In the past few years, health professional students across East Africa have become increasingly involved in health and human rights advocacy, coming together with peers and future colleagues, professors and the human rights community to demand policy and programming that protects and promotes the right to health.

In a few short weeks we'll be bringing these student advocates together for the East Africa Health and Human Rights Leadership Institute in Kampala, Uganda—organized in collaboration with our partner group in Uganda, the Action Group for Health, Human Rights and HIV/AIDS (AGHA).

From April 2-4, 2009 over 70 future health professionals from Uganda, Kenya, Rwanda, Burundi and the United States will meet in Kampala to build their knowledge on health and human rights, develop advocacy skills and share experiences with peers, health professionals and health rights advocates from across the region.

In total, 10 universities will be represented. This is a fantastic opportunity for students to come together to learn about their role in protecting and promoting human rights and to build the skills necessary for student-led advocacy for key policy and programming changes. Most importantly, it's a time for future health professionals from across the region (and the United States!) to share their experiences in advocacy—share their successes, their challenges and their plans for the future.

Three of us from PHR will be traveling to Kampala, along with 3 representatives from PHR's US student chapters, to join the students and our partners in East Africa. Keep checking back to see posts from some of the many students who have been working tirelessly to help us plan and prepare for this event. They'll be sharing with you how the Leadership Institute is proceeding, what they're learning and what this all may mean for the future of health professional student advocacy in East Africa and the United States.

It is already happening—Darfuris are dying—directly as a result of President Bashir’s expulsion of the humanitarian organizations.

Meningitis, a highly contagious disease, is spreading through one of Darfur’s largest camps for the internally displaced, Kalma, home to 90,000. Doctors Without Borders (known by their French name, Medecins Sans Frontieres (MSF)), was due to begin a vaccination campaign to prevent the spread of the deadly disease when they, along with fifteen other humanitarian organizations, were expelled by the Sudanese Government.

The expulsions came the day after the International Criminal Court announced a warrant for the arrest of Sudan’s President, Omar al-Bahir. The Sudanese Government, in turn accused these groups, which together provide more than half of the aid to Darfur of using humanitarian assistance as a facade to support the ICC and even fabricating evidence of human rights violations.

Because aid organizations depend on the approval of the host government to maintain access to the populations, they remain apolitical. It’s simply unrealistic and inconceivable that all of these organizations were secretly passing information along to the International Criminal Court.

But now, more than 1.1 million people face a very bleak future. The camps are crowded and sanitary conditions will quickly deteriorate, allowing the meningitis outbreak to spread through the Kalma Camp like wildfire.

Not all the suffering will be as dramatic or immediate. The World Food Programme will not have enough partners to distribute food to all of the displaced, so people will slowly go hungry. The wells that are used by thousands of people a day to get water for cooking, drinking and bathing will break, so people will go thirsty. As Susan Rice, the US Ambassador to the UN put it so succinctly, “This may well amount to genocide by other means.”

We cannot idly let this happen. Click here to take action.

Recently we sent out an urgent action alert about Zimbabwe human rights and civil leaders who have been jailed and tortured since their unlawful arrest in December 2008. More than 500 of you responded by emailing Professor Welshman Ncube, Chairman of the Joint Monitoring and Implementation Committee (JOMIC) and the director of the Zimbabwe Prison Service, and urging their release.

Your action made a difference. Last week, Justina Mukoko and Fidelis Chiramba, both named in our action alert, were freed on bail, along with several other activists.

"It's good to be free," Mukoko told a group of journalists from her bed in a clinic where she is being treated for health troubles. "The cloud that was hanging over me," is gone, she said. (CNN)

The fight is not over. Justin and Fidelis remain hospitalized, and they still face charges of terrorism for their heroic work to undercoverhuman rights abuses by President Mugabe's government. And other human rights activists remain in prison, including Movement for Democratic Change (MDC) activists Ghandi Mudzingwa and Kisimusi Dhlamini. But your efforts have reunited a mother with her children, and an activist with her freedom, which is amazing.

Your actions have helped secure the release of fellow human rights activists.

Joia Mukherjee, MD, Health Action AIDS Advisor and Medical Director of Partners in Health at the XVII International AIDS Conference in Mexico City, August, 2008

Health Action AIDS Campaign Advisor and Medical Director of Partners In Health Joia Mukherjee has a hard-hitting op-ed in today's Boston Globe, focusing on the importance of fulfilling the Obama Administration and Congressional commitments to combat global diseases.

