Thomson Reuters

“……The Caribbean island nation has a respected health service and generates major export earnings by sending more than 50,000 health workers to more than 60 countries.

But it came under criticism in Brazil, where President Jair Bolsonaro last year called the Cuban doctors “slave labor” and Cuba recalled its 8,300 medical workers stationed there.

Ramona Matos, a Cuban doctor, said she worked with medical missions in Bolivia and Brazil where Cuban security agents took away the doctors’ passports and other identification.

“We were undocumented,” she said at the State Department’s news conference. “If anything happened to us, we got hurt, we died … nobody would know our identity.”

Nearly all of the doctors’ earnings were sent back to Cuba where they were frozen in accounts that they could not access until they completed their missions, she said.

“We were basically being trafficked, and we were victims and exploited by the Cuban government,” she said……”

CNBC

NYT

BBC

Who are the Uighurs?

“The Uighurs are ethnically Turkic Muslims mostly based in Xinjiang. They make up about 45% of the population there.

They see themselves as culturally and ethnically close to Central Asian nations, and their language is similar to Turkish.

In recent decades, large numbers of Han Chinese (China’s ethnic majority) have migrated to Xinjiang, and the Uighurs feel their culture and livelihoods are under threat.

Xinjiang is officially designated as an autonomous region within China, like Tibet to its south.”

NYT

…..Dr. Mukwege campaigned relentlessly to shine a spotlight on the plight of Congolese women, even after nearly being assassinated a few years ago. Ms. Murad, who was enslaved by the Islamic State, also known as ISIS, has told and retold her story of suffering to organizations around the world, helping to persuade the United States State Department to recognize the genocide of her people at the hands of the terrorist group…..”

ABC

The Guardian

NY Times

“….Drug treatment, mostly for psychosis, blunted day-to-day symptoms of hallucinations and delusional thinking. But it did not reduce the length of time people were held in chains at the camp.…”

British Journal of Psychiatry

“Care of people with serious mental illness in prayer camps in low-income countries generates human rights concerns and ethical challenges for outcome researchers.

To ethically evaluate joining traditional faith healing with psychiatric care including medications (Clinical trials.gov identifier NCT02593734).

Residents of a Ghana prayer camp were randomly assigned to receive either indicated medication for schizophrenia or mood disorders along with usual prayer camp activities (prayers, chain restraints and fasting) (n = 71); or the prayer camp activities alone (n = 68). Masked psychologists assessed Brief Psychiatric Rating Scale (BPRS) outcomes at 2, 4 and 6 weeks. Researchers discouraged use of chaining, but chaining decisions remained under the control of prayer camp staff.

Total BPRS symptoms were significantly lower in the experimental group (P = 0.003, effect size –0.48). There was no significant difference in days in chains…..”

Chatham House

Authors

“Summary
• In some parts of the world it is common practice for patients to be detained in hospital for non-payment of healthcare bills.
• Such detentions occur in public as well as private medical facilities, and there appears to be wide societal acceptance in certain countries of the assumed right of health providers to imprison vulnerable people in this way.
• The true scale of these hospital detention practices, or ‘medical detentions’, is unknown, but the limited academic research to date suggests that hundreds of thousands of people are likely to be affected every year, in several sub-Saharan African countries and parts of Asia. Women requiring life-saving emergency caesarean sections, and their babies, are particularly vulnerable to detention in medical facilities.
• Victims of medical detention tend to be the poorest members of society who have been admitted to hospital for emergency treatment, and detention can push them and their families further into poverty. They may also be subject to verbal and/or physical abuse while being detained in health facilities.
• The practice of detaining people in hospital for non-payment of medical bills deters healthcare use, increases medical impoverishment, and is a denial of international human rights standards, including the right not to be imprisoned as a debtor, and the right to access to medical care.
• At the root of this problem are the persistence of health financing systems that require people to make high out-of-pocket payments when they need healthcare, and inadequate governance systems that allow facilities to detain patients.
• Universal health coverage (UHC) cannot be achieved while people are experiencing financial hardship through their inability to pay for healthcare, so by definition any country that allows medical detention is failing to achieve UHC.
• Health financing systems should be reformed by moving towards publicly financed UHC, based on compulsory progressive pre-payment mechanisms. This would enable hospitals to become financially sustainable without the need to charge significant user fees……”

Lancet

“…..Between early November, 2015, and Dec 31 2016, 938 people were directly harmed in 402 incidents of violence against health care: 677 (72%) were wounded and 261 (28%) were killed. Most of the dead were adult males (68%), but the highest case fatality (39%) was seen in children aged younger than 5 years. 24% of attack victims were health workers. Around 44% of hospitals and 5% of all primary care clinics in mainly areas with a substantial presence of armed opposition groups experienced attacks. Aerial bombardment was the main form of attack. A third of health-care services were hit more than once. Services providing trauma care were attacked more than other services……”