In August 2012, Physicians for Human Rights (PHR) reported on the extensive, persistent, and disproportionate use of toxic chemical agents by anti-riot police against civilians in Bahrain. Police weaponized tear gas in order to crush protests, leading to at least 39 confirmed deaths since 2011 and causing long-term deleterious consequences for those repeatedly exposed to the toxic chemicals in enclosed spaces. PHR is once again concerned about an escalation of violence and the use of toxic chemical agents against protesters as latest developments point to continued instability in Bahrain.

Security forces in Bahrain have regularly cracked down on demonstrators since pro-democracy protests began in February 2011. Police continue to use force to disperse protesters, with recent reports in early October indicating that anti-riot police used buckshot, sound grenades, and tear gas against demonstrators following the death of a political detainee. There have been other sources of tension as well – in the past month, scores of activists have been sentenced in unfair trials, with allegations that authorities used torture to extract confessions. On September 29, 50 Shiite activists received sentences of up to 15 years in prison for their involvement in the 14 February Coalition, a youth-led opposition movement. Al-Wefaq, a political opposition party, has accused the government of escalatory security methods and pulled out of a national dialogue in September because of the arrest of one of its leaders. The United States has voiced concerns over both the recent unrest and lack of progress in the national dialogue that was agreed upon following the violent demonstrations in 2011.

A leaked document, released on October 16, 2013 and publicized by Bahrain Watch, has renewed concerns that the Bahraini government is stockpiling tear gas to crackdown on protesters. The document is a Ministry of Interior tender that shows the country’s plans to import 1.6 million tear gas canisters, 90,000 tear gas grenades, and 145,000 sound and flash grenades, totaling more than the entire Bahraini population of 1.3 million people. Given regular protests in the country and the authorities’ sustained inappropriate and excessive use of force against them, there is little doubt that this new purchase order will target protesters. And based on Bahrain’s aforementioned abuse of tear gas, PHR is seriously concerned that Bahraini forces will again use tear gas to punish protesters, inflict suffering, and suppress dissent.

PHR reiterates its call to the government of Bahrain to cease the use of tear gas in the country until the government conducts a full and impartial investigation into tear gas abuse, re-trains security forces in its proper application, and holds perpetrators of excessive or improper use of force accountable. Given the recent history of rampant tear gas abuse in the country, PHR strongly urges a suspension of the shipment of toxic chemical agents to Bahrain until these basic benchmarks are met, after which the government of Bahrain must adhere to United Nations guidelines on the use of force regarding any future use of tear gas or related substances.

This post originally appeared in The Huffington Post.

This month marks the anniversary of a terrible event: the October 2012 attempt on Dr. Denis Mukwege's life at his home in the Democratic Republic of the Congo (DRC). I had just met Dr. Mukwege the previous month following an unforgettable speech at the United Nations, in which he drew attention to the sexual violence crisis in his home country of the DRC and elsewhere. He chastised the international community for its fear and lack of courage in working to end to the practice of using women and girls for sexual slavery and as weapons of war in the DRC. Dr. Mukwege – founder and medical director of Panzi Hospital in eastern DRC – talked about how, having treated tens of thousands of girls and women who were raped in the brutal conflict zone, he could no longer repair their damaged bodies without simultaneously advocating for protection, peace, and justice.

Over the past two weeks, I had the privilege of spending additional time in New York with Dr. Mukwege, who is not only my personal hero, but also a dear friend, colleague, and partner of Physicians for Human Rights. Since 2011, we have worked closely with him, his hospital staff, and other partners in the DRC to improve the forensic documentation of evidence of sexual violence in order to end the vicious cycle of mass rape that is fueled by a culture of utter impunity in the DRC. Once again, I was reminded why he is not just an extraordinary physician, but also a remarkable advocate for peace and women's rights.

