The Coronavirus in the Middle East: Its Impact on Sectarianism and Refugees

The coronavirus has spread to virtually every country of the world, but due to differences in privilege and access to resources, many countries are unable to adequately address this pandemic as well as other countries are. However, for countries in the Middle East, in addition to these differentials, the pandemic has also further exacerbated many preexisting problems that the region faces, namely political, economic, and social unrest. While this outbreak has had ramifications on several facets of life in the Middle East, this blog post will be focusing on the outbreak’s impact on sectarianism and the refugee crisis.

An image showing Shia Muslims visiting a shrine.
Shrine visitation. Source: Yahoo Images, Creative Commons.

Sectarian Conflict

The Middle East is marred by the Sunni-Shia conflict, and geopolitics are heavily influenced by this divide. Because of this, the divide is often invoked when something disastrous occurs in the region, with each side blaming the other, and the coronavirus outbreak has proven to be no exception. Although the coronavirus has spread to all Middle Eastern countries, Iran, a Shia-majority country, has been disproportionately impacted; as of March 31st, Iran has had 44,605 coronavirus cases and 2,898 deaths, making it one of the countries with the most cases in the world. Further, Iran has now been identified as the source of spread to other Middle Eastern countries; some of the earliest identified cases in the Middle East were all of people who had recently traveled to Qom, one of the holiest cities in Iran. Despite the fact that people were aware of the outbreak in Iran, visitations to holy shrines in Iran were not discouraged, and people continued to travel to these holy sites. Any large gatherings during this time pose a risk, but shrine visitations are especially risky; many people engage in practices at shrines, such as kissing and touching the shrines, that lead to an increased likelihood of spreading. Since the outbreak is speculated to have spread from Qom, the city where one of the holiest shrines, the shrine of Sayyida Fatima al-Zahraa, is located, it is not unlikely that transmission did occur like this.

Because the spread has been identified as coming from Iran, many Sunni-majority countries in the Middle East have used this as an opportunity to justify further prejudice and discrimination against Shia Muslims. For example, Shia Muslims in Saudi Arabia who recently traveled to Iran for shrine visitations were labeled as traitors, leading some to call for their execution. In other countries, such as Lebanon, preexisting sectarian conflict has only gotten worse. It has been claimed that the first case in Lebanon came from Iran, leading many to blame the Shia Muslim population of Lebanon. Further, the Lebanese government continued to allow flights from Iran up until mid-March. Due to this, many have criticized Iran’s influence in Lebanon, specifically its influence on the government.

 

An image showing a Syrian refugee camp.
A Syrian refugee camp. Source: Yahoo Images, Creative Commons.

Refugees in the Middle East

There have been refugees in the Middle East for the past several decades, but the number of refugees significantly increased after the Arab Uprising in 2011. Because refugees often live in destitute conditions, the coronavirus outbreak would prove to be disastrous for them. Once a case of the coronavirus reaches a refugee camp, there will be little to nothing that can be done to stop its spread; large families live within the same tent, usually only five feet apart from other nearby tents. For this reason alone, social distancing is not an option for refugees living in camps, highlighting the intrinsic privilege of others’ ability to practice and call for social distancing. In addition to this problem, refugees also do not have access to the resources necessary for sanitization, namely due to lack of access to clean water. Further, there are often no established healthcare systems within refugee camps, making it difficult for them to access resources that would be needed to aid infected individuals. Even if refugees were to seek health care outside of the camps, it is not guaranteed that they would have access to this care. For example, many refugees are internally displaced in war-torn countries where hospitals have been demolished and those that are still standing are severely lacking in resources. Further, even when refugees resettle in other countries with established health care systems, it is not incorrect to assume that nationals of that country will be given preference over refugees for treatment and access to resources.

Despite the scarcity of resources and bleak outlook for refugee camps, measures have been taken to ensure that refugees are protected as best as they can be from the coronavirus. For example,  many refugee camps have been sanitized with anti-bacterial spray. Certain organizations, such as Islamic Relief, have donated supplies, including rubbing alcohol and medicine that treats certain symptoms of the coronavirus, to ensure that if an outbreak does occur within a camp, there are some necessary resources available. Finally, the UNHCR has appealed governments for $33 million in funds to provide refugees access to hygiene kits, protective gear, and sanitary water, among other things, that could help deter the spread of the coronavirus.

Recently, an IHR Intern wrote a blog about racism and discrimination that arises during outbreaks such as this one. While Asians have largely been victims to racism during this period, in the Middle East, Iran and Shia Muslims have been targeted, highlighting that people do indeed try to blame such events on others when, in reality, there is no one that should be blamed. Further, times like this also highlight the level of privilege many of us live in; while we have the privilege to access resources and to distance ourselves from one another, other groups who lack such privileges, namely refugees, cannot practice any of these things. Thus, while we are all impacted by this outbreak, it is important to recognize that many people, in addition to worrying about the coronavirus, face other obstacles during this time as well, and these groups should be kept in mind.

Good and Mad: The Political Consequences of Women’s Anger with Rebecca Traister

Book cover - Good and Mad: The Political Consequences of Women's Anger
Source: Yahoo Images

On Tuesday, March 10th the Institute for Human Rights alongside the UAB Department of English and the UAB Department of Political Science and Public Administration welcomed Rebecca Traister, writer-at-large for New York magazine, to present a lecture entitled, “Good and Mad: The Political Consequences of Women’s Anger.” The lecture is a part of the UAB Department of English Alumni Lecture series, a series that invites prominent writers and scholars twice a year to discuss ideas and issues related to the study of English. In this lecture, Traister discussed her inspiration for writing and how she became a writer, women’s anger throughout history, the validity of women’s anger, and how women’s anger can make change in the modern era.

The lecture focused on the consequences of women’s anger, a topic that Traister has extensively written about in her book “Good and Mad: The Revolutionary Power of Women’s Anger,” published in 2018. Traister has also written books entitled “All the Single Ladies: Unmarried Women and the Rise of an Independent Nation,” published in 2016, and “Big Girls Don’t Cry,” published in 2010, that focus on similar topics. Alongside her books, Traister has been a feminist journalist for 15 years and describes anger to be a significant part of her work. This anger, Traister says, is a reaction to the many inequalities and injustices in the world. Without anger, it would be impossible to be in the line of work she is in. However, Traister describes being unable to be openly angry. She found that expressing her personal rage would undermine the messages she has been so committed to sharing.

Rebecca Traister speaking.
Rebecca Traister speaking. Source: UAB Institute for Human Rights.

This changed in 2016 with the election that ultimately resulted in Donald Trump becoming the President of the United States. Traister had covered the Hillary Clinton campaign as a journalist and describes being unsurprised that Clinton had lost but at the same time “shocked to the point of paralysis” that Trump won. She also describes feeling a sense of responsibility for being a part of the demographic that voted for Donald Trump (white, middle aged women) and expresses being unable to think clearly because of her anger. Her husband encouraged her to actively pursue her anger and write about it. In a way, this encouragement permitted her to think about anger very intentionally, prompting her to write her 2018 book.

