PHR Student Program Northeast Regional Hub

Following PHR’s calls for the release of detained doctors and medical staff in Bahrain, nine doctors were reportedly freed. According to PHR’s sources in the field, eight female doctors and one male doctor were released late yesterday evening.

Doctors in Bahrain have been disappearing as part of a systematic attack on medical staff, as detailed in PHR’s recent report, “Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients.” Many of the medical professionals are being held incommunicado in unknown locations and on Tuesday the government of Bahrain charged 47 medical staff with trying to overthrow the regime.

Last month, PHR launched the campaign, Bahrain Free the Docs. The campaign has called for the release of detained medical staff and for the government of Bahrain to end violations of medical neutrality, a principle enshrined in international law and international humanitarian law which dictates noninterference with medical professionals in times of civil unrest and conflict. In the weeks following, PHR released a report, PHR members wrote letters to the Crown Prince of Bahrain calling for the release of the doctors and PHR joined with prominent medical associations to call for the Crown Prince of Bahrain to cease the attacks on medical staff. The campaign resulted in widespread media coverage including pieces on CNN and in The New York Times as well as the US State Department expressing concern about the violations of medical neutrality in Bahrain.

While PHR celebrates with the families of those released yesterday, we continue to call on the government of Bahrain to free the remaining physicians and stop their attacks on health professionals.

Physicians for Human Rights (PHR) today released an emergency report which documents and decries systematic human rights abuses in Bahrain. For the first time, the report, “Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients,” provides forensic evidence of attacks on physicians, medical staff, patients and unarmed civilians with the use of bird shot, physical beatings, rubber bullets, tear gas and unidentified chemical agents. The report was featured on several major news outlets including the Associated Press, AFP, BBC, CNN, the Independent, New York Times, and Washington Post.

The report details systematic and coordinated attacks against medical personnel, as a result of their efforts to provide unbiased care for wounded protestors. These attacks violate the principle of “medical neutrality” and are grave breaches of international law which dictates noninterference with medical services in times of civil unrest. Included in the violations were targeted kidnappings, beatings, and threats of rape and killing by security officials. These attacks extended to the patients of medical personnel created an atmosphere of fear which dissuaded patients from seeking care.

The report concludes with policy recommendations for Bahrain, the Unites States and the international community. Among other calls for action, PHR demands for Bahrain to immediately cease and desist all attacks on medical personnel and facilities. PHR also calls on the Obama Administration to lead an international effort to appoint a Special Rapporteur on Violations of Medical Neutrality through the United Nations Human Rights Council.

A letter to the Editor on immigration, by PHR’s Asylum Program Director, Christy Fujio, appeared on April 1 in the New York Times.

To the Editor:
Re “Southern Lawmakers Focus on Illegal Immigrants” (news article, March 26):

The overreaching attempts of lawmakers in several states to “fix” perceived immigration problems are shortsighted and dangerous. Many proposals, including those that would bar undocumented people from attending college or marrying United States citizens, are alarmingly reminiscent of the segregation laws that plagued our country and set an embarrassingly recent precedent for institutionalized discrimination.

South Carolina’s proposed bill, which would make it illegal to transport immigrants anywhere, including to a hospital, is particularly egregious because it could effectively deny critically needed medical care to thousands of people. This not only threatens the health of individuals, but also the public health of the entire state.

Additionally, it would place emergency medical technicians in the untenable position of having to act as immigration enforcement officers rather than healers. Health professionals’ first duty is to provide their patients with the best care possible; they cannot do that if the state forces them into an enforcement role.

CHRISTY FUJIO
Asylum Program Director
Physicians for Human Rights
Cambridge, Mass., March 26, 2011

Medical students during PHR's human rights training, Fall 2008.

Last year, thanks to the dedication of our wonderful PHR intern Margeaux Fischer, a donation of 441 medical textbooks was shipped to the Zimbabwe Association of Doctors for Human Rights (ZADHR), with whom we helped organize a health and human rights training for medical students in 2008.

