Human Rights Issues – Page 18 – UAB Institute for Human Rights Blog

How Covid-19 Exposes the American Healthcare System

When I studied abroad in Spain, I had many discussions with my host family comparing the United States and Spain. These conversation topics ranged from politics, social expectations, and the weather. One topic that my host mother was especially interested in is the American health care system in comparison to the Spanish health care system. Spain has a universal health care system while still allowing private insurance whereas the United States has purely private insurance. Neither system is perfect. However, as the Covid-19 crisis continues to progress it is important to understand how the crisis brings to light the many issues with the American health care system.

A woman in a mask. — Woman in Mask. Source: Patrice CALATAYU. Creative Commons.

It is a well-accepted fact that the United States was significantly less prepared for the impact of Covid-19 than most other developed countries. By any metric of pandemic preparedness, America is significantly behind the rest of the developed world in regard to medical supplies. The country has a severe lack of health care infrastructure within the system; even before the international pandemic, the United States had fewer doctors and hospital beds than the majority of other developed countries. The United States lacks in the number of doctors per capita with 2.6 doctors per 1,000 people. The comparable country average is 3.5 per 1,000 people, which shows just how behind America is. The United States also has fewer hospital beds per capita than the majority of other developed countries. To make matters worse, America has some of the highest rates of unnecessary hospitalizations. These are hospitalizations of patients with chronic conditions that have preventable treatment, making it unnecessary for the patient to be hospitalized. With a pandemic such as Covid-19, these unnecessary hospitalizations are diminishing. However, in the beginning of the crisis within the United States, unnecessary hospitalization significantly slowed down the efficiency of the health care system in caring for Covid-19 patients.

An important trend in the preparedness of the United States for Covid-19 is that the United States, with a private health care system, was noticeably less prepared than countries with universal health care systems. It is true that universal health care is not the perfect response to pandemic emergencies like Covid-19. This is shown by Italy, a country who has a federalized national health insurance program. Italy still needed to lock down and for a while had the highest case and death rate than any other country. However, countries like Italy with universal health care were able to begin recovery and slow the spread of the virus much quicker than those without.

a hospital — Hospital Beds. Source: Presidencia de la Republica Mexicana. Creative Commons.

As health providers have been working tirelessly to make the necessary changes to care for Covid-19 patients, private health insurance companies have been making very few changes to their processes. One system health care providers have been implementing is telemedicine, a program that allows patients to securely consult with their health care providers virtually therefore easing the burden on the infrastructure of the hospitals. Despite President Trump expanding provisions on telemedicine, private health companies are not required to pay health systems for telemedicine. At the same time, while some insurance companies have waived some Covid-19 related costs, out-of-pocket expenses are not waived resulting in patients needing to pay thousands of dollars. To put these costs in perspective, in 2018 the average amount for a patient covered by private insurance admitted to the hospital for a respiratory condition similar to coronavirus was $20,000. Additionally, as hospitals across the country prepared for an influx of Covid-19 patients, stable patients without the virus were forced to stay in the hospital beds. These patients, who should have been moved to a rehab facility or released, were taking up unnecessary space due to private insurance companies taking multiple days to authorize the next steps for each patient. This has been a known delay in hospitals before the pandemic but now it is a delay that has dire consequences.

Quite possibly the biggest problem in the American health care system is cost. This problem is unique to the United States. Citizens are required to pay higher out-of-pocket costs than those in most other countries, leading Americans to forgo their health care in order to save money. Reports have shown that 33 percent of Americans reported a cost-related barrier to receiving care. This is in comparison to the 7 percent who reported the same in Germany. In 2019, a study showed that 33 percent of Americans also reported postponing medical care due to the cost of that care. It is only in the United States that citizens are risking thousands of dollars in order to seek help in a medical crisis like the one posed by Covid-19. A major concern across the world is that Americans will not seek care for corona symptoms due to the high costs of healthcare in the United States and the high amount of people without insurance in the country. This will spread the disease significantly faster than officials within the country would like to believe.

man with supplies — Medical Supplies. Source: Navy Medicine. Creative Commons.

As the Covid-19 cases rise in number across the country, an unusually high number of African Americans in the United States have been infected with Covid-19. This news, while terrible, is unfortunately not shocking and highlights the many racial inequalities in the health care systems. Coronavirus does not have a racial factor but the structural racism within the American health care system is evident. African Americans are over-represented in many essential workplaces making the population more at-risk than other populations. At the same time, African American populations are less likely to have health insurance coverage leading to a disproportionate number to not receive the necessary help from the health care system. There also exists a racial empathy gap that disproportionately affects African Americans and Hispanics within the United States. A racial empathy gap is when medical professionals show less empathy and sympathy to African American patients who are experiencing pain. Human rights workers have been working on mandatory reviews to ensure that health workers are providing an equitable form of treatment for minority patients. However, due to a bias developed and enforced by societal constructs of different races, there exists a higher risk for minority populations within the American health care system.

