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Medical Neutrality Protection Act
The following talking points may be useful to you when meeting with your Representative, when calling in to their office, or when writing a letter to the Member. They can also be useful in facilitating discussions with group members, or when talking to friends or family about the medical neutrality bill.
- Violations of medical neutrality include attacks on health care facilities, obstruction of medical personnel who are attempting to provide nondiscriminatory care, blocking of access to health care, punishing a person for providing care to the sick and injured, or arbitrary arrest or detention of medical personnel for their attempt to provide care.
- Independent investigations conducted by Physicians for Human Rights demonstrate that violations of medical neutrality are often widespread and systematic, and are not confined to one particular country or region. There needs to be strong U.S. response to this global problem.
- H.R. 2643, the Medical Neutrality Protection Act of 2011, would authorize several responses from the U.S., including the withholding of U.S. military assistance, visa bans for individual perpetrators, a push for a Special Rapporteur for medical neutrality at the Human Rights Council, and mandated inclusion of medical neutrality in the State Department country reports.
The following talking points may be useful to you when meeting with your Representative, when calling in to their office, or when writing a letter to the Member. They can also be useful in facilitating discussions with group members, or … Continue reading
- Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients  (2011)
- Hospital Staff Upholds International Medical Ethics During Unrest in Bangkok  (2010)
- Medicine Under Siege in the Former Yugoslavia  (1996)
- Human Rights Crisis in Kashmir — A Pattern of Impunity  (1993)
- Bloody May: Excessive Use of Lethal Force in Bangkok  (1992)
- The Health Care Situation in Iraqi-Occupied Kuwait  (1991)
- El Salvador: Health Care Under Siege  (1990)
- Panama 1987: Health Consequences of Police and Military Actions  (1988)
Other NGO Reports
- Bahrain’s Assault on Medical Professionals  (Amnesty International)
- Health Care in Danger: Questions and Answers  (ICRC)
- Yemen: Unlawful Attacks, Denial of Medical Car in Taizz  (Human Rights Watch)
- Medical Neutrality  by Peter Hall, Journal of the Royal Society of Medicine (November 1999)
- Medical Neutrality: Confidentiality Subject to National Law: Should Doctors Always Comply?  by Hernan Reyes, M.D., Medisch Contact Jaargang 51/8 November 19961456-9.
- Erasing History: Ethnic Cleansing in Kosovo ,U.S. Department of State (1999)
PHR Reports Do No Harm: A Call for Bahrain to End Systematic Attacks on Doctors and Patients (2011) Hospital Staff Upholds International Medical Ethics During Unrest in Bangkok (2010) Medicine Under Siege in the Former Yugoslavia (1996) Human Rights Crisis … Continue reading
- War in Somalia Paralyzes Healthcare Sector , PressTV, 2012
- Bahrain: Shouting in the Dark  (documentary), Al Jazeera, 2011
News Videos War in Somalia Paralyzes Healthcare Sector, PressTV, 2012 Bahrain: Shouting in the Dark (documentary), Al Jazeera, 2011 Amateur Video Syria Hospital Suffers Heavy Damage from Assad Army Tank Attacks on March 17, 2012
H.R.2643 — Medical Neutrality Protection Act of 2011 (Introduced in House)
H. R. 2643
To provide for medical neutrality and to establish accountability for violations of the principle of medical neutrality, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
July 26, 2011
Mr. MCDERMOTT (for himself, Mr. JONES, Mr. CONYERS, and Mr. ELLISON) introduced the following bill; which was referred to the Committee on Foreign Affairs, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned
To provide for medical neutrality and to establish accountability for violations of the principle of medical neutrality, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1.SHORT TITLE.
This Act may be cited as the `Medical Neutrality Protection Act of 2011′.
SEC. 2.FINDINGS; STATEMENT OF CONGRESS.
- (a) Findings- Congress finds the following:
- (1) International humanitarian law codifies the principle of medical neutrality in the Geneva Conventions, to which the United States is a signatory, during times of national or international armed conflict, which offer special protections to medical facilities and personnel. These provisions recognize ambulances, hospitals, hospital ships, the personnel serving in ambulances and hospitals, citizens who assist the wounded as neutral and protected during conflict.
- (2) The Geneva Conventions specify that the wounded and sick shall receive adequate care, be protected from ill-treatment, and be protected from discrimination, and that emblems such as the red cross and red crescent are recognized as protective emblems in conflict. Many parts of the Geneva Conventions have been declared by the International Committee on the Red Cross (ICRC) to be customary international humanitarian law.
- (3) International human rights law further expands norms of medical neutrality during the absence of an armed conflict. Article 25 (1) of the Universal Declaration of Human Rights and Article 12 of the International Covenant on Economic, Social and Cultural Rights, to which the United States is a signatory, establish the right to health.
