Russia-Ukraine War Update and Interview with Ukrainian UAB Student

Two women holding the Ukrainian flag and shouting.
Image 1: Two women holding the Ukrainian flag and shouting. Source: Yahoo Images.

Recently, North Korea has promised closer ties with Russia and to further its aid in the Russia-Ukraine war. Throughout the war, many civilian structures have been destroyed, as Russia has continued to target educational facilities, homes, and hospitals. For many Ukrainians, their country has been something they’ve constantly had to fight for. 

UAB (The University of Alabama at Birmingham) student, Kate Tkach, was nine years old when she left Ukraine to move to the U.S. For her privacy, I will use an alias to protect her identity. Tkach’s father and his family were in Kyiv when Russia invaded Ukraine in February of 2022. Since then, her grandparents have visited Ukraine during the summer of 2024. Their experiences give an idea of what life was like when the invasion occurred and what nights in Kyiv were like over the summer. 

Brief History of Ukraine-Russia Conflicts and the Start of the War

Destroyed civilian building in Ukraine.
Image 2: Destroyed civilian buildings in Ukraine. Source: Yahoo Images.

Ukraine was previously an area of conflict in 2014 when Russia annexed Crimea. This was one of the first times since WWII that a state in Europe was annexed by another territory. In the fighting between 2014-2021, at least 14,000 civilian people died. Russia and Ukraine have been strongly connected economically, politically, and culturally. However, after the Soviet Union fell in 1991, Ukraine and Russia parted ways. This was considered a substantial loss for Russia’s international standing. 

Putin began the invasion of Ukraine to combat Western powers that he claimed had the intention to destroy Russia. Ukraine had begun trading with other countries, much to the displeasure of Russia, who only wanted Ukraine to trade with them. Sources of energy have been a connecting factor between Russia and Ukraine. 

President Putin has said that NATO (North Atlantic Treaty Organization) and the U.S. have violated promises they made not to grow alliances in the former Soviet States. A relationship between Ukraine and the U.S. would be seen as an act of aggression to Russia. Nonetheless, Ukraine was growing ties with NATO, leading to the invasion in 2022. Kyiv has since then backed the idea of fully joining NATO. For more information about the history of Ukraine and Russia, as well as a report from when the invasion first occurred, visit Dr. Reuter’s IHR Blog.

The cultural ties between Ukraine and Russia have given Putin justification for reunification. Over the years, President Putin has described Russians and Ukrainians as “one people.” Regardless of that statement, Russia has continued to target civilian infrastructure in cities like Kyiv. Over 100,000 Ukrainian civilians have been wounded or killed since 2022. Around 8 million refugees have been forced to flee to surrounding countries. One of those refugees was Kate Tkach’s father, who fled to a surrounding country. The roads had been so crowded that it took her father 24 hours to escape to Moldova.  

Tkach’s hope for the future is that more awareness will be spread about Ukraine and Russia. While in the U.S., she’s experienced people expressing their confusion over what would be so bad about Russia taking over Ukraine.

“Ukrainian people have died for the independence of our country. Likening Russians to Ukrainians would be like saying, You’re from America? That must mean you’re Canadian. Our languages and cultures are different. We are not Russian; we are Ukrainian” — Kate Tkach.

While President Putin has pushed the agenda that Ukrainians are Russian, that is undoubtedly not the way Ukrainians feel.  

North Korea’s Support and Aid to Russia

Regional map of Ukraine.
Image 3: Regional map of Ukraine. Source: Yahoo Images.

In June of 2024, President Putin and North Korean leader Kim Jong Un signed the Russia-North Korea joint comprehensive partnership agreement. The partnership highlights a mutual agreement to help each other in times of aggression. On October 23, 2024, North Korean troops were deployed to Kurkoblast, Russia which borders Ukraine. Reports say that North Korean personnel have been gathering in Russia throughout all of October. Simultaneously, over the past two years, North Korea has sent military equipment and ammunition to Russia as a means to strengthen ties. 

Ukrainian intelligence sources stated that six North Korean officers were killed in a strike near Donetsk City. Donetsk City is located near the east side of Ukraine and is around 140 miles away from Russia’s border. President Zelenskyy said that reports suggest Russia is training two brigades that each contain 6,000 North Korean personnel. Recently, King Jong Un met with Russian Defense Minister Andrei Belousov in November of 2024 to discuss North Korea’s support of Russia. During the meeting, Kim criticized the U.S. for supplying Ukraine with weapons. 

When asked about her thoughts on North Korea’s increased support of Russia’s war against Ukraine, Tkach said, “I wasn’t surprised. Atrocity after atrocity keeps happening in Ukraine. At a certain point, all of the bad things have plateaued in my mind. My first thought was, ‘Oh, what’s one more bad thing?’ It hasn’t affected my viewpoint so much.” 

Russia’s War Crimes in Ukraine 2024

A destroyed maternity ward and children hospital in Mariupol, Ukraine after a Russian attack.
Image 4: A destroyed maternity ward and children’s hospital in Mariupol, Ukraine, after a Russian attack. Source: Yahoo Images.

According to Amnesty International, war crimes include attacks on civilian and/or civilian infrastructure, killings of civilians, torture, crimes of sexual violence, murder or bad treatment of prisoners of war, and the use of illegal weapons. These are all violations of the International Humanitarian Law. This law is meant to limit the effects of armed conflicts on surrounding communities. It protects civilians, which includes medical personnel and humanitarian workers, as well as refugees and the wounded and sick.

On July 8, 2024, Russia attacked civilian infrastructures in Ukraine. Human Rights Watch reports that 42 civilians were killed, 5 of whom were children. Along with that, the largest children’s hospital in Ukraine, Okhamtdyt, was hit by Russian bombs over the summer of 2024. The intensive care unit, oncology, and surgical unit were severely damaged, while other units, such as the toxicology and traumatology, were completely destroyed. 

The first strike had hit the hospital before it could be completely evacuated. The strike occurred when three patients were in heart surgeries. Additionally, one of the children who was evacuated before the strike was in critical condition. After being moved to a different hospital, the child died. Since June 2024, the UN Human Rights Monitoring Mission in Ukraine reported that 9,560 civilians have been killed and 21,450 were injured. At least 594 children have been killed since the summer, and 1,207 have been injured. 

During the interview with Kate Tkach, I asked her what experience her grandparents had during the summer when visiting Ukraine. In the summer of 2024, Tkach’s grandparents visited both Kyiv and Ternopil. Kyiv is the capital of Ukraine and is located near central north Ukraine. Ternopil is located near the far west of Ukraine. 

