Republic At Risk: COVID-19 in India

While the novel coronavirus (COVID-19) has impacted almost every corner of the globe, parts of Asia are still just beginning to see the systemic effects of the pandemic. As the second most populous country in the world, India has experienced a rise in COVID-19 cases and deaths which magnify current injustices across the country. This blog addresses India’s importance within the COVID-19 pandemic and its relationship with human rights issues concerning feeble governance, police brutality, migrant displacement, and Islamophobia.

As of late-July, over 1.4 million Indians have been diagnosed with COVID-19, while over 32,000 have died from the virus. India’s western state of Maharashtra is currently the country’s epicenter with over 375,000 confirmed cases of COVID-19. On the southern coastline, the state of Tamil Nadu has the country’s second-largest number of confirmed cases (210,000+), while the capital territory of Delhi in the northwest has recently exceeded 130,000 confirmed cases. Additionally, the southeastern state of Andhra Pradesh has confirmed over 95,000 cases of COVID-19. Interestingly, India’s most populous state, Uttar Pradesh, has only confirmed just over 65,000 cases which triggers questions about access to COVID-19 testing and essential resources throughout the country.

A National Lockdown

In late-March, the Indian government issued a nationwide lockdown that lasted two months. Inconveniently, the country’s 1.3 billion inhabitants were given less than a 4-hour notice of this initial 3-week lockdown. The effects of this tall order were apparent on day one since so many people throughout the country live on a daily wage or in extreme poverty. As food supply chains became compromised and manufacturing facilities closed, the country’s unemployment rate reached a 30-year low. All the while, facilities such as schools and train coaches have been converted into quarantine centers. These attempts have seemingly delayed the inevitable spike of COVID-19 cases. However, it is speculated that the low number of confirmed cases is the result of low testing rates.

This outcome has been attributed to lax contact tracing, stringent bureaucracy, and inadequate health service coordination, namely in Delhi where cases have recently surged. However, as India reopens, the number of confirmed COVID-19 cases has increased. Additionally, the introduction of newly-approved antigen kits have allowed for rapid diagnostic testing, although testing is not to be distributed proportionately. More specifically, family members and neighbors of people who have tested positive for COVID-19 claim they are not being tested. Also, in several instances, the family members of people who have tested positive for COVID-19 were not being informed about their loved one’s diagnosis. After much scrutiny, however, local health authorities in Delhi have attempted to pick up the pieces by using surveillance measures such as door-to-door screenings, drones, and police enforcement.

Policing the Police

While the recent murder of George Floyd sent shockwaves across the world, India has been confronting its own relationship with police violence. In June, two Tamil Nadu shopkeepers, J Jayaraj and his son Bennicks Immanuel, were arrested for keeping their business open past permitted hours during the national lockdown. They were then tortured while in police custody and died days later in the hospital. Due to this event garnering considerable attention and protesting, six police officers have since been arrested for their deaths. Also, Tamil Nadu police officers with questionable track records will now undergo behavioral correction workshops. However, this incident is no anomaly. According to the National Human Rights Commission (NHRC), nine Indians die in judicial or police custody every day. In comparison, official government crime data claims 70 people were killed in Indian police custody in 2018. This striking differential in reported custodial deaths suggests India’s law enforcement entities lack accountability and are riddled with corruption.

Much like the United States, India has a history tainted with police violence that disproportionately affects minority groups, namely people from the lowest Dalit caste, indigenous groups, and Muslims. With no choice but to work during the national lockdown, many of India’s poorest citizens were beaten by police. Videos of these violent acts surfaced across social media. In opposition, there have been over 300 reported incidents of attacks on police officers alone in Maharashtra. These recent events highlight the need for the Indian government to pass anti-torture legislation that curbs police violence. By ratifying the United Nations Convention Against Torture, the Indian government can help remove the colonial vestiges of power and punishment that have plagued the country for generations.

Migrant Displacement

The sudden announcement of a national lockdown had tremendous repercussions for the tens of thousands of daily-wage migrants throughout India. Overnight, businesses closed and transportation systems suspended throughout the country, placing many migrant workers in precarious economic conditions. Men, women, and children hunkered down in urban centers across the country as they waited for their workplaces to reopen but to no avail. In response, India’s major cities experienced an exodus of migrant workers attempting to return to their home states on foot, many living hundreds, even thousands, of miles away. As thousands trekked home, many died due to dehydration, exhaustion, sunstroke, and traffic accidents. Reports of pregnant women delivering, and subsequently carrying, their children in these horrific conditions have also surfaced.

A recent Supreme Court order has urged the well-being of India’s 100 million internal migrant workers affected by the hardships of COVID-19 by requiring the government to register, feed, shelter, and transport them until they return home. However, these efforts are seemingly inadequate because most internal migrant workers have not qualified for these “relief packages”, while those who have qualified are experiencing limited coordination between state governments. All the while, India has ended its national lockdown and many migrant workers are trying to return to their places of employment. Some employers are sponsoring the return of their lost workers, while some must find their own means to return. As such, some states have sought local help to accommodate the loss of migrant workers which places many Indians in even greater economic uncertainty.

Migrant workers walking on the shoulder of a highway during the nighttime.
The Indian Lockdown Migration – IV (PB1_4728). Source: Paramvir Singh Bhogal, Creative Commons.

Pathologizing Islam

COVID-19 in India has contributed to a surge in anti-Muslim rhetoric that suggests this religious minority group is purposely spreading the virus.  The rumors began after Tablighi Jammat, a Muslim missionary group, held a congregation outside of India and, soon after, many members tested positive for COVID-19 in New Delhi. Videos on WhatsApp and various television channels have proliferated this misinformation to the Indian public alongside the usage of phrases such as “corona jihad” and “corona terrorism”. To make matters worse, the Bharatiya Janata Party (BJP)-led government, which is notorious for its Hindu nationalist sentiments, has begun incorporating Tablighi Jamaat-related statistics to its daily COVID-19 briefings. Such rhetoric has influenced a slew of Islamophobic acts such as prohibiting neighborhood entry, restricting sales by street vendors, and even violent attacks.

These recent events fuel an existing fire that posits Muslims as reproducing at a pace to outnumber Hindus and compromising “Mother India”. However, recent efforts between Muslim Indians and allies has been quick to respond to this COVID-19 misinformation because they have been protesting India’s new citizenship law that offers amnesty to various non-Muslim immigrants and a nationwide citizen count that necessitates proof of documentation dating several years back. The BJP has made it apparent that Muslims are not welcome in India and weaponized the COVID-19 pandemic as a part of its Islamophobic campaign. As such, these efforts corner Muslim Indians into political and economic insecurities that pressure apartheid at a time when unity is paramount.

Masked medical professionals walking with a crowd in the background.
coronavirus-india-rep-image-hyd. Source: Anant Singh, Creative Commons.

Human Rights in India

As displayed, India has an array of prevalent human rights issues that have compounded since the arrival of COVID-19. Among the efforts that could protect Indians from these concerns are labor protections, health care reform, civil rights for minority groups, food security, and income equality. However, Prime Minister Narendra Modi has propagated a narrative of self-reliance that undermines these systemic inequalities. Service provision has highlighted these discrepancies because resources are scarce, and those with power and privilege are placed to the front of the line. In addition, many Indians cannot abide to the recommended sanitation and social distancing measures due to living in poor, dense settlements in the heap summer when water sources are limited.

Although tearing through communities and disrupting daily life in India, the COVID-19 pandemic can be viewed as an opportunity for social change. More specifically, it is well within the power of Parliament, the media, civil society, and local governments to right these wrongs by ending communal bias and impartiality within state institutions. Addressing these corrupt and oppressive practices will not only remediate the effects of COVID-19 but help shape an equitable future for a country that is rapidly becoming a global super power and expected to be the most populous country in the world by 2027. Real change and equity in the world’s largest democracy could send a much-needed shockwave of justice across the globe.

