Fight Poverty by Protecting Human Rights

(Originally published on the Boston Globe)

On the evening of Sept. 18, 2007, six men broke into the home of Justine Masika Bihamba in Goma in the Democratic Republic of the Congo. Bihamba wasn’t home, but six of her children, ages 5 to 24, were. The men, reportedly government soldiers, tied up the children at gunpoint and abused two daughters in their 20s, sexually assaulting one with a knife. Bihamba and her children identified the attackers to military police but authorities refused to arrest the suspects, saying there was no evidence against them. They remain free today.

The men targeted Bihamba’s children because of her work coordinating medical and psychological care for women and girls who have been sexually assaulted. In the violent conflict that has raged in Congo for a decade, rape is a weapon of war.

The conflict has claimed hundreds of thousands of lives and forced more than a million to flee; it is the latest in Congo’s long and bloody history. During the colonial period, ivory and rubber were the prizes for which Europeans sacrificed African lives. Today, the fighting is fueled by the country’s vast mineral resources – diamonds, gold and coltan, which is used in all mobile phones and laptops. Armed groups control mines and export minerals illegally, using the cash to buy arms.

The mineral wealth is of little benefit to the impoverished Congolese population.

More than 1,000 people die daily from preventable diseases such as cholera and dysentery. Most are children. These preventable deaths are human rights abuses in violation of international treaties on the right to health and the rights of the child. Until corporations that benefit from the mineral trade, together with the Congolese government and the international community, are persuaded to end the abuses, cases like Bihamba’s will keep recurring.

Amnesty International campaigns to ensure that human rights defenders like her can carry out their vital work in safety. But to stop the carnage in Congo, we recognize that we must also fight poverty – what Mahatma Gandhi called “the worst form of violence.”

People are accustomed to thinking of human rights violations as abuses committed by repressive regimes – torture, arbitrary arrest and imprisonment, enforced “disappearances,” political assassination, and the like.

But the international human rights framework is much broader. Sixty years ago, following the brutality of World War II when the Nazis denied Jews, Roma, gays, and others their very right to exist, the response of the international community was unequivocal – human rights had to be based on the principle of inclusion. That is, everyone is entitled to the same set of rights by virtue of being human. These include the right to freedom from torture and arbitrary imprisonment, and no less importantly, the right to adequate food and shelter, basic healthcare, education and employment. In short, the right to live a life of dignity.

People living in poverty are trapped, much like political prisoners.

Now, as the global economic crisis threatens to push an estimated 53 million more people into poverty this year, Amnesty International is launching the most ambitious campaign of its nearly 50-year history.

Just as we have fought effectively to protect civil and political rights on behalf of tens of thousands of political prisoners, we intend to mobilize our volunteers and supporters to hold governments, corporations, armed groups, and others accountable for the human rights abuses that drive millions around the world into poverty.

Governments have reneged on human rights obligations in the belief that economic growth alone would lift all boats. But now the tide is receding. Virtually none of the growth of the last two decades benefited poor and marginalized communities; instead, the gap between rich and poor only deepened in many parts of the world.

All human rights are interlinked, as the Congo demonstrates. If development was based on the fulfillment of basic human rights instead of skewed toward enriching a few at the expense of many, we might not be witnessing the violent upheaval of Congo and elsewhere.

Without an approach to poverty and development that puts human rights first, there will be many more stories like that of Justine Masika Bihamba.

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2 thoughts on “Fight Poverty by Protecting Human Rights

  1. Sameer-

    Good afternoon,

    Why did you remove my post to your other blog titled "Human Rights Missing from Health Care Debate"?

    And now it appears you have blocked anyone from replying to that particular blog?

    The truth hurts, but don't ignore it.
    ______________
    The Bloody Shirt

    Have you heard the name Deamonte Driver? Well you should, for he is about to become the bloody shirt waved in 2008 by the advocates of more goverment-provided and controlled healthcare.