- (b) Statement of Congress- Congress affirms its support of participants of peaceful demonstrations around the world, as part of the United States’ support for freedom of assembly as enshrined in the United States Constitution. The United States takes particular umbrage at countries that harm or endanger medical professionals during times of unrest.
SEC. 3.RULE OF CONSTRUCTION.
Nothing in this Act shall be construed to prevent or interfere with legitimate law enforcement objectives conducted in accordance with recognized international human rights norms and legal standards.
SEC. 4.STATEMENTS OF POLICY.
It shall be the policy of theUnited Statesto–
- (1) consider the protection of medical neutrality a policy priority of the United States as an integral part of the defense of recognized international human rights norms and law;
- (2) use its voice, vote, and influence in international for a to further define and codify the principle of medical neutrality and to establish accountability for violations of the principle of medical neutrality; and
- (3) use its voice, vote, and influence at the United Nations Human Rights Council to create and appoint a Special Rapporteur on the Protection and Promotion of Medical Neutrality.
SEC. 5. DETERMINATION AND NOTIFICATION OF FOREIGN COUNTRY REQUIRED.
- (a) Determination- Not later than 180 days after the date of the enactment of this Act, the Secretary of State shall compile and update at least annually a list of those foreign governments that the Secretary determines, after consultation with local and international nongovernmental organizations and the Assistant Secretary for Democracy, Human Rights and Labor, have engaged in violations of medical neutrality. The Secretary shall publish such list on the website of the Department of State.
- (b) Notification- The Secretary of State shall provide a formal notification to a foreign government that is included on a list described in subsection (a).
- (a) Prohibition on Certain Assistance- Subject to subsection (c) of this section and section 8, and except as provided in section 7, the authorities specified in section 516 or 541 of the Foreign Assistance Act of 1961 (22 U.S.C. 2321j or 2347) or section 23 of the Arms Export Control Act (22 U.S.C. 2763) may not be used to provide assistance, and no licenses for direct commercial sales of military equipment may be issued, to the government of a country that the Secretary of State has, in accordance with section 5 of this Act, determined to have engaged in a violation of medical neutrality.
- (b) Prohibition on Certain Visas- Except as provided in section 7, upon receiving credible information, including information contained in the Annual Country Reports on Human Rights Practices, that an alien is or was engaged in or has organized any act that is a violation of medical neutrality, the Secretary of State shall deny the issuance of a visa to, and the Secretary of Homeland Security shall deny the entry into the United States of, such alien.
- (c) Minimum Duration- The prohibitions on assistance described in subsection (a) shall remain in effect for a minimum of one fiscal year, after which the President may reinstate such assistance pursuant to section 8.
- (a) In General- The President may temporarily waive the prohibitions on assistance described in section 6 if the President transmits to the appropriate congressional committees a determination that–
- (1) such waiver is in the national security interest of the United States, including the reasons therefore; and
- (2) establishes a date, not later than two years after the issuance of such waiver, on which such waiver shall expire.
- (b) Congressional Override- If Congress enacts a joint resolution disapproving such waiver, such waiver shall have no force or effect.
SEC. 8.REINSTATEMENT OF ASSISTANCE.
The President may reinstate assistance to a country otherwise prohibited under section 6(a) upon written certification to the appropriate congressional committees that the government of such country has implemented–
- (1) measures that include the successful implementation of an action plan and actual steps to come into compliance with medical neutrality; and
- (2) policies and mechanisms to prohibit and prevent future government or government-sponsored acts that are a violation of medical neutrality and has the input and agreement of local and international nongovernmental organizations.
SEC. 9.INVESTIGATIONS OF VIOLATIONS OF MEDICAL NEUTRALITY.
- (a) Investigations of Allegations of Violations of Medical Neutrality- The heads of United States diplomatic and consular missions shall investigate all reports of violations of medical neutrality in the countries or regions in which such missions are located for inclusion in the annual Country Reports on Human Rights Practices under sections 116(d) and 502B(b) of the Foreign Assistance Act of 1961 (22 U.S.C. 2151n and 2304).
- (b) Inclusion in Annual Country Reports on Human Rights Practices- The Foreign Assistance Act of 1961 is amended–
- (1) in section 116 (22 U.S.C. 2151n), by adding at the end the following new subsection:
- `(g) The report required under subsection (d) shall include a description of any violations of medical neutrality (as such term is defined in the Medical Neutrality Protection Act of 2011) and an identification of the individuals who have engaged in or organized such violations in each foreign country covered by such report.’; and
- (2) in section 502B (22 U.S.C. 2304), by adding at the end the following new subsection:
- `(i) The report required by subsection (b) shall include a description of any violations of medical neutrality (as such term is defined in the Medical Neutrality Protection Act of 2011) and an identification of the individuals who have engaged in or organized such violations in each foreign country covered by such report.’.