Traister moved from her personal journey to discuss the historical implications of women’s anger and how history classes often remove this narrative. Traister encouraged the audience to think about what we learned about Rosa Parks from grade school: a stoic, exhausted seamstress who practiced an act of quiet resistance. Traister expands on this well-established narrative of Rosa Parks by reminding the audience of Parks’ other accomplishments as a member of the NAACP and encouraging us to remember Rosa Parks as a woman who participated in conscience political action based in fury. In another example, Abigail Adams is known for saying, “remember the ladies,” in a letter she wrote to her husband John Adams. Traister reminds the audience that in the same letter Adams wrote, “All men would be tyrants if they could” and warned her husband that if the founding fathers did not take women into consideration, “women are determined to ferment a rebellion.” Traister also includes Elizabeth Freeman, or Mum Bett, into the example, a slave who sued for her freedom and was successful, concluding in a landmark case that was influential in the emancipation of slaves in Massachusetts. Not many people in the audience had heard Elizabeth Freeman’s name before. It is relatively common to find furious women at the start of many movements in this country, Traister says. The deliberate depiction of women as quiet and merely supplemental or in the right place at the right time removes the purposeful, furious action that women have partaken in throughout history.

Rebecca Traister event
Rebecca Traister event. Source: UAB Institute for Human Rights.

Now why has this become the case? Traister argues that this pattern has occurred because angry women are powerful and powerful women are a danger to the patriarchal society. She proceeds to analyze the many ways that angry women have been portrayed in media and history. The stereotype of angry women is that they are infantile and not worthy of listening to. There are examples of describing high profile, powerful, and angry women as shrill, unhinged, ugly, unnatural and “a crazy aunt.” Traister explains that women’s anger is coded in our minds as unattractive, the opposite of how society perceives an angry white man. The best way to discredit women, Traister states, is to simply show them opening their mouths. However, Traister describes some of anger’s most important roles. It can bring people together by creating a movement around a shared fury. It can encourage people to become involved in politics, inciting political change. Black Lives Matter, Mom’s Demand Action, Black Lives Matter, Brett Kavanaugh protests, Time’s Up, #metoo, and many others were all started by women.

At the end of her lecture, Traister encourages us to think about anger differently, as fuel propelling us forward. She states that a movement is made up of many moments and the movement for full equality has been ongoing for two centuries. Each person must decide whether or not to change the world and should we decide to do so, our anger is what is going to keep us fighting. Traister ends the lecture by giving each audience member the same task: keep going, do not turn back, and stay angry for a long time.

Responding to COVID-19 in Developing Countries: An Appeal from Our Friends at Nashulai Maasai Conservancy in Kenya

Photo showing Maasai men standing next to each other in a field.
Maasai men at Nashulai Conservancy. Source: nashulai.com

Just a few short months ago, the IHR hosted Nelson and Maggie Reiyia from Kenya who spoke to us about Nashulai Maasai Conservancy, wildlife conservation, preservation of culture, and how to empower whole communities from the inside out, especially girls and women.

How long ago this seems now, in the midst of the COVID-19 crisis. The impetus of this blog post is Nelson and Maggie’s desperate appeal to help support their people who have been hit extremely hard by this crisis, and to show how COVID-19 affects people in the developing world.

COVID-19 in developing countries

While we have raised awareness of what this crisis means for some of the most vulnerable and marginalized in our own society, having to deal with a pandemic in developing countries is a whole different endeavor. The virus itself and the sickness it causes are only half of the danger. Major societal issues such as widespread poverty, economic deprivation, and lack of access to water, food, sanitation, and healthcare present huge challenges for people in the Global South. The COVID-19 crisis threatens already fragile economies and has the potential to negatively impact human rights, education, basic resource allocation, and food security. Under-resourced healthcare systems and hospitals are likely to be overwhelmed, creating a probability for higher death rates. A majority of people in developing countries also lack access to water and soap, increasing the likelihood of infections and facilitating the spread of the disease. In addition, there are no social safety nets or government bailouts for workers and businesses, exacerbating scarcity, political struggles, violence, and poverty.

Women and children talking in Maasai house.
Women and children in a Maasai house at Nashulai Conservancy. Source: Nora Nord, nashulai.com

In other words, it is not just the virus that threatens people’s lives in developing countries, but the whole context – poverty, underdevelopment, structural violence, lack of government resources to respond to the pandemic – that puts lives in peril and threatens the existence and survival of whole communities.  People in developing countries are doubly at risk.  This crisis will leave deep scars, not only with regards to lives lost, but also with regards to international development gains made in the last decades in development, human rights, and human dignity. These are the issues Nelson and Maggie are afraid of. They are not only worried about the immediate impact of this crisis on their people, but also about the setback this crisis will cause to the wildlife, economic, and cultural advances that have sustained and elevated their community for the last years and made Nashulai indispensable for their society. Their people, their project, and their way of life are in peril of survival.

What COVID-19 means for Nashulai Conservancy

Nashulai is a community-led conservancy in the Maasai Mara in the southwestern part of Kenya, close to the border to Tanzania. The Maasai are an indigenous community of strong and brave warriors, but poverty and lack of development have negatively affected their quality of life. Most Maasai exist on less than $1 a day, depending mostly on their livestock for food and income. More recently, due to Nashulai’s efforts, the community has been able to garner revenue through tourism by offering safaris and running guest houses and camps. About 2,000 people live on Nashulai’s 6,000 acre conservancy, and an additional 3,000 people live in the surrounding communities. Most of them reside in traditional Maasai villages, in which small dwellings arranged in a large circle for community living. Women, men, and children live together in small spaces and share food, resources, and chores with one another. Men mostly look after cows, sheep, and goats or work in local tourist camps and lodges, while women prepare food, raise children, and make jewelry and art work to sell to tourists. Livestock is sold on twice-weekly open markets in exchange for grains, oil, salt, and other basic necessities.

Picture showing a Maasai man with his cattle in a Maasai village.
The Maasai live in close-knit communities where women, men, and children of different families share all aspects of everyday life. Source: Marianne Nord, nashulai.com

COVID-19 has put all of this in danger. The markets are closed due to government safety measures, leaving people without food and without income. Tourist streams have run dry, which means no money and no jobs (90% of employed Maasai rely on the tourist industry). The communal way of Maasai life is in direct opposition to the guidelines of social distancing and self-isolation. There is no running water in Maasai homes, making constant handwashing not an option. Healthcare in the rural areas of Kenya is difficult access in the best case, and Sekenani health clinic in the conservancy is not equipped to deal with COVID-19 cases. It is unclear what should happen to people who become infected. There is a lack of information and education about the crisis, and an absence of guidance of what the WHO guidelines of handwashing, social distancing, and self-isolation and quarantine mean for people in places like Nashulai. There is no electricity beyond solar power, and while some people have phones or radios, spreading news and information is extremely difficult.

The situation is dire. People are starving.

Nelson and Maggie have developed an emergency plan to provide each household with basic food items, to repurpose part of Nashulai’s tourist camp to isolate sick people, and find ways to educate the community about safety measures and health. They have established a strategy on how they can become self-sustaining in terms of food production and continue their important conservancy work over the next months. However, because their stream of revenue has been cut, they rely on us, their friends, to support them, the Maasai people in their community, and the long-term survival of their project.

Please visit Nashulai Maasai Conservancy’s website if you would like to learn more and/or if you would like to donate to Nashulai Maasai Conservancy’s COVID-19 Emergency Fund.

