Susannah Sirkin, director of international policy and partnerships at Physicians for Human Rights (PHR) attended and presented at the Assembly of States Parties to the ICC Plenary Panel Session on Cooperation and Sexual and Gender Based Crimes on December 11, 2014, in order to bring a medical and forensic voice to the panel of legal experts and leaders. Here are her prepared remarks.
In light of the release of the executive summary of the Senate Select Committee on Intelligence (SSCI) report on CIA enhanced interrogation techniques – which stated that rectal hydration or feeding was inflicted on at least five detainees – Physicians for Human Rights (PHR) compiled this fact sheet on rectal hydration and rectal feeding. The use of rectal hydration and feeding, according to the SSCI summary, was conducted "without medical necessity." Moreover, the SSCI summary indicates that rectal hydration was used to control and/or punish detainees. Learn more in our fact sheet.
This analysis by Physicians for Human Rights (PHR) of the U.S. Senate Select Committee on Intelligence (SSCI) report’s executive summary builds on years of investigation and research documenting the systematic use of torture by the United States following the September 11, 2001 attacks. A detailed review of the 500-page SSCI executive summary was conducted by a team of PHR experts.
The torture report’s executive summary describes in detail the acts and omissions of CIA health professionals who violated their professional ethics, undermined the critical bond of trust between patients and doctors, and broke the law. Based on PHR’s detailed review of the SSCI summary, health professionals who participated in the CIA torture program violated core ethical principles common to all healing professions, including the following obligations:
PHR calls for a federal commission to investigate, document, and hold accountable all health professionals who participated in the CIA torture program.
This week in Strasbourg, France, the European Parliament bestows its most prestigious human rights award, the Sakharov Prize, to Dr. Denis Mukwege, who is world-renowned for the struggle to prevent rape in the war-ravaged and underdeveloped Democratic Republic of the Congo (DRC). A fiercely devoted gynecologic surgeon, he and his hospital have treated thousands of women whose bodies have become, in his words, a “battlefield” during decades of violence – especially in the eastern region bordering Lake Kivu and Rwanda, where millions have died and untold numbers have been brutally raped.
As Dr. Mukwege’s work is celebrated in Europe, he and his colleagues at the hospital are responding to an epidemic of unsolved rapes of very young girls and infants in the Kavumu district, just outside the South Kivu capital of Bukavu. This area is ironically near the airport that also serves MONUSCO, the largest peacekeeping operation in the world. More than 23 victims of rape between the ages of six months and 12 years have arrived at Dr. Mukwege’s hospital for emergency surgery during the past 18 months – often bleeding profusely, with their reproductive organs mutilated and shattered. I visited Panzi Hospital this past October and saw some of these tiny girls clinging intensely to their doctors – their heads buried in the arms of their beleaguered caretakers. According to witnesses, these children have been kidnapped from their homes at night, brutally assaulted, and often left on the street or in nearby fields. It is believed that a network of perpetrators is involved, but so far a thorough investigation and prosecution have proven elusive, letting the brutal sexual assaults to continue.
Meanwhile last month in the capital, Kinshasa, the Congolese President’s Personal Representative on Sexual Violence and Child Recruitment, Jeannine Mabunda addressed an assembled group of leading jurists, military magistrates, government officials, and international donor governments, including the European Union. “We need to change the narrative,” she announced. “The Democratic Republic of the Congo can no longer be known as the rape capital of the world.” Mabunda proceeded to recite the progress her government has made in supporting survivors, prosecuting perpetrators of mass sexual violence, and even sustaining the recent unprecedented conviction of a general in the Congolese Armed Forces for mass rape. Emphasizing a policy of zero-tolerance for sexual violence, the personal representative stressed that, “It’s the activities on the ground and the proximity of the justice system” to the victims that matter.
However, changing the narrative will take much more than rhetoric, as Dr. Mukwege and all those who work with him in delivering a holistic response to sexual violence well know. It will take sustained governmental and private leadership; transparent and effective investments in medical and psycho-social assistance; committed, well-trained, and properly salaried police, lawyers, and judges; and support to grassroots women’s organizations working to end stigma and discrimination. They all must be able to advocate openly and safely when they see malfunctions or malfeasance in the response to this crisis.
In order for this essential work to be successful, first responders and human rights advocates must be protected and supported. For all the global attention and local support to Dr. Mukwege and his hospital, a brazen armed assault on his household in 2012 – that took the life of his trusted bodyguard and terrified him and his family – remains unsolved, under-investigated, and unpunished. As a result, the doctor courageously continues his work in an environment of fear, essentially locked down for weeks at a time in his hospital compound, and requiring security escort whenever he travels. Sadly, this situation is not unlike dozens of other cases of murder and rape where the failure of local and national courts to investigate and prosecute serious crimes leaves communities with a deep sense of fear, insecurity, and mistrust of authorities. The ongoing impunity also fuels a vicious cycle of violence and revenge.
