May 16, 2008Dr Binayak Sen seems to have caught the imagination of the mainstream media in India at last. But one has to remember that he has spent a year in a Chhattisgarh jail.
An international award by the Global Heath Council named after Jonathan Mann to Dr Sen for his untiring work in the field of people's health and human rights followed by a strong appeal by 22 Nobel Laureates demanding his release seems to have convinced the media that there is something extraordinary about Dr Sen's arrest and that the issue needs to be probed.
Dr Sen, a paediatrician by training, was arrested on May 14 last year by the Chhattisgarh police under the dreaded Chhattisgarh Special Public Security Act and Unlawful Activities Prevention Act, which are in many ways more draconian than the now repealed Prevention of Terrorist Activities Act.
The police claimed it had evidence to prove that Dr Sen was actively helping out Maoists by providing them logistic support. The only piece of evidence they have been able to show till date is the fact that he made 33 visits to Narayan Sanyal, an old, ailing Maoist leader in jail. They were perfectly legal visits and allowed under the jail manual, not something clandestine. Sanyal was suffering from many diseases and required regular medical support.
As a civil right activist and doctor it was not unusual for Dr Sen to come into contact with extremist Maoists, especially since he was in Chhattisgarh, which is reeling under the bloody conflict between the state and the Maoists.
His plea for bail in the Supreme Court was rejected, which did not find it necessary to verify the claims by the state counsel. It agreed with the state that a free Binayak was a threat to the national security in Chhattisgarh.
The state is a dangerous place for civil right activists. It is the most recent destination for rich capitalists eyeing its mineral rich land and want it to be made available. How do you do it unless the tribals are driven out of their lands?
This is a state where governance is traditionally and criminally tilted in favour of moneylenders and the land and forest mafia. And welfare schemes aimed at the poor, especially the tribals, do not trickle down.
In such a scenario there is bound to be an emergence of a movement for justice. It does not necessarily have to be non-violent as the exploitation of the poor, who have been forced to be part of the developmental state, is extremely violent. National prosperity stands in striking contrast to the increasing impoverishment of the tribals.
Chhattisgarh was fertile land for the Maoist movement as the state failed shamefully to make the mechanism of justice work for the poor. Its loyalty to rich, national and multinational companies creates a compelling urge to eliminate anyone coming in the way. A report by an expert group set by the Planning Commission to look at the developmental challenge in extremist affected areas, says, 'there is, however, failure of governance, which has multiple dimensions and is not confined to the inefficiency of the delivery systems only. It is not fortuitous that overwhelmingly large sections of bureaucracy/technocracy constituting the delivery systems come from the landowning dominant castes or middle classes, with their attachment to ownership of property, cultural superiority and a state of mind which rationalises and asserts their existing position of dominance in relation to others. This influences their attitudes, behaviour and performance.'
'Internal displacement caused by irrigation/mining/industrial projects, resulting in landlessness and hunger, is a major cause of distress among the poor, especially the Adivasis. It is well known that 40 per cent of all the people displaced by dams in the last 60 years are forest-dwelling Adivasis� The law and administration provides no succour to displaced people and often treats them with hostility since the displaced people tend to settle down again in some forest region, which is prohibited by law. The Naxalite movement has come to the aid of such victims of enforced migration in the teeth of the law.'
The report further states that the Adivasis displaced from Orissa and Chhattisgarh, settling in the forests of Andhra Pradesh would have been easily evicted by officials but for the presence of the Naxalite movement.
Suffering from continuing land loss and displacement, dwindling livelihood resources, acute malnutrition and pitched against a formidable combine of profit-hungry companies and a callous administration, Adivasis found some solace from the Maoists. The Maoists therefore are not the cause but a result of the miseries of the Adivasis.
Instead of addressing these issues, the state took recourse to a militarist shortcut by helping in creation of an armed campaign called Salwa Judum which vowed to eliminate the Maoists. It employed Adivasis in its ranks, most of the times forcibly. It is not a coincidence that Salwa Judum started days after the signing of contracts between the state and some companies.