The Right to Mental Health and the Importance of Self-Care

An image of a brain embroidered on a piece of fabric in an embroidery hoop.
Brain Anatomy Hoop Art. Hand Embroidered in Pink and Blue. Source: Hey Paul Studios, Creative Commons

While it seems that most people today would agree that taking care of one’s mental health is important, it may come as a surprise that mental health is actually a human right.  According to Article 25 of the Universal Declaration of Human Rights, all people have the right to “a standard of living adequate for the health and well-being of himself and his family…”  The Office of the United Nations High Commissioner for Human Rights has declared that “that the right to health is a fundamental part of our human rights and or our understanding of a life in dignity.”  

Mental Health as a Human Right 

The United Nations Human Rights Council recognizes three principles regarding the right to health: 

The first is that it is an inclusive right.  This means that it extends “not only to timely and appropriate health care, but also to the underlying determinants of health.”  This includes things like access to clean water, safe working conditions, and important information about health.  These factors, while clearly relevant to physical health, are also important in maintaining one’s mental health. 

The second principle is that the right to health includes both freedoms and entitlements.  Freedoms would include things like “the right to control one’s health,” while entitlements would include things like “the right to a system of health protection that provides equality of opportunity for people to enjoy the highest attainable standard of health.”  This is significant because one needs to be able to access important information and resources related to mental health in order to have meaningful support for their mental health.   

The third principle is that the right to health is a broad concept that can be divided up into more specific rights.  For example, there are some aspects of health that are specific to people who are assigned female at birth, and those aspects are associated with specific rights.  The right to mental health (and the rights associated with it) is one of the many rights that make of the right to health.   

Mental Health Impacts Your Overall Future Health 

According to the World Health Organization’s Constitution, health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”  Based on this, taking care of your mental health is not simply making sure that you are not actively going through a crisis.  Being healthy is more than just surviving.  Taking care of your mental health involves taking daily steps to care for yourself that not only improve your health in the present, but also protect your health in the future. 

Having poor mental health puts you at a greater risk for physical health problems.  According to the American Psychological Association, having a mental health condition reduces men’s life expectancy by an estimated 20 years and reduces women’s life expectancy by about 15 years.  This is in part due to the fact that nearly two-thirds of people with mental health conditions do not seek any form of treatment. 

Mental Health is a Key Part of Accessing Many Other Rights 

In addition to being a right on its own, maintaining good mental health is also a key part of being able to meaningfully access many other human rights.  For example, even when given all the necessary tools that are directly related to education, struggling with mental health issues can impede a person’s ability to receive a truly meaningful education.  This is reflected by the long-term effects of depression.  In one study, scientists found that individuals who faced depression during mid-adolescence and continue to deal with it as young adults are at an increased risk of educational underachievement and unemployment.  One’s mental health can also impact their access to other rights such as the right to participate in the cultural life of their community, the right to rest and leisure, and the right to work. 

Scrabble pieces spell out the words "mental health."
Mental Health. Source: Kevin Simmons, Creative Commons

You Have to Help Yourself Before You Can Help Others  

You’re probably familiar with the concept of putting your oxygen mask on before assisting others on a plane.  If you are struggling to breathe yourself, not only is your ability to help others inhibited, but you’re putting your own health and well-being at risk of harm.  This can be applied to mental health as well.  If you are facing serious struggles with your own mental health, it is important to focus on helping and support yourself before taking on responsibilities related to other people’s mental health. 

For this reason, the maintenance of good mental health is especially important for people who work in fields such as human rights advocacy.  The world of human rights is full of issues and topics that can be emotionally draining, so one can easily become overwhelmed by it all.  It is vital that advocates make their mental (and physical) health a priority, even if their main concern is helping others.  Self-care needs to be a part of any human rights advocate’s tool kit. 

The Basics of Self-Care 

Self-care can be defined as “any activity that we do deliberately in order to take care of our mental, emotional, and physical health.”  

Raphailia Michael, a licensed counseling psychologist, suggests that there are three golden rules to starting self-care: 

  1. “Stick to the basics.”  This makes it easier to include self-care into your schedule, make it a part of your regular routine, and figure out what works best for you.
  2. “Self-care needs to be something you actively plan, rather than something that just happens.”
  3. “Keeping a conscious mind is what counts…if you don’t see something as self-care or don’t do something in order to take care of yourself, it won’t work as such.”  

Michael also gives a basic checklist of self-care tasks that can apply to pretty much anyone.  This list includes things such as eating a nutritious diet, getting enough sleep, following up with medical care, and looking for opportunities to laugh every day. 

It is so easy to get caught up in the hustle and bustle of everyday life and forget to take care of oneself.  We all do it sometimes.  It is important that we set aside time to properly take care of ourselves and pay attention to our own needs.  Mental health matters just as much as everything else that is going on, and that’s something we need to remember. 

 

Challenges with Undocumented Immigrants in the U.S.

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Source: Yahoo Image

Humans have always been regarded as higher animals due to several similarities we share, including instinct, cognition, problem solving skills, introspection, creativity, emotional intelligence and planning skills. Just as planning is an ability of both humans and animals, it involves adequate effort and encompasses a wide range of ideas and research put in place to actualize our desired objective. One of the most fascinating parts of planning to me includes identifying the best place or location we can truly reach our goals, achieve our objectives and fulfil our purpose, which all basically centers around migration. Migration remains a constant and unending phenomenon for both humans and animals, and various motives can be attributed to this endeavor, such as the search for food and water, seasonal weather change, mating reasons, employment opportunities, health and education reasons, adventures and thrills, insecurity, and many others. More still, we can basically summarize migration purposes as a search for a better life, which is a basic instinct all living things possess.

In the last ten years, migration within the international context has risen to a significant level despite continuous efforts many countries have dedicated in ensuring their borders are adequately tightened with hope of discouraging immigrants from illegally entering their borders. According to Ross, Cunningham, & Hanna, an estimation of 244 million migrants are presently living temporarily or permanently outside their country of birth.  Violent conflict, discrimination and lack of employment opportunities are major reasons for the increasing number of immigrants in several developed countries, and has forced many countries into adopting drastic measures such as rigorous identity checks, detention camps and deportation, to reduce their entry. Another means of curbing the increasing number of immigrants includes formulating and enforcing policies that limits them access to affordable healthcare services. For instance, the United States Affordable Care Act excludes undocumented immigrants from accessing health insurance, while the immigrant provisions of the 1996 Welfare Reform Act, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) excludes undocumented immigrants from publicly funded services.

Several immigration laws and policies within the United States continuously hinder undocumented immigrants’ access to adequate healthcare services, which constitutes a major challenge to all who fall under this category despite evidence proving they contribute more money in taxes to the U.S. economy than they consume in services.  What I believe the U.S. government has failed to understand is the fact that these laws and policies not only put the health of these undocumented immigrants at a high risk, but also the health of the general public and socioeconomic development of the country. One of the most detrimental ways these laws and policies have greatly affected this vulnerable population is in the fight against the HIV epidemic. According to Ross et al., migrants who reside in developed countries are disproportionately affected by HIV as the proportion of new HIV diagnosis amongst migrants exceeds the percentage of the general population. HIV, as we all know, is a global epidemic that demands the best care and treatment which was the reason that spurred world leaders in 2015 to restate their commitment to the right to health by enacting the universal health coverage in the sustainable development goals that guarantees all people and communities access to high quality health services.

HIV +-
Source: Yahoo Image

It is clear the United States government clearly disregards this universal policy that aims at ensuring everyone receives the best healthcare services irrespective of their personality or condition. I guess the U.S. government by their own understanding believes migrants do not fall under the universal coverage as it is evident through their discouraging treatment of undocumented immigrants, more so, those living with HIV. Ross et al. believes migrants persons living with HIV have more characteristics that are associated with poor HIV clinical outcome, and are more likely to die from HIV compared to non-immigrants. For undocumented people living with HIV, there are more factors that exacerbate their condition such as discriminatory laws and policies, lack of follow-up care, ignorance, stigmatization and discrimination. I do believe these discriminating laws and policies serves as the major factor affecting undocumented people living with HIV. One area that typifies this can be seen during the documentation process of a patient health record, which compulsorily demands the immigration status information of individuals. This got me wondering if a client’s immigration status information is actually needed in their health record.

