On May 25, Ireland eliminated its near-total ban on abortion, just days before women’s right advocates around the world celebrated the International Day of Action for Women’s Health on May 28. With 64% voter turnout, 66% percent voted in favor of repealing the Eighth Amendment of the Constitution — a 1983 measure that conferred equal rights on the fetus and the mother and banned abortion under almost all circumstances.
Why now? What comes next in Ireland? And what could this mean for the rest of the world? You can find a list of resources that seek to answer these questions included below:
As part of my role with the O’Neill Health Law Initiative, I recently attended part two of the Global Faith-Based Health Systems (GFBHS) Conference in Trento, Italy, titled “Global Faith-Based Health Systems: Integrating Technology and Empowering Communities.” The GFBHS project was conceptualized by Dr. Bette Jacobs (Georgetown University Health Law Initiative), Fr. Kevin Fitzgerald (Georgetown University), and Colleen Scanlon (Catholic Health Initiatives) to leverage the longstanding commitment of Catholic ministries to promote global health. The project was made possible through a donor funded partnership led by Dr. Jacobs—the Health Law Initiative. Georgetown has partnered with Fondazione Bruno Kessler (FBK), the premier research institute in Trento, Italy, for this important project.
The purpose of these first two convenings is to: (1) discuss the role of faith-based organizations (FBOs) in delivering healthcare to some of the world’s most isolated and vulnerable populations, and (2) identify challenges and opportunities to improve upon their work. The first convening was held on October 2-3, 2017, while the second meeting was held six months later on May 21-23, 2018. Both took place in Trento, Italy. Because of the size, service area, and long history, these first two meetings focus on Catholic health systems.
The convenings consisted of leaders of some of the largest FBOs in the world—including Catholic Medical Mission Board, Catholic Relief Services, Catholic Health Association, Catholic Health Initiatives, and Caritas Internationalis—as well as scholars, lawyers, and policy experts who work in public health. The goal of these two meetings is to gather major Catholic-based organizations providing direct healthcare services and resources to communities to identify strengths and weaknesses within their organizations and the entire FBO healthcare delivery system. The first convening focused on a number of themes including living the mission; community engagement; technology and digital health; communication; mapping; and supply chain issues.
The second meeting gathered even more experts, including community health workers (CHWs) from countries such as Kenya, India, and Bangladesh, to discuss the issues identified in the first meeting and attempt to formulate recommendations for improving services. Thus far we have made progress in increasing communication and collaboration among these Catholic-based healthcare providers. This second meeting also allowed the group to hear voices from CHWs working on the ground in low-resource countries about their day-to-day needs, concerns, and struggles. Aside from a major publication, there is hope of a usable digital health technology tool to come from these convenings.
One important lesson we learned from the community health workers is the importance of emotional and mental health for overall well-being. This was reflected in a story about the healing powers of the “black stone”, a traditional healing method used in Bangladesh and parts of Africa for snake bites. Rural clinicians often use these stones to help remove venom after a patient is bitten by a snake. The stone is often kept on the wounded area for a number of days, and the length of time varies depending on the type of snake bite. Throughout the conference and over long dinners, we were entertained with stories of the magical powers of the black stones. Although some western doctors and scientists may rebuke the healing powers of the stones, as a group, we all agreed that regardless of the science and/or medicine behind the stone, it has—at the very least—some healing power in that people believe in the black stone’s power to heal, and that alone can help improve overall health outcomes.
This is just one of the many important lessons we learned from the CHWs at the conference. We have just begun what will hopefully be a longstanding partnership among major healthcare providers and people who deliver care to the world’s most vulnerable populations. I am glad to have been a part of these first two meetings, and we soon identify concrete next steps for the project to continue to move forward in hopes of improving overall quality of healthcare and delivery while empowering communities globally.
Posted in Global Health, Human Rights, Resources; Tagged: access to health care, georgetown, global health, health and human rights, health equity, National Healthcare, right to health, women's health.
The Institute’s Hepatitis Policy Project has released a new report that features the stories of people affected by hepatitis C. The report was authored by Sonia Canzater and Jeffrey S. Crowley.
“Full of Life: The Stories of People Affected by Hepatitis C,” underscores the impact of hepatitis C and the potential for improving the lives of those with the disease.