Impact of Covid-19 in Conflict Zones

A photo of 3 medical professionals in masks and white suits carrying testing machines in war-torn Syria
Medical professionals in war-torn Syria fear the worst after first case reported. Source: Yahoo Images

“Wash your hands.” “Avoid close contact with others.” “Stay home.” These are the CDC’s recommendations for protecting yourself against the coronavirus and the disease that it causes, COVID-19. For those of us fortunate enough to have clean water and soap and space and a home, that is helpful advice and easy enough to follow, even if it is somewhat of a disruption to our normal lives. Unfortunately, these recommendations are completely irrelevant to the millions of people across the globe who live in conflict zones and refugee camps where fresh water is scarce, sanitary facilities are lacking, and the healthcare infrastructure has been decimated by war and continuous violence. In places where day to day survival is already a key concern, the novel coronavirus poses a new kind of threat, one that the struggling healthcare systems in these countries is not prepared to take on. 

While the U.S. government and media have focused on individual vulnerabilities, such as age and underlying respiratory conditions, very little has been done to address social and structural vulnerabilities, including limited access to basic services, health care, safe water, sanitation, and hygiene, in some of the most dangerous places in the world. Overcrowded refugee camps are a virus’ dream – they provide conditions in which the virus can spread rapidly and easily. Individuals living in these places are already prone to respiratory problems due to air pollution and living in close quarters. Unsanitary conditions and lack of housing, food, and clean water exacerbate the risk of contracting an infectious disease, and the lack of access to basic health care makes fighting any kind of infection difficult. The coronavirus is highly contagious and has a very high global mortality rate, even in places where social distancing and healthcare are accessible, and this rate will likely be significantly higher in conflict zones where large numbers of displaced people live. Preventing the virus from entering these spaces is the only hope, but as Dr. Esperanza Martinez, head of health for the International Committee of the Red Cross, has said, “this is uncharted territory,” and it is unclear how effective containment strategies will be in reality (or if they are even possible in certain places).

According to the Center for Strategic and International Studies, 126 million people around the world are in need of humanitarian assistance, including 70 million who have been forcibly displaced from their homes, mostly due to violence. COVID-19 is adding a new layer of uncertainty and fear to the already precarious and vulnerable status of these individuals and families. The UN High Commissioner for Refugees (UNHCR) and the International Organization for Migration have suspended refugee resettlement programs, and many governments worldwide have stopped the intake of refugees who are fleeing violence and food insecurity. Cases of COVID-19 have been confirmed in war-torn areas in the Middle East, including Afghanistan, the Gaza Strip, and Ninevah, a displaced persons camp in Iraq, as well as in several African countries, including war-torn Libya, Cameroon, and the Congo. This post considers how this global pandemic will likely impact people living in three particularly dangerous and vulnerable countries in the Middle East and West Africa: Syria, Yemen, and Burkina Faso. 

Syria

Nine years into the seemingly endless civil war in Syria, more than 380,000 people have died, dozens of towns and cities razed to the ground and half of the country’s entire population displaced. Targeted attacks have left Syria’s once thriving public health care system in shambles. Hospitals and clinics have been destroyed or damaged to the point of not functioning. Medicine and medical supplies are limited, healthcare workers are few, and travel to the still-operational clinics and hospitals is out of the question for many of the sick and suffering. Of particular concern is the refugee camp in Idlib, a town in the northwestern province near Turkey, where many displaced individuals now live. The conditions of the camp are dire – there is limited access to soap and water and overcrowding makes social distancing impossible – so self-protecting is a major challenge.

Syria reported its first case of coronavirus a few days ago, from a woman who had recently traveled to Iran, a country that is backing the Syrian government in the civil war and where Shia pilgrims frequently travel. There are now five confirmed cases (the actual number is suspected to be much higher), and there is growing fear that the virus is spreading unimpeded throughout the northwest, where there is limited capacity to test and monitor the situation, but experts have warned that “if the disease starts, it will spread massively.” Jan Egeland, director general of the Norwegian Refugee Council, has warned that COVID-19 could “decimate refugee communities.” Containment is the only hope, but the shortage of supplies, including test kits, makes this unlikely. 

A young Yemeni man sits atop the rubble with his face in his palm grieving the destruction of his home
Source: Yahoo Images

Yemen

The United Nations has labeled the situation in Yemen the world’s worst humanitarian crisis. No cases of COVID-19 have been confirmed yet in Yemen, but the country is bracing for a devastating catastrophe if and when the virus arrives. Since the U.S.-backed war in Yemen began five years ago, Saudi and Emirati coalitions have leveled 120 attacks on medical facilities throughout the country. These attacks, including airstrikes, ground-launched mortar and rockets, and attempts to occupy hospitals and clinics, have led to widespread disruptions in access and service to some of the world’s most vulnerable people, including displaced women, children, and persons with disability. With a mere 51% of the country’s health centers operational, there is a severe shortage of medicine and medical equipment. Even if people in this area can get to a hospital, many hospitals don’t have electricity, rendering a ventilator — a potentially life-saving device for people suffering the most severe symptoms of COVID-19 — out of the question. The decimated healthcare infrastructure is unable to control preventable disease (there was a cholera outbreak a few years ago) and is completely ill-equipped to handle a pandemic. Both the Houthi rebel group (aligned with Iran) and the government recognize the threat the virus poses and are implementing precautionary measures, such as closing schools and halting flights into the area. However, both sides are amping up their rhetoric and are posed to blame the other if and when cases of COVID-19 are confirmed. The United States, for its part, has cut off emergency aid to Yemen, citing the Houthi’s interference in the distribution of supplies and services to starving Yemenis (likely a Saudi-directed approach), but humanitarian officials have warned that this decision will create major funding gaps in efforts to provide hand soap and medicine to clinics and to staff health centers with trained healthcare workers. Yemen’s basic healthcare programs are heavily reliant on foreign aid – about 8 out of 10 Yeminis rely on some form of aid. Eliminating this source of funding could mean suffering and death for millions of displaced persons in Yemen. 

Burkina Faso

On March 18, Burkina Faso, the impoverished West African country of 20 million people, registered its first confirmed case of COVID-19. A week and a half later, that number leapt to146 cases, with hundreds more suspected, making it the hardest hit West African country so far. This tiny, conflict-scarred country is no stranger to hardships, including poverty, drought, rampant hunger, and militia-led coups. In 2019, clashes between government forces and militia groups linked to ISIL and al-Qaeda led to more than 2,000 deaths in Burkina Faso and forced more than 700,000 people to flee their homes. This escalation of violence has led to the closure of 135 health centers in the country, and an additional 140 have reduced their services, leaving 1.5 million Burkinabe in dire need of humanitarian health assistance. With a healthcare system that has been ravaged by war, a mere three facilities in the country are able to carry out the tests, and only a few hundred test kits have been provided. As part of the government’s response, Malian refugees once displaced into Burkina Faso are being forced back into Mali, where ongoing violence inhibits humanitarian and medical access to affected populations. COVID-19 will exacerbate an already dire situation — it is feared that an outbreak would see fatality rates of ten times higher than the global average. “These populations are already very vulnerable to diseases that are otherwise easy to treat,” says Alexandra Lamarche, senior advocate for West and Central Africa at Refugees International, “but that’s not the case when they have no access to water or proper sanitation or health care.” She adds, “We could watch entire populations vanish.”

Bumper sticker that says "All people are created equal members of One Human Family"
Source: Yahoo Images

Against a common enemy?