Kim, Molina & Saadi believes documenting immigration status in patient records not only possess a challenge to the clients but also to clinicians. Although by recording this, the information would most likely improve the communication process between the client and the clinician, and also facilitate continuity of care, on the other hand, recording the same information could expose the client alongside their family to risks of being stigmatized or discriminated by non-immigrant friendly clinicians who may expose them to immigration enforcement officers even though it violates patient confidentiality. They believe explicit documentation of immigration status of patients alongside their families in a health record be avoided as evidence suggest risks outweigh benefits in this regard. Conversation about immigration status using indirect language in describing social context should rather be prioritized over written documentation to ensure patients have their healthcare needs met without fear. They concluded by advising clinicians and the general healthcare system to ensure policies and guidelines reduce the high level of stigma and discrimination for all rather than the present opposite.

Families fighting against forced separation
Madison, WI, USA- February 18, 2016 – group of people protesting new Wisconsin immigration laws. Source: Yahoo Image.

Another area that strikes me hard for undocumented immigrants living with HIV are those who are currently in detention camps across various states in the U.S., a revelation which came to me through one of my on-campus events with the representative of the Alabama Latino Aids Coalition. The speaker spoke about the inhumane treatment undocumented immigrants go through while in detention, more so, people living with HIV. This made me do some research and I found several evidences that confirmed undocumented immigrants living with HIV can actually maintain continuous access to care and treatment while being detained in correctional facilities to ensure they sustain or achieve good virologic outcomes and well-tolerated regimens if structured protocols are implemented and enforced. It should be noted that the detention process for migrants during their deportation proceedings is complex and rigid which has led to several lapses due to poor access to proper medical care. Even though there are 21 Federal Detention Centers across the U.S., which are operated by the Bureau of Prisons, and all provide Antiretroviral treatment and medication to detainees who disclose their HIV status, there exists fear of stigmatization or discrimination amongst detainees living with HIV as they believe their disclosure may negatively impact their immigration trial, especially if they also fall under any gender or sexual minority groups. Also, the poor living condition and environment of this population while in detention forces some to relapse into substance use, engage in risky sexual behaviors, and disregard their treatment plan.

Based on this understanding, it is hard to imagine the inhumane condition undocumented immigrants are forced to live through while being detained. There is need for the U.S. government to understand that even though several undocumented immigrants after their trial, are usually deported or released at the nearest borders or territories close to their home countries, several others return into the society without receiving adequate rehabilitation or reintegrative education which possess a challenge to the society at large. Human and material resources that could have been used to resolve other pressing needs will then be used to serve their avoidable demands. To resolve this challenge, there is the need to abolish any form of discrimination against detainees living with HIV and ensure it does not affect their deportation trial. Also, clinicians and correctional officers need to be more sensitive to the needs of the detainees having been separated from their families and may never see them again, which is a situation that can easily exacerbate their condition in such a hostile detention environment. Human rights institutions, immigration right advocates, academicians, alongside health authorities, media and the general public should also advocate and help raise awareness about the poor condition of these detention facilities. For deported detainees living with HIV, the U.S. government alongside non-governmental institutions should provide adequate health education using evidence-based treatment medications and materials that meets the specification of their home country to ensure transnational HIV continuity of care.

Picture of Undocumented Immigrants
Undocumented Immigrants in dire need of help. Source: Yahoo Image

In all, we all should understand that undocumented immigrants are also humans and should be treated with utmost respect irrespective of their situation. There is need to ensure their health and wellbeing are adequately met and well taken care of. As humans, we should not only sympathize with them, but also support them by raising awareness and advocating for better laws and policies that can assist them during their ordeal. We should always aim for a multi-sectoral approach that addresses the structural challenges for undocumented immigrants living with HIV such as housing, food security, mental health, and access to employment because there is a continuous effort by the U.S. government to dehumanize undocumented immigrants as community members and remove vital resources that is available to them. As we all know the U.S. government remains extremely resolute in enforcing the 2015 immigration laws that places all undocumented immigrants at risk of being deported, they can also ensure the universal law on respect to all life is adequately respected by enforcing laws, guidelines and policies that protects the lives and wellbeing of undocumented immigrants.

A Human Rights Perspective on Solutions to the Opioid Crisis in America

My most recent article described an overview of the opioid addiction crisis from a human rights perspective. You can view it here. In this article, I attempt to explain the different solutions from medical professionals regarding opioid addiction and the racial and economic disparities that have arisen amongst the most successful solution.

There are two forms of treatment that most clinics can decide between: traditional counseling therapy with a focus on mental strength or using medication, such as buprenorphine and methadone, to combat addiction. Research has proven that without medication, people are twice as likely to die from an overdose. However, the traditional counseling methods have persisted across treatment centers. The Journal of Substance Abuse conducted a study that showed that between 2003 and 2010, of 50,000 opioid addiction patients on Medicaid, patients who had received counseling therapies were six times more likely to relapse than those who received methadone as treatment and four times more likely than those who received buprenorphine. The risk of overdoses is increased during the period of detoxification utilized by abstinence based programs because of a lack of tolerance.

A counseling session
Counseling. Source: Alan Cleaver. Creative Commons.

Opioid substitution has proven to reduce mortality. To avoid a misuse of buprenorphine and methadone, the two medications are tightly controlled by doctors. Buprenorphine is a drug that reduces the craving for opioids and reduces the chances of a fatal overdose overall. Suboxone, a compound of buprenorphine, is engineered to reduce the possibility of an overdose. However, using medication as treatment for addiction has only truly been utilized at a small number of walk-in clinics and has not been fully incorporated into the nation-wide health care system. In 2015, in the United States, 8-10% of treatment programs offered buprenorphine and methadone as substitution therapy. Even in this small number of programs, the method was often unsuccessful as the medicine was offered for too short of a period to be effective. The treatment is only provided in very regulated clinics and prescribers are limited to a maximum of 275 patients.

Between 2012 and 2015, the number of doctor visits where the health professional prescribed buprenorphine greatly rose. Despite this, a research report found that of 13.4 million medical cases involving buprenorphine, there was no increase in prescriptions written for minority groups. Dr. Pooja Lagisetty, one of the authors of the study, reported that white populations are nearly 35 times more likely to have buprenorphine discussed in their visit than black populations. Accessibility and insurance ability are commonly cited as reasons why this disparity has occurred, especially as the majority of white patients paid for their treatment using cash or insurance whereas only 25% of visits were covered by Medicare or Medicaid. This is especially concerning when it is taken into consideration that the rise in the use of buprenorphine occurred at the same time that opioid overdose related deaths were rising significantly faster for black populations than for whites.

Representation of the cost of healthcare.
The cost of healthcare. Source: ImagesMoney. Creative Commons.

In many cities, opioid addiction treatment is segregated by income. Lower income patients find themselves needing to attend a clinic in order to receive treatment while more affluent patients are able to avoid the clinic and instead receive treatment from a doctor’s office where medicines can be prescribed. These clinic programs are federally funded and often covered by Medicaid. However, in order to receive treatment from the highly regulated clinics, patients must visit daily. Many patients commute for hours every day before waiting within the clinic to receive their life-saving medication. These patients, who are already part of a lower income bracket, are losing precious hours where they could be working or with their families. Work, childcare, families, and other related life events must revolve around the daily trip to the clinic. Some patients have described needing to turn down job offers. Because of this, methadone has earned the nickname, “liquid handcuffs.”

