When I go to a hospital or clinic, I expect to receive good quality, respectful care, and I usually do. Unfortunately, that is not the experience for many people around the world. For them, health care settings are not places of healing, but places where severe mental or physical suffering is inflicted as a result of government policy or negligence. This is especially true for patients from socially marginalized groups—people living with HIV, gays and lesbians, transgender persons, people who use drugs, and people with intellectual disabilities or mental health problems. Their contact with health facilities is too often characterized by physical abuse, insults, invasion of privacy, forced medical procedures, or denial of treatment. This amounts to cruel, inhuman, and degrading treatment—and in some cases, torture.
Such abuses must stop, and we all must do our part to make sure that they do. That is why a coalition of health and human rights organizations, including the Open Society Foundations, is launching the Campaign to Stop Torture in Health Care. We are committed to a world where health care centers are safe, and where our governments act to prevent all forms of torture.
Such egregious and pervasive cruelty is often condoned in the name of medicine, public health, or public order. For example, in the so-called “rehabilitation” centers throughout Southeast Asia, people who use drugs are locked away without any access to medical care or legal recourse. These centers are overseen by government authorities, with private business operating the forced labor facilities inside. The centers rely on physical abuse, shackles, solitary confinement, and other indignities to “treat” drug addiction and extract labor from the detainees. Not surprisingly, the vast majority of people quickly return to drug use once they are released from these centers.
Across the globe, women continue to be forced or coerced by medical personnel to submit to permanent and irreversible sterilization procedures, sometimes even without their knowledge. Cases of forced and coerced sterilization have been reported in North and South America, Africa, Asia, and Europe. Women who are poor or stigmatized—Roma women, women living with HIV, indigenous women, women with physical or intellectual disabilities, women who use drugs—are most likely to be deemed “unworthy” of reproduction. Governments turn a blind eye to these practices in their own public hospitals. Perpetrators are seldom held accountable. Victims rarely obtain justice for this violent abuse of their rights.
Torture also happens when health care workers are prevented from helping patients because of ill-conceived government policies or regulations, or because of bureaucratic inertia. We recently met a young man named Vlad in the small town of Cherkasy, Ukraine (see his interview above). He was 18 when doctors discovered he had a brain tumor. He underwent several treatments in multiple hospitals but nothing could be done. Vlad’s condition deteriorated over the years: he became paralyzed, his kidneys began to fail, and he developed severe sepsis on both sides of his body from his bedsores.
Throughout all this, Vlad was tormented with pain. His mother begged every doctor and nurse she could find to give him more Omnopon or morphine—common and inexpensive medicines used to treat pain. But she was told, time and time again, that patients in Ukraine are only allowed 50 milligrams of morphine per day. When we inquired, we were told that 50 mg was first mentioned in a textbook produced by a pharmaceutical company some years back. It has no basis in medical evidence, and is completely arbitrary. In countries where access to pain relief is a reality, a typical patient with late-stage cancer might get 2,000 mg or more of morphine per day, whatever is needed to manage his or her pain symptoms. Yet no one in the Ukrainian government appears to be moving to clarify the appropriate amount of pain medication Vlad should have received. Denying Vlad and others like him appropriate and cheap pain medicine is literally an act of torture. It cannot be excused under any circumstance.
We are launching this campaign today for the hundreds of thousands of people who are tortured as a result of insufficient access to pain medicine, for the many who are locked away in drug detention centers where they are regularly beaten and abused, and for the women who are coerced or forced into being sterilized because they “should not be having children.”
We hope you will join us in fighting abusive treatment in health care worldwide.