Rarely does a disaster – natural or otherwise – affect the entire world. The coronavirus is a different story, unlike anything we have witnessed in the modern age. It is exposing the fragility of even the most advanced economic, technological, social and medical systems, and it poses a grave threat to humans the world over. The virus doesn’t discriminate on the basis of status or religion or skin color or any of the other things that divide us or give us cause to fight each other. It travels across borders and between enemies, and the more people it infects, the greater the risk for everyone. Just like the virus, the distribution of basic human rights must not be qualified on the basis of anything other than humanity. Turning a blind eye to the suffering and inadequate conditions of the world’s most vulnerable populations only facilitates the spread of the virus. In a practical sense, limiting the spread of the virus in refugee camps and conflict zones in Yemen and Syria and West Africa is just as important as it is in wealthy countries if the goal is to eliminate the virus and end this global pandemic. That requires distributing resources and investing in large-scale infrastructure improvements in places where people are not able to follow the protocols for containment under the current conditions. As we scramble to make enough surgical-grade masks for healthcare workers in the United States to wear, we need to be concerned with sending as many as possible to medical facilities in places around the world that are under-served and over-taxed, including displaced persons camps. We cannot hope to protect ourselves if we refuse to protect our fellow humans, no matter the distance or cultural difference between us. U.N. Secretary-General Antonio Guterres has called this “the true fight of our lives,” insisting that we put aside our differences, which now seem small and inconsequential, and turn our aggression toward a common enemy. “That is what our human family needs, now more than ever.”

Breathing Lessons: Disability Rights in the Wake of COVID-19

The novel coronavirus (COVID-19) has provoked an unprecedented reality for much of the global population by streamlining widespread bureaucratic frustration, health anxiety, and social distancing. Most people know that older adults and people with underlying health conditions are disproportionately affected by COVID-19, although many people fall under both these categories and identify with a disability. Also, due to the limited resources available to treat people with COVID-19, concerns have emerged about who receives what type of care. This would force health providers with the grim task of dictating whose lives are worth saving. This blog addresses concerns about rationing care amid the influx of COVID-19 patients and how this might affect the largest minority group in the United States (26%) and world (15%), people with disabilities.

Word Health Organization suggests COVID-19 is particularly threatening to people with disabilities for a list of reasons: (1) barriers to implementing proper hygienic measures, (2) difficulty in social distancing, (3) the need to touch things for physical support (e.g. assistance devices; railings), (4) barriers to accessing public health information, and (5) the potential exacerbation of existing health issues. These issues add insult to injury because, even without COVID-19, people with disabilities by-and-large receive inadequate access to health care services. This is largely due to the competitive nature of health systems which value profit maximization and, thus, disadvantage people with disabilities as consumers in the health care market.

Recently, select states and hospitals have issued guidelines for health providers that would potentially deny people with disabilities treatment for COVID-19. Two entities, Alabama Department of Public Health (ADPH) and Washington State Department of Public Health (WSDPH), have recently come under scrutiny because of their efforts to fulfill such guidelines.

ADPH’s Emergency Operations Plan suggests that ventilator support would be denied to patients with “severe of profound mental retardation”, “moderate to severe dementia”, and “severe traumatic brain injury”. This controversial protocol has recently grabbed the attention of Alabama Disability Advocacy Program and The Arc thus leading to a complaint with U.S. Department of Health and Human Services Office for Civil Rights (OCR) regarding discrimination toward people with intellectual and cognitive disabilities.

With Washington notoriously being one of the first COVID-19 hotspots, WSDPH and the University of Washington Medical Center have come under fire for their plans to develop a protocol that would allow health providers to access a patient’s age, health status, and chances of survival to determine treatment and comfort care. These efforts have been confronted by Disabilities Rights Washington with their own complaint to OCR that declares any medical plan that discriminates against people with disabilities effectively violates the their rights and is, therefore, unlawful.

OCR swiftly responded to these concerns, as well as those from Kansas and Tennessee, by stating that, even in the case of pandemics, hospitals and doctors cannot undermine the care of people with disabilities and older adults. OCR Director Roger Severino exclaimed, “We’re concerned that crisis standards of care may start relying on value judgments as to the relative worth of one human being versus another, based on the presence or absence of disability,” and “…that stereotypes about what life is like living with a disability can be improperly used to exclude people from needed care.”

Also, with New York currently having most of the U.S.’s confirmed COVID-19 cases, they may very well be the first state to face the imbalance of available ventilators and patient demand. Disability advocates have recently decried verbiage in New York’s Public Readiness and Emergency Preparedness (PREP) Act that could provide immunity from civil rights for some patients. Thus, U.S. state and federal powers are playing tug-of-war with the status of disability rights during the COVID-19 crisis.

Not Today #COVID19 Sign Resting on a Wooden Stool.
Not Today COVID-19 Sign on Wooden Stool. Source: Pexels, Creative Commons.

However, these concerns are not limited to the U.S. In the developing world, many people with disabilities are segregated from their communities in overcrowded facilities, while thousands of others are shackled and incarcerated. This weak enforcement of disability rights positions people with disabilities, in countries such as Brazil, Croatia, Ghana, India, Indonesia, and Russia, at-risk of further inhumane treatment by receiving limited or no appropriate care related to COVID-19. As a result, Human Rights Watch urges state and local authorities to return these populations to their families and demand they provide needed support and services within their communities.

Nearly every country in the world has ratified the United Nations’ Convention on Rights of Persons with Disabilities (CRPD) which aims to fulfill the human rights and fundamental freedoms of people with disabilities. More specifically, Article 25 of CRPD suggests people with disabilities have the right to non-discriminatory health care and population-based public health programs. Thus, nearly every person with a disability around the globe is associated with a governmental power that claims to be dedicated to fulfilling the promise of CRPD. However, in the wake of COVID-19, will these words be put into action?

These unprecedented events are a turning point for how we view our bodies, health, and communities. This is also an opportunity to view the world through the perspective of those in your community such as people with disabilities who represent an array of impairments, challenges, and experiences. Despite boredom and apathy being at the forefront of many people’s isolation, images of life versus death surround others, and for a good reason. In these decisive weeks, and likely months, there has never been a greater time for people in the U.S. and abroad to acknowledge that disability rights are human rights.

Saudi Arabia Human Rights Violations: Freedom of Religion and Speech

I recently wrote a blog post commending Saudi Arabia on advancements made with women’s rights. However, to follow up, I think it is important to note what Saudi Arabia still gets wrong in terms of human rights. While there are many ongoing human rights violations, the following discourse will focus specifically on the oppression of religious minorities, namely Shia Muslims, and the lack of freedom of speech. I am writing this post not to join the voices that criticize for the sake of criticizing, but rather because I think it is important for Muslims to be vocal about their expectations for countries that claim to be representing Islam.

An image showing Shia Muslims in Saudi Arabia protesting the bombing of one of their mosques.
Shia Muslims in Saudi Arabia protesting after one of their mosques has been attacked. Source: Yahoo Images, Creative Commons.

Shia Muslims

Shia Muslims are a minority sect in Islam, making up around 10 percent of all Muslims. Because of this, they are often subject to oppression and discrimination by Sunni Muslims. Despite the fact that harmful rhetoric against Shia Muslims exists in most, if not all, Sunni-majority countries, it is especially disturbing in Saudi Arabia considering that the hatred and intolerance towards Shia Muslims has become institutionalized. For example, the Saudi Arabian government has allowed officials and religious scholars to belittle Shia Muslims and their beliefs. This is not only concerning because of the harmful language used, but also because these officials and scholars have influence over both the government and the general public, and thus play significant roles in shaping policy and public opinion. One government official known for spreading hateful rhetoric about Shia Muslims was Former Grand Mufti Abdel Aziz bin Baz, who was quoted saying, “The Shia are Muslims and our brothers? Whoever says this is ignorant, ignorant about rejectionists for their evil is great.” This is one example of many, but it illustrates the hateful rhetoric that Shia Muslims are often victims of.