Dr. Mukwege told us about the women and girls, including young children, that he and his colleagues treat at Panzi Hospital in Bukavu. Many of them have been raped by gangs, brutally stabbed or shot in the genitals, with the intention of causing permanent harm to their bodies and lives. The doctors and nurses do all they can, often with great success – restoring their ability to control their bodily functions and – when possible – the potential to conceive children. And despite these heroic efforts, these women sometimes return to their home villages only to be raped again – victims of a cruel weapon of war.

Dr. Mukwege has courageously continued his work despite the assassination attempt that took the life of his colleague and bodyguard Joseph Bizimana. Many believe the violent assault was prompted by his U.N. speech, in which he condemned "the deafening silence and the lack of courage of the international community," as well as the lack of political will in his country. This month, Dr. Mukwege has been in the United States to meet with leaders at the highest levels of the United Nations and the U.S. government, and has also humbly accepted several awards, including the 2013 Civil Courage Prize. He dedicates these awards to the courageous women of the DRC. I can't think of anyone more deserving of such an honor. He risks his own life to perform lifesaving medical work and provide a sanctuary for the appalling number of women and girls in the eastern DRC who have been the target of such crimes. His tireless advocacy has been crucial to ensuring that survivors have access not only to medical care, but also to justice and reparations, so that those who commit these brutal acts are held accountable.

The numbers are staggering. Since opening in 1999, Panzi Hospital has treated nearly 40,000 survivors of sexual violence. Dr. Mukwege doesn't like to talk about the numbers; instead, he talks about his patients as brave survivors, as only a caring physician could. He wonders when the international community will draw a "red line" for the women of the Congo and muster the political will to put an end to this brutal weapon of war that has plagued his country for over 15 years.

Despite the seemingly unimaginable situations Dr. Mukwege sees on a daily basis in his work, he is an optimist. Like him, I firmly believe that collectively we can work to address and prevent such human rights violations. As part of the International Campaign to Stop Rape & Gender Violence in Conflict, PHR is calling on political leaders – in the DRC and beyond – to take steps to prevent rape in conflict and protect civilians and rape survivors. We are calling for the full implementation of the Peace, Security and Cooperation Framework Agreement for the Democratic Republic of the Congo and the region signed in Addis Ababa in 2013 and for the arrest of those indicted by the International Criminal Court for mass atrocities, including mass rape, in the region. Congolese President Joseph Kabila has also pledged to appoint a special representative to combat sexual violence and the recruitment of child soldiers. While an encouraging development, we must now hold President Kabila to this promise.

Just as important is that clinicians like Dr. Mukwege, who bear witness to these human rights abuses, are protected. As gynecological surgeons, he and his colleagues are uniquely skilled to repair the bodies of girls and women who have experienced horrific physical injuries, while also helping to heal their psyches and rebuild the collective well-being of their communities. As a physician and a tenacious leader, Dr. Mukwege has also had the courage to denounce the perpetrators of these crimes and the governments that enable them. All of us, as human beings, can help amplify his powerful call for peace and justice.

As Dr. Mukwege said in his U.N. speech in 2012, "the courage of women victims of sexual violence in the Eastern Congo will, in the end, overcome this evil." But let's not allow these brave women and men to stand alone. As the Congolese proverb so poignantly reminds us: "A single tree doesn't make a forest."

On October 12, 2013, the African Union (AU) will convene in Addis Ababa, Ethiopia to discuss withdrawing from the International Criminal Court (ICC). Physicians for Human Rights (PHR) – in conjunction with various other NGOs from around the world – is participating in the upcoming Thunderclap campaign encouraging the AU to #staywiththeICC. This campaign mirrors the demands of 130 civil society groups in Africa that recently urged AU members not to withdraw from the Court. PHR urges the AU to maintain their relationship with the ICC in order to promote justice, support regional peace and security, and enhance accountability. The ICC is an invaluable resource that African leaders should continue to use to protect against large-scale acts of violence against civilians.

