Health and Human Rights:

How Health and Human Rights Are Interrelated

Human rights and health are two complementary approaches and languages used to address and advance human well being. The human rights approach first describes the societal level prerequisites for human well-being, in which each individual can achieve his or her full potential, and then seeks to promote and protect those prerequisites.

The most widely used modern definition of health was developed by the World Health Organization: Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Public health can be defined as ensuring conditions in which people can be healthy. The core of public health knowledge, based on research and experience, is that a blend of individual and societal level factors are involved in determining health status. For many people, the societal context is the major determinant of vulnerability to preventable disease, disability and premature death.

In 1948, the Universal Declaration of Human Rights was adopted as a universal or common standard of achievement for all peoples and all nations. It is the highest aspiration of the common people and the foundation of freedom, justice and peace. Broadly speaking, individual and collective well-being are considered to depend upon the "promotion of universal respect for and observance of human rights."

When we look at history, the trial of Nazi doctors documented the most extreme examples of physicians participating in human rights abuses, criminal activities, and murder. Hitler called upon physicians to help justify his euthanasia programs, experimentation programs and ultimately his death camps.

Physicians should be educated about and aware of the fact that they are sometimes indirectly involved in the torture of prisoners. Physician involvement includes examination and assessment of fitness of prisoners to be tortured, monitoring of victims during their torture, resuscitation and medical treatment of prisoners, and falsification of medical records and death certificates especially after torture.

Health and human rights have rarely been linked in an explicit manner. Yet health and human rights are both powerful, modern approaches to defining and advancing human well-being. Linking health and human rights may provide practical benefits to those engaged in health or human rights work and may help reorient thinking about major global health challenges.

The effects of health policies and programs on human rights

Here is an example of an effect. Violations of the right to nondiscrimination occur during the collection of data on important health problems when data are not collected on all possible health problems or when there is failure to recognize the health problems that affect a marginalized or stigmatized group.

The consequences of human rights violations on health

Certain human rights violations such as torture, imprisonment under inhumane conditions, and summary executions obviously have impacts on physical and mental health.

Burma is a good example to show how violations of human rights impact health.

Some background information about Burma — In August of 1988, due to extreme political oppression and economic hardships, Burma erupted with people's power street demonstrations. This nation wide uprising was brutally gunned down by army troops, killing thousands of people. An election was held in May 1990. The National League for Democracy party, led by Aung San Suu Kyi, a 1991 Nobel Laureate won the election by a landslide victory. The military junta ignored the election result and refused to hand over power. The repression and hardships became worse and continue to the present day. Over the last 12 years, the situations are getting worse.

According to UNICEF, the infant mortality rate in Burma in 1996 was 105 per 1000 live births compared with 33 in Vietnam, 31 in Thailand and 11 in Malaysia.

The incidence of HIV/AIDS is increasing at alarming rates. The statistics are incomplete and unreliable, but estimate about 530,000 people are infected. The joint UNAIDS of the United Nations has identified the four hardest hit countries in the Asian region as (in order of HIV prevalence): India, Thailand, Burma and Cambodia. Prof. John Dwyer, Founding President of the AIDS Society of Asia and the Pacific, stated in June 1997 that "Burma is the epicenter of the epidemic in Asia." Burma was rated as having high and rising HIV prevalence and high and rising HIV incidence by an international panel, convened by UNAIDS and the AIDSCAP, at the most recent Asia-Pacific Conference on AIDS in Manila in 1997. That rating was the worst of the panel's possible scenarios.

Burma is one of the world's largest opium producing countries. Domestic use rates are among the highest in the world — from 2 to 25% of adults according to a 1995 UNDCP multi-community survey. Burmese heroin exports to India, China, and Thailand have fueled regional outbreaks of drug use and HIV infection in Burma's border areas.

The spread of HIV/AIDS is facilitated by a growing commercial sex industry, trafficking of Burmese women and girls into the regional sex industry, untreated STDs, very low condom use and availability, lack of sexual health information, unsafe blood supply, and lack of universal precautions and health care settings.

Domestic resources for health expenditure have been exceptionally low — more than 60% of the government revenues go for military expenditures.

The human rights dimensions of HIV/AIDS in Burma highlight the inseparability of civil, political, economic, social and cultural rights. The severity of the problem indicates the level of denial involved. The government deny freedom of expression and other rights.

Conclusion

Progress is required. Identification of health impacts, associated with violations of rights and dignity, will benefit both health and human rights fields. More research is needed to establish valid associations between rights violations and health impacts. Health experts concerned about human rights should use their expertise and help document human rights abuses.

Dr Khin Saw Win (Alice)

This commentary is based on a posting Dr. Khin Saw Win made in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2000-10-16. The posting has been edited for inclusion on the Burma Watch International Web site.