Volume 15 No 1 Spring 2004

  • 1. PHR-UK's eclectic programme

    PHR-UK’s 2004 programme stands comparison with any other international human rights organisation in terms of its scope and its potential impact. The quality of the programme is testament to the successful development of the organisation under Bernie Hamilton’s 5 year tutelage.

    PHR-UK continues to negotiate for the institution a focal point for genocide prevention located at UN headquarters in New York, timed to commemorate the 10th anniversary of the start of the Rwandan genocide on 7th April 1994. There is presently no systemic mechanism to prevent the same thing happening again. [see Newsletter 14:4]

    In 2004 a PHR-UK delegation will, having refined their arguments in front of experts on capital punishment at Westminster University this spring, seek to persuade members of the UN Human Rights Committee of the medical evidence establishing that methods of execution, including lethal injection, constitute cruel inhuman or degrading treatment or punishment proscribed by the International Covenant on Civil and Political Rights [see Update on death penalty]

    The organisation has a number of scheduled and still to be scheduled meetings as part of the campaign to advance the Right to Health - both internationally, collaborating with key players and organisations globally - and at home by, for example, negotiating with media and institutions over medical education in health and human rights, and exploring the role for litigation in advancing the Right to Health.

    In June the theme of the conference to mark Torture Victim Solidarity Day will be the health and human rights of unlawful detainees in Guantanamo Bay and elsewhere [see also Indefinite detention without legal safeguards]

    This autumn the annual AGM health and human rights conference will focus on UK health provision and human rights.

  • 2. Plastic bullets

    PHR-UK is very concerned to learn of the continued availability of plastic bullets to security forces in Northern Ireland. According to the Steering Group established by the Secretary of State for Northern Ireland, 8,165 plastic bullets were discharged at Drumcree and elsewhere, in July 1996, resulting in 172 injuries on 155 patients examined in hospital. Three patients required treatment in intensive care units.

    The areas of highest vulnerability from a non-penetrating impact are reported as being the head, thorax and abdomen, and tolerance may vary according to age and stature. Between 1972 and 1989, seventeen deaths involved rubber (now discontinued) or plastic bullets. Nine of the seventeen deaths involved children under the age of 18. Four had not reached their teen years. Both the UN Committee against Torture and the UN Committee on the Rights of the Child urged the UK to abolish the use of plastic bullets as a means of riot control. The UK Govt. has now produced a study of plastic bullets, on which PHR-UK, or its sister human rights NGOs may comment. Because of our medical expertise, it would be particularly appropriate for PHR-UK to comment on the chapter dealing with medical questions. If any member would like to study and comment on this report we would like to hear from them.

    Please contact the Chair, Dr. Peter Hall, Tel. 077707 96609 E-Mail: phall@gn.apc.org

  • 3. A member’s letter supporting a PHR-UK campaign (reproduced with the author’s permission)

    21st November, 2003

    Dear Mr. Annan

    re. Genocide Prevention Focal Point

    You may not remember me but we met in New York after the service for British nationals who suffered in the attack on the World Trade Center on September 11th 2002. I was sent by the British Foreign Office and was responsible for organising support to the bereaved families. When we met I mentioned I had worked for UNICEF in Rwanda, a year after the genocidal massacres, to help organise a Trauma Recovery Programme.

    It is that experience that prompts me to write now. I witnessed the terrible consequences of those massacres and can only sympathise with the feelings of helplessness which you must have experienced at that time. I know you will want to do everything possible to prevent future occurrences of a similar kind.

    I am a member of Physicians for Human Rights–UK and would like to endorse the proposals which they have made, in conjunction with the International Campaign to End Genocide and Genocide Watch, to mark the tenth anniversary of the genocide in Rwanda by the creation of a United Nations Genocide Prevention Focal Point. This would act as a watchdog, alerting you and the member nations to the build up of tensions likely to lead to future genocidal conditions and drawing on the experience of genocide scholars, lawyers, politicians and others to reduce that risk.

    In my work as a psychiatrist specialising in the psychological consequences of trauma and bereavement I am aware of the danger of cycles of violence whereby traumatic deaths sow the seeds of more traumatic deaths. Genocide is the most disastrous end result of such circumstances.