There are surely signs of hope and progress in the face of these horrors. Clinicians continue to work bravely to heal wounds and document injuries for those survivors who seek access to justice. Dedicated gender police work with limited resources at their disposal to investigate these crimes and collaborate with those prosecutors who are committed to ending impunity for sexual violence. But what is lacking in solving these crimes and changing the narrative is a serious investigation and prosecution strategy supported by local and national political authorities. Solving the attack on Dr. Mukwege and his household, and stopping the rapists in Kavumu, would be good next steps.
Traffic is horrible on my drive back to Nairobi from a suburban town on the outskirts of the capital, where the Program on Sexual Violence in Conflict Zones at Physicians for Human Rights (PHR) has just finished its latest training on forensic documentation. Between the stop and go, I meditate to the drone of trucks brimming with goods from the coast and the brightly painted busses, all clamoring for passengers and space on the busy Mombasa Highway. My attempt at concentration is interrupted when my phone buzzes in my pocket. It’s a text from the participants of our recent training, inviting me to join a new social networking group for the medical-legal network they created just hours earlier. Only three days ago, these participants were largely strangers, meeting with our team for the first time to learn about documenting crimes of sexual violence. Their dedication is remarkable: as they sit in the same traffic on busses headed back to their neighborhoods, they are already building the medical-legal network that will ensure that survivors of sexual violence in their country receive justice.
PHR has helped local activists create numerous self-governing medical-legal networks across Kenya and the Democratic Republic of the Congo to help facilitate collaboration and cooperation among medical professionals, legal and judicial experts, the media, local communities, and NGOs. These networks allow local professionals to meet one another and work together to ensure that victims receive the care they need and that perpetrators are held to account.
During PHR’s three-day training, Joseph Kibet, a police officer, reflected on the value of the network he helped create in his home community of Eldoret, Kenya. He remarked, “You can never handle a survivor [of sexual violence alone]. You need other people. Being a police officer, I need a medical officer, I need a social worker, I need a community, my other colleagues in the police force, I need a prosecutor, and a judge.”
The power of community-driven medical-legal networks was best described to me by Dr. Edith Onyango, an obstetrician/gynecologist at Kenyatta National Hospital, who told me that the networks allow her to refer patients to specific individuals in the legal or law enforcement fields. She tells me that when survivors come to her hospital, she is able to tell them, “You will meet so-and-so, and you’ll be seen.” No longer forced to navigate a complex system alone, survivors are able to speak with a specific professional who has specialized skills for working with survivors of sexual violence. Soon, the daunting process becomes streamlined. The simple process of connecting the necessary professionals who then work together has a powerful impact on the lives of survivors.
As I put my phone away, I am brought back to the commotion of the busy highway and am once again lost in thought. I am inspired by this group of activists, who are now using their time stuck in gridlock to advance their work together. They are committed to providing survivors of sexual violence with the support they need, enabling not only the individual victims, but also entire communities, to heal. This is what activism really means: using every possible moment and the power of collaboration to advance the cause of justice.
Last week, President Obama announced the Immigration Accountability Executive Action, which temporarily defers deportation and provides work permits for an estimated 4.9 million undocumented immigrants. While this announcement is a welcome effort to bring undocumented immigrants “out of the shadows,” advocates remain deeply concerned over how the executive action will affect asylum seekers, unaccompanied children, and other vulnerable groups. Asylum seekers in the United States already face a process that largely fails to protect their rights. In the absence of comprehensive changes – beyond what the new order provides –the defects in our asylum system will remain, if not worsen.
Among other reforms, the executive action instructs the Department of Homeland Security (DHS) to create Deferred Action for Parents (DAP) – a program that will suspend deportation and provide work authorization for parents of children who are U.S. citizens or legal permanent residents born on or before November 20, 2014, and have resided in the United States for at least five years, passed background checks, paid fees, and are not otherwise ineligible.
Significantly, the president’s action also rolled out a Priority Enforcement Program, which creates categories of “good” and “bad” immigrants, heightening existing concerns for asylum seekers. In the “bad immigrant” priority category, along with “terrorists,” “gang members,” and “felons,” are those apprehended at the U.S. border. Measures to identify asylum seekers arriving at the border already fail to adequately screen those who may qualify for humanitarian protection. Ramped up efforts to militarize the border and expeditiously deport recent arrivals will make an already defective process even worse.