The institutionalization of hatred against Shia Muslims is most clear in the Saudi Arabian justice and education systems. The justice system is highly discriminatory against Shia Muslims, namely in the criminalization of their religious practices and beliefs. Further, the government has made it illegal to build Shia mosques outside of Shia-majority cities. The education system is perhaps the worst of all, though, because it perpetuates the cycle of discrimination against Shia Muslims by indoctrinating young Saudi children with anti-Shia sentiments. For example, textbooks used in elementary and middle schools stigmatize Shia beliefs and practices and go as far as to claim that Shia Muslims are disbelievers, suggesting that Shia should not be considered Muslims. While criticizing their beliefs and practices is problematic in and of itself, saying that Shia are not Muslims is impermissible, both ethically and religiously, and only serves to cause further hatred and intolerance.

An image showing a protest sign advocating for the release of an imprisoned female Saudi Arabian activist.
A protest sign advocating for both freedom of speech and the release of Israa al-Ghomgham, an imprisoned female Saudi Arabian activist. Source: Yahoo Images, Creative Commons.

Freedom of Speech

The most blatant example of a human rights violation against the people of Saudi Arabia is the lack of freedom of speech, which has especially detrimental ramifications for individuals advocating for human rights. For example, in 2018, several women’s rights activists were arrested and charged with treason solely for their work in activism. This came at the same time that Prince Mohammed bin Salman had lifted the ban on women driving, and ironically, many of the women who were arrested had been advocating for women’s right to drive. Thus, while lifting the ban was a positive move forward, the imprisonment of these women makes the intentions behind Prince Mohammed bin Salman’s decision to lift the ban confusing; it is difficult to deduce whether Prince Mohammed bin Salman is truly concerned with women’s rights, or if this was a step taken to make Saudi Arabia appear that it is being reformed and moving towards modernization. His intentions can be further called into question considering the extent to which these women’s rights have been violated; not only were these women arrested and detained, but it is known that they were also electrically shocked and whipped during interrogations, which amounts to cruel and inhumane treatment. To this day, some of these women are still imprisoned, unlikely to be released without international intervention. However, it is important to note that this was not an isolated event. While Saudi Arabia has always used arrests and detentions to deal with dissidents, the number of detentions significantly increased after Prince Mohammed bin Salman took power in 2017; over 60 individuals identified as dissidents have been arrested and held.

Muslims around the world strongly oppose Islamophobia and the oppression of Muslims, which is a great thing. However, Muslims tend to be silent about Saudi Arabia’s human rights violations, which is troubling. While many Muslims do call out these violations, many others either turn a blind eye, or even worse, find justifications for these violations. However, this is a double standard; if Muslims around the world truly care about their own rights, it follows that they must care about the rights of all of those who are oppressed, especially when Muslim majority countries are responsible for causing this oppression.

Women’s Rights in Saudi Arabia: A Counter-Narrative

This past winter break, I visited Saudi Arabia with my family. While there, I noticed that many women were active in the work force, working as police officers, salespeople, and even airport security. Under the preconceived notion that women were not allowed to work in Saudi Arabia, I was surprised to see this. Slowly, I began to realize that the Western perspective about women’s rights in Saudi Arabia was not entirely correct. So, after I came back from my trip, I decided to look into different sources to try to get an accurate portrayal of women’s rights in Saudi Arabia.

An image of a news broadcast with Bayan Alzahran, the first female lawyer to have her own law firm in Saudi Arabia
Bayan Alzahran, who is the first female lawyer to open her own law firm in Saudi Arabia. Source: Al Arabiya, Creative Commons.

Women’s Rights Narrative

After conducting extensive research, I realized that while there is no denying that Saudi Arabia still has many improvements to make in terms of gender equality, there are several women’s rights that have been historically implemented or are currently being established. Almost always, women in Saudi Arabia are portrayed as oppressed, and again, while there is an undeniable lack of many rights for women, it is not a fair assessment to only discuss what rights are not realized; it is important to recognize the rights that they have as well. While I cannot say for certain why this particular narrative is often propagated, it can be argued that the mainstream media is committed to portraying Islam in a negative light, and because Saudi Arabia is governed by Sharia Law, or Islamic Law, it follows that it will be portrayed negatively. As the media does this, people begin to argue that Islam is in and of itself misogynistic and is thus incompatible with progress and civilization. While I will not be going in too much depth about the rights Islam gives women, I will note that it is important to remember that culture and religion are not interchangeable terms and should not be treated as such; Saudi Arabia may govern using Sharia Law, but many of their restrictive practices are rooted in culture, not Islam. Thus, the purpose of this post is to provide a counter-narrative to show that what the media portrays pertaining to women’s rights in Saudi Arabia is not an entirely accurate depiction.

Employment Rights

While there is a dearth of women in the employment sector, seen through the fact that only 22 percent of Saudi womenparticipate in the workforce, there are no legal restrictions on which jobs women are allowed to work in, with garbage collecting and construction being the only exceptions to this. Sharia Law encourages women to work, so the lack of women in the work force is not due to restrictive religious practices, but rather to restrictive cultural practices. Further, Sharia Law allows women to earn and manage their own finances, making employment especially appealing to women who want to be financially independent. While the number of working women is low, Saudi Arabia is currently attempting to further integrate women into the workforce, with a goal of a 30 percent participation rate by 2030. While this is mostly due to the fact that Saudi Arabia wants to replace non-Saudi workers with Saudi Arabian citizens, it is still commendable that women are a part of this plan.

Education Rights

Perhaps most interesting is the emphasis Saudi Arabia has placed on women’s education. Saudi women have had access to education for several decades; women have been attending universities since the 1970s. Recent advances made highlight the country’s commitment to providing opportunities for women in education, namely the 2005 study abroad program, which sends thousands of Saudi women to the United States, Canada, and the United Kingdom, among other countries, to obtain an education. Another very impressive advancement is Saudi Arabia’s first all-women’s college, Princess Noura bint Abdulrahman University, founded in 2010. The purpose of the school is to give women better access to fields that are traditionally male dominated, such as medicine and pharmacology. Due to these improvements and the general importance placed on women’s education, women currently represent 52 percent of university students in Saudi Arabia.

An image showing a Saudi Arabian woman holding up her driving license.
A Saudi Arabian woman holds up her driver’s license. Source: Yahoo Images, Creative Commons.

Recent Progress

Recently, steps have been taken to reverse restrictive practices, such as lifting the ban on women driving and reducing male guardianship. The former, implemented in 2018, saw the legalization of women driving. Thus far, tens of thousands of women have received their driver’s licenses, highlighting the success of this change. The latter, implemented a few months ago, saw changes made to restrictive guardianship laws. Historically, these laws heavily restricted women’s rights, specifically the right to freedom of movement; women were not allowed to obtain a passport or travel abroad without a male family member’s consent. While I could explain how changes to these guardianship laws will have a positive impact on women’s lives, I think it is best to share the perspectives of a Saudi Arabian woman on this issue. In an article for BBC News, Lulwa Shalhoob, a Saudi journalist, wrote that “the new rule means the relationship between a husband and his wife becomes a partnership between two responsible adults, rather than guardianship of a minor.” She also notes that an increasing number of Saudi women “no longer want to be framed as women of special circumstances who lack rights that women around the world take for granted.” For Saudi Arabian women, then, this move not only grants certain rights they were long deprived of, but it also fosters an unprecedented sense of agency and personhood.

