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PHR's Letter to the Turkish Ministry of Health

Persecution of Health Workers, Türkiye

PHR sent this letter to the Turkish Ministry of Health expressing our deep concern over the ministry's efforts to pass legislation that would prevent medical personnel from providing emergency care to anyone in need, including demonstrators.

Dear Dr. Mehmet Müezzinoğlu,

I am writing on behalf of Physicians for Human Rights to express serious concern over the use of unnecessary violence against demonstrators and deliberate attacks on medical personnel who have courageously attempted to provide emergency medical assistance to those who have been injured by police in the Gezi protests. We understand that the Ministry of Health has submitted draft legislation that, if passed in Parliament, would require a new, special certification for independent medical personnel providing emergency assistance. We also understand that the Ministry has taken steps to collect information on medical personnel who have provided emergency medical services to the injured. 

We are deeply concerned that such actions undermine essential medical principles of independence and autonomy and effectively criminalize the medical ethical duty to provide emergency medical care.

I have contacted your office more than 5 times in the past two weeks to arrange a meeting with you to discuss these issues and understand the experiences and perspective of the Ministry. We are currently in Ankara and kindly request that you consider a meeting with us on Monday morning, July 1.

Thank you for your consideration,

Vincent

Vincent Iacopino, MD, PhD
Senior Medical Advisor
Physicians for Human Rights
Adjunct Professor of Medicine
University of Minnesota Medical School
Senior Research Fellow
Human Rights Center
University of California, Berkeley

 

Blog

A Day to Honor Torture Survivors

Asylum, Global

An Ethiopian man who sought asylum in the United States had been repeatedly beaten and tortured in his home country simply for engaging in protests against the government. A young Sudanese woman who was an outspoken human rights advocate bears scars from having been burned and beaten by her torturers; she now struggles to interact with people and is afraid of enclosed spaces like subway stations. A Russian college student now living in the United States was beaten to the point of unconsciousness by skinheads because of her sexual orientation, while security agents declined to intervene.

As volunteer medical advisors in Physicians for Human Rights’ Asylum Network, we have examined hundreds of people who came to the United States seeking asylum after being tortured in their own countries. They have endured physical and psychological harm based on their religion, political beliefs, sexual orientation, or gender identity. We have seen 6-year-old girls raped by militia, teens who were kidnapped and trafficked by gangs, pregnant women who were beaten and lost their newborn infants, gay men who were detained and tortured, and grandmothers who watched as their entire families were slaughtered and their homes burned to the ground. The enormity of their suffering is hard for any of us to imagine.    

Today, June 26, the International Day in Support of Victims of Torture, we remember all the children, women, and men who died at the hands of their torturers, and those still among us. The day provides an opportunity to recognize the remarkable spirit of those who live and work in the United States and are healing from the devastating effects of torture, as well as a chance to demand from our leaders that they take urgent steps to stop torture in all countries, including the United States.

Although torture is a crime under international law, it is still practiced in many nations of the world. It represents the worst of what human beings can do to each other, and often leaves behind painful and long-lasting physical and psychological scars. The medical-forensic evaluations that hundreds of doctors like us around the country conduct are among the best tools we can use for documenting these horrific crimes.

More than 25 years of experience have shown us that effective medical investigation and documentation of torture and ill treatment are essential for preventing and redressing torture while also ending impunity for perpetrators. PHR led the UN effort to develop standards for the effective investigation and documentation of torture and ill treatment.  Now, more than ever, countries need to recognize and implement these standards – known as the Istanbul Protocol – if they are serious about ending torture.  Our country should take the lead, sending the message that torture in all settings is unacceptable, since it conflicts with American values and the fundamental principles on which our nation was built.

The United States is the new home for people like the brave Ethiopian man and the Sudanese woman we have had the privilege to meet. Today, we honor them, and the value they bring to our communities. As a nation, we can do more to ensure that human rights abuses are identified and punished. Every case of torture is one too many.

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PHR Joins Civil Society Groups in Urging an End to Persecution of Rohingya

Mass Atrocities, Burma

PHR has joined 75 other organizations in expressing concern about the ongoing human rights violations and humanitarian crisis occurring in Burma. Their joint statement expresses deep concern for the Rohingya, a stateless minority that has long been persecuted and subjected to countless acts of violence, persecution, and discrimination. Other Muslims in the country have also suffered significant property destruction, segregation, arbitrary arrests, and deaths. In May 2013, PHR documented a massacre of Muslim children and adults in Meiktila, central Burma, during which government actors took no action to prevent or stop the violence and have been slow to investigate and arrest the perpetrators. 

