International Human Rights News: Focus on the impact of Coronavirus on vulnerable groups

by Pauline Canham, Lauren Ng, Bethany Webb-Strong,  Julia Kedziorek, Alana Meier, Amita Dhiman

As the world goes into lockdown to tackle COVID-19, some sectors of society are particularly at risk, not only to contracting the virus but to the very measures being put in place to protect us all.  This week we look at how the most vulnerable are being impacted by this unprecedented crisis.

The Homeless in the UK

Homeless“Stay at home.”

This plea, now an instruction, permeates through the coronavirus crisis and echoes around the United Kingdom.  But where does it leave those who do not have a home, or at least a safe home, to go back to?

The United Nations Special Rapporteur on extreme poverty and human rights, Philip Alston, published a report in 2019 outlining that despite being the world’s fifth largest economy, 14 million people in the UK live in poverty, with the number of rough sleepers and homeless persons having increased throughout the period of austerity.

This group is particularly vulnerable in the face of the Coronavirus pandemic.  They are more likely to suffer from poor nutrition, have unaddressed health complications and no safe place to self-isolate from other people.  With the hoarding of toilet paper, food, sanitary gels and essential medicines, they are unlikely to be able to access these essential items to protect them from the virus.  Furthermore, the closure of stores, and organisations such as gyms and public bathrooms, has led to significant disruption in support systems, and the ability to maintain hygiene standards.

The Ministry of Housing, Communities and Local Government has written to local councils advising that housing must be found for all rough sleepers in order to prevent further spread of the virus.  However, the lack of clarity has resulted in many remaining without a home.  Hotels and offices are also being used to house rough sleepers, although figures of how many have been accommodated across the country have yet to emerge.

 

Those in detention

DetentionLife has ground to a global halt as many countries subject their nations to strict lockdown.  Prison settings are particularly vulnerable to the spread of the coronavirus and preventative measures are inadequate in overcrowded prisons without adequate handwashing facilities.  The World Health Organisation (WHO) has warned that prisons are unprepared and must act immediately to avoid ‘huge mortality rates’.

Without increased testing, the virus is likely to spread rapidly amongst inmates.  Those deprived of their liberty are more vulnerable to the psychological impact of severe isolation measures.  Lockdown in prisons in England and Wales bans family visits leaving inmates confined to cells for 23 hours a day.

In the United Kingdom, immigration detainees with underlying health conditions face the prospect of 3 months in solitary confinement. Detention may only be imposed where there is a realistic prospect of removal from the UK, yet many individuals cannot be returned because their countries have been devastated by the pandemic.  Legal action in the UK which argued that the Home Office has failed to protect immigration detainees led to the release of almost 300 people from detention centres earlier in March.

The psychological impact of quarantine upon children is raising concerns in the United States. Judge Dolly M Gee of the US District Court has called for the release of detained migrant children after four children tested positive in a shelter in New York.

Dr Hans Kluge, the WHO’s regional director in Europe, has called for ‘the boldest of actions’ in response: ‘we must not leave anyone behind in this fight’.

 

Indigenous people around the world

IndigenousThe CODIV-19 pandemic has proved the inadequacy of delivering equity to indigenous people, denying them access to health care.  Indigenous people are one of the most vulnerable groups because of their natural immunological vulnerability caused by civilisation diseases and poor access to clean water, suitable housing and healthcare.  Many communities in Australia receive additional soap and sanitisers supplies, but sadly this is a drop in the ocean.  The healthcare system in aboriginal communities is not equipped to cope with the pandemic and suspending non-essential medical treatments only exacerbates the situation.

In Brazil, since one medical worker from the Kokoma tribe tested positive for coronavirus, doctors became increasingly concerned about indigenous communities, because respiratory infections tend to spread quickly through tribes.  Many children suffer from anaemia, malnutrition and have lung conditions because of constant forest fires, which makes them particularly vulnerable.

Older generations also face a greater risk of death from COVID-19.  Therefore, if village elders pass away, their wisdom and social organisation will not be passed onto younger generations which may lead to the disappearance of their culture.

Many indigenous people have decided to isolate themselves either within their communities, or out in nature.  Once again, this vulnerable group cannot expect any sufficient external support because as Marlene Poitras, Assembly of First Nations Regional Chief for Alberta, states; they have never been a priority.

