Minority Rights – UAB Institute for Human Rights Blog

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.

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

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. 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 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 20^th 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

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 Detainment of Uighur Muslims: An Ineffective Approach to Counterterrorism

Image showing detained Uighur Muslims in the re-education camps. — Detained Uighur Muslims. Source: 牙生, Yahoo Images.

For the past several months, the plight of the Uighur Muslims (pronounced wē-ˌgu̇r) has been covered extensively in national and international news. Under the guise of counterterrorism, the Chinese government has been holding the Uighur in detention camps. While the detention of the Uighur is in and of itself a human rights violation, the torture and inhumane treatment that they experience in these camps has been the greatest cause for concern for human rights activists. Undeniably, the detainment and treatment of the Uighur is concerning, but the counterterrorism measures taken by the Chinese government are just as concerning; not only are they arguably ineffective for decreasing the likelihood of attacks, but they also could inadvertently lead to an increase in radicalization.

Background

The Uighur are a Muslim, Turkish-speaking minority group who make up less than 1 percent of the Chinese population, or around 11 million people. Xinjiang, the province in which the majority of the Uighur live, was annexed in 1949 and has been under China’s control since. While the Uighur have historically been subject to discrimination by the Chinese government, this discrimination increased when the Chinese government formally identified the Uighur as a threat to security in China. It is irresponsible to claim that all Uighur are a security threat, but there have been attacks carried out by Uighur militants in China; the Turkistan Islamic Movement, an extremist Islamic group founded by Uighur militants, has carried out more than 200 attacks with the goal of creating an independent state for the Uighur. While the Chinese government has an obligation to protect the citizens of China, this does not justify the Chinese government’s discrimination against and detainment of the Uighur.

Measures taken by the Chinese Government

China first began its crackdown on the Uighur in 2017, when men were prohibited from growing long beards, women were prohibited from wearing the niqab, or the face veil, and several mosques were demolished. Further, the government began using face recognition technology and phone monitoring to track the Uighur. However, the Chinese government took the most drastic measures a few months ago, when over a million Uighur were detained and placed in camps. When reports first began to emerge on the mass detention of the Uighur, the Chinese government claimed that the camps were solely vocational training centers. However, this past November, leaked governmental documents proved that the camps were built to be re-education centers in which the Uighur are forced to renounce their religion and language, or simply put, their identities.

The Camps

The purpose of re-educating the Uighur is highlighted throughout the leaked documents, wherein it is made clear that they must not only renounce their previous beliefs and traditions but must also accept and adhere to the new beliefs they are indoctrinated with. Thus, the process of indoctrination is twofold; first, the Uighur are forced to admit that their belief in Islam is illegal, criminal, and dangerous, highlighting the negative views the Chinese government holds towards Islam, and second, they are forced to pledge allegiance to President Xi Jinping and the Communist Party. In an interview with Uighur-American lawyer and human rights advocate Nury Turkel, the Intercept details the methods used to ensure the success of the re-education process. Based on testimonials of people who have fled the country, the process includes starvation, sterilization, torture, rape, and even killing. According to Turkel, this is all done to eradicate the Uighurs’ religious and ethnic identities, as these identities are perceived as signs of disloyalty to the Chinese government.

Image showing the outside of the re-education camps. — Exterior of a re-education camp. Source: Yahoo Images.

The Wrong Approach

While measures must be taken against any group of people who pose a security threat to a country, the methods used by the Chinese government are inhumane. After the vast number of attacks carried out by Uighur fighters, it is understandable that the Chinese government should attempt to deter future attacks from happening. However, the methods that have been implemented are not only violating innocent people’s basic human rights, but they may also have the reverse effect. There are examples that have occurred elsewhere that can be used to highlight this. First, Tajik officer Gulmorod Khalimov, who made headlines after he left the Tajik army to join ISIS. He explained that he made this decision after he was exposed to anti-Muslim rhetoric during his anti-terrorism course training in the United States, illustrating that a harmful or negative rhetoric about Muslims, similar to the one currently being propagated in China, can lead to and encourage radicalization. Second, when David Cameron, previous British Prime Minister, announced his plans for cracking down on extremists in Britain, the Muslim Council of Britain argued that this would only push people further towards radicalization, noting that the “problem is the constant talk of legislation, harassment, and monitoring… [which] is what’s leading young people towards radicalism.” This is another instance that exemplifies the faulty approach taken by the Chinese government; when stringent measures are taken, such as monitoring and detainment in the case of the Uighur, there can be the unexpected outcome of increased extremism.