Tkach said that there is no airfare going across the borders of Ukraine. Because of this, her grandparents had to fly to Moldova and then take a bus all the way to Ukraine. This bus was not allowed to stop the entire way to Ukraine. In addition, every night, the water and electricity would be shut off, so Kyiv looked abandoned. This caused the already hot summer to become even worse. Her grandfather is 86 years old, and her grandmother is 88 years old. 

Tkach stated, “I cannot even imagine what it is like now in the winter. Our winters are harsh and having no heat in the buildings at night is a death sentence.”

 Looking towards Ukraine’s Future

Ripped Ukrainian flag that's still standing amongst a crumbled building.
Image 5: Ripped Ukrainian flag that’s still standing amongst a crumbled building. Source: Yahoo Images.

At the time that Kate Tkach lived in Ukraine, she was a child. She reflects on her time spent there and her fondest memories. One of those was when the first snow would fall. Every year, all the kids would go up to a hill near their apartments and slide down it. No one knew each other, but everyone was together, and at that moment, they could enjoy spending time with one another. Tkach had lived in an apartment near a school in Kyiv. She is unaware whether or not the place she grew up in is still standing or not.

“I grew up in a very beautiful Ukraine, with beautiful Orthodox churches and green fields [that were] not yet touched by civilization. To think of all of that getting destroyed and left in rubble because Ukraine doesn’t want to surrender to a different country is hard to process. My people wanted an independent country and fought to gain their freedom, [which] is something I take pride in.” — Kate Tkach.

To help, one of the best things you can do is to spread verified news. It is imperative that awareness continues to be spread about the war crimes that are committed in Ukraine. For ways to support, donations can be made to humanitarian relief organizations like The UN Refugee Agency, which helps refugees, and the Ukrainian Red Cross Society, which has continuously sent humanitarian aid to places in Ukraine that most need it. 

Human Trafficking: Sugaring and Social Media on College Campuses

Students walking on college campus
Image 1: Students walking on a college campus. Source: Yahoo Image.

For most people, college is the first time they are living away from home. Restless nights and cheap dinners line our schedules like old friends greeting us. Oftentimes, college students struggle financially. College campuses can easily turn into hotspots for people trying to find fast and easy ways to make money. 

People on social media platforms are always advertising for side gigs. Maybe it is a convenient modeling gig that wants new people, or maybe it is a random person in your DMs asking you to be their sugar baby. Suppose you’ve ever received a DM or ad like that, and you might have laughed them off. But have you ever thought about the implications of those messages and ads? What are they actually asking you? And could there be a darker side to their propositions? 

The startling reality of human trafficking is that it can happen in plain sight. Trafficked victims are not always locked away and secretly exploited. Social media, dating apps, and dating websites are used to recruit victims into human trafficking. Traffickers will create deceptive jobs or opportunities that a person more vulnerable may be susceptible to.   

Human trafficking is the use of fraud, coercion, and/or force to acquire labor and/or sexual acts. Blue Campaign is an organization that outlines guides for recognizing human trafficking victims and things to look out for in college students. Persons who may be more susceptible to becoming victims might struggle financially, lack support, be considered people pleasers, and be someone on their own for the first time.

The Process and Sugar Dating Among College Students

Letter cubes that spell online dating
Image 2: Letter cubes that spell online dating. Source: Yahoo Image.

Relationships between sugar babies and sugar daddies are based on the exchange of goods, money, and other incentives for intimate images and/or sexual intercourse. This relationship creates an imbalance of power. Sugar dating websites advertise themselves as your average dating website. The former sugar dating website SeekingArrangement, now known as Seeking, offers mutually beneficial relationships for its members. In the section, How Seeking Works, the first sentence advertises a luxury site for beautiful and rich people to meet. 

These sites are aimed at younger people who struggle with money problems. In the Polaris Project, they examine the process of how human trafficking can begin. In their introduction to the topic, they state: “Sometimes they offer material support – a place to live, clothing, a chance to ‘get rich quick’.” Traffickers offer “support” to their victims either monetary, materialistic, and/or emotional. 

While not everyone on sugar dating websites will be trafficked, the power imbalances of the relationships can create unhealthy environments that can lead to even worse circumstances. Some college campuses, like Georgia State University, have been reported to have decent amounts of  students using sugar dating websites. To combat this, the university has implemented a National Campus Safety Month. College campuses are encouraged to hold information events and send out resources that students can use to be educated on the subject. 

Social Media in Trafficking

Social media collage that says, "The Real Impact of Social Media"
Image 3: Social media collage that says, “The Real Impact of Social Media.” Source: Yahoo Image.

Recruitment can happen in many different ways. Not only can a trafficker manipulate a victim in person or on a website, but also on social media. These are some of the most popular places where recruitment can take place. In a study by the Pew Research Center, the most used social media platforms were YouTube, Facebook, and Instagram. When narrowing the age to under 30, the majority of platforms used are Instagram, Snapchat, and TikTok. 

Another study showed that 84% of adults ages 18-29 use some type of social media. Out of that number, 70% use Facebook, and a large sum use Snapchat, Instagram, and/or TikTok. Traffickers have been found to use social media to groom their victims. By faking relationships, they gain the trust of their victims. The technique that is used is called “boyfriending” where traffickers will portray themselves as loving partners and confidants. Traffickers will look at potential victim’s social media for signs that they might be easy to manipulate. People who overshare online and show active struggles with things such as financial stability, lack of romantic life, and loneliness are at higher risk of becoming targets. 

It has also been reported that traffickers use social media as a means of control. Victims’ social media are heavily regulated and their messages are monitored. In some instances, the trafficker will take complete control of the victims social media, going as far as to impersonate them. From there they are able to post explicit images and videos; some even communicate with friends and family. The purpose is to further alienate the victim from any potential support systems. 

Social media–as is the case with many things–has the potential for good and bad. While it is a tool for recruitment and controlling victims, it has also given escape routes for fortunate survivors. Social media platforms like Snapchat allow for disappearing messages and pictures. In some cases, this has been used to communicate with outside forces that could help them escape their dire situation. 

How to Prevent, Things to Look For, And Sources to Use

Image of face made up of the words, "Don't Close Your Eyes To Human Trafficking" with blindfold covering eyes
Image 4: Artwork of face with a blindfold on for human trafficking awareness. Source: Yahoo Image.

College can be a stressful time for people. For the majority of students, it is their first time away from home. Each year, college gets more expensive, and with these added expenses comes added pressure and stress. It is in times like these that it can be especially tempting to turn to other means of financial and emotional support. 

