Originally published in Malaysiakini.

The integrity of the Malaysian government’s strong rhetorical support for the safety and protection of Myanmar’s beleaguered Rohingya minority got put to the test last week. And Malaysia failed to deliver.

On dangerously overcrowded boats, hundreds of Rohingya seeking refuge in the country from oppression and violence in Myanmar’s Rakhine state learned that the hard way. 

When they entered Malaysian territorial waters after making their perilous journey from Myanmar, Malaysian naval craft intercepted them, denied them permission to come ashore, and steered them back to open sea.

The official justification for that blatant denial of the universal right to seek asylum for a cruelly persecuted minority? The government’s concerns that “undocumented migrants who try to enter Malaysia either by land or sea will bring (Covid-19) into the country.” 

The authorities did so despite the fact that those fleeing persecution are protected under international law, and the United Nations Refugee Agency (UNHCR) has confirmed that countries must not deny entry to asylum seekers solely because of the Covid-19 pandemic.

All states have an obligation to address legitimate concerns about transmission of the novel coronavirus during this pandemic. But that should not be a pretext to deny refugees the right of asylum. 

Malaysian authorities could and should have tested the Rohingya refugees for coronavirus and then appropriately isolated or quarantined them to prevent possible transmission of the virus. 

Instead of undertaking such basic screening measures that would have ensured both Malaysian public health imperatives and the lives of the Rohingya refugees, the navy forced them to continue their perilous journey in search of safe harbour.

The dangers that the Rohingya face when they flee Myanmar by sea cannot be underestimated. The Bangladeshi coast guard reported on April 16 that at least 60 Rohingya died and hundreds of others were found starving on a boat that had previously been turned away from Malaysia. 

In 2015, intolerable conditions in Myanmar prompted thousands of Rohingya to attempt to flee the country by boat to neighbouring Malaysia and Thailand. A humanitarian crisis ensued when authorities in those countries denied them entry, resulting in an estimated 8,000 Rohingya stranded at sea for weeks after their smuggler boat crews abandoned them.

The timing of the Rohingya refugees’ arrival to Malaysia this month coincides with an escalating Myanmar military offensive in Rakhine and Chin states. The Myanmar military, or Tatmadaw, claims to target the insurgent Arakan Rohingya Salvation Army, which is seeking to establish a breakaway Rohingya state. 

The Tatmadaw is notorious for egregious abuses of the rights of Myanmar’s ethnic minority populations and the offensive has already reportedly claimed the lives of eight civilians in Rakhine.

Malaysia’s unwillingness to provide refuge for the fleeing Rohingya is incongruous with its official expressions of support for the persecuted minority in the wake of widespread and systematic violence against the group by Myanmar security forces in Rakhine in 2017. 

Then foreign minister Saifuddin Abdullah issued an unambiguous call in June 2019 for the perpetrators of that slaughter “to be brought to justice.” Then prime minister Dr Mahathir Mohamad declared a month later that the Rohingya were the victims of a “genocide” that merited them their own sovereign “self-governing territory.” 

Mahathir declared in September 2019 that the Rohingya had been targets of Myanmar government “institutionalised terrorism,” that included “mass killings, systematic rape and other gross violations of human rights (that) resulted in Rohingya fleeing the country en masse.”

New Prime Minister Muhyiddin Yassin, who took office in March, should not only repeat those assertions of support for the Rohingya, but bridge the gap between that rhetoric and action by accepting desperate Rohingya asylum seekers onto Malaysian soil.

Muhyiddin has an opportunity to demonstrate that states can and should balance public health concerns during the pandemic with the essential duty of every state to respect the right of asylum for victims of persecution. 

The Rohingya risking their lives to flee oppression and violence in Myanmar deserve nothing less.

Originally published in Malaysiakini on April 18, 2020

The COVID-19 virus has left its mark on all aspects of life, paralyzing entire countries, closing borders, and pushing the global economy to the brink of collapse. At a time when it is spreading across continents and exposing the weaknesses of health systems in the richest and most advanced countries, it is important to realize that the novel coronavirus has exacerbated threats against the most vulnerable populations in other countries – especially in war-torn or post-conflict places where internally displaced people (IDPs) and refugees struggle to survive.

