Health and Human Rights:

Shall we speak the TRUTH?

Roget's thesaurus dictionary has defined health as "robustness, soundness of body, free from disease." However, health is described in the preamble to the constitution of the World Health Organization (WHO) as "A state of complete physical, social, and mental well-being, and not merely the absence of disease or infirmity." The World Health Organization highlights the importance of health promotion, which it defines as "the process of enabling people to increase control over, and to improve, their health."

Health status is influenced by many factors including social, economic, cultural, genetic, and health care delivery system factors — all of which are complex and interrelated. In the preamble to the WHO Constitution, it was declared that "the enjoyment of highest attainable standard of health is one of the fundamental rights of every human beings without distinction of race, religion, political belief, economic or social condition." This definition, adopted in 1946, was reaffirmed at the 1978 International Conference on Primary Health Care at Alma-Ata, cosponsored by WHO and UNICEF.

Concerns for human rights and health share the common goals of alleviating suffering and promoting well-being of all people. Health and human rights are both powerful, modern approaches to defining and advancing human well-being. Health professionals are positioned on the front lines of the struggle for protection of human rights, often being the first witnesses of the physical and psychological harm that human rights violations cause to individuals and communities.

It is crucial for health professionals to take this opportunity to collect all medical documentation that provides concrete evidence of human rights violations. It is only through this documentation that we can pressure the perpetrators to change their behavior and urge governments and the international community to respond effectively to stop human rights abuses. It is only through this documentation that we will be able to seek justice and relief for victims of abuse. Health professionals need to know when to report abuses and to whom they should report them. At the same time, we must respect the political constraints under which some of our colleagues operate. It is vital for them to learn how to balance that obligation with the personal risks they may assume for reporting abuses.

Simple actions, such as addressing humanitarian emergencies, raising alarms on environmental threats to health and promoting awareness on political prisoners who need immediate medical attention, are fundamental to promoting and protecting health. It is our responsibility, as exiled health professionals, to speak out in support of our colleagues who are under pressure from the military regime not to report torture related injuries and other medical conditions such as the incidence of HIV/AIDS.

The Hippocratic Oath, to which physicians still refer, conveys the concept that the medical doctor has a special duty towards patients in addition to the rights of patients to confidentiality. The physician must not only be prepared to do what is right himself, but also make the patient, the attendants, and externals cooperate. There are many physicians who say they are not interested in politics and only care for the health of the people. Perhaps the precise opposite approach is called for: to recognize and attempt to respond to the impact that human rights and political situations have on the physical and mental health of our people.

Dr Khin Saw Win (Alice)

This commentary is based on a paper Dr. Khin Saw Win presented at the First Burma Medical Association (BMA) Conference held in July 2001. She also posted it in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2001-03-29. The posting has been edited for inclusion on the Burma Watch International Web site.