It is incredibly important to be conscious of the things we post on our social media. It is even more detrimental that we are aware of online “friends” and whether or not they are using manipulation tactics. By being more aware of our and other people’s social media presence, bad situations can be avoided. Taking an active role in our community and spreading awareness are important ways to help in the fight against human trafficking. It can be as easy as sharing an article, donating to organizations that support survivors, keeping a lookout, and reporting strange ads, websites, or social media users. Human trafficking is one of the biggest stains on our society as humans. As advances in technology increase, so too do new methods of recruitment. It is imperative that social media platforms and websites that advertise connection with other people have better preventative systems in place.  

A source to report human trafficking is the Homeland Security Investigations (HSI) Tip Line. If you want more information on safety tips, check out the National Human Trafficking Hotline. There are many organizations that dedicate their resources and time to helping trafficked survivors. The WellHouse is one of those organizations that provides survivors support and a chance to reintegrate into society. At this organization, survivors are given structured support on their healing journey, opportunities to further education, and encouraged to pursue personal interests. The WellHouse has a shop where you can help support survivors by buying handmade jewelry. If you would like to donate, support through purchasing at their shop, or volunteer, check out the WellHouse

United States: The Case for Transitional Justice

“Statue of Lady Justice” Source: Jernej Furman via Flickr

Note from the Author: This blog was written to accompany the Social Justice Café Transitional Justice: Here & Now hosted by the Institute for Human Rights at UAB on Wednesday, November 30th at 4:00pm CST. At this event we will discuss a brief history of Transitional Justice in the United States and hold an open discussion about what it could look like in the home city of the Institute, Birmingham Alabama. You can find out more information and join the virtual event here. In this post, we will explore transitional justice in the United States. We will have another post on the international context of transitional justice. 

Transitional justice is a field of international justice that “aims to provide recognition to victims, enhance the trust of individuals in State institutions, reinforce respect for human rights and promote the rule of law, as a step towards reconciliation and the prevention of new violations” (OHCHR). Often referred to as TJ, transitional justice is a system of multiple mechanisms and processes that attempt to create stability and ensure justice and remedies for victims of oppression and human rights transgressions. Some of the most commonly used mechanisms of TJ are truth commissions (TCs), reparations, and trials of perpetrators.

In practice, transitional justice has often been restricted to nations following active conflict or repressive authoritarian regimes, otherwise known as transitional time periods. This traditional understanding of transitional justice is beginning to evolve as stable, established democracies like Canada and South Korea implement TJ mechanisms such as truth commissions and reparations to address and amend state-sponsored abuses of certain groups. As it evolves the international gaze has once again turned to the United States and the uncomfortable discussion about the historical and ongoing oppressions. This article intends to establish the historical basis of transitional justice in the United States and recent developments to encourage a conversation about acknowledgement, fact-finding, reparations, and justice in the land of the free.

Section 1: Historical Examples of Transitional Justice in the United States

With an international spotlight on the Black Lives Matter movement in the United States in 2020 came an increase in conversations about reparations to African Americans for the abuses of slavery, segregation, police brutality, prison labor, exclusion from housing and education and other forms of state-sponsored oppression that have proliferated for centuries. The discussion about the harms the American government has caused to Indigenous tribes, Alaskan Natives and people of Hawai’i, and other marginalized groups has been a matter of public discourse for decades. While the word reparations saturated international media, little attention was given to what reparations would truly look like, could look like, and examples of when the United States have provided reparations before. 

While the spotlight of this discussion about reparations is often on monetary forms, such as property, cash or pensions, transitional justice recognizes that reparations can and should come in many different guises in order to provide a more holistic and healing process for victims. Reparations are deeply context-specific, and should be tailored to the needs of the victim, nation, and individual circumstance. However, examples of other forms of reparations and TJ include official acknowledgements and apologies, funding of research to uncover facts and educate the public on the truth, providing education and/or healthcare to victims and their families, and preserving historical sights and monuments. Ultimately, they should be determined by and catered to the people involved. 

I have included both a brief infographic timeline and a more detailed look at a few examples of government-led transitional justice mechanisms in the United States below. It is important to note that, as many of these instances occurred prior to our modern definitions of transitional justice and reparations, this timeline encompasses cases of compensation which, under similar circumstances today, would likely be considered reparations, but were not explicitly intended as such at the time. The same goes for fact finding commissions that are analogous modern Truth and Reconciliation Commissions, though they lack that title. I have excluded instances of payments or acknowledgements being issued following a lawsuit through our judicial system, as well as instances of TJ being led by non-governmental entities like community organizations, charities or other non-governmental institutions.

Infographic by Maya Crocker for the Institute of Human Rights. Source: https://guides.library.umass.edu/reparations
  • President Lyndon B. Johnson established the National Advisory Commission on Civil Disorders, otherwise known as the Kerner Commission, in 1967. It was established to serve the purpose of a fact-finding mechanism akin to a Truth Commission today. The goal of the commission was to identify the causes of the violent race riots of 1967. While widely ignored, the Kerner Commission found that the root of the unrest were unequal economic opportunities, racism, and police brutality against minority racial groups in America. 
  • Following concentrated efforts from interest groups and international attention, the United States federal government committed to two massive examples of explicit transitional justice mechanisms in the 1980s for Japanese Americans that were interned by Executive Order 9066 during World War II. In 1980 President Jimmy Carter signed the  Commission on Wartime Relocation and Internment of Civilians (CWRIC) into law, establishing a clear transitional justice mechanism (truth commission) at the national level. The CWRIC published the full report of their findings in February of 1983, and momentum from the commission persisted with the recommendations which were published in June 1983. The recommendations included an official apology, pardons for those convicted of violations of the executive order or during detainment, and the establishment of a federally funded foundation for research and education on the incident. 
  • Shortly after the results of the CWRIC circulated across the nation, the United States Congress passed the Civil Liberties Act of 1988 which provided all eligible interned individuals with a one time payment of $20,000 in reparations as well as official acknowledgement and apology from the United States. In addition, all individuals who were convicted of disobeying the executive order or violating rules while interned were officially pardoned.
  • In response to the massive Black Lives Matter protests in 2020, many subnational level truth commissions and reparations programs were initiated, including those in the State of California, Evanston, Illinois, and Asheville, North Carolina. As the national conversation continues, we may see an increase of examples of transitional justice at work in United States communities.
“Freedom?” Source: Nicu Buculei via Flickr

Section 2: You, us, and the future of transitional justice in the United States

Whether in Europe, Africa, the Asia-Pacific, the Middle East, or the Americas, civil society plays a key role in the transitional justice sphere. Civil society actors are civilian organizations which can be activist groups, media, charities, non-profit organizations, educational groups and schools, or just citizens interacting with policy. Most recent transitional justice measures that have been implemented in the past few years in the United States have been on the subnational level. They are occurring as a result of citizens’ calls for action, constant attention on the need for transitional justice, and the everyday acts of discussing transitional justice. 

