Right to Health and Public Health – Page 16 – UAB Institute for Human Rights Blog

Reframing Intimate Partner Violence: Human Rights in the Home

co-authored by Lindsey Reid, Ajanet Rountree, Nicholas Sherwood, and Nora Hood

Domestic violence, domestic abuse, domestic terrorism, intimate partner violence (IPV)—all refer to abusive patterns of behavior within the context of relationship. While a universal definition has not been agreed upon, this blog operationally defines IPV as “causing or attempting to cause physical or mental harm to a household member or engaging in activity toward a family or household member that would cause a reasonable person to feel terrorized, frightened, intimidated, threatened, harassed, or molested.” In other words, IPV transpires when an individual exerts abusive control over another, resulting in a pattern of physical and/or psychological pain. Due to the extensiveness of IPV, we concur with the CDC assessment that IPV is a public health and a human rights issue, as stated in Article 3 of the Universal Declaration of Human Rights, “Everyone has the right to life, liberty and security of person”. While we tend to think repressive governments or other sinister forces violate human rights, survivors of IPV experience and endure human rights violations within their home. With this blog, we aim to raise awareness of your rights in a relationship.

What is Intimate Partner Violence?

The vagueness of the term “IPV” makes recognizing and combatting this human rights violation difficult; as is the case with any vague definition in the human rights literature. One thorny issue in particular is the oftentimes (over)emphasis of the physical elements of IPV. To be completely clear: IPV, or any form of relational abuse or neglect, refers to physical and psychological maltreatment of an individual. Just because there are no physical scars does not mean it is not abuse. Psychological IPV includes behaviors such as: creating psychological isolation, sexual abuse (unwanted sexual contact, inhibiting access to birth control, unwanted sexual comments, and pressuring or threatening someone into sex), economic abuse (taking actions in order to maintain total control of the household’s finances), and digital abuse (using technology to control, stalk, or manipulate the survivor). This list is neither complete nor comprehensive; IPV as a human rights violation can take many, many forms.

Who are the victims and survivors of IPV? The classical answer is a wife or husband with a marriage; this is why the original term to describe IPV was ‘domestic abuse’ (implying this crime occurs within a domestic setting). The new term of IPV expands that outlook to include unmarried partners, as well as any form of relationship with emotional closeness and proximity. IPV can happen between married partners, and IPV can happen on a first date.

The Changing Demographics of IPV

As ‘battered wife syndrome’ has fallen out of favor, the IPV has been shaped and expanded to include male, female, and child survivors and perpetrators alike. While majority of IPV perpetrators are male, human rights advocates and laypersons alike must recognize perpetrators come in all genders and ages. In previous decades, cultural stigma against male victims may have pressured men from speaking out against their abusers; therefore, the actual gender breakdown of this crime remains unknown.

Male and female perpetrators themselves utilize markedly different forms of violence, which may compound efforts to qualify and deconstruct the gender breakdown of IPV. Machado et al. studied Portuguese men and discovered a pattern among their female perpetrators: “self-partner aggression”. They characterize self-partner aggression as the occurrence where the female injures herself in some way and then claims to be a victim of domestic violence to the police. She (the perp) takes advantage of confirmation bias, recognizing society generally believes that the male partner is abusing his female partner as it confirms gender stereotypes and social norms. Female abusers may also be more likely to use weapons or other objects to cause harm. One study involved a sample of 2,760 victims using the National Crime Victimization Survey from 1987 to 2003 found that 6% of the male victims had been stabbed with a knife, while 1% of the female victims had. Additionally, they found 10% of the male victims had been hit by an object that was thrown by their abuser, while 3% of the female victims had. However, male victims were less frequently found to have experienced violence through direct contact such as grabbing or pulling, with 20% of them having experienced it, while 53% of the females had.

Finally, IPV is not limited to adult perpetrators. Children can exhibit abusive behavior towards anyone in the household, whether another child or an adult. The normative assumption is parents possess the power in the home when compared to children, so it is difficult to imagine children as abusive. Control is the motivation for domestic violence and abuse; therefore, it is necessary that we pay attention when children perform violent actions, avoid brushing them off as merely “bad kids” because the behavior and consequences may have a serious impact on the present and future. Children exhibiting abusive behavior, if unchecked and untreated, may later show further signs of psychological deviance or disorder.

a picture of a boy with 'stupid' written across his forehead — Stupid IV. Source: Laura Lewis, Creative Commons

Controlling to Death

Social researchers have long sought to understand the motives of IPV perpetrators in order to predict violent behavior patterns. By predicting situations of relational violence, social researchers can empower advocates, policy-makers, and survivors themselves prevent occurrences of IPV. Several conceptual frameworks of IPV exist, including the stress-diathesis model, feminist / gender studies theories, and a pathological need for psychological control.

The stress-diathesis model suggests abusive behavior results from high psychosocial stress on the perpetrator. As the stress load increases, the perpetrator takes his or her frustration out on a less-threatening target (the victim). In this model, attempts to mitigate or prevent IPV focus on the perpetrator eliminating or healthily dealing with stressors. This theory has fallen out of favor, as its deterministic view of patterns of abuse at times ‘excuse’ perpetrators for their behavior. However, these theorists take a biopsychological approach to understanding behavior, which indeed aids in painting a holistic portrait of motivations and emotions in general.