In order to prescribe buprenorphine, physicians are required to undergo a special form of training. Only 5% of physicians have participated in this training. The shortage of clinicians has resulted in the ability of physicians to demand cash payments in return for a prescription of buprenorphine. 40% of white patients paid cash while 35% relied on private insurance. Just 25% of these visits were covered and paid for by Medicaid and Medicare. These percentages highlight just how costly a lifesaving prescription can be for people of low income. Because of the racial disparities within the United States economy, the people who fall into this category tend to be of a minority group. Gentrification has also caused a problem within the clinic community as their buildings get bought out in favor of other businesses. In 2016 in New York City, 53% of participants in methadone programs were Latino and 23% were black, while 21% were white. Also, in 2016 more than 13,600 people in New York filled at least one prescription for Suboxone with nearly 80% of these 13,600 paid for the medication using private insurance.

2011 Protest against the War on Drugs
No More Drug War. Source: Neon Tommy. Creative Commons.

Buprenorphine was purposely introduced into a private market, intended only for those who could pay a high price. Therefore, the unequal distribution of the drug can be determined to be not accidental. Due to the government regulations surrounding the prescription of the drug and the training required for doctors, there are too few doctors actually allowed to prescribe the medication. Those who can often do not accept insurance for their services as demand is so high and they can make more of a profit. Insurance will pay for the actual drug, but patients must pay for the doctor out of pocket.

A permanent stigma surrounding methadone has developed, hailing from the War on Drugs days in the 1960s. Racially charged stereotypes regarding addiction have fueled this stigma which has in turn caused lawmakers to be reluctant in passing legislation that would make the drug more accessible to underprivileged populations. However, this would be the push the community desperately needs. Medicines like buprenorphine and methadone need to be significantly more accessible, both for patients and doctors alike. They need to be included in more clinics while therapy based solely on mental counseling should be phased out from the common addiction treatment centers. In order to close the racial and economic disparities within this crisis, it is important to first recognize them. Once that has been done, our communities need to take direct action that will result in a positive change.

Cataclysm: COVID-19 in Brazil

As the number of novel coronavirus (COVID-19) cases continue to grow in the United States (U.S.), another epicenter has been growing in South America. As the sixth most populous country in the world, Brazil has experienced an uptick in COVID-19 cases and deaths alongside an array of national controversies that make the response efforts considerably more difficult. This blog addresses Brazil’s growing importance in the COVID-19 discussion and how it impacts human rights issues concerning indigenous peoples, environmental degradation, favela communities, and good governance.

As of late-June, more than 1.3 million Brazilians have been diagnosed with COVID-19, while over 55,000 have died from the virus. Brazil’s most populated state, São Paulo, is currently the country’s epicenter with nearly 250,000 confirmed cases of COVID-19. The northeastern state of Ceará has the country’s second-largest number of confirmed cases (100,000+), while Pará in the northwest is nearing 100,000 confirmed cases. Additionally, the iconic city of Rio de Janeiro has over 105,000 confirmed cases of COVID-19. Unfortunately, Amazonas has to the highest COVID-19 death rate of any state with 67 deaths per 100,000 cases, compared to Bahia’s 11 deaths per 100,000 cases, which highlights the disproportionate impact of COVID-19 on indigenous communities that have been systematically killed, displaced, and denied access to health care and other preventative services that could help fight the spread of the virus.

Indigenous Peoples of Brazil

As the largest Brazilian state in the Amazon region, Amazonas is known for its indigenous communities who often live in isolated villages and have poor access to health care. In the city of Manaus, which has a population of 2 million+ and is only accessible by aircraft or boat, many recent respiratory-related deaths have resulted in quick burial in mass graves, which has likely led to a severe underestimate the pandemic’s toll on the local population. In the remote community of Betania, the Tikuna tribe has five government medical workers that accommodate an approximate 4,000 inhabitants, but they are not treating the sick due to lack of protective equipment and COVID-19 testing supplies. One considerable threat are the indigenous community members who are not quarantining and are, instead, traveling in and out of town for work.

These unprecedented events compound the colonial legacy that has threatened Brazil’s indigenous peoples for centuries. Centuries ago, indigenous tribes throughout the Amazon were decimated by diseases brought by Europeans. In a way, history is repeating itself because the Brazilian government’s ineffectual response to the crisis have allowed COVID-19 to ravage the surviving indigenous communities and put them on the brink of genocide. Aside from the tribes who have contact with the modern world, the Brazilian Amazon inhabits 103 uncontacted tribes who have virtually no knowledge or resources to protect them from the threat of COVID-19. Signing this petition will help urge Brazilian officials to protect the surviving indigenous communities throughout the Amazon.

Deforestation in the Amazon

Since COVID-19 has reached these Amazonian communities, deforestation in the region has also proliferated. The Amazon is the largest rainforest in the world and is important to the global ecosystem because it absorbs approximately 5% of the world’s carbon dioxide (CO2) emissions. Thus, protecting the Amazon is pivotal for stalling the effects of climate change. However, for years, the Amazon has been ravaged to accommodate the agricultural industry as well as illegal loggers and drug traffickers. As a result, indigenous leaders fear that the COVID-19 pandemic will be used to exacerbate the destruction these industries have already caused.

During the month of April, deforestation in Brazil increased by nearly 64% which resulted in more than 150 square miles of rainforest destruction. In response, 3,000+ Brazilian soldiers were deployed to the region to prevent illegal logging and other criminal activities that contribute to deforestation. Some worry that such activity in the rainforest will lead to outsiders giving indigenous communities infectious diseases, namely COVID-19. Brazil’s Secretariat of Indigenous Health (SESAI) has made efforts to distribute N95 masks, gloves, and goggles to the region, but activists warn that the only way to protect uncontacted tribes is by keeping illegal loggers and miners out of these areas. Despite the Brazilian government establishing three military bases to prevent illegal actors from permeating the region, they are only expected to be present for 30 days. This is because Brazil’s main environmental enforcement agency, Ibama, is expected to take over these efforts but are currently understaffed and underbudgeted.

Favelas in the Age of Social Distancing

More than 11 million Brazilians live in favelas which are shantytowns outside of urban centers. Already hit hard by gun violence, unsanitary conditions, and militaristic police presence, people living in Brazil’s favelas struggle to adhere to social distancing measures. Research has found that people living favela-like conditions spend roughly 50% more time per day with others than people in less-impoverished areas. Often, favelas are composed of two or three rooms with five or six people sharing these spaces. As such, favela conditions enable the spread of COVID-19, and with precious little assistance from the government, Brazil’s most impoverished communities are left to fend for themselves.

With little government help, residents of Paraisopolis in Sao Paulo (population: 100,000) have offered a community-based solution. Due to donations and volunteer work, residents have responded to COVID-19 by organizing distribution of free meals, ambulatory services, and neighborhood watch persons. They even designated one building the quarantine house and repurposed closed schools in self-isolation centers. In Rio, members of the gang City of God drive through the local favelas, blaring a recorded message ordering people to stay home. Other gangs have become knowledgeable about COVID-19 in order to deliver essential goods to favela residents and have even gone as far to enforce social distancing measures by preventing restaurants from putting tables out. These forms of gang vigilantism in Brazil’s favelas demonstrate the lack of government support and tension with local police.

Small grave onlooking a favela.
At the bottom of this block destined to the burials of COVID-19, is the favela of the Vila Nova Cachoeirinha housing complex. Source: Léu Britto, Creative Commons.

Trump of the Tropics

These criticisms are largely attributed to the leadership of Brazilian President Jair Bolsonaro who notoriously dismissed COVID-19 as a “little flu”. Aside from personally ignoring social distancing measures, Bolsonaro has organized large rallies in an effort to confront local governors who have locked down their regions. Recently, after ignoring federal regulation that require wearing a face mask in all public places, a judge ruled that Bolsonaro (and any public official) is not exempt from this policy and should expect a 2,000-reais ($387) fine like anyone else. Bolsonaro even fired his Health Minister, Luiz Mandetta, in April after he supported social distancing measures. His successor has since promoted a reopening of the economy and unproven medical treatments for COVID-19.