Civil society actors who have been closely monitoring the situation remain concerned about excessive violence and involvement of government officials and security forces in acts of violence, impunity for perpetrators, forced displacement, segregation, restrictions on freedom of movement, and crimes against humanity. One of the largest obstacles facing the Rohingya is their lack of government recognition as Burmese citizens. This exclusion denies them the basic rights, protections, and freedom other citizens are granted within the region.

The civil society organizations that signed the statement recommend that the government of Burma allow humanitarian aid workers to help refugees, administer a plan for reconciliation, and end restrictions on minority groups such as the Rohingya. These steps could be facilitated by establishing a fair judicial system, allowing the establishment of a country office of the UN Office of the High Commissioner for Human Rights, and reviewing the 1982 Citizenship Act, which bars Rohingya from citizenship.

In addition to collaborating with civil society organizations, PHR has conducted rigorous research and investigation into the human rights abuses occurring in Burma. In 2010, PHR documented the persecution and violent starvation of stateless Rohingya by Bangladeshi authorities. 

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Violations of Medical Neutrality in Türkiye Are Reminiscent of Bahrain

Attacks on Health Care, Bahrain

Along with many of my medical colleagues, I have been appalled to read recent news accounts of Turkish doctors being arrested, questioned, and threatened with having their medical licenses revoked merely for treating protesters wounded in clashes with security forces in Istanbul.

We have also been encouraged, however, to see the Turkish Medical Association’s (TMA’s) Central Council respond so forcefully to the Ministry of Health’s attempts to discourage physicians from treating protesters engaged in “illegal” activities. In comments posted on its web site, the TMA declares that “the health of our patients will be our first consideration” and that “we shall not permit considerations of creed, nation, ethnicity, party politics or social standing to intervene between our duty and our patients.”

Such strenuous pushback in defense of medical neutrality will likely be required not just in Türkiye but in many other countries before this principle becomes firmly rooted in places where governments see the provision or denial of medical care as just another tool to be used in their efforts to exert control over their citizens.

Even here in the United States, where Congress has not yet passed the bipartisan Medical Neutrality Protection Act, some of the detainees now on hunger strike in Guantanamo might well contend that this country has room for improvement when it comes to observing medical neutrality. That is one reason why Physicians for Human Rights (PHR) and other organizations are calling for independent doctors to be allowed access to evaluate and treat the hunger strikers, who have lost confidence in their military doctors.

Elsewhere in the world, medical professionals continue to pay a high price for treating wounded people in defiance of governmental opposition. Several still languish in prison in Bahrain, more than two years after they treated people injured in the Arab Spring protests, while many more have been ousted from their jobs.

Recent events in Türkiye remind me of the human rights abuses in Bahrain that I investigated for PHR in April 2012—including the security forces’ apparent use of tear gas as a weapon, as documented in the PHR report that we published subsequent to the investigation. The situations in Bahrain and Türkiye, though similar in some ways, are very different in others, of course. In Istanbul, the doctors who were taken into custody have been released.

The doctors’ courage should inspire the rest of us to redouble our efforts to ensure that the principle of medical neutrality is embraced wherever doctors, nurses, and other medical professionals are working—in other words, in every country across the globe. As Hippocrates instructed us some 2,500 years ago and the Turkish Medical Association reminded us this month, the patient’s well-being must always be our primary consideration.

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UN Rights Council Calls on Burma to End and Investigate Anti-Muslim Violence

Mass Atrocities, Burma

The United Nations Human Rights Council took a significant step toward protecting the rights of Rohingya in Burma by adopting by consensus today a presidential statement on the human rights situation of the country’s Muslims. The statement, drafted by Pakistan on behalf of the Organization of Islamic Cooperation, called for an end to violence against Muslims, the establishment of accountability mechanisms, and the granting of citizenship to Rohingya. Under current Burmese law, Rohingya are denied citizenship, and they face systemic persecution that keeps them from accessing essential public services. The statement, supported by the Government of Burma, reflects the council’s unified voice in supporting the rights of the country’s Muslims.

While the council should be applauded for calling attention to the often-ignored situation of stateless Rohingya as well as violence against Muslims in general, the statement should have been stronger. For example, it referred only to attacks on Muslims, and not attacks on other minority groups. Physicians for Human Rights (PHR) has investigated abuses against civilians in Chin State, Kachin State, Karen State, and Shan State, where the military and local government authorities have committed heinous human rights violations against religious and ethnic minorities. These systematic attacks were not mentioned in the statement adopted today by the council. The statement also made no mention of the potential opening of an Office of the High Commissioner for Human Rights office in the country, even though Burma’s government has already agreed to its establishment, nor does it mention the extremely worrisome reinvigorated policy that limits Rohingya couples in northern Rakhine State to having only two children.