Historically, Saudi Arabia has invested in specific spheres of women’s rights, such as employment and education, and in recent years, the Saudi Arabian government has made progress by rescinding many restrictive practices and laws. When Saudi Arabia is included in the discourse pertaining to the rights of women, none of this is mentioned; only the shortcomings are. While I am the first to admit that Saudi Arabia still has much work to do in terms of women’s rights and human rights in general, it is important to acknowledge what they have done right.

Solitary Confinement Amounting to Torture

Image of concrete walls allowing some sunshine with a small window near the top.
jmiller291. Solitary Confinement, Old Geelong Gaol 7. Creative Commons for Flickr.

In the United States, the earliest experiments with solitary confinement began over two centuries ago, during the Enlightenment. Champions of the idea of natural rights, thinkers of the era found that public corporate punishment was incompatible with the development of a free citizen. Instead, silence and solitude would allow prisoners to reflect and that would induce repentance that would drive prisoners to live a more responsible life, making individuals the instrument of their own punishment. However, as the United States’ first silent prisons and penitentiaries were publicized, renowned nineteenth-century thinkers such as Alexis de Tocqueville and Charles Dickens visited these institutions to observe these revolutionary systems. Once intrigued, these icons now condemned these silent prisons as de Tocqueville remarked,

This absolute solitude, if nothing interrupts it, is beyond the strength of man; it destroys the criminal without intermission and without pity; it does not reform, itkills.

As other physicians and experts echoed their concerns, reporting the high risk and evidence of insanity and death of inmates existing in solitude, it gained the attention of the United States Supreme Court which influenced a new philosophy in correctional administration and gradually reduced the regularity of the practice.

This period of relief lasted until prisons began using solitary confinement to segregate more “threatening” and “dangerous” prisoners who were considered a risk to the safety of other prisoners and staff. Then, retribution and deterrence replaced rehabilitation as the professional purpose of corrections. As the U.S. responded by institutionalizing longer sentences, building more prisons, and abolishing parole, the use of solitary confinement rapidly increased with prison growth.

Today, the United States not only incarcerates more people than any other nation, but we also expose more of these people to solitary confinement than any other nation. The United States holds around 100,000 prisoners in solitary confinement typically as punishment, as a tactic to control overcrowded institutions, and as safety from or for the general population.

As individuals, inmates tell us what it is like in solitary confinement. In solitary confinement, your world is a gray concrete box. You may spend around 23 hours a day alone in your cell which are only furnished with a toilet, sink, and bed. When prisoners are escorted out of their cells, they are first placed in restraints through the cuff port and sometimes with additional leg or waist chains and tethered by the hooks on their cuffs to an officer. Prisoners are controlled by bodily restraints, with pervasive and unforgiving round the clock surveillance, and the restricting hallways and cells they exist in. They are lead to solitary exercise each day and a brief shower three times a week then back to their cells. Confined to their own concrete cells, prisoners are both physically and psychologically removed from anyone else. Prisoners depend on officers to bring them anything they may need and are allowed to have such as toilet paper, books, or letters they may receive. Many prisoners relate with dark thoughts that haunt them in isolation. Many become angry and hateful behind compliance.

Where many express anger, they all express a struggle to maintain dignity and a sense of self or humanity. Being alone, prisoners forget how to interact with others. Feeling as though they have nothing to live for in isolation, prisoners may give up on these things. Many interviews describe watching others who were locked in indefinite solitary choosing between giving up by either through suicide or turning into an unfeeling and uncaring creature. Correctional facilities’ workers express their concerns as to why and how they become desensitized through strict policy, regulation, and the specialized emotional stance necessary to interact with these prisoners. Acting as servants for the lives of some bad apples, observing civilized men be reduced to the natural man, and acting in adherence to authority with little voice heard by superiors, this work requires a specialized emotional stance.

Instead of regular and healthy social relationships important to human survival, these prisoners are embedded in a structure that extends itself into them. It enters their mind and sometimes switches off the human inside or sometimes forces it to become violent enough to compete. In this way, it also robs them of self-determination, liberty, and other forms of autonomy.

Image of protesters of solitary confinement holding signs connecting solitary confinement to torture and mental illness.
Felton Davis. 16-11-23 02 Union Square Vigil. Creative Commons for Flickr.

Because the practice of solitary confinement is a global one and brings claims of widespread abuse, the UN special rapporteur presented his report, or evaluation, of solitary confinement. This rapporteur defined prolonged solitary confinement as isolation for more than fifteen days because studies show that the effects of solitary confinement may become irreversible after this point as the rapporteur concluded that solitary confinement can amount to torture or cruel inhuman and degrading treatment.

International and domestic laws prohibit all forms of Racial Discrimination, which address variations in solitary confinement’s demographics, and rights of persons with disabilities which protect individuals with mental, or other, illnesses. They also guarantee the rights of women and children or juveniles, which are especially vulnerable under conditions of solitary confinement or isolation. Both sides address the minimum standards for the treatment of prisoners. More specifically, they address conditions of solitary confinement which always may apply to every individual.

Domestically, the Eighth Amendment reveals how the United States Constitution addresses Solitary Confinement. The Eighth Amendment prohibits the government from inflicting “cruel or unusual punishment” on someone convicted of a crime. This allows these prisoners to challenge their conditions while in custody and the actions of prison officials. To do this, prisoners must first show that the challenged condition is “sufficiently serious” and that prison officials acted with deliberate indifference to the condition. Close observation of court decisions reveals that there is no organized methodology to determine what makes a condition “sufficiently serious”. This decision is made in each case by the personal standards of judges. The judge may question why the prisoner was placed there; however, the Supreme Court has not made a ruling whether intent should play a part in this evaluation. Courts disagree whether it should matter why the individual was placed in solitary confinement. Also, the Amendment did not answer when a prison condition is punishment or not. The debate remains whether the effect of the conditions on the prisoner or the intent of officials makes them punishment. In court, Eighth Amendment analysis hinges on the motivations of state actors and prison officials it is supposed to act as a check against. The conditions of the Eighth Amendment fail to protect prisoners from inhumane treatment through the scope of prison officials’ intent and judges’ objective analysis.

The ICCPR is international law that prohibits torture or cruel, inhuman or degrading treatment or punishment. It later states that people deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of a person and the treatment approach for prisoners should be aimed at efficiently improving their reformation and social rehabilitation.

In 2015, the United Nations General Assembly adopted the Mandela Rules that prohibited restrictions and disciplinary sanctions that could amount to torture or cruel and degrading treatment or punishment, such as Indefinite Solitary Confinement, Prolonged solitary confinement, or to place a prisoner in a dark or constantly lit cell. It defined solitary confinement of prisoners for 22 hours or more a day without meaningful human contact and prolonged solitary confinement for any time period over fifteen days. It states that solitary confinement should only be used as a last case resort for the shortest time possible and given due process to each case. Finally, it paid special attention to protect prisoners with disabilities which may be magnified, and especially vulnerable women and children from solitary confinement.

Through these treaties and agreements, States do not only assume obligations internationally but to their own people as well. Just like our own constitution, these international laws were agreed to and are legally binding to regulate the conduct of states with their citizens. However, without international forces to enforce and regulate these agreements, states may ignore or lose sight of their importance.