    Here is his story:

    For Want of a Dentist
    Pr. George's Boy Dies After Bacteria From Tooth Spread to Brain
    By Mary Otto
    Washington Post Staff Writer
    Wednesday, February 28, 2007; B01

    Twelve-year-old Deamonte Driver died of a toothache Sunday.

    A routine, $80 tooth extraction might have saved him.

    If his mother had been insured.

    If his family had not lost its Medicaid.

    If Medicaid dentists weren't so hard to find.

    If his mother hadn't been focused on getting a dentist for his brother, who had six rotted teeth.

    By the time Deamonte's own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George's County boy died.

    Deamonte's death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

    It's a very sad story about the horrors of poverty, American-style. But you have to do some hard reading between the lines to perceive those horrors as they really are. In conformity to the most ancient canons of liberal advocacy journalism, reporter Mary Otto has ignored the real story – a shocking account of parental incompetence and neglect – to advance an agenda.

    You have to scroll more than halfway down into the story to arrive at these details:

    The Driver children have never received routine dental attention, said their mother, Alyce Driver.

    But doesn't Medicaid cover dental care?

    The children's Medicaid coverage had temporarily lapsed at the time Deamonte was hospitalized.

    Wait a minute: how does Medicaid "lapse"? Maryland's Medicaid program covers children under 19 whose parents earn up to 200% of the federal poverty level : $33,000 for a family of 3. If Driver earned more than $33,000 from her "bakery, construction, and home healthcare jobs," you would think she might be able to afford a visit to the dentist for an ailing child. Or did her coverage "lapse" for some other reason? What was it?

    To find that answer, you have to wait till the very end of the story. Driver ends up in a homeless shelter.

    She suspects that the paperwork to confirm their [Medicaid] eligibility was mailed to the shelter in Adelphi, where they no longer live.

    In which case, would it not have been truer to add one more "if" clause to the opening above: "If only his mother had not been so utterly neglectful as not to take one single solitary personal step to ensure that her Medicaid coverage continued when she changed addresses?"

    But wait, it's not Ms Driver's fault!

    And even with Medicaid's promise of dental care, the problem, she said, was finding it.

    It took me three clicks at 1800Dentist.com to find a dentist office in north Washington, convenient to Prince George's county, that had an appointment available for a Medicaid patient this very morning.

    This next passage speaks for itself I think:

    When Deamonte got sick, his mother had not realized that his tooth had been bothering him. Instead, she was focusing on his younger brother, 10-year-old DaShawn, who "complains about his teeth all the time," she said.

    DaShawn saw a dentist a couple of years ago, but the dentist discontinued the treatments, she said, after the boy squirmed too much in the chair.

    Now this:

    By September, several of DaShawn's teeth had become abscessed. Driver began making calls about the boy's coverage but grew frustrated.

    Did this frustration impel her to more frantic efforts to help her sons? Not at all. She turned the whole problem over to

    Laurie Norris, a lawyer for the Baltimore-based Public Justice Center who tried to help the Driver family

    - and who also emerges as the principal source for Mary Otto's wave-the-bloody-shirt story.

    Norris secured the Drivers some help, but seems not to have brought much urgency to Deamonte's care.

    Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family's Medicaid provider and a state supervising nurse who helped them find a dentist.
    Why couldn't they find a dentist on their own?

    On Oct. 5, DaShawn saw Arthur Fridley, who cleaned the boy's teeth, took an X-ray and referred him to an oral surgeon. But the surgeon could not see him until Nov. 21, and that would be only for a consultation.
    Driver said she learned that DaShawn would need six teeth extracted and made an appointment for the earliest date available: Jan. 16.
    But she had to cancel after learning Jan. 8 that the children had lost their Medicaid coverage a month earlier.
    In other words, the lawyer who is supposedly urgently seeking care for an ill boy has likewise made no effort over the four months between September 2006 and January 2007 to determine whether the family had in fact sustained their Medicaid coverage – or to get it reinstated. Instead, Ms Driver cancelled her appointment and then … did nothing.

