Latest human rights news from around the World by Human Rights Watch 8:21pm 29th Mar, 2011   Human Rights Watch is one of the world’s leading independent organizations dedicated to defending and protecting human rights. For 30 years, Human Rights Watch has worked tenaciously to lay the legal and moral groundwork for deep-rooted change and has fought to bring greater justice and security to people around the world.    Human Rights Watch is dedicated to protecting the human rights of people around the world. We stand with victims and activists to prevent discrimination, to uphold political freedom, to protect people from inhumane conduct in wartime, and to bring offenders to justice. We investigate and expose human rights violations and hold abusers accountable. We challenge governments and those who hold power to end abusive practices and respect international human rights law. We enlist the public and the international community to support the cause of human rights for all.    June 2011    Tens of Millions Face Death in Agony-Palliative Care Neglected Worldwide.    Tens of millions of people worldwide are denied access to inexpensive medications for severe pain, Human Rights Watch said in a report released today.    The report, "Global State of Pain Treatment: Access to Palliative Care as a Human Right," details the failure of many governments to take even basic steps to ensure that people with severe pain due to cancer, HIV, and other serious illnesses have access to palliative care, a health service that seeks to improve quality of life. As a result, millions of patients live and die in great agony that could easily be prevented, Human Rights Watch said.    "Worldwide, palliative care needs are enormous, but many governments simply ignore them," said Laura Thomas, health researcher at Human Rights Watch. "There''s no excuse for letting people suffer from severe pain when inexpensive medications are available to help them."    Experts estimate that 60 percent of those who die each year in low- and middle-income countries - a staggering 33 million people - need palliative care. In these countries, most cancer patients are diagnosed when they already have advanced disease and can no longer be cured. The only treatment option is palliative care. In high-income countries, palliative care needs are increasing with aging populations and the resulting higher cancer incidence.    The report is based on a survey of policy barriers to palliative care in 40 countries and an assessment of the availability of pain-relieving drugs worldwide.    Human Rights Watch found that in 35 of 192 countries reviewed, fewer than 1 percent of patients with moderate to severe pain from terminal cancer or HIV could get the strong pain medications they needed. These countries are concentrated in Sub-Saharan Africa, but some are in Asia, the Middle East, North Africa, and Central America.    Availability of strong pain medications is very limited in many of the world''s most populous countries, Human Rights Watch found. At least 100,000 people die from cancer or HIV/AIDS each year without access to adequate pain treatment in countries such as China, India, Indonesia, Nigeria, Russia, and South Africa.    "My leg would burn like a chili on your tongue," Dilawar Joshi, a Nepali man with a bone tumor living in India told Human Rights Watch. "The pain was so severe I felt like dying. I was very scared. I felt that it would be better to die than to have to bear this pain. [I thought], just remove the leg, then it will be alright. Just get rid of the leg so I''ll be free of pain."    The survey found multiple barriers to palliative care in most of the 40 countries surveyed. Three quarters do not have national palliative care policies, despite a World Health Organization recommendation to develop such policies. In most of these countries, healthcare workers are not adequately trained in pain management or palliative care, and in some, no training is offered at all. In 33 of the countries, the government imposes restrictions on prescribing morphine beyond the requirements of UN drug conventions.    Human Rights Watch found a number of bright spots. Colombia, Jordan, Romania, Uganda, and Vietnam have successfully undertaken comprehensive reform programs to improve access to palliative care. In these countries, government officials have worked with the medical community and civil society to identify and address barriers to palliative care.    The World Health Organization considers palliative care an integral component of cancer care and has urged countries to improve its availability. The 1961 Single Convention on Narcotic Drugs, to which 184 states are parties, requires countries to ensure the adequate availability of narcotic drugs for the relief of pain and suffering.    "Colombia and Uganda and the other countries that have worked to provide palliative care powerfully show that all countries can make progress," Thomas said. "The key ingredient is the political will to make these health services available and to relieve people''s suffering."    Quotes From Patients and Healthcare Workers Interviewed by Human Rights Watch:    "Before I came [to Kenyatta National Hospital], I couldn''t eat or breathe well [because of the pain]. Now that I have been given medicine [morphine], I can eat and breathe. I couldn''t sit down, but now I can. I had pain for more than a month. I told the doctor and nurses [at another hospital] that I had pain. It took too long to get pain treatment... Here I got it immediately and started feeling well again." - Christine L., an 18 year-old woman with Breast Cancer, Nairobi, Kenya.    "I would sleep maybe an hour and a half per night. I could take any number of sleeping pills [without effect]. With morphine, I can relax. This place [the palliative care unit] is heaven-sent..." - Shruti Sharma, Hyderabad, a breast cancer patient, India.    "Cancer is killing us. Pain is killing me because for several days I have been unable to find injectable morphine in any place. Please, Mr. Secretary of Health, do not make us suffer any more." - A classified ad placed in El País bnewspaper in Cali, Colombia, on September 12, 2008, by the mother of a woman with cervical cancer.    "I wanted to fall head down and be dead right away so it wouldn''t hurt anymore." - ­Vlad Zhukovsky, a cancer patient from Ukraine.    "We have no pethidine, no morphine.... We have children here with advanced HIV; some are in severe pain. The pain management for children with advanced HIV is not enough." - Nurse, Bondo District Hospital, Kenya.    May 27, 2011    International Justice: A Crucial Effort Not only about Africa, by Elise Keppler. (AllAfrica)    With all of the situations before the International Criminal Court (ICC) in Africa, it is not surprising that claims that international justice is targeting Africans resonate widely with some diplomats and commentators, and a segment of the general public. But Serbia''s arrest and pending transfer to an international tribunal of one of the most notorious people wanted for genocide in Europe is a reminder that international justice extends far beyond the African continent.    Ratko Mladic-who was taken into custody in Serbia-is the former Bosnian Serb army commander. He is charged before the International Criminal Tribunal for the former Yugoslavia (ICTY) with 11 counts of genocide, crimes against humanity, and war crimes, including the massacre of up to 8,000 Bosnian men and boys in Srebenica during the 1990s war in Bosnia. Mladic''s capture comes some three years after Serbia''s arrest of Radovan Karadzic, another Bosnian Serb leader, who is now on trial for crimes connected to the Srebrenica massacre and other atrocities in Bosnia.    The past 15 years of prosecutions for heinous crimes in the former Yugoslavia do not negate the fact that international justice is applied unevenly. People from powerful states and their allies have been able to evade accountability, including for crimes in Gaza, Chechnya, and Burma. The United Nations Security Council''s role in establishing international courts and the ability of the council''s permanent members to veto initiatives plays a significant role.    No doubt far more robust efforts are needed to ensure that politics does not limit or block prosecutions. But the response should mean working to expand the reach of the ICC, not to undercut it where it can have an impact. Complaints by African leaders about the uneven application of international justice would carry a lot more weight if they focused more on ensuring prosecutions for atrocities wherever they are committed, such as by promoting wider ratification of the ICC''s Rome Treaty, than impeding the court''s functioning with calls for noncooperation.    Mladic''s arrest, 16 years after he was first indicted, is also a stark rebuttal to those who question the value of seeking justice when timely surrender is unlikely. That Mladic was finally taken into custody despite the long delay underscores how important it is to work to hold those responsible for horrific crimes to account even when the short-term arrest prospects seem limited.    Concerted political pressure can make a profound difference in whether an alleged war criminal is ultimately arrested. While Serbian authorities claimed to have no information about where Mladic was, the ICTY prosecutor and independent Serbian media insisted that he was in the country under the protection of elements of the army, hiding in plain sight. Mladic''s arrest follows continued calls by European Union states for Serbia to cooperate fully with the Yugoslav international tribunal before EU membership would be seriously considered.    A similar phenomenon occurred with the former Liberian president Charles Taylor, who was sought for atrocities during the Sierra Leone armed conflict by the UN-backed Special Court for Sierra Leone. For several years, it was known that Taylor was living in a villa in Nigeria-where he received refuge after he stepped down from power. Today, though, Taylor awaits judgment on his case from a jail cell in The Hague. Growing international pressure from civil society and governments led to his arrest in Nigeria in 2007.    Mladic''s arrest puts ICC suspects on notice that while they walk free today, they may well come into custody in the not-too-distant future. Even now, some accused-such as President Omar al-Bashir of Sudan, who is charged with heinous crimes committed in Darfur-already operate in a far smaller universe since many countries have made clear that arrest warrants will be executed if suspects enter their territory. But ICC states parties and the UN Security Council will need to put a lot more diplomatic weight behind their verbal commitments to international justice to ensure that all suspects are turned over for trial.    Mladic''s arrest is a landmark development and cause for celebration for victims in Bosnia, but it is also cause for celebration everywhere atrocities have been committed. The prospect of justice for victims of horrific crimes is what counts, not which continent the suspects come from.    (Elise Keppler is senior counsel with the International Justice Program at Human Rights Watch). Visit the related web page
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