As the 60^th Anniversary of the 1951 Convention Relating to the Status of Refugees approaches, the United Nations High Commissioner for Refugees (UNHCR) has affirmed its commitment to better address protection gaps created by modern forms of forced displacement.

The 1951 Convention was designed to protect European refugees in the aftermath of World War II. Later, the 1967 Protocol expanded the scope of the 1951 Convention to address the problem of displacement around the world. Today, rapid population growth, urbanization, and climate change are contributing to increased levels of conflict and forced displacement around the world. However, the Convention and Protocol only cover a limited number of those who are forcibly displaced and seeking protection under these circumstances.

Fortunately, the "refugee" definition in the 1951 Convention has been interpreted relatively broadly by many courts, helping to address asylum needs for many populations. During his recent visit to the nation's capital, UN High Commissioner António Guterres commended US courts for their broad interpretation of persecution based on one's membership to a "particular social group." He referred to recent improvements in protection for persecuted members of the LGBT population and families targeted by violent groups.

Others aren't as lucky. Often, circumstances of a person's suffering are too blurred to clearly establish a claim for asylum. Additionally, it can be difficult to grant protection to people who are not persecuted directly by the government. As increasing numbers of displaced people flee violence and circumstances beyond their control, the need to expand the interpretation of "refugee" to better address all forms of forced displacement is apparent.

Gang-related violence, particularly in El Salvador, Honduras, Guatemala, and some areas of Mexico, is a growing concern. Gangs and organized criminal groups have effectively taken control over some regions of Central America, intimidating and brutalizing those who oppose their efforts or refuse to join them. Despite clear evidence of persecution, US immigration courts have largely denied gang-based asylum claims because it is nearly impossible to identify a state actor responsible for the persecution. Applicants must demonstrate that the government was unable or unwilling to control the gang violence. To complicate matters, in 2008, courts imposed new, restrictive, requirements on gang-based asylum claims. Applicants must now demonstrate that their social group was sufficiently "socially visible." Such a requirement would be difficult to prove and dangerous for most applicants, given that many are attempting to keep their social, national, religious, or political identities secret in order to avoid detection and punishment.

There is good news though. Recently, the Board of Immigration Appeals reopened Matter of S-E-G-, a 2008 case that set new restrictive precedents regarding gang-based asylum claims. Immigration advocates are hopeful that the outcome will bring clarity to this complex issue, and enable the outdated "refugee" definition to protect yet one more group of forcibly displaced persons.

Last Friday, Burma applied for the chairmanship of the Association of Southeast Asian Nations (ASEAN). The chairmanship rotates between member countries, and as a military dictatorship, Burma has been prohibited from holding the position in the past. Following Burma's recent elections, Burma now believes it is eligible for the chairmanship. The problem is that the recent changes in Burma's military regime are more democratic in form than substance; nearly 90% of all seats are either reserved for the military or held by the military-backed party which bodes poorly for true reform. These same army forces committed 73% of all reported human rights violations last year suggesting a continuation of the status quo at best.

Despite strong protests from NGOs and civil society groups, ASEAN is still considering the application. Human rights abuses are still widespread in the country, and ASEAN should acknowledge the Burmese government's continued violations and the regional impact they have. The regional body should maintain pressure on Burma to stop the abuses. Further, ASEAN should support the call for a UN commission of inquiry (COI) into human rights abuses in Burma. A government that is abusing its own people is not a legitimate one, and ASEAN should not give its chairmanship to any such government.

Boston Area Readers: PHR Invites You to a Public Forum:

WHEN THE STATE MAKES DEMANDS:

MEDICAL PROFESSIONALISM, DUAL LOYALTY, AND HUMAN RIGHTS

THURSDAY, MAY 12, 7 P.M.

Carl W. Walter Amphitheater 260 Longwood Avenue Tosteson Medical Education Center Harvard Medical School

This program is presented by Harvard Medical School, Physicians for Human Rights, and the United States Holocaust Memorial Museum.

Featured Speakers:

• Holly G. Atkinson, MD, Past President, Physicians for Human Rights
• Robert Jay Lifton, MD, Lecturer in Psychiatry, Harvard Medical School, and Distinguished Professor Emeritus of Psychiatry and Psychology, The City University of New York
• Jonathan H. Marks, BCL, Professor of Bioethics, Humanities, and Law and Affiliate Law Faculty, Pennsylvania State University Dickenson School of Law, and Edmond J. Safra Research Fellow, Edmond J. Safra Center for Ethics, Harvard University
• Robert N. Proctor, PhD, Professor of History of Science, Stanford University

The history of the Holocaust teaches us that in Nazi Germany, the state relied on the support of medical professionals to implement its eugenics program and ultimately enable genocide. The history also reminds us of the pressures that health care workers can face and the need for vigilance to protect health and human dignity as well as the needs of society.

