Afghans have endured injustice for decades. Victims languish in an environment where abuses are committed with impunity, fueling resentment and the country’s conflict itself. Amnesty International recently published a report examining accountability for civilian deaths caused by international military operations in Afghanistan. The report focused on 10 incidents involving the U.S. military between 2009 and 2013 where civilians were killed under questionable circumstances. The investigation found that in 140 cases of civilian deaths, there was “abundant and compelling evidence of war crimes.”

Medical and forensic experts from Physicians for Human Rights (PHR) have witnessed similar abuses committed with impunity in Afghanistan. Between January and February 2002, PHR experts traveled to northern Afghanistan and reported on the horrific detention conditions facing surrendered combatants and an apparent mass grave in Dasht-e-Leili, where as many as 2,000 prisoners may have been buried. Following the fall of Kunduz in November 2001, these prisoners surrendered to the Afghan Northern Alliance under General Rashid Dostum and to the U.S. Special Forces supporting him. Allegations suggest that Dostum’s forces suffocated the prisoners in cargo containers and then buried the dead in Dasht-e-Leili, on the outskirts of the northern city of Sheberghan. Allegations by Afghan detainees suggest that U.S. troops were either present at the time or knew about the killings. In April 2002, under the auspices of the UN, PHR uncovered the remains of more than a dozen bodies and confirmed that the cause of death was consistent with asphyxiation. PHR repeatedly called for the full protection of and a thorough investigation into what appeared to be a mass grave site.

PHR returned to Dasht-e-Leili on behalf of the UN to survey the site in 2008. Upon arrival, PHR found that the area had been disturbed and large parts of the alleged mass grave site had been removed. The UN denounced this development, as the site and the evidence had clearly been tampered with despite recommendations for an investigation back in 2002.

While calls have been made over the years for an investigation into Dostum and his forces, allegations against the United States around Dasht-e-Leili have gone unanswered. PHR requested an investigation into U.S. involvement, but silence has generally prevailed, even when the Bush administration was accused of deliberately impeding investigations by four separate government agencies into the killings.

U.S. mainstream media has also failed to take the allegations seriously. Salon reported that the New York Times withheld information suggesting that U.S. troops were present during the massacre, fueling speculation that the U.S. government opposed any investigation into the massacre out of fear that evidence of its role would be exposed.

PHR has continued to call for a full investigation into what happened to the victims of the mass grave at Dasht-e-Leili. A thorough and independent investigation would send a signal to Afghans that no one is above the law – not even U.S. officials. In many ways, the Dasht-e-Leili mass grave demonstrates how both the international community and the government of Afghanistan have failed the Afghan people. The lack of justice reinforces the norms experienced by everyday Afghans: impunity for the powerful and tolerance for brutality. Ignoring what happened at Dasht-e-Leili signaled to the surviving families that the international community had no interest in providing Afghan citizens with the truth.

Afghans have a right to know what happened to those buried in the mass graves that dot their countryside, and peace cannot be achieved until justice is served – especially for crimes committed or countenanced by the United States. The U.S. government must be held accountable for violations committed in the countries in which we wage war, and the withdrawal of troops does not relieve us of this responsibility.

American psychologists designed and oversaw the brutal regime of interrogation used on detainees in U.S. military custody at Abu Ghraib, Guantánamo Bay, and elsewhere during the U.S. war on terror; but the profession has yet to punish any psychologist who participated in torture or to fully distance itself from this legacy.

The ties between psychologists, the American Psychological Association (APA), and the U.S. military date back at least a century. The APA directly recruited psychologists into military service during both world wars, where they evaluated new recruits, assisted in the treatment of soldiers with “shell shock,” and offered advice about captured enemy soldiers in order to make interrogations more effective. In 1919, the APA elected the army’s highest ranking psychologist as its president. After World War II, the navy established one of the first APA- approved internships. The tradition has continued and today the Department of Defense (DOD) is the single biggest provider of psychology internships in the country. Additionally, 7 percent of all psychologists are employed by the DOD.

After the involvement of psychologists in the CIA’s abusive detention and interrogation practices came to light in 2004, the American Medical Association and the American Psychiatric Association issued statements prohibiting participation in interrogations as a violation of medical ethics. In stark contrast, the APA allowed psychologists to participate in interrogations, including those that meet the definition of torture under international law. This position, which was adopted in 2005 with some secrecy about its drafters, was outlined in the APA’s PENS report. The position outlined in the report remained in effect until 2013, when it was repealed.