In this moment, those farthest from view and at the highest risk must not be forgotten. Urgent action at all levels must include providing key public health measures to combat the spread of COVID-19. It should also result in a concrete strategy to mobilize adequate resources that will ensure access to services for all those who need them.

Iraq is a case in point. Since announcing the first COVID-19 case on February 24, the Iraqi central government, as well as the Kurdistan Regional Government, have taken strict measures to stop the spread of the virus, including closing borders, suspending schools, and ordering people to stay home. Unfortunately, staying at home is not a viable option for Iraq’s more than 1,665,000 Internally displaced people, 24 percent (277,000) of whom are living in 67 camps across Iraq.

The 2014 ISIS invasion of large areas of Iraq – in which fighters of the self-declared “caliphate” targeted Yazidi and other ethnic and religious minorities, massacring men, abducting  children, and kidnapping  women and girls into sexual enslavement – forced hundreds of thousands of people to flee their homes to seek safety. People hastily left their livelihoods, their families, and communities to live in dire situations: in tents that afford no protection from extremely high summer temperatures nor from severe flooding in winter.

Dr. Nagham Hasan, a Yazidi gynecologist and activist who has dedicated her life to advocating for the rights of her people, warns that the teeming camps that house displaced Yazidi offer a prime setting for a COVID-19 outbreak: “These camps are overcrowded, large families live in each tent, and they share bathrooms and other facilities. There aren’t enough sanitary materials or enough medical supplies.”

Mr. Fadel al-Gharawi, a commissioner at The Iraqi High Commission for Human Rights (IHCHR), which has been monitoring the governmental response to COVID-19, cautions that camps for IDPs could become epicenters for the spread of the virus, as they lack proper health services as well as the possibility for residents to implement safe quarantines. The IHCHR also points out that IDPs have weakened immune systems due to the deteriorated health, humanitarian, and nutritional systems available to them.

Curfews and movement restrictions are also impeding the delivery of assistance in Iraq, including programming related to COVID-19 prevention, preparedness, and response, according to reports from the United Nations Office for the Coordination of Humanitarian Affairs and other humanitarian actors.

The looming threat of COVID-19 comes amidst a decrease in humanitarian funding to IDP communities following the retaking of the city of Mosul from ISIS control in July 2017. While the Iraqi federal government is implementing various measures in IDP camps, including disinfection campaigns, these are not commensurate with the magnitude of the impending public health crisis.

This is particularly true in cities like Dohuk, which borders the most conflict-affected areas in Iraq and saw the greatest influx of people seeking safety after the 2014 ISIS attacks. According to a humanitarian aid worker in Kurdistan, who asked for anonymity out of safety concerns: “Many international humanitarian NGOs have been leaving Dohuk, which hosts the largest number of IDPs, so the services they offer to these people are being reduced, even though it is not yet safe for them to return home. There is less food being distributed and few medical and other services, [and] there are fewer jobs in the camps or available nearby, so [people have] little income to purchase necessary materials to protect themselves from the coronavirus.”

The fear that COVID-19 could spread in camps is pervasive. Containing it will be challenging, given the difficulty of tracking, testing, and isolating suspected cases. Dr. Hasan explains: “Doctors and volunteers are working non-stop with whatever available capacities to help the communities in IDP camps. For now, we are working to produce masks locally and conducting awareness campaigns to explain to these communities what the symptoms are, how to wash hands, and how to maintain social distancing to the extent possible, in their unusual circumstances.”

But much more is needed. Now more than ever, it is crucial that the Iraqi government, the Kurdistan Regional Government, and the international community work together to recognize the risk COVID-19 poses to IDPs and collaborate to prioritize the health, both physical and mental, of the displaced. This coordination must include rearranging priorities and allocating budgets to rapidly respond to the needs of these communities, starting with providing water and basic cleaning and sanitary products and continuing with designing creative ways for IDPs to access services.