Known by many as the “Trump of the Tropics,” Bolsonaro has successfully maintained a strong coalition of supporters such as the agriculture community, evangelical Christians, and the military. Unlike the U.S., Brazil is an emerging economy with a weak social safety net that makes it difficult for government officials to convince people to stay at home. Health care access and the conditions to work from home are also quite limited. Recent cell phone tracking data has revealed that 45-60% of Brazilians are not complying with social distancing measures, likely due to the fact that they have to choose between feeding their families and being exposed to the virus. As such, it is assumed Bolsonaro’s defiance of a public health approach to COVID-19 is an effort to appeal to his core supporters. Bolsonaro has also slashed regulations and enforcement of land grabbing, which exacerbates the deforestation crisis currently impacting the Amazon.

Human Rights in Brazil

As demonstrated, Brazil has an array of chronic human rights problems that have been compounded by the arrival of COVID-19. In 2016, a constitutional amendment was passed that limited public expenditures in Brazil for the next 20 years. As a result, we are now witnessing how these austerity measures have affected access to housing, food, water, and sanitation when Brazilians need it the most, particularly within the most vulnerable groups – women, children, Afro-Brazilians, indigenous peoples, rural communities, and informally-settled persons.

Much like the U.S., Brazil’s COVID-19 response has mostly been subnational social distancing measures and an emergency basic income to placate the masses. However, these efforts are clearly inadequate considering Brazil’s COVID-19 cases are surging alongside another potential Zika outbreak. As a result, Brazil has effectively become the most prominent COVID-19 case study in the Global South, a nation plagued by a deadly virus and an array of human rights issues. Human rights experts suggest fiscal stimulus and social protection packages would only be the beginning of a COVID-19 response because many of these concerns are the consequence of marketization and privatization of public goods and services. As such, the COVID-19 pandemic serves as an opportunity to reverse the market-based ideology that has failed so many countries, especially the Land of the Palms.

Please sign the petition to help urge Brazilian officials to protect the surviving indigenous communities throughout the Amazon.

A Human Rights Perspective on the Opioid Crisis in America

Pills
Pills. Source: Jamie. Creative Commons.

The opioid crisis in the United States is not something I often hear about in the news nowadays. Or maybe it is so often in the news that the title fades into the background amongst the news about politics. However, the opioid epidemic affects millions of people across the United States, and it has affected them for years. Human rights concerns connected to the epidemic have begun to grow in recent years as controversies regarding the United States health care system and law enforcement systems have come to light.

The crisis began with the expansion of opioids for medical purposes in the 1990s. The initial goal with opioids was to treat pain but the drugs soon became exploited by pharmaceutical companies eager to increase their profit revenue [1]. Before the addictive and harmful properties of opioids became known both to the public and to healthcare professionals, prescriptions for opioid medications increased rapidly across the country.

The introduction of extended-release oxycodone in 1996 along with claims by the manufacturers that it was less addictive and effective for up to 12 hours was a major catalyst for the epidemic. There are three described waves of opioid overdose deaths in the United States. The first wave began with an increase in the prescription of opioids, increasing since at least 1999. The second wave included overdose deaths involving heroin, the increase beginning in 2010. The third wave included an increase in overdose deaths involving synthetic opioids such as illicitly manufactured fentanyl (IMF) in 2013.

Hospital
Hospital. Source: Marissa Anderson. Creative Commons.

The first reaction to the opioid crisis was to limit the number of prescriptions in the market. However, this drove many to use the less expensive and more accessible street heroin. Cheaper and stronger opioids kept reappearing on the market, leading to an accelerated rate of fatal overdoses. Most addictions start with diverted supplies instead of among doctors’ patients. This was the case with heroin, which causes 4% of those who were using prescription opioids to switch to heroin. While 4% seems like a small percentage, 4% of the large number of people taking opioid pills is actually very large and enough to exacerbate the crisis [2]. In 2017, the United States Department of Health and Human Services declared a public health emergency. Over 130 people die every day from opioid-related overdoses and 10.3 million people in the United States misused prescription opioids in 2018. In 2017, more than 70,200 people died from drug overdoses. Of those 70,200, around 68% involved opioids.

White Americans make up roughly 80 percent of opioid overdose victims. The attention of the coverage of the opioid crisis has primarily centered on white Americans, pushing aside the attention on minorities affected by the crisis. Minorities made up 20 percent of opioid related deaths in July of 2019, but that number is growing. The crisis has highlighted the racial disparities in the US healthcare system as many experts believe that the number of opioid related deaths in minority populations would be greater if minorities had access to the same level of health care as white Americans. It is known that people of color have had a significant lack of access to the American healthcare system throughout history and throughout the recent years. This disparity lowers the probability that non-whites in American would be prescribed opioids and thus lowers the chance that the population would suffer fatal overdoses. Despite the low death rates due to the exclusions within the health care system, the abuse of opioids is still abundant in communities of color. Scientists have witnessed a doubling of overdose death rates among African Americans, a factor that is being overshadowed by the media and societal focus on the death rates of whites.

Police
Police Officer. Source: G20 Voice. Creative Commons.

The law enforcement system has failed minorities in the opioid crisis as well. The War on Drugs, an attempt at cracking down on the opioid epidemic, has disproportionately affected African American communities across the United States. Studies have shown that law enforcement officials target black communities for drug violations significantly more than they target white communities. While drug use is similar between white communities and black communities, members of the black community are 13 times more likely to be arrested for buying and using drugs. In 2013, black and Hispanic populations represented 29 percent of the entire United States population. Despite this, the number of black and Hispanic prisoners arrested for drug related charges dominated that of whites. Not only is this true, but the United States Sentencing Commission also released a report stating that black prisoners receive longer sentences than white prisoners, despite both groups being convicted of similar weighted crimes.

The opioid crisis has hurt millions of people and families across the United States, one of the most diverse countries in the world. Despite this, the national attention has primarily focused on how the crisis has affected the white population. It is important to focus not only on how the opioid crisis has affected minorities, but also how the health care and law enforcement systems have responded to the opioid crisis in minority groups. The disparities within these systems must be fixed in order to provide an equal treatment of all groups.

[1] The Global Commission on Drug Policy. The Opioid Crisis in America. 2017.

[2] The Global Commission on Drug Policy. The Opioid Crisis in America. 2017.

Oil: The World’s Black Gold?

Known as black gold, petroleum has long been, a valuable resource that many of us benefit from during our daily lives. The petroleum industry’s products range from transportation to even the feedstocks that make the “plastics and synthetic materials that are in nearly everything we use.” Shockingly, the United States has consumed almost 7.5 billion barrels of oil per year, with about 46% of it used as motor gasoline. However, “there is an alarming record of human rights abuses by governments and corporations associated with fossil fuel operations,” ranging from relocation to even suppression of critics.

What is Petroleum?

An image of a pipe pouring some type of green substance, oil in particular, into a barrel.
Recirculated petroleum is pumped from the well by a replica steam engine. Source: Wikipedia, Creative Commons.

Known officially as crude oil, petroleum is a fossil fuel that can be found underneath the Earth’s surface in areas known as reservoirs. Petroleum is mainly used for gasoline that fuels most cars in the world. Petroleum is also used as diesel, jet fuel, heating oil, propane, and others.

However, petroleum is not just a fuel source. Many factories and production sites use petroleum in order to make “crayons, dishwashing liquids, deodorant, eyeglasses, tires, and ammonia.”

Beginnings of the Petroleum Industry

An image of an oil well, colored black, in the process of digging for oil. Located in Lufkin, Texas.
Pumpjack, Spindletop oil field. Source: Flickr, Creative Commons

Through the growing and prosperous iron and steel industry, the 20th century became a period of “great change and rapid industrialization.” However, the birth of the railroad and new construction materials gave way to the petroleum industry offering an alternative source of fuel needed in everyday life.

