urgently to ensure that everyone, including older people, is free from the threat of chemical restraint.”

Human Rights Watch has documented the harm of overmedicating older people living in nursing homes in the United States.

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 has proposed a rule that would allow insurers and health care providers to discriminate against transgender patients, making it even more difficult for transgender people to find accessible, inclusive healthcare in the United States.

The Department of Health and Human Services (HHS) should reject the proposed rule, which would narrow how the department defines sex discrimination.

During the Obama administration, HHS clarified that discrimination based on gender identity, sex stereotypes, pregnancy, and termination of pregnancy are forms of sex discrimination, and are prohibited under the Affordable Care Act. That meant insurers couldn’t refuse to insure someone, raise their rates, or deny them coverage for certain forms of health care simply because they’re transgender, and providers couldn’t turn away or mistreat transgender patients.

A federal judge in Texas put some of these protections on hold in 2016 in response to a court challenge, and the Trump administration has declined to defend them in court. It now plans to claw them back altogether – at the expense of LGBT and pregnant patients.

Human Rights Watch has documented the difficulties transgender people in the US face when seeking health care providers who offer the services they need without discriminating or making them feel unwelcome. People described struggling to obtain insurance for basic health care needs, traveling hours to find welcoming providers, and being mocked or humiliated by medical personnel or refused service outright. The proposed rule would make it even harder to change this harmful status quo.

Without federal protections, individuals have to look to states for protection – and the landscape is bleak. Only 14 states and the District of Columbia expressly prohibit private insurers from discriminating on the basis of gender identity, while only 20 states and the District of Columbia ban them from offering plans that categorically deny coverage for transition-related care. The impact of the federal rollback will be swiftly felt in places such as Iowa, where lawmakers recently overrode a court decision prohibiting health care discrimination by expressly excluding transition-related care from the state’s Medicaid policy.

Eliminating existing protections would put transgender people and pregnant people at risk. The Trump administration should keep these vital safeguards in place, instead of bending over backwards to stop the federal government from fighting discrimination.

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) – Lebanon’s ministerial committee tasked with solving Lebanon’s waste management emergency has yet to act despite a four-month trash crisis in the north, Human Rights Watch said today. The crisis has resulted in trash in the streets and harmful open burning of waste.

Absent action by the central government, the Environment Minister has proposed a short-term solution that has triggered a public outcry. The ministerial committee should urgently study the roadmap submitted by the Environment Ministry on June 3, 2019 aimed at implementing the new solid waste management law and submit a final draft to the cabinet that would protect everyone’s right to health.

“The government has had four months to find a solution to the north’s trash crisis, but it is still dragging its feet and relying on temporary half-measures,” said Lama Fakih, acting Middle East director at Human Rights Watch. “Residents in the north are paying the price for the government’s continued failure to manage the country’s waste.”

The Aadoueh dumpsite, an unregulated open dump that had been used by the northern districts of Minieh-Dinnieh, Koura, Zgharta, and Bcharre for 17 years, was closed by the owner on April 5.

Local media have reported that some residents in the north are burning the waste that has piled up on the sidewalks and in some instances blocked streets, even though the practice is illegal, endangering the health of nearly 330,000 people. Media reported that an elderly woman fainted from smoke inhalation from waste burning in the town of Sir al-Dinnieh.

A 2017 Human Rights Watch investigation found that burning waste was risking the health of nearby residents. Residents reported health problems including chronic obstructive pulmonary disease, coughing, throat irritation, skin conditions, and asthma. Air pollution from open waste burning has been linked to heart disease and emphysema, and can expose people to carcinogenic compounds.

In the absence of action by the central government, on August 6, the Environment Minister announced that trash would be removed from the streets and stored in a “parking” site until a location for a new sanitary landfill could be agreed upon.

The Environment Minister did not announce the proposed site, but Tony Frangieh, a parliament member form Zgharta, told local media that it was in the village of Terbol in the Minieh-Dinnieh district. Local residents objected to this plan, saying that it would be an “environmental catastrophe” and that “they will not accept the establishment of a landfill at the expense of the health of residents.”

An Environment Ministry official has described the roadmap as a step toward carrying out the nationwide strategy that the ministry was tasked with establishing under Law 80/2018 on integrated solid waste management, passed on September 24, 2018. Although the strategy should have been adopted in March, the ministry official said it is still being finalized in line with the comments from civic groups and other stakeholders and will be sent to the cabinet before the end of the month.

The roadmap recommends expanding the Borj Hammoud landfill in Beirut and includes a map of 24 other proposed sites for new sanitary landfills across the country, but not all of these have had the required Environmental Impact Assessment. In at least one case, an assessment was conducted more than a decade ago. Under Lebanese law, the assessment is valid for two years, after which the Environment Ministry must consider whether any changes on the ground call for a new assessment.

The cabinet should not agree to landfill expansions or new landfills without first ensuring that adequate environmental assessments have been carried out, Human Rights Watch said.