The ICC is critical to the international human rights process, as it is the only permanent venue designed to hold perpetrators of war crimes, crimes against humanity, and genocide accountable. As the court of last-resort, the ICC has jurisdiction only where local judicial systems are unwilling or unable to appropriately hold perpetrators accountable at the national level. Of the eight situations currently before the ICC, four of them were referred to the Court by the countries themselves, seeking international assistance in holding perpetrators of mass atrocities accountable. African nations have looked to the Court for assistance when no other viable avenues to criminal accountability exist.

Current situations before the Court include some of the most violent and devastating crimes in history. In response to the mass atrocities committed in Darfur, the Court indicted Sudanese President Omar al-Bashir, who is the first sitting head of state to have been indicted by the ICC. Al-Bashir has been indicted for war crimes, crimes against humanity, and genocide – on charges that include rape, torture, and murder. PHR researched the effects of the mass crimes authorized by al-Bashir and others, revealing widespread reverberations beyond the initial acts of violence. Those who are displaced by violence face compounded forms of violence, including vulnerability to rape. Mass atrocities not only destroy individuals, but entire communities. For now, the ICC is the only court that aims to hold leaders like al-Bashir accountable for abhorrent acts of violence.

The president of Kenya, Uhuru Kenyatta, and his vice president, William Ruto, currently face charges of crimes against humanity for allegedly planning and organizing violence in the aftermath of the 2007 election. Between December 2007 and February 2008, some 900 people were killed during violent post-election riots, while more than 300,000 others were displaced.

PHR is working to strengthen local prosecutions for crimes of sexual violence in Kenya, but accountability must include those at the top echelons of political power in order to truly stem the scourge of rape.

The work of PHR and others who strive to end sexual violence in conflict zones is enormously reliant on the ICC, as it is often the best mechanism available to address rape and sexual violence as weapons of war. For victims, the ICC serves as a tool to increase accountability and a venue to safely confront attackers, share the truth about their experiences, and begin the personal and communal healing processes.

Sexual violence affects entire communities, and impunity for perpetrators of sexual violence can stymie community development and reconciliation, even after conflict subsides. PHR strives to promote improved local legal systems that can manage the enormous weight of these cases, but until that becomes possible, the ICC is the only resource for many victims of sexual violence in conflict. Withdrawing from the ICC would imply that the AU supports perpetrators of sexual violence and other kinds of egregious crimes, placing itself in opposition to those victims of violence that the ICC seeks to protect.

PHR stands with the tens of thousands of silent victims who have lost their lives in the cases before the Court and the survivors who depend on the Court as the locus of last resort for justice in the aftermath of mass crimes committed against them and their communities. PHR urges the AU leadership to continue using the ICC as a tool to ensure accountability and protect their citizens from war crimes, genocide, and crimes against humanity.

Dr. Denis Mukwege, founder and medical director of Panzi Hospital in the Democratic Republic of the Congo (DRC), tells the story of his fight against violence against women. Dr. Mukwege is a world-renowned gynecological surgeon and PHR’s close colleague and project partner. He and his staff have helped treat over 30,000 survivors of sexual violence.

Hunger striking is undertaken as a nonviolent form of protest when other ways of expressing demands are unavailable. A significant portion of the detainees at the U.S. detention facility at Guantánamo Bay, Cuba have been engaged in on-and-off hunger strikes since 2002. More and more detainees began hunger strikes in February 2013, with the number of hunger strikers climbing into the hundreds by late April.

The U.S. military has responded to the detainees’ protests by subjecting them to force-feeding, a procedure that authorizes the restraint of detainees so they can be forced to take in nutrients by having a tube inserted through their nose. Domestic and global medical groups, including Physicians for Human Rights (PHR), have condemned force-feeding as unethical, and – in some cases – the practice can amount to torture. The continued hunger strikes, and resultant force-feeding, is just one example illuminating the dire situation and ongoing abuse at Guantánamo Bay.

This fact sheet gives an overview of the medical ethics of force-feeding, the U.S. government's response to hunger strikers, and PHR's recommendations to the Obama administration.