 

Women

female_nurseAs the COVID-19 pandemic continues, both highlighting and deepening pre-existing social and economic inequalities, it is important to acknowledge the disproportionate burdens that are being placed upon women.  As Maria Holsberg, humanitarian and disaster risk advisor at the UN Women Asia and Pacific stated, “Crisis always exacerbates gender inequality.”

Foremost, women are a large majority of those working on the front lines of the COVID response. According to the World Health Organization, 70% of workers in the health and social sector are women.  Women also comprise the majority in sectors being hit the hardest economically including precarious work and jobs within the service sector.  For example, a quarter of women across the EU fill roles that go unpaid if they don’t work.

women_health_workers

Boniol et al. (2019)

Additionally, with school closures impacting 91% of the world’s students, childcare is moving from the paid economy of schools and nurseries to the unpaid one.  Older relatives ‘social-distancing’ also are now in need of additional care and support.  This shines light on the ‘care crisis’ as these types of unpaid care will fall most heavily on women, thus limiting their work and economic opportunities.  Some countries like Australia are compensating for this by making childcare services ‘fee-free’ for families, despite potentially disastrous impacts for care centres.

Policies and public health responses must account for the sex and gendered effects and experiences of the outbreak.  A gender analysis approach is needed to address coronavirus concerns – an approach that includes sex-disaggregated data, recognising the crucial role that woman must play in the decision-making process.

Finally, the toll of the lockdown on women suffering from domestic abuse came to light this week after a survey of organisations that help domestic abuse victims revealed a dramatic increase in cases.  The UN Chief, Antonio Guterres is calling for urgent action to address the surge.

https://news.un.org/en/story/2020/04/1061052

 

Children

ChildrenThe WHO has established that only a very small proportion of children have contracted coronavirus but the crisis is impacting children in a variety of other ways.  In an effort to ‘flatten the curve’, some states have imposed severe restrictions on some vulnerable groups, including children.

In the Philippines, authorities have resorted to barbaric acts such as confining children inside coffins and cages if found in violation of the covid-19 regulations. In some cases, mothers have been arrested for violating the regulations.  Human Rights Watch officials said the locking up of children would increase the transmission of the disease and the government must prioritize the right to health, while respecting the human rights of all their citizens.

In Bosnia and Herzegovina, the government imposed a blanket ban on children and the elderly from leaving their houses, issuing fines for violations.  An exception was made only for children with disabilities, who are allowed to take a walk with their parents within 50 to 100 metres of the house. Activists said that though restrictions on some rights during the Covid-19 pandemic are justified, they need to be backed with proper evidence and be non-discriminatory in nature.

Due to the closure of schools, UNESCO has recommended that states  ‘adopt a variety of hi-tech, low-tech and no tech solutions to assure the continuity of learning’. Governments must adopt measures for the challenges faced due to this sudden loss of schooling.

 

 

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International Human Rights News: Focus on Coronavirus in Conflict Zones

by Amita Dhiman, Lauren Ng, Julia KedziorekPauline CanhamBethany Webb-Strong, Alana Meier

As we all struggle to adjust to a new way of life that includes loss of freedoms, loss of income, food insecurity, healthcare systems under strain, and daily briefings from leaders using the language of lockdowns and death tolls, unknown during peacetime, there are those for whom this, and much worse, is a never-ending daily reality.   An estimated 2 billion people live in areas of conflict and fragility around the world and the ICRC is calling for an immediate response by humanitarian organisations before the virus takes hold in countries ravaged by war.  The UN Secretary General has called for a ‘global ceasefire’  across the world to support efforts in combating the threat of Covid-19.

Our news update this week focuses on five countries most devastated by conflict and least able to confront a new enemy that even the wealthiest of states are struggling with.

Afghanistan

Afghan_healthcentreFollowing decades of war, Afghanistan is not well-placed to contend with an outbreak of covid-19. Many Afghans who had fled to Iran, during the conflict have returned back to their country, creating a burden on the already fragile health care system.  Out of some 200,000 returnees, only 600 had been tested as of March 27 due to inadequate medical staff and equipment.  Afghanistan’s Public Health Ministry have estimated that 25 million could become infected, adding that 100,000 could die, and on 28th March, Kabul, a city of 6 million, went into lockdown.