But the questions remain: Why did psychologists allow the PENS report – a policy condoning torture and the violation of APA’s own code of ethics – to be passed in the first place? And why did it take eight years to rescind it?

Medical colleagues and I were curious to know what psychology students knew about the ethical responsibilities of military psychologists, so we surveyed 185 students at 20 different graduate programs in clinical psychology. We wanted to find out whether they were aware of their professional obligations during military service, including under the Geneva Conventions – the most widely cited set of international standards.

Through our research, we found that 74 percent of psychology students had received less than one hour of instruction about military medical ethics. Even though 75 percent claimed to be familiar with the Geneva Conventions, the majority gave incorrect answers when tested on specific points. For example:

• Only 37 percent could correctly identify that the Geneva Conventions apply irrespective of whether war has formally been declared
• 43 percent did not know that the Geneva Conventions state that physicians should "treat the sickest first, regardless of nationality”
• Half of the students did not know that the Geneva Conventions prohibit ever threatening or demeaning prisoners as well as depriving them of food or water for any length of time
• 48 percent could not state when they would be required by the Geneva Conventions to disobey an unethical order from a superior

Based on these findings, my co-authors and I surmise that not only do psychology students learn little about the professional standards that constrain unlawful and unethical practices, but they also have a false sense of complacency about their knowledge of such matters. This is a troubling finding, given that psychologists lacking an understanding of their ethical obligations are less prepared to disobey, let alone protest, unethical orders, and are more likely to be compliant when told to assist interrogators in ways that violate international standards.

Although the APA recently annulled the PENS report, it still positions psychologists as adjuncts to national security by allowing them to participate in interrogations under certain circumstances. The Senate’s report on the CIA torture program — whose 500 page executive summary is poised to be released — will likely reveal further details of this complicity. Given the APA’s lack of moral clarity and flouting of international law, it is imperative that psychology students receive more education in military medical ethics in order to prevent a repeat of psychologist participation in abusive interrogations and torture.

The fact that the detention center at Guantánamo ever opened – much less is still in operation and continues to abuse detainees, most recently by force-feeding hunger strikers – will likely go down as one of our country’s most egregious ethical lapses. Psychologists need to be educated about the Geneva Conventions and other international codes of ethics to ensure they do not become pawns of the U.S. military establishment – inadvertently or otherwise.

APA members need to demand that their organization not take positions that are contrary to international law and to ensure that psychologists who have committed crimes in the name of patriotism are held accountable for their actions.

The complete findings of our research were published this month in the International Journal of Health Services.

The use of health programs by the United States Agency for International Development (USAID) to recruit political activists in Cuba is reprehensible and unacceptable. Using health care as a cover for political activities goes against the internationally accepted principle of medical neutrality and is harmful to the wider practice of providing medical aid in countries around the world.

An investigation by the Associated Press has revealed that USAID has sent nearly a dozen young people from Latin America to Cuba over the last two years to support democratic reform by recruiting political activists who are against the Castro government. These individuals used an HIV-prevention workshop as a ploy to find political activists within groups of patients. USAID documents referred to the HIV-prevention workshop as a “perfect excuse” to conduct political activities.

Health workers are protected under the international principle of medical neutrality, which specifically outlines that governments must not interfere with the duties of medical professionals, especially in times of national and international armed conflict and civil unrest. Political goals should never enter the trusted relationship between a doctor and a patient, and health facilities should never be used for covert political operations.

The concept of espionage runs directly against the notions of honesty and trust, which are essential to doctor-patient relationships and form the foundation of successful medical care. When health care workers have ulterior motives, such as political interests, the trust between doctor and patient is compromised and the broader reputation of public health programs is called into question.

Such activities jeopardize the credibility of the United States and put other USAID programs around the world at risk – programs that, when implemented properly, can significantly improve health care and other essential services. The recent operation has the potential to negatively affect the credibility of USAID health programs not only in Cuba, but around the world.

Similar methods have been employed to gather intelligence in the past, including the CIA’s use of a polio vaccination program in Pakistan to assist in locating Osama bin Laden. After the program was revealed in 2011, widespread distrust for health programs and vaccination campaigns in Pakistan followed, leading to the persecution of health workers and the resurgence of polio in the country. After condemnation by public health experts, President Barack Obama also denounced the CIA operation and vowed to never again use vaccination programs to gather intelligence. President Obama should make a similar decision to ban all subversive activities that interfere with important public health interventions, such as the program in Cuba.