    It was on Jan. 11 that Deamonte came home from school complaining of a headache. At Southern Maryland Hospital Center, his mother said, he got medicine for a headache, sinusitis and a dental abscess. But the next day, he was much sicker.

    Eventually, he was rushed to Children's Hospital, where he underwent emergency brain surgery. He began to have seizures and had a second operation. The problem tooth was extracted.

    Now look: I'm not going to deny that there may well be much wrong with health coverage for America' poor. Obviously there is. And some of the steps mentioned at the end of the article, including expansion of dental service at state health clinics, may well be useful and cost-effective measures. Maryland could pay for a lot of routine care with the quarter-million dollars it spent at the end to save Deamonte Driver's life.

    But no government program on earth can protect children's health from a custodial parent who refuses to bestir herself in any way to help them, no matter how obviously sick they are. And no responsible journalist should allow herself to be manipulated by welfare-industry advocates into minimizing or excusing this truth in her reporting.

    Deamonte Driver was a victim of parental neglect, not the hard-heartedness of the Medicaid program. And the really tough question for the guardians of the poor is: How on earth do we insure against that?

    **

    Update: A reader suggests another question Mary Otto should have asked Alyce Driver. "How often did Deamonte brush his teeth?" Teaching your children to brush and floss will eliminate almost all cavities even in the absence of any visits to the dentist at all. And if the answer is that Driver neglected even this basic, basic level of hygiene, you have to wonder whether there was any conceivable government health program that could have saved her son's life – short, that is, of actually removing her children from her care. But that's a very different debate, isn't it?

  2. Sameer-

    Good afternoon,

    Why did you remove my post to your other blog titled “Human Rights Missing from Health Care Debate”?

    And now it appears you have blocked anyone from replying to that particular blog?

    The truth hurts, but don’t ignore it.
    ______________
    The Bloody Shirt

    Have you heard the name Deamonte Driver? Well you should, for he is about to become the bloody shirt waved in 2008 by the advocates of more goverment-provided and controlled healthcare.

    Here is his story:

    For Want of a Dentist
    Pr. George’s Boy Dies After Bacteria From Tooth Spread to Brain
    By Mary Otto
    Washington Post Staff Writer
    Wednesday, February 28, 2007; B01

    Twelve-year-old Deamonte Driver died of a toothache Sunday.

    A routine, $80 tooth extraction might have saved him.

    If his mother had been insured.

    If his family had not lost its Medicaid.

    If Medicaid dentists weren’t so hard to find.

    If his mother hadn’t been focused on getting a dentist for his brother, who had six rotted teeth.

    By the time Deamonte’s own aching tooth got any attention, the bacteria from the abscess had spread to his brain, doctors said. After two operations and more than six weeks of hospital care, the Prince George’s County boy died.

    Deamonte’s death and the ultimate cost of his care, which could total more than $250,000, underscore an often-overlooked concern in the debate over universal health coverage: dental care.

    It’s a very sad story about the horrors of poverty, American-style. But you have to do some hard reading between the lines to perceive those horrors as they really are. In conformity to the most ancient canons of liberal advocacy journalism, reporter Mary Otto has ignored the real story – a shocking account of parental incompetence and neglect – to advance an agenda.

    You have to scroll more than halfway down into the story to arrive at these details:

    The Driver children have never received routine dental attention, said their mother, Alyce Driver.

    But doesn’t Medicaid cover dental care?

    The children’s Medicaid coverage had temporarily lapsed at the time Deamonte was hospitalized.

    Wait a minute: how does Medicaid “lapse”? Maryland’s Medicaid program covers children under 19 whose parents earn up to 200% of the federal poverty level : $33,000 for a family of 3. If Driver earned more than $33,000 from her “bakery, construction, and home healthcare jobs,” you would think she might be able to afford a visit to the dentist for an ailing child. Or did her coverage “lapse” for some other reason? What was it?

    To find that answer, you have to wait till the very end of the story. Driver ends up in a homeless shelter.