In Texas, the discovery of the Spindletop oil reserve allowed for the creation of hundreds of oil companies, especially Texaco and Golf, and for the massive decrease in oil prices, from “$2 a barrel to 3 cents.” In 1901, the Hamill brothers, contracted to drill into the ground using a steam engine, came into contact with 160-million-year-old crude oil, shooting up in a geyser meters high. They had anticipated 50 barrels of oil being produced in a day, but more than 80,000 barrels were being produced each day, enriching the backers of the oil rig exponentially.

When talking about the history of oil, one must never forget one of the key figures in the industry, John D. Rockefeller. Through his experience in entrepreneurship and organization, he became a leading figure in the oil industry by creating the Standard Oil company, one of the “world’s greatest corporations.” Through a monopoly, his company integrated itself both horizontally and vertically by eliminating competition and making products cheaper and production more efficient.

The discovery of the Spindletop oil reserve allowed for competition against Standard Oil, through the rise of the Texas Company and the American Gasoline Company (Shell Company of California during the mid-1910s). However, because of Standard Oil’s attempts to “monopolize and restrain trade,” the Supreme Court decided to split up the company into 34 smaller companies.

Oil in the World

Reserves can be found all over the world, but there are countries that produce more oil simply due to the vast reserves found underneath the Earth’s surface. In the United States, the five largest oil producing states are Texas, Alaska, California, Louisiana, and Oklahoma. In the world, the top oil producing countries are Saudi Arabia, Russia, the United States, Iran, and China. The need for oil in the United States surpasses the amount it can produce, generating the need to import oil from Canada, Saudi Arabia, Mexico, Venezuela, and Nigeria.

Looking closely at the top producers of oil in the world, you may notice that two countries in the top five are countries in the Middle East, each with their own host of problems regarding human rights. They range from Saudi Arabia’s supposed killing of journalist Jamal Khashoggi in 2018 and the killing of more than 6,500 Yemeni civilians as a result of numerous airstrikes against the Houthi rebels to Iran’s crackdown on peaceful protestors and the presence of Iran’s death penalty for most extreme offenses. Allegations of human rights abuses also extend to China as well, where Xi Jingping has removed term limits for the president and enabled the mistreatment of Muslims living in northwestern China. Many consider these human rights issues are due to something called the “Resource Curse,” where the abundance of natural resources in developing countries, like oil, usually lead to “economic instability, social conflict, and lasting environmental damage.”

Oil and Human Rights in the United States

If you read the news as much as I had a couple of years back, then you might recall a certain conflict occurring in North Dakota regarding the Dakota Access Pipeline. The Dakota Access Pipeline, built by Texas-based Energy Transfer Partners, is designed to transport more than 500,000 barrels of crude oil everyday from North Dakota to Illinois. Proposed by Energy Transfer Partners in 2014 and completed in 2017, many interest groups protested the pipeline, ranging from environmental activists to the Standing Rock Sioux tribe.

An image of protesters holding up a banner with the words "STOP DAKOTA ACCESS PIPELINE" across it.
Dakota Access Pipeline protesters against Donald Trump

The pipeline currently travels under the Missouri River, a source of drinking water for the Standing Rock Sioux tribe as well as a source of biodiversity in the environment. Part of the reason for the protests include the damage to the water supply that said pipeline could inflict if leaking occurs which is justifiable due to the more than 3,300 occurrences of leaks since 2010 at many pipelines in the United States.

An image of the route of the Dakota Access Pipeline, with the Standing Rock Sioux tribe tribal location highlighted as well, showing where the pipeline would threaten those tribal areas.
Le Dakota Access Pipeline avec la réserve indienne de Standing Rock en orange. Source: Wikipedia, Creative Commons.

Reactions towards the protestors have also been extreme, as Maina Kiai, UN Special Rapporteur, has reported. The North Dakota National Guard, law enforcement officials, and private security organizations have used extreme force, shown through the use of “rubber bullets, tear gas, mace, compression grenades, and bean-bag rounds.” These reactions have been in violation of the U.S. Constitution, specifically the First Amendment. Although some protests have become violent, Kiai suggests that “the response should remain strictly proportionate and should not impact those who protest peacefully.”

“The right to freedom of peaceful assembly is an individual right and it cannot be taken away indiscriminately or en masse due to the violent actions of a few.” — Maina Kiai

By also having part of their cultural homeland destroyed during the construction process, the company contracted for this project is violating the United Nations Declaration on the Rights of Indigenous Peoples, where Article 8 of the Declaration clearly states that “Indigenous peoples and individuals have the right not to be subjected to forced assimilation or destruction of their culture.” However, it is clear to note that U.S. support does not consider the Declaration as a “legally binding or a statement of current international law,” but instead a political or moral force.

Economic trends and forces have commanded the way in which our country has treated those who have been disenfranchised and harmed culturally. The creation of the Dakota Access Pipeline is merely an example of the effect that these economic interests can have on native populations, the environment, and the treatment of those peacefully protesting. Although the pipeline’s main intent is to provide a source of energy for the United States, the threat to harm a cultural tribal site can lead to the destruction of homes for many residents.

Eugenics in Peru

Indigenous Peruvian woman carrying her child on her back with mountains in the background
Quechua Woman and Child. Source: Quinet, Creative Commons

Many people don’t know what the eugenics movement is. Others know what it was, but think it was restricted to Germany’s sterilization—or making people unable to reproduce—of millions of people they saw as unfit: Jews, people with mental and physical disabilities, and the LGBTQ community, among others. However, Germany was not the first or the last to sterilize certain citizens in an attempt to “better the gene pool”; the United States’ policies actually inspired Hitler’s eugenic goals. After WWII, the United States publicly condemned sterilization and eugenics, but the last forced legal sterilization in the country wasn’t until 1981.

Eugenics has operated as a science of improving humans, whereby the procreation of the people deemed fit is promoted and procreation of those deemed unfit is limited. Proponents of eugenics believe nature wins in the nature vs nurture fight; if you’re born into poverty, it’s because you have a gene that’s keeping you there. Throughout history, the groups of people that were deemed unfit were those in low socioeconomic groups, minorities, and epileptics, most of which were women—basically, the people that didn’t fit the mold. They did this under the broad and vague diagnosis of “feebleminded”.

While the sterilization of poor and minority women in the United States is over, eugenics still goes on today. There are groups of people targeted by the modern eugenics movement—one of which is indigenous people. In Peru, almost 300,000 people—mostly poor, indigenous women living in rural areas—were sterilized between 1996 and 2000. Most of these sterilizations were forced or coerced, and some even led to death.

Then President Alberto Fujimori ran on a campaign of expanding health care and lowering poverty rates. However, instead of providing contraceptives to indigenous women, doctors forced sterilizations on them. Fujimori claims that doctors that forcibly sterilized women were not following the strict regulations that were put in place to prevent these occurrences. However, many of the doctors who performed these sterilizations have revealed they were given quotas to fulfill: “Dr. Hernando Cevallos… received an order to sterilize 250 women in 4 days in 1997.”

There were many ways doctors reached their quotas. Some sent public health officials to the homes of women with large families and pressured them to be sterilized even if they wanted more kids. For example, officials visited Gloria Basilio multiple times until she finally agreed. When she changed her mind in the operating room, they restrained and blindfolded her so they could continue with the surgery. Some of these women are illiterate or don’t speak Spanish at all, so the officials took advantage of that and got them to sign the consent forms without them understanding the procedure. Other officials never tried to get informed consent. Women have been pressured to be sterilized moments after giving birth.

These women have been affected in a far greater way than just being unable to have children. One woman had serious medical complications, which were written off by the doctors. She died less than two weeks later at home. She is not the only woman to have sterilization disable or kill her.