In this Act:
- (1) APPROPRIATE CONGRESSIONAL COMMITTEES- The term `appropriate congressional committees’ means–
- (A) the Committee on Foreign Affairs and the Committee on Appropriations of the House of Representatives; and
- (B) the Committee on Foreign Relations and the Committee on Appropriations of the Senate.
- (2) VIOLATION OF MEDICAL NEUTRALITY- The term `violation of medical neutrality’ means–
- (A) militarized attacks on health care facilities, health care service providers, or individuals in the course of receiving medical treatment;
- (B) wanton destruction of medical supplies, facilities, records, or transportation services;
- (C) willful obstruction of medical ethics as specified in the World Medical Association’s International Code of Medical Ethics, including preventing medical professionals from administering ethical medical care to individuals in need;
- (D) coercion of medical personnel to commit acts in violation of their ethical responsibilities;
- (E) deliberate misuse of health care facilities, transportation services, uniforms, or other insignia;
- (F) deliberate blocking of access to health care facilities and health care professionals; or
- (G) arbitrary arrest or detention of health care service providers or individuals seeking medical care.
H.R.2643 — Medical Neutrality Protection Act of 2011 (Introduced in House) 112th CONGRESS 1st Session H. R. 2643 To provide for medical neutrality and to establish accountability for violations of the principle of medical neutrality, and for other purposes. IN … Continue reading
“PHR investigators interviewed a young Bahraini man who was attending a wedding ceremony on 13 March 2011. Riot police attacked the wedding guests by firing tear gas canisters inside the communal hall. As the crowd fled, more police arrived from the other side of the building and began firing birdshot – from only several meters away – into the fleeing crowd. The riot police withdrew after one hour, at about 9:00 p.m. The youth whom Physicians for Human Rights interviewed and examined was injured by birdshot in the right upper arm (biceps brachii) and left lower extremity (gastrocnemious). He reported that he was too afraid to visit Salmaniya Hospital or the local medical center because he had heard that government authorities were disappearing patients. He said that with an unsterilized knife, he dug out approximately 70 metal pellets from his arm and leg.”
United States (2011)
“HuiLui Ng, a 34-year-old computer engineer married to a US citizen wife and father of two US citizen children, was taken into ICE custody during his final green card interview for allegedly overstaying a visa many years earlier. Ng was repeatedly transferred among jails and detention centers as his case was pending. During this time he experienced excruciating back pain and was too weak to walk, but security personnel denied his requests for a wheelchair and failed to take him to critical medical appointments for MRI or CT scans. When Hui eventually died in ICE custody, the medical examiner found a fractured spine and a body completely overcome with undiagnosed and untreated cancer.”
“Guido Newbrough was held in immigration detention for nine months while his case was pending. During that time a virulent staph infection took hold of his system, causing intense pain in his stomach and back. While Guido’s pleas to see a doctor went unanswered, his symptoms worsened dramatically until he was “sobbing throughout the night.” When Guido began pounding on a door in desperation and shouting for help, guards accused him of faking his illness and dragged him, shouting, into an isolation cell. By the time Guido was transported to the hospital, his heart had begun to fail and he was likely suffering from multiple organ failure, which may have been treatable by antibiotics. Two hours after Guido’s family arrived at the hospital, his heart stopped. Detention health care expert Dr. Homer D. Venters, who was called in by Guido’s family to review the autopsy report, observed that the errors in the care of Mr. Guido Newbrough were threefold. “First, Mr. Newbrough’s medical complaints were apparently ignored. Second, Mr. Newbrough was placed in a disciplinary setting while ill and despite having voiced medical complaints. Third, Mr. Newbrough was not adequately (if at all) medically monitored.”
“Omar reported to PHR that the 32nd Brigade soldiers guarding the warehouse gave the detainees insufficient food and water, consisting of only a small piece of bread with a thin spread to eat for an entire day, or a handful of pasta; many of the men reportedly suffered severe constipation. Many detainees did not have bowel movements for weeks, and one reportedly suffered rectal prolapse after finally moving his bowels after five weeks of constipation. Guards left him for a day with his prolapsed rectum protruding out, and he physically deteriorated. Finally they brought in a doctor, who told the guards to send him to Mitiga military hospital where he spent one month recuperating before returning to the warehouse. The guards occasionally allowed this physician from Zleitan to treat detainees with shots of antibiotics and vitamins, but the physician later refused to return to the detention facility.”
“PHR interviewed “Ali” (pseudonym) on 10 September 2011. Ali was initially detained sometime in mid-April 2011 at the warehouse in the Agricultural Compound at Khalat Al Forjan. He was then transferred in early August to another makeshift prison, apparently located on the premises of a Brazilian construction company (Odebrecht) located in Guser Bin Gashir, Tripoli, where he was a witness to six summary executions of detainees. Ali is a day laborer who stated that he had no political affiliations, but began supporting the revolutionary forces as of 19 February, preparing them meals in Martyr’s Square in Zawiya.