The U.S. Centers for Disease Control and Prevention says more than 3.5 million Americans are living with hepatitis C in the United States. Because people with the disease can live for many years without symptoms or feeling sick, most do not know they have it. Hepatitis Testing Day serves to remind those born from 1945 through 1965 should be tested in accordance with CDC recommendations.
“Sadly, the persistent stigma around these facts overshadows and detracts from efforts to eliminate the disease. There is real harm caused by untreated hepatitis C, and treatments available today represent a true opportunity to improve lives of those living all around us,” says co-author, Jeffrey S. Crowley, program director of infectious disease initiatives at the O’Neill Institute.
The U.S. has the opportunity to play an integral role in the global mission to eliminate hepatitis C by prioritizing domestic elimination efforts, but the reality of what is happening to respond to HCV in the United States falls short of the possibility of what we could make happen to save lives and strengthen communities.
Lives like Jessica’s, Sharon’s and Jesse’s.
Jessica was diagnosed with hepatitis C after her mom, Jay, fell ill from the disease. Neither knew they had it. Doctors believe Jay contracted HCV from a blood transfusion she had early in life and passed it to Jessica after becoming pregnant with her. Fearing she too would pass it on to her children, Jessica sought treatment but was told she wasn’t “sick enough” and that insurance wouldn’t cover curative treatment. With that denial, she was forced to start her family without treatment and is now a mother of two. Jessica is working with a hepatitis advocacy group assisting her in getting the HCV treatment she is entitled to, but has been unlawfully denied.
Sharon is a cancer survivor who contracted hepatitis C after receiving transfusions related to her cancer treatment. Now also a hepatitis C survivor, Sharon’s favorite story is how she shared her experience and about the new treatments with a gentleman who revealed he had hepatitis C. She encouraged him to seek treatment. He did, and now he is cured!
Jesse, is an outreach worker. He says he is not sure if it was intravenous “chaotic drug use” or his prison tattoos that exposed him to the virus. Many years later while in drug recovery Jesse was able to get insurance coverage through the Affordable Care Act (ACA). This enabled him to seek HCV treatment. Today, he is HCV free. He has graduated from school and plans to become a social worker like the ones who helped him without judgment during his “chaotic” drug use times, when no one else wanted anything to do with him.
The report with additional stories of those impacted by hepatitis C is now available online.
Namibia is an upper middle-income country where prosperity is not shared by everyone; pervasive inequality persists in Namibia and only a small proportion of people in Namibia live under conditions of an upper-middle income country. Having lived under apartheid until independence in 1990, significant disparity in health, wealth and in many other facets of life persists.
Economic disparity has improved in recent years but remains extremely high. While Namibia measured 63.3 on the gini-coefficient in 2003 (with 100 being perfect inequality), Namibia improved to 60.8 in 2012. Despite the improvement, Namibia remains one of the most unequal countries in the world, and has a high rate of poverty rate at 29.9% and an unemployment rate of 26.6%.
Significant disparities in social and physical living conditions fuels health inequality in Namibia; for many people in Namibia, realization of the right to health is inhibited by low income, lack of education, inadequate sanitation and water supply, among other challenges. One significant challenge is Namibia’s vast size; the country is sparsely populated with 2.8 persons per square km, making it more difficult and expensive to ensure that people in remote areas have access to quality health services and education.
In at least one health indicator, Namibia has improved significantly in recent years. Average life expectancy has risen a large amount, especially after the sharp decline as a result of the HIV epidemic in 2001 when life expectancy dropped to 48 for men and 50 for women. In 2016, life expectancy was 61 for men and 66 for women, attributable in part to increased access to anti retrovirals. On the other hand, concerningly, instead of falling, maternal mortality is Namibia has risen since 2000, to 200 per 100,000. This decline is also in part attributable to HIV and AIDS; in 59% of maternal deaths, HIV is a factor, as well as in 14% of infant deaths.
There has been high level recognition of ongoing challenges concerning poverty and inequality and policies and programmes have aimed toward decreasing disparity, including Vision 2030. Hage Geingob, elected as president in 2015, has publicly emphasized the need to address poverty, declaring a war on poverty in 2015 and expressing concern that failure to address income inequality could jeopardize existing peace and stability in 2016.
