Health and Human Rights:
How Health and Human Rights Are Interrelated
Human rights and health are two complementary approaches and languages
used to address and advance human well being. The human rights approach
first describes the societal level prerequisites for human well-being,
in which each individual can achieve his or her full potential, and then
seeks to promote and protect those prerequisites.
The most widely used modern
definition of health was developed by the
World Health Organization:
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Public health can be defined as ensuring conditions in which people can be healthy.
The core of public health knowledge, based on research and experience, is
that a blend of individual and societal level factors are involved in
determining health status. For many people, the societal context is the
major determinant of vulnerability to preventable disease, disability
and premature death.
In 1948, the Universal Declaration of Human Rights was adopted as a
universal or common standard of achievement for all peoples and all
nations. It is the highest aspiration of the common people and the
foundation of freedom, justice and peace. Broadly speaking, individual
and collective well-being are considered to depend upon the "promotion
of universal respect for and observance of human rights."
When we look at history, the trial of Nazi doctors documented
the most extreme examples of physicians participating in human rights
abuses, criminal activities, and murder. Hitler called upon physicians
to help justify his euthanasia programs, experimentation programs and
ultimately his death camps.
Physicians should be educated about and aware of the fact that they are
sometimes indirectly involved in the torture of prisoners. Physician
involvement includes examination and assessment of fitness of prisoners
to be tortured, monitoring of victims during their torture,
resuscitation and medical treatment of prisoners, and falsification of
medical records and death certificates especially after torture.
Health and human rights have rarely been linked in an explicit manner.
Yet health and human rights are both powerful, modern approaches to
defining and advancing human well-being. Linking health and human rights
may provide practical benefits to those engaged in health or human
rights work and may help reorient thinking about major global health
The effects of health policies and programs on human rights
Here is an example of an effect. Violations of the right to nondiscrimination occur
during the collection of data on important health problems
when data are not collected on all possible health problems or when there
is failure to recognize the health problems that affect a marginalized or stigmatized group.
The consequences of human rights violations on health
Certain human rights violations such as torture,
imprisonment under inhumane conditions, and summary executions obviously have impacts on physical and mental health.
Burma is a good example to show how violations of human rights impact health.
Some background information about Burma
In August of 1988, due to extreme political oppression and economic
hardships, Burma erupted with people's power street demonstrations. This nation wide uprising was brutally gunned down by army troops, killing
thousands of people. An election was held in May 1990. The National
League for Democracy party, led by Aung San Suu Kyi, a 1991 Nobel
Laureate won the
election by a landslide victory. The military junta ignored the election
result and refused to hand over power.
The repression and hardships became worse and continue to the present day.
Over the last 12 years, the situations are getting worse.
UNICEF, the infant mortality rate in Burma in 1996 was 105 per 1000 live births
compared with 33 in Vietnam, 31 in Thailand and 11 in Malaysia.
incidence of HIV/AIDS is increasing at alarming rates. The statistics
are incomplete and unreliable, but estimate about 530,000 people are infected. The
joint UNAIDS of the United Nations has identified the four hardest hit
countries in the Asian region as (in order of HIV prevalence):
India, Thailand, Burma and Cambodia. Prof. John Dwyer, Founding President
of the AIDS Society of Asia and the Pacific, stated in June 1997 that
"Burma is the epicenter of the epidemic in Asia."
Burma was rated as having high and rising HIV prevalence and high
and rising HIV incidence by an international panel,
convened by UNAIDS and the
AIDSCAP, at the most recent Asia-Pacific Conference on AIDS in Manila in
1997. That rating was the worst of the panel's possible
Burma is one of the world's largest opium producing countries. Domestic
use rates are among the highest in the world from 2 to 25% of adults
a 1995 UNDCP multi-community survey.
Burmese heroin exports to India, China, and Thailand have fueled
regional outbreaks of drug use and HIV infection in Burma's border
The spread of HIV/AIDS is facilitated by a growing commercial sex industry,
trafficking of Burmese women and girls into the regional sex industry,
untreated STDs, very low condom use and availability, lack of sexual health
information, unsafe blood supply, and lack of universal precautions and
health care settings.
Domestic resources for health expenditure have been exceptionally low
more than 60% of the government revenues go for military expenditures.
The human rights dimensions of HIV/AIDS in Burma highlight the
inseparability of civil, political, economic, social and cultural
rights. The severity of the problem indicates the level of denial
involved. The government deny freedom of expression and other rights.
Progress is required.
Identification of health impacts, associated with violations of rights
and dignity, will benefit both health and human rights fields. More
research is needed to establish valid associations between rights
violations and health impacts. Health experts concerned about human
rights should use their expertise and help document human rights abuses.
Dr Khin Saw Win (Alice)
This commentary is based on a posting Dr. Khin Saw Win
made in the soc.culture.burma newsgroup and the FreeBurma Yahoo! Group on 2000-10-16. The posting has been edited for inclusion on the Burma Watch
International Web site.