As director of PHR’s anti-torture program and as an attorney for Guantanamo Bay detainees, Kristine Huskey has been fighting for basic human rights and social justice since a few months after 9/11, when she took on her first clients. In this Yin Radio interview, Huskey talks about her work and how she manages to stay with it amid the worst of what human beings are capable of.

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Source: Yin Radio

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Three medical workers in Syria were injured in June when a bomb was deliberately dropped on their hospital, destroying its intensive care unit. Soon after, another hospital became a target – government forces raided the facility, destroyed the equipment, and harassed medical staff solely for doing their job of treating the wounded. Ambulance drivers delivering medical supplies have also been attacked. Last year, government officials searched one ambulance and took the driver to a detention facility. Two weeks later, his body turned up with injuries indicating that he had been tortured.

These are just some of the disturbing examples that have emerged from a recent UN report highlighting the systematic assault on medical providers, facilities, and patients in Syria. It gives compelling evidence about how medical care is being used as a weapon of war, and identifies the targeting of the medical profession as “one of the most alarming features of the Syrian conflict.”

This month, the UN inspections team confirmed the use of chemical weapons in Syria, and the world was right to decry the inhumanity of the attack. But there are other lines that cannot be crossed during times of war – lines that limit the barbarity of conflict by protecting civilians. When Syria bombs its hospitals, attacks medical providers, and tortures patients seeking medical care, it crosses these lines. If government forces intentionally target medical facilities, people become afraid to seek care.

As we note with horror that more than 100,000 lives have already been lost in the Syrian conflict, we must recognize with equal horror the direct consequences of attacks on medical care. When doctors are targeted for adhering to their ethical responsibilities in caring for the wounded, and hospitals are repeatedly targeted by bombs, the war’s gruesome consequences multiply. Mortality rates among the sick and wounded increase, caregivers cannot help the most vulnerable, and places of healing become yet another front of the battlefield.

Attacks against medical professionals in Syria have forced many health workers to leave their jobs at a time when they are needed most, which has had devastating consequences for the country’s entire public health system. A study from June found that 70 percent of Syria’s medical professionals had already left the country. A report released in March found that only 36 doctors continue to practice in Aleppo, while some 5,000 doctors had previously been working in the city before the conflict began. Meanwhile, the number of people requiring medical care is increasing exponentially.

The United Nations has called upon the world to address this targeted attack on medical care in Syria. The UN report has pointed out that government forces have killed patients and their medical providers by intentionally targeting hospitals, which have at times also been used by government forces as military facilities. The Syrian government has also passed laws that effectively criminalize providing medical aid to the opposition, meaning doctors risk their lives each time they dare to provide unbiased care to those in need. Responding to this reality, UN Secretary-General Ban Ki-moon has highlighted before the UN General Assembly the “unconscionable targeting of medical facilities and personnel” in Syria. Though the government assault on medical care is disturbing in its reach, anti-government armed groups have also committed some of these violations.

We must help put an end to these attacks. All sides of the Syrian conflict must respect the laws of war, which protect the sick and wounded in times of armed conflict and oblige doctors to provide them with neutral and ethical care. The United States and international community should address these war crimes in Syria negotiations. Our common humanity calls on us to decry these attacks on the vulnerable and on those who help heal them.

On October 17–18, 2013, the United States will be under review by the United Nations to examine U.S. compliance with its legal obligations under the International Covenant on Civil and Political Rights (ICCPR) – a treaty the United States ratified in 1992. Among other protections, the ICCPR provides for the right not to be enslaved, the right not to be tortured, and the right to due process. Each of the states party to the treaty are bound to comply with its language, and the UN Human Rights Committee (HRC) regularly reviews signatory countries to ensure they are doing so.

Last week, PHR submitted a shadow report to the HRC to assist in their review of U.S. compliance with the ICCPR. As a part of their review process, the HRC poses questions to the United States related to potential violations of the ICCPR. PHR’s report provides the HRC with information from our independent reports and analysis, which offer invaluable information about the psychological and physical health effects of indefinite detention and force-feeding. The PHR report will not only serve to supplement the U.S. government’s responses to HRC questions, but also provide the HRC with additional information to help inform humane recommendations for domestic U.S. policy changes.