The Chinese government claims that they have detained the Uighur to prevent terrorism and extremism, but the methods used are neither humane nor effective. While there need to be measures taken to guarantee the safety of the citizens of China, there are many other methods that can be utilized to achieve this. Further, if the Chinese government does indeed want to address this problem, an approach that does not involve stigmatizing a whole ethnic group and religion is the only way to effectively do so.

Coronavirus and Religion

As the Covid-19 pandemic is taking the whole world by a storm of chaos and confusion, it is directly affecting various aspects of people’s lives. People around the world are trying to get used to this new normal and cope up with the challenges and changes in daily life caused by this global crisis. Since we are facing an outbreak like none other, it has directly affected and changed how we live, work, communicate, and carry out our daily lives. Religion is a very important part of most people’s lives and affects their everyday routine as well as physical, psychological, emotional, and spiritual beings. The freedom to have, follow, and practice a religion is a fundamental human right, and I will explore how the novel coronavirus crisis is impacting and interfering with the religious rights of people.

Since the pandemic has affected most places in the world, religious institutions and houses of worship are no exception. Churches, mosques, synagogues, and temples have been closed for all kinds of gatherings due to the social distancing protocols set through by the CDC as a response to Covid-19. In these unprecedented times, billions of people are resorting to religion as a first resort for comfort and solace. When all else looks unsettling, people of faith are turning closer to religion and spiritual observance throughout the world. But the pandemic has also interfered with traditional ways of practicing religion through the closure of the places of worship and withdrawal of gatherings of this sort. As a Muslim myself, I would like to share my observation and experience of the influence of this pandemic on the religious experiences of Muslims around the world.

Islam is the second largest and fastest growing religion in the world with more than 1.9 billion followers, thus a significant population of the world is facing challenges in exercising their religious rights and rituals. During the initial phase of the outbreak, the first immediate effect on Muslims was the cancellation of the Friday communal prayer. People were ordered to pray in their homes in order to avoid close contact with each other. This congregational prayer is of great significance to Muslims as they come together in mosques to listen to the weekly sermon, pray together, and fulfill this obligatory ritual. Therefore, its dismissal was a big deal for the Muslim communities worldwide and also led to conflicts in some areas. For example, worshippers in Pakistan clashed with police personnel trying to enforce the lockdown at the time of the prayer. Similarly, some mosques in Bangladesh continued to operate despite government restrictions and a massive prayer gathering with tens of thousands of devotees was held without permission from the authorities. The pictures of the event were shared on social media, where it was greatly criticized and sparked an outcry from people in favor of the lockdown. People in Indonesia were divided over Friday prayers and coronavirus fears, resulting in some praying at home and others gathered in mosques. Religious leaders in the U.S. also faced a dilemma in making the best decision for their followers, facing disagreements on whether or not to cancel Friday prayers. In the second week of March, Muslim organizations including the Islamic Medical Association of North America and the Islamic Society of North America gave a joint statement suspending Friday prayers and recommending necessary precautions to the Muslim community.

Protecting human life is one of the fundamental objectives of Islamic Shari’ah. This concept takes precedence over all other objectives of Islamic faith as life represents the foundation of our existence. Therefore, at times, preservation of human life and human rights is far more significant than the continuity of even essential practices of devotion.

People are finding alternate ways to keep practicing religion while also practicing social distancing. Online platforms are being widely used to share information, resources, and ways to get closer to religion as well as interact with other people of faith for support. To lift up the spirits of the Muslim community amid this pandemic, the call to prayer, Adhan, was chanted from loudspeakers in the heart of Europe in early April. Nearly 100 mosques in Germany and the Netherlands rang out with the sound of Adhan as a gesture of support for Muslims. A lot of mosques in Muslims countries have added a line at the end of every call to prayer, asking people to pray at home.