By contrast, feminist and gender-studies theories focus on the broad sociocultural factors compelling IPV in perpetrators. Exploring the notion of male dominance in interpersonal relationships, Ornstein and Rickne sampled 714 post-separated and divorced couples in Sweden in 2001. They suggest separation between partners triggers a loss of control (especially for the male partner), weakening his domination of the situation, thus increasing the escalations of violence in the relationship. Violence reported by the respondents showed high variance, including verbal abuse (i.e. name-calling and cursing) psychological abuse resultant from emotional vulnerability of the perpetrator (i.e. feelings of inferiority), and finally physical abuse (including stalking and physical / sexual assault). Overall, feminist and gender-focused theories explore how fundamental issues of identity (such as gender) influences the occurrence of IPV.

Finally, the “control” theory of IPV posits an unhealthy need for psychological control, regardless of gender, is the most significant factor predicting IPV. This theory formulates relational abuse is symptom of a person’s subjective feeling of lack of control in a situation. Violence is therefore the means to an end, with the ‘end’ being feelings of control. Controlling behavior can take many forms, including stalking. The National Council commission in Sweden issued a 2006 report of 4000 surveys that found 362 (3/4 of whom are women) responded to questions of stalking in their lifetime, with 3% in the previous year. In 2011, the establishment of Swedish stalking law brought a four-year prison sentence for those found guilty. It is imperative to note justice systems, regardless of locale, treat the symptoms of violence but not the roots.

a picture of a girl with bruises on her back — Domestic Violence. Source: CMY Kane, Creative Commons.

Regardless of the underlying causes (such as stress, gender roles, or a need for control), each case of IPV is unique and complicated. Recognizing signs of an abusive relationship is the first step and often difficult for the survivor to admit. Leaving the relationship itself is a whole other ordeal. Ornstein and Rickne affirm Kit Gruelle, a victim advocate in North Carolina (NC), who insists battered women are the experts on their relationships- no one knows more about IPV than someone who has gone through it. Gruelle suggests there is a noticeable pattern in abusive relationships—the couple has good days and bad days, just like every other couple. However, the ‘normalcy’ of the good days in no way makes up for the deviance of the bad days. Perpetrators often wear a façade of kindness and normalcy in mixed company, which makes spotting these perpetrators even more difficult.

Deanna remained married to her husband, Robbie, for nine years. She returned to him three times over the course of the years despite police knowledge of threats and violent tendencies. ‘The police knew he was violent but they believed he wasn’t violent enough to kill someone’.

When Robbie kidnapped and beat her across state lines, courts sentenced him to 21 years in prison—majority of the sentence for the kidnapping rather than the abuse. Assault on a female is an A1 misdemeanor in NC, resulting in 150 days in jail, whereas theft is a felony. IPV (or domestic violence) laws in Alabama have a stratified penalty process, ranging from Class A misdemeanor to Class A felony.

Controlling and abusive behavior may persist, even when the abusive relationship terminates. Prison, for many abuse survivors, is the only place they feel safe due to a system that does not protect them.

Latina returned to her abusive boyfriend numerous times because of love and at the time of his death, there was a warrant for his arrest. Courts charged her with first-degree murder when she killed him, after years of threats and abuse left her blind in her right eye.

Gruelle concludes, “our criminal justice system requires that she be beaten enough to satisfy the system, and by the time it get to that point, she’s already been so worn down psychologically and physically and emotionally. That’s when it’s really time for advocates to step up and begin to treat her like she has some value because she’s been told now systematically that she doesn’t. The courts have told her that she doesn’t have value; her partner has told her that she doesn’t have value… and all that strips away from her. Advocates, instead of stripping away, we have to build back up.”

If You See Something, Say Something

It is important to understand the difficulty of reporting cases of IPV. Who wants to get their partner in legal trouble? Who wants to report their wife, husband, girlfriend, boyfriend, and partner is abusive to them? Who is ready to accept they themselves are abused? IPV, like other forms of sex-based violence, often leaves the survivor in a traumatized state. This can manifest psychologically (irritable mood, overeating / undereating, splitting, dependency, fear of being along or fear of being with the abusive partner, and increasing isolation) or physically (exhaustion, severe weight gain or weight loss, and jumpiness). The symptoms of abusive relationships typically run deep, and the longer the relationship lasted, the more difficult these symptoms may be to spot. One critical symptom to look for is increasing isolation. The IPV situations typically result from an over-controlling or obsessive partner. These controllers may begin their abusive pattern of behavior by cutting off the victim from social contact with others outside of the relationship; the less face-time the victim has with others, the less likely to victim will be able to ask for help. In total isolation, the victim is hardpressed to find an ally, and he or she may fall prey to hopelessness and further traumatization. If you believe you know someone is in an abusive situation, reach out.

IPV is a complex human rights violation, and efforts to combat IPV must be flexible, durable, and persistent. Many social scientists work on deconstructing the psychopathology of perpetrators and patterns of survival in IPV victims. Advocates use their voice and social capital to broadcast the plight of IPV survivors and the identity of perpetrators. Ethical policy-makers codify punishments for IPV perpetrators, and enact funding for NGOs and government organizations that help IPV survivors. Finally, you can take action too. If you see something, say something. If you see a friend or loved one is in a relationship that does not seem right, initiate a conversation. Commit to naming and preventing intimate partner violence whenever you see it.

If you or someone you know is or may be in an abusive relationship, here are authorities to contact: in immediate danger, call 911 and The National Domestic Violence Hotline: 1-800-799-7233.

Ms. Hood considers domestic violence to be a form of domestic terrorism, and aims to raise awareness about the issue through her efforts including ThreeDaily.org.