Join the Holocaust Museum as experts in medical ethics, psychology, and the history of medicine delve into the history and lessons of the Holocaust for physicians and explore the difficult ethical questions that medical practitioners face in today’s society.

Panel Moderator

• Mildred Solomon, EdD, Associate Clinical Professor of Medical Ethics, Department of Global Health and Social Medicine, Harvard Medical School; Associate Clinical Professor of Anesthesia, Children’s Hospital Boston; and Director of the Fellowship in Medical Ethics, Harvard Medical School

The program is free and open to the public. Reservations are requested; register online or contact the Museum’s New England Regional Office at 202.488.6585 or newengland@ushmm.org.Parking information and directions.

Following PHR's calls for the release of detained doctors and medical staff in Bahrain, nine doctors were reportedly freed. According to PHR's sources in the field, eight female doctors and one male doctor were released late yesterday evening. Doctors in Bahrain have been disappearing as part of a systematic attack on medical staff, as detailed in PHR's recent report, "Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients." Many of the medical professionals are being held incommunicado in unknown locations and on Tuesday the government of Bahrain charged 47 medical staff with trying to overthrow the regime.

Last month, PHR launched the campaign, Bahrain Free the Docs. The campaign has called for the release of detained medical staff and for the government of Bahrain to end violations of medical neutrality, a principle enshrined in international law and international humanitarian law which dictates noninterference with medical professionals in times of civil unrest and conflict. In the weeks following, PHR released a report, PHR members wrote letters to the Crown Prince of Bahrain calling for the release of the doctors and PHR joined with prominent medical associations to call for the Crown Prince of Bahrain to cease the attacks on medical staff. The campaign resulted in widespread media coverage including pieces on CNN and in The New York Times as well as the US State Department expressing concern about the violations of medical neutrality in Bahrain.While PHR celebrates with the families of those released yesterday, we continue to call on the government of Bahrain to free the remaining physicians and stop their attacks on health professionals.

Advocates cheered in 1996 when a landmark case, In re Kasinga, recognized that female genital mutilation (FGM) could be a basis for asylum. Ms. Kasinga was granted protection based on her membership in the social group of young women in her tribe who oppose FGM and have not yet been subjected to it. Although the Kasinga decision declined to discuss whether FGM would always be considered persecution, and whether or not women who have undergone FGM would still qualify for asylum, it set an important precedent that resulted in the availability of asylum in the US for thousands of women and girls who are faced with the prospect of FGM every year.

Fast forward to 2005-2007 when Ms. A-T- (her identity remains confidential) was denied asylum because she had already been forced to undergo FGM and could not prove to the court's satisfaction that she would face future persecution if forced to return to Mali. The judge reasoned that FGM was a one-time occurrence that cannot be repeated and refused to acknowledge that the circumstances described by Ms. A-T- (forced FGM as a child, growing up with a violent and controlling father, and impending forced marriage to a first cousin) constituted persecution, a requirement for asylum.

Thanks to a strong, dedicated, and heavy-hitting legal team, former Attorney General Michael Mukasey intervened in 2008 and vacated the decision. Mukasey reasoned that because forms of gender-based violence are often interconnected, evidence of past FGM may indeed indicate that a woman will be subjected to other forms of gender-based persecution in the future. The case was sent back to the original immigration court for a new hearing. This time around, the judge found that Ms. A-T- had suffered past persecution (FGM) as a member of the particular social group "Bambaran women in families that practice the Wahabi religion," and that the threat of forced marriage to her cousin in Mali rose to the level of persecution.

While we celebrate this important victory for Ms. A-T- and the important precedent it sets for future cases, we note that clear and comprehensive guidelines for gender-based asylum claims are still desperately needed to protect women and girls who face torture in their home countries simply because they are female.