Aside from medical complications, they also experience social and mental complications as a result. In the indigenous culture, women are expected to have many children, and women who have been sterilized can no longer serve that purpose. These women can lose a sense of purpose in themselves and also lose the people close to them who were counting on them to have children. Maria Elena Carbajal, a woman who was pressured into a sterilization after giving birth at the hospital, lost her husband because he thought she had willingly been sterilized so that she could be unfaithful without consequences. She found another partner, but he also left her because she could not provide kids. Additionally, these women have to face the fact that they will never have more children—while some will have none at all. Florentina Loayza was only 19 years old when she was forcibly sterilized. She hadn’t had kids, but she wanted some, and she often felt “a deep sadness” whenever she saw a baby.

Another profound impact this has on many women is their connection with religion. Some religions, Catholicism included, believe that sterilization is a sin and that those who have been sterilized, voluntarily or not, have sinned. Justina Rimachi was told by nuns that she could no longer come to church because she had been sterilized. The stigma felt within the walls of a place that felt like home were only relieved by the forgiveness from the priest. He did not tell her it was not her fault, but he did not tell her to leave, so she was grateful.

The crimes against these women were atrocious, and luckily, they are starting to receive attention. In November of 2000, Fujimori stepped down after ten years of presidency. It wasn’t until 2009 that he was arrested and sentenced for some of his crimes, but none of them were for the sterilizations that occurred under his regime.

Some women and their families have received settlements and the Peruvian state promised in 2003 to conduct investigations. However, the Peruvian state continues to deny that the government had a part in the forced sterilizations. They blame instead the public health officials and medical practitioners. To this day, the Peruvian government, which is no longer under the control of the Fujimori regime, has not issued apologies or reparations to the survivors and their families.

While the government continues to deny its role in the sterilization of indigenous people, activists and human rights organizations are trying to call global attention to these injustices. One group, The Quipu Project, has used a free telephone service to collect the stories of over 150 people who have been sterilized, and the number continues to grow. You can hear these stories on their website in Spanish and in English. Not only is this campaign used to bring international awareness to this issue, but these stories are also being used by people fighting for justice within Peru.

The Fiasco between Africans and African-Americans

A multi-cultural Image
In unity lies our strength.                          Source: Yahoo Image

For a long period of time, there has been a long-existing history of an unfathomable and a silently raging rift between Africans and African-Americans or “Afro-Americans,” as some now refer. It should be noted that the relationship between these two races can never be erased or forgotten even though there seems to be a discouraging high-level of historical ignorance or lack of in-depth understanding, especially amongst the newer generations of both races. The connection between Africans and African-Americans goes quite a long way prior to the era of slavery, which I believe warrants a brief trip down memory lane to refresh some existing knowledge on this subject.

We begin by looking at the words of Audrey Smedley, who believes race or ideas about the difference in human color was developed during the era of African slavery. He believed up until the 18th century, Africans were generally positive people who engaged mostly in farming and cattle breeding. They had industries, arts and crafts, commerce and an existing form of government. After invading Africa, the Europeans realized Africans were better farmers and laborers, and immune to several diseases, which were perfect attributes in high demand within the colonialist world at the time. The colonists understood they needed the prowess and strength of Africans to meet their demands and as such, they developed the idea of transporting them across Europe and America, which was then referred to as the ‘New-World’, knowing they would have no means of escape or return.

According to the UShistory website, the Portuguese began the first slave trade agreement in 1472, which saw an influx of over 11 million Africans into America and across a few European nations as slaves. African slave trading became a lucrative business avenue amongst the Portuguese, Spanish and Dutch, and after North America was colonized by Europeans, there were vast lands in dire need of labor which led to the purchase of the first permanent African slaves from Dutch in 1619. Due to their physicality and agricultural abilities, the slaves proved to be highly productive on the farms where they mostly cultivated cash crops ranging from sugar, rice and tobacco. This went on for decades until the anti-slavery movement began which subsequently led to the Civil War in 1861, the Preliminary Emancipation Proclamation by President Abraham Lincoln on September 22, 1862, and an adoption of the 13th Amendment of the constitution in 1865 which outlawed all slave trade practices.

After the abolition of slave trade, issues of race got more intensified due to the non-acceptance of black people and has since become the central point of human attention, interaction and relationship.  It constituted the major form of human identity, a discouraging phenomenon that still gallantly exist in our world today. The creation and addition of a new race in form of Africa-America started a new chapter in human existence and history, which has led to a whole new level of feisty societal restructuring, rebalancing and rearrangements till date. Although whenever issues relating to racial differences arise, most people would most likely always refer to the forever existing tensed-filled relationship between African-Americans and the White race, but not so many would consider the possibility of any discord between other races, most especially Africans and African-Americans. To this end, I will be explaining a few reasons for the existing rift between Africans and African-Americans.

An image distinguishing between an African look from an african-american
Two continents fussed in one face           Source: Yahoo Image

The first reason to consider is the comparison debate between Africans and African-Americans, about who have suffered or continuously suffers the most. We begin by considering the latter’s historical slavery struggles which has obviously spilled over and transformed into the present-day inequality and inequity they are continuously forced to endure. History clearly made us realize the dehumanizing and disheartening low-level of inhumane treatments and conditions they had to go through before the abolition of slavery, and it is no longer news that the present American structure and system is continuously finessed to favor Caucasians who are majority over the minority blacks. With this understanding, some African-Americans always see African immigrants as opportunist who are profiting from their struggles despite not having shared in their pains or experienced  the horrible and derogatory racial discriminations like they did, which is a reason for their mutual relationship with White Americans. They believe Africans do not share in their ideology and are unwilling to participate in their political and civil rights movements.

On the other hand, Africans continuously grieve their pathetic level of underdevelopment which evidence suggest came as a result of the European invasion. As earlier stated, the entire African continent was developing at a steady pace but lost the plot when valuable human and material resources were taken by the colonialists. According to Nathan Nunn, slavery is the major factor for Africa’s underdevelopment till date; a phenomenon which has created ethnic fractionalization and undermined the effectiveness of several African nations. Recent studies suggest Africa’s 72% average income gap with the rest of the world would not have existed if not for slave trade. He believes the reason for the continent’s poor economic performance is due to the effect of slave trade and colonialism which has led to the endless poverty and incessant conflict, poor leadership, lack of basic social amenities and infrastructure, over dependency on foreign aid, poor health and educational facilities, amongst other challenges. It also affects the present cultural and social outcomes of the continent responsible for the present ethnic division, trust concerns, HIV prevalence, ethno-religious differences, and the high rate of polygyny (i.e. a practice of men having multiple wives) amongst other factors that continuously push the continent aback.

Another reason to consider is the trust issues that exits between the two races. So many African-Americans have some misconceptions that Africans cannot be trusted due to their willingness in allowing their fellow brothers and sisters be taken or sold into slavery, while some perceive them to be highly promiscuous due to the high rate of polygyny in the region. To point out the fallacy with the former, studies have revealed that majority of African slaves were captured through acts of kidnappings, raids and warfare, and through judicial processes, while only a few were literally sold by their relatives or friends as slaves. To address the latter, several studies have identified the trans-Atlantic slave trade as the major factor for the high prevalence of polygyny because only men were initially captured and sold as slaves across America which consequently resulted in the decrease amongst the male population and further tilted the sex ratio in many African nations most especially within West and East Africa.

Furthermore on the factors to consider, there is a wide belief or notion amongst Africans about African-Americans misusing their available opportunities despite enduring numerous challenges and difficulties. It is important to note that Africans alongside other races also, share in the belief that America is a land of dreams and opportunities and will always be a dream destination for many. For Africans, one major reason why they migrate to the U.S. is centered around education due to the outstanding level of human and material resources invested in this sector. As widely known, education remains one of the best and golden ticket to living a better life as individuals, which also helps improve the socio-economic growth and development of the community. Another reason why Africans migrate to the U.S. is because of the availability of several decent job opportunities for both legal and undocumented immigrants. By either migrating for job purposes or education, they remain great opportunities that most likely guarantees any individual to live a long, healthy and happy life.