    I shall be visiting the United States in March to chair a working party on ‘The Cycle if Violence’ which has been set up by the International Work Group on Death, Dying and Bereavement. If I can be of any further assistance to you or your colleagues in furthering these or similar plans do let me know.

    Yours sincerely

    Colin Murray Parkes, OBE MD FRCPsych.

  • 4. Annual General Meeting December 4th 2003

    The Chair’s address:

    When the Committee completed its evaluation five years ago, and agreed that we needed to hire a human rights expert to help focus the strengths of PHR-UK, we decided that we would be unwise to race for a place in the super league, alongside such well-established international NGOs as Human Rights Watch and Amnesty-International. We thought instead we would try for the First Division, where we could contribute our unique knowledge, expertise and influence. We knew that when doctors told governments there was evidence of torture, they would listen, and we knew that we could apply this to the growing concerns to end impunity for gross violations of human rights, genocide, crimes against humanity and the laws of war. But we also discovered that we could contribute to economic and social rights, because violations of these also had a terrible impact, not least on the right to health, which provides the rubric for our conference this afternoon. It has been an exciting journey and one that provides me personally with great satisfaction.

    With PHR-UK's work on developing the UN's General Comment on the Right to Health, and our subsequent work with the Special Rapporteur on the Right to Health, the World Health Organisation and UNAIDS, and my participation over the last two years in teaching the course designed by Bernie on litigation and lobbying on the right to health - in which we have explored the ways in which the Right to Health can be advanced - I have come to realise the extent to which human rights violations are a threat to health globally. I think the best way to express it is to say that health is contingent on respect for human rights - and conversely that the largest obstacle to advancing health globally is disregard for existing international, regional and domestic human rights legislation.

    In a notional sense, this has always been so but we did not realise it until we had the legislation with which to conceptualise it. Some people have always lived long and healthy lives and they did not have to be rich. They needed accommodation, food, clean water and a healthy environment. Health preservation not only includes avoiding conventional risk factors such as smoking but avoiding violations of civil and political rights such as torture or genocide. Modern healthcare has of course a part to play but poverty is not necessarily a bar to a healthy life, and ill health can exist in the richest of nations. Furthermore not only do people from poor countries have a right to development, but developed countries are obliged to help poorer countries deal with disasters such as AIDS, and indeed to help them develop.

    These are truly exciting times for defenders of health rights. The UK's Audit Commission recently published a report critical of the NHS over its response to the Human Rights Act. In South Africa, the Treatment Action Campaign (TAC) has forced their government to perform a complete volte face, lurching from outright rejection of HIV as the cause of AIDS, to planning to treat its infected population with anti HIV drugs. By astute use of the courts, by mobilising massive grass roots opinion across the country, and by encouraging international lobbying ,TAC forced its obdurate government to transform its policy. So successful has the three year campaign been that last week TAC and its chair Zackie Achmat were nominated for the 2004 Nobel Peace Prize.

    It is because the right to health can have such a huge impact that PHR-UK has taken it on board. That's why we responded to the appeal by Mary Robinson, as UN High Commissioner for Human Rights, made to me at a lunch meeting in Westminster two years ago, and why we provided an alternative report to that of the UK Government, when it appeared before the UN Committee on Economic, Social and Cultural Rights to discuss health provision last year. We are following up on this, with both the UK's Parliamentary Joint-Committee on Human Rights, and the UN Committee in Geneva. Also, we are working closely with a panel of lawyers to develop a right to health litigation strategy, using the new Human Rights Act.

    Members will know that Parliamentary Secretary David Lammy MP, has recently counselled public health authorities to play a fuller part in the UK's human rights culture, and I can announce today that I have invited Mr. Lammy to share his ideas with us, possibly at a future public meeting. PHR-UK will play its part. The Hippocratic Oath, from which our logo - from harm and injustice - is derived, urges us to give the very highest respect to our patients and those who are with them and to share precepts with our students. It nowhere says that we should defend the indefensible, whether it is discrimination, disregard for confidentiality or worse, and we will not do so.

