On October 30, the Program on Human Rights (PHR) at Stanford's Center on Democracy, Development and the Rule of Law (CDDRL) held a day-long conference to examine health and human rights. The conference was held to discuss how a rights-based approach to health services can impact the delivery of effective health interventions and advance other socio-economic and cultural rights in developing regions. The conference titled, “Why We Should Care: Health and Human Rights” was divided into five panels with presenters from diverse backgrounds and professions including lawyers, doctors, public health experts, students and activists.

The Program:

The conference started with a welcoming address by Helen Stacy, director of the Program on Human Rights. CDDRL Director Larry Diamond introduced the keynote speaker Paul H. Wise, professor of child health and society and pediatrics at Stanford University’s School of Medicine, and director of the Center for Policy, Outcomes and Prevention. Wise's opening remarks began on a somber note, “The language of rights means very little to a child stillborn, an infant dying in pain from pneumonia or a child desiccated by famine.” In his address, Wise emphasized the need for an aligned and integrated rights-based approach that does not undermine effective and efficient medical interventions. “We need to fill the gap between the worlds of child health and child rights so that our programs and policies are both effective and just,” he stressed.

Following the keynote address, the conference presenters shared their work according to a geographic or thematic focus. The first panel brought together three generations of speakers from Stanford - a faculty member, a pre-doctoral fellow and a recent graduate - in a unique opportunity to share ideas and discuss possibilities of health work in Africa. Rebecca Walker, clinical instructor in emergency medicine at Stanford School of Medicine, presented her impressions and reactions on Mindy Roseman’s study of forced sterilization in Namibia. Roseman, academic director of the Human Rights Program and lecturer on law at Harvard Law School, was unable to attend due to flight complications after hurricane Sandy hit the East Coast.

Eric Kramon, 2011-2012 pre-doctoral fellow at CDDRL, spoke about the political sources of ethnic inequality in health outcomes in Africa.  Kramon’s work in Kenya illustrated how politics plays a determinant role in ethnic inequalities and consequently in access to health and health outcomes. Jeffrey Tran, a 2011 Stanford graduate in human biology, described the vision behind the launch of the Project of Emergency First Aid Responder in Western Cape Province, South Africa that he helped implement. Tran explained, “Individuals and communities are an integral part of the solution and we work with the communities to develop first aid training programs that are taught and eventually run by community members.”

Panel two was dedicated to the health impact of drones in Pakistan and in Gaza. Based on research by the Stanford International Clinic on Human Rights and Conflict Negotiation in Pakistan, Professor James Cavallaro and Stanford law school student Omar Shakir, explained that drones are not only responsible for deaths of civilians but also constitute a constant disturbance to social life and mental health of ordinary people, including their relations with children and the elderly. Drones impact other rights as well - such as the right to education - as children are prevented from attending schools for fear of drone strikes. Rajaie S. Batniji, resident physician in internal medicine at Stanford and a CDDRL affiliate, explained the clinical diagnosis of traumatic disorders that result from constant surveillance and insecurity. He cited the work of Jonathan Mann in defining dignity and the devastating effects on physical, mental, and social well-being when these senses are violated. Batniji explained that populations in Gaza are prevented from living life with dignity and respect because they live under constant threat to their security and intrusion into their homes and communications.

Vivek Srinivasan, manager of the Program on Liberation Technology at CDDRL, presented his experience on the Right to Food Campaign in India. He believes that this campaign has led to the mobilization for rights and the provision of services. “Not all demands are confrontational. Communities begin demanding something that is perceived as small in scope but have ramifications that extend to other rights such as the right to education, the right to housing and the right to work.” According to Srinivasan, the Right to Food Campaign in India has had a tremendous impact in putting hunger on the policy agenda. Suchi Pande, an activist-researcher who worked on the Right to Information Campaign in India for over seven years and was the secretary for the National Campaign for People’s Right to Information from 2006 to 2008, supported Srinivasan’s argument of strong correlation in achievements and right-based mobilization. However, Pande pointed out that despite successes in the Right to Food Campaign, other economic and social rights including the right to health in India continues to be a non-issue for politicians and the government. She is optimistic and believes that rural public hearings, the role of the right to information and its supporting mechanisms will facilitate access to public health in rural India.

In panel four, Sarah MacCarthy showed results that suggest that counseling and testing services for HIV-positive pregnant women remain limited, insufficient or lacking in quality in Salvador, Brazil. “While Brazil’s HIV/AIDS program has been internationally acclaimed, national practice still fails to meet national and global guidelines,” she explained. Calling attention to the regional discrepancies in the HIV/AIDS policy and program implementation in Brazil, Nadejda Marques, manager of the Program on Human Rights at CDDRL,, expressed concerns about the implementation of an HIV/AIDS program in a context of limited resources. “In Angola, counseling and voluntary testing units for HIV/AIDS don’t have drinking water or sanitary conditions to receive patients. They lack basic equipment for testing and data collection, there is a generalized shortage of doctors, and health care providers have no specific training on HIV/AIDS.” Despite this alarming situation, Marques explained that advocating for the rights of persons living with HIV/AIDS in Angola has put in evidence the failure of a heath system unable to provide even the most basic services to its population and has enabled mobilization in a context where human rights are routinely violated.