The roadmap also includes a draft law outlining the fees and taxes that the central government and municipalities can impose to cover their waste management costs. Without such a law, neither the ministry nor the municipalities will be able to fulfill their responsibilities under the law and the strategy, Human Rights Watch said.

Outside Beirut and Mount Lebanon, municipalities are responsible for collection, treatment, and disposal of their waste. Municipalities are supposed to receive part of their funding from an Independent Municipal Fund financed with taxes collected by the central government. However, disbursements have been irregular and several years behind schedule. The Aadoueh dumpsite’s owner told Human Rights Watch that the main reason for his decision to close the dumpsite was the municipalities’ failure to pay their dues.

Residents across Lebanon have told Human Rights Watch they have lost faith in the government’s ability to manage waste in a way that is not detrimental to their health and environment. Since the 2015 trash crisis, during which garbage built up on the streets of Beirut, the government has been relying on stopgap measures and temporary fixes that do not solve Lebanon’s underlying waste management problems. About 85 percent of Lebanon’s waste goes to open dumps or landfills. But American University of Beirut researchers have found that only 10 to 12 percent of the waste cannot be composted or recycled.

As Beirut’s landfills also rapidly reach capacity, the ministerial committee should urgently review the roadmap and the strategy and adopt an integrated approach to solid waste management that decreases Lebanon's reliance on landfills and gives municipalities the resources they need to fulfill their duties. Any plan presented to the cabinet should comply with environmental and public health best practices as well as Lebanese and international law. The plan should ensure that the authorities respect everyone’s right to health and to live in a healthy environment, and that everyone is fully informed of threats to their health in their area.

Once the ministerial committee submits the roadmap and strategy to the cabinet, the cabinet should urgently meet and take the necessary decisions. The cabinet has not met in over a month due to political deadlock resulting from clashes between two parties. The cabinet should not allow a political dispute to hijack its operation, endangering the health of millions of residents, Human Rights Watch said.

The Environment Ministry should also urgently begin monitoring compliance with the solid waste management law and ensure that violators are appropriately penalized and cases are referred to the relevant environmental public prosecutors.

“Lebanon’s residents have a right to a healthy environment, yet the Lebanese government has continuously failed to uphold its international obligations to protect that right,” Fakih said. “If Lebanon is to avoid another trash catastrophe in the next few weeks, the ministerial committee needs to act quickly.”

Posted: January 1, 1970, 12:00 am

Human Rights Watch has conducted research on sex work around the world, including in Cambodia, China, Tanzania, the United States, and most recently, South Africa. The research, including extensive consultations with sex workers and organizations that work on the issue, has shaped the Human Rights Watch policy on sex work: Human Rights Watch supports the full decriminalization of consensual adult sex work.

Why is criminalization of sex work a human rights issue?

Criminalizing adult, voluntary, and consensual sex – including the commercial exchange of sexual services – is incompatible with the human right to personal autonomy and privacy. In short – a government should not be telling consenting adults who they can have sexual relations with and on what terms.

Criminalization exposes sex workers to abuse and exploitation by law enforcement officials, such as police officers. Human Rights Watch has documented that, in criminalized environments, police officers harass sex workers, extort bribes, and physically and verbally abuse sex workers, or even rape or coerce sex from them.

Human Rights Watch has consistently found in research across various countries that criminalization makes sex workers more vulnerable to violence, including rape, assault, and murder, by attackers who see sex workers as easy targets because they are stigmatized and unlikely to receive help from the police. Criminalization may also force sex workers to work in unsafe locations to avoid the police.

Criminalization consistently undermines sex workers’ ability to seek justice for crimes against them. Sex workers in South Africa, for example, said they did not report armed robbery or rape to the police. They said that they are afraid of being arrested because their work is illegal and that their experience with police is of being harassed or profiled and arrested, or laughed at or not taken seriously. Even when they report crimes, sex workers may not be willing to testify in court against their assailants and rapists for fear of facing sanctions or further abuse because of their work and status.

UNAIDS, public health experts, sex worker organizations, and other human rights organizations have found that criminalization of sex work also has a negative effect on sex workers’ right to health. In one example, Human Rights Watch found in a 2012 report, “Sex Workers at Risk: Condoms as Evidence of Prostitution in Four US Cities,” that police and prosecutors used a sex worker’s possession of condoms as evidence to support prostitution charges. The practice left sex workers reluctant to carry condoms for fear of arrest, forcing them to engage in sex without protection and putting them at heightened risk of contracting HIV and other sexually transmitted diseases.

Criminalization also has a negative effect on other human rights. In countries that ban sex work, sex workers are less likely to be able to organize as workers, advocate for their rights, or to work together to support and protect themselves.

How does decriminalizing sex work help protect sex workers?

Decriminalizing sex work maximizes sex workers’ legal protection and their ability to exercise other key rights, including to justice and health care. Legal recognition of sex workers and their occupation maximizes their protection, dignity, and equality. This is an important step toward destigmatizing sex work.

Does decriminalizing sex work encourage other human rights violations such as human trafficking and sexual exploitation of children?

Sex work is the consensual exchange of sex between adults. Human trafficking and sexual exploitation of children are separate issues. They are both serious human rights abuses and crimes and should always be investigated and prosecuted.

