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IFHHRO | Medical Human Rights Network promotes health-related human rights, including the right to health. Our focus is on the important role of health professionals.

We believe that there lies a huge potential in the health professions that could be mobilized for the promotion and protection of human rights.

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IFHHRO’s online Human Rights for Health Workers training manual: training sessions in four languages

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Steps for Change

How to use human rights to address problems in your own healthcare institution

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Voices in the Field

Experienced professionals in the field of health on the role of human rights in their careers

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News

Universal Health Coverage as a means to promote the right to health

universal health coverage dayUniversal Health Coverage Day, commemorated each year on 12 December, is the anniversary of the first unanimous United Nations resolution calling for countries to provide affordable, quality health care to every person, everywhere. This resolution on Universal Health Care was passed in December 2012. Universal Health Coverage (UHC) is an important means to promote the human right to health.

UHC has been included in the Sustainable Development Goals adopted by the United Nations. It means everyone can access the quality health services they need without financial hardship.

All people, including the poorest and most vulnerable, should be able to access a full range of essential health services, including prevention, treatment, hospital care and pain control. The way this can be achieved is when costs are shared among the entire population, e.g., through an affordable health insurance scheme.

According to the WHO, more than 100 low- and middle-income countries  have taken steps to deliver UHC. These countries represent three quarters of the world’s population.

Source: News item website WHO

 

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Medical ethics in times of conflict

Medical ethics has a key role in discussing the effects of conflicts and other violent human rights abuses, John Chisholm and Julian Sheather of the British Medical Association argue in a recent Comment in the Indian Journal of Medical Ethics

Recent history has seen a closer relationship and interdependency between medicine and the State. This has led, at times, to tension between professional obligations and State interests. Many would prefer medical ethics to step aside from sectarian politics and focus on the doctor-patient relationship and the objective and neutral medical sciences that underpin it. However, given the role that social inequities play in health outcomes, doctors have been obliged to speak out against such inequities or even against State practices which directly contribute to poor health. For those committed to the impartial practice of medicine, and to the promotion of human wellbeing, silence during times of conflict is seldom an option.

Where, for example, doctors are seeing patients who have sustained injuries as a result of state responses to civil unrest, the documentation and reporting of those injuries is a core part of the medical response. If doctors cannot speak out, if they cannot draw attention to the health-related impacts of conflicts, they risk the loss of professional independence. Paradoxically, it is the ability of doctors to speak out that best serves their neutrality. By contrast, any attempt to restrict the freedom of doctors to raise concerns threatens the principle of neutrality, risking the co-option of medical care into non-medical purposes. In our view vocal medical comment on the health impacts of conflict and of violence is a far better guarantee of the independence of the profession – and of the wellbeing of patients – than an imposed or self-imposed silence.”

 


Access the comment Medical ethics in times of conflict – why silence is not an option. John Chisholm & Julian Sheather, Indian Journal of Medical Ethics, 7 November 2017

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Medical detention of patients

In parts of Africa and Asia, patients who cannot pay their medical bills are detained and abused by healthcare staff, a new research paper from Chatham House in the UK states. The report lists evidence of “medical detention” of patients, particularly women and babies, in countries  like Nigeria, Kenya, Ghana,  Zimbabwe, Liberia, Uganda, Cameroon and the Democratic Republic of Congo.

Report: From Cameroon to Kenya, hospitals violate patient rights over bills
Photo: Chatham House

Some examples highlighted in the paper:

  • Patients at Kenyatta National Hospital in Nairobi, Kenya, claimed in 2015 that they had been pressured into having sex with hospital staff in exchange for cash to help pay their bills.
  • Two women said baby-trafficking had been taking place at Kenya’s public Pumwani Maternity Hospital, with nurses offering single mothers money in exchange for their babies.
  • In South Africa, the detention of undocumented foreign women from Zimbabwe and elsewhere has been reported, despite the fact that South African law protects their right to free maternity services in state-owned facilities.

Summary

  • In some parts of the world it is common practice for patients to be detained in hospital for non-payment of healthcare bills.
  • Such detentions occur in public as well as private medical facilities, and there appears to be wide societal acceptance in certain countries of the assumed right of health providers to imprison vulnerable people in this way.
  • The true scale of these hospital detention practices, or ‘medical detentions’, is unknown, but the limited academic research to date suggests that hundreds of thousands of people are likely to be affected every year, in several sub-Saharan African countries and parts of Asia. Women requiring life-saving emergency caesarean sections, and their babies, are particularly vulnerable to detention in medical facilities.
  • Victims of medical detention tend to be the poorest members of society who have been admitted to hospital for emergency treatment, and detention can push them and their families further into poverty. They may also be subject to verbal and/or physical abuse while being detained in health facilities.
  • The practice of detaining people in hospital for non-payment of medical bills deters healthcare use, increases medical impoverishment, and is a denial of international human rights standards, including the right not to be imprisoned as a debtor, and the right to access to medical care.
  • At the root of this problem are the persistence of health financing systems that require people to make high out-of-pocket payments when they need healthcare, and inadequate governance systems that allow facilities to detain patients.
  • Universal health coverage (UHC) cannot be achieved while people are experiencing financial hardship through their inability to pay for healthcare, so by definition any country that allows medical detention is failing to achieve UHC.
  • Health financing systems should be reformed by moving towards publicly financed UHC, based on compulsory progressive pre-payment mechanisms. This would enable hospitals to become financially sustainable without the need to charge significant user fees.

Access the report Hospital Detentions for Non-payment of Fees: A Denial of Rights and Dignity. Robert Yates, Tom Brookes & Eloise Whitaker. Chatham House/Centre on Global Health Security, December 2017

Source of the examples: Report: From Cameroon to Kenya, hospitals violate patient rights over bills. Laureen Fagan, Africa Times, 10 December 2017 

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