A few examples of problems within the American health care system that have been exacerbated by Covid-19 are highlighted above. While officials within this system and within the government must work to make necessary changes, it is also important to recognize the lifesaving and tireless health care workers who work within the imperfect system. Covid-19 has shown the country how necessary health care workers are. Nurses, doctors, surgeons, and so many other health care providers have dedicated an immense number of hours to fighting Covid-19. These individuals who are working to save lives within the corrupt health care system are extremely important and we must recognize their hard work while we work to make the system fairer and more equitable.

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 31^st, 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.

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

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.

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.

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

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.

Human Rights and the Coronavirus

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. 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.

MAUNAKEA & THE FIGHT TO PROTECT SACRED LAND

Image of Mauna Kea protectors blocking the road — TMT blockade on Mauna Kea. Source: Occupy Hilo, Creative Commons/Flickr

A $1.4bn observatory called the Thirty Meter Telescope (TMT) is slated to be built on Maunakea, a mountain on Hawaii’s Big Island, this year. This telescope would be the largest in the Northern Hemisphere and would provide images more than 10x sharper than those from the Hubble Space Telescope, allowing astronomers to explore even deeper into space. Yet, while the construction of a new telescope on a tall mountain might seem like a neutral endeavor, it is rife with issues of justice.

The construction of TMT was initially stopped in 2015 when Native Hawaiians and allies blocked the road to construction crews for months until the Hawaiʻi Supreme Court officially stopped construction that December. Then in 2019, developers were given the go-ahead to once again begin construction. In response, protesters (or as they prefer to be called protectors) turned out to block the road, with the protest coming to a head in July, when 38 kūpuna (revered elders) were arrested and Hawaii’s governor, David Ige, signed an emergency proclamation giving law enforcement more control over the area and allowed them to bring in National Guard troops. However, the protectors did not back down and have been camped at the road ever since.

In December, protectors at the Mauna Kea Access Road removed barricades and shifted their camps to the side of the road for the first time, opening the access road to all traffic except construction equipment as part of a deal with Mayor Kim. In return, the Mayor promised, “that no attempt will be made to move TMT construction equipment up the mountain for a minimum of two months.” Protectors hope this time can be used to influence decisionmaking in other arenas. While this update does look promising, in January the trial for the first group of protectors arrested began and has so far highlighted the opposing viewpoints of this protest. According to Deputy Attorney General Darrell Wong “These defendants may have characterized their actions as kapu aloha and peaceful, but nonetheless it involved a plan, an organized plan, something that was calculated and basically something that was unjustified.” Yet the protectors and their attorney view their actions as a response to the government blocking the activists from practicing their religion and culture, which is protected under the law.

Sacred Land

Picture of Mauna Kea in Hawaii — Mauna Kea Hawaii. Source: Eric Tessmer, Creative Commons/Flickr

The protectors are not anti-science, as some TMT supporters have claimed. They are not opposed to the scientific advancements brought by such a telescope but they are opposed to its chosen location. Maunakea is a sacred mountain that is said to connect native Hawaiians to the cosmos. According to the Maunakea Visitor Information Station, the mountain is the dwelling place of the goddess Poli’ahu, it is associated with the Hawaiian deities Lilinoe and Waiau, and the summit is considered the realm of the gods.

The construction of TMT would negatively impact the sacred land and the telescope would increase activities on the mountain, further degrading the environment. The mountain top is already home to 13 other telescopes and since multiple alternative sites were found by the board of directors behind TMT to be “excellent for carrying out the core science” of the observatory, it at first seems off that TMT supporters seem so committed to this location. However, if we take a step back to look at the issue it is easy to see the link between this current protest and the history of ill-treatment to native Hawaiians and the continued desecration of their native lands.

A Brief History of US Interference in Hawaii

The history of Hawaii was absent from all of my education. It had always been just the 50th state and an island vacation spot until I lived in American Samoa and decided to learn more about the history of US intervention in Polynesia. It was then that I learned about the fraught history of Hawaii, a history that I honestly should have known and could have at least guessed at if I had taken a moment to. Just as North America was colonized, so too was Hawaii and many continue to consider the island to be occupied by the US.

In 1887, King David Kalakaua was forced, at gunpoint, to sign a new constitution for the Kingdom of Hawaii, which stripped the monarch of the majority of his authority. The new constitution had been written by a group of white businessmen, many of whom were connected to the sugar and pineapple plantations on the island, who wanted the Kingdom to become part of the US. When the King died, his sister Lili’uokalani succeeded him and attempted to restore power to the monarchy. This action angered the same white businessmen and they formed a 13-member Committee of Safety which forced Queen Lili’uokalani to abdicate her throne. The Committee then proclaimed itself the Provisional Government of Hawaii.