Laws that clearly distinguish between sex work and crimes like human trafficking and sexual exploitation of children help protect both sex workers and crime victims. Sex workers may be in a position to have important information about crimes such as human trafficking and sexual exploitation of children, but unless the work they themselves do is not treated as criminal, they are unlikely to feel safe reporting this information to the police.

What should governments do?

Governments should fully decriminalize sex work and ensure that sex workers do not face discrimination in law or practice. They should also strengthen services for sex workers and ensure that they have safe working conditions and access to public benefits and social safety nets.

Moreover, any regulations and controls on sex workers and their activities need to be nondiscriminatory and otherwise comply with international human rights law. For example, restrictions that would prevent those engaged in sex work from organizing collectively, or working in a safe environment, are not legitimate restrictions.

Why does Human Rights Watch support full decriminalization rather than the “Nordic model?”

The “Nordic model,” first introduced in Sweden, makes buying sex illegal, but does not prosecute the seller, the sex worker. Proponents of the Nordic model see “prostitution” as inherently harmful and coerced; they aim to end sex work by killing the demand for transactional sex. Disagreement between organizations seeking full decriminalization of sex work and groups supporting the Nordic model has been a contentious issue within the women’s rights community in many countries and globally.

Human Rights Watch supports full decriminalization rather than the Nordic model because research shows that full decriminalization is a more effective approach to protecting sex workers’ rights. Sex workers themselves also usually want full decriminalization.

The Nordic model appeals to some politicians as a compromise that allows them to condemn buyers of sex but not people they see as having been forced to sell sex. But the Nordic model actually has a devastating impact on people who sell sex to earn a living. Because its goal is to end sex work, it makes it harder for sex workers to find safe places to work, unionize, work together and support and protect one another, advocate for their rights, or even open a bank account for their business. It stigmatizes and marginalizes sex workers and leaves them vulnerable to violence and abuse by police as their work and their clients are still criminalized.

Isn’t sex work a form of sexual violence?

No. When an adult makes a decision of her, his, or their own free will to exchange sex for money, that is not sexual violence.

When a sex worker is the victim of a crime, including sexual violence, the police should promptly investigate and refer suspects for prosecution. When a person exchanges sex for money as a result of coercion – for example by a pimp – or experiences violence from a pimp or a customer, or is a victim of trafficking, these are serious crimes. The police should promptly
investigate and refer the case for prosecution.

Sex workers are often exposed to high levels of violence and other abuse or harm, but this is usually because they are working in a criminalized environment. Research by Human Rights Watch and others indicates that decriminalization can help reduce crime, including sexual violence, against sex workers.

Aside from decriminalizing sex work, what other policies does Human Rights Watch support with regard to sex workers’ rights?

People engaged in voluntary sex work may come from backgrounds of poverty or marginalization and face discrimination and inequality, including in their access to the job market. With this in mind, Human Rights Watch supports measures to improve the human rights situation for sex workers, including research and access to education, financial support, job training and placement, social services, and information. Human Rights Watch also encourages efforts to address discrimination based on gender, sexual orientation, gender identity, race, ethnicity, or immigration status affecting sex workers.

Human Rights Watch research documenting abuse against sex workers:

Posted: January 1, 1970, 12:00 am

A child health nurse holds up a vial and box for the HPV vaccine, brand name Gardasil 

© AP Photo/Daily Free Press, Charles Buchanan

The UK is taking a step toward ending preventable forms of cervical cancers, and some other cancers, by offer free HPV vaccines to boys ages 11 and 12. HPV causes nearly all cervical cancers and most throat and mouth cancers, often in men.

The program, which was announced on July 9, will be in place at the start of this academic year - September 2019.

The UK’s National Health Service has offered the vaccination to girls for free since 2008 and has given out about 10 million doses. The program is estimated to have contributed to an 86% drop in strains of HPV that commonly cause cancer. Including boys is a step towards eliminating new cases of HPV-related cancer.

Other countries, such as the US, should consider following suit. HPV is the most common STI in the US and the CDC estimates that it affects almost every person not vaccinated and who is sexually active at some point in their life. Increasing vaccine access for people of all genders could prevent many of the 4,200 cervical-cancer-related deaths that occur each year in the US.

While the number of adolescents in the US who are up-to-date on HPV vaccination increased five percentage points from 2016 to 2017, it still means only half of them received all recommended doses of the HPV vaccine in 2017. Of particular concern is that the rate of Black girls up-to-date in their HPV vaccinations fell in both Mississippi and Georgia over the same period.

A recent Human Rights Watch report discusses the crucial role the HPV vaccine also plays in closing racial disparities in health in Alabama. The US can raise vaccination rates by increasing awareness and accessibility. Legislators should support policies that ensure more information and access to the vaccine, and state health agencies should provide age-appropriate and accurate training for physicians on how to talk to parents and patients about the HPV vaccine.

By working through law and community strategies, the US can eradicate preventable cancers.

The UK has set an example that the US and other countries can follow.

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