American Citizens Affected By Hurricane Maria

Over the month of September, the island of Puerto Rico experienced two traumatic hurricanes: Hurricane Irma and Hurricane Maria. The eye of Hurricane Irma, a category five hurricane, hit north of the Island on September 7, 2017. Irma, the most powerful Atlantic hurricane to hit the island, left 1 million people without power. Shortly after Irma, Puerto Rico (PR) was ravaged again by another devastating hurricane. Hurricane Maria made direct landfall on Puerto Rico, resulting in a complete power outage in the island. 60,000 people were without electricity by the time Maria hit the island. Governor of Puerto Rico, Ricardo Rosselló explained to CNN the island’s power grid is “a little bit old, mishandled and weak,” thus grid could take months to repair. Stemming from Puerto Rico’s power catastrophe, which especially strained the island’s power authority, Puerto Rico Electric Power Authority (PREPA) filed for bankruptcy last July after racking up a $9 billion dollar debt. Not only did PREPA file for bankruptcy, so did Puerto Rico in May 2017. Puerto Rico’s bankruptcy is the biggest municipal bankruptcy ever filed in United States history, owing the US more than $70 billion, thereby complicating officials ability to borrow money for public use. Post natural disaster recovery is reliant on money and resources, and without adequate funding and focused government management, rebuilding the island’s power system will be strained at best. The Puerto Rican economy and infrastructure was already struggling, and the impact of Hurricane Maria will exacerbate the issue further.

Even though Puerto Rico is not an American state or located on the mainland, PR is an American territory. Legally, a US territory has “the status of commonwealth, a legal and political status that is above a territory but still below a state.” In 1917, President Woodrow Wilson signed the Jones-Shafroth Act, which granted U.S. Citizenship to Puerto Ricans born in Puerto Rico on or after April 25, 1898. Puerto Rican US citizens are entitled to the same inalienable rights as mainland US citizens. Puerto Rican US citizens are also entitled to equal FEMA federal government response to natural disasters. Puerto Rico is home to 3.4 million US citizens and, without power, millions of Americans will not have access to clean water, medical supplies, food, and basic public health services.

Food and Water

Currently, food and water supplies are at emergency levels throughout Puerto Rico. According to FEMA, 42% of the people on the island do not have access to potable water. Potable water is safe to drink and use for food preparation, without risk of health problems. The loss of power resulted in a lack of access to clean water to bathe, cook, or flush toilets since water cannot be pumped into resident’s homes. Limited clean water sources result in a substantial public health crisis. Without clean water, individuals are prone to malnutrition, and poor hygiene and sanitation; this amplifies the spread of communicable diseases across the entire island. Specifically, the CDC highlights proper water, hygiene and sanitation has the “potential to prevent at least 9.1% of the global disease burden and 6.3% of all deaths globally.”

As for food, 85% of the island’s food is imported from neighboring countries, like the Dominican Republic. Extreme infrastructural damage by Hurricane Maria massively disrupted the territory’s typical food imports. Maria additionally decimated Puerto Rico’s agriculture sectorresulting in a depletion of 80% of the crop value and local food production in Puerto Rico. The destruction of food imports and local food production is predicted to dramatically increase the cost of food itself and dramatically increase food shortages. These consequences will likely result in increased malnutrition of PR citizens, thereby increasing related illnesses and their effects, such as stunting and wasting throughout the island. Recently, President Trump temporarily waive the Jones Act which “requires goods shipped between American ports to be carried out exclusively by ships built primarily in the United States, and to have U.S. citizens as its owners and crews.” Governer Richardo Rosello of Puerto Rico requested the act be waived, as the Act hinder disaster relief efforts post Hurricane Maria. Lack of power and crumbled infrastructure continue to make the distribution of food and humanitarian aid a challenge and pressing human rights issue.

a picture of water bottles — III MEF Marines prepare to provide assistance following tsunami in Japan. Source: DVIDSHUB, creative commons.

Health Care

“Just about every interaction with the health system now involves electricity, from calling a hospital for help to accessing electronic medical records and powering lifesaving equipment like hemodialysis machines or ventilators”

– Jullia Belluz, Vox

Puerto Rico’s health care infrastructure is devastated. Without an operational electrical grid, hospitals utilize gas-powered electric generators for energy. However, continuous diesel fuel shortages and lack water have ruthlessly weakened the capacity to treat patients throughout dozens of hospitals on the island. Likewise, numerus citizens injured during the hurricane have yet to be treated by health care professionals. Vulnerable populations, including: 1) children, 2) the elderly, and 3) persons with disabilities 4) life threatening health conditions, are at more severe risk for injury and death. Vulnerable populations such as the elderly and newborns require greater medical attention than the general population. Lack of power and hospital infrastructure becomes life threatening to patients needing live saving medical treatment.

Right to Adequate Health

The entire loss of power throughout the island exacerbates the intensity of Puerto Rico’s state of emergency. In our technologically advanced society, power is used in almost every aspect of our lives, especially in the US bureaucracy. Power helps us achieve our right to adequate health, explicitly defined in the Universal Declaration of Human Rights (UDHR). It is necessary Puerto Rico finds a timely solution to the territory’s failed power grid. The longer the communities live without power, the prospect of healthy and safe living environments remains grim. A complication furthering the aforementioned crises is the US’s congressional response to Hurricane Maria, which has been exceedingly disproportionate as compared to FEMA’s response to Hurricanes Harvey and Irma. Two weeks after Hurricane Harvey hit Texas, the president signed a $15 billion Harvey relief fund to help victims. However, for victims of Hurricane Irma, more than 20 days have passed since the initial hit on Puerto Rico. Two weeks later Hurricane Maria hit the island, and still Congress has failed to propose a spending budget for post-disaster relief. US officials claim they are waiting for greater insight into the full assessment of damage on Puerto Rico.