    She suspects that the paperwork to confirm their [Medicaid] eligibility was mailed to the shelter in Adelphi, where they no longer live.

    In which case, would it not have been truer to add one more “if” clause to the opening above: “If only his mother had not been so utterly neglectful as not to take one single solitary personal step to ensure that her Medicaid coverage continued when she changed addresses?”

    But wait, it’s not Ms Driver’s fault!

    And even with Medicaid’s promise of dental care, the problem, she said, was finding it.

    It took me three clicks at 1800Dentist.com to find a dentist office in north Washington, convenient to Prince George’s county, that had an appointment available for a Medicaid patient this very morning.

    This next passage speaks for itself I think:

    When Deamonte got sick, his mother had not realized that his tooth had been bothering him. Instead, she was focusing on his younger brother, 10-year-old DaShawn, who “complains about his teeth all the time,” she said.

    DaShawn saw a dentist a couple of years ago, but the dentist discontinued the treatments, she said, after the boy squirmed too much in the chair.

    Now this:

    By September, several of DaShawn’s teeth had become abscessed. Driver began making calls about the boy’s coverage but grew frustrated.

    Did this frustration impel her to more frantic efforts to help her sons? Not at all. She turned the whole problem over to

    Laurie Norris, a lawyer for the Baltimore-based Public Justice Center who tried to help the Driver family

    - and who also emerges as the principal source for Mary Otto’s wave-the-bloody-shirt story.

    Norris secured the Drivers some help, but seems not to have brought much urgency to Deamonte’s care.

    Norris and her staff also ran into barriers: They said they made more than two dozen calls before reaching an official at the Driver family’s Medicaid provider and a state supervising nurse who helped them find a dentist.
    Why couldn’t they find a dentist on their own?

    On Oct. 5, DaShawn saw Arthur Fridley, who cleaned the boy’s teeth, took an X-ray and referred him to an oral surgeon. But the surgeon could not see him until Nov. 21, and that would be only for a consultation.
    Driver said she learned that DaShawn would need six teeth extracted and made an appointment for the earliest date available: Jan. 16.
    But she had to cancel after learning Jan. 8 that the children had lost their Medicaid coverage a month earlier.
    In other words, the lawyer who is supposedly urgently seeking care for an ill boy has likewise made no effort over the four months between September 2006 and January 2007 to determine whether the family had in fact sustained their Medicaid coverage – or to get it reinstated. Instead, Ms Driver cancelled her appointment and then … did nothing.

    It was on Jan. 11 that Deamonte came home from school complaining of a headache. At Southern Maryland Hospital Center, his mother said, he got medicine for a headache, sinusitis and a dental abscess. But the next day, he was much sicker.

    Eventually, he was rushed to Children’s Hospital, where he underwent emergency brain surgery. He began to have seizures and had a second operation. The problem tooth was extracted.

    Now look: I’m not going to deny that there may well be much wrong with health coverage for America’ poor. Obviously there is. And some of the steps mentioned at the end of the article, including expansion of dental service at state health clinics, may well be useful and cost-effective measures. Maryland could pay for a lot of routine care with the quarter-million dollars it spent at the end to save Deamonte Driver’s life.

    But no government program on earth can protect children’s health from a custodial parent who refuses to bestir herself in any way to help them, no matter how obviously sick they are. And no responsible journalist should allow herself to be manipulated by welfare-industry advocates into minimizing or excusing this truth in her reporting.

    Deamonte Driver was a victim of parental neglect, not the hard-heartedness of the Medicaid program. And the really tough question for the guardians of the poor is: How on earth do we insure against that?

    **

    Update: A reader suggests another question Mary Otto should have asked Alyce Driver. “How often did Deamonte brush his teeth?” Teaching your children to brush and floss will eliminate almost all cavities even in the absence of any visits to the dentist at all. And if the answer is that Driver neglected even this basic, basic level of hygiene, you have to wonder whether there was any conceivable government health program that could have saved her son’s life – short, that is, of actually removing her children from her care. But that’s a very different debate, isn’t it?