    As we have moved to work on social and economic rights, PHR-UK has continued to develop its work in civil and political rights. We devoted enormous time to securing an independent International Criminal Court and to ensuring that the Home Secretary understood why Senator Pinochet should not be released on health grounds without clear and compelling indications. As those of you who were here with us in June know, we are working on a presentation to the UN Human Rights Committee in Geneva on current methods of execution, and why they amount to torture. It has been very gratifying to receive so many cheques from members in response to my appeal for support for this project, and I pay tribute to Dr. Ferris and Dr. Hillman for the dedicated way in which they are approaching this task.

    We have also received support from members in response to our appeal to you to write to the UN Secretary General in New York, urging him to use his powers under Article 99 of the UN Charter to establish a Genocide Prevention Focal Point at the UN HQ, and announce it next April 7, the tenth anniversary of Rwanda's genocide. It is scandalous that so many reports since then have recommended stronger preventive measures, yet UN members prefer to cling on to their sovereign right to commit genocide.

    Speaking of scandals, I announce today that on Saturday 26 June, we shall be holding a conference on the health and human rights of detainees in Guantanamo Bay and elsewhere. I plan to invite Sarah Lumford MEP [Lib-Dem], Professor of forensic psychology, Gisli Gudjonsson, the Red Cross, lawyers for detainees and others.

    All this, of course, depends on our maintaining a healthy budget. Our annual outgoings approach £30,000, not much when you consider what we achieve, but our income is much less. We have been drawing on our capital reserves, and they are almost exhausted. Long-term member Chris Burns-Cox has worked on a fund-raising exercise for us, but most donations are geared to specific projects, and leave little over for our basic costs. We cannot continue as we are. To mix metaphors, we have been punching above our weight for five years now, and we can only do that for so long. I have written to every member saying I need a hundred pounds per member, and asking them for as much as they can afford. I have been enormously heartened by the number of cheques that came in, some for more than £200. But I need something from everyone. Everyone here has a letter asking them to support us. Please give something to one of our Committee members before you leave today. I can think of no better investment. Thank you for your attention. [Editors note - they really said, let us have cheques]

  • 5. Human Rights to become an election issue? *


    This spring, the UK government is to publish a White Paper on its proposed Commission on Equality and Human Rights. The idea of a national Human Rights Commission has been around since the UK's Human Rights Act of 1998, but the proposed Commission will be broad in scope. It will take on the work of the existing Commissions on Racial Equality, Disability Rights and Equal Opportunities, as well as new responsibilities arising from the European Union in the areas of age, sexual orientation and religion or belief. A lengthy period of consultation will follow the 2004 white paper. It is thought that the new Commission will not be established until 2007, and so could become an election issue.

    Why a Commission ?

    The establishment of a Commission is in line with the recommendation of the UK Parliament's Joint Committee on Human Rights, which took evidence from a large number of experts. The Joint Committee concluded that a Commission could contribute to the establishment of a human rights culture in the UK. It said that a "culture of respect for human rights would exist when there was a widely-shared sense of entitlement to these rights, of personal responsibility and of respect for the rights of others, and where this influenced all our institutional policies and practices". It envisaged that such a culture, "would help create a more human society, a more responsive government and better public services, and could help to deepen and widen democracy by increasing the sense amongst individual men and women that they have a stake in the way in which they are governed."

    The added value of human rights

    The merging of existing equality commissions with human rights posed some initial questions. Might one take over the other? Would the partnership approach used in equal employment, be jeopardised by the more confrontational approach associated with human rights litigation? These concerns were offset by an appreciation of the advantages a proactive human rights initiative can bring. The existing equality commissions welcome the human rights approach, and some see human rights as equality's natural home in the Twenty-first Century.

    Key questions

    Crucial areas during the consultations will be the powers, the resources and the scope of the new Commission. Will it be able to conduct enquiries on its own initiative? Will it be able to demand evidence? Will it be able to assist in or bring test cases and amicus briefs? Will it be properly resourced? Above all, perhaps, will the Commission's mandate be confined to the Strasbourg rights enunciated in the UK's Human Rights Act, or will it embrace the other internationally recognised standards of human rights to which the UK is bound?


    If the new Commission is to earn public respect, it must be seen to have independent powers. It must be able to determine its own agenda, pursue such enquiries wherever they may lead, and publish the results. Only then will the Commission be perceived as accessible to ordinary people, as experiences elsewhere including South Africa have shown. The Commission must also be empowered to demand evidence of any body. It might be argued that the Danish Institute of Human Rights lacks such powers, and yet is treated as though it did. To this, it could be responded that, as a society without a developed human rights culture becomes more demanding of its rights, the more important it is that its enquiry procedures are clear and ironclad.