Hurricane Maria completely infringed on the rights of US citizens. The effects of Maria are going to negatively interfere with a population’s economic, social, and cultural rights explained in the UDHR. Food, water, and health care are all required to maintain adequate health. Delayed financial response by congress to Hurricane Maria will continue to perpetuate poverty throughout the region. Future PR recovery initiatives need to focus on rebuilding the island’s economy, and power grid infrastructure. Puerto Ricans are American citizens and are entitled to the same protection as all citizens; however, all people’s human rights should be protected regardless of citizenship.

Silence = Death: ACT UP

The basis of this blog is How to Survive a Plague. The story and all direct quotes are from this documentary.

a sign from the 30th anniversary of ACT UP rally — 01a.Start.March.ActUp.NYC.30March2017. Source: Elvert Barnes, Creative Commons.

“We’re in a PLAGUE”, shouts Larry Kramer.

A plague to an outsider looks differently to an insider, particularly one who battles symptoms every day. The plague Kramer shouts of is HIV/AIDS and its decimation of the homosexual community. Until I watched this documentary, I had not considered AIDS a plague because its label was an epidemic or pandemic. My perspective on the topic was limited by my understanding of another’s plight. My first recollection of learning about HIV/AIDS happened in the early 1990s when Ryan White, a hemophiliac, died and Magic Johnson, a heterosexual basketball player, made his announcement. I still remember how as a middle-schooler, I rationalized the knowledge someone a few years older than myself died while also anticipating the death of one of my favorite basketball players. At the time, I had no idea the millions who succumbed to AIDS would die after a lack of treatment for the disease; nor did I know of the group of radical activists shaking up the government and scientific community with demands for intervention. The individuals of ACT UP, through the coalescence of anger and non-violent direct action, took the on the burden of the dying community. How to Survive a Plague chronicles the 10-year fight for antiretrovirual medications (ARV) needed to both save the lives of those living with the disease and help end the AIDS crisis in the US.

Greenwich Village in New York City was the epicenter of HIV/AIDS in the early 1980s. During its initial outbreak, the virus was widely considered a ‘homosexual’ disease. Hospitals offered no treatments and turned the dying away, placing blame and responsibility for the epidemic squarely on the victims’ shoulders. AIDS Coalition To Unleash Power (ACT UP) began “fighting for their lives, patients and their advocates took matters into their own hands.” The activists, labelled fascists rather than concerned citizens, began locally – at NY City Hall in 1987, six years into the pandemic.

Peter Staley, a bond trader on Wall Street at the time, insisted, “I’m going to die from this. This isn’t going to be cured” because without government trials or treatments at that point in time, all hope seemed lost. Hope arrived in a scientist named Iris Long, who offered her time to explain and teach members of ACT UP the ins and outs of the scientific community, arming them with medication and funding information. Survival became dependent upon knowledge of what needed to go into the body; therefore, forming the Treatment and Data Committee (T&D). The goal of T&D remained reading medical journal articles as a means of raising awareness while arming the members with terms and ideas for advocacy. The first medical treatment offered was AZT.

AZT, for many infected including Staley, proved more harmful than helpful. First, it cost $1000 per year. Second, it was not widely available. Third, side effects were unbearable in some cases. Lastly, it did not prevent any opportunistic infections from attacking an already weakened immune system. Robert Rafsky questioned, “What does a decent society do with people who hurt themselves because they are human? A decent society does not put people out to let them die because they have done a human thing.” By 1988, over 800,000 people worldwide died of AIDS-related complications. For members of ACT UP, there was a direct correlation between the loss of American lives to AIDS and the government’s failure to make medications accessibly affordable and safe. Overseas markets had accessible medications, but Americans bought medication on the black market—the “buyers’ club”, a desperate means of saving their lives while protesting government agencies. The buyers’ club stored and sold medications not approved by the US FDA, and provided information about HIV/AIDS related infections, including opportunistic infections.

The US FDA tested and marketed ARVs at a significantly slower rate than Europe—7 to 10 years versus 9 months respectively. While the FDA sat on their power to make, test, and market medications, deceased patients gathered into garbage bags and refused by funeral parlors; disregarded and denied dignity, even in death. In 1989, hope arrived again through a partnership with Bristol Myers and NIH as activists used platforms to bridge the gap between science and themselves by reaffirming the same goal: saving lives. NIH increased research priorities and allowed activists to participate in panels regarding trials and treatments. By 1992, the death toll worldwide was more 3,300,000 and a small sample of ARVs was ready to trial in the US.

The goal of ARVs is to suppress and halt the progression of the virus. In the 1992 trial, researchers found that over the course of a week, suppression of the virus occurred but did not remain in most patients. Fortunately, in one participant dubbed “Patient 143”, viral load suppression stabilized over time. Despite this small victory, 1993-95 became the most difficult for the activists. Internal splintering of ACT UP created a division of priorities which resulted in the founding of the Treatment Action Group (TAG). George H.W. Bush argued a change in lifestyle and behavior could stop the threat/spread of AIDS, yet he failed to conclude that it is irrational to believe that others should change their behavior, specifically LGBTQ community, without him changing his response to their requests, demands, and deaths. Additionally, Europe confirmed the ineffectiveness of the ARVs that were accessible at the time. This setback meant a reframing, restructuring, and reanalysis of the AIDS research scientific process.

TAG activists, together with the scientific community, focused on the possibility of a triple drug combination rather than a single drug solution. In 1995-96, the Lazarus effect began to take place in patients after 30 days on the medications. The antiretroviral therapy (ART) combinations arrived too late for millions including Ryan White; however, they sustain and give life to millions of others including Magic Johnson. The decision of ACT UP activists spawned justice for humanity, not just the LGBTQ community. Staley summarizes, “…just so many good people [died]… like any war, you wonder why you came home.”