Ami Laws, adjunct associate professor of medicine at Stanford, described how a physician can provide services in collaboration with the judicial system to advance human rights. Laws is an expert witness on cases of torture survivors that require asylum status in the U.S. and has worked mainly with victims of torture in the Punjab region in India. Everaldo Lamprea, a JSD candidate at Stanford Law School and an assistant professor at Los Andes Law School in Bogotá, Colombia, spoke about his recent comparative study on health litigation in low and middle-income countries. The escalation of right-to-health litigation in these countries can have unexpected and harmful consequences to healthcare reforms and the enforceability of the right to health. In part, this is because significant financial resources are allocated to the litigation processes and not to the health system. In addition, while litigation can highlight gaps that exist in the health system that need regulation, countries have been very slow to adapt and adjust to these signals.

Next Steps:

A number of key ideas, questions and insights emerged from the conference including:

. How to identify an effective intervention that will also mobilize communities to advocate for its implementation?

. How to provide services to the more vulnerable populations without alienating a contingent that has access to basic health care services?

. What instruments can be used to share best practices among national healthcare systems?

. How do global priorities adapt to contexts of limited financial resources and human capital?

. How can punctual achievements in rights that guarantee access to health be expanded for the achievement of other social, economic and cultural rights?

The Program on Human Rights at CDDRL will continue to pursue a research agenda examining health and human rights following the conference and announced that it will be the thematic focus of the Sanela Diana Jenkins Speakers Series in 2014. The PHR is also actively seeking support for research projects that include a right to health component at the core of its academic investigation for the 2012-2013 academic year.

U.N. Deputy High Commissioner for Refugees T. Alexander Aleinikoff estimates that in the last two years, the UNHCR has taken in an additional 2,000 refugees every day, making it one of the most challenging periods for the U.N. body in decades. Meanwhile, the traditional methods to shelter, protect and aid those refugees don’t always keep pace with growing demands and emerging technologies.

"Many of us work in ways we have worked for many years, where things that have worked in the past continue to work in the present. But, meanwhile, the world has moved on," Aleinikoff recently told a gathering of nongovernment organizations from around the world. The UNHCR, he said, is looking at mobile phone technology, solar power and lighting, fuel-efficient stoves, microcredit loans and stimulating refugee livelihoods.

The agency needed an incubator to test out some of these innovative ideas. So Aleinikoff turned to CISAC, calling on its security experts to collaborate with the UNHCR on a handful of prototypes that would better protect and support the more than 42 million refugees, internally displaced and stateless people worldwide.

The request has led to a multidisciplinary partnership between the UNHCR and CISAC, with students from across the Stanford campus, professors and NGOs, as well as physicians, architects and other professionals eager to volunteer their time and expertise.

“This really matters; it’s about real people,” said Mariano-Florentino Cuéllar, CISAC’s co-director and a Stanford Law School professor teaching a class to coincide with the project. “I like to think we are creating a network of people who will stay engaged. I’m looking for people who say: This is exciting, this is doable, this is important, and I want to be a part of this.”

Cuellar has found dozens. Students, professors at the Hassno-Platner Institute of Design – better known as the d.school – as well as Bay Area NGOs and Silicon Valley designers have signed on, attending workshops and brainstorming sessions with UNHCR officials and Stanford students from around the world.

Some of the Stanford professors include Paul H. Wise, a professor of pediatrics at the Stanford Medical School and a CISAC affiliated faculty member; Francis Fukuyama, a senior fellow at the Freeman Spogli Institute for International Studies and a specialist in international political economy; and Bernard Roth, a professor of mechanical engineering and one of the founders of the d.school.

“I’m curious to see how it’s all going to play out,” Paul Spiegel, deputy director of the Division of Program Support at the UNHCR and a senior fellow at the Harvard Humanitarian Initiative, recently told the Stanford Law School class during a Skype chat from Geneva. “For us at the UNHCR, the most interesting thing is the multidisciplinary nature of this project. This is something we’ve never done before. So this is very innovative and different.”

Two dozens students with majors ranging from engineering to computer science, international policy studies, law and public health are taking Cuéllar’s class, Rethinking Refugee Communities, co-taught by Leslie Witt of the global design consultancy, IDEO.

“I got involved in the project out of intellectual curiosity and because of the prospect of seeing our ideas applied in the field,” said Danny Buerkli, a second year master’s student in international policy studies. “While most of us are not experts in humanitarian policy, we have the luxury of time to reflect and rethink how UNHCR deals with refugee situations. The project is a great way of exploring design thinking, humanitarian policies and working with a large institutional client all at the same time.”

Some of the students are preparing for a visit to a UNHCR refugee camp in Jordan for Syrians fleeing the violence in their homeland. They want to see operations firsthand to better visualize what’s needed on the ground.

You can follow the project at CISAC’s Storify.com page.