No reforms to the existing detention system were included in the executive action. In fact, in less-reported news, DHS announced plans to open a new detention facility in Dilley, Texas, which will house approximately 2,400 individuals, most of whom are families with children fleeing deadly violence in Central America. Asylum seekers arriving at the border, asking for protection, will continue to be detained.
Some advocates also question how the new program will affect those who have already been waiting excessively-long periods of time for hearings or interviews at immigration court and U.S. Citizenship and Immigration Services. Until Congress acts to fully fund these agencies, asylum applicants who already wait in limbo for several years to have their cases heard may now have to wait even longer.
The president devoted about half of his announcement last week to discussing American values, saying his actions were a reflection of “who we want to be as a nation.” But do we really want to be a nation that deports vulnerable children back to countries where they are forced to join violent gangs? Do we want to be a nation that locks up women who have committed no crime, but are trying to keep their children safe? If our immigration system is to truly be a reflection of our values, we have a long way to go.
Of course, it is important to celebrate our victories. President Obama’s actions will bring reprieve, albeit temporarily, to many members of our communities. This is due primarily to the tireless efforts of grassroots activists who pressed hard at every level of government, from the bottom up. But for the millions more who were left out of this action and continue to wait in fear and uncertainty, we must keep the momentum going. There is a long way to go before we have a truly humane immigration system that upholds American values. Let’s get to work.
Amal Leila* on November 4, 2014
This post originally appeared on Syria Deeply.
‘I wish that the urgency that moved the U.S. and other governments to bomb ISIS was matched by an urgency to save the lives of civilians’
Before the uprising began more than three years ago, the Syrian healthcare system was suffering, but now it is in critical condition and desperate need of life-saving support.
The increase in casualties caused by the international campaign against ISIS may well be what makes the already unbearable situation in the opposition-held areas of Syria, where I work, even more unbearable. The work is demanding – not just because we are trying to save lives in a war zone – but because there are so few of us left.
Approximately 70 percent of doctors who were practicing medicine in 2010 have now left the country. The 30 percent who remained have been decimated by detentions, torture and executions at the hands of Bashar al-Assad’s intelligence service, which considers it a crime punishable by death to provide medical treatment to “the other side.”
Then there are the near constant attacks on hospitals, which not only destroy the structures and equipment, but also result in the death of more doctors and other healthcare professionals.
The targeted attacks on hospitals by Assad’s air force – already devastating – have increased markedly since the bombing campaign against ISIS began. But we are caught in the middle: dodging the barrel bombs from the government; praying that the U.S. bombs won’t drop on us by accident; and, treating the wounded who are flooding in to hospitals during the day. At night I try desperately to grab a couple of hours of sleep even as U.S. bombers scream overhead.
I am not sure how much longer we can hold on. There is not a single hematologist left in the opposition to treat blood diseases, but we try our best to save the lives of children who have a dangerous form of anemia. This should not be a life-threatening disease – but for these children of war, it is.
Every day I watch people die. Some die quickly from wounds too devastating to treat. Some die slowly from diseases that could have been managed – but not in today’s Syria.
We need help. We need equipment. We need supplies. We need medicine. We need people with expertise to treat all the patients with chronic diseases such as diabetes and cancer because our supplies have run out, our equipment has been destroyed, and we are exhausted.
It is impossible to move patients to government-controlled areas where most of the U.N. aid has gone, and where one might expect to receive care – because instead they will be detained and tortured. We can only move the gravely wounded over the border to Türkiye. For all the other patients – the child dying of anemia, the woman suffering from a complicated pregnancy, the cancer patient – we do our best, knowing that unless we get proper equipment, a steady stream of medical supplies and medicine, we will lose more lives than we save.
We are doctors. We live to help and heal people – not to watch them die. Every one of us living in opposition-held territory of Syria has made a conscious decision: despite all the risks, we will stay and treat whoever needs us.
We need the U.N. to understand how desperate our situation is. There is no time for bureaucracy. Time is running out. The U.N. can alleviate the suffering of people living in besieged areas of Syria by delivering life-saving aid.
As bombers tear across the sky on their way to dropping their deadly cargo, I wish that the urgency that moved the U.S. and other governments to bomb ISIS was matched by an urgency to save the lives of civilians. Please do not wait until there is no one left to save.
*The author’s name has been changed to protect her security.
The 2014 Physicians for Human Rights Annual Report provides a comprehensive overview of our work between July 2013 and June 2014 (our fiscal year).