Birmingham, Alabama is a historic city for human rights, civil rights and civic action. Civil society here, in this city, has influenced national change through the Civil Rights Movement as well as citywide changes like the removal of confederate statues in public parks and the preservation of historic sites from the Civil Rights Movement like the Greyhound Bus Station and 16th Street Baptist Church. 

The Institute of Human Rights at UAB fosters an educational environment where you can see civil society at work, and hosts Social Justice Cafes on the second Wednesday of every month during the school year at 4:00pm CST. We will be hosting our last Social Justice Café of the semester, Transitional Justice: Here & Now on Wednesday, November 30th to discuss what transitional justice should look like in American cities like Birmingham. You can find out how to join these open discussions, and become a civil society actor yourself, and attend more free educational events from the Institute of Human Rights here

The Implications of an Abusive Command Economy on the Rural People of North Korea

Four young Korean children stare sorrowfully through an open window with blue doors. Their ribs are visible and their arms are skinny.
Malnutrition in childhood leads to long-term physical and cognitive health effects. By limiting resources to impoverished communities, the DPRK holds control over the bodies and minds of these people. Source: Yahoo! Images

Note from the author: This post is the first of my four-part series on the North Korean Regime. To find the other parts, scroll down and click “View all posts by A. Price.” If the other parts are not available yet, check back in during the upcoming weeks when they will be posted.

Content Warnings: mass financial abuse, famine, malnutrition, dehumanization, classism, starvation


Imagine grocery shopping for your family, and instead of finding a variety of food choices, you find a store filled with a surplus of children’s socks, different colored hats, and beach toys even though you live nowhere near the coast. The only food you can find in the store is a few loaves of moldy bread, a small produce section filled with rotting vegetables, and a frozen section with freezer-burned packaged meat. The best you can do is buy a bag full of rotting vegetables and plant them in the ground behind your house, careful not to be caught doing so by the police. The soil you remember being rich with vitamins has turned to gray dust, and everything you plant dies before sprouting. Your family will live off the rotting leftovers from last week’s grocery trip until you can scrounge together enough scraps to make it through. You know that your neighbor has a secret garden that does moderately well, so you sneak over to offer her what’s left of your money in exchange for a few vegetables. If the police catch you exchanging goods, you and your neighbor will be charged for participating in a free market, thrown in a prison camp without a fair trial, and held for an unregulated amount of time. 

The only media you’ve ever seen tells stories of a utopia; the Kim family is sent from heaven to make the Democratic People’s Republic of Korea (DPRK), also known as North Korea, the most wonderful place to live. They tell you that people in other countries, like South Korea and the United States, live under terrible governments who do not care for them the way the Kim family cares for you. In the end, you have no reason not to believe them. You have never seen the conditions of other countries and any criticism of your regime has been consistently disputed throughout your entire life. The stark reality of your consistent mistreatment exists in a dichotomy with the ideals that you have been brainwashed to believe to be true. 

Approximately 20 million rural North Koreans live in this reality…

Songbun

The class system of North Korea is called Songbun. At birth, each North Korean citizen is labeled as core, wavering, or hostile based on their place of birth, status, and the national origin of their ancestors. For example, a person whose ancestors immigrated from South to North Korea will be given a low Songbun and be assumed to have genetically inherited hostility towards the government. One’s Songbun can never be changed, as it determines every aspect of one’s life including how resources will be allocated to your community and how much mobility you will have throughout the state.

A pyramid chart with five horizontal sections. It is a gradient from white at the top to red at the bottom. The top section is labeled, “Supreme Leader: Kim Il-Sung (1949-1994) / Kim Jong-Il (1994-2011) / Kim Jong-Un (2011-present)” The next section is labeled, “Workers Party of Korea (WPK): More commonly known as the North Korean Regime - Consists of relatives of the Kim family and high-up government officials” The third section is labeled, “‘Core’ Songbun: Consists of people with a long family history of loyalty to the regime - most are residents of Pyongyang” The fourth section is labeled, ““Wavering” Songbun: Consists of people who have a family history of immigration and have since assimilated and residents of semi-large suburbs outside of Pyongyang” The bottom section is labeled, ““Hostile” Songbun: Consists of people with a family history of defecting, immigrating, or convicted criminals; people of non-Korean nationalities; people who have an acquired or assumed genetically-inherited hostility towards the regime”
The Hierarchy of the DPRK. Source: Diagram made by author.

The Command Economy

The Workers Party of Korea (WPK), more commonly known as the North Korean Regime, holds tight control over the command economy and uses it to abuse all people of low Songbun, specifically those who live outside the capital, Pyongyang. Instead of ordering the production of valuable goods like food and home maintenance products for their communities, they overproduce menial things, like children’s socks and beach toys. Many do not have the mobility to go to a neighboring town for resources, and as I will expand on later, many believe that they deserve to starve if they are not entirely self-sufficient.

This economic system has the dual effect of limiting opportunities to participate in the job market. People are not allowed to sell products unless they are commanded to do so by the WPK. Because the WPK is not tasked to create job opportunities for rural people, these people have no opportunity to make money, which only exacerbates the problem of reduced resources.

Lots of brightly colored shoes are piled onto shelves and hanging from the walls and ceilings in a Korean store. There are yellow signs with red and black text in Korean
The overproduction of menial things at the expense of food and necessities. Source: Yahoo! Images

The March of Suffering

The culture that encourages the idea of “suffering for the greater good” is called juche. Juche is the Korean term for the culture of self-sufficiency. It is an idea that is pushed hard into the minds of all North Koreans. Asking for help, depending on friends or family, or participating in a small-scale economy of goods with your neighbors makes you an inherently weak person because you are expected to work harder instead of “begging”. This idea is so ingrained in the minds of North Koreans that they will accept immense abuse from higher-ups at the expense of asking for help or demanding rights.

Starting in 1990, a great famine swept the nation under the rule of Kim Il-Sung. He coined the term “The March of Suffering” to refer to the famine. Using this name, he convinced those who took the hardest hit, the rural people of low Songbun, that they were doing the most honorable thing for their country by suffering in this famine. They were dying for it. Kim Il-Sung glorified their suffering by convincing them that not only did they deserve it (juche), but that their suffering was contributing to the greater good of the country. He had such control over the minds of these people that they loyally followed him straight to their graves. 

Handled correctly, this famine could have lasted no longer than a year, and would not have become nearly as severe as it has. Instead, estimates from Crossing Borders suggest that between 240,000 and 3.5 million people have died in the DPRK from malnutrition since 1990.* The famine has outlived not only Kim Il-Sung but also his predecessor Kim Jong-Il. 

*The reason for such a wide range of statistics is that collecting accurate data in North Korea is virtually impossible. I expand on the use of outside media control in the second part of this series titled, “How the North Korean Regime Uses Cult-Like Tactics to Maintain Power.”