One of the ways we were able to help satisfy the needs of the students we met was through the donation of these medical texts. Our friends at ZADHR wrote about it in their recent eNewsletter:

ZADHR in conjunction with Physicians for Human Rights (USA) has donated books worth more than US$ 50,000 to the College of Health Sciences at the University of Zimbabwe. The total number of books donated is 441 and of these books 37 have already been selected for the reserve section as they are deemed very important and needs close surveillance on their usage.
ZADHR continues working with Physicians for Human rights in trying to improve access to medical books to medical students in Zimbabwe.
ZADHR would like to continue with such a positive relationships with the College of Health Sciences and they are looking for more ways they can improve access to information and other necessary resources at the College of Health Sciences.

Senior staff from the college examine the donated books.

The ZADHR student leadership PHR trained two years ago have just conducted their own training for 37 students. Norman Matara, one of the leaders, writes:

We have just held a health and human rights where we have trained 37 students in HHR. What was really exciting was that we were the ones who made the presentations, sharing what you have taught us with our young brothers. We still fight for health rights.

Norman Matara (l) and fellow students with donated books.

PHR is proud to  support these students and others around the world. We are in discussions with other US student chapters to see if another book donation drive can be put together. Let us know if you’re interested or can help!

Medical students during PHR's human rights training, Fall 2008.

Last year, thanks to the dedication of our wonderful PHR intern Margeaux Fischer, a donation of 441 medical textbooks was shipped to the Zimbabwe Association of Doctors for Human Rights (ZADHR), with whom we helped organize a health and human rights training for medical students in 2008.

One of the ways we were able to help satisfy the needs of the students we met was through the donation of these medical texts. Our friends at ZADHR wrote about it in their recent eNewsletter:

ZADHR in conjunction with Physicians for Human Rights (USA) has donated books worth more than US$ 50,000 to the College of Health Sciences at the University of Zimbabwe. The total number of books donated is 441 and of these books 37 have already been selected for the reserve section as they are deemed very important and needs close surveillance on their usage.
ZADHR continues working with Physicians for Human rights in trying to improve access to medical books to medical students in Zimbabwe.
ZADHR would like to continue with such a positive relationships with the College of Health Sciences and they are looking for more ways they can improve access to information and other necessary resources at the College of Health Sciences.

Senior staff from the college examine the donated books.

The ZADHR student leadership PHR trained two years ago have just conducted their own training for 37 students. Norman Matara, one of the leaders, writes:

We have just held a health and human rights where we have trained 37 students in HHR. What was really exciting was that we were the ones who made the presentations, sharing what you have taught us with our young brothers. We still fight for health rights.

Norman Matara (l) and fellow students with donated books.

PHR is proud to  support these students and others around the world. We are in discussions with other US student chapters to see if another book donation drive can be put together. Let us know if you’re interested or can help!

Only 37% of Ugandan physicians are satisfied with their jobs and nearly half are at risk of either exiting the health sector or leaving Uganda entirely, according to a study published this year by the International Journal of Health Planning and Management. The study, “Satisfaction, Motivation, and Intent to Stay Among Ugandan Physicians,” is co-authored by Emily Bancroft, a former Leland Fellow with PHR in the US and AGHA in Uganda. Dovetailing with PHR’s previous works on health worker shortages in Africa, the study’s results come from a sample group of physicians working in 18 public and private health facilities in Uganda representing approximately 3% of Ugandan physicians. This study came about at the behest of Uganda’s Ministry of Health, which hopes to analyze how to implement effective policy reforms to strengthen and expand their health workforce. Bancroft’s team, headed by long time PHR advisor Professor Amy Hagopian of the University of Washington, urges Ugandan policy-makers to intervene to stem the “brain drain” that is heightened by factors such as low wages, poor infrastructure and materials, few opportunities to progress within the medical field, and regional isolation for doctors outside large cities.