Image of Women dressed in African Attires during an event
Diversity should be celebrated not discriminated Source: Yahoo Image

On the other hand, some African-Americans blame the continuous influx of African immigrants into the U.S. to have negatively impacted the number of jobs that is available to them. According to the National Bureau of Economic Research (NBER), the early immigrant influx into the U.S. between 1980-2000 resulted in 20% to 60% wages decline, 25% employment decline, and 10% rise in incarceration rates among blacks with high school education or less. Based on these statistics, it is understandable to see the plights and frustrations amongst African-American populations, but the increase in the incarceration rates could also be attributed to the heavy trafficking of crack cocaine within black communities which caused the police to enact and enforce tougher sentencing laws and subsequently resulting in the incarceration of one-quarter of low-skilled black men.

On a light note, the United States Census Bureau in June 2019, confirmed that about 13 million workers have more than one job, while a report by CNBC on February 2019, shows U.S. employers posted the most open jobs of about 7.3 million which was a valid evidence that the U.S. job market is actually strong. Also, according to the political typology survey 2020, 61% supports the notion for the country to continue making changes to give blacks equal rights with Whites, 65% believe immigrants hard work and talents have strengthened the country tremendously, 61% believe most people who want to get ahead can make it if they are willing to work hard, while over 55% believe blacks who can’t get ahead are mostly responsible for their own condition.

NFL Star dressed in an African attire
Let’s Save our Future                               Source: Yahoo Image

Based on this knowledge, it aches the heart to see Africans and African-Americans alongside other races have such a resentful, unfriendly and defensive relationship against one another till date. It is true we have all gone through various levels of hardship, turmoil, and suffering which serves as reasons we continuously hold deep grudges against others, but its high time we looked beyond and move on. In as much as we feel justified about our present bitterness or anger towards certain people or races due to our past experiences, we should remember the adage which says, “Two wrongs can never make a right”. It is almost certain that whenever we cloud our minds with negative judgements before relating with others, we would most likely find a way to justify our negative thoughts about them irrespective of the outcome, as such, we all should always set aside our presumptions, perceptions and judgements when relating with others and it is only through this means, can we look beyond our racial differences and respect each other as humans. It is a shame we are still regressing in this 21st century but we can begin by remembering our past, but not dwell on them because when we do, we are prone to live our everyday lives on them, and history has made us to understand that decisions we make in anger or frustration are those that will take us aback or hurt us for a long time.

 

STD Rates Among the Poor and Homeless in Alabama

by Kelsey Johnson (guest blogger)

Picture of a homeless shelter with people standing around and lying down, waiting for a meal and a bed
Source: Yahoo Images

As of 2018, approximately 38.1 million people in the U.S. live below the poverty line. Furthermore, on a given night, over 550,000 people experienced homelessness. 

Of those numbers, more than 800,000 Alabama residents live in poverty, making it the sixth poorest state in the U.S. Approximately 3,434 people experience homelessness in Alabama on a given night. 

Poverty and a lack of adequate housing are considered human rights violations, as they interfere significantly with an individual’s ability to live safely and with dignity. For people experiencing poverty and/or homelessness, these situations impact all aspects of their lives, especially their physical health.

One way that these health issues manifest is in the prevalence of sexually transmitted diseases (STDs) and HIV/AIDS among these populations. Overall, rates of STDs, particularly chlamydia, gonorrhea, and syphilis, are at an all-time high in the U.S., according to a 2019 report from the Center for Disease Control and Prevention (CDC). In 2017-18, there were nearly 2.5 million total reported cases of the three STDs, including over 1.7 million cases of chlamydia, 583,405 cases of gonorrhea, and 115,045 cases of syphilis. 

Two urban areas in Alabama, Montgomery and Birmingham, are among the top 20 U.S. cities reporting the highest rates of STDs, including HIV, syphilis, gonorrhea, and chlamydia. Mobile and Huntsville also ranked in the top 100. Alabama has the fourth highest rate of gonorrhea infections in the country. Additionally, as of 2016, there were 12,643 people in Alabama living with HIV. 

While the CDC report examined STD prevalence among various demographics, it did not focus on STD rates among low-income or homeless populations. However, a literature review published in 2018 in the journal Sexually Transmitted Diseases found that STD prevalence ranged from 2.1% to 52.5% among the homeless adult population. 

This study also identified many of the factors that increase the risks of contracting an STD among homeless individuals. A number of these risk factors also apply to individuals living in poverty, even if they have stable housing. Additional studies offer more insight into the recent rise in STD cases, as well as recommendations for how to decrease their spread among all populations.

Factors contributing to STD prevalence among low-income and homeless populations 

There are several factors that contribute to the prevalence of STDs in low-incomes and homeless communities, including lack of access to affordable prevention and treatment options; lack of comprehensive sex education; the comorbidity of issues like mental illness or substance abuse, and the stigma surrounding STDs. 

According to a 2019 report by the National Coalition of STD Directors, “…poverty is both a cause of infection, and a barrier to the ability to seek care. Poorer populations are less likely to receive appropriate sexual health education, suffer higher rates of substance abuse, and may have more trouble accessing sexual health services.”

Poor or homeless individuals are less likely to have health insurance, or resources to pay for out-of-pocket healthcare costs. Many individuals living in southern states, including Alabama, fall into what is known as the coverage gap, meaning they make too much money to qualify for Medicaid, but not enough to pay for health insurance.

Even if individuals have health insurance, their coverage may be limited to certain providers or services, and may exclude STD testing or treatment. The time and money it takes to travel to healthcare facilities, especially in predominantly rural states like Alabama, also present a barrier to care, even for insured individuals. 

Additionally, budget cuts have forced many STD clinics to close or reduce their services. The loss of these clinics is harmful because not only do they often provide STD testing and treatment on a sliding fee scale, they are staffed by individuals with specialized knowledge in diagnosing and treating STDs.  

The other primary factor in higher STD rates is a lack of comprehensive sex education. As the NCSD report states, “States typically define the broad parameters of sexual health education in public schools. Not surprisingly, these parameters vary widely among states.” Studies show a correalation between insufficient sex education and higher STD rates. Kathie Hiers, the CEO of AIDS Alabama, says the state represents a “perfect storm” for the spread of AIDS and other STDs, in part because of its “poor educational systems that often ignore sexual health.”

This lack of education about STDs also perpetuates the stigma surrounding them, which prevents people from seeking treatment, according to Hiers. Other conditions that are prevalent among poor and homeless populations, including mental illness, incarceration history, and intravenous drug use, also make individuals more susceptible to STDs, and present barriers to seeking treatment.

How to prevent the spread of STDs among low-income and homeless populations

The studies and experts cited in this post offer several recommendations for steps that can be taken, nationwide and in individual states, to decrease the spread of STDs among low-income and homeless populations, including: 

  • Removing financial barriers to healthcare, including adopting Medicaid expansion. The Alabama Hospital Association estimates that by adopting Medicaid expansion, an additional 300,000 residents would be eligible for health insurance.
  • Increasing or restoring funding to public health agencies and STD clinics that provide free or low-cost testing and treatment.
  • Improving access to healthcare facilities through transportation and operating on evenings and weekends.
  • Providing comprehensive sex education in schools. In 2019, the Alabama House of Representatives failed to address a bill that would have made the state’s sex education curriculum more scientifically and medically accurate. The bill would have updated the curriculum’s language to address “sexually transmitted diseases” as “sexually transmitted infections,” which is considered less stigmatizing.
  • Expanding resources to support homeless individuals, and increasing their access to stable housing. A 2016 report by the Homelessness in Alabama Project offered several specific recommendations for addressing homelessness in Alabama.

Additional Resources