Law
and Health Digest—Issue 2012(1)
Featuring joint work with the Public Health
Program’s Access to Essential Medicines Initiative, Accountability and
Monitoring in Health Initiative, Campaign to Stop Torture in Health Care,
Global Health Financing Initiative, International Harm Reduction Development
Program, and International Palliative Care Initiative, and Sexual Health and
Rights Project, as well as OSF’s Human Rights and
Governance Grants Program (HRGGP) and numerous
national and regional foundations.
For more information, please visit http://www.soros.org/initiatives/health/focus/law/news
In This Issue:
Objective 1:
Advancing the Health and Human Rights Framework by Applying
it to New Issues and Priority Regions
Georgia Practitioner Guide on Human Rights in
Patient Care Launched
On September 9, 2011 the Open Society Georgia
Foundation (OSGF) hosted a launch of the Georgia
Human Rights in Patient Care Practitioner Guide. The Guide, supported by LAHI and OSGF, provides a practical
tool for lawyers in taking human rights in patient care cases. It addresses the
rights and responsibilities of both patients and health care providers and
includes relevant constitutional provisions, conventions, laws, bylaws, and
cases. The Practitioner Guide was designed as a resource for both litigation
and training. Although targeted at lawyers, the Guide may additionally be of
interest to doctors, public health professionals, health managers, and patients
who are interested in better understanding of patients’ and providers’ rights
and responsibilities and the available mechanisms for their enforcement.
The launch brought together representatives
from the Georgian government, NGOs working in health care and the human rights
field, international organizations, lawyers, and the media. The Practitioner
Guide was distributed in hard copy and on CD in both Georgian and English and
is also available at www.healthrights.ge. Since health
care law and regulations are constantly evolving, the electronic version of the
Guide will be regularly updated at this site. For additional information,
please contact Nina Kiknadze at nkiknadze@osgf.ge or Mariam
Gavtadze at healthrights@gyla.ge.
LAHI, Open Society
Georgia Foundation Launch Initiative on Alternative Dispute Resolution
Despite a strong legal framework for
protecting human rights in patient care in Georgia, dissatisfaction by patients
and conflicts between patients and providers remain a pervasive problem, as in
many countries in the region. This is in part due to the absence of an
effective and easily accessible system of alternative conflict resolution. To
complement the Practitioner Guide initiative in Georgia, LAHI and the Open Society Georgia Foundation (OSGF) are supporting the Georgian Coalition for Human
Rights in Health Care (HRH Coalition) to develop the most appropriate model
of alternative dispute resolution in the field of health care of Georgia. The
project will study various models of mediation from other fields and
jurisdictions and adjust them to the needs and context of the country,
particularly to the needs of the most vulnerable groups who are a priority for
the PHP. The project will combine desk research,
qualitative research methods such as key informant interviews and focus group
discussions, and study tours to elaborate a set of recommendations for presentation
to the key stakeholders of the field. The projects implementer, the HRH
Coalition, was created in 2008 with the support of OSGF,
LAHI and the PHP’s Health
Media Initiative, with the aim of creating a national entity to lead the
process of advocacy, promotion and protection of human rights in health care
through implementation and further development of international human rights
standards. The HRH Coalition was established by eight Georgian NGOs that had
previously undertaken several successful projects related to the promotion of
fundamental freedoms and human rights in various health-related fields. For
more information, please contact Nina Kiknadze at nkiknadze@osgf.ge.
Faculty Workshop on Human Rights in Patient
Care
In October 2011, LAHI
and Soros Foundation Kyrgyzstan held a workshop for faculty of the law and
health courses from Kazakhstan and Kyrgyzstan to strengthen the human rights
component of these courses and interactive teaching methodology. Faculty shared
with each other innovations in themes, resources, and methods in teaching human
rights in patient care. Additionally, faculty learned about palliative care and
human rights, the health and human rights concerns of injecting drug users and
sex workers, and the Campaign to Stop Torture in Health Care. They also had the
opportunity to design and role play their own human rights in patient care case
studies. Materials from the workshop can be found on the Community of Practice
for faculty at http://cop.health-rights.org/teaching/153.