The camera is facing down a building-lined street. The buildings are neutral colors and appear old. There are two trees with no leaves. There is a group of people all wearing the same dark green/blue clothing. One person is dressed in bright blue and standing in the middle of the street.
Even in Pyongyang, vibrant colors are rare. The buildings are drab and dull, the trees are dead, and people dress monochromatically and uniformly. The person in bright blue serves as a traffic director. Source: Flickr

Suppose the topic of North Korea is interesting to you and you want to work towards clearing up the fog surrounding the nation. In that case, I highly recommend Dying for Rights: Putting North Korea’s Human Rights Abuses on the Record by Sandra Fahy. This book is very informative and one of the only easily accessible, comprehensive accounts of North Korean human rights. It is where I learned most of what I know about the DPRK. It set the baseline on which I built my entire comprehensive understanding of the social systems at play. 

The cover of Sandra Fahy’s book. The picture on the cover is taken through a fence in North Korea. The camera’s focus is on the background, making the fence of the foreground very blurry. The view of the fence consists of a top white metal bar and five vertical bars that are red and white. In the background, which is in focus, we look over a small body of water to see a few densely packed and desolate-looking houses. The grass and trees out front are dead. There is snow on the ground. The sand is rocky and gray. There is one bright blue structure that looks like a child’s playhouse starkly contrasting its desolate surroundings. Above the fence, text reads, “Dying for Rights: Putting North Korea’s Human Rights Abuses on the Record; Sandra Fahy.”
The cover of the aforementioned book. Source: Fahy, Sandra. Dying for Rights: Putting North Korea’s Human Rights Abuses on the Record. Columbia University Press, 2019. Picture taken by A. Price.

As I will expand upon in the rest of this series, it is imperative that people outside of the DPRK “clear the fog” and find ways to look into the state. One of the biggest motivators for activism is awareness. As people on the outside, some of the most valuable things we can do are spread awareness, garner activism, and bring that activism with us into our participation in the government, whether that be running for office or simply voting for people who share our concerns.

If you are not registered to vote, you can do so here: Register to vote in the upcoming midterm election today.

A Bright Future – Recent Human Rights Victories

Source: Yahoo Images, Unknown Artist

In the midst of a pandemic and international unrest, it is vital to stay encouraged and optimistic as we continue our efforts to uphold and protect human rights internationally. That is why we at the Institute for Human Rights at UAB will be using this article to break up the negative news cycle and put a spotlight on a few of the amazing victories and progress the international community has made during the pandemic that you might not have heard about. Though positive human rights news may not always make headlines, it is important to recognize each success, just as it is vital we address each issue. 

Source: Quentin Meulepas via Flickr

The UN Declares Access to a Clean Environment is a Universal Human Right – July 2022

Of the 193 states in the United Nations general assembly, 161 voted in favor of a climate resolution that declares that access to a clean, healthy and sustainable environment is a universal human right; one that was not included in the original Universal Declaration of Human Rights in 1948. While the resolution is not legally binding, it is expected that it will hugely impact international human rights law in the future and strengthen international efforts to protect our environment. Climate justice is now synonymous with upholding human rights for the citizens of member-states, and the United Nations goal is that this decision will encourage nations to prioritize environmental programs moving forwards.

Kazakhstan and Papua New Guinea Abolish the Death Penalty- January 2022

Kazakhstan became the 109th country to remove the death penalty for all crimes, a major progress coming less than 20 years after life imprisonment was introduced within the country as an alternative punishment in 2004. In addition to the national abolition,  President Kassym-Jomart Tokayev has signed the parliamentary ratification of the Second Optional Protocol to the International Covenant on Civil and Political Rights. Article 6 of the ICCPR declares that “no one shall be arbitrarily deprived of life”, but the Second Optional Protocol takes additional steps to hold countries accountable by banning the death penalty within their nation. Though the ICCPR has been ratified or acceded by 173 states, only 90 have elected to be internationally bound to the Second Optional Protocol (the total abolition of the death penalty), and Kazakhstan is the most recent nation to join the international movement to abolish the death penalty globally. 

Papua New Guinea also abolished their capital punishment, attributing the abolishment to the Christian beliefs of their nation and inability to perform executions in a humane way. The 40 people on death row at the time of the abolishment have had their sentences commuted to life in prison without parole. Papua New Guinea is yet to sign or ratify the Second Optional Protocol to the ICCPR, but by eliminating the death penalty nationwide the country has still taken a significant step towards preserving their citizens right to life. 

Source: Randeep Maddoke via Wikimedia

India Repeals Harmful Farm Plan – November 2021

Many of you will remember seeing international headlines of the violent protests following India’s decision to pass three harmful farming laws in 2020. The legislation, passed in the height of the pandemic, left small farmers extremely vulnerable and threatened the entire food chain of India. Among many other protections subject to elimination under the farm laws was the nations Minimum Support Price (MSP), which allowed farmers to sell their crops to government affiliated organizations for what policymakers determined to be the necessary minimum for them to support themselves from the harvest. Without the MSP, a choice few corporations would be able to place purchasing value of these crops at an unreasonably low price that would ruin the already meager profits small farmers glean from the staple crops, and families too far away from wholesalers would be unable to sell their crops at all. 

Any threats to small farms in India are a major issue because, according to the Food and Agriculture Organization (FAO) of the United Nations, “Agriculture, with its allied sectors, is the largest source of livelihoods in India”. In addition, the FAO reported 70% of rural households depend on agriculture and 82% of farms in India are considered small; making these laws impact a significant amount of the nation’s population.  A year of protests from farmers unions followed that resulted in 600 deaths and international outcries to protect farmers pushed the Indian government to meet with unions and discuss their demands. An enormous human rights victory followed as Prime Minister Narendra Modi announced in November of 2021 that they would rollback the laws, and on November 30 the Indian Parliament passed a bill to cancel the reforms. As the end of 2021 approached, farmers left the capital and returned home for the first time in months, having succeeded at protecting their families and their livelihoods.

Source: Sebastian Baryli via Flickr

Sudan Criminalizes Female Genital Mutilation – May 2020

Making history, Sudan became one of 28 African nations to criminalize female genital mutilation / Circumcision (FGM/C), an extremely dangerous practice that an estimated 200 million woman alive today have undergone. It is a multicultural practice that can be attributed to religion, sexual purity, social acceptance and misinformation about female hygiene that causes an onslaught of complications depending on the type of FGM/C performed and the conditions the operation is performed in. Among the consequences are infections, hemorrhage, chronic and severe pain, complications with childbirth, and immense psychological distress. It also causes many deaths from bleeding out during the operation or severe complications later in life. We have published a detailed article about female genital mutilations, gender inequality and the culture around FGM before, which you can find here

FGM/C is a prevalent women’s rights issue in Africa, and in Sudan 87% of women between the ages of 14 and 49 have experienced some form of “the cut”. While some Sudanese states have previously passed FGM/C bans, they were ignored by the general population without enforcement from a unified, national legislature. This new ban will target those performing the operations with a punishment of up to three years in jail in the hopes of protecting young women from the health and social risks that come from a cultural norm of genital mutilation and circumcision.

