The OHCHR states that the right to health is an inclusive right, it has many aspects and factors to lead a healthy life.
On the one hand, the right to health contains freedoms such as being free from non consensual medical treatment, torture, and other cruel, inhuman, or degrading treatment or punishment. On the other hand, it contains entitlements as well, mainly the right to a system of health protection providing equality of opportunity for everyone to enjoy the highest attainable level of health.
Health services, goods, and facilities must be provided to all without any discrimination. Non-discrimination is a key principle in human rights and is crucial to the enjoyment of the right to the highest attainable standard of health (see section on non-discrimination below). The Committee on Economic, Social, and Cultural Rights also lists social factors essential to good health such as education, economic development, and gender equity.
As stated in Amnesty International’s submission to the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, any discrimination in access to the underlying determinants of health, as well as to means and entitlements for their procurement is prohibited. Access to these determinants often reflects structural inequality and discrimination which drive/perpetuate racial health disparities.
Inequalities in access to the social determinants themselves are often linked to racial and other discrimination, as detailed in the examples below.
NAMIBIA
Namibia's San indigenous people face disproportionately high rates of Tuberculosis (TB) and Multidrug- resistant TB (MDR-TB). Amnesty International has delved into the complex factors behind this alarming public health crisis.
Historical marginalisation has plagued the San people for centuries, from displacement by Bantu-speaking migrants to subjugation under colonial administrations. Despite their resilience in preserving their languages, traditions, and beliefs, the San have been reduced to an underclass, facing landlessness, unemployment, social marginalisation, and poverty.
These conditions have resulted in poor health outcomes due to discrimination in service provision, geographic isolation, and language barriers. Consequently, the San suffer far higher TB and MDR-TB rates compared to the general population.
Amnesty International argues the Namibian government has failed to address the structural barriers and social determinants that perpetuate the San's TB burden, violating national, regional, and international human rights obligations, especially the right to health. The report calls for immediate action, including ratification of the ILO Convention 169 on Indigenous and Tribal Peoples, policies to address historical discrimination, and improved healthcare accessibility. Respecting the rights and well-being of the San people is not just a moral imperative but a legal obligation for the government.
SWEDEN
Sweden is facing a concealed epidemic of medical racism, which is silently affecting the lives of a large number of vulnerable EU citizens, particularly those belonging to the Roma community. This form of discrimination is evident in the healthcare system, where marginalised EU migrants encounter daunting obstacles that deprive them of their fundamental right to receive adequate medical attention.
Amnesty International has released a comprehensive report titled "A Cold Welcome", shedding light on this insidious issue. The article titled "Human rights of Roma and other 'vulnerable EU citizens' at risk" reveals a concerning reality. It is imperative that we address this issue and safeguard the fundamental rights of all EU citizens. Marginalised EU migrants, seeking a better life, are confronted with inadequate housing and sanitation as well as a discriminatory healthcare system. Their living conditions, often in tents, cars, or temporary settlements, expose them to freezing temperatures. The consequences, particularly for those with chronic conditions, are devastating. The living conditions of individuals in Sweden worsen their pre-existing health issues, including diabetes, heart, and kidney problems, or ulcers, exacerbating their hardships.
Medical racism stems from the inadequate legal and policy frameworks that result in these individuals falling through the gaps in the healthcare system. Access to shelter, clean water, sanitation, and basic health services is systematically denied to them, resulting in dire consequences for their well-being. Moreover, the lack of secure housing significantly limits their employment prospects, driving numerous individuals to resort to begging for their survival.
While medical discrimination affects the lives of vulnerable EU citizens, there is cause for optimism. Several municipalities have implemented effective local policies. Lund and Gotland offer year-round shelters, providing stability and security that enable individuals to plan for their future, including seeking employment.
Sweden must ensure that its commitment to legal obligations results in healthcare equity. It is crucial that shelter, clean water, sanitation services, and subsidised healthcare are accessible to all destitute EU migrants, irrespective of their ethnicity. A humane and comprehensive approach is not only morally necessary but a fundamental human entitlement. As a signatory to multiple human rights conventions, Sweden is obligated to enforce these rights for all people within its jurisdiction. The issue of medical racism within the healthcare system requires urgent attention, as the lives of vulnerable individuals are at risk. Objective analysis and action must be taken to address this pressing matter.
LIBYA
In the oasis city, Sabha of southwest Libya, people belonging to the Tabu tribe fear going to the main hospital controlled by the rival Arab Awlad Sliman tribe. When questioned why, they rehash previous experiences of Tabu patients facing attacks, abductions, and killings in the hospital. But what does this threat of violence cause? It forces the tribe to go to a smaller and under-equipped hospital instead. In one such hospital in Murquz, sources stated that there were only 4 ventilators that no one knew how to use and a shortage of protective gear for healthcare workers.
This begs the question: what causes this fear of violence among the tribes? Libya has been historically segregated based on tribal affiliations and ethnicities. Over the years, hostilities between the groups and violent attacks translated into the ability of people to move freely. This barrier to freedom of movement has been affecting their access to free healthcare found in territories controlled by rival groups.
Secondly, some members of the Tabu and Tuareg communities were denied documentation of citizenship during al-Gaddafi’s rule and have been subjected to forced evictions, arbitrary arrests, and detentions. This has resulted in an additional barrier to accessing free healthcare that is only offered to citizens, and many cannot afford healthcare.
What exacerbates this situation is that members of this community also tend to live in impoverished and densely populated neighbourhoods, increasing the likelihood of the disease spreading. For example, social distancing was made impossible during the COVID 19 pandemic.
Thirdly, the persistent armed conflict and insecurities in Libya have led to attacks on medical personnel, facilities, and militia interference in the access to healthcare services. This has rendered their medical system fragile and has been exacerbated by the COVID-19 pandemic.
So what is the way forward? There has recently been a call for Libyan authorities and militias to allow equal access to healthcare regardless of social characteristics under international humanitarian law. Therefore, we must begin with compliance with international agreements and treaties. Furthermore, the Libyan government should take a step further and provide the necessary documentation to undocumented tribes so that they can access free health care services as well. Lastly, we need to remove the root of medical racism that begins with structural and environmental asymmetries (eg. Tabu people living in impoverished areas).
NAAMLOOS
Amnesty International has recently released a report shedding light on the alleged mistreatment and torture of Haitian asylum seekers in the United States. The report claims that US authorities have subjected Haitian asylum seekers to arbitrary detention and discriminatory, humiliating ill-treatment that amounts to race-based torture, rooted in systemic anti-Black discrimination within the US immigration system.
The allegations revolve around the expulsions of Haitian asylum seekers under Title 42, a policy enacted due to COVID-19 concerns. The report suggests that these expulsions lacked individual assessments, and those expelled often lacked interpreters, legal representation, or information regarding their detention, leading to arbitrary detention. Shockingly, babies as young as nine and 14 days old were reportedly detained and separated from their parents. Furthermore, the report accuses US authorities of failing to provide proper COVID-19 testing, vaccines, masks, or the opportunity to physically distance, undermining the policy's public health justification.
Amnesty International's findings emphasise a history of systemic racial discrimination in the treatment of Haitians, with echoes of slavery and anti-Black racism. The organisation calls for reforms to dismantle harmful racial and nationality-based stereotypes and urges the US government to commit to reversing anti-Black policies while reviewing the disparate treatment of Black asylum seekers in the immigration system.
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