Disease outbreaks around the world, from cholera to Ebola, demonstrate that disease management and eradication require global cooperation. When the credibility of these efforts are undermined, the potential risks to the global and local communities can be devastating. Health care efforts and medical facilities must remain refuges for medical care that strengthen, not erode, the trust between the health workers and communities they serve.

Names have been changed in this post for security purposes.

Although Maria is just 13-years-old, she already suffers from post-traumatic stress disorder and major depression, reports Dr. Carol Kessler, a child psychiatrist and member of the Asylum Network at Physicians for Human Rights (PHR). Originally from El Salvador, Maria fled to the United States after a gang member attempted to rape her and force her to join his gang. Maria escaped the attempted assault physically unharmed, but then received death threats from gang members after her refusal to join them. They also threatened to kill her grandparents with whom she lived at the time, and Maria felt that the police could not protect her. Dr. Kessler, who documented Maria’s symptoms for her immigration court case, notes that Maria “would rather die than return to El Salvador,” and suffers from nightmares, a sense of helplessness, and acute anxiety.

Maria is one of the thousands of unaccompanied children who have recently fled El Salvador and are seeking humanitarian protection in the United States. Despite the harrowing events that Maria suffered, she is one of the lucky ones. Maria was able to secure pro bono legal counsel and her attorney requested a psychological evaluation through PHR’s Asylum Network. Dr. Kessler conducted a forensic evaluation of Maria, and wrote a medical-legal affidavit documenting the psychological symptoms that Maria suffers as a result of her experience in her home country. This young girl has to tell her story of abuse again and again because – even though she is a child – the burden of proof falls on her to provide evidence of past persecution.

Like Maria, many unaccompanied children entering the United States have suffered traumatic experiences and are fleeing violence in their home countries. They make a treacherous journey during which they often experience further physical and sexual violence. Understandably, it is often difficult for these children to tell a border patrol agent or asylum officer about the horrors they have escaped and the violence they have suffered – especially when these are the same agents and officers who detain the children upon arrival and place them in an overcrowded holding cell. The children are then interviewed by an immigration officer who is generally not trained to work with children.

It is alarming that some policy proposals have called for rolling back protections afforded to unaccompanied children under the Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA) to give border patrol agents the power to immediately render deportation decisions. The TVPRA was passed unanimously because lawmakers recognized the need to protect this vulnerable population. Maria would not have had the opportunity to share her story with Dr. Kessler if she were immediately forced to undergo an interrogation with a border patrol agent. She had difficulty sharing her story with a trained expert in childhood trauma, so we can imagine how difficult, if not impossible, it would have been for Maria to tell her story to the border patrol agent who apprehended her.

Dr. Minal Giri, another member of PHR’s Asylum Network who has examined dozens of unaccompanied minors who have crossed the U.S. border, explains the struggle that children face after being apprehended: "These kids have been severely traumatized and will not be able to divulge their history in one entire session. It takes time for them. These kids often don’t have the cognitive ability to form a narrative, and it won’t necessarily be a linear narrative. Just like adults, they have trauma and injuries that may prevent them from remembering.”

According to a report by the UN High Commissioner for Refugees, 58 percent of unaccompanied children who the agency interviewed were forcibly displaced and suffered harms that indicated the need for international protection. Rolling back legal protections that were put in place to protect children from trafficking, violence, and enslavement is not an appropriate response. Before calling for expedited removal proceedings, the U.S. Government must consider whether it is sending these children back to life-threatening situations.

The children at the U.S. border who are currently attracting so much attention deserve to have their stories heard and receive the help of trained professionals. Their trauma is real, as is the danger they could face upon being summarily deported. Maria’s case should not be an outlier – it should be a model for the humane treatment of children who seek asylum.

This post originally appeared on Women Under Siege.

“What a fabulous suit. She was perfect, perfect,” said a French woman standing behind me on the escalator. We had just emerged from two hours in a giant auditorium on the outskirts of London where we heard politicians, UN officials, and Nobel Peace Laureate Leymah Gbowee speaking at the Global Summit to End Sexual Violence in Conflict, billed as the largest gathering ever to focus attention and develop effective solutions to ending rape in war. With treaties and UN resolutions firmly in place, and ministers and representatives of more than 150 countries attending, the message of this summit was #TimeToAct. The suit in question was that of the movie star and humanitarian Angelina Jolie.