The UN Deputy Special Representative for the country is urging warring parties to come together to “prioritize national interests”, following in-fighting causing delays in the measures agreed back in February, on American troop withdrawals and Taliban anti-terrorism guarantees.   Human Rights Watch suggested that “The two sides need to work together with the UN and humanitarian agencies to ensure that aid reaches the whole country, or a dire situation will become catastrophic.”

In a country with a 50 percent poverty rate and a resilience that has become a way of life, ordinary Afghans are helping each other by making masks, delivering food and landlords waiving rents to ease the burden on the most vulnerable.

Gaza

GazaLast week saw the first two cases of coronavirus in Gaza.  Its delay has predominantly been attributed to the pre-existing border restrictions placed on the movement of people in Gaza.  The two individuals diagnosed had recently returned from Pakistan and have since moved to isolation.  Hamas, the militant organisation governing Gaza, has since closed its street markets and wedding halls, and urged citizens to practice social distancing in an attempt to slow the spread of coronavirus.

Yet with an overstretched healthcare system following the Israel-Egyptian blockade and decades of cross-border conflicts between Israel and Palestine, an impending outbreak carries a high level of concern in Gaza.  In one of the most densely populated areas in the world, the virus could easily rapidly spread.  Combined with the overcrowded conditions, the chronic shortage of medicines, regular power cuts, scarce resources, and lack of adequate medical care has the potential to lead to a “nightmare scenario” in the event of an outbreak.

Despite these concerns, repression from Israeli authorities has persisted, with raids on Palestinian communities continuing, pleas to release 5,000 Palestinians (including children) currently held in jail being refused following positive Covid-19 tests, and a persistent siege on the Gaza strip with no end in sight.

 

Libya

Libya_fightingWar-torn Libya is one of the latest victims of the international coronavirus pandemic with its first case confirmed on 24th March. While to date, only 8 people have tested positive for COVID-19, testing is limited and the failing health care system will struggle to cope if the virus spreads.

With the country split between two rival governments, there will be issues in implementing safety measures to protect citizens from the deadly virus. Since the civil war erupted in 2011, there has been an ongoing shortage of doctors and lack of central authority responsible for the national healthcare system. All borders have now been closed and foreign nationals are prohibited from entering the country. Schools and cafes are closed and prayers are suspended until further notice.

Despite a humanitarian pause being announced, the UN was “alarmed that hostilities have continued around Tripoli”.  Despite January’s truce, the fighting has killed over 1,000 and displaced 150,000 since April 2019. To relieve pressure on the already strained prison system, The Government of National Acord, the internationally recognised government, has freed just over 450 detainees from overpopulated correctional facilities.

Detainees and people in shelters are at paramount risk of infection, which Human Rights Watch predicts could lead to a humanitarian disaster for the country if the virus spreads.

 

Syria

Syria_hospitalOn Sunday, Syria reported its first COVID 19 fatality, heightening fears of the devastation the virus could wreak.  Ten years of conflict in Syria has led to the displacement of over half the population, 6 million of whom remain internally displaced in camps which are unprepared to respond to the pandemic.

Given the extent to which COVID 19 has overwhelmed western healthcare systems, the potential catastrophic risk it poses to Syria is almost unfathomable. Médecins Sans Frontières (MSF) has warned that access to healthcare is extremely poor in Syria given bombing of civilian areas and destruction of over 50% of hospitals. The London School of Economics released a research paper on Syria’s healthcare capacity last week stating that the maximum number of cases that can be ‘adequately treated’ is 6,500.

The World Health Organisation has mobilised an urgent response, delivering tests and protective gear.  However, aid agencies have been unable to deliver supplies given closure of the border with Iraq.  Human Rights Watch has reported that Turkish authorities are failing to supply water to north eastern areas of Syria, hindering the ability of agencies to protect against an outbreak of the virus.