Salwa Judum is a law unto itself. Though it is claimed to be a peaceful people's movement in reality it is a State-sponsored peoples' militia which marches into villages, forces people to join or burns their houses, destroys their cattle, livelihood and drives them out. More than 640 villages have been evacuated in this drive. Lakhs of Adivasis have been forcibly removed from their habitations and some 40,000 of them live in Salwa Judum camps set up by the government, living in hellish conditions as another state-sponsored Administrative Reform Committee report found out. The committee was lead by senior Congress leader Veerappa Moily.
The Supreme Court was forced to express its displeasure of Salwa Judum by observing that the government cannot arm people and instigate them to kill others. Defending Salwa Judum was not a state lawyer but counsel for the central government who made an astonishing admission that the state police were unequal to the might of the Maoists. They were employing as special police officers only those who have been at some point, in some way been victimised by the Maoists, he pleaded. It was extraordinary for a state to openly defend an army of revenge.
Dr Sen's consistent opposition to Salwa Judum is the real cause of the state's ire. It was all good and rosy till he confined himself to providing health services to the poor. In fact, the government had invited him to advise on its health programmes.
Binayak Sen was a gold medallist from the prestigious Christian Medical College, Vellore, Tamil Nadu. He decided to leave his teaching job at Jawaharlal University in New Delhi to move to Chhattisgarh in 1978 to work with the legendary trade union leader Shankar Guha Niyogi, who built up the formidable Chhattisgarh Mukti Morcha. Niyogi was later killed by the industry mafia. Dr Sen moved around in villages, establishing clinics and providing healthcare to those who were damned by State-run systems.
But as Dr P Zachariah, his teacher at CMC, says, "His interest in civil activism grew out of witnessing malnutrition deaths among children. The lack of governance worried him deeply. Chhattisgarh is a complicated state with a complicated history. The government did not meet the people's needs and it was easy for Naxalites to exploit that. The government found it difficult to deal with militants who operated out of dense forests and took a very repressive stance. In the end, it led to the creation of Salwa Judum."
"The police machinery too was getting large funds to fight the Naxalites. In the dark days that followed, people began to disappear. As a member of the People's Union for Civil Liberties, Binayak couldn't help but get involved. The PUCL was constantly approached by villagers saying that their relatives had disappeared. The police had to be approached, FIRs had to be filed, and Binayak began to help," Dr Zacharaiah said.
Areas of disagreement between Dr Sen and the state government were bound to emerge. He could not have approved of measures like Salwa Judum. His work as the general secretary of the state's PUCL became a pain for the government. He was also staunchly anti-communal and critical of the activities of the Vishwa Hindu Parishad in Adivasi-dominated areas. Otherwise a quiet man, this English-speaking doctor was increasingly becoming a cause of worry for the state government. He was, like other law-abiding activists, a critic of unlawful encounters by the police and thus an impediment to national and multinational companies. He needed to be silenced and removed from the scene.
This was done by the state symmetrically, with an active help from the local media. In April and May last year, the Chhattisgarh police stared a vilification campaign against him when he was away in Kolkata to see his ailing mother. He was declared an absconding Naxalite doctor who had fled to evade arrest.
Dr Sen's brother circulated an open letter telling the world that he was not absconding, had gone to visit his mother and the police was in fact indulging in this vilification only to justify his arrest. His fears came true. Dr Sen returned to the state capital Raipur and was immediately arrested under the Chhattisgarh Special Public Security Act and the Unlawful Activities Prevention Act.
These laws do not need actual acts of conspiracy to make you criminal, even a perception that you may, even in future entertain thoughts which would be potentially against the state interest is sufficient reason for arrest.
Appeals by several civil right activists and individuals demanding the repeal of such absurd laws and the release of Dr Sen have been treated with disdain by the Chhattisgarh and central governments.