Despite these resolutions, Domestic laws are vague so that it is doubtful they meet minimum requirements regarding the ones set by human rights instruments. This creates debate and little guarantees in the legal system. They also undermine fundamental guarantees of due process, are applied randomly, and do not protect the prisoners’ rights.

Today tens of thousands of humans remain alone in concrete boxes in the United States. This report concludes that their conditions are emotionally, physically, and psychologically destructive. They are destructive because it robs us of many things that makes life human and bearable like stimulus through social interaction and interaction with the natural world. Under total control and out of the public eye, people may be subjected to incredible human rights violations. By allowing our government to ignore these people, we are accepting this indifference towards others under its care. By ignoring their human rights, in this way, we diminish our own.

Coronavirus and Racism

informational poster on coronavirus and travel
Coronavirus Public Alert Oslo. Source: Annikdance, Creative Commons.

At this point, I’m sure almost everyone knows about COVID-19. With schools shutting down, conferences being cancelled, and travel being restricted, even those in uninfected areas are affected. However, while some of us are most worried about washing our hands and not touching our faces, some people have to worry about discrimination. Those of East Asian descent are being discriminated against all over the world, whether they’re from China or not, whether they’ve been in infected areas or not, whether they’re sick or not. COVID-19 is bringing out racism that has laid dormant, and, unfortunately, this isn’t the first time it has happened.

Historically speaking—especially before the scientific knowledge we have now—large outbreaks were blamed on minority groups. In 14th century Europe when the Black Death occurred, many looked for an answer, and when they couldn’t find an answer, they found a scapegoat: the Jews. They were seen as nonconformists by the Christian majority and were subsequently blamed for the outbreak that would be known as the Black Death. Many were tortured until they made false confessions and killed, and their persecution continued centuries later.

Since then, almost every major outbreak has illuminated underlying racism within the global community: when syphilis appeared in Renaissance Europe every country blamed another; Irish immigrants were blamed for the 1830 cholera outbreak; and Mexicans and others from Latin American countries were discriminated against during the Swine Flu epidemic in 2009.

Most recently, the Ebola outbreak of 2014 brought out racism towards those of African descent. College admission was denied to two Nigerian students to Navarro College, and a Guinean high school soccer player attending school in Nazareth, Pennsylvania was heckled by the opponent’s fans, who chanted “Ebola” at him. Americans hesitated to shake hands with people of African descent, whether they were American or not, and the US imposed a travel ban to and from West Africa.

What we are seeing now with COVID-19, is similar to what we saw during the 2003 SARS outbreak. While the Ebola outbreak illuminated prejudices towards African Americans, in 2003, those of East Asian descent, regardless of their nationality were discriminated against in certain areas. The three Chinatowns in Toronto, Canada were empty for weeks, East Asians were constantly asked if they were sick when no one else was, and they were avoided when they went out in public. In Canada, there is the stereotype of yellow peril that labels Asians as “unsanitary, lower-class, and alien.” This stereotype obviously found root in SARS and only exacerbated these prejudices.

picture of xenophobia in the dictionary
Spiritual Xenophobia. Source: George Ian Bowles, Creative Commons

Unfortunately, it seems like we haven’t learned from these numerous outbreaks, and the racism and xenophobia along with COVID-19 is way more widespread and way more violent. A man attacked an unidentified woman was attacked on the subway in New York, and reports say that the confrontation was a result of the Asian woman wearing a mask. Like in 2003, the discrimination is not restricted to people of Chinese descent: a man singled out a Thai American lady on a bus in LA. He gestured at her while saying that “every disease ever came from China.” Finally, in Indiana, two men of Asian descent were denied a room at a hotel and told that if they were Chinese, they’d be “picked up and quarantined for two weeks.” All of these attacks were before any deaths occurred in the US.

These incidents aren’t unique to the Untied States either. In London, a student from Singapore was attacked in a busy shopping area. While he was being attacked his assailants told him, “I don’t want your coronavirus in my country.” He was left with fractures on his face, and he might need reconstructive surgery.

The racism that is emerging is not new, it has just been hidden. The fear that everyone is feeling is being redirected towards previous biases. The student from Singapore reported that he had been experiencing racist comments for the entire two years he had been studying in London. Because COVID-19 originated in China, the racism already present towards those of Asian descent has been exposed, and thanks to misinformation, it continues to grow. Fear has been shown to bring out the racism that already exists within people, not cause it.

In times like these it’s important to know the facts because that’s how we fight this discriminatory fear culture: Asians are no more likely to have COVID-19 than the rest of us. No one is any more likely to get COVID-19 because of their race or ethnicity. Despite the virus originating in China, there is no evidence Chinese people or Asians are predisposed to infection. Secondly, just because someone of Asian descent is wearing a mask, it does not mean they’re sick. In many East Asian cultures, it is normal to wear a mask year-round, not just when you’re sick.

It’s important to spread the facts. One of the biggest factors in discrimination is ignorance, so education is the best way to fight it. People are scared, and that is bringing out the prejudices they’ve kept hidden and might not even know they had. Additionally, catch and correct yourself when you think or do something with prejudice. Start improving our global community by improving your own thoughts.

COVID-19 is a pandemic, and it’s a serious infection, especially for the elderly and those with preexisting health conditions. However, the racism and xenophobia are spreading just as fast. As a global community, we shouldn’t add to the burden of this disease by using it as an excuse to be discriminatory.

Human Rights and the Coronavirus

Scene at Atlanta airport
Source: Chad Davis, Creative Commons

As countries around the world continue to fight the outbreak of the coronavirus and deal with the disease is causes (COVID-19), the question arises how this public health crisis affects human rights. It is essential that we not ignore human rights during this crisis, even if our primary focus is fighting the outbreak and finding a cure for the disease. The epidemic and the response to it have a major effect on people’s lives, and thus are guided and impacted by human rights. Human rights cannot be an afterthought, but need to be worked into both public and private responses.

To follow up on my colleague Dr. Peter Verbeek’s earlier blog post, I will focus my considerations on two issues: 1) how public policies and legislation in response to the coronavirus and COVID-19 affect human rights; and 2) the broader human rights consequences of the proposed and implemented public health measures.

May public health policy limit human rights?

Most countries have statutes that allow for limitations to human rights in times of national emergencies or major public health threats. According to international law (and in most democratic states constitutional law), these limitations have to be necessary, proportionate, and related to clear and lawful public aims. They also have to be implemented in accordance with existing laws and the greatest measure of transparency.

In response to the coronavirus, emergency legislation in many countries (see for example in the U.S., U.K., Canada, or Australia) allows health departments and public health officials to impose a number of measures that affect people’s lives and their human rights. These measures include detaining people to be screened, collecting their health information, and putting them in isolation. People who do not comply with orders by public health officials or obstruct their work, refuse detention, leave a place of isolation, or supply misleading information can face criminal charges. For example, when a woman was evacuated from Wuhan and quarantined at Travis Air Force Base in California asked to leave the facility, California authorities issued an order forcing her to stay against her will.

While these types of measures might be necessary during such emergencies, it is worth noting that they do interfere with basic human rights, especially the right to liberty (UDHR Article 3), protection from arbitrary detention (UDHR Article 9), right to privacy (UDHR Article 12), and freedom of movement (UDHR Article 13). Considering the significance of these rights and freedoms and the grave consequences that can come from violating them, it is vital that government policies impede individual freedoms and human rights as little as possible. Further, any interference on human rights has to be based on strongest scientific evidence available (as opposed to, for example, racist or xenophobic justifications).