Mr Pederson, the UN Special Envoy for Syria, has called for a nationwide ceasefire to allow for a ‘common effort’ against COVID 19. This has sparked hopes that a coordinated fight against the new coronavirus could unite forces and encourage a political settlement to end the conflict.   However, the situation remains dire as the already vulnerable population of war-torn Syria faces the new threat of a COVID 19 crisis.

 

Yemen

Yemen_Hospital_facemask_2How can Yemen, a country described already as experiencing the world’s worst humanitarian crisis, possibly cope with the looming threat of coronavirus?   80 percent of the population is at risk of hunger and disease, 17.8 million are without safe water and sanitation, 19.7 million are without adequate health care and the country has suffered the worst cholera epidemic ever recorded, at 2.3 million infected since 2015.

Last week, Yemen entered a 6th year of war, and with fighting continuing to rage, the UN Secretary General’s call for a ceasefire, to focus on the fight against coronavirus, appears to have fallen on deaf ears.  Despite lulls in the fighting during 2019, recent weeks have seen an alarming re-escalation in the conflict between Houthi rebels and the Saudi led coalition, which includes the US and UK.  A group of UN regional experts have called for warring parties to release political prisoners on both sides, to mitigate the risks of the spread of Covid-19 due to the overcrowded and squalid conditions in detention centres.

Yemen is the only country in the Middle East yet to record a case of coronavirus, due largely to having been placed under siege since the start of the war, with airports closed to commercial airlines and movement in and out of the country severely restricted.  However, the healthcare system in Yemen is already close to total collapse, and with news this week that the US is intending to cut aid funding for the poorest country in the Middle East, officials are warning of disastrous consequences, should an outbreak take hold.

 

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Poignant memories of Yemen after 5 years of war

by Pauline Canham, Student Editor

I stepped off the Yemenia Airways flight, and onto a bus, transporting me and a dozen or so Yemeni nationals the short distance to the arrivals terminal at Aden International Airport.  It was April 2014 and my brief visit to the country, once dubbed ‘Arabia Felix’ or ‘fortunate Arabia’, came amidst a build-up of political tension.  Just 11 months after my visit, Yemen would tragically descend into what is now described as the world’s worst humanitarian disaster.

The coming week marks the 5th anniversary of the launch of ‘Operation Decisive Storm’, the Saudi Coalition offensive against Houthi rebels on 25th March 2015.  The anniversary was marked with the closure of airports to all traffic, except for humanitarian aid, due to concerns that the coronavirus would exacerbate what is an already catastrophic situation.

YEMEN_AREAS_CONTROL

Yet again at the top of IRC’s Emergency Watchlist for 2020, the fragile hope brought about by a recent de-escalation in the conflict was rocked by a renewed surge in fighting in some provinces.  The UN Special Envoy to Yemen, Martin Griffiths said last week that Yemen is at a “critical juncture” and urged warring parties to “de-escalate now” to prevent a slide back to greater violence.   His statement came after what he described as “the most alarming military escalation” which included a Saudi air strike in February that killed more than 30 civilians.  He also reiterated calls for access to the Safer Oil Tanker, as fears of an environmental disaster grow.  The ship, anchored in the Red Sea, contains 1.15 million gallons of crude oil, and experts fear it could explode at any time, due to a lack of maintenance.

In a statement to the Security Council on 12th March, the UK Permanent Representative to the UN, Karen Pierce said that the crisis “cannot be allowed to deteriorate any longer”.  The renewed violence has pushed even more people out of their homes and into camps around the country with three quarters of the 4.3 million internally displaced being women and children.

 

UK arms sales to Saudi Arabia unlawful

The civilian death toll in Yemen led to a British High Court ruling in 2019 that declared UK sales of arms to Saudi Arabia unlawful.   Despite this, the Government has continued to grant arms licenses to the Saudi Kingdom, in what were described as “inadvertent breaches” of the ruling.   The UK, US and other European Governments came under pressure to cease arms trading with Saudi Arabia after a number of so called ‘targeted’ attacks resulted in high civilian casualties.  One such attack killed 40 children and injured 56 while they were travelling on a school bus in the Sa’ada district in 2018.