    Relationship with the courts

    Because of its expertise, the new Commission should be well placed to submit amicus briefs to relevant court hearings. The Northern Ireland Human Rights Commission intervened in Jordan v. UK, at the European Court of Human Rights in 2001, and in Amin, at the House of Lords in 2003. It should also bring test cases and help others to do the same. Clearly, some members of the public will not understand why certain cases are selected and not others. Explaining such decisions, will draw on the Commission's expertise as a human rights communicator and should further the development of a human rights culture. Another difficulty in giving the Commission such powers lies in the risk that it will become the UK's sole human rights litigant. This would undermine the development of a human rights culture in which a vibrant civil society participated. The UK should learn from post-Apartheid South Africa where, as donors shifted their funding to the government, NGOs were less able to mount major human rights cases so that perhaps only four were brought during the last decade. In addition to its own cases and interventions, the new Commission will need to work in partnership with, but not quench civil society initiatives with regard to the courts. Such work is a vital part of human rights promotion.

    The need for proper resources

    It will be seen from the above that proper resourcing is vital to a successful Commission. Commissioners and their staff must feel secure in their work. They cannot be in such fear of their tenure or budget not being renewed that they contemplate placating the government of the day. Some newspapers suggested that the South African Human Rights Commission withdrew from the Treatment Action Campaign case as a result of pressure from the government. The terms and structure of the new Commission must ring-fence it from such suggestions, so that it will attract commissioners and staff of the highest calibre. Resources must be sufficient to enable the new Commission to respond appropriately to the various enquiries it will receive from the public, from businesses and from public authorities, while pursuing its own agenda in the courts and elsewhere.

    Will it deal with all human rights?

    A final issue of concern is the scope of the Commission's work. The Government's statement to Parliament announcing the intention to create a Commission, and the Parliamentary Under-Secretary's speech of the following week, both mention the Human Rights Act. However, it is difficult to conceive of a Commission mandated to foster a human rights culture that confines its work to the civil and political rights contained in the European Convention. Given that the Commission's remit also covers equality and discrimination, the provision of economic or social rights for members of vulnerable groups must cross its radar screen. It is to be hoped that, like the UK Parliament's Joint Committee on Human Rights, the new Commission will be mandated to address all of those international human rights standards that bind the UK.

    Human rights an election issue?

    The debate on the future Commission should be a stimulating one. It can draw on the UN's ten-year old Principle's Relating to the Status of National Institutions - the Paris Principles, as well as the experiences of various States. Some will emphasise its educational purpose, others might want to see it given a conciliation or even remedial function. A central focus is likely to be the degree of autonomy the Commission is granted to fulfil its role of promoting a culture of respect for human rights. Were the debate to get caught up in the UK's next national election, human rights might really excite some attention.

    PHR-UK's position

    PHR-UK welcomes the Government's initiative. We believe that a Commission will contribute to a much-needed culture of human rights in the UK, and can strengthen the work of bodies concerned with equality. To be effective, the new Commission must have political independence and financial security. Although it can never supplant the rightful place of the courts in protecting human rights, the new Commission must have access to the courts. A Commission on Equality and Human Rights must embrace all human rights economic, social, cultural as well as civil and political.

    * An earlier version of this article appeared in the Human Rights Interest Group Newsletter of the American Society for International Law. PHR-UK gratefully acknowledges permission of the Editor to reproduce sections of it here.

  • 6. Guantanamo Bay Detainees' Health Remains a Concern

    PHR-UK remains concerned about the health and human rights of unlawful detainees in Guantanamo Bay and elsewhere. Despite the White House assurances of June 26, 2003 regarding torture that we reported in Newsletter 14.3, the stress of continuous imprisonment with no end in sight, perhaps coupled with isolation, can impair the mental health of detainees.

    In October 2003, the International Committee of the Red Cross made a rare public statement calling for an end to indefinite detention without legal safeguards. The Red Cross is the only outside body with regular access to the Guantanamo Bay detainees. It checks on who is detained and advises detainees' families, who may then write letters. It is a condition of such visits that the Red Cross takes its concerns to the detaining authorities, and only when no progress is made, will it make a public statement.