From documenting attacks on hospitals in Syria to exposing the role medical professionals played in CIA torture, Physicians for Human Rights continued our work in 2014 using irrefutable medical and forensic evidence to call attention to mass atrocities and other human rights abuses across the globe. We used our unique position in the human rights field to bring forensic scientists, physicians, psychologists, and public health experts to the front lines of conflicts to document abuse, to use forensic tools to gather evidence for prosecutions, and to ensure the safety of those providing life-saving care. We remain committed to uncovering ongoing violations of human rights and international law, and securing justice for victims of these abuses.
By Widney Brown and Andrea Gittleman, JD
In this report, Physicians for Human Rights (PHR) outlines the findings of its recent survey of households forcibly displaced by the Thilawa Special Economic Zone development project in Burma. The Japanese government and three Japanese companies partnered with the Burmese government and a consortium of Burmese companies to develop the site, a project that will require the relocation of nearly 1,000 families in total. PHR’s findings cover phase one of the project, during which 68 households were displaced. PHR performed a survey of 29 of these households and conducted 22 key informant interviews.
PHR found that the displacement process fell significantly short of meeting international guidelines, most notably because the residents felt threatened by the government with lawsuits and imprisonment if they did not move. The displacement process in Thilawa violated residents’ human rights, negatively affected their ability to provide for themselves, and resulted in deteriorating food security and limited ability to access health care. The small community PHR sampled during this survey serves as a harbinger of adverse consequences for the additional 846 households that will be displaced during phase two of the Thilawa project. Unless the governments of Japan and Burma achieve a standard of practice consonant with their stated commitment to international norms and guidelines, these 846 households will very likely suffer a fate similar to those affected during phase one.
Friday marks 14 years since the United Nations Security Council unanimously adopted Resolution 1325, also known as the first resolution on Women, Peace, and Security. The resolution acknowledges the disproportionate effects conflict has on women and girls, and urges all actors to take special measures to protect this group from sexual violence in conflict. However, the resolution does not stop there, going on to express the significant and undervalued role women should play in peacebuilding and stressing the importance of their full participation in conflict resolution and prevention. The resolution affirms that in the story of sexual violence in conflict, women are not only victims, but also survivors, leaders, activists, service providers, and advocates.
The Program on Sexual Violence in Conflict Zones at Physicians for Human Rights (PHR) recognizes the crucial role that women play as first responders to survivors of sexual violence. In Kenya and the Democratic Republic of the Congo (DRC), PHR has developed partnerships with women who are at the forefront of the fight against sexual violence. They include women like Dr. Sandrine Masango, who spoke in June at the Global Summit to End Sexual Violence in Conflict in London about a family of four who came for treatment at her hospital in Uvira, DRC, all of them survivors of sexual violence. As a doctor, she serves as both a medical provider and a critical documenter of forensic evidence of violence that can later be used in court. In these capacities, she provides a vital link in the survivor’s personal path, assisting not only with physical and emotional healing, but also helping the larger community to reckon with such crimes – an essential condition for sustainable peacebuilding.
Dr. Masango’s role is not unique as a female first responder. Women’s involvement in responding to sexual violence was highlighted at a recent training on forensic documentation conducted by PHR in Nairobi, where 22 of the 34 participants were women. These professionals came from the medical, legal, law enforcement, community advocacy, and media sectors, representing a range of ways in which women are engaging in the fight against sexual violence.
Internationally, the appointment of figures like Fatou Bensouda, chief prosecutor for the International Criminal Court, and Zainab Bangura, special representative to the secretary-general on sexual violence in conflict, reflects the recognition of women’s ability to serve at the highest levels of global leadership on sexual violence. Bensouda has affirmed her obligation to make crimes of sexual violence a priority for future cases, and Bangura has drawn attention to the prevalence of sexual violence in conflict, including in places like Iraq, South Sudan, and Sri Lanka, and has called sexual violence the "great moral issue of our time."
Both have also spoken about what it means to be a woman doing this work. On becoming a lawyer, Bensouda has said: "I realized that there were not many female lawyers [but that there] were a lot of issues affecting gender and children. I thought I should be able to play a huge part in…standing up for them." Bangura has noted that her path has been difficult in certain ways because "as a woman, you have to set…your own standards. You have no female role models, and you carry a huge responsibility." Luckily, individuals like Bensouda and Bangura are changing this reality.
Resolution 1325 recognizes in no uncertain terms that women’s voices must be heard and their skills must be utilized at every step of peacebuilding, including caring for survivors of conflict-related sexual violence and supporting the survivors’ search for justice. While it is tragic that women are disproportionately victims of sexual violence in conflict, this is by no means their only role. On the anniversary of Resolution 1325, let‘s celebrate the diverse and important contributions of women as active participants in the fight against sexual violence and the search for justice and accountability.