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Health-care crisis in Turkey: urgent actions needed
Editorial
Canada’s inquiry into violence toward Indigenous women
Associated Press
On Aug 3, the Government of Canada announced a national inquiry on the epidemic of violence toward Indigenous women. The inquiry follows decades of urging by advocates, international human rights groups, and the UN to investigate and explain the 1200 women and girls who have been murdered or gone missing in the country since 1980. Indigenous women in Canada are eight times more likely to be killed by an intimate partner than are nonIndigenous women and three and a half times more likely to be victimised. The inquiry promises to investigate the root causes, including racism, marginalisation, and poverty. It has committed to a systemic approach to examining how law enforcement procedures, the judicial system, and social services can be more responsive and ensure women’s rights. An early criticism is the inquiry’s lack of explicit focus on policing and police misconduct. Indigenous women are said to be over-policed in terms of criminalisation and incarceration, but under-policed in terms of protection. The same could be said of the health-care system. On one hand, the over-medicalisation of Indigenous women is well documented: pharmacological rather than holistic
treatment for distress, depression, or addiction; the subversion of traditional practices of childbirth and infant care. On the other, by failing to detect signs of abuse or women’s vulnerability, health-care providers similarly under-medicalise women in terms of protection. Health-care communities around the world assert their key role in addressing violence toward women—through screening in primary care, emergency, obstetrics and paediatric settings, and by providing referrals to shelters, social services, and legal aid. That Indigenous women have substantial health-care needs—their rates of illness and fertility are generally higher than those of non-Indigenous women—means there are considerable opportunities for health-care providers to help but many chances to fail. Canada’s historical disregard for Indigenous women is a national tragedy with international lessons. Although the inquiry’s mandate is suitably broad, encompassing justice, reconciliation, and the self-determination of Indigenous peoples, it should also illuminate the failure of and opportunities for health-care systems to protect Indigenous women. The Lancet
Ap Cagdas Erdogan/Getty
Health-care crisis in Turkey: urgent actions needed
For the PHR report see http://physiciansforhuman rights.org/library/reports/ southeastern-turkey-healthcare-under-siege.html
732
“When we finally entered, the emergency room was like a military base. There were sandbags lining the walls, men with guns everywhere. It wasn’t a hospital, it was a fortress”, said a resident of Cizre, a district in southeastern Turkey. The health-care crisis and allegations of pervasive grave human rights violations provoked by Turkish security forces in southeastern Turkey over the past year is documented extensively in a new report released by Physicians for Human Rights (PHR) on Aug 9. Since the breakout of conflict between Turkey’s Government and the armed Kurdistan Workers’ Party (PKK) in July, 2015, the Turkish authorities have imposed a succession of 24-hour sieges, known as curfews in southeastern Turkey. The report states that curfews have led to military occupation and attacks on health facilities and health professionals and obstruction of access to emergency medical transport and health care. The PHR report points out that during the protracted curfews, the Turkish Government failed to meet its legal obligations to uphold both international human
rights and humanitarian law, and recommends that the Turkish Government “immediately cease and prohibit the unlawful practices”. Additionally, the report provides a series of recommendations to the PKK and other opposition armed groups in southeastern Turkey, calling them to “respect the rules of distinction and proportionality in conflict situations”. Notably, the European Union (EU) is also called upon to facilitate monitoring of human rights conditions in southeastern Turkey. The failed coup in July, 2016, has drastically altered the human rights conditions within the whole of Turkey, resulting in mass arrests, including of doctors and others working in military hospitals. The serious human rights violations, particularly the failure to respect medical neutrality in Turkey, is unacceptable. More than ever, it is important for the international community, including the EU and Council of Europe, to act urgently to support further independent international investigations and help protect health and human rights in Turkey. The Lancet www.thelancet.com Vol 388 August 20, 2016
Canada’s inquiry into violence toward Indigenous women
Associated Press
On Aug 3, the Government of Canada announced a national inquiry on the epidemic of violence toward Indigenous women. The inquiry follows decades of urging by advocates, international human rights groups, and the UN to investigate and explain the 1200 women and girls who have been murdered or gone missing in the country since 1980. Indigenous women in Canada are eight times more likely to be killed by an intimate partner than are nonIndigenous women and three and a half times more likely to be victimised. The inquiry promises to investigate the root causes, including racism, marginalisation, and poverty. It has committed to a systemic approach to examining how law enforcement procedures, the judicial system, and social services can be more responsive and ensure women’s rights. An early criticism is the inquiry’s lack of explicit focus on policing and police misconduct. Indigenous women are said to be over-policed in terms of criminalisation and incarceration, but under-policed in terms of protection. The same could be said of the health-care system. On one hand, the over-medicalisation of Indigenous women is well documented: pharmacological rather than holistic
treatment for distress, depression, or addiction; the subversion of traditional practices of childbirth and infant care. On the other, by failing to detect signs of abuse or women’s vulnerability, health-care providers similarly under-medicalise women in terms of protection. Health-care communities around the world assert their key role in addressing violence toward women—through screening in primary care, emergency, obstetrics and paediatric settings, and by providing referrals to shelters, social services, and legal aid. That Indigenous women have substantial health-care needs—their rates of illness and fertility are generally higher than those of non-Indigenous women—means there are considerable opportunities for health-care providers to help but many chances to fail. Canada’s historical disregard for Indigenous women is a national tragedy with international lessons. Although the inquiry’s mandate is suitably broad, encompassing justice, reconciliation, and the self-determination of Indigenous peoples, it should also illuminate the failure of and opportunities for health-care systems to protect Indigenous women. The Lancet
Ap Cagdas Erdogan/Getty
Health-care crisis in Turkey: urgent actions needed
For the PHR report see http://physiciansforhuman rights.org/library/reports/ southeastern-turkey-healthcare-under-siege.html
732
“When we finally entered, the emergency room was like a military base. There were sandbags lining the walls, men with guns everywhere. It wasn’t a hospital, it was a fortress”, said a resident of Cizre, a district in southeastern Turkey. The health-care crisis and allegations of pervasive grave human rights violations provoked by Turkish security forces in southeastern Turkey over the past year is documented extensively in a new report released by Physicians for Human Rights (PHR) on Aug 9. Since the breakout of conflict between Turkey’s Government and the armed Kurdistan Workers’ Party (PKK) in July, 2015, the Turkish authorities have imposed a succession of 24-hour sieges, known as curfews in southeastern Turkey. The report states that curfews have led to military occupation and attacks on health facilities and health professionals and obstruction of access to emergency medical transport and health care. The PHR report points out that during the protracted curfews, the Turkish Government failed to meet its legal obligations to uphold both international human
rights and humanitarian law, and recommends that the Turkish Government “immediately cease and prohibit the unlawful practices”. Additionally, the report provides a series of recommendations to the PKK and other opposition armed groups in southeastern Turkey, calling them to “respect the rules of distinction and proportionality in conflict situations”. Notably, the European Union (EU) is also called upon to facilitate monitoring of human rights conditions in southeastern Turkey. The failed coup in July, 2016, has drastically altered the human rights conditions within the whole of Turkey, resulting in mass arrests, including of doctors and others working in military hospitals. The serious human rights violations, particularly the failure to respect medical neutrality in Turkey, is unacceptable. More than ever, it is important for the international community, including the EU and Council of Europe, to act urgently to support further independent international investigations and help protect health and human rights in Turkey. The Lancet www.thelancet.com Vol 388 August 20, 2016