There is a strong belief in the establishment that all civil right activists are nothing but a respectable cover for extremists of all kinds, including the Maoists. They very conveniently ignore the criticism of Maoist violence by these individuals. What is disturbing is that if this liberal middle space is gone, there would not be a counter voice to violence.
It is only appropriate that the Global Health Council chose Dr Sen for its Jonathan Mann award. His international colleagues cutting across disciplines have asked the state and central governments to create situation for him to be able to receive this award in person which would be given in a public ceremony in the US on May 29. Given the arrogant insensitivity of our state institutions, it is unlikely that the appeals would be heard.
Can we expect our judiciary to help redeem the promise the Constitution makes to the people to safeguard their right to hold opinions and express it even if goes against the official line the state would like all of us to follow?
Apoorvanand is a literary critic and a Reader in Hindi at Delhi University
source-http://www.rediff.com/news/2008/may/16guest1.htm
Friday, May 16, 2008
Health and human rights are inextricably intertwined
Human Rights Day is commemorated every year on 10th December as the anniversary of the adoption of the Universal Declaration of Human Rights ( UDHR) by the United Nations General Assembly on December 10th, 1948. The first sentence of the preamble reads, “Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world.”Health and human rights are interconnected and their promotion fundamentally and inextricably intertwined. The effects of violations of dignity and physical integrity on health (mental or otherwise) are as crucial as the effects of poor health on dignity. Both the Universal Declaration of Human Rights (UDHR) and the International Covenant on Economic, Social, and Cultural Rights(ICESCR) recognise that health is central to the dignity of the person and the state’s commitment to health of the population as a fundamental human right.
The realisation of other rights is not possible if an individual cannot maintain his/her own health: “Particularly crucial health needs to include the prevention of stillbirths and infant mortality; the improvement of environmental and industrial hygiene; the prevention, treatment, and control of diseases; and the provision of medical care to the sick.
The linkage of health and human rights refers to the understanding that health status is in a large measure determined by the degree to which human rights are enjoyed. It also entails the application of human rights norms to policies and programs of health systems and to the conduct of health practitioners. The approach principally builds upon the scientific discipline of public health, epidemiology, and especially social epidemiology. Multilevel approaches to understanding social determinants of health, the role of social integration, social cohesion, and social networks, and similar concerns of social epidemiology all suggest a human rights context for policies to improve the prospects for vulnerable populations to lead healthy lives.
Poor health and inadequate health care are often related to human rights violations. And violation and underfulfillment of human rights are often due to poor health and lack of access to health care. The link is direct in the case of other basic social and economic human rights, such as the right to a standard of living adequate for the health and well-being of oneself and one’s family. But poverty and lack of health protection are also indirectly linked to failures to secure civil and political rights.
The ICESR, Article 12 reads in part “the States Parties to the present Covenant recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”. The interpretation of this article is elaborated in the General Comment 14, which the Committee on Economic, Social and Cultural Rights issued in 2000. Governments have obligations to respect, protect and fulfil the right to health as well as other human rights.
Human Rights are based on moral universals, their formulation is historically contingent and reflects societal understandings at particular points of history. A commitment to providing basic and adequate health care or other types of positive entitlements is far more appropriate and possible for the late twentieth Century advanced industrial economy than for the Eighteenth Century agrarian economy. We are in a new era of human rights and globalisation. The dramatic changes brought about by the end of the Cold War, partly as a consequence of the wider introduction of communication and information technology and partly as a result of trade liberalisation, prompted a global drive towards neo-liberal economic reforms and democratisation, globalisation of democracy and human rights, in contrast, has often-though not always-contributed to upholding certain civil and political rights. The most visible signs of the globalisation of human rights is the growth of international human rights non-governmental organisations (NGOs), global conferences, and transnational networking. Over the past twenty-five years, women’s civil rights and reproductive rights have found their way into the international legal and human rights agendas. The two most relevant human rights conferences of the 1990s were the 1993 Vienna Second World Conference on Human Rights and the 1995 Beijing Fourth World Conference on the Status of Women. In the Vienna Declaration, for example, for the first time, violence against women was recognised as a human rights abuse. The Beijing Conference set an impressive agenda for promoting human development by addressing gender inequality and women’s rights. Since Alma Ata, there have been some limited successes for global health in human rights-related areas: the elimination or reduction of important communicable diseases; increases in food production and longevity; elimination of some threats to the environment; and reductions in infant and child mortality. Nevertheless, success overall has been grossly inadequate. Critical health problems persist and are growing, and new threats have emerged. The ever-expanding global health crisis knows no borders or boundaries.