Adhan recited from mosques to fight against COVID-19 in Germany. Source: Yeni Safak, Creative Commons

Islam’s holiest site in Mecca, known as the Kaaba, which is always packed with tens of thousands of pilgrims year-round, was emptied due to Covid-19 concerns earlier this March. Muslims around the world were shocked, shuddered, and deeply saddened to see the holy place deserted for the first time in millennia. The images of the empty Kaaba inside Mecca’s Grand Mosque were extensively spread over social media as Muslims showed their concern and disappointment on this unprecedented yet imperative move. Every year, nearly 2.5 million pilgrims visit the holy sites of Mecca and Medina for a week-long ritual known as Hajj; one of the five pillars of Islam and obligatory for every able-bodied Muslim once in their lifetime. The kingdom of Saudi Arabia stopped Umrah, a non-mandatory pilgrimage, in late February due to the pandemic. As the unfavorable situation still persists, the cancellation of Hajj, which starts in late July, is also being considered. This is one of the largest human gatherings in the world, and its potential cancellation will affect millions of people and businesses around the world.

The holy Kaaba in Mecca, Saudi Arabia. Before and after Covid-19. Source: Creative Commons

The Islamic month of Ramadan started a few days ago and it is one of the most important, sacred, and celebrated time of the year for Muslims. It is marked by fasting from sunrise to sunset, charitable giving to the less fortunate, spiritual renewal, praying and reading the Quran, abstaining from worldly pleasures to reconnect with the self and with God, and coming together as a community to celebrate. Muslims around the world are having a Ramadan like no other this year. The mosques are empty, the daily nightly prayer Tarawih is canceled, people are observing the holy month by praying in their homes and sharing meals with immediate families instead of large community feasts. People are trying to find alternate ways to have the Ramadan experience by holding virtual Iftar meetups, online sermons and halaqa sessions, and donating through online platforms amidst these social-distancing times. On one hand, lockdown in Ramadan has also allowed people to spiritually indulge themselves without worldly distractions like work and school and to modify their daily schedules accordingly. It has given some relief to those who are fasting to catch up on lost sleep from late night prayers and waking up in the middle of the night for the pre-fast meal suhoor. On the other hand, the cancellation of open Iftars organized by mosques and charitable organizations that allowed sharing a meal for everybody has taken a toll on the less fortunate who rely on these meals during Ramadan. Since the world is already facing an economic crisis and a lot of people are in an uncertain situation financially, this time of festive observance is becoming harder for those who are unable to provide for their families and take part in all the celebrations. Since the month of Ramadan teaches empathy and encourages acts of compassion and generosity, Muslims around the world are stepping up to help their brothers and sisters in this time of need. The act of fasting teaches patience, self-discipline, sacrifice, and empathy and these virtues are more important than ever for all of us to practice in these difficult times.

The end of Ramadan is commemorated with a celebration called Eid, which is also referred to as a gift for those who fasted the whole month. For us, the day of Eid is marked by wearing new clothes, going to the communal Eid prayer in the morning, celebrating with the community, and sharing meals and presents with family and friends afterwards. This year, it is expected to have a similar fate as Ramadan if the state of emergency continues, resulting in all the festivities being called off.

Muslims praying in a mosque. Source: Shaeekh Shuvro, Creative Commons

Coronavirus has also changed how funeral services and burials are carried out across the world. Islam has specific guidelines and rituals to perform for the deceased including washing/bathing the dead body, putting it into a coffin, and offering the collective prayer before a procession of friends and family takes the body for burial. According to the CDC guidelines, gatherings are not supposed to exceed 10 people and the body of the infected person should not be touched. Muslim scholars in the US have proposed alternative ways to carry out these procedures such as limiting the handling of the body to the specific staff of the graveyard or funeral home with the use of proper personal protective equipment (PPE). They have also suggested doing tayammum instead of bathing the dead body, which is characterized by wiping the face and hands of the deceased after touching a sandy surface. Additionally, family and friends are not allowed to be physically present during the burial or the prayer. Attendance at funerals is considered a collective obligation that must be carried out by a sufficient number of people, but changes are being made to ensure the safety of everyone. My mother’s uncle passed away from coronavirus last week in Boston, Massachusetts and his family was not allowed to see him at all. Instead, the funeral was live streamed and the prayer was held in the presence of only four people, one of them being the imam who led the prayer.

