WHEN THE STATE MAKES DEMANDS:

MEDICAL PROFESSIONALISM, DUAL LOYALTY, AND HUMAN RIGHTS

THURSDAY, MAY 12, 7 P.M.

Carl W. Walter Amphitheater
260 Longwood Avenue
Tosteson Medical Education Center
Harvard Medical School

This program is presented by Harvard Medical School, Physicians for Human Rights, and the United States Holocaust Memorial Museum.

Featured Speakers:

• Holly G. Atkinson, MD, Past President, Physicians for Human Rights
• Robert Jay Lifton, MD, Lecturer in Psychiatry, Harvard Medical School, and Distinguished Professor Emeritus of Psychiatry and Psychology, The City University of New York
• Jonathan H. Marks, BCL, Professor of Bioethics, Humanities, and Law and Affiliate Law Faculty, Pennsylvania State University Dickenson School of Law, and Edmond J. Safra Research Fellow, Edmond J. Safra Center for Ethics, Harvard University
• Robert N. Proctor, PhD, Professor of History of Science, Stanford University

The history of the Holocaust teaches us that in Nazi Germany, the state relied on the support of medical professionals to implement its eugenics program and ultimately enable genocide. The history also reminds us of the pressures that health care workers can face and the need for vigilance to protect health and human dignity as well as the needs of society.

Join the Holocaust Museum as experts in medical ethics, psychology, and the history of medicine delve into the history and lessons of the Holocaust for physicians and explore the difficult ethical questions that medical practitioners face in today’s society.

Panel Moderator

• Mildred Solomon, EdD, Associate Clinical Professor of Medical Ethics, Department of Global Health and Social Medicine, Harvard Medical School; Associate Clinical Professor of Anesthesia, Children’s Hospital Boston; and Director of the Fellowship in Medical Ethics, Harvard Medical School

The program is free and open to the public. Reservations are requested; register online or contact the Museum’s New England Regional Office at 202.488.6585 or newengland@ushmm.org.

Parking information and directions.

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.

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.

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

Marking the 100th International Women's Day

This blog post is the first of a series of 10 posts that will chronicle PHR Deputy Director Susannah Sirkin’s recent 13-day trip to Kenya and the Democratic Republic of the Congo (DRC) accompanied by PHR Asylum Network member Dr. Coleen Kivlahan. This diary of their assessment trip seeks to highlight the small — but seminal — achievements of grassroots organizations, women’s rights groups, health professionals, and legal advocates working to serve women and girl survivors of sexual assault in Eastern and Central Africa. The blog series will also underscore the challenges and hurdles that remain.

Kenya Journal

Nairobi, Kenya: How to combat widespread impunity for rape in Central and East Africa, starting here in Kenya? As PHR and other experts have documented for more than a decade, tens of thousands of women and girls have been — and continue to be — sexually assaulted by government soldiers, rebel forces, and civilians, both during and following armed conflict.

A critical problem in addressing this crisis has been the difficulty of prosecuting crimes of sexual violence, to enable survivors to seek justice and to help deter future crimes.

Groups who seek to support survivors’ needs face daunting obstacles: shame, stigma, rejection, lack of political will and poor resources. Perpetrators act with impunity and medical and legal capacity and forensic training required to support prosecutions against these perpetrators are lacking.

We’re here to learn more about this crisis and challenge in Nairobi, and then we’re heading West in a few days to eastern Congo. Dr. Coleen Kivlahan, a veteran PHR doctor, has joined me. She’s a pioneer in setting up SAFE (Sexual Assault Forensic Evaluation) programs in the US, one of our expert asylum evaluators in the DC area, and what’s more, a marathon runner, experienced trainer, and intrepid traveler. I’d go anywhere with her.

Day 1: All over town we see the bold black words on posters, key chains, flyers, wall paintings: Sita Kimya (“I will not keep quiet” in Kiswahili): Say No to Rape — a new awareness or “sensitization” campaign funded by USAID, the US Agency for International Development.

Sita Kimya means 'I Will Not be Quiet!', a rape
awareness campaign funded by USAID

Our aim is to check out the gaps in forensic evaluation — the best practices for health professionals who respond to victims in gathering physical and psychological evidence that can be used in prosecution — and documentation needed to hold perpetrators accountable for this crime. As we know, this all-too-silent crime is suffered by countless women in war as well as in the fragile peace that follows mass violence or armed conflicts. We’re meeting with doctors, lawyers, nurses, police, program administrators, government officials in health and justice, women’s rights activists, and aid workers.

These are travel impressions. The full assessment will come as we pack in our days and peel the onion, since every time we think we understand something, a new layer of complexity reveals itself. Each interview on this trip unravels another set of challenges: policies that seem great versus practices that don’t resemble them at all:

• Standards for treatment of victims and documentation of injuries that exist on paper but are not widely known or understood.
• Confusion about police and/or medical forms required for criminal investigation or evidence.
• Incomplete or inadequate formats for forms.
• Who does what in the investigation and justice systems to prosecute sexual violence?
• What capacities do professionals gathering evidence have and need? Do they have basic equipment?
• Extraordinary people here are making change and pioneering new approaches. Is there the necessary political will to end impunity for rape and serve justice to survivors?