For additional information, please contact Tamar Ezer
at tezer@sorosny.org or Zulaika Esentaeva at zesentaeva@soros.kg.
Update on Human Rights and the Global Fund
In the previous issue of LAHI
Digest, we reported that the Board of the Global Fund to Fight AIDS,
Tuberculosis and Malaria had acknowledged the first draft of the Fund’s
2012-2016 Strategy, which included Human Rights and Equitable Access as
one of five strategic objectives. Since then, advocacy to increase the Fund’s
attention to human rights has seen both victories and setbacks. At its November
2011 meeting, the Fund’s Board formally adopted an ambitious and
forward-looking Strategy that contains a dedicated strategic objective on human
rights, committing to integrating human rights considerations throughout the
grant cycle, increasing investments in programs that address human
rights-related barriers to access, and ensuring that the Global Fund does not
support programs that infringe human rights. However, at the same meeting, the
board revealed a massive funding shortfall that compelled them to cancel the
Fund’s next round of grants and reduce eligibility in order to maintain the
essential services it was currently supporting. As our colleague Shannon
Kowalski subsequently blogged (http://blog.soros.org/2011/12/we-could-end-aids-but-will-we/),
“At precisely the moment we've realized how to curb HIV, donors have left the
Global Fund treading water, struggling to keep funding flowing to preserve the lives
of those who are already on treatment.” The UNAIDS
Reference Group on HIV and Human Rights issued a statement calling the
reduction or failure to honor pledged support to the Global Fund by donors “an
abrogation of legally grounded human rights obligations.” The fate of human
rights in the Global Fund is now at a crossroads. Will the Fund redouble its
efforts to protect human rights as way of protecting its remaining investments
in health services? Will it recognize human rights programming as an essential
service to maintain during the funding crisis? Will it approach its own funding
crisis as the human rights issue it is? These and other questions related to
the operationalization of the Fund’s human rights
objective must remain high on the agenda as the Fund intensifies its efforts to
mobilize financial resources for the three diseases. For more information,
please contact Shannon Kowalski at skowalski@sorosny.org.
Experience Sharing on Palliative Care Rights
In September 2011, at a conference for
Russian nurses, LAHI consultant Judy Overall
presented on the LAHI Practitioner Guide (PG)
Initiative, the development of a series of manuals on taking human rights in
patient care cases in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia,
Moldova, Russia, and Ukraine. Judy focused her remarks on a comparative
analysis of protections for the “Right to Avoid Unnecessary Suffering and Pain”
from the various countries. Yulia Gorshokova,
the international and Russia web coordinator for the PG project, presented the
international website (http://health-rights.org)
and an overview of materials available on the Community of Practice. Anna Kryukova, head of the Open Medical Club and Russia PG host,
highlighted the Russia PG website. Iryna Senyuta, head of the All-Ukrainian Foundation of Medical
Law and Bioethics and Ukraine PG host, discussed regulation of palliative care
rights in Ukraine and shared the Ukraine PG website. For additional
information, please contact Judy Overall at joverall10@aol.com.
Objective 2:
Developing Individual and Organizational Leadership in the Field of Health and
Human Rights
Lawyering on the Margins Convening
Held in Copenhagen, Denmark
At the end of November 2011, 26 lawyers from
across the world gathered in Copenhagen, Denmark, for a unique seminar. “Lawyering on the Margins,” a joint project of the Law and
Health Initiative (LAHI), the Sexual Health and
Rights Project (SHARP) and the International Harm Reduction Development Program
(IHRD), brought together lawyers working with people
who use drugs, sex workers, and lesbian, gay, bisexual and transgender people.
The seminar included sessions on human rights, law, and marginalized
communities; working in hostile environments; avoiding burnout and working with
difficult clients, lawyers and advocates; on using strategic litigation to
advance the rights of marginalized groups; as well as on the marginalization
the lawyers themselves experience within their legal communities. The gathering
provided a forum for professional development and peer support that is
much-needed but lacking in the participants’ everyday work. It created
opportunities to discuss strategies for advancing access to justice for those
on the margins of society.