14% of Ugandan physicians emigrate abroad, largely to four English-speaking countries—the US, Canada, the UK, and Australia. This number is significantly lower than that of some other countries in peril. For example, it is frequently said that more Malawian doctors practice in Manchester, England, than in the entire country of Malawi. Although Uganda’s health workforce shortage seems less drastic than Malawi’s, the crisis is no less dire: in 2008, the study’s authors estimated that there are only 2,500 physicians for Uganda’s 31 million inhabitants. Physicians, far more so than other Ugandan health professionals, were seen by Bancroft and colleagues as dissatisfied with their work and both ready and capable of vacating their posts if the opportunity should arise. Along with nurses, physicians are the group most heavily courted by international recruiters, which means many of the physicians Bancroft spoke with may already have found an opportunity to leave Uganda.

The World Bank and International Monetary Fund have exacerbated the “brain drain” seen in Uganda and throughout Africa with “structural adjustment” policies that cap domestic health expenditures. Wealthy countries can offer doctors higher salaries, greater career advancement opportunities, and, in many cases, a more stable political environment in which to work.

The Global HEALTH Act, introduced by Rep. Barbara Lee in March 2010, would assist Uganda’s efforts and help curtail health workforce shortages in countries facing similar crises by providing $2 billion over five years to increase the number of physicians, nurses, and other health workers in developing countries—and to help retain those health workers already there. The bill not only authorizes new resources, it also calls for the creation of a US Global Health Strategy to complement the goals of countries like Uganda and ensure US aid money goes where it can make a difference. This study will help foreign aid innovations like the Global HEALTH Act to better tackle complex problems like brain drain and to work with communities to solve these challenges—something PHR is dedicated to helping support.

The Obama Administration has initiated a comprehensive review of US landmines policy to decide whether or not the US will join the Mine Ban Treaty. President Obama needs to hear from you about how harmful landmines are to the health and human rights of people worldwide.

Email President Obama today and tell him to join the Mine Ban Treaty.

PHR shared the 1997 Nobel Peace Prize for our work to ban landmines. Since then, 156 countries have signed onto the treaty, which bans the use, trade, production and stockpiling of antipersonnel mines.

However, the US has refused to join. President Obama now has the opportunity to partner with every member of NATO—and every country in the Western Hemisphere, save Cuba—in supporting this critical treaty. Tell him to take action today.

Landmines kill thousands of people a year, with millions more affected by the agricultural, economic and psychological impact of the device. While landmines are a weapon of war, most casualties are civilians: indeed, UNICEF estimates that 30-40% of landmine victims are children. And landmines don’t just kill in conflict zones: there are millions of landmines and unexploded ordinances in more than 80 countries worldwide.

These indiscriminate weapons maim and kill, and destroy families and communities. The US has not used landmines since the 1991 Gulf War; it is time for us to promise never to use them again. Tell Obama to join the Mine Ban Treaty today.

68 Senators co-signed a letter to President Obama in May, showing their support for the Mine Ban Treaty. Now Obama needs to hear from you. Email him today, and ask 6 friends to do the same. PHR members have been advocating to ban landmines for more than 15 years. This is our best chance to join the Mine Ban Treaty in years, and we need your support.

Take action today!

Want to do more? We are asking major US health professional associations to sign a letter to the Administration against the use of landmines. If you have any contacts at health professional associations who might be able to help, please email Gina at gcoplon-newfield[at]phrusa[dot]org.

As you read in our previous landmines blog post, the Obama Administration is reviewing current US landmine policy right now, and will soon decide whether or not the US will join the Mine Ban Treaty. Why should the US join? Check out these compelling facts and see why this is a critical health and human rights issue:

Injury and Death:

• The International Campaign to Ban Landmines (ICBL) estimates that 15,000-20,000 people are maimed or killed by landmines yearly, with millions more affected by the agricultural, economic and psychological impact of the weapon.
• UNICEF estimates that 30-40% of mine victims are children under 15 years old.
• Landmines are responsible for the injury and death of thousands of US and allied troops in all US-fought conflicts since World War II, including dozens in Iraq and Afghanistan. In the 1991 Gulf War, landmines caused 34% of US casualties.
• At the beginning of the 20th century, nearly 80% of landmine victims were military personnel. Today, 90% of landmine victims are civilians.