This PHR shadow report addresses questions posed by the HRC specifically related to the indefinite detention of detainees at Guantánamo Bay. PHR outlines the physical and psychological effects of indefinite detention, which include depression, chronic anxiety, and PTSD – all of which can have deleterious effects on physical body systems. PHR’s shadow report also discusses hunger strikes, which are often a response by detainees to the physical and psychological effects of their indefinite detention and the illegality of the U.S. standard operating procedures on force-feeding. After chronicling facts about indefinite detention, hunger strikes, and force-feeding, the report examines how current U.S. policies fail to fit into the UN framework and its laws, particularly the ICCPR.

PHR also submitted proposed questions and recommendations for the HRC to present to the United States. One such recommendation is for the United States to change its current standard operating procedures at Guantánamo for the inhumane and unlawful force-feeding of detainees on hunger strike, a procedure that PHR has found amounts to torture in some cases.

Shadow reports can help raise the profile of ongoing concerns regarding our national human rights record. To this end, PHR encourages the United States to approach its upcoming review with the aim of making concrete improvements regarding its record on indefinite detention and force-feeding.

Kenya became the first country to approve a motion to withdraw membership from the International Criminal Court (ICC) yesterday. While the potential withdrawal will not affect the charges already brought against leaders in Kenya, it sets a bad precedent for other countries party to the ICC, increases the likelihood of impunity, and leaves no recourse for future victims of violence.

The ICC – established by the Rome Statute in 1998 – is meant to prosecute four egregious international violations: genocide, crimes against humanity, war crimes, and crimes of aggression. Kenya’s president, Uhuru Kenyatta, and deputy president, William Ruto, have both been charged with committing crimes against humanity during the 2007 post-election violence in which more than 1,200 people were killed and 600,000 others displaced, while an estimated 3,000 faced sexual violence.

African nations have expressed concern over the operations of the ICC, citing the disproportionate prosecution of African leaders. However, the court’s docket is based on the makeup of states that are party to the Rome Statute, cases that are referred to the court, and the existence of other international tribunals that have jurisdiction over mass atrocities committed elsewhere. For example, four out of the eight situations that the ICC is currently handling were initiated at the request of those countries themselves. Furthermore, international courts other than the ICC have carried out prosecutions in many other countries. Prior to the founding of the ICC, the International Criminal Tribunal for the former Yugoslavia prosecuted war crimes committed during the conflict in the Balkans in the 1990s and the International Military Tribunal at Nuremberg worked to provide justice for the victims of the Holocaust. Currently, the Extraordinary Chambers in the Courts of Cambodia is prosecuting those responsible for crimes committed during the Khmer Rouge regime and the Special Tribunal for Lebanon is holding trials for an attack in Lebanon in 2005 that killed 23 people including the country’s former prime minister.

However, continued distrust of the ICC among some nations combined with Kenya’s potential withdrawal may lead additional African countries to follow Kenya and reconsider their memberships. Kenya’s action sets a bad precedent for countries involved in activities prohibited under international law. With countries refusing to pursue justice through the one permanent option available, it’s a dreary picture for victims and their family members.

Many countries recovering from such atrocities do not have the means, or are otherwise unwilling, to deliver justice to victims. The ICC offers people an avenue to justice when in-country courts are unable or unwilling to do so. By withdrawing from the ICC, Kenya’s leaders are telling victims of violence that they will not provide justice locally and will do everything in their power to stop international actors from pursuing justice as well.

Kenya’s leadership is taking the country a step backwards and perpetuating a culture of impunity. While the current prosecutions in Kenya will continue, future victims may not have the jurisdiction of the ICC to help make things right. The lack of cooperation from Kenya, and possibly other African nations, can only disrupt and delay the delivery of justice to victims.