Transcript Human Rights, Health and Refugees Eleanor D. Kinney, JD, MPH Hall Render Professor of Law & Co-Director Anthony C.

Human Rights, Health and
Refugees
Eleanor D. Kinney, JD, MPH
Hall Render Professor of Law & Co-Director
Anthony C. Pearson (JD Candidate)
Hall Center for Law and Health
Indiana University School of Law – Indianapolis
Co-Director, Consortium for Health Policy, Law & Bioethics, IUPUI
Talk Outline
• Review the framework of international
treaties for the protection of refugees.
• Review US law and policy on the protection
of refugees and asylum seekers.
• Review resources on refugee health.
The Aftermath of World War II and
the United Nations
Aftermath of World War II in Europe
Aftermath of World War II in Asia
Total Loss of Life in WWII
• The total estimated human loss of life
caused by World War II, irrespective of
political alignment, was roughly 62 million
people.
• The civilian toll was around 37 million, the
military toll about 25 million.
• The number of refugees from the war
was staggering.
United Nations, 1945
Constitution of the
World Health Organization
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Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
The enjoyment of the highest attainable standard of health is one of the
fundamental rights of every human being without distinction of race,
religion, political belief, economic or social condition.
The health of all peoples is fundamental to the attainment of peace and
security and is dependent upon the fullest co-operation of individuals and
States.
The achievement of any State in the promotion and protection of health is of
value to all.
Unequal development in different countries in the promotion of health and
control of disease, especially communicable disease, is a common danger.
Healthy development of the child is of basic importance; the ability to live
harmoniously in a changing total environment is essential to such
development.
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Governments have a responsibility for the health of their peoples which can
be fulfilled only by the provision of adequate health and social measures.
UN Universal Declaration of Human Rights
Article 25.1
“Everyone has the right to a
standard of living adequate for the
health and well-being of himself and
of his family, including food,
clothing, housing and medical care
and necessary social services, and
the right to security in the event of
unemployment, sickness, disability,
widowhood, old age or other lack of
livelihood in circumstances beyond
his control.”
United Nations Refugee Agencies
• 1942, United Nations Relief and Rehabilitation
Administration (UNRRA) established to provide
humanitarian relief to the vast numbers of potential
and existing refugees in areas facing Allied liberation.
• 1947, it ceased operations in Europe, and in Asia in
1949, upon which it ceased to exist.
• 1947, was replaced in 1947 by the International
Refugee Organization (IRO), which in turn evolved
into United Nations High Commissioner for Refugees
(UNHCR) in 1950.
• The UN High
Commissioner for
Refugees is the leading
international agency
addressing refugee
matters.
• UNHCR works closely
with the US government
in identifying and
assisting refugees and
asylum seekers.
1951 Convention
Relating to the Status of Refugees
The 1951 Convention relating to the
Status of Refugees is the key legal
document in defining who is a refugee,
their rights and the legal obligations of
states. It pertained only to European
refugees
1967 Protocol
Relating to the Status of Refugees
The 1967 Protocol removed geographical
and temporal restrictions from the
Convention.
Relevant Human Rights Instruments
MAJOR UN INTERNATIONAL
HUMAN RIGHTS INSTRUMENTS
• UN Universal Declaration of Human Rights (art. 25.1)
Everyone has the right to a standard of living adequate for
the health and well-being of himself and of his family,
including food, clothing, housing and medical care and
necessary social services, and the right to security in the
event of unemployment, sickness, disability, widowhood,
old age or other lack of livelihood in circumstances beyond
his control.
• International Covenant for Civil and Political Rights (ICCPR)
• International Covenant for Economic, Social and Cultural Rights
(ICESCR) (art. 12)
INTERNATIONAL COVENANT FOR
ECONOMIC, SOCIAL AND CULTURAL RIGHTS (ICESCR)
ARTICLE 12
1. The States Parties to the present Covenant recognize the right of
everyone to the enjoyment of the highest attainable standard of
physical and mental health.
2. The steps to be taken by the States Parties to the present
Covenant to achieve the full realization of this right shall include
those necessary for:
(a) The provision for the reduction of the stillbirth rate and of
infant mortality and for the healthy development of the child;
(b) The improvement of all aspects of environmental and
industrial hygiene;
(c) The prevention, treatment and control of epidemic, endemic,
occupational and other diseases;
(d) The creation of conditions which would assure to all medical
service and medical attention in the event of sickness.
OTHER UN TREATIES RECOGNIZING AN INT’L
HUMAN RIGHT TO HEALTH
• International Convention on the Elimination of All
Forms of Racial Discrimination of 1965 (art
5(e)(iv))
• Convention on the Elimination of All Forms of
Discrimination against Women of 1979 (art.