This pandemic is inherently indiscriminate and must be confronted with every tool in the public health and humanitarian arsenal. Multipronged and inclusive national and international efforts to respond to the coronavirus should be fully integrated into emergency response plans not only in Iraq, but in all conflict-affected countries.

There is a dangerous new hazard facing health workers who speak out about the health risks posed by inadequate resources necessary to safely treat COVID-19 patients: intimidation and even termination by their employers.

Across the United States in recent weeks, reports have surfaced of doctors and nurses who have lost their jobs in reprisal for publicly criticizing perceived safety lapses at the health facilities where they work. These include three doctors and a nurse in Mississippi reportedly fired earlier this month “after raising concerns about COVID-19 safety measures in hospitals,” including insufficient supplies of personal protective equipment (PPE), such as N95 respirators. There have been similar firings or disciplinary measures against  health workers who have spoken out publicly about what they perceived as unacceptable risks to themselves and their patients due to inadequate PPE supplies in Washington State, Chicago and New Jersey.

Some hospitals or their managers are threatening or punishing health workers who bring to work their own PPE in response to insufficient availability of such equipment in their workplaces. Weill-Cornell Medical Center in New York has reportedly suspended an emergency room physician after she brought her own PPE to work. It is currently uncertain whether the physician will retain her job. The California Nurses Association and National Nurses United warned last month that Kaiser Permanente has threatened to fire health workers at its hospitals and clinics in California who respond to PPE shortages by bringing their own supplies to work.

The shortages of PPE for frontline health workers during this pandemic is an international crisis. Shortages of surgical and N95 masks and equipment rationing for health workers have become the hallmark of the deficient government preparedness and response to the crisis. Those shortages are forcing some doctors and nurses to create homemade masks of dubious efficacy. But health workers can and should have the freedom both to speak out publicly about the health implications of those shortages and to take measures to protect themselves, not least because the nature of their work in the pandemic means that lax safety measures can be life threatening. New Jersey-based Dr. Frank Gabrin on April 6 became the first U.S. emergency room physician to die of COVID-9. Gabrin died two weeks after expressing concerns to a friend that he didn’t possess “any PPE that has not been used.” New York-based Mount Sinai Hospital intensive care unit nurse Tre Kwon calls such tragedies “absolutely preventable deaths” due to their link to inadequate PPE.

Some hospitals are also proactively seeking to prevent their health workers from speaking out about those concerns with gag orders backed by threats of punishment for expressing their complaints publicly. New York City’s NYU Langone Health management has warned its employees that they risk “disciplinary action, including termination,” for speaking to media without authorization. Another New York hospital firm, Montefiore Health System, has likewise warned its staff that they are forbidden to speak to the media “without pre-approval.”

Physicians for Human Rights strongly condemns any retaliation against health workers who seek to expose the truth based on facts about unsafe conditions that they and their patients encounter when their concerns go unaddressed by employers who turn a deaf ear to those issues. Health workers’ professional associations are likewise outraged. The Washington State Nurses Association (WSNA) on March 28 declared that “no health care worker should face being disciplined or fired for speaking the truth” and urged that they be free to expose “where our health care system is falling short in its response to COVID-19.” That same day, the American Academy of Emergency Medicine likewise defended the right of health workers to speak out about perceived safety lapses in their workplaces by asserting the “essential duty of a physician to advocate for the health of others.” The American Medical Association declared on March 31 that health workers should have the right to use their own personal PPE “when these critical resources are unavailable and not provided by their employer.” The American College of Physicians the Council of Medical Specialty Societies have all echoed that call and supported the right of health workers to expose health and safety lapses in their workplaces “without fear of retaliation.”

We need to stand with the doctors, nurses, public health specialists, and others on the front lines of this pandemic and demand that hospital administrations respond to their concerns. This unprecedented public health crisis requires us to  wash our hands, maintain safe “social distance,” and ensure that our health workers are supported, not silenced.

A nurse in the city of Kolkata in West Bengal recently learned first-hand the price that Indian health workers are paying for being first responders in the Covid-19 pandemic: an eviction notice.