The statement also fell short by calling for a domestic investigation of acts of violence instead of an international investigation. Burma’s government has shown with its recent Rakhine Investigation Commission that its methodology for local investigations does not respect human rights and instead preys upon stereotypes about minority populations. Those drafting the statement should have called for an investigation by the Special Rapporteur on the Situation of Human Rights in Myanmar, Tomas Ojea Quintana, who has already announced his willingness to assist in pursuing investigations of attacks on minority groups. To date, there has been no thorough and impartial investigation by Burmese authorities of the massacre in Meiktila, Mandalay Division, which occurred in March of this year. Physicians for Human Rights documented the massacre of two dozen people in Meiktila that was carried out by civilians with the acquiescence of local police.

PHR has been calling for the Government of Burma to address the massacre in Meiktila, and the Burmese ambassador to the Human Rights Council did mention the incident in his remarks about the presidential statement. Sadly, he chose to gloss over the serious violence that took place in Meiktila by only mentioning those Buddhists who extended a helping hand to people at risk of attack. While PHR did find that some people bravely saved potential victims from attack, the events in Meiktila should not be remembered as a moment of interfaith solidarity but as a crime scene where brutal violence was tolerated and remains unpunished. The victims and survivors of the violence in Meiktila deserve more from their government.

Today’s presidential statement by the Human Rights Council was a welcome step to recognize the situation of Rohingya in Burma, but the council should prepare to show renewed and stronger support for minorities in the country in the future. If the situation of ethnic and religious minorities in Burma continues to deteriorate, and if the country’s government continues to shirk its responsibilities to protect its people and enact fair accountability mechanisms, then we must look to the council to establish an international investigation at its next session in September.

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Burma Must Take Steps to Quell Ethnic Violence

Mass Atrocities, Burma

This post originally appeared on Democratic Voice of Burma.

This week’s outbreak of violence against Muslims in Lashio marks nearly a year of targeted attacks on Muslims in Burma. Physicians for Human Rights (PHR) recently interviewed witnesses and victims in Arakan state, Mandalay and Saigaing divisions about the ongoing attacks, and found that the government places a low priority on protecting the human rights of ethnic groups in the country.

Earlier this month, a team of researchers from PHR spent ten days in central Burma investigating attacks on Muslim civilians. The team interviewed 33 people, including 14 eyewitnesses, and compiled a thorough account of the slaughter of at least 20 children and four teachers in Meikhtila, Mandalay division. Other reports estimate that many more were killed.

PHR researchers obtained video footage showing Muslims beaten and burned to death, and confirmed the authenticity of these events with GPS, satellite mapping and eyewitness interviews.

In Meikhtila, investigators found that police were complicit in the violence against Muslims   ̶  they marched unarmed Muslims toward an armed civilian mob, then refused to protect them from beating, stoning, and murder; they did not help injured Muslims; and they failed to apprehend perpetrators. The police force’s actions in Meikhtila are in violation of the UN code of conduct for law enforcement officials, and the general lack of an effective response from the central government is a monumental failure to protect its citizens from organised and targeted violence.

In the wake of unspeakable violence carried out in a methodical manner by civilians with the acquiescence of local police, there must be a strong and swift response within Burma. Despite overtures about tolerance, there has been no credible effort thus far to investigate the massacre and hold perpetrators accountable.

The government’s weak response to stop the violence and its reluctance to help Muslim victims is a symptom of a larger problem—ethnic groups are not benefitting from fledgling democratic reforms.  Despite some improvements at the political level, they are treated by the new government as they were by the previous regime. Although some analysts suggest the recent violence is a result of new freedoms and democratic reforms, it’s actually just the opposite — it is a continuation of abuses against ethnic groups that are done with impunity and either tacit or outright government approval.

The evidence PHR collected in Meikhtila shows a pattern of destruction indicative of targeted and coordinated strikes against Muslim-owned businesses, homes, and mosques, and coordinated efforts to drive Muslims out of the town. Although the government imposed curfews in some towns with threats of violence and arrested some perpetrators, the response has been insufficient. Police continue to respond too slowly to stop mobs, victims are targeted for arrest as often as perpetrators, Muslims are warned not to defend themselves against mobs, and there has been no effort to prosecute those behind the attacks. The government’s acquiescence sends a strong message that these attacks can be done with impunity.

The evidence does not suggest that the government orchestrated the attacks, but it does indicate that the government did not act effectively to curb the violence. As new reports of anti-Muslim violence emerge from other parts of the country, the central government as well as local police must do much more to stop the violence from spreading.