President Harrison signed a treaty of annexation with the Provisional Government, but before it could be ratified, President Cleveland was elected and the treaty was withdrawn. President Cleveland also appointed a special investigator to investigate the events in Hawaii, who found that there had been a coup. He then ordered Queen Lili’uokalani to be restored to power, but the Provisional Government refused and declared Hawaii a republic in 1894. Soon after the US government officially recognized it as a republic. In 1895, Native Hawaiians staged mass protests and eventually took up arms to stop the annexation, but the protest was suppressed and the leaders, along with Queen Lili’uokalani, were jailed. In 1898, Congress passed the “Newlands Resolution” officially annexing Hawaii and, in 1959, it became the 50th state.

For decades, the use of the Hawaiian language was punished, Native culture was suppressed and a large military presence was maintained on the islands. Many Native Hawaiians remember these US policies explicitly designed to suppress traditional Native Hawaiian religious and cultural practices, and while no longer explicit, native culture is still being infringed upon.

Religious Protections?

Theoretically, sacred land disputes should not exist because of existing protections of religion in the US. The First Amendment to the Constitution guarantees the right for people to practice their own religion, with the first clause providing that “Congress shall make no law … prohibiting the free exercise” of religion and the second prohibiting Congress from making laws “respecting an establishment of religion”. Since sacred lands are part of the “religious” practices of many Native Americans they should be protected. Unfortunately, this has not been the case in the courts. In Lyng v. Northwest Indian Cemetery Protective Association, a group of Native Americans from the Yurok, Karuk, and Tolowa tribes objected to proposed road construction within the Six Rivers National Forest because it would destroy land that they held sacred. The district, appellate, and Supreme courts all agreed that the activity would indeed violate their religious needs, yet the Supreme Court ruled against them. The Court ruled that in this case, while the activity would adversely affect their religion and destroy the sacred location, the government was not prohibiting the practice of their religion and therefore construction could continue (Bowman, 1989).

The establishment clause of the First Amendment, prohibiting government endorsement of religions, has also proven detrimental to the fight for the protection of sacred lands. According to the Supreme Court ruling in Lemon v. Kurtzman, government actions must be secular in nature, or at least neutral, and must avoid “excessive entanglement in religion”. In practice, this has resulted in the protection of sacred lands by the government being ruled unconstitutional. Based on this decision, courts found that the National Parks Service’s 1995 Final Climbing Management Plan (FCMP) for Devil’s Tower National Monument violated the establishment clause because it placed a mandatory ban on climbing during June out of respect for local tribal religious practices (Bonham, 2002). In response, the ban was changed to a voluntary one and the case was dismissed, however, some in the climbing community still oppose the ban in any form arguing that they have a right to climb the Tower. While this might appear at least as a partial win for the tribes, what it illustrates is that protecting native sacred land sites is considered a governmental endorsement of religion by the courts and would, therefore, violate the establishment clause.

In short, the courts have continuously failed to protect sacred lands and to adequately protect the practice of indigenous belief systems and cultural practices. A point to think about in light of this failure is that the US Constitution and legal system are not culturally neutral. It is rooted in European legal traditions and Christain morality and theology. Just as culture shapes how individuals see the world, it also shapes how the legal system sees the world and responds to disputes. The Anglo-American legal tradition is capable of recognizing the “sacred” when it takes the form of a church structure, a sermon or a piece of art; but a mountain, a lake, a river? These places are empty until people make their mark. Therefore these sacred land disputes are not merely conflicts between individual rights and government or corporate power but are conflicts between different cultures and different ways of seeing and experiencing the world.

Final Thoughts

In the case of Mauna Kea, the mountain is holy and an integral element of native Hawaiian religion and culture, a culture that the US systematically tried to wipe out. The land in and of itself is sacred and deeply connected to the people and that should be respected. While the building of a telescope may seem neutral, it is not. It is the destruction and desecration of the mountain and cannot be separated from the history of colonization and occupation of the island. In the end, no telescope is worth dehumanizing others. Mauna Kea shows that science does not happen in a vacuum. It must critically examine who is benefitting from the information and at what cost.

As Kealoha Pisciotta, one of the protest leaders, put it, “For Native Hawaiians, there is a question of our right to self-determination as defined by international law, but I think it’s so much bigger than that,” said Pisciotta. “It’s about us learning to live and be interdependent.”