Where do we go from here?

While we have many incredible victories to celebrate today, local and international human rights groups will continue to expose injustices and fight for a safer and more equal future for all people. Our goal at the Institute for Human Rights at UAB is to educate; to inform readers about injustices and how they can get involved, and to celebrate with our incredible community when we have good news to share! While the past year has been marked with incredible hardships, it is always exciting when we have heart-warming international progress to share!

You can find more information about us, including free speaker events and our Social Justice Cafes on our Instagram page @uab_ihr! Share which of these positive stories you found most interesting in our comments, and feel free to DM us with human rights news you would like us to cover!

Barren- Food Deserts and Hunger in America

What Is a Food Desert?

Source: Mike Mozart via Flikr

Currently in America, the neighborhood you were born in can affect your future income, education level, and your ability to consistently access nutritional food. The Food Empowerment Project (FEP) defines food deserts as “geographic areas where residents’ access to affordable, healthy food options (especially fresh fruits and vegetables) is restricted or nonexistent due to the absence of grocery stores within convenient traveling distance”. The USDA has defined two types of food deserts: one that exists in both rural areas more than 10 miles from the nearest store and the second which exists in urban environments, where citizens face daily obstacles in obtaining healthy food due to lack of availability or resources. But, the average conversation about food deserts surrounds zones within American cities where citizens, hindered by lack of access to transportation and restricted budgets, are unable to obtain nutritional food. Food deserts play a critical role in food insecurity in the United States, and they are typically visible in urban areas where the residents are already living in extreme economic hardship. 

The Institute of Human Rights at UAB has recently published an article about food deserts in our hometown of Birmingham, Alabama that you can read here– but for readers in other parts of America, I want you to do an exercise with me. Think about your nearest big city, or an urban area you are familiar with. This can be in New York City, Atlanta, Miami, Chicago, or whichever metropolis best applies to you. Visualize the roads you drive, the areas both wealthy and impoverished. Now, think of the few streets within that city where there are almost no Walmarts, Targets, Krogers or Publix chains. In this stretch, there are tons of fast food restaurants, cash bond and payday loan businesses, laundromats and gas stations. There is an abundance of drive throughs and minimarts, but you could drive for a few minutes before you find a grocery store. Can you see that part of your city in your head now? THAT, dear reader, is your local food desert. 

Note: The USDA compiled census and other data into an interactive map called the Food Environment Atlas, which allows any user to view rates of food insecurity, diet quality, and food prices in your area or any neighborhood you are curious about. If you struggle to think of a food desert near you, or want to learn about what areas are impacted by food insecurity, I recommend you try out the Food Environment Atlas here.

Source: DcJohn Via Flickr

The Cause:

Food Deserts have typically been attributed to socioeconomic status. One of the main characteristics that defines a food desert is lack of accessibility, which means people living in a certain region have limited resources, be it money, time or transportation to access nutritional, fresh food. Food deserts are most common in low socio-economic  areas, where residents are unlikely to own a car or have one that is not always working. Americans living here typically live paycheck-to-paycheck, and require both accessibility and affordability to make ends meet throughout the month. It is currently estimated that one in six Americans still experience food insecurity, and that roughly 19 million people are affected by food deserts or limited access to supermarkets in America. Recent studies by the United States Department of Agriculture confirm the connection between race and food deserts, stating in 2019 that “rates of food insecurity were substantially higher than the national average for single-parent households, and for Black and Hispanic households”. 

The conversation surrounding food deserts has shifted to include race in recent years. Originally, the term food desert was coined to represent the socioeconomic disparities that cause some Americans to face food insecurity. Now, organizations like the Natural Resources Defense Council (NRDC) are pushing to recoin the term as food apartheid to accurately represent the way food insecurity affects those of minority race in America. The NRDC explains the term shift, saying that, 

“Many groups are now using the term “food apartheid” to correctly highlight the how racist policies shaped these areas and led to limited access to healthy food. Apartheid is a system of institutional racial segregation and discrimination, and these areas are food apartheids because they too are created by racially discriminatory policies. Using the term “apartheid” focuses our examination on the intersectional root causes that created low-income and low food access areas”. 

Essentially, it is vital that we recognize how a historical and current racial inequalities act as a cause of both the food deserts and the zones of poverty they’re found in. The historically black areas of segregated cities were underfunded and underdeveloped, plagued by lack of opportunity and equal access, and in some areas across the United States an economic shadow of that segregation still remains.

Source: Gilbert Mercier via Flickr

Their Effect and Why It Matters:

America has incredibly high rates of obesity and nutrition-based health issues in comparison to other developed countries. While there are decades of research connecting poverty and race to higher rates of nutrition-based disease and other health issues in America, science is now beginning to track the specific effects of food deserts on obesity and chronic illness. A corner store or a pocket-sized version of big supermarket chains like a Walmart Neighborhood Market, but if you take the time to walk inside you’ll see the fresh produce section is either neglected or nonexistent. These smaller stores have less room for inventory, their foods are less likely to be fresh produce due to the requirements to keep them fresh, and these foods are often packaged and processed. That means those who depend on these stores are limited to fast food, packaged goods, or other processed and low quality options that can contribute to malnutrition, heart disease, obesity, diabetes and more.

In addition to the effects of food deserts on health, the prices per unit are almost always more expensive than their suburban, chain-grocery counterparts. A person who can afford a Costco membership will almost always spend less on the same food products as a family living paycheck to paycheck or utilizing EBT for groceries. A 1997 USDA study found that “geographic location was the single most important contribution to higher nationwide average prices faced by low-income households”, and that smaller stores charged more per item than supermarkets nationwide. Food scarcity and cost disparities disproportionately affect minorities and those already living in financial insecurity, and each city has a part to play in ending this national crisis of inequality.

Source: Sue Thompson via Flickr

Join the movement to end food insecurity in the US:

Ultimately, the end to food desertification requires an effort between elected officials and businesses to make nutritious food affordable and accessible for all people. If you recognized a food desert near you in the imaginative exercise we did earlier, that could be the perfect topic to address with your local lawmakers through emails, calls or petitioning. If you prefer other types of action, there are countless ways to work as individuals to help your community in the meantime. Getting involved in the fight against food insecurity can be as hands-on and involved as you want, from donating non-perishable foods and needed items to local organizations, shelters or food kitchens to establishing a community garden, or everything in between. There are plenty of ways to make a difference at whatever level of involvement works best for you, and I’ve linked some of my favorites below!