Yemen_bus_bombing

Despite Human Rights Watch describing that incident as a war crime, Saudi Arabia has increased its arms purchases and those involved in the business of selling them have been accused of having blood on their hands.  In what appeared to be an eerie echo of German-American political philosopher, Hannah Arendt’s theory of the ‘banality of evil’, an official working at the UK Export Control Joint Unit, which signs off on shipments of weapons to Saudi Arabia said “I’m doing what I’m told and doing my job, but I’m uncomfortably aware that Adolf Eichmann said the same thing.”

Amnesty International is calling on the International Criminal Court (ICC) to investigate executives and officials involved in the sales of arms used in alleged war crimes in Yemen.  Working alongside the European Centre for Constitutional and Human Rights (ECCHR), they are requesting an investigation into 26 specific airstrikes which resulted in the unlawful killing or injuring of civilians “and destroyed or damaged schools, hospitals and other protected objects.”

 

Memories of a different Yemen

My flight from Qatar to Yemen’s southern coastal city of Aden in 2014 had felt unexpectedly like a family outing, with me in a role akin to visiting cousin from a distant land.  There was a fair amount of curiosity as to why I might want to visit Yemen during such a ‘delicate’ moment in time.  Though the Saudi-led intervention was still almost a year away, sporadic violence was commonplace and protests by Al Hirak Al Janoubi (Southern Secessionist Movement) were held regularly in Aden.  Al Qaeda in the Arabian Peninsula (AQAP) had been very active in Yemen and there had been kidnappings of Westerners by the group or their affiliates.

IMG_3556

But whatever apprehension I had before my departure was quickly soothed.  I was welcomed warmly from the very moment I stepped on the Yemenia jet in Qatar all the way through to my eventual departure from Aden.  I was embraced by the famously generous Arabic culture of my hosts, Yemeni people considered by many as the friendliest and most welcoming to visitors in the world.

Of course security was tight, there were checkpoints all over the city, we had several power cuts, and on one occasion Aden Mall was evacuated due to an escalating skirmish in the surrounding streets, but what I witnessed was a resilient community continuing with life undeterred.  The beaches were busy with families enjoying the spring sunshine, children swimming, young men riding horses along the sand and women having lunch with friends.  It was a happy atmosphere with no hint of the tragedies yet to come less than a year later.

IMG_3677My hosts took me to Aden’s historic sites, long since abandoned by visitors from around the world who used to flock to the South Arabian coast for winter sun.   The stunning 11th Century Sira Castle, embedded into a rocky peninsula in a prime defensive spot in the Gulf of Aden, and the incredible Cisterns of Tawila, estimated to be 1500 years old.  But my lasting memories were not of rock and stone, but rather of joy, laughter, friendship and a sense of living life in the moment that I realised I had lost.

On the way back to the airport, as I stressed about getting there on time, my friends pulled over at a small roadside tea stand.  Little glass cups of red tea were passed through the window and as I sipped at the sweet hot liquid, my friend turned up the car stereo, stepped out into the middle of the road and began to dance.  These poignant memories have become more precious with every anniversary of the war that passes.

What now for Yemen?

This anniversary brings with it the threat of coronavirus on top of an already perilous humanitarian situation.   But for Yemen’s collapsing health system, coronavirus is simply another issue on a growing list of threats.  Among the immediate concerns, in addition to the escalation in violence, is the impending rainy season, which every year heralds the onset of a rise in cholera cases.  In 2019, Yemen recorded 860,000 cases of the disease and 56,000 cases have already been recorded in 2020.  Oxfam’s Yemen Country Director said “This is a health crisis hiding in plain sight.  It’s shocking that this ongoing crisis is getting so little attention.”   With health workers needed evermore urgently, they too are coming under attack, being targeted by all warring parties in a blatant violation of humanitarian law.

Yemen hospital

The situation on the ground in Yemen is incredibly complex, with various proxy battles playing out between vying Gulf neighbours, most notably Saudi Arabia, UAE and Iran.  The UAE, officially part of the Saudi Coalition, recently tested the relationship with the Kingdom when it backed Al Hirak Al Janoubi to seize Aden from forces loyal to President Hadi, still internationally recognised as Yemen’s leader.   The Yemeni people, as always are caught in the cross-fire between major global powers, hungry to secure their positions in such a strategic location on the Bab al-Mandeb strait at the mouth of the Red Sea.