In this time of global economic crisis, it becomes even more imperative that we keep our promises to the world's poor, who are even more affected by this crisis than those in the developed world. Funding the expanded commitment to PEPFAR and the Global Fund is critical to fight the three diseases that collectively kill 6 million people each year and cost African nations an estimated $12 billion a year in lost productivity. If this economic crisis has taught us anything, it's that the fate of one economy can affect all of us. By investing in health in poor countries, the United States helps to stabilize and grow the world economy.

During the Global AIDS Month of Action, PHR is marshalling the full resources of health professionals and students to echo Dr. Mukherjee's important call to action. Starting in the halls of Congress in Washington, DC later this month and continuing on Main Street and at universities, PHR Staff, health professionals, and students are calling on Congress to fully fund and implement PEPFAR.

You can join us by signing up for a meeting with yout local Congressperson at their district office. PHR will set up the meeting and provide training; we just need you to sign up to participate. Health professionals, students and concerned citizens can ensure Congress and the Administrations fulfill their commitments fight AIDS.

Dr. Peter Mugyenyi with a young patient in Uganda. (AFP 2005)

At the State of the Union address in 2003, President Bush made an announcement that changed the course of global AIDS. As the first non-American to attend the State of the Union of the guest of the First Lady, Uganda AIDS pioneer Dr. Peter Mugenyi, who will join PHR in DC this month, heard Bush lay down a mandate for the US—and a vision of hope for his country:

Today, on the continent of Africa, nearly 30 million people have the AIDS virus, including 3 million children under the age of 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than 4 million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims—only 50,000—are receiving the medicine they need… A doctor in rural South Africa describes his frustration. He says, "We have no medicines; many hospitals tell people, 'You've got AIDS. We can't help you. Go home and die.'" In an age of miraculous medicines, no person should have to hear those words.

On that night in Washington DC, President Bush asked Congress to put $15 billion over five years into the President's Emergency Plan for AIDS Relief, or PEPFAR. As President Bush said in his address,

Seldom has history offered a great opportunity to do so much for so many.

As Dr. Mugyenyi, the Executive Director of the Joint Clinical Research Center (JCRC)—a center of excellence for AIDS treatment, prevention, and research in Sub-Saharan Africa—heard these words, he felt an incredible sense of hope and relief.

Dr. Mugyenyi returned to Uganda in the late 1980’s after studying and practicing medicine abroad to find that HIV was destroying thousands of lives in his beloved country. Even though life-saving medicine was available in wealthy countries, it was out of reach for Ugandans. As Dr. Mugyenyi says in his 2008 book, Genocide by Denial, the vast majority of his patients during these days “died not just of AIDS but of poverty.”

PEPFAR changed this picture, bringing AIDS treatment to millions who could not afford it in Sub-Saharan Africa and the Caribbean. And Dr. Mugyenyi has been there, every day, providing treatment, research and prevention programs for thousands of Ugandans who previously had no chance at survival.

Now, in the midst of a global financial crisis, the US is considering scaling back on its commitments to global health programs like PEPFAR. PHR is very pleased to be hosting Dr. Mugyenyi in Washington DC from March 16-20 to raise awareness about the impact that a scaling back of commitments would have on the lives of millions in Sub-Saharan Africa.

Dr. Mugyenyi and hundreds of other African doctors know first hand what the outlook will be for their patients if this happens. We invite you to follow Dr. Mugyenyi’s visit to Washington DC on this blog over the coming weeks to learn more about why we must follow through on our commitments to global health and HIV/AIDS.

Woman and her daughter accessing integrated services in Kenya (Amanda Cary/PHR)

"Women have been split into parts – eyes, ears, heart, breasts – by the health system. We must see women holistically." (Margaret Gitau, Kenya's National AIDS/STD Control Programme).

This Sunday, March 8, PHR will join the global celebration of International Women’s Day—a day to honor the achievements of women around the world and to focus attention on the challenges and opportunities that lie ahead in the fight for gender equality.

Last year on this important day, Health Action AIDS launched a new campaign initiative entitled, Health Rights=Health Women: A Commitment to Halt the Feminization of AIDS. We have received tremendous support of this initiative over the past year and indeed have seen improvements in US global AIDS policies.

But the work is not over.

This year, International Women's Day coincides with the start of PHR's Global AIDS Month of Action. Starting today for the month of March, we will offer a weekly blog series featuring stories and lessons learned from a recent PHR trip to Kenya—as well as a library of advocacy resources to further your understanding of how integrating family planning and HIV services can help halt the feminization of AIDS and advance the right to health.

Women are particularly vulnerable to the epidemic due in part to fragmented health services and episodic care. The integration of reproductive health services, including family planning, and HIV/AIDS services is a rights-based intervention that addresses underlying conditions that fuel the AIDS epidemic, including stigma, discrimination, gender inequalities, lack of sexual and reproductive rights, as well as physical and social barriers to health services.