Last week, the government of Bangladesh blocked a $33 million UN project aimed at poverty alleviation in Cox Bazaar district, near the Burma border. The government claimed the beneficiaries would be Rohingya refugees and not Bangladesh’s citizens. The Bangladesh government said the project would increase tensions between refugees and the local population, although, according to the project proposal, local residents would also benefit from the project. “The finance ministry has rejected the scheme because the actual aim of the UN initiative is to rehabilitate refugees in Cox’s Bazar district under the pretext of poverty reduction for locals”, an official told Kaladan News. More than 200,000 Rohingya refuges live in the Cox Bazaar area and a recent investigation by Refugees International (RI) documented atrocious living conditions and echoed the findings of a 2010 PHR report, Stateless and Starving. PHR and RI found:

• Only about 28,000 of the refugees are registered and receive regular aid from the UN and relief organizations.
• Unregistered Rohingya refugees have been attacked and imprisoned by the local authorities and some have been forced to return to Burma.
• The prevalence of child malnutrition was one of the highest in the world.
• 91% of households were forced to borrow food or money within the month leading up to the survey. Several of the refugee camps had no clean water source or proper system to dispose of waste, which drastically increases the spread of infectious disease.
• Bangladesh government officials have repeatedly blocked relief efforts to provide services to the unregistered refugees.

The government of Bangladesh should not block aid to this vulnerable population.? It should strive to find other ways to diffuse the tension between refugees and local people and to grant more access to relief agencies working in the area.

In an article published yesterday by PLoS Medicine, Physicians for Human Rights (PHR) experts showed that medical doctors and mental health personnel at Guantánamo Bay, Cuba neglected or concealed medical evidence of torture and ill treatment including bone fractures, lacerations, and symptoms of post-traumatic stress disorder. According to the article, Guantánamo health providers should have been able to observe and document the physical and psychological evidence of torture. However, PHR’s investigation found that, despite noticing the detainees’ physical injuries and psychological symptoms, medical personnel failed to question or document the causes.

In an interview with ABC News, Vincent Iacopino, one of the article's authors, said, "What was so striking in our investigation was that it's clear the Department of Defense clinicians provided medical care in the way you'd expect at any hospital or clinic, except that whenever an injury implied the possibility of intentional harm or psychological symptoms suggesting torture, the cause of those symptoms were completely ignored."

To hear Iacopino discuss the article and the implications of the investigation, listen to his interview on KPFK this morning.

Physicians for Human Rights (PHR) today released an emergency report which documents and decries systematic human rights abuses in Bahrain.

For the first time, the report, “Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients,” provides forensic evidence of attacks on physicians, medical staff, patients and unarmed civilians with the use of bird shot, physical beatings, rubber bullets, tear gas and unidentified chemical agents. The report was featured on several major news outlets including the Associated Press, AFP, BBC, CNN, the Independent, New York Times, and Washington Post.

The report details systematic and coordinated attacks against medical personnel, as a result of their efforts to provide unbiased care for wounded protestors. These attacks violate the principle of “medical neutrality” and are grave breaches of international law which dictates noninterference with medical services in times of civil unrest. Included in the violations were targeted kidnappings, beatings, and threats of rape and killing by security officials. These attacks extended to the patients of medical personnel created an atmosphere of fear which dissuaded patients from seeking care.

The report concludes with policy recommendations for Bahrain, the Unites States and the international community. Among other calls for action, PHR demands for Bahrain to immediately cease and desist all attacks on medical personnel and facilities. PHR also calls on the Obama Administration to lead an international effort to appoint a Special Rapporteur on Violations of Medical Neutrality through the United Nations Human Rights Council.

The World Bank in Zimbabwe is piloting a new project aimed at averting another cholera crisis like the massive outbreak the country experienced in 2008. Called the Beitbridge Emergency Water Supply and Sanitation Project, the project aims to improve water and sanitation infrastructure in Beitbridge, the largest inland port in Sub–Saharan Africa and also major land transit corridor.

New reports of cholera outbreaks in other parts of the country prove the disease remains a major threat. The cholera outbreak of 2008-2009 led to over 90,000 cases of cholera and more than 4,000 deaths. Beitbridge was especially hard hit by that epidemic, recording 26% of all cases. The World Bank estimates that this new $2.65 million project will help Beitbridge’s 40,000 residents and 2,000 people who travel through the town every day.

PHR documented in 2009 the connection between Zimbabwe’s cholera epidemic and the collapse of the country’s healthcare system. The report, Health in Ruins: A Man-Made Disaster in Zimbabwe, exposes the state’s failure to maintain safe water, sanitation, or a functioning health system. PHR continues to monitor the health and human rights situation in the country.