This Wednesday, October 4 at Birmingham Museum of Art, 6pm, ACT UP activist Peter Staley will participate in panel discussion “30 Years of Acting Up”. The panel is a part of the One in Our Blood exhibition taking place around the city, including AEIVA and Birmingham Civil Rights Institute.

It’s Not Just Irma and Harvey: Deadly Floods Affect Millions Around the World

map_of_southeast_asia. Source: ANHCANEM88, creative commons.

These past few weeks have been a very vulnerable time for our global community. Media has been predominately focusing on the countries and victims affected by Hurricane Harvey, Irma, and Jose, however nature’s violent outcry stormed communities all over the world- not just the hurricanes in the West. Powerful monsoons struck South Asia, affecting more than 41 million people throughout Bangladesh, Nepal, and India. In Karachi, Pakistan, devastating monsoon floods abruptly invaded communities preparing to celebrate an Islamic holiday, Eid al-Adha. Lastly, Typhoon Hato swept into the cities of Macau and Hong Kong, causing thousands of people to flee their homes.

After all of these natural disasters transpired, one concept became very clear: Mother Nature does not discriminate. Natural disasters affect the rich and poor, high income countries and low income countries, and people of all nationalities and ethnicities. Regions struck by these disasters are left with substantial amounts of infrastructural, property, and environmental damage. As a result, victims of these disaster experience traumatic consequences, such as internal displacement and food insecurity. Growing up, I believe I was too young and just overall uninformed to really comprehend what natural disasters entail, and why they are so devastating. However, now being an adult, it’s obvious to me that the reason why natural disasters are so devastating is because post-disaster damage completely compromise the dignity of human rights detailed in the Universal Declaration of Human Rights (UDHR).

Disasters interfere with a population’s economic, social, and cultural rights emphasized through 17, Article 22-27 of the UDHR. Articles 22-27 of the UDHR focus on establishing social security through people’s right to education, employment, adequate living conditions, cultural life, and leisure. Likewise, Article 17 of the UDHR establishes that “no one shall be arbitrarily deprived of his property.” Unfortunately, after a natural disaster, these rights are undeniably negatively affected.

Hurricane Katrina LA7. Source: News Muse, Creative Commons.

Right to Work

The right to work and employment is severely hindered after natural disasters due unimaginable infrastructural damage. In 2005, the US experienced public health tragedy when Hurricane Katrina devastated millions along the Gulf Coast of Mississippi and Louisiana. Two years after Hurricane Katrina, the Bureau of Labor Statistics released numerous reports on the effects of Hurricane Katrina on employment and unemployment. These statistics state: “approximately 38 percent of business establishments in Louisiana and Mississippi were within a 100-mile corridor of the path of Hurricane Katrina’s center.” From August 2005 until June 2006, Louisiana unemployment rates soared from 5.8% pre-hurricane to 12.1% post-Hurricane Katrina. In Mississippi, unemployment rates climbed from 6.8% in 2004 before the hurricane to 10.4% after Hurricane Katrina. Everyone has the right to work to “ensur[e] for himself and his family an existence worthy of human dignity”; this is ultimately difficult to achieve when opportunities for employment have literally been washed away. In the Caribbean regions, hit hardest by hurricane Irma, tourism one of the largest revenue-builders and an important source of income for many families. Specifically in Anguilla, a territory hit by Hurricane Irma, tourism contributed to 57% of the island’s GDP in 2016. Generally, travel and tourism alone contributed to about 15% of the Caribbean region’s total GDP. For the Caribbean victims of Irma, the disruption of the tourism industry is a disruption to a family’s livelihood. Natural disaster victims living in rural regions such as India, Nepal, and Bangladesh face continuous threat to work when their agriculture and crop land get destroyed and the becomes unprofitable.

Right to Adequate Living

The most noticeable human right that natural disasters discernibly jeopardize is 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…” For many survivors after natural disasters, ‘adequate living’ is no longer a reality. What happens when a family’s home is demolished in the wake of disasters such as these? Tragically, millions of people become internally displaced within their countries. The United Nations reports that about 851,000 people are displaced in India, 352,738 Nepalese are displaced from their homes, and lastly 696,169 people have been displaced in Bangladesh since the monsoons. Food insecurity also becomes an urgent need to address throughout regions affected by these disasters. Within two days after the floods, Nepal Food Security Monitoring System (NEKSAP), issued a first assessment of the damage. Results exposed that 70% of flood-affected areas are moderately food insecure or worse. Of that 70%, 42% of those regions are highly and severely food insecure.

Right to Education

Natural disasters also impede on one’s right to an education due to the damage sustained by schools and educational infrastructure. Human loss to education systems, comprising the loss of school administration personal, teachers, and education policy makers, affects the institution’s ability to deliver a quality education. UN reports affirm that in Bangladesh, 2,292 primary and community schools suffered substantial water damage. In Nepal, 1,958 schools have been ruined, thereby impacting the education of 253,605 children. In India, nearly one million students’ education have been disrupted when floods damaged 15,455 schools. Damage to schools not only undercut education in the short term, but threaten long-term educational goals as well. USAID explains “the normal processes of educational planning break down during an emergency, weakening the overall system and creating future problems in the development of an inclusive educational system.”

“Famine”. Source: Jennifer Boyer, Creative Commons

What’s next?