It is important to note that not only is this Covid-19 situation affecting religious experiences, but some of these rituals have also contributed to the spread of the virus. For example, a gathering of 16,000 worshippers at a Malaysian mosque became the largest known viral vector of the pandemic in Southeast Asia, spreading the coronavirus to half a dozen countries. Similarly, the pilgrimage of Shia sect Muslims to the holy cities of Iran led to the spread of the virus through Central and South Asia. The pilgrims reportedly caught the virus in the holy city of Qom, which was the epicenter of covid-19 in Iran and caused it to spread in their home countries upon return. Even though Pakistan shares its border with China, the novel coronavirus was introduced into the country through pilgrims returning from Iran. Similar cases have been seen around the world where coronavirus infections have been linked to religious gatherings, such as church services in South Korea and North Carolina, Jewish Purim celebrations, and Muslim prayer gatherings.

To conclude, religion is both a source of solace as well as a possibility of risk during a pandemic. People of faith around the world are struggling to keep a balance between religious practices and safety precautions. It is in the best interest of everyone to follow the social distancing guidelines whenever possible and find peace in their own beliefs, whatever they may be.

Outside the Frame: Where is the Native Story in American Art?

On Monday, March 9^th, the Institute for Human Rights co-sponsored an event alongside College of Arts & Sciences and Abroms-Engel Institute for the Visual Arts (AEIVA) to present a panel discussion with Dr. Deidra Suwanee (Director/Tribal Archivist – Poarch Band of Creek Indians), Dr. Tina Kempin Reuter (Director – Institute for Human Rights, UAB), Oakleigh Pinson (Guest Co-Curator – Focus IV Exhibition, AEIVA), and moderator John Fields (Senior Director – AEIVA). During their discussion, they addressed the Native erasure from American art and pathways to greater representation.

The discussion began with mention of Manifest Destiny, which were the events that led to the removal of Natives throughout North America. This effort was influenced by the ‘doctrine of discovery’ that painted non-Christians as pagans and, thus, targets of oppression. The Indian Removal Act of 1830 affected tribes throughout the Southeast, namely the Poarch Creek Indians who are the only federally recognized Native tribe in the state of Alabama.

Thus, many works of art in U.S. museums do not include depictions of Natives. In contrast, many paintings of the American frontier include landscapes without people, although sometimes incorporating wildlife, which conveys the message that this land was simply there for the taking. These portrayals also hide behind the altered and destroyed scared sites that were once home to millions of Natives.

Woman with a ceremonial indigenous dress presents artwork as onlookers listen. — Dr. Suwanee presenting art to the audience. Source: UAB Institute for Human Rights

Such treatment has resulted in harsh living conditions where nearly a quarter of the U.S. Native population reside on tribal lands riddled with unemployment, inadequate housing, and limited facilities. These conditions serve as a harvest ground for poor access to resources that translate to health disparities related to heart disease, suicide, tuberculosis, etc. Native women are particularly at-risk in these harsh conditions because thousands every year go missing or are found murdered, thus inspiring the #AmINext awareness campaign in Canada.

During the Q&A segment, an audience member asked if this type of art could be considered propaganda. Dr. Suwanee suggested that suppression of art is a red flag because it limits expression, although she then claimed that art can also be created to facilitate social change. The conversation then evolved into a discussion about film depictions of Natives and the involvement of indigenous peoples in the United Nations. These sentiments centered on the general theme that Native representation is not only missing in art but also popular culture and politics.

Ultimately, the erasure of Native perspectives whitewashes what is to be told and understood. As such, it is imperative these wrongs are corrected through fair representation of Natives in the media and political arena. Recognizing the rights of indigenous peoples not only brings us closer to the full realization of human rights but also prevents history from painting with a broad brush.

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.

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.