Vision 2030 and National Development plans aim to reduce extreme poverty and the gini-coefficient to .30 by 2030. A recent World Bank report found that these plans have reduced poverty and inequality to some extent, notable successes for one of the youngest countries in Africa, but more action should be taken to make further gains including job creation, a more inclusive economy and greater efficiency in public services. President Geingob has emphasized that “the only true and sustainable prosperity is shared prosperity.” He has two years remaining in his current term (and possibly an additional term) to put these aspirations into practice.
In the year before his murder in April 1968, the Rev. Dr. Martin Luther King embarked on a new era of justice work in which he aligned with organized labor and the poor to unite a movement across racial, gender, ethnic, religious, and geographic lines.
King’s “Poor People’s Campaign” marked the connections between the various ills that work together to entrench systemic poverty and racism in America; from massive expenditure on war – then in Vietnam and now in Afghanistan, Iraq and elsewhere – to the denial of the right of farm workers to unionize and the denial of access to healthcare to millions. King also preached that just as America’s ills are related, so too are human rights interconnected. In his last Sunday sermon before his assassination, he testified:
“We read one day: we hold these truths to be self-evident, that all men are created equal, that they are endowed by their creator with certain inalienable rights. That among these are life, liberty, and the pursuit of happiness. But if a man doesn’t have a job or an income, he has neither life nor liberty nor the possibility for the pursuit of happiness. He merely exists.”
And just as rights rise and fall together, King preached that so, too, would the movement live by unity or die by division. In his famous last speech, the “Promised land”, he called for the poor and oppressed to unite across divisions created to keep them apart:
“You know, whenever Pharaoh wanted to prolong the period of slavery in Egypt, he had a favorite, favorite formula for doing it. What was that? He kept the slaves fighting among themselves. But whenever the slaves get together, something happens in Pharaoh’s court, and he cannot hold the slaves in slavery. When the slaves get together, that’s the beginning of getting out of slavery.”
Indeed, King died in the act of bridging gaps across struggles; a last-minute stop to march with striking sanitation workers took him to Memphis, where a bullet entered his cheek then smashed down through his spine.
The movement, though wounded, did not die with King. America’s disparate huddled masses had begun to unite into what King described as a “new and unsettling force.”
The Poor People’s Campaign: A National Call for Moral Revival
On Monday May 14th, 2018, Pharaoh witnessed the people re-launch the Poor People’s Campaign: A National Call for Moral Revival. The Campaign made history with unprecedented simultaneous acts of protest and civil disobedience across over 35 states spread from Alaska to Alabama. The Campaign plans 40 days of action with weekly “moral, fusion, nonviolent, direct action” every Monday in states across the country and in the nation’s capital. The Campaign will also hold weekly Truthful Tuesday Teach-ins, Thursday Theomusicology and Poetry events, and Sunday Mass Meetings across the country.
And the 40 days are just the beginning—the Campaign seeks to unite people across all the same divisions King denounced, as well as across siloed areas of focus into which so many organizations climb, into a sustained movement for justice at a scale not seen in the United States since the 1960s.
Eugene V. Debs famously said to the court upon his conviction for sedition that “while there is a lower class, I am in it, and while there is a criminal element I am of it, and while there is a soul in prison, I am not free.”
The Poor People’s Campaign’s emphasis on fusion turns this old notion – that my liberation rises and falls equally to yours – from the existential to the practical. The right to health will remain illusory while our political system allows water to be poisoned in Flint Michigan or voter suppression to prevail in North Carolina. And we will never address these evils unless we unite beyond the divisions that keep us from justice.
In acting on this reality, we understand that when Dr. King preached “we are caught in an inescapable network of mutuality, tied in a single garment of destiny” it was as much a practical truth as a theological one. The Poor People’s Campaign: A National Call for Moral Revival springs from that truth. It is a new and unsettling force for health and beyond.
Follow the Poor People’s Campaign: A National Call for Moral Revival on social media to join in actions and events in your state:
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The views reflected in this blog are those of the individual authors and do not necessarily represent those of the O’Neill Institute for National and Global Health Law or Georgetown University. This blog is solely informational in nature, and not intended as a substitute for competent legal advice from a licensed and retained attorney in your state or country.