11.1(f) and 12)
• Convention on the Rights of the Child of 1989
(art. 24)
• Constitution of the World Health Organization
(1946)
National Constitutions
Percent of Countries Adopting Constitutional Provisions
and/or Ratified International and/or Regional Treaties
Constitutional
Provisions
Ratification of
ICESCR
Ratification of
Regional Treaties
67.6%
54.1%
30.4%
Distr.
GENERAL
E/C.12/2000/4, CESCR
General comment 14
4 July 2000
Original: ENGLISH
The right to the highest attainable standard of health : . 11/08/2000. E/C.12/2000/4, CESCR
General comment 14. (General Comments)
COMMITTEE ON ECONOMIC, SOCIAL
AND CULTURAL RIGHTS
Twenty-second session
Geneva, 25 April-12 May 2000
Agenda item 3
SUBSTANTIVE ISSUES ARISING IN THE IMPLEMENTATION OF
THE INTERNATIONAL COVENANT ON ECONOMIC, SOCIAL
AND CULTURAL RIGHTS
General Comment No. 14 (2000)
The right to the highest attainable standard of health
(article 12 of the International Covenant on Economic, Social and Cultural Rights)
GENERAL COMMENT 14
NORMATIVE CONTENT OF THE RIGHT TO HEALTH
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The right to health is not to be understood as a right to be
healthy.
The right to health contains both freedoms and entitlements.
The freedoms include the right to control one's health and body,
including sexual and reproductive freedom, and the right to be
free from interference, such as the right to be free from torture,
non-consensual medical treatment and experimentation.
By contrast, the entitlements include the right to a system of
health protection which provides equality of opportunity for
people to enjoy the highest attainable level of health.
Relevant US Law and Policy
Secretary of State Hillary Clinton
on U.S. Refugee Programs
“The United States is committed to supporting refugees
and displaced people worldwide. We are proud to support
the heroic efforts of the United Nations High
Commissioner for Refugees (UNHCR), the International
Committee of the Red Cross, the International
Organization for Migration, and many other nongovernmental organizations that work on behalf of
refugees worldwide, often in difficult and dangerous
circumstances. Last year, we gave more than $1.4 billion
to support this work, making us the world’s largest donor
for refugee relief. And we’re honored to welcome the many
refugees who have resettled in our nation; since 1975,
nearly 3 million refugees have made new homes in the
United States, more than any other nation in the world.”
Secretary of State Hillary Clinton
World Refugee Day, June 2009
An excellent annual
report to Congress
from DOS on
Refugee and Asylum
Policy
US REFUGEE PROGRAMS
Under the authority in the Migration and Refugee
Assistance Act of 1962, as amended, the United
States contributes to the programs of UNHCR, the
International Committee of the Red Cross (ICRC),
the International Organization for Migration (IOM),
the UN Relief and Works Agency for Palestine
Refugees in the Near East (UNRWA), and other
international and non-governmental organizations
that provide protection and assistance to refugees,
internally displaced persons (IDPs), victims of
conflict, and other vulnerable migrants.
Refugees under US Law
• Generally, to be considered a refugee, a person must be
outside his or her country of nationality or, if stateless,
outside his or her country of last habitual residence.
• Under the Immigration and Nationalities Act §
101(a)(42)(B), however, the President may specify
circumstances under which individuals who are within
their countries of nationality or last habitual residence
may be considered a refugee for purposes of admission
to the U.S..
• The FY 2010 proposal recommends continuing such incountry processing for specified groups in Iraq, Cuba,
and the countries of the former Soviet Union, and
stateless individuals referred by UNHCR.
Refugees as Defined by USCIS
Refugee status or asylum may be granted to people who have
been persecuted or fear they will be persecuted on account of
race, religion, nationality, and/or membership in a particular
social group or political opinion.
Refugee status is a form of protection that may be granted to
people who meet the definition of refugee and who are of special
humanitarian concern to the United States. Refugees are
generally people outside of their country who are unable or
unwilling to return home because they fear serious harm. For a
legal definition of refugee, see section 101(a)(42) of the
Immigration and Nationality Act (INA). One may seek a referral
for refugee status only from outside of the United States.
Asylum Seekers as Defined by USCIS
Refugee status or asylum may be granted to people who have
been persecuted or fear they will be persecuted on account of
race, religion, nationality, and/or membership in a particular
social group or political opinion.
Asylum status is a form of protection available to people who:
– Meet the definition of refugee
– Are already in the United States
– Are seeking admission at a port of entry
– You may apply for asylum in the United States regardless of
your country of origin or your current immigration status.