The Economic and Social Cost:

• The ICBL estimates that there are millions of landmines and other unexploded ordnance in the ground in over 80 countries.
• Landmines cost as little as $3 to produce and up to $1,000 per mine to clear.
• Most kinds of landmines last forever. Mines laid during WWII are still killing and maiming civilians.
• It costs $100 to $3,000 to provide an artificial limb to a landmine survivor. Adults require a prosthesis replacement every two to three years and a child must have a new one every six months to a year.
• Landmines cause environmental damage in the forms of soil degradation, deforestation, and the pollution of water resources with heavy metals. Subsistence farmers are unable to work the land in mined areas.
• Landmines affect all aspects of human life, including the ability of refugees to return home. A report from the United Nations High Commissioner for Refugees (UNHCR) published in 1997 stated that 13.2 million refugees, 4.9 million internally displaced people and 3.3 million returnees were at risk from landmines.

The US and Landmines:

• The United States is one of only 39 countries that have not yet joined the Mine Ban Treaty; in the Western Hemisphere, only the U.S and Cuba are non-signatories.
• The US has the third largest mine arsenal in the world—a stockpile of 11 million Anti-Personnel Landmines (APLs)—despite not using landmines since 1991 or producing them since 1997. Enormous amounts of taxpayer money are used to maintain these weapons.
• The United States is one of only 13 countries that refuse to halt production of APLs.
• The Bush Administration’s landmine policy, announced in February 2004, represented a major rollback of US progress on the landmine issue. The policy increased funding for mines, permitted indefinite US use of self-destructing mines, and refused to phase out long-lived mines until 2010. The Obama Administration has yet to revise the Bush policy.

These indiscriminate weapons maim and kill, and destroy families and communities. President Obama is currently reviewing US landmine policy. We need your voice to tell the President to ban mines now! The US has not used landmines since the 1991 Gulf War. It is time for us to promise never to use them again.

Take action today: email Obama and tell him to join the Mine Ban Treaty!

The Obama Administration has initiated a comprehensive review of the US landmines policy to decide whether or not the US will join the Mine Ban Treaty. PHR has re-engaged in this campaign at the request of The US Campaign to Ban Landmines (USCBL) and members of the Administration, and we are hopeful that this will be an opportunity to show the world that the US respects health and human rights.

Over the next few months, we’ll be updating you on the treaty via a new blog series (this is blog #1) and asking for your help to urge President Obama to join the Mine Ban Treaty.

One immediate action item: We are asking the presidents of major US health professional associations to sign a letter to the Administration showing the unity of the medical, public health and nursing community against the use of landmines. If you have any contacts at major health professional associations who might be able to help, please email Gina Coplon-Newfield at gcoplon-newfield[at]phrusa[dot]org as soon as possible.

As you may know, PHR is a founding member of the International Campaign to Ban Landmines (ICBL), a grassroots movement that brought the international community together to form the 1997 Mine Ban Treaty, which bans the use, trade, production, and stockpiling of antipersonnel mines. PHR and the other ICBL founding groups were awarded the Nobel Peace Prize for their work toward achieving the treaty, which 156 countries have signed.

As with many international human rights treaties, the US has refused to sign, arguing that US soldiers are exposed to risk if the country can’t use landmines as a deterrent weapon. The United States’ position sets us apart from most other countries: Indeed, all other member countries of NATO are signatories to the treaty (Poland plans to ratify the treaty in 2012). By refusing to sign, the US joins China, Russia, Cuba, India and Pakistan among the countries that have not committed to stop using landmines. The US has not used landmines since the 1991 Gulf War, yet previous administrations have chosen to keep the weapon available, just in case.