Copenhagen was chosen as the meeting location
to provide the opportunity to learn about the innovative work of the Street
Lawyers, an organization that does outreach lawyering
to drug users (for more information, please visit the blog written by Tatyana Margolin at http://blog.soros.org/2010/10/what-we-can-all-learn-from-danish-street-lawyers).
As part of the seminar, the participants also visited a heroin treatment center
and the Danish Institute for Human Rights. In response to the participants’
feedback, LAHI, SHARP and IHRD
are planning to hold a follow-up meeting in late 2012. For more information,
please contact David Scamell at dscamell@sorosny.org or Tatyana Margolin at tmargolin@sorosny.org.
Strasbourg Study Tour Held for LAHI Fellows and Grantees
In November, LAHI
grantees and Practitioner Guide Fellows participated in a Study Tour in
Strasbourg, France to learn about the European human rights system. They
visited the Council of Europe, the overarching European body focused on
advancing human rights, democracy, and the rule of law; the European Court of
Human Rights; the European Committee of Social Rights; and the European
Committee of Ministers, charged with enforcement of judgments. The European
Court of human rights focuses on civil and political rights and examines health
and human rights concerns through the lens of the rights to life, liberty and
security of person, private and family life, non-discrimination, and freedom
from torture and inhuman and degrading treatment. Past cases have explored
issues such as detention conditions, access to care and medical records,
physical disability and mental health, drug use, reproductive health,
transgender health, and assisted suicide. The European Committee of Social
Rights monitors country realization of both the right to health and the right
to social and medical assistance through a review of periodic country reports.
Since 1998, it further rules on collective complaints addressing the 14 member
states who have agreed to be bound by this authority. A highlight of the visit
was a talk by a Macedonian Judge from the European Court of Human Rights, who
shared insights from her experience, as well as reforms underway to ensure the
Court functions more efficiently in the future. For additional information,
please contact Tamar Ezer at tezer@sorosny.org or Kirsten Ruch at kruch@sorosny.org.
Developing Leadership in the HIV and Human
Rights Sector in Southern Africa
Leadership, management and governance are
distinct yet related components of organizational development in any sector. As
part of the multi-year Core Grants Initiative (CGI), which supports six HIV and
human rights organizations in Southern Africa, LAHI
and OSISA convened a workshop in December 2012 on
leadership, management and governance for executive directors, senior staff and
selected board members of the six participating grantees. The workshop explored
leadership from three perspectives: the self, the organization, and the sector.
The lessons imparted at the workshop included: the impact of different
leadership styles on organizational culture; the difference between leadership
and management; the concept of “leadership from within”; and the diverse ways
in which organizations in the sector are engaging their boards. Some highlights
of the workshop included one-on-one coaching sessions with an executive coach,
a panel of noted leaders from the region who reflect on their personal
journeys, and a lively discussion amongst board members of five different
organizations. Participants kept leadership journals throughout the workshop
and have been offered the opportunity to sustain and deepen what they learned
through further coaching, peer-to-peer activities during the year, and
continued one-on-one capacity development with the CGI’s lead consultant,
Tamara Braam. For more information, please contact
Amelia Motsepe at ameliam@osisa.org
or Shari Turitz at sturitz@sorosny.org.
Objective 3:
Piloting Innovative Access to Justice Tools as Health-related Human Rights
Interventions
Association of Harm Reduction Lawyers
Launched in Ukraine
In November 2011, following its inaugural
meeting in Crimea, Ukraine, the All-Ukrainian Association of Harm
Reduction Lawyers was established to unite lawyers from around Ukraine who will
work in their respective regions to provide legal aid to drug users, and to
serve as a platform for them to periodically come together to share best
practices. The network will also help lawyers throughout the year to receive
feedback or advice from one another, as well as facilitate client referrals.