The fun began early with a pub night. By the end of the evening, I had met students from as far away as Texas, learned something new about connective tissue diseases from a researcher at Boston Children’s Hospital, and even received career advice from one of the conference speakers—all while sipping delicious cocktails and enjoying good music. It was a great way to jump-start the weekend and to arrive at the conference knowing there would be familiar faces to greet.

The conference itself provided all the inspiration I had been looking for. The all-star presentation line-up included a keynote by Dr. Howard Zucker, who described the power of even small ideas to change the face of care for the underserved if we persist in pursuing their implementation. He was followed by Professor Stephen Marks, who expounded upon the notion of a right to health in the context of the current American political climate. The panels that transitioned the conference from morning to afternoon included:

• Motivational advice from PHR Past President Dr. Holly Atkinson about our role in bending the arc of history toward justice;
• Moving first-hand testimony about the conflicts in Chechnya and Darfur from Dr. Khassan Baiev and Dr. Mohammed Ahmed Eisa, respectively, along with commentary by Dr. Michael VanRooyen, Dr. Sondra Crosby, and PHR Deputy Director Susannah Sirkin about how American medical professionals can assist in the face of atrocities;
• Practical advice from resident Sohil Sud, fellows Stephen Morris and Parveen Parmar, and Oxfam America advisor Sarah Kalloch about how to pursue a commitment to human rights throughout medical training;
• Explanation by Dr. Ramin Asgary and lawyer Christy Fujio of the role medical affidavits can play in ensuring that torture survivors receive asylum;
• A primer from PHR Deputy Director Richard Sollom on the power of epidemiological research to hold perpetrators of human rights abuses accountable;
• Tips for developing advocacy initiatives based on clinical problems and taking these initiatives to the press, by Dr. Gloria White-Hammond, ABIM Foundation Director of Communications John Held, and PHR Senior Press Officer Megan Prock.

Click here to learn more about the speakers.

(In the next post, recap of the awards ceremony and Sujal Parikh Memorial Education Expo…)

About this time each year, I always find myself feeling a little burned out – thinking about whatever is coming (my “last free summer,” step 1, clinical rotations, residency).  The PHR National Student Conference serves as a powerful pick-me-up and inspires me towards greater heights.  Whether I was listening to Dr. Julio Frenk talk about his experience as the former Minister of Health in Mexico, Dr. Robert Lawrence discuss the founding of PHR and the development of Human Rights charters, my peer Justin List accept the Navin Narayan award for his incredible work in Uganda, or the conversations of inspired students like myself at tables all around me I was always instilled with a new passion for advocacy.  So many of my projects over the years have a direct tie to this conference.

This year’s conference will be no different.  Dr. Howard Zucker has held a variety of prestigious positions at the WHO, at the White House and at the UN – his insight into current international and domestic situations will be invaluable to hear.  Dr. Jennifer Leaning has a long history of powerful advocacy initiatives – here is a 2007 video of her discussing her personal investigations of the Darfur region and her thoughts about what will be needed: http://www.youtube.com/watch?v=Um2V0vf8SIk.  Sarah Kalloch worked for PHR for many years and has great insight into the national student program – she is currently working as a policy advocate and education specialist for Oxfam; she is also one of the most inspirational people I have ever had the pleasure of working with.  And there are so many more!

I think I am starting to stink again.

A demonstration in Uganda.

The film forum will explore the power of film in bringing about a movement to combat commercial sexual exploitation and modern-day slavery. PHR recently blogged about this issue.

Additional events include an opening night live performance by Tony award-winning actress and humanitarian Sarah Jones, followed by a cocktail hour with hors d’oeuvres by legendary chef Lydia Shire of Scampo, music performance, and a silent auction. On Saturday there will be a book signing with Siddharth Kara, author of Sex Trafficking: Inside the Business of Modern Slavery.

Tickets are available for purchase now. Discounted tickets are available for students, seniors, and non-profits.

Learn more, including film titles and times, at BITAHR’s the official website, and at their Facebook page.
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At this year’s Insitute, we’ll hear from such exciting speakers as PHR CEO Frank Donaghue (who is always a treat), a representative of the Asylum Network, an expert on health and human rights in Burma, and a resident from Dartmouth, who will tell us about keeping yourself active in human rights advocacy through residency, something I’m sure we’re all interested in.

So, everyone should come, I promise it will be worth taking the time out of your busy schedule. You can register here. (And on that note, everyone in your chapter should also register themselves to receive updates and opportunities from the PHR National Student Program – you can do that here.)

Hope to see you there!