The greatest challenges facing our ability to advance the Human Right to health are not medical but cultural, economic, environmental, political, and social. Health is the sum of empowering education, adequate nutrition, safe environments, social support, and community cohesion. Rights are a way to mobilise and empower the disadvantaged, and in many parts of the world this is their principal function. The language of rights makes people conscious of both their oppression and the possibility of change. A human rights approach assumes a trade -off in which the political system provides the security of a health care entitlement in exchange for the people accepting limits on the benefits that are publicly funded.
Further using a human rights approach also implies that the entitlement is universal. This means there is no exclusion from the provisions made to assure health care on any grounds whether purchasing power, employment status, residence, religion, caste, gender, disability, and any other basis of discrimination. But this does not discount the special needs of disadvantaged and vulnerable groups who may need special entitlements through affirmative action to rectify historical inequities suffered by them. Thus establishing universal health care through the human rights route is the best way to fulfil the obligations mandated by international law and domestic constitutional provisions. International law, specifically ICESCR, the Alma Ata Declaration, among others, provide the basis for the core content of right to health and health care. But country situations are very different and hence there should not be a global core content, it needs to be country specific. Because a human right is a universal entitlement, its implementation is measured by the degree to which it benefits those who hitherto have been the most disadvantaged and vulnerable and brings them up to mainstream standards.
A human rights approach to health therefore necessitates both non-discrimination and affirmative action to eliminate historical inequities and patterns of discrimination in access to health services. As entitlements rights are contrasted with privileges, group ideals, societal obligations, or acts of charity, and once legislated they become claims justified by the laws of the state.. The emphasis thus should not be as much on ’respect’ and ’protect’ but on ’fulfil’. For the right to be effective optimal resources that are needed to fulfil the core obligations have to be made available and utilized effectively.
Health professionals have a great stake in the UDHR because human rights and health concerns share the common goals of alleviating suffering and promoting the conditions for health and well-being of all people. These goals represent an ideal that cannot be achieved unless the fundamental rights set forth in the UDHR are recognised, respected, protected, and fulfiled.
The realisation of other rights is not possible if an individual cannot maintain his/her own health: “Particularly crucial health needs to include the prevention of stillbirths and infant mortality; the improvement of environmental and industrial hygiene; the prevention, treatment, and control of diseases; and the provision of medical care to the sick.
The linkage of health and human rights refers to the understanding that health status is in a large measure determined by the degree to which human rights are enjoyed. It also entails the application of human rights norms to policies and programs of health systems and to the conduct of health practitioners. The approach principally builds upon the scientific discipline of public health, epidemiology, and especially social epidemiology. Multilevel approaches to understanding social determinants of health, the role of social integration, social cohesion, and social networks, and similar concerns of social epidemiology all suggest a human rights context for policies to improve the prospects for vulnerable populations to lead healthy lives.
Poor health and inadequate health care are often related to human rights violations. And violation and underfulfillment of human rights are often due to poor health and lack of access to health care. The link is direct in the case of other basic social and economic human rights, such as the right to a standard of living adequate for the health and well-being of oneself and one’s family. But poverty and lack of health protection are also indirectly linked to failures to secure civil and political rights.