A Few Ways to Get Involved:

  • Click HERE to find your elected officials on the state and local level and how to contact them about the food deserts affecting their voters. You can use your voice to push for changes that directly impact your community in a positive way.
  • Feeding America is a charity that uses your donations to help the 1 in 8 Americans experiencing hunger now. This link takes you straight to their front page, which features a zip code locator for the closest food bank to you!
  • Organize or contribute to a local food drive. Many public schools and local businesses run food drives for charities throughout the year, and Rotary International has an awesome guide available for starting your own community food drive HERE. Sharing surplus food is an excellent way to help others while reducing waste as well!
  • Use this link to find food pantries near you to donate, volunteer, and get involved in your state’s fight against food insecurity.
  • Find what works for you. Try searching for more ways to get involved that are tailored to your area and preferences…every contribution helps!

Our Lost Indigenous Women

A protest, with placards displaying the faces and information of missing women
Source: Obert Madondo Via: Flikr/cc

The Problem

Indigenous women face overwhelming rates of violent crime, more than twice the amount of their non-Indigenous counterparts in the United States and 3.5 times in Canada. A 2016 study published by the National Institute of Justice revealed that approximately 84.3% of American Indigenous women have experienced violence against them in their lifetime and 56% of these women would become victims of sexual violence as well. In Canada, only 53% of Indigenous women’s homicides have been solved; drastically less than Canada’s national solve rate of 84%. That statistic becomes even more damning when we take into account that Indigenous females only make up 4% of Canada’s population, yet account for nearly one quarter of all homicide victims in Canada. For decades, Indigenous leaders, tribal governments and human rights organizations alike have called for national reviews in both Canada and the United States into the treatment of cases regarding Indigenous women. A publication from the US Department of Justice states that Indigenous female victims in the United States are far more likely to need services that aid survivors of such violence, but are the least likely group to have access to these services. The majority of Native American women will face physical or sexual violence in their lifetime, and more than a third will be unable to access necessary services after the event due to drastic disparities in access to healthcare and treatment by law enforcement. With each new set of data we have re-confirmed the existence of a plight sweeping through native communities, robbing women within them of their security, safety, and visibility. 

Marchers holding a banner that says "No more stolen sisters"
Source: Yahoo Images

Missing and Murdered Indigenous Women (#MMIW)

In recent years, social media pushes have been made to raise attention for what is now known as “Missing and Murdered Indigenous Women”, a simple catchphrase encompassing decades of neglect from all channels that is now spearheading a movement for justice. This hashtag and social media campaign generates hundreds of thousands of interactions and impressions on social media every day, and brings attention to the individual stories of missing indigenous women or families of women lost to homicides that are still unsolved. However, indigenous women rarely get the national media attention that white women experience when they go missing; and when every minute and resource makes an empirical difference in the likelihood of that woman being found alive. A prior article from the Institute of Human Rights speaks specifically about the recent Gabby Petito case, and the disproportionate response of the American public for missing white women in comparison to women of color and indigenous women here. These drastically different responses only amplify the vulnerability of indigenous women.

It is horrific to think about a situation in which no one will come looking for you if you go missing. That nightmare has become an internalized reality in so many indigenous communities, where young women are being raised with impressive levels of advocacy for their missing sisters, but are witnessing first hand how much of a struggle that advocacy is. Social media is beginning to catch up to decades of research that has been waiting for a time like now, where the general public may be ready to listen and push for change. The Murder Accountability Project (MAP) has tirelessly collected data on unsolved homicides in the United States to apply pressure on law enforcement in communities with disproportionately high unsolved homicide rates, and put a spotlight on communities that fail to report important information to federal databases. The Indigenous community is heavily reflected in both of those categories.

A broken chain of command and lack of communication is often cited for why so few of these reported cases are ever investigated, as local, state and federal law enforcement agencies struggle to find a balance of working with native land and sovereign tribes through the reporting process. Many violent crimes against indigenous women occur on sovereign native land, however, 96% of the perpetrators are non-indigenous. This causes major confusion as tribal governments are unable to prosecute non-indigenous persons, and most standard law enforcement agencies have no jurisdiction over any crimes that occur on native land. This complicated mess of jurisdiction and authority confuses law enforcement, tribal governments, and victims alike. 

Unfortunately, law enforcement has repeatedly made glaring errors that are impossible to ignore; tribal organizations have found that the United States National Crime Information Center recorded 5,712 reports of missing American Indian and Alaska Native women and girls in 2016, but the US Department of Justice’s federal missing persons database shows that only 116 of those 5,712 cases were never logged. Essentially, this information means that only 2% of all cases of missing indigenous women were properly reported. This cannot be ignored; many families, friends and loved ones are left wondering why our government has forgotten and neglected their sisters, mothers, wives and daughters. While the answer may not always be clear, movements like #MMIW are bringing this conversation to the forefront of politics and media. In order to provide justice for these women, we must demand increased preventative and investigative efforts to protect these women when they need it the most.

An infographic displaying data on missing indigenous women
Source: Reclaiming Power and Place: The Final Report of the National Inquiry into MMIWG VIA: Yahoo Images

Truths of Targeting

The vast majority of homicides of indigenous females go unsolved for years, and even the solved cases display how this systemic neglect has been repeatedly exploited. As determined by the FBI, “vulnerability” is a key factor in a killer’s process of victim selection; a category most indigenous women have been forced into by countless factors beyond their control. Prolific serial killers like Robert Pickton (Canada) and Robert Hansen (United States) specifically targeted indigenous women and sex workers during their killing sprees, and doing so allowed them to murder dozens of women completely undetected by law enforcement for decades. More than half of Pickton’s victims were thought to be aboriginal women, though many were never identified, and Hansen’s victims were often young indigenous women who had turned to survival sex work out of financial desperation. While describing research confirming how killers have manipulated vulnerabilities to their benefit, Co-director of MAP and criminologist Michael Arntfield determined that “Serial killers prey on marginalized populations, and indigenous women make up a disproportionate number in the victim pool”.

