Health and Human Rights:
Tuberculosis and Human Rights
The case of a Burmese student with TB
It was one late afternoon in January 1989 when I received a phone call from
the NLD office that one of the tricolor students, who is also one of the
body guards of Ma Ma Suu, was ill. He was having bouts of hemoptysis
(coughing out blood). I asked them to bring the student to Rangoon General
Hospital and I had his Chest X Ray taken at the emergency department. As
expected he had tuberculosis (TB of the lungs). I got him admitted to my
medical ward 19&20 and appropriate treatment was given. Ma Ma Suu phoned me to
enquire about his condition. She was worried and really concerned for
the student whom she regarded as just like her own son. I told her not
to worry as TB is a treatable and curable disease just take the
treatment for one year (or at most maybe one and a half years) and then
he will be fine. BUT I WAS WRONG. The student was taken to the prison before he
could complete his anti-TB treatment.
It has been 12 years and he is still in Myingyan prison, still suffering
from bouts of hemoptysis (from uncured tuberculosis), weakness, and
edema (swelling of the limbs). He is not getting any treatment for the
illness he is suffering from.
International standards for the treatment of prisoners
The rules governing the treatment of prisoners are codified in a number
- United Nations Standard Minimum Rules for the Treatment of
- United Nations Body of Principles for Protection of All Persons
under Any Form of Detention or Imprisonment
- Council of Europe Recommendation Concerning the Ethical and
Organizational Aspects of Health Care in Prison.
The Third Report of the European Committee for the Prevention of Torture
and Inhuman or Degrading Treatment or Punishment reads in part:
- Article 71: The health-care staff in any prison is a staff at risk.
Their duty is to care for their patients (sick prisoners).
- Article 72: The available resources (for medical services) should be
managed by a (qualified medical authority), not by bodies responsible
for security or administration.
Prisons and Human Rights
Here I would like to raise the issue of prisons, tuberculosis and human
rights, and their inter-relation.
Human rights derive from the dignity of the individual and are
universal. Tuberculosis is easily diagnosed, treatable and curable, but
may lead to death if neglected. Not getting appropriate treatment in the
prisons is considered as a violation of human rights.
Because proper diagnosis and treatment of tuberculosis are life-saving,
treatment and control of tuberculosis and any other diseases is the
component of a prisoner's minimum rights. Prisoners have the right to
health care at a level that meets community standards.
No incarcerated individual should bring tuberculosis into the prison; no
prisoner should be exposed to tuberculosis while in prison; and no
released prisoner should take tuberculosis from the prison environment
back to the community.
Prisoner's rights must be respected while taking public health
considerations into account. The conditions of prisons in Burma are
cruel, inhuman and degrading. They are torturous. Prisoners are denied
In places where basic human rights are well respected, tuberculosis is a
tradeable commodity. Prisoners may even try to get on tuberculosis
programs because of the benefits of getting special diet, heated bed and
The role of health care workers
Health workers employed by the custodial authorities are at risk of
developing divided loyalties (or fear of losing job, fear of
persecution), between the service that employs them and the patients
(prisoners) entrusted to their care. If medical staff are not
independent, ill prisoners may be exposed to a variety of abuses.
Health workers must have the ability to report to and appeal to a
superior medical authority or to the Minister of Health in the event of
conflicts between professional ethics and requirements imposed by the
We have studied medicine in order to care for the people, not to kill them. It is
time for the health professionals to stand up for what is right!!
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 2000-11-10. The posting has been edited for inclusion on the Burma Watch
International Web site.