These events have got a lot of people asking why these disasters even occurred in the first place. Well, science indicates that climate change has become a major catalyst to such drastic weather related disasters witnessed throughout the past couple of weeks. As NASA explains “changes in climate not only affect average temperatures, but also extreme temperatures, increasing the likelihood of weather-related natural disasters.” With rising temperatures and a predicted increase in weather-related disasters, maybe the United Nations and our government should start to consider changing the definition of an internally displaced person (IDP) or a refugee to include people fleeing from natural disasters. The UN definition of a refugee is a person who , “owing to well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable, or owing to such fear, is unwilling to avail himself of the protection of that country…” Just like people running away from armed conflict, victims of weather-related disasters are also trying to escape harsh realities, including inadequate living conditions, food insecurity, no economic opportunities, and violence. A modern day example of weather-related disasters is the famine spreading across Ethiopia, Somalia, and Kenya caused by intensified droughts.

“We have moved four times in the last four months. We were trying to follow the rain – moving according to where the rains were supposed to come. But they haven’t. If the rains don’t come, none of us will survive”

– Farhia Mohamad Geedi, Oxfam

Just like Farhia and her family, 10.7 million people across Somalia, Ethiopia and are facing sever hunger. If their governments are not able to provide them with a feasible and effective solution, they have no other choice but to leave, or die. With a predicted increase in weather-related disasters such as drought and floods, more people will be living in extremely life-threatening environments that will force them to leave their home. The destruction of the consecutive water disaster have been very tragic, but there is hope for the future. Countries have begun to recognize that “their shared burden of climate-related disasters can only be lifted by universal action to address the causes of climate change.” 175 countries from all over the world have signed onto the Paris Agreement, which will focus on keeping a global temperature rise this century below 2 degrees Celsius. We as a global community have already made such positive impact by acknowledging we have a problem, now it’s time to hold ourselves accountable for progress.

Additional resource: This Changes Everything by Naomi Klein.

Moving Towards Environmental Justice: The Flint Water Crisis & Structural Racialization

the Flint Michigan Water Plant — Flint Water Crisis is ongoing. Source: George Thomas, Creative Commons

“Nothing that has been uncovered to date suggests that anyone intended to poison the people of Flint” (Michigan Civil Rights Commission, 2017). The Flint Water Crisis: Systemic Racism Through the Lens of Flint report was authored in response to the growing cries from community members, government officials, victims, and bystanders concerned with the abject lack of proper response to Flint water crisis which began roughly at the middle of 2014. The Flint Water Crisis, nationally and internationally infamous for the beleaguered and dangerous handling by all levels of government, has been documented, historicized, lectured upon, and dissected from news publishers, academics institutions, watchdog groups, government organizations, and everyone in between. The bottom line is government officials cut costs in water sanitation and pipe replacements, the consequences of which sparked a full-blown state of emergency, and finally culminated in the deaths of Flint citizens from Legionnaire’s disease and other complications from the consumption of unclean water; those implicated range from District Water Supervisor Busch to Michigan Governor Rick Snyder. The failings in Flint, as argued by the Michigan Civil Rights Commission, extend far beyond the ineptitude of handfuls of government officials and their lack of planning or preparedness. The requisite conditions necessary for a crisis of this magnitude festered many years ago, perhaps as far back as the US Supreme Court’s ruling in Plessy v. Ferguson. Flint’s problems are institutional and systemic, and unfortunately, it took a catastrophe to bring these issues to the surface.

Structural racialization is understood as the tendency for social groups to “organize around structures that produce discriminatory results… without themselves possessing any personal animus” (Michigan Civil Rights Commission, 2017). In other words, an individual can actively contribute to community systems that result in suppression without actually harboring ill will to the victims of suppression themselves. Ignorance/implicit bias, according to john a. powell (2010), is the primary driver behind structural racialization and its horrifying consequences. Implicit bias–directly linked to structural racialization–sustains the longevity of the structures which cause discrimination, and these structures are kept alive only if the contributors to the structures are unaware of the malevolent consequences of the structures themselves (powell, 2010). In the case of Flint, structural racialization began many years before the water crisis, and these implicit, racial structures ensured destruction from the crisis unfairly affected largely black, poor, politically unconnected individuals in the Flint area (Michigan Civil Rights Commission, 2017). Using the term ‘structural racialization’ to describe a public health catastrophe, such as the Flint Water Crisis, offers no binding legal or moral prescription. There is no way to sue a ‘structure’ for unfair or discriminatory harm. The structure, in these cases, is reciprocally determined by every individual who unknowingly benefits from the structure and does not actively fight against the structure’s survival (powell, 2010). The case of Flint is rife with example. Contribution to underlying power structures such as these begins with implicit bias- it is the first stronghold keeping the structure in place. Implicit bias, by definition, is unseen and unfelt. In this case, the denizens of Flint and the surrounding areas had no awareness of their complicity in structural racialization. Without this awareness, there can be no hope to fight it.

Beyond the psychology of the issue is the legalistic support of structural racialization. In Flint, this involves segregated housing. The 1900-1930s saw a time of deeply-seated racist and discriminatory housing market practices that forcibly shepherded blacks and poorer whites into select neighborhoods in Flint. These were effectively ‘ghettos’ and ensured black renters and homeowners were segregated from whites (Michigan Civil Rights Commission, 2017). Fast forward to present day: the neighborhoods hit hardest by the Water Crisis are neighborhoods that historically have belonged to poor and black renters and homeowners. Racist business practices in the Jim Crow era exacerbated the loss and destruction felt by black and poor Flint citizens in the present day.

A woman holds water bottles filled with contaminated water in Flint — Flint Water Crisis. Source: Renee B, Creative Commons.