As we hunker down to protect each other from coronavirus, Yemen slips silently into a 6th year of war, unreported by a world focused on an unseen enemy of a different nature.

About the Author:

PC_AJ

Pauline Canham is the HRC Blog’s student editor.  Pauline is studying a Masters Degree in Human Rights and Cultural Diversity at Essex, after 20 years in the broadcasting sector, working for the BBC and AlJazeera, with a focus on large change projects including the BBC’s move into the new Broadcasting House in 2013, and the re-launch of Al Jazeera’s Arabic Channel in 2016.

An End to PFI/PF2- Implications for the Right to Health

By Amy Dickens

On 29thOctober 2018, Philip Hammond delivered a Conservative Budget declaring an end to austerity and outlining plans for a post-Brexit economy. Amidst his speech was the announcement that the government will finally end the Private Finance Initiative (PFI/PF2) on the basis of ‘compelling evidence’ that it does not deliver value for money or transfer risk to the private sector, as proclaimed by the Conservatives and their political predecessors.

Hammond also stated the government’s commitment to honouring its existing contracts. What the Chancellor omitted is the scale of the legacy PFI leaves behind; the 700 existing PFI and PF2 deals will cost the taxpayer an estimated £199 billion by the 2040s. These staggering costs, and the political opacity surrounding PFI, have attracted expert criticism and public outrage. I argue, however, that the PFI saga amounts to more than just an administrative scandal; it is an egregious violation of the rights of UK citizens. Continue reading

Right to health impact assessments needed before using Big Data

By Carmel Williams

Big Data is transforming health care in multiple ways, from patient management to diagnostic and treatment methods. These new technologies are changing the health and public health landscapes, offering improved public health and clinical care. However, careful oversight of proposed uses of Big Data technologies is needed to protect against discrimination and increasing health inequities. In this blog, I propose that governments should undertake human rights impact assessments, including assessments that integrate right to health impacts, before using Big Data driven technologies in health. These assessments provide a structured approach to examining multiple ways in which the right to health could be at risk, including, but moving beyond, privacy issues.

Examples of the use of Big Data in healthcare include personalised medicine where a patient’s treatment is tailored to their genetic and environmental profile, DNA sequencing (which results in vast amounts of data stored in bio banks), forensic, genetic or medical databases, including data from public health studies and clinical trials – and all of which can be re-purposed for various technical inventions. The artificial intelligence (AI) industry in health care is booming, with growth rates in economic terms of around 40% per annum, reaching over $US6 billion by 2021. All this depends on access to huge data sets.

The concerns about the use of patient data, whether for patient management or clinical purposes, have focused predominantly on privacy and breaches of security.  Although this is crucially important, here I examine broader social and economic rights issues, through the use of an abridged right to health framework (see the Oxford Textbook of Global Public Health, chapter 3.3, new version due in 2020).

Continue reading

Beyond privacy: the right to health implications of data sharing partnerships in healthcare

By Amy Dickens and Linsey McGoey

In November 2015, the Royal Free NHS Foundation Trust transferred over 1.6 million identifiable patient records to DeepMind, an artificial intelligence subsidiary of Google. Earlier that year, the Trust had privately signed an agreement commissioning DeepMind to develop an early warning system to detect Acute Kidney Injury (AKI). The resulting smartphone application, called Streams, is now in clinical use across the Royal Free and will soon be rolled out to other NHS Foundation Trusts.

When news of the deal broke, privacy advocates expressed astonishment at the private agreement. They were outraged by the Trust’s willingness to share confidential patient data without consent and other necessary protections. The Information Commissioner’s Office subsequently launched a year-long investigation into the deal, concluding in July 2017 that the Royal Free had violated the 1998 Data Protection Act. Despite the ruling, DeepMind has since partnered with multiple NHS Trusts. The company’s CEO, Mustafa Suleyman, has declared his ambitions to expand into the NHS and develop a digital platform that could support artificial intelligence technologies in the future.

Criticism of the DeepMind-Royal Free partnership has centred around privacy rights and data protection issues. While privacy concerns are important, our research suggests that a narrow focus on privacy has thwarted attention to related human rights concerns, particularly around the right to the highest attainable standard of health. Continue reading