Early in his tenure, it appeared President Obama had made the same decision. In November 2009, a White House spokesman stated that after reviewing the matter, the Obama Administration had decided not to sign the Mine Ban Treaty. The announcement prompted public outcry among human rights groups, and the following day, the White House insisted the issue was still under review. The current review is headed by Samantha Power and Barry Pavel at the National Security Council.

We expect the Obama Administration to make a decision in the next few months, making it critically important that the President hear from health professionals and human rights activists about how harmful landmines are to humanity. We will soon send out an action alert, which will give you the chance to email Obama and urge him to sign onto the Mine Ban Treaty. Please take action, and urge friends and family to do the same.

Congress is joining in the advocacy too. On May 22, Senator Patrick Leahy of Vermont sent a letter co-signed by 68 senators (including 10 Republicans) to President Obama, encouraging him to develop a plan to overcome any obstacles to joining the Convention. 68 is a magic number: international treaties must be approved by a 2/3 majority in the Senate, so if Obama decides to sign onto the treaty, 68 Senators would be enough to accede to it (of course, though this letter is a good indication of potential votes, it’s not a guarantee).

PHR members have been advocating to ban landmines for more than 15 years, and we need your help again at this critical juncture. Keep an eye out for more actions alerts and blogs. And spread the word—this is our best chance to join the Mine Ban Treaty in years, and we need your voice!

On May 10th, The New York Times published a heartrending story on the faltering fight against AIDS in Uganda — a story that has sparked a firestorm of controversy and criticism of the Obama Administration’s global AIDS strategy.

The Times identified a deep funding gap for combating AIDS in Uganda, including a freeze on new funds from the United States and a lack of commitment to AIDS spending by the Ugandan government (which evidently has no problem finding $300 million to spend on Russian fighter jets). The Times also outlined the devastating human toll this funding gap is taking on people living with — and dying of — AIDS.

Sadly, this news is not new. In March 2009, PHR invited Dr. Peter Myugenyi, Founder and Director of the PEPFAR-supported Joint Clinical Research Centre in Uganda, to Washington, DC to talk about the emerging funding gap for AIDS in Uganda. Said Dr. Mugyenyi:

After urging people to get tested and enter care, we now have to tell them there is no treatment available when they need it. We created hope and now we are returning to the days when one member of a family can get treatment and the others cannot.

It is a recipe for chaos as patients start to share doses or skip treatment altogether. I fear that we will soon start to see more drug-resistant strains of HIV and rising death rates.

As The Times notes, one year later, Dr. Myugenyi remains fearful:

Dr. Peter Mugyenyi, the hospital’s founder, helped the Bush administration form its AIDS plan and sat beside Laura Bush during the State of the Union address as it was announced.

The loss of donor interest “makes me frantic with worry,” Dr. Mugyenyi said.

He offers copies of e-mail messages he exchanged with American aid officials. One reminds him that he has been instructed to stop enrolling new patients and asks for an explanation of reports that he is treating 37,000 when only 32,000 are authorized. Another asks him not to announce publicly that his funds have been frozen.

He admits slipping pregnant women and young mothers like Ms. Kamukama into treatment slots “contrary to instructions.”

“Morally, I can’t turn them away,” he said.

This story gained traction worldwide, and was followed by a New York Times editorial, The Wavering War on AIDS, which outlined a $13 billion deficit in AIDS spending, and a series of letters to the editor, including one by PHR Global Health Action Campaign advisor Pat Daoust.

Dr. Mugyenyi won’t turn away patients. And we won’t turn away from this issue.

PHR, in conjuction with other global health groups, sent a letter to Secretary of State Clinton last week, urging her to end the AIDS funding freeze and ensure Ugandans have access to life-saving AIDS treatment.

PHR members have spent years advocating for more global AIDS funding and health programming based on science and human rights. We will continue to fight for greater global health funding, a strong US global health strategy, and to ensure people living with AIDS worldwide have access to drugs and quality care.

Want to help? Encourage your Representative to co-sponsor the Global HEALTH Act, which will provide $2 billion for health system strengthening and support a comprehensive US global health strategy, both of which will help in the fight against AIDS.