The nurse’s landlord attempted to justify the 48-hour eviction order by claiming that health workers during the Covid-19 pandemic posed a significant risk of coronavirus transmission to their neighbors. Despite the fact that the nurse took pains to explain that she didn’t work in Covid-19 treatment sections of the hospital, “She would not listen to me,” the nurse said. “She told me … This is why thousands of people around the world have been infected. You have to leave the apartment.”

This shocking instance of stigmatization of India’s health workers at a time when their skills are essential in saving lives of patients who have contracted Covid-19 is not unique. Across India, doctors, nurses, and other health workers are facing eviction by landlords and neighbors who allow their fear and ignorance to drive them to grossly discriminate against health workers in their midst.

The problem has become so acute that the New Delhi-based Resident Doctors Association of the All India Institute of Medical Sciences (AIIMS) warned on March 24 that the rising number of such evictions means that “many doctors are stranded in the road with all their luggage, with nowhere to go, across the country.”

But health workers aren’t just receiving eviction notices. They are also the targets of unlawful harassment and intimidation by neighbors who consider the presence of health workers in their communities an unacceptable risk during the Covid-19 pandemic.

A group of Dr Sanjibani Panigrahi’s neighbors intercepted her as she returned home from a hospital shift in the western city of Surat at the end of last month, threatening unspecified “consequences” if she continued working. Some hospital workers facing harassment and intimidation from their neighbors are now sleeping in their workplaces to avoid such confrontations.

It’s unconscionable that Indian health workers are facing public ostracism and homelessness for merely fulfilling their professional obligations during a global health crisis. Such abuse is not just unlawful, it demoralizes the key components of a national health system that was already dangerously stretched prior to the pandemic.

India’s ratio of doctors to citizens is one per 1,445, almost 50% below the World Health Organization’s recommended standard of one doctor per 1,000 citizens. Without robust government intervention, some Indian doctors may well decide that their safer course during the pandemic is to stop practicing in order to avoid the double risk of public hostility and possible coronavirus infection.

So far, the Indian government’s response to these abuses has been heavier on rhetoric than action. Home Minister Amit Shaw late last month instructed police in Delhi to protect doctors from unlawful eviction, but it’s uncertain how effective that order has been. The health minister issued a statement on March 24 via Twitter stating that he was “deeply anguished” by reports that “doctors and paramedics are being ostracized in residential complexes” and urged the public not to panic. Prime Minister Narendra Modi has also spoken out in defense of health workers facing unlawful eviction due to coronavirus fears by stating that “In this time of crisis, any person wearing a white coat in a hospital is an incarnation of God.”

But despite Modi’s evocation of the divine in defense of Indian health workers, eviction is just one of the problems they face during the Covid-19 pandemic. Like clinicians elsewhere, Indian health workers are deeply concerned about unsafe work conditions created by the worldwide shortage of personal protective equipment (PPE), including surgical masks and N95 respirators. Those shortages have been so acute that some health workers in India have resorted to wearing raincoats and motorcycle helmets in the absence of surgical gowns and masks.

The shortages have prompted numerous Indian health workers to speak out publicly about the lack of protective gear and to demand accountability for those shortfalls and swift government action to remedy them. However, as in other countries, some Indian health workers who have spoken out for adequate PPE have reported reprisals for doing so. In an April 6 letter to Prime Minister Modi, the  Resident Doctors Association of the AIIMS complained that health workers “have received a harsh backlash” for going public with their concerns about PPE inadequacies.

India’s health workers deserve better. As the country faces what health experts warn will be an “onslaught” of coronavirus infections over the coming weeks, the onus is on the government to protect its health workers in every way possible and to defend their ethical obligation to speak out about safety risks.

Originally published in Asia Times

For the past month, although I am a physician, I have been watching from the sidelines as many friends and colleagues have become overwhelmed caring for patients with COVID-19. As the medical director of Physicians for Human Rights (PHR), I have been working in other ways to do my part, campaigning to demand more personal protective equipment (PPE) and other measures to protect health workers, patients, and caregivers. In my own outpatient primary care clinic in Ann Arbor, Michigan, I adapted my practice to caring for all non-urgent matters virtually, and marveled at how many of my patients appreciate staying in their own home while we talk, review their medications, and discuss how they are feeling and managing their health conditions. “Why didn’t we do more virtual visits before? These are often so much better for patients,” I enthusiastically emailed my colleagues.