The network is co-funded by LAHI, PHP’s
International Harm Reduction Development Program, and the International
Renaissance Foundation. For more information, please contact Tatyana Margolin at tmargolin@sorosny.org.
Premier Legal Aid Website Partners with
Leading Human Rights Association “AGORA” for More Effective Assistance to Drug
Users
Hand-help.ru, a Russia-based legal aid
consultations website that is jointly funded by the LAHI,
PHP’s International Harm Reduction Development
Program, and the OSF Russia Project, has teamed up
with the Russian NGO “AGORA,” an inter-regional network of human rights groups.
The partnership will increase the impact of the website by enabling its clients
with drug-related offenses to be referred to lawyers identified by AGORA for
in-person consultations in several Russian cities. Cases with high strategic
litigation potential will be chosen for these in-person consultations, while
the website will continue providing online answers to the rest of the clients.
The website can be accessed at www.hand-help.ru
(in Russian). For more information, please contact Tatyana Margolin
at tmargolin@sorosny.org.
Objective 4:
Advocate for Rights-based Legal Environments that Support the Health of
Marginalized Groups
Right to Inherit Victory for Women in Malawi
In November 2011, Women in Law in Law in
Southern Africa (WLSA)-Malawi celebrated success
after over a decade of advocacy. The Malawi Parliament finally recognized that
women have the right to inherit from the marital estate. In the past, widows
and their children were often left with nothing after in-laws took possession
of their homes and valuables. Women’s economic disempowerment is particularly
problematic in the shadow of AIDS. Not only has AIDS magnified suffering from
discriminatory inheritance laws, but women’s economic dependence on men makes
it difficult for women to control relationships, protect themselves from HIV
infection, and seek treatment. To address these concerns, WLSA
Malawi joined forces with Federation of Women Lawyers (FIDA)-Kenya
to found WIN (Women’s Inheritance Now!). This network (http://winafrica.org) of legal practitioners
and human rights activists from Eastern and Southern Africa, supported by LAHI, Open Society Initiative for Southern Africa, and Open
Society Initiative for Eastern Africa, works to advance women’s property rights
in the context of HIV and AIDS through joint advocacy and the sharing of
information, experiences, and strategies. For additional information, please
see http://blog.soros.org/2011/11/victory-for-women-in-malawi or contact Tamar Ezer
at tezer@sorosny.org.
Expert Consultation on Monitoring for Health
in Pretrial Detention Held in Vienna, Austria
Under the auspices of the Global Campaign
for Pretrial Justice The Global Campaign for
Pretrial Justice promotes a comprehensive approach to reduce and
rationalize the use of pretrial detention around the world and thereby
ameliorate the many negative consequences of detention. The excessive use of
pretrial detention magnifies the dangers of overcrowding, inadequate health
services, lack of access to long-term treatment and care, and the spread of
infectious diseases such as HIV and tuberculosis. Injection drug users are
particularly vulnerable to health risks of pretrial detention, where they are
likely to suffer from painful withdrawal, which is often used as a tool to
coerce testimony. Those who were receiving HIV or opioid
substitution treatment are likely to experience prolonged interruptions, LAHI, PHP’s International Harm
Reduction Development Program, and Open Society Justice Initiative held an
Expert Consultation in October 2011, in Vienna, Austria to develop a monitoring
tool for illnesses and health risks of people in pretrial detention, with a particular
focus on harm reduction. The monitoring tool meeting was a hands-on workshop
that brought together experts in the fields of communicable diseases, harm
reduction, prison health, torture, and prison administration to develop a
monitoring tool specific to the health needs of people in pretrial detention.
This tool will pay particular attention to the needs and problems of pretrial
detainees who are injection drug users. The aim is to pilot-test the resulting
tool in three sites within the next year (Ukraine, Russia, and Armenia), review
the results to validate the monitoring tool, and release the tool for broad
use. For more information, please contact Tatyana Margolin
at tmargolin@sorosny.org.