In December 2008, I traveled to Kenya where I joined my fellow PHR staffer, Lissy DeSantis, to learn from providers, clients, local NGO staff, and government officials about their experiences with integrating family planning and HIV/AIDS voluntary counseling and testing (VCT) services.

When we asked what service integration means to providers and clients in Kenya, the idea of a “one-stop shop for health” was echoed throughout our conversations. Integration happens when people can come to one health facility and receive multiple services during the same visit. Family planning is a key entry point to the health system for women and therefore an important time to provide HIV prevention and educational services. Likewise, existing (VCT) centers are key places to provide family planning information and services that should be available for all sexually active women. Integrating these services provides multiple entry points to the health system, while expanding the reach and uptake of HIV services.

"I ask myself, if I’m genuine about HIV, the women coming for family planning are sexually active and if I don’t tell them about HIV then I’m denying them an opportunity to know their status." (Emma, a nurse who pioneered the integration of services for women in the Nairobi area.)

Now more than ever we must be vigilant with our advocacy to promote women’s rights in the fight against AIDS.

Despite the many improvements in the reauthorized PEPFAR last year, the new bill failed to give needed attention to the integration of family planning and HIV/AIDS services for women. That’s why every week this month, as the Health Action AIDS Campaign kicks off a nationwide Global AIDS Month of Action, we will bring you more information on how to push the agenda forward on the integration of family planning and HIV/AIDS services.

Sunday is International Women’s Day: don’t sit this one out. Join us in making the right to health a reality for all women!

The consequences are nearly unfathomable.

In the last 48 hours, Sudan has expelled 16 international aid organizations from Darfur.  

The UN’s Office for the Coordination of Humanitarian Affairs estimates that, nearly overnight, 1.1 million people will be without food, 1.5 million without medical care and more than one million without drinking water. This could lead to widespread suffering and death within weeks.These humanitarian agencies have been providing the necessities of life to people in Darfur for many years, working in one of the world’s most challenging environments. And they were expelled en masse on the very day that the International Criminal Court released an arrest warrant for President Omar al-Bashir.

Humanitarian assistance is about feeding the hungry, and caring for the sick, and should not be politicized by the host government. As a spokeswoman for one of the expelled organizations said,

There doesn't seem to be much rhyme or reason to it all. None of us … have any kind of advocacy agenda or any connection to the International Criminal Court. It's really quite a mystery to everyone involved.

Our thoughts are with the people of Darfur and the aid workers who have worked with them. We hope that the Government of Sudan will reverse its decision and allow these groups to stay and provide life-saving assistance to the people of Sudan who need it.

UPDATE (3/9): Tsvangirai says crash an accident (BBC):

Mr Tsvangirai said there was only a "one in a thousand" chance that the incident involved any foul play.

UPDATE (3/8): Public remorse from the distraught driver of the truck that ran into the Tsvangirais leads some to believe the crash was an accident. The Movement for Democratic Change continues to insist on a full and impartial investigation. (Source)At PHR we follow the Zimbabwe news closely, so we were all distraught to hear this morning that the new Prime Minister, Morgan Tsvangirai, and his wife Susan were involved in a car accident today. The PM is apparently in stable condition at the private Avenues Clinic Hospital, but sadly his wife died.Hours later, we received an email from a close colleague and friend in Harare. She conveyed some of her suspicions:

We are in shock here at the death of Morgan Tsvangirai's wife today. His car met, as we say here, "A Black Dog"—an organized accident. ZANU-PF has done it many, many times to people who have gone against them.

She saw it first on SKY News.Then she changed the channel to the local ZBC news—mouth piece of the government—which waited until the end of its broadcast to mention that the PM was involved in an accident and that his wife was killed. Our friend heard that the ZBC didn't know how to handle the story, or they were not told to report it. She's also heard that in case of any unrest, the police and army are in position with water cannons and ready to beat up the citizens.She concluded:

This is the worst thing that could happen.

We couldn't agree more and extend our heartfelt sympathies to Morgan Tsvangirai and his family for the tragic loss of his wife. We urge a full and independent investigation, so the facts can be known and appropriate action taken.

I bet there are some women at the Farchana Refugee Camp in eastern Chad dancing today. When I was there last fall, some of the Darfuri refugees told me that ‘old women would get up and dance’ if Omar al-Bashir, Sudan’s rogue President and ‘mastermind’ of the genocide in Darfur, was arrested. Well, he hasn’t been arrested yet, but the International Criminal Court has issued a warrant for his arrest.

Unfortunately, the Court has no burly police force to enforce the warrant, so Bashir stays ensconced in Khartoum, with the stigma of being the world’s first sitting head of state to be wanted for war crimes and crimes against humanity by the world’s first permanent international criminal court.