    The ICRC say that the main question detainees ask is what is going to happen to them. It is this uncertainty that can lead to psychological problems. In 18 months, 21 detainees made 32 suicide attempts. The camp holds 650 prisoners, some as young as 13, from about 40 countries. This rate of suicide attempts is much higher than in an average prison. Prisoners are reportedly held in tiny cells and are only allowed out for 30 minutes each day. It is believed that between two and five detainees are held in isolation within a maximum security compound there.

    It is likely that the combination of isolation and uncertainty caused 23 year-old Feroz Abassi, a Briton from Croydon, to be diagnosed as suffering from depression when examined by a US military forensic psychiatrist this Autumn. A second British citizen showed signs of withdrawal recently. During a consular visit, he sat facing the corner and refused to speak with the diplomat with whom he had discussed soccer results during earlier visits.

    The US authorities have released some detainees and tried to establish military commissions to put on trial other inmates. They are reported to have constructed a courtroom and adjacent execution chamber. The military commissions are a throwback to World War II, and do not meet current legal standards. There is no right to appear before the commission, the defendant's right to a counsel of their own choosing is severely limited. Defence counsel are themselves subject to restrictions, there is no right of appeal to an independent civilian court and an acquittal does not guarantee release. The US Government denied reports that an initial group of defence counsel refused to agree to the proposed restrictions and so was dismissed.

    Speaking in London, earlier this year, PHR-UK Chair Dr. Peter Hall said, "It is scandalous that individuals have been kept on Guantanamo Bay for two years without any understanding of what is going to happen to them or when. Whilst we appreciate the US Government's assurances that torture is not taking place, the health consequences of this form of detention can be severe. The US Government must conform to Article 5 of the 1949 Geneva Convention III Relative to the Treatment of Prisoners of War by treating each detainee as a prisoner of war and determining any detainee's doubtful status through a competent tribunal. Alternatively, the US should afford detainees the judicial protections of Article 14 of the 1966 International Covenant on Civil and Political Rights. As a party to both treaties, the US could bring certainty into the lives of the detainees as well as to those who wish to see justice done in accordance with internationally recognised standards." PHR-UK will hold a conference on the health and human rights of unlawful detainees on Saturday 26 June. Details will appear in the next Newsletter but please mark your calendar now.

  • 7. Death Penalty Update

    PHR-UK's team will be taking new material on lethal injection with them when they travel to Geneva to discuss current execution methods with the UN Human Rights Committee. In 2001, it became a crime for vets in the US State of Tennessee to destroy pets by using one of the three chemicals normally used in combination to execute criminals. The drug is called pancuronium bromide. It is usually the second of the three to be administered during executions. It paralyses muscles but does not impact the brain or nerves. Used alone, it leaves a person conscious but unable to speak or move. A patient who underwent eye surgery, in which pancuronium bromide was used to immobilise the eye but where the anaesthetic was ineffective, described her surgery as torturous, and said she could not communicate that she was awake, despite doing everything she could to move.

    A prisoner given pancuronium bromide may appear to undergo a serene execution when actually they are suffering an excruciatingly painful ordeal of death by lethal injection. One death row prisoner in the State of Tennessee has raised the prohibition of the drug's use on pets. However, the State's legal papers point out that the ban on pancuronium bromide in pet euthanasia does not apply to a criminal under-going the death sentence because he or she is not a "nonlivestock animal." Responding to the report, PHR-UK Chair Dr. Peter Hall said, "It is not clear why pancuronium bromide is employed by the thirty or so US states that use it. Variations in dosage or the expertise of those who administer lethal injections, could lead to suffering. It is essential that lethal injection is subjected to the closest possible scrutiny at a time when it is replacing demonstrably barbaric methods of execution. I hope that PHR-UK's team have an opportunity to raise this with the Human Rights Committee"

    At present members' generous donations towards this project have amounted to £250. We need more if we are to send a multidisciplinary team to mount a convincing argument to the independent experts in Geneva. If you can support this project, please send a cheque now to: Dr. Peter Hall, 91 Harlech Road, Abbots Langley, Herts WD5 0BE. Please make your cheque payable to "PHR-UK" and write on the back "death penalty appeal". Thank you.


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