|Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.)|
|69. A Reader in Human Rights (1) - The Short Papers Here Collected are Part of an Ongoing Series the Author Irregularly Submits to About a Half Dozen E-Mail List Servers|
*: Some topics do and will repeat themselves slightly in these readers. It has been my experience that by being exposed to them from slightly different angles they slowly begin to sink-in into our consciousness.
Food for questions to be asked
Typical Human Rights questions one should ask about services are:
Is there sufficient attention being paid to the most vulnerable groups?
Is there equal access to services?
Do service providers practice non-discrimination towards people with scant means or no de-facto entitlements? , and further,
Are privacy and confidentiality observed?
If present, social vulnerabilities can and should be reduced. One of the important means is to pass/modify laws/regulations so that they now positively discriminate in favor of the specific vulnerable populations.
But the vulnerable themselves do not have the clout to pressure for this to be done.
It is we, the providers, who have to start working with the most vulnerable so they can pick the tools they need to claim the specific rights of their own.
Human Rights do provide a tool of analysis that will help the forgotten identify key societal determinants that are responsible for their vulnerability and their violated rights.
Human Rights can and should thus be used to reduce those vulnerabilities and violations by modifying pertinent behaviors, attitudes, power relations, and ultimately programs, regulations and laws.
Because Human Rights focus on the forgotten, understanding the diseases of poverty (which are foremost the biological translation of social, economic and political diseases) necessitates an understanding of Human Rights.
Human Rights puts the individual at the center, and this is not to be seen as contradictory but synergistic and complementary with public health which deals primarily with populations rather than with individuals.
As a process or an approach, Human Rights actually also call for a broad-scale movement that engages people in achieving specific goals and outcomes.
To live up to this, we have to promote practical ways of participation that make Human Rights relevant to peoples everyday lives! ...this, not necessarily an easy task.
The road will be long and tortuous. Sustainable social and behavioral changes will be needed at many levels and we have to foster those --starting yesterday...
In practical terms, Human Rights define what governments can do to us, cannot do to us, and should do for us. It is in this context that we have to understand their obligation to respect, protect and fulfill:
· Governments respect when they refrain from directly or indirectly interfering with the enjoyment of peoples rights, e.g. by providing non-discriminatory social services for all.
· Governments protect when they rescind old decrees or prevent third parties from interfering with or infringing peoples rights, e.g. by canceling user fees, or by de-facto impeding that pharmaceutical houses or the insurance industry affect equal access to health (as recently in South Africa).
· Governments fulfill when they adopt legislation towards the full realization of peoples rights, e.g. by providing redress for people whose rights have been impinged, or by ensuring strictly equal protection under the law, or by stopping discrimination in the access to the procurement of services such as health.
(Freedom from discrimination is central in international Human Rights law.
A prominent example is discriminations against women.
As a matter of Human Rights, women have to have (!) the ability to control
and make decisions about their lives).
Human Rights are thus important standard setters in the assessment of government performance, of governments taking the appropriate measures and ensuring internationally sanctioned provisions.
And civil society simply has to take up the challenge and become the protagonist in these accountability checks.
Governments may decide to embark on a progressive realization of Human Rights, i.e. progressively proceeding --to the maximum of their available resources-- to get there. If this can be independently proven, that is OK. (Conversely, lack of government resources, is not a reason for not implementing Human Rights provisions!).
From the global perspective, and under exiting provisions, the international community does have the obligation to support the upholding of Human Rights in such resource poor countries, especially if the latter are genuinely embarked in the progressive realization of rights.
Three more issues need be emphasized here at the end:
1.- The neglect of the right to information/education does have a substantial health impact, especially for women. For instance, mis or lack of information about antenatal care, nutrition, TB, HIV, or epilepsy (to mention just a few), or even about available curative and preventive treatments can and does make the difference between life and death.
Therefore, a retooled (!) public health IEC (information/education/communications) will have to play its role in eliminating Human Rights violations.
2.- Human Rights have implications for data collection and use.
Human Rights principles and norms are relevant when choosing which data are to be collected to determine the type and extent of, for example, health problems affecting a population. Decisions on how to disaggregate data equally have direct influence, not only on the policies and programs that are put into place, but also on the sub-populations to be reached as a matter of priority.
3.- Commercial sex workers, substance abusers and AIDS patients are being particularly stigmatized and criminalized in our societies; they are pushed to the margins.
This does not obviate their right to equal and non-discriminatory access to information, prevention and treatment services, as well as to the social services that address the underlying and structural causes of these facts of 21st century social life.
Claudio Schuftan, Hanoi
Stop TB Guidelines for Social Mobilization: A Human Rights Approach to TB. Health and Human Rights in Sustainable Development Group, WHO, Geneva, 2001.