The ICESR, Article 12 reads in part “the States Parties to the present Covenant recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”. The interpretation of this article is elaborated in the General Comment 14, which the Committee on Economic, Social and Cultural Rights issued in 2000. Governments have obligations to respect, protect and fulfil the right to health as well as other human rights.
Human Rights are based on moral universals, their formulation is historically contingent and reflects societal understandings at particular points of history. A commitment to providing basic and adequate health care or other types of positive entitlements is far more appropriate and possible for the late twentieth Century advanced industrial economy than for the Eighteenth Century agrarian economy. We are in a new era of human rights and globalisation. The dramatic changes brought about by the end of the Cold War, partly as a consequence of the wider introduction of communication and information technology and partly as a result of trade liberalisation, prompted a global drive towards neo-liberal economic reforms and democratisation, globalisation of democracy and human rights, in contrast, has often-though not always-contributed to upholding certain civil and political rights. The most visible signs of the globalisation of human rights is the growth of international human rights non-governmental organisations (NGOs), global conferences, and transnational networking. Over the past twenty-five years, women’s civil rights and reproductive rights have found their way into the international legal and human rights agendas. The two most relevant human rights conferences of the 1990s were the 1993 Vienna Second World Conference on Human Rights and the 1995 Beijing Fourth World Conference on the Status of Women. In the Vienna Declaration, for example, for the first time, violence against women was recognised as a human rights abuse. The Beijing Conference set an impressive agenda for promoting human development by addressing gender inequality and women’s rights. Since Alma Ata, there have been some limited successes for global health in human rights-related areas: the elimination or reduction of important communicable diseases; increases in food production and longevity; elimination of some threats to the environment; and reductions in infant and child mortality. Nevertheless, success overall has been grossly inadequate. Critical health problems persist and are growing, and new threats have emerged. The ever-expanding global health crisis knows no borders or boundaries.
The greatest challenges facing our ability to advance the Human Right to health are not medical but cultural, economic, environmental, political, and social. Health is the sum of empowering education, adequate nutrition, safe environments, social support, and community cohesion. Rights are a way to mobilise and empower the disadvantaged, and in many parts of the world this is their principal function. The language of rights makes people conscious of both their oppression and the possibility of change. A human rights approach assumes a trade -off in which the political system provides the security of a health care entitlement in exchange for the people accepting limits on the benefits that are publicly funded.
Further using a human rights approach also implies that the entitlement is universal. This means there is no exclusion from the provisions made to assure health care on any grounds whether purchasing power, employment status, residence, religion, caste, gender, disability, and any other basis of discrimination. But this does not discount the special needs of disadvantaged and vulnerable groups who may need special entitlements through affirmative action to rectify historical inequities suffered by them. Thus establishing universal health care through the human rights route is the best way to fulfil the obligations mandated by international law and domestic constitutional provisions. International law, specifically ICESCR, the Alma Ata Declaration, among others, provide the basis for the core content of right to health and health care. But country situations are very different and hence there should not be a global core content, it needs to be country specific. Because a human right is a universal entitlement, its implementation is measured by the degree to which it benefits those who hitherto have been the most disadvantaged and vulnerable and brings them up to mainstream standards.
A human rights approach to health therefore necessitates both non-discrimination and affirmative action to eliminate historical inequities and patterns of discrimination in access to health services. As entitlements rights are contrasted with privileges, group ideals, societal obligations, or acts of charity, and once legislated they become claims justified by the laws of the state.. The emphasis thus should not be as much on ’respect’ and ’protect’ but on ’fulfil’. For the right to be effective optimal resources that are needed to fulfil the core obligations have to be made available and utilized effectively.
Health professionals have a great stake in the UDHR because human rights and health concerns share the common goals of alleviating suffering and promoting the conditions for health and well-being of all people. These goals represent an ideal that cannot be achieved unless the fundamental rights set forth in the UDHR are recognised, respected, protected, and fulfiled.
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