Sign stating "You are not forgotten" at a march for missing indigenous women
Source: Pressbooks Open Library Via: Yahoo Images

How to Help

There are many exceptional campaigns, research organizations and nonprofits to get involved that are currently on the forefront of the fight to end violence against indigenous women. If you wish to learn more about the topic, you can explore other Institute of Human Rights articles promoting Indigenous rights here, or click here to find an excellent resource sheet with educational sources and ways to get involved with MMIW. There are countless petitions for reform in both the US and Canada as well; this petition calls for the passing of Savanna’s Act, which will require the Department of Justice to update their missing persons database to better help identify missing and murdered Indigenous women and prevent further discrepancies in reported cases. This petition is a plea to the US Senate, calling for the Violence Against Women Act (VAWA) to be re-authorized and receive greater funding as VAWA increases abilities for tribal nations to prosecute non-native offenders as well as providing resources for responses from law enforcement on all levels when cases of violent crimes or missing women are reported. The Coalition to Stop Violence Against Native Women offers ways to donate, volunteer, attend community training, and other incredible opportunities to get involved in the movement. The Sovereign Bodies Institute utilizes donations to collect culturally-informed research on gender and sexual violence against indigenous peoples.

The only way to protect these women is to take drastic steps towards change. We can no longer ignore, deny or neglect the truths of everything both systemic and societal that has consistently failed the indigenous community, and the women within it. Please research, donate, volunteer, and find a way to become an advocate for the missing and murdered. We can have no more stolen sisters.

Reflections on the APHR Graduate Program

Image showing an alumnus.
Samih Eloubeidi, author of this post and APHR and IHR alumnus.

I graduated from the University of Alabama at Birmingham’s Anthropology of Peace and Human Rights (APHR) graduate program a year ago, and I will be starting law school at Emory University School of Law this upcoming fall. I decided to pursue a master’s degree in APHR both to increase my knowledge about human rights and because human rights law is one of the fields of law that really interests me. When choosing a graduate school program, I think it’s important to take into consideration previous students’ experiences, so I would like to share my favorite things about the program in the hopes that I can provide some insights that you may not otherwise have access to.

There are a lot of qualities about the program that I liked, but I will specifically focus on three. First, my experiences with my peers. In every program, there is the expectation that one will learn from the course reading and material, which is true, but I also found that I learned a lot from my peers. The unique character of the program lies in the fact that it combines anthropology, human rights, and peace work altogether, and, because of this, the program attracts students with a wide range of interests. Thus, I was exposed to worldviews and perspectives different from my own, and, through this, was able to engage in and learn about topics that I otherwise would not have.

Second, my thesis work. In preparation for the thesis, we were required to take a research and methodology course, which readied us for the thesis research and writing process. For my thesis, I chose to work with Palestinian refugees in Lebanon, a topic that is of much interest to me. The program has little to no limits on what topics one can choose for their thesis, and the faculty members encourage each student to invest in and work through topics that are important to them. This, to me, really made the thesis process an enjoyable one.

Third, my work at the Institute for Human Rights (IHR). Under the leadership of Dr. Tina Kempin Reuter and Dr. Courtney Andrews, the IHR is a human rights advocacy and research center. Students in the master’s program can be recruited to work at the IHR, where the work mainly involves writing blog posts about current human rights issues. Students are given complete autonomy about what they want to write about, which is a great opportunity for one to explore personal passions and interests. Also, students who work with the IHR organize on campus events to raise awareness of ongoing human rights issues around the world.

When I first applied to the APHR graduate program, I had no idea what my time in the program would look like. One year later, I can easily say that this was the best decision I could have made after graduating from undergrad. I am very grateful for all the lessons I learned and all the opportunities I was given while in this program, and I truly believe that this experience was indispensable for my personal and career growth!

By Samih Eloubeidi, APHR Alumnus, May 2020

A Glimpse at the Battles Women Face in Nicaragua

by April Alvarez

Photo of two little girls holding beans and smiling
Source: The author

A Human Rights Internship

This 2021 Spring Semester, UAB’s Institute for Human Rights had the privilege of partnering with Clínica Verde in Nicaragua to dive into the human rights issues that women in the country face, especially regarding health care. The internship, directed by Dr. Tine Reuter and Dr. Stacy Moak, has opened doors to important conversations about the importance of voicing and advocating for people who need support. Although the semester just started, those involved with the internship have already been exposed to several educated and experienced scholars that are making a mark on the country and are looking to equip and inspire others to do the same. In just one month, students have learned about the life of women and children have struggled to find economic stability, and access to basic resources. The purpose of this partnership with Clínica Verde is dive deeper into the ways that UAB (University of Alabama at Birmingham) students can serve others even during a global pandemic. Through the development of the course students will develop programs and educational presentations that aim to advocate the same values and goal displayed by the staff at Clínica Verde to reach out to more people in the clinic’s surrounding community but also to those in more rural areas.

Feed My Starving Children (FMSC)

Yolanda Paredes-Gaitan was the first speaker invited to speak to the students. She lived in Nicaragua for twelve years but is now currently living in California and working for the U.S. government. While in Nicaragua, she worked alongside Clínica Verde helping find ways to advocate for human rights issues, now she does that in partnership with the U.S. Valuable information shared through her presentation revealed that 65% of people in Nicaragua live in rural areas that are usually only accessed by walking or horses. Although the country of Nicaragua is rich in resources such as coffee, chocolate, and honey, however the country has been deemed the second poorest country, after Haiti. So why does this matter? It matters because it affects everything, including the quality of life in the country. Every community in the country has what is known as a health post. Each health post is usually the primary place for individuals to go to for basic health care needs, especially since few people have access to a nearby hospital. However, the problem is that most of the posts are rundown and in need of repairs. With the help of Clinica Verde, one post which had a structure that was falling apart, had holes in the roof, had no running water was transformed into a new and improved post that is now a green building that has natural ventilation, lighting and has access to water and the resources needed to provide the community with quality services. The goal of Clínica Verde is not to keep all the knowledge to themselves but instead to spread it with those in the country. Another thing that the clinic has been able to do is to provide posts with the knowledge necessary to run an intensity garden. The reason the clinic does this is because they are not looking to provide the women and children with short term solutions to their problems. They want to equip people with the knowledge to improve their lives long term, so they are more educated on how to live a more healthy and sustainable life.

Who visits the clinic?

People from all around the country visit the country. One lady traveled by bus and walked two hours up a hill just to get back home, but she did it because she loved the care provided by Clínica Verde. However, unlike the traditional view that when patients need care, they must go to the clinic, Clínica Verde travels to rural communities three times a week. Their mission goes beyond what the four walls of their building. They make it a priority to reach those who would otherwise not have time to visit the clinic. Another important thing to note is that the clinic also Nicaragua had no education in optometry until one donor came to the country and changed that. Now the team at Clínica Verde also has a program that helps provide people in the community with free glasses which is centered around the students but also anyone in the student’s lives that may also need glasses. This optometry program has also allowed senior citizens to have surgeries that have saved them from going blind.

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

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

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

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

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

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

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

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

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

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

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

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