It’s hard not to be cynical when dozens of cameras flash for a glamorous celebrity and follow her through exhibits of survivors speaking out, more focused on her appearance than on the words of the assembled experts.

Many of the more than 400 international advocates attending the summit were rightfully dismayed when a day scheduled for ministerial dialogues failed to allow for serious interactions between government leaders and members of civil society living and working in places like Burma, Colombia, Democratic Republic of Congo, Somalia, Sudan, and Syria. Many of our colleagues responded to the call to act now by wondering what they’ve been doing in the trenches all these years, if not that.

Yet despite this expected cynicism, the summit created a huge opportunity. The initiative of UK Foreign Secretary William Hague convened world leaders with a single-minded focus of engaging government representatives and civil society actors in ending sexualized violence in conflict. And Jolie’s presence helped draw the global media, at the very least raising the issue to a higher rung on the international agenda. Doctors and police officers from remote areas of eastern DRC marveled at the enormity of the attention on rape in conflict. For them, this summit broke their isolation and sense of toiling in silence, anonymity, and—all too frequently—fear…

Read the full article on Women Under Siege.

The #BringBackOurGirls social media campaign, which is pressing for the rescue of over 200 Nigerian girls kidnapped by the terrorist group Boko Haram, brought unprecedented attention to impoverished northern Nigeria. Pundits and politicians have provided myriad reasons for the growth and audacity of Boko Haram; economics, politics, and religion have all been cited as ripening conditions for the extremist movement.

In early May, governments discussed what they should do to assist Nigeria, while Nigeria tried to determine if it would accept any assistance at all. Around the same time, a misguided comment about the Leahy Law, which prohibits official U.S. agencies from providing military assistance to foreign military units that violate human rights, was thrown into the fray.

During a media call focused on Boko Haram and hosted by the Council on Foreign Relations on May 7, former Assistant Secretary of State for African Affairs, Johnnie Carson, erroneously stated that “much of the Nigerian military cannot legally be assisted by the United States because [they] would not be able to pass the Leahy vetting.” Carson’s statement set off a flurry of claims that U.S. law was preventing the United States from helping Nigeria rescue the kidnapped girls. Representative Ed Royce (R-CA), chairman of the House Foreign Relations Committee, even called for a temporary waiver to the Leahy Law in order to assist Nigeria. However, a State Department inspector general found that Leahy vetting rejected only 211 out of 1,377 Nigerian applications for military training in 2013. The Leahy Law does, in fact, allow the United States to provide assistance to the majority of Nigerian forces.

The Leahy Law is not the problem in this, or in any other military training, scenario. Nigeria has a choice.

Imagine that Nigeria recognizes that it cannot deal with the threat of Boko Haram and needs help from the United States. In order to comply with U.S. law, the government agrees to pursue credible accountability mechanisms within its own security forces for violations of human rights. These reforms allow the United States to train Nigerian soldiers and police officers who realize that their role in protecting the people absolutely prohibits abuse. Nigerian civilians also see their government tackling impunity and begin to trust, instead of fear, security forces; the extremist narrative loses credibility. Nigeria gains a well-trained and professional security force that respects human rights and is capable of protecting its citizens from internal and external threats. The United States gains a military partner with whom it can work and trust in Africa. Terror groups like Boko Haram are successfully countered and young girls can attend school without fear of abduction. While the transformation won’t happen overnight, the trajectory that the Leahy Law sets can facilitate long-term success.

Senator Patrick Leahy (D-VT) first introduced the Leahy Law in 1997 after recognizing that U.S. funding for overseas security assistance had, at times, been used by foreign security forces to repress and abuse their own populations. The law mandates Leahy vetting, which evaluates credible evidence of security force units or individuals responsible for grave violations of human rights and blocks foreign military assistance to those perpetrators.

Fundamentally, the abuse of human rights runs contrary to basic U.S. principles. Furthermore, the association of the United States with rights-abusing governments damages our nation’s reputation overseas and lends justification to extremists who seek to target the United States. The Leahy Law places necessary limits on assistance in places like Nigeria where a small number of security forces have arrested citizens without charge, tortured people on grounds of “counterterrorism,” and been involved in extrajudicial killings. Leahy vetting ensures that U.S. tax dollars do not prop up security forces engaged in such practices. However, it also allows for clean units to receive military training and assistance from the United States, creating incentives for security forces to respect human rights.

For the sake of millions living under the threat of Boko Haram, I hope that Nigeria chooses a path that adheres to the conditions of the Leahy Law – a path that respects human rights.