This is not to say the black community in Flint is the only one to feel the deleterious effects of the water crisis. This public health emergency does not discriminate along ethnic lines. The discriminatory practices that trapped black Flint citizens holds that honor alone. In 2017, a full three years after the crisis began, clean water is still an issue in Flint. What do we tell the citizens of Flint? How can they take civic action to expedite the process of returning to ‘normal’ life post-crisis? Diana Francis, noted peacemaker and democracy advocate, espouses the concept of ‘speaking truth to power’. This notion contends people–everyday concerned citizens–are the impetus of action in situational injustice. Indeed, the recent criminal charges brought against Flint city administrators and politicians show a ‘top-down’ approach to this crisis is both unrealistic and ineffective. For Francis, the true heroes in this story are citizens affected by and emphatic to the crisis. Examining the normative response to Flint reveals a public willing to undertake protest and direct action, and a public expecting a direct confrontation with the individuals and systemic structures responsible for this crisis. Here are some examples: a music festival raising awareness and money for the victims of Flint, national groups donating time and energy to provide resources to disenfranchised Fint citizens, whistleblowers risking their livlihoods to make the crisis public, and academics donating their skills to investigating the crisis itself. These civil society actors may hold the key to eliminating the effects of the Flint water crisis and eradicating the conditions that precipitated the crisis in the first place. Of course, this empowered response is not an assumed reaction.

In the face of a fully-fledged public health emergency, many citizens in Flint did not feel any semblance of trust in their elected officials to mitigate the crisis without state- or national-level intervention. Without this trust, the citizens may have felt unable or ineffective to act against the discriminatory power structures in Flint. This problem, unlike replacing pipes, cannot be ameliorated by federal funding or outside medical intervention. Addressing this collective distrust will involve some form of cultural transformation. These deeper fixes must involve the access to elected officials the general public has and the public’s ability to provide continuous feedback to these officials. At several times in the Michigan Civil Rights Commission (2017), citizens of Flint (of all ethnicities) went on the record saying their concerns regarding water safety went unaddressed due to many factors, such as:

1) no knowledge of how to reach elected officials,

2) feeling their complaints were ‘unheard’ or ‘unseen’ to those who could help the situation,

3) fear of retaliation if undocumented immigrants or individuals with criminal records came forward with concerns, and

4) willful neglect on the part of government officials who simply did not feel accountable for the plights of minorities (involving both ethnicity and socioeconomic status) in the Flint area.

Two protesters hold signs decrying the lack of clean water in Flint — January 19, 2016 Lansing Protest against Gov Snyder regarding Flint Water Crisis. Source: nic antaya, Creative Commons

Moving forward, how can both human rights advocates and ordinary citizens protect rights equally in all corners of the globe and also address the grievances of individuals in Flint? A shift towards environmental justice may be the answer. This term means two things. First, all persons, regardless of identifying characteristics (ethnicity, gender identity, sexual orientation, income level, etc.) have the right to enjoy the environment equally. Second, the responsibility of civic participation in the protection and maintenance of the environment belongs to all persons (Michigan Civil Rights Commission, 2017). Environmental justice takes its cue from Third Generation Human Rights (aka right to the environment) and adds the necessary ingredient of civic participation. As I have stated previously on this blog, human rights are protected by “people, not documents”. Given the second caveat of environmental justice, what happens if ordinary people have no avenue to address a public health hazard? A crisis like Flint erupts. What conditions predicate an inability to make these addresses? This post contends a key condition is structural racialization. Addressing the massive failures apparent in the Flint Water Crisis moves far beyond faulty equipment and the Flint city administration’s glacial response time. Addressing this egregious human rights violation requires analysis going back at least a century in order to fully understand the complex interaction between history and the present. Furthermore, the only long-term, stable solution to this issue is to equip the citizens of Flint with inexperienced political power and know-how. This may include any of the following: a free, fair, and frequent election process; a truly representative (i.e. ethnicity, socio-economic status) local administration; a political mechanism by which citizens can openly voice public health concerns; and funding available in case large-scale crises such as these emerge. Environmental justice in Flint, Michigan will only be achieved when the insidious structures barring unfettered access to a clean environment and free critique of those hindering this access are dismantled in their entirety.

Sources:

Powell, j. a. (2010). Structural racialization and the geography of opportunity. Online lecture. http://kirwaninstitute.osu.edu/wp-content/uploads/2011/02/2010_0611_tfn_sm_growth_training.pdf

Michigan Civil Rights Commission (2017). The Flint Water Crisis: Systemic Racism Through the Lens of Flint. https://www.michigan.gov/documents/mdcr/VFlintCrisisRep-F-Edited3-13-17_554317_7.pdf

HIV and Human Rights

People and Places. Source: Ted Eytan, Creative Commons

The history of the HIV and AIDS epidemic started in illness, anxiety and mortality as the world encountered and handled a new and unidentified virus. It is commonly believed that HIV begun in Kinshasa, in the Democratic Republic of Congo around 1920 transmitted from chimpanzees to humans. The original earliest case where a blood sample could confirm the infection of HIV was from a blood sample taken in 1959 from a man living in the Kinshasa region. Available records suggests that the rampant spread of HIV and contemporary epidemic started in the mid- to late 1970s. During the 1980s, the HIV pandemic spread across South America, North America, Australia, Africa and Europe. The progress and efforts made in the last 30 years to prevent the disability and mortality due to HIV have been enormous. Despite the tremendous improvements regarding HIV research and support, progress remains hindered by numerous challenges. Originally, HIV was identified and diagnosed in men who have sex with men, people who inject drugs, and sexually active people such as sex workers. HIV was perceived and declared a disease only deviant people get because they engage in inappropriate behavior; therefore, HIV and people infected with HIV have been subjected to a corresponding negative social image. Research and education has aided in countering the negative association of HIV transmittance. The CDC explains HIV transmittance takes place via “only certain body fluids—blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk—from a person who has HIV can transmit HIV.” People impacted by HIV, regardless of how it was transmitted, withstand constant stigmatization, discrimination and violations of their basic human rights. There is an inseparable link between human rights and HIV is now extensively acknowledged and accepted.