Now, however, I am gearing up to join the tens of thousands of health workers – physicians, nurses, respiratory therapists – who are directly caring for those at most risk of dying from COVID-19 – or continuing to care for people hospitalized for heart attacks, heart failure, and all the illnesses that don’t stop in the middle of a pandemic. Here in southeast Michigan, we watched with horror as elsewhere in the country the number of people with severe cases of COVID grew exponentially. But now, after what was only a few extra days, the surge is here, too.

The patients I encounter in the coming days and weeks will have access to standards of medical care that the tens of thousands of migrants who are being forced to wait at the U.S. border as a direct result of U.S policies or who are being held in U.S. immigration detention centers can only dream of.

Like many other physicians who have not provided inpatient hospital care for years or decades, I will soon report to join the health care workers who have been working around the clock in local hospitals. Our colleagues initially cared for a trickle of cases, now for the overflow from the already-full hospitals in Detroit, and soon for the projected explosion of cases in the coming weeks. The notice of my assignment explains that those of us redeployed to inpatient care will be expected to work in the hospital a week at a time over the next months. I will put on hold my research, teaching, work for PHR. It’s a transition I could not have imagined just a month ago. But it reflects how the pandemic and the necessary societal response to it has upended the lives of all of us.

It’s still unclear whether I will be assigned to a floor dedicated to the treatment of COVID-19 patients or will instead treat patients with other health issues. If assigned to work in an intensive care unit, I am assured that I will be paired with an experienced critical care doctor. I feel reassured by that, and also by knowing that the nurses are all outstanding and highly experienced. As during my internal medicine residency, everybody will pull together. But I still fretfully wonder if I have enough hours to read all the preparatory materials our hospital has provided to prepare those of us who have devoted our last decades of clinical work to outpatient primary care.

I recognize though that – for now, at least – I am in a fortunate position compared to many of my colleagues in New York City – the U.S. epicenter of the outbreak – as well as in many other parts of the country, including nearby Detroit. And we are in an incomparably fortunate position compared to many places around the world, especially where health systems are weak or almost nonexistent. For now, the growth in expected cases here is in line with the hospital’s careful modeling. There has clearly been extensive planning and preparation over the past weeks. Our clinical leadership send daily emails to all of us on faculty and staff with clear and thorough updates. And, as important, there appear to be no imminent shortages of PPE, such as N95 masks and surgical gowns for health workers, or ventilators for those patients who need them.

I am acutely aware that the current resources at our hospital far outstrip those of hospitals in countries shattered by war and conflict. And that there are essentially no resources now to help populations around the world who are at high risk, such as the Rohingya refugees in Bangladesh or the internally displaced Syrians in the besieged northwest of their country. I am also acutely aware that the patients I encounter in the coming days and weeks will have access to standards of medical care that the tens of thousands of migrants who are being forced to wait at the U.S. border as a direct result of U.S policies or who are being held in U.S. immigration detention centers can only dream of. Moreover, most of the patients I will care for are not undocumented or recent immigrants. They thus do not live in fear that by accessing necessary medical care they will be deported or blocked from changes in their immigration status under the recently enacted Public Charge Rule, a new rule stating that individuals who use certain public benefits can be denied legal residence documentation.

What I share with physicians and other health professionals worldwide is outrage about how COVID-19 misinformation has spread and imbued the general public with deep anxiety and mistrust. While state and local leadership in Michigan has responded to the pandemic with clear information and vigorous protections, I remain frustrated and angry at the lack of strong and consistent federal leadership and transparency that a national and global public health crisis demand. And I fear for colleagues, friends, loved ones, and acquaintances who I know are particularly susceptible to the virus because of their age, underlying conditions, or inability to access the care they will need.

In early March, we traveled to the southern border in Texas to document how U.S. policies have trapped asylum seekers and other migrants in unsafe cities in Mexico. As an attorney and a physician who defend the right to asylum with Physicians for Human Rights (PHR), we are deeply concerned about how the rapid spread of COVID-19 will exponentially add to the dangers – including robbery, abduction, and human trafficking – that migrants already face there.