Materials on Forced Sterilization and Human
Rights Launched
In many parts of the world, women rely on
access to a range of methods to control their fertility, including voluntary
sterilization. However, too often, sterilization is not a choice. Women across
the globe are forced and coerced by medical personnel to submit to unwanted,
permanent and irreversible sterilization procedures. Despite condemnation from
the United Nations, cases of forced and coerced sterilization have been
reported in North and South America, Africa, Asia, and Europe. Women who are
poor or stigmatized are most likely to be deemed “unworthy” of reproduction.
Perpetrators are seldom held accountable and victims rarely obtain justice for
this violent abuse of their rights. Forced and coerced sterilizations are grave
violations of human rights and medical ethics and can be described as acts of
torture and cruel, inhuman, and degrading treatment. Forcefully ending a
woman’s reproductive capacity may lead to extreme social isolation, family
discord or abandonment, fear of medical professionals, and lifelong grief. To
address this alarming trend, the Forced Sterilization Working Group of the
Campaign to Stop Torture in Health Care (www.stoptortureinhealthcare.org),
co-chaired by LAHI Senior Program Officer, Tamar Ezer, has produced two publications to draw attention to
this abuse and to provide guidance to advocates and policy makers on how to
ensure that fully informed consent is obtained before any sterilization
procedure.
Against Her Will:
Forced and Coerced Sterilization of Women Worldwide provides an overview
of the global problem of forced sterilization. Sterilization of
Women with Disabilities: A Briefing Paper delves
deeper into the specific considerations that must be taken into account when
considering sterilization of women or girls with disabilities. Both
publications are available at http://www.stoptortureinhealthcare.org/forced-sterilization.
For additional information, please contact Tamar Ezer
at tezer@sorosny.org or Lydia Guterman at lguterman@sorosny.org.
Lesotho Constitutional Court to Hear
Chieftainship Succession Case
On February 22, 2012 the Lesotho
Constitutional Court heard a case challenging section 10 of the Chieftainship
Act of 1968, which denies women the opportunity to succeed to chieftainship.
The Applicant, Senate Masupha, is the first-born
child of a chief and has been denied the chieftainship solely on the basis of
her gender. The Southern Africa Litigation Centre has intervened in the matter
as amicus curiae, arguing that section 10 violates fundamental
constitutional protections, including the right to be free from discrimination;
right to equality; and the right to participate in public affairs. SALC further argued that section 10 violates Lesotho’s
regional and international legal obligations. The Court addressed various
procedural issues and scheduled a hearing on the substantive issues for early
May 2012. For further information, please contact Priti
Patel at pritip@salc.org.za.
2011 in Review
LAHI Concludes Final Year
of First Strategy
Our 2011 round-up of LAHI
funding highlights the final year of implementation of LAHI’s
first (2006-2010) strategic plan with our five original priorities. In total, LAHI supported over $2.7 million worth of health and human
rights projects in 2011, not including significant co-funding by other parts of
the PHP and OSF. Among the
many highlights were:
A more detailed account of LAHI’s achievements and challenges in 2012 can be found in
our annual Activity Plan submitted to PHP senior
management. Thank you to all of our partners for another great year of
collaboration and for making LAHI’s first Strategic
Plan such a successful learning experience!
Announcements
LAHI is pleased to
introduce Alex Parker who joined LAHI on February 6th
as the Temporary Administrative Assistant for the duration of Olga Baraulia’s upcoming maternity leave. Alex will work on the
administrative support functions with Kirsten Ruch
who will take over many of Olga’s core responsibilities until June 2012. Alex
graduated from Appalachian State University with a B.A. in International
Business and Francophone Studies. He recently completed a full time internship
with Amnesty International USA, where he worked in operations and development
as the Planned Giving intern and assisted the development team with various
administrative, fundraising and event planning efforts. Prior to that, Alex
worked for two years as a community organizer and event planner with the Office
of International Education and Development at Appalachian State University. He
focused on scholarship fundraising, organizing local grassroots campaigns, and
funding international development efforts.