Unfortunately, institutionalised impunity has taken root across the country, not only in areas plagued by recent religious violence. In ethnic areas, the abuses have been ongoing for 60 years—military attacks on civilians, forced displacement, environmental destruction, and failure to provide humanitarian aid have not stopped. There has been no effective effort to rein in abuses or prosecute offenders.

One of the starkest examples of ongoing violence is in Kachin state, where the Burmese army has ignored orders from President Thein Sein to stop fighting, and continues to violate the human rights of civilians. Human rights groups have documented attacks on civilians in the state throughout the current conflict, which has raged since June 2011. Violence and impunity also persist in Shan state, where fragile ceasefires recently crumbled and civilians are once again being displaced by conflict. Long-running government abuses against Rohingya are now coming to the world’s attention, and violations of human rights against Arakanese, Chin, Karen and other groups have continued.

The international community has rewarded the government of Burma for its democratic reforms by lifting sanctions, increasing development aid, and forgiving loans. Yet Burma’s roadmap to democracy has yet to include ethnic groups, which make up at least 40 percent of the population. Though most of the sanctions and development concessions were made with the understanding that life for civilians is improving, progress has been far too slow for those in ethnic groups. The international community should not leave ethnic groups in Burma at the mercy of systematic attacks, and it must press for an end to ethnic violence and discrimination in diplomatic negotiations.

There will be no easy or quick transition to a peaceful Burma where ethnic and religious groups enjoy the fullest protections of their rights. Instilling a culture of tolerance across ethnic and religious lines and replacing impunity with accountability will not happen without concerted efforts by government actors as well as civil society leaders.

Perhaps the most difficult task facing the people of Burma today is the process of social reconciliation. After years of military dictatorship, rampant criminality, and a culture of violence, everyone must make the choice to end violence within their communities. Direction should come from recognized leaders within government and civil society, high-level religious leaders, and well-known democracy activists, who must condemn in unequivocal terms all ethnic and religious violence and hate speech.

There must also be an independent and transparent investigation of incidents of religiously motivated violence and discrimination with the ultimate aim of holding any perpetrators accountable. Other countries may be able to assist in these essential efforts, especially with the development of an independent investigation, but the will and the design for a society built on respect and tolerance must originate with the people of Burma.

Bill Davis is the former Burma project director and volunteer medical advisor for Physicians for Human Rights and Andrea Gittleman works as the group’s senior legislative counsel.

Blog

The closure of Guantánamo: a modern Gordian Knot

Torture, United States

In a 21st century version of the Gordian Knot legend dating back to 333 BC, President Barack Obama boldly tried to resolve one of the most intractable human rights and national security problems he inherited on his first day in office: the closure of the detention facility in Guantánamo, Cuba. Similar to Alexander the Great's solution of simply cutting the unsolvable knot tied by Midas in half without actually trying to untangle it, the modern leader of the free world signed in 2009 an executive order to close Guantánamo within a year.

The enthusiasm of that day quickly gave way to a more profound realisation of the difficulties of this endeavour. When a federal judge in 2008 ordered a group of Uyghur detainees to be released from Guantánamo and transferred to the United States, his decision was overturned in 2009, and a highly politicised Congress made any such transfers to the US impossible by prohibiting the use of any public funds. Guantánamo releases therefore always require one thing: a foreign government willing to accept them. In subsequent years, congressional provisions have routinely increased the obstacles for Obama to close Guantánamo, and transfers have come to a grinding halt as the administration has not robustly exploited the little maneuvering room it has left.

(Read the full blog post at PublicServiceEurope.com.)

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Visit by Burmese Leader Offers Key Opportunity to Press for Human Rights Improvements

Mass Atrocities, Burma

Burmese President Thein Sein is scheduled to meet with President Obama today, marking the first visit to the United States by a Burmese head of state in 47 years. Since that visit in 1966, the people of Burma have endured governmental mismanagement, brutal military rule, and serious human rights violations. Burma became a pariah state, synonymous with its infamous imprisonment of political activists and militarized attacks on civilians.

In the past several years, Burma seemed to have been emerging from its shadowy past. The government released political prisoners, allowed greater press and media freedoms, and granted increased political participation on the part of opposition groups. These reforms, seemingly unrealistic just a few years earlier, have encouraged western countries to ease their stiff sanctions and begin a new era of engagement.

The strategy of the Obama administration was to encourage more sustainable reforms by matching action for action: removing sanctions or other barriers in response to improvements. While this may seem like a wise method of promoting further reform, the strategy included few responses to persistent problems in Burma, including rampant impunity for human rights violators, continued attacks on civilians, and extreme sectarian violence.