Since January 2019, the Trump administration has returned some 60,000 asylum seekers to Mexico under the so-called Migrant Protection Protocols (MPP). MPP requires them to wait for months in border towns that are deemed among the world’s most dangerous while their cases crawl through U.S. immigration courts.

In Texas, we witnessed the cruelty that these policies have inflicted on some of the region’s most persecuted people. We watched Maria* (name changed to protect her from reprisals), a Venezuelan woman seeking asylum, break down in tears on a video screen in a San Antonio immigration court after the judge informed her that her next asylum hearing was more than four months away. Maria participated in the proceedings from a tent facility at the border, approximately 150 miles from the court. At risk of kidnapping and extortion by cartels in Mexico, Maria pleaded in vain for an earlier court date. She and the other asylum seekers in that tent court would instead cross the bridge back to Nuevo Laredo, Mexico after the day’s hearings.

Maria’s perception of the risks on the Mexican side of the border were no exaggeration. Over the past 14 months, there have been public reports of more than 1,000 asylum seekers returned to Mexico under MPP who were victims of “murder, rape, torture, kidnapping, and other violent assaults.” Asylum seekers waiting along the border also have very little health care infrastructure to support them.

In similar hearings in San Antonio and Brownsville, we witnessed women, men, and children from across Latin America subjected to similarly inhumane bureaucratic disregard for the urgency of their asylum claims. One morning, when the judge asked all 30 assembled asylum seekers to raise their hands if they were afraid to go back to Mexico, 25 hands shot up.

If and when COVID-19 rips through asylum seekers’ encampments and shelters, those who contract the virus have little hope of accessing adequate care in Mexico.

U.S. asylum seekers’ perilous, months-long wait in Mexico has now become potentially indefinite. The Trump administration has used the threat of COVID-19 to suspend MPP legal proceedings through at least May 1 and to close the border to all new asylum seekers, despite the fact that novel coronavirus infection rates are far higher in the United States than in Mexico. Nonetheless, the new policy contains a built-in transmission risk for asylum seekers in MPP. They are required to present at ports of entry on their previously scheduled hearing dates to receive new hearing dates, which means they must interact with Border Patrol personnel who could be carriers of the virus. They face expulsion from MPP if they fail to show up.

Courts should absolutely be closed to prevent spread of infection. But doing so without offering migrants the opportunity to seek asylum at the border and to wait for their court dates in the United States is not only cruel, it is potentially lethal, as it exposes them both to the risks of violent crime and to a possible COVID-19 outbreak in crowded migrant encampments or shelters along the Mexican side of the border. The director of the U.S. Centers for Disease Control (CDC) himself stated that a COVID-19 outbreak among MPP participants is “inevitable” under current conditions.

If and when COVID-19 rips through asylum seekers’ encampments and shelters, those who contract the virus have little hope of accessing adequate care in Mexico. Matamoros – a city of more than half a million that hosts a migrant population of 3,000 in just one camp – has only 25 ventilators and 11 critical care beds. Matamoros public health officials warn that a widespread COVID-19 outbreak in that camp would “collapse” the city’s health system.

These grave risks are a direct result of U.S. policies that are as callous as they are unnecessary.

These grave risks are a direct result of U.S. policies that are as callous as they are unnecessary. An estimated 92 percent of migrants trapped on the Mexican side of the border have family members or close friends in the United States with whom they could quarantine safely. Community-based alternatives to detention have extremely high rates of compliance and much better health outcomes.

The United States is obligated under both international and domestic law to honor the right to seek asylum. The U.S. government should conduct initial health screenings of asylum seekers at ports of entry and then release them to their families in the United States, through parole or other community-based alternatives to detention. History will judge the United States harshly if the country closes its doors to asylum seekers now.

Doctors, nurses, and other health workers are the acknowledged heroes of the Covid-19 pandemic. So why do so many online commentators apparently want Dr. Anthony Fauci dead?