The ceiling of the UN Human Rights Council in Geneva. Source: United States Mission Geneva, Creative Commons

There are a number of important ways to achieve this.

      1. To ensure the protection of privacy and other rights, only data directly relevant to combatting the coronavirus outbreak should be gathered from individuals. The Center for Disease Control (CDC) has wide-ranging powers in case of emergencies, including obtaining clinical specimens and data from persons affected by an outbreak, obtaining data from healthcare facilities, enforcing control measures including quarantine, and seizure or destruction of private property. While some of these measures might be needed to stop the spread of a virus, it is important that the principles of necessity and proportionality are at the front and center of response policies to guarantee the respect for human rights.
      2. Crisis-related messaging should be led by scientists with the assistance of government officials, not the other way around. The consequences of abusing public health threats like the coronavirus for political purposes was demonstrated in China where censorship and denial led to a worsening of the public health situation. The misuse of the coronavirus outbreak for political purposes has also and continues to happen here in the U.S., which is especially dangerous at this time when trust in the government and political institutions is at an all-time low and independence, objectivity, and usefulness of science and its ability to act in the public interest is divided along partisan lines.
      3. Public health organizations, as well as the government, need to establish official communication channels that remain open for detained and quarantined people. Moreover, those subjected to restrictions such as detention and quarantine should have the ability to appeal their situation and voice their concerns regarding their treatment.
      4. Officials, as well as the public, have to recognize that those in quarantine or detention are in an extremely difficult situation. In addition to their medical state, they are often socially and economically vulnerable. The stigma that often accompanies quarantine and/or detention can lead to exclusion, emotional difficulties, and mental health issues. Similarly, loss of income or jobs can lead to short-term and long-term problems for affected people. For their part, governments should act to mitigate the negative consequences of public health policies and be aware of underlying socioeconomic conditions, potential human rights violations, and structural violence.
      5. The duration and severity of necessary limitations on human rights should be clearly communicated. It is not just the extent of human rights limitations that matter, but also how long they are set in place. The so-called “war on terror”, for example, was originally launched as a response to the terror attacks of 9/11, but it has persisted for decades, with legal authorities extending well beyond their original goals.

The human rights consequences of fighting the coronavirus

This brings me to the second part of my post, which focuses on the broader human rights and societal consequences of the current coronavirus outbreak. As Mary Bassett and Natalia Linos of Harvard’s FXB Center for Health and Human Rights write in the Washington Post, “[e]pidemics emerge along the fissures of our society, reflecting not only the biology of the infectious agent, but patterns of marginalization, exclusion and discrimination.” Beyond the more immediately obvious issues of how quickly the virus spreads, how many people will die, and how our healthcare system is affected, we need to ask ourselves about the societal effects of public health threats.

The most significant question is: who is the public? Who are public health responses designed for? Race, gender, caste, class, migration status, disability, ethnicity, religion, sexual orientation and gender identity, living conditions (urban v. rural), and other attributes determine the level of inclusion or exclusion of a person or group in society and their vulnerability in case of crisis. Even when measures seem neutral on the surface, public health responses to infectious diseases tend to follow a “utilitarian logic”, which can lead to unintended consequences and discrimination. For example, results are often gendered: Women tend to be caretakers of children and older people, making them the first to have to skip work when children are out of school or elderly parents fall ill. They are also often front-line healthcare providers, and any family-related responsibilities for these women can lead to shortages of available health personnel. Other advice, such as “social distancing”, cannot be upheld in prisons, public transportation, or migrant camps, and are therefore only useful for the privileged who live in their own flats or houses and can use their cars for transportation. In some cases, public health responses emphasize xenophobic or racist tendencies and reinforce societal divisions. There are already a number of stories and occurrences people of Asian descent shared about sneezing or coughing in public and experiencing responses ranging from angry looks to outright racist comments. Also, not all people have access to information if it is not prepared in minority languages, accessible formats, and spread through different means (e.g., illiterate people will need audio or visual announcements).

A bag with the word "health" on it overflowing of money
Source: 401kcalculator.org, Flickr Creative Commons

Arguably, the people affected worst by this crisis are those of low socioeconomic status, and often they face double or triple discrimination. Many low income and hourly workers do not get sick days or sick pay, which means to become infected and quarantined could result in  job loss, and potentially the loss of savings (if they have any), and potentially housing, cars, and other important possessions.  For poor children, school closings might mean that they miss their only meal of the day. Moreover, not all households in the U.S. have running water, making advice like “wash your hands” difficult to implement. At worst, by transferring public preparedness responsibilities to individuals without taking human rights into account, we reinforce “entrenched patterns of privilege and deprivation across social determinants of health.”

This situation is particularly problematic in the U.S. healthcare system, as it excludes people based on employment and/or immigration status and on the availability of financial resources. The large number of people without access to health insurance will not have the same level of information, testing, or treatment available to them as those with health insurance, and they face additional worries about financial burdens associated with seeking care. Further, private companies can decide how much to charge for treatments of the virus or vaccines without concern about affordability.

In my mind, a purely market-based allocation of healthcare resources in times of COVID-19 is not only unethical, but a human rights violation. Article 25 UDHR calls for everyone to have “the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” How far we are from this ideal! Viruses and pandemics don’t care about a person’s legal, economic, or social status, but because of lack of human rights-based public health responses, crises will have differing impact on rich, privileged people as opposed to poor, disenfranchised populations. As UN High Commissioner for Human Rights Michelle Bachelet stated, “people who are already barely surviving economically may all too easily be pushed over the edge by measures being adopted to contain the virus.” The search for an inclusive public health response and a more equitable and accessible healthcare system is even more urgent and important in times of the coronavirus and COVID-19.

people in a mirror
Distorted world? Source: Kevin Dooley, Creative Commons

Where does this leave us?

What happens next and the way our political leaders handle this crisis is therefore crucial. If authorities take a heavy hand, twist the truth, and/or compromise hard fought for fundamental freedoms and human rights, the public might be less willing to cooperate in a future crisis situation. Successful interventions in public health crises do not only depend on the level of control issued and the sophistication of medical responses, but also, and most importantly, on whether or not the people trust the government to handle the crisis, to communicate transparently, and to be accountable to its citizens. It also depends on solidarity and community building – whether people cover their coughs and sneezes, self-isolate when they think they got infected, and not hoard scarce supplies to the detriment of others. Public participation and agency of all people is therefore a key component of managing the disease successfully.

As the UN High Commissioner for Human Rights and my colleague Peter Verbeek pointed out, it is vital to structure any response to the coronavirus outbreak holistically, and that includes respect for and protection of human rights. It means to develop a transparent public response based on principles of equity and accountability for all actors involved, including the private sector. It also requires taking care of those most vulnerable in a crisis and protecting the most marginalized in a society, both medically and economically. Human rights cannot be an afterthought in epidemics. How governments handle the coronavirus and their response to COVID-19 might as well set a precedent for human rights in the future. Let’s hope that this crisis will be an opportunity to see the value of human rights, public participation/democracy, and multilateralism.

For more information about the coronavirus and COVID-19, medical advice, and how to protect yourself, please see UAB’s COVID-19 Resources and the updates provided by the Center for Disease Control (CDC).

 

I would like to thank Dr. Robert Blanton and Dr. Courtney Andrews for their comments on this piece.