Water Insecurity in the United States

Access to clean water and sanitation is rarely something we have to worry about here in the United States; it comes out of faucets and water fountains at a seemingly endless supply. However, in many parts of the world—including some areas of the United States—access to clean water and sanitation is a major issue and can affect more than just people’s physical health.

In 2010, the UN recognized access to safe water and sanitation as a human right, and the issue was included among the UN’s sustainable development goals in 2015. With the UN’s focus on clean water access, many developing countries have started making efforts to increase access. However, many developed countries, like the United States, have neglected to develop their rural areas, which leaves a significant portion of their population without clean water for drinking and sanitation purposes. In fact, their situations can be similar to situations in developing countries.

Many Americans would be surprised to know that in more rural areas, it’s often not uncommon for people to go without a sophisticated sewer and water system because the infrastructure has not yet been built. In Lowndes county in Alabama, a largely rural and agricultural area, less than one fifth of the population has a safe way to dispose of their sewage waste. This issue can cause the sewage to back up into their systems or to overflow to their backyards. Neither of these outcomes are ideal for promoting health.

The people that are mainly affected by water insecurity and a lack of clean water in the United States are those that are already disadvantaged; the higher your income, the more likely it is you will have complete and adequate plumbing. This leaves those that live in lower socioeconomic areas with lower performing schools and fewer resources more likely to experience issues like inadequate plumbing and lead-contaminated water.

The systems that have the most problems are the ones that serve rural communities. When a city has a sewer issue, more people are paying for the water, so the extra cost is distributed more widely. In a rural community, there are less people to distribute the cost across, so it’s harder to come by the money to update the sewer systems. Because smaller communities have a harder time paying for necessary repairs and upgrades, the residents in these areas have to choose between drinking contaminated water or paying for bottled water.

Another issue that arises is when communities have a city water system but lack the appropriate people to run it. Some areas have no one to run their systems, while other rural sewer systems are operated by volunteers. In Kanawha Falls, West Virginia, a resident was elected to clean the water, but failed to test and report the water, and the state threatened to arrest him. Scotts Mills, Oregon cannot afford to hire workers for the water system, so they rely on volunteers and community reports of smells to know when work needs to be done.

Because some systems don’t have the staff and infrastructure to test regularly, many don’t realize their water is contaminated until they experience an adverse health outcome. For example, in Kanawha Falls, cited 2 thousand times over ten years for not testing and reporting water quality, a man who had skull surgery got two infections from the contaminated water. He now has to keep his head covered when he showers.

These problems aren’t exclusively in rural areas; lower-income areas—typically those in minority communities—also experience these problems. The most famous example is the lead poisoning in Flint, Michigan, where 62.6% of the population is a racial or ethnic minority. At one point, the lead levels—caused by improperly treated water corroding pipes—were almost three times past being considered hazardous waste. While the lead contamination was discovered in 2015, Flint is still dealing with these issues today. The lead’s effect on the community of Flint was enormous: children came down with a rash and mysterious illness; experts believe that lead was responsible for 198 to 276 fetal deaths; and twice as many children were diagnosed with lead-poisoned blood than before.

Flint is not the only area that has experienced issues like this, and Flint is not the only community at risk. Using income information and housing age, Vox and the Washington State Department of Health created a map to show what areas are more susceptible to lead poisoning. They also take the potential of lead paint into account, but the map shows that the at-risk areas are mainly cities, especially those that used to be industrial areas. Looking at the cities I know—Birmingham and Chattanooga—I can tell the areas at the highest risk are those that have a large minority population.

Water insecurity affects people’s mental health as well. Those that have less access to clean water experience more emotional distress. One thing many people, especially in urban areas, count on is easy access to water from their taps. However, when that easy access turns out to be harmful, like it is in Flint, anxiety and worry can rise. Parents that unknowingly gave their children contaminated water may feel guilt even though they didn’t intentionally give their children toxic water. In Flint specifically, levels of fear and anxiety were at an all-time high following the news of the contamination. In 2016, there were reports of parents coming to the ER with water-related breakdowns; many were distressed over the health of their children.

In areas where there’s a lack of water altogether, people can face similar issues. A lack of access to water—whether it be a loss of water through drought or a lack of water to begin with—has been connected to decreased mental health. Those in areas that are water insecure may experience anxiety, water-related emotional distress, and insomnia, among other symptoms. Additionally, the effects of dehydration play a role in mental health. Dehydration has been linked to increased stress, anxiety, depression, and panic attacks. Those facing water insecurity are more likely to become dehydrated, so these symptoms should not be taken likely.

Water insecurity and lack of clean water access disproportionately affect minorities and rural populations. This means these already disadvantaged groups are more likely to experience the adverse effects. Clean water access is considered a human right, but even here in the United States there are people suffering from a lack of clean water.