Fauci, the U.S. government’s top medical voice on the pandemic and director of the National Institute of Allergy and Infectious Diseases, now requires a personal security detail due to a torrent of threats to his safety. The anonymous online sources of those threats absurdly label him a Trump opponent and characterize his public health recommendations to contain the novel coronavirus as inaccurate and reflective of a politicized agenda. These allegations have prompted a stream of bilious online invective against Fauci, with hashtags like #FauciFraud and #FireFauci.

The online smears, threats, and disinformation against a public health official would be obscene under any circumstance — and they are especially so now, in light of the prudent, science-backed measures and precautions Fauci has championed to mitigate the spread of the coronavirus. But these calumnies also underscore how health workers have become targets for people — official and unofficial, in the U.S. and worldwide — seeking to inhibit and undermine sound, evidence-based medicine that saves lives and alleviates suffering.

The earliest of these threats could be seen in the Chinese government’s persecution of medical whistleblowers in the pandemic’s original epicenter in Wuhan city. They include Dr. Li Wenliang, whose December 30, 2019 warning to the public via social media of the severity and contagiousness of the novel coronavirus resulted in police detaining him and threatening him into silence.

Another Wuhan-based whistleblower currently under threat is Dr. Ai Fen. She publicly disclosed two weeks ago that government officials had silenced her and other doctors, preventing them from publicly disclosing the severity of the outbreak. Ai has gone missing and is assumed to have been detained by the authorities. Revelations this week that the Chinese government has deliberately misrepresented the severity of the outbreak and its death toll in China perpetuate an environment in which Chinese doctors will continue to have to choose between honoring their professional ethics and risking official reprisals for doing so.

Government threats against health workers urging sound, science-based medical approaches to addressing the pandemic aren’t limited to Chinese authoritarians. Brazil’s President Jair Bolsonaro has subjected his health minister, Dr. Luiz Henrique Mandetta, to withering criticism and threats of dismissal for questioning Bolsonaro’s unwillingness to adopt essential measures to mitigate the outbreak among Brazilians. Bolsonaro has sought to undermine Brazilian states’ lockdown measures designed to “flatten the curve” of infection by calling for Brazilians to return to work. Mandetta’s pleas that doing so would result in catastrophic loss of life from Covid-19 — one that he warned would “collapse” the country’s health system by the end of April — prompted Bolsonaro to respond: “Some will die. I’m sorry. That’s life.”

Other state leaders are demonstrating contempt for the expertise and lives of health workers by ignoring their pleas for a more robust state response to the worldwide shortages of medical personal protective equipment (PPE), such as N95 masks. An egregious example of this callous disregard came last week from Philippine President Rodrigo Duterte, who called health workers who have contracted and even died from Covid-19 in the line of duty “lucky” because they “died for the country.”

Such politicized, anti-science backlash against health workers seeking to contain a deadly public health threat have disturbing and far-reaching implications — and they are everywhere. Even in the U.S., reports have surfaced of hospital staff being threatened with firing if they speak out publicly about the lack of resources — masks, gloves, and even tests for themselves and their growing rosters of patients. And it’s not just threats: As Bloomberg reported last week, the firings have already begun. “Hospitals are muzzling nurses and other health care workers in an attempt to preserve their image,” Ruth Schubert, a spokeswoman for the Washington State Nurses Association, told the news outlet. “It is outrageous.”

This is a time when we need our health workers to be fully engaged in their work and to have their fears and concerns given the highest consideration. The respective plights of Fauci and China’s health care whistleblowers, and the steamrolling of health workers’ concerns in the Philippines and Brazil, can have a pernicious chilling effect on health workers entrusted to ensure public health best practices in addressing the pandemic.

We need to stand with the doctors, nurses, public health specialists, and others who are leading efforts to address the pandemic. And that requires ensuring that medical science, public health best practices — and the professional health workers who implement them — are supported, not threatened or silenced.

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Phelim Kine oversees the research and investigations team at Physicians for Human Rights, a U.S.-based non-profit organization using medicine and science to document and advocate against mass atrocities and human rights violations globally.

This article was originally published on Undark. Read the original article.