Priorities for the US Program
• Priority 1 – Individual cases referred to the program
by virtue of their circumstances and apparent need
for resettlement;
• Priority 2 – Groups of cases designated as having
access to the program by virtue of their
circumstances and apparent need for resettlement;
• Priority 3 – Individual cases from eligible nationalities
granted access for purposes of reunification with
anchor family members already in the United States.
Priority 2 Designations:
In Country Processing
Former Soviet Union for Jews, Evangelical Christians, and Ukrainian
Catholic and Orthodox religious activists, with close family in the United
States.
Cuba for human rights activists, members of persecuted religious
minorities, former political prisoners, forced-labor conscripts (1965-68),
persons deprived of their professional credentials or subjected to other
disproportionately harsh or discriminatory treatment resulting from their
perceived or actual political or religious beliefs or activities, and persons
who have experienced or fear harm because of their relationship – family
or social – to someone who falls under one of the preceding categories.
Iraqis Associated with the United States for employees of the USG, a
USG-funded contractor or grantee, and U.S. media and NGOs working in
Iraq, and certain family members of such employees, as well as
beneficiaries of approved I-130 (immigrant visa) petitions, are eligible for
refugee processing in Iraq.
Priority 2 Designations:
Groups of Humanitarian Concern
outside the Country of Origin
• Ethnic Minorities and others from Burma
in camps in Thailand
• Ethnic Minorities and others from Burma
in Malaysia
• Bhutanese in Nepal
• Iranian Religious Minorities
• Iraqis Associated with the United States
• Eritreans in Shimelba
Statistical Snapshot of US on Refugees and
Asylum Seekers, as of 1/2009
Residing in United States of America
Refugees 279,548
Asylum Seekers 69,228
Returned Refugees 0
Internally Displaced Persons (IDPS) 0
Returned IDPs 0
Stateless Persons 0
Various 0
Total Population of Concern 348,776
REFUGEE ADMISSIONS TO THE US IN FY 2008 AND
FY 2009, PROPOSED REFUGEE ADMISSIONS BY
REGION FOR FY 2010
Circumstances that cause involuntary
migration are complicated and part of
larger issues
Federal Programs for Refugee Health
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Office of Refugee Resettlement (U.S. Administration for Children and Families)
Read about the office's mission and projects to aid refugees resettling in the United
States.
International Emergency and Refugee Health Branch (U.S. Centers for Disease Control
and Prevention)
News, publications, and other information related to CDC’s work with refugees involved
in disaster or emergency situations.
Immigrant, Refugee, and Migrant Health (U.S. Centers for Disease Control and
Prevention)
CDC's efforts to improve the health of refugees in specific areas across the globe.
Refugee Mental Health Program (U.S. Substance Abuse and Mental Health Services
Administration)
The program provides refugee mental health consultation and technical assistance to
federal, state, and local agencies.
Bureau of Population, Refugees, and Migration (U.S. Department of State)
The bureau's role is to assist refugees to permanently resettle in the U.S.; it also
administers U.S. refugee assistance and admissions programs.
Office of Foreign Disaster Assistance (U.S. Agency for International Development)
This USAID office coordinates assistance for refugees displaced by emergencies, such
as civil conflicts or acts of terrorism.
Challenges to Refugee health
Refugees experience a threefold challenge to their
health and well-being: 1) psychiatric disorders
precipitated by the refugee experience, 2) infectious
and parasitic diseases endemic to countries of origin,
and 3) chronic diseases endemic to host countries.
These challenges are faced in stages by the refugees
themselves and by the array of health and social
service agencies committed to providing refugee
assistance.
LA Palinkas et al, The Journey to Wellness: Stages of Refugee Health Promotion
and Disease Prevention, Journal of Immigrant Health (2003)
US Committee for Refugees and
Immigrants (USCRI)
Every day we help:
• Refugees fleeing war and persecution find
immediate safety and assistance Refugee
families find permanent safe homes where
they can rebuild their lives. Sometimes this
means going back to the country of their birth,
other times settling in the country to which
they have fled, and occasionally settling in a
third country that accepts refugees such as
Canada, Australia, the US, or many European
countries
• Refugee families resettling in the US
• Unaccompanied refugee and immigrant
children who are in the US with without their
parents or other responsible adult
United States Association for
UNHCR (USA for UNHCR)
• The United States Association for UNHCR (USA for
UNHCR) supports the UN Refugee Agency's
humanitarian work to protect and assist refugees
around the world. We strive to meet the needs of the
world's most vulnerable people, building support and
awareness in the United States for UNHCR's lifesaving relief programs.
• Established by concerned American citizens, USA for
UNHCR is a 501(c)(3) non-profit organization.
Proceed with your wonderful work!!