“Protecting, promoting, respecting and fulfilling people’s human rights is essential to ensure that they are able to access these services and enable an effective response to HIV and AIDS.”

-Avert Society

Human rights treaties and laws play an essential role in protecting the rights of HIV positive populations. The Universal Declaration of Human Rights (UDHR), Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), and the International Covenant on Economic, Social and Cultural Rights (ICESCR) are all important documents that thoroughly elaborate the rights of all people, which include HIV positive individuals. Article 25 of the UDHR, Articles 10 – 12, and 14 of the CEDAW, and lastly Article 12 of the ICESCR all secure the human right of healthcare and the prevention, treatment and control of diseases. Finally, the ICESCR and the UDHR secures employment, cultural and community participation rights for individuals regardless of age, disabilities, illness, or any form of discrimination.

Human rights violations in the context of HIV

Access to health care services

In 2015, 36.7 million people are currently living with HIV/AIDS, with the majority of HIV/AIDS positive individuals– 25.5 million – living in sub-Saharan Africa. Today, in 2017, only 46% of HIV positive adults and 49% of HIV positive children worldwide are receiving treatment, with large gaps in access to HIV testing and treatment in Africa and the Middle East. Individuals living in low-middle income locations face constant financial, social and logistical barriers to accessing diagnostic services and treatment. Some of the main obstacles individuals of lower income families’ face include the high costs of medical services, the lack of local and nearby health care facilities, and the inability to leave work to visit the doctor. vert Society asserts that stigma and discrimination from community and family influences the utilization of HIV healthcare services by HIV positive individuals. Additionally, the criminalization of HIV is also significantly affecting the access to HIV health care services. In 2014, 72 countries have implemented laws that allow HIV criminalization. Criminalization laws are usually either HIV specific, or either HIV is just one of the diseases covered by the law. HIV criminalization laws normalize, instigate and allow discrimination and stigma towards HIV positive individuals. HIV criminalization laws and socio-ecological barriers undermine HIV prevention efforts and do not decrease the rates of HIV.

Our Lives Matter !! Anti-LGBTI Laws Stall HIV Prevention. Source: Alsidare Hickson, Creative Commons

Criminalization of men who have sex with men (MSM)

Currently, 76 countries around the world continue to criminalize same-sex conduct. Having these laws set up really discourages MSM and the public to get tested for HIV, transition into treatment, and disclose their information due to possible discrimination and arrest. A comparison between nations with anti-homosexuality laws and nations without such law shows considerably higher HIV prevalence rates among MSM in countries with anti-homosexuality laws compared to nations without such legislation. For example, Jamaica has strict anti-buggery laws but has a prevalence of HIV in over 30% of MSM, compared to Cuba that lacks anti-buggery and has a prevalence of HIV in less than 5% of MSM. These laws also make it particularly problematic for organizations providing sexual health and HIV services to reach men who have sex with men. Further research is needed to clarify the correlation between the criminalization of same-sex conduct and rates of HIV. The criminalization of MSM ultimately ignores the fact that HIV can be transmitted through various ways such as unintentional exposure, mother-to-child, and non-disclosure of HIV status which results in individuals not seeking health care services due to the fear of people assuming HIV was transmitted through a different route than how it was actually transmitted.

Gender Inequality

HIV disproportionately affects women and young girls because of unequal cultural, social, and economic standing in society. Gender based violence (GBV) is normalized in many societies. GBV such as rape, trafficking and early marriage makes it more difficult for women and adolescent girls to protect themselves against HIV. Women do not have power over sexual intercourse encounters. Women, in many cultures, are economically dependent on their male counterparts, making it increasingly difficult to choose their lifestyle choices. Additionally, due to the imbalanced gender power dynamic, women do not have control over family planning services, sex-based community rituals, or the choice to participate in safe sex. Studies reveal the impact of gender-based discrimination and HIV. According to one study, women living in Sub-Saharan Africa, on average have a 60% higher risk of HIV infection than their male counterparts. Another study analyzed the role of gender power imbalance on women’s ability to discuss self-protection against HIV/AIDS in Botswana and South Africa. Results concluded that “women with partners 10 or more years older than them, abused women, and those economically dependent on their partners who are less likely to suggest condom use to their partners. Gender power imbalance also influences men’s inclination towards refusing to use the suggested condom.” There is a great need to focus on women education, empowerment and self-confidence to suggest condoms, and lastly to educate and encourage men about safe sex. Gender inequalities towards women are addressed in the CEDAW; therefore, publicly and legislatively addressing the issues could significantly reduce HIV.

Millions of people have lost their lives fighting to make sure HIV positive people are able to live a long, healthy and quality filled lives. Even though we live in a country that does provide HIV healthcare services, the prevalence of HIV in the USA is still relatively high. The Human Rights Campaign reported in 2014 that Birmingham, Alabama had one of the highest rate of infection in the nation; however, the latest CDC report Birmingham is presently 12th, citing a myriad of reasons including a lack of sex education. We have and opportunity and need to stand up for each other, advocating for education and equality. There are various ways to get involved in advocating for human rights and HIV in our Birmingham community, including volunteering at local clinics: 1917 Clinic or Birmingham Aids Outreach. If you’re sexually active, you can help prevent the spread of HIV by knowing your status, getting tested, and talking openly about HIV. Constructive conversations aid in removing the stigma and fear attached to HIV because it becomes a part of the social discourse. An HIV/AIDS prognosis is a life changing event, not a life ending moment.