Physicians for Human Rights (PHR) recently documented one example of brutal violence by investigating the scene of a massacre in Meiktila, a town in central Burma. In a report released today, PHR outlines how a mob of civilians attacked a Muslim religious school, killing 20 children and four teachers. The violence was tolerated by police officers, who stood by and sometimes participated in the attacks. The killings in Meiktila are but one stark example of the systemic problems that continue to plague Burma despite other recent improvements.  

Today’s visit comes at a key time in Burma’s transition to democracy – a time when its government must decide whether to grapple with the abuses of the past and bring an end to a culture of militarization and impunity. The landmark meeting provides President Obama with a key opportunity to encourage President Sein to do just that.

The Burmese government has a wish list of items from the United States, including, most likely, a wide open door to US investment in Burma, military assistance, and the removal of additional names from the Specially Designated Nationals list, which names individuals who cannot engage with US investors. President Obama should only relinquish these benefits in return for substantive progress on key human rights issues. Economic boons should only be rewarded to the Burmese government when it establishes effective accountability mechanisms to address human rights violations, allows humanitarian aid workers unfettered access to those in need, and institutionalizes protections for ethnic minority groups. These advances will require long-term dedication on the part of the Burmese government – and if President Sein returns to Burma with economic assistance without having made substantive progress on these issues, the likelihood of progress without external pressure is small.

There are a few possible outcomes of today’s meeting. President Obama could grant Burma’s leader his wish list without seeing human rights improvements in return. That would send a strong signal that the US will turn a blind eye to human rights violations in the name of economic assistance. There is also a possibility that President Obama will use this opportunity to demand further reforms in Burma before giving additional assistance. This second scenario would involve a sober realization of the reforms yet to be implemented in Burma, and help lay the foundation for a sustainable peace in Burma.

Blog

Ongoing Politicization of Medical Affairs in Bahrain Requires Vigorous Response

Attacks on Health Care, Bahrain

The cancellation of an international medical ethics conference that had been scheduled for April 10-12 in Bahrain is another sign that the country’s rulers continue a systematic pattern of politicizing medical affairs.

The organizers, Médecins Sans Frontières and the Royal College of Surgeons in Ireland at the Medical University of Bahrain, said they were forced to cancel the conference because they had not received confirmation of the government’s approval. The medical school’s president, Prof. Tom Collins, resigned in protest over the cancellation.

The dozens of medical professionals arrested in early 2011 include graduates of the Royal College of Surgeons. Those arrests, along with military crackdown at the Salmaniya Medical Complex in Manama, showed flagrant disregard for all principles of medical neutrality. The attack on the hospital and on its medical personnel, the misuse of its facilities by security forces, and the subsequent militarization of the entire health sector have had a huge negative impact on health services in Bahrain.

The decision in March by a Bahrain court of appeals to reverse the convictions of 21 medics does little to improve the situation. The medics’ confessions were obtained under torture and their convictions were illegal. Despite the appeals court’s decision, the Ministry of Health has not permitted the medics to return to their jobs, and continues its harassment by complicating their attempts to practice medicine not just in Bahrain but in other Arab Gulf states. And politics have also infringed on the independence of such private institutions as Bahrain’s medical, dental, and nursing societies.

Still languishing behind bars on political charges are several dedicated medical professionals: Drs. Ali Al-Ekri (serving a five-year sentence) and Ibrahim Al Demestani (three years), along with staff nurse Hassan Matouq (three years), pharmacist Ahmed Al Mushatat (two years), and nurse assistant Halima Al Sabagh (one year).

In the face of such ongoing attacks and injustices, we must continue pressure on the Bahrain regime to release all medical staff still in prison and to stop its violation of all forms of medical neutrality. We call on all human rights organizations and United Nations institutions to add their voices to this urgent plea for justice for medical professionals in Bahrain.

Dr. Nabeel H. Tammam is a Bahraini ear, nose, and throat specialist who established the Voice Clinic at Salmaniya Medical Complex in Manama in 2000. He has worked for Bahrain’s Ministry of Health since 1986.

Statements

President Obama Urged to Coordinate Executive Branch Response to Senate Committee's Study on CIA Interrogation Program

PHR has joined seven other NGOs, including the ACLU, Human Rights Watch, The Center for Victims of Torture, and others, to urge President Obama to make sure the Executive Branch response to the Senate Select Committee on Intelligence study is not driven by individuals who might be implicated in the CIA’s use of torture.

>> Read the Letter (pdf)

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