Maybe now he can relate to the countless number of women who, because of the rapes that he ordered soldiers to commit against the women of Darfur, have brought shame upon their families. Maybe he will start to think about the thousands of villages rendered uninhabitable by his orders to plunder and destroy, and the families torn apart by murder and displacement. Hopefully, the women we spoke with at Farchana will see justice done.

The Court charged Bashir with five counts of crimes against humanity and two counts of war crimes, but not on the crime of genocide. PHR has learned that one of the three judges was prepared to issue the warrant on the genocide charge on the basis of what evidence they had before them, and that the two others are open to receiving more information (on specific intent) that would allow them to amend the warrant to include the genocide charge. PHR, which has seen the devastation in Darfur at close-range and has spoken to so many survivors, hopes that the Court will do so.

But now, the worry is the people still on the ground in Darfur. In the wake of the Court’s announcement, the Sudanese government swiftly revoked the licenses of at least six international NGOs operating throughout Sudan, giving them 48 hours to leave the country.

If this happens, millions may be left without humanitarian aid that they depend on.

Call the White House at 202-456-1111. Insist that the US tell Khartoum that this action will have serious consequences.

I attended the Senate Judiciary Committee hearing today on a “commission of inquiry” to examine Bush Administration policies governing detainee treatment.

Committee Chairman Senator Leahy (D-VT) introduced the hearing, stating:

We must not be afraid to look at what we have done, to hold ourselves accountable as we do other nations who make mistakes. We must understand that national security means protecting our country by advancing our laws and values, not discarding them.

Senator Arlen Specter (R-PA) conceded that he wouldn’t mind looking back if there is a reason to do so, acknowledging that torture is a violation of our law. How many more reasons does Senator Specter need? Here is one: Susan Crawford, convening authority of the Guantanamo military commissions, stated in a recent Washington Post article that Mohammed al-Qahtani was tortured, citing the “medical impact” of the techniques used against him.

You think of torture, you think of some horrendous physical act done to an individual. This was not any one particular act; this was just a combination of things that had a medical impact on him, that hurt his health. It was abusive and uncalled for. And coercive. Clearly coercive. It was that medical impact that pushed me over the edge.

Consequently Crawford dropped the charges against al-Qahtani.

On a related note, in his testimony, John Farmer, who has served as a senior counsel and team leader for the 9/11 Commission, cautioned that the abusive tactics have compromised our ability to respond to 9/11. Frederick A. O. Schwarz, Jr., Senior Counsel from the Brennan Center for Justice, echoed that sentiment in his testimony, stating that it is necessary to find out whether abandoning the rule of law has made us less safe. In his testimony before the Committee in support of a commission, Retired Vice Admiral Lee Gunn emphasized the problems Bush policies have created for our servicemen and women.

PHR believes that the integrity of military medical ethics must be restored by pursuing a thorough review and implementing guidelines that uphold medical ethics. In the statement we submitted for the record in today's hearing (PDF), we emphasized that

In addition to determining how health professionals came to be placed in harmful roles, the Commission needs to recommend that effective guidelines be put in place to ensure that such a gross subversion of medical ethics cannot be repeated. The Defense Department continues to mandate that health professionals play a major role in interrogations, through its Behavioral Science Consultant teams. This is ethically inappropriate. By helping interrogators determine when to push harder to get detainees to reveal information, health professionals abandon their role as healers and become instead advisors on calibrating harm. Psychologists and psychiatrists should be limited to training personnel in non-coercive rapport-building interrogation techniques…

The enormous prestige of the health professions in this country was earned over many decades, in part by adherence to a strict set of ethical standards. The participation of some health professionals in ethically disturbing and even criminal behavior while engaged with the national security apparatus serve to erode that high standing, especially if their actions are not investigated and corrected. The medical and health professions as a whole have a responsibility to support a national commission that will move toward a restoration of the highest moral and ethical standards, rooted in the respect for human dignity.

Senator Specter cautioned against criminalizing policy differences. That distorted rhetoric must be rejected. The authorization of torture is not a policy difference; the legal prohibition against torture is absolute and unequivocal. Exploitation of the law to conform to policy warrants an investigation.

In discussing the Office of Legal Counsel memos released earlier this week authorizing interrogations that violate human rights, Senator Leahy said, “How can anyone suggest that such policies do not deserve a thorough, objective review?”

The American people and the victims of abuse deserve the truth; the wrongs of the past must be uncovered, addressed and prevented from recurring.

Please help make a commission of inquiry a reality by signing the PHR petition in support of a bipartisan commission.

If you've already signed the petition help us get 10,000 signatures by sending it to six of your friends.