“At that time Qaddafi forces were attacking the city, trying to retake Zawiya. One night, around nightfall, after he had just cooked for the different groups in the square, Ali and a group of revolutionary forces in Zawiya came under attack. Tanks reportedly fired 14.5mm shells into the crowd in Martyr’s Square. Revolutionary forces returned fire, but were heavily out gunned. Ali was not carrying a weapon, but retreated with others to a nearby mosque. Heturned the corner and was suddenly hit by shrapnel. His left foot, leg, thigh, and lower abdomenwere severely wounded. Rebels carried him to an ambulance and drove him to Zawiya hospital where he underwent emergency surgery.
Ali stayed overnight in the hospital, where he heard that Qaddafi forces may attack and occupy the hospital. Ali called his brother to take him home, but as soon as he got in his brother’s car, the wound in his leg broke open and began bleeding heavily. His brother brought him back to the hospital where doctors immediately operated on him a second time. Ali’s leg was placed in a cast, and he stayed a second night in hospital before returning home.
The next day, family members who worked at the same hospital told Ali that Qaddafi forcesoverran the hospital and arrested wounded patients on suspicion of being combatants. Ali recuperated at home for the next month.”
“PHR spoke with a 46-year-old man living with his wife and seven children, five of whom are under fifteen years of age. The family, Chin and Christian, lives in Paletwa Township. He describes himself as feeling depressed and hopeless nearly every day during the past two weeks and shares that his entire family has faced religious persecution by the Burmese army within the past year. More than one family member was tortured with deadly weapons by army troops in the last 12 months, he explains. Family members have been forced to relinquish livestock, food and money to state authorities, which this man interprets as means to kill his family and make them flee. Though there is a public health facility in his township (a full day’s walk away), no one in this man’s family has received treatment from a medical doctor, nurse, or community health worker within the past year. He fears being denied care because of his religion or ethnicity.”
“In February 2010, Physicians for Human Rights spoke with a 39-year-old Chin man living in Hahka Township. He, his wife, and their 12-year-old daughter were conscripted for 26 days of forced labor during the past year.
The Village Peace and Development Council (VPDC) forced them to build roads, porter, grow jatropha, and engage in other forms of forced labor last year. The family still paid 3,000 kyat ($3 USD) in fines to avoid further forced labor duties. In addition to the VPDC’s demands for money, tatmadaw soldiers demanded that this family provide troops with livestock.
His health is poor, he says, and he has felt depressed nearly every day over the past two weeks. He shares that his family has had difficulty obtaining reliable medical care nearby; a medical health worker denied family members treatment this year, during a time when someone in his house was very sick and unable to get medical care in Chin State. He fears being denied treatment because of his religion.”
United States (2005)
“In certain cases, such as in Abu Ghraib military intelligence section, methods of physical and psychological coercion used by the interrogators appeared to be part of the standard operating procedures by military intelligence personnel to obtain confessions and extract information. Several military intelligence officers confirmed to the ICRC that it was part of the military intelligence process to hold a person deprived of his liberty naked in a completely dark and empty cell for a prolonged period to use inhumane and degrading treatment, including physical and psychological coercion, against persons deprived of their liberty to secure their cooperation.”
“I don’t know how many, but there were lots of tanks and armored vehicles. I saw more than 150 paramilitary wearing different uniforms. I saw some police and paramilitary with masks. I went at 6 a.m. to alert the doctor that we all had to leave the house because we were surrounded. When they tried to go in one valley, used as a cover from shelling, the police started shooting. I heard more than 50 shots. My brother in law (brother of the doctor) left the house and went to the valley. But the doctor stayed in the house. He said, ‘I am a doctor. I‘m a health worker.’ I was 50 m from him. They told him, ‘you are exactly the person we are looking for’ and shot him. We buried the body—it had a lot of bullet wounds.”
“On April 5, I went to report to work. I used to work in the internal diseases department in Kosovska Mitrovica. At about 11:00 a.m., armed soldiers with masks and guns came in and ordered us to separate into groups of Albanian and Serbs. No one from our Serb colleagues tried to help us. We had only five minutes to leave the hospital. They didn’t allow us to even undress so I left in my white uniform. I saw a lot of patients running out also as they had been dressed as patients. In our department, we had some disabled persons and I don’t know what happened to them. I am especially concerned about my patients from the surgery department.”
“Everybody was closed in their homes. We had no freedom of movement. If a doctor was on duty from that part of the city, he had no chance for movement. I was the last one who worked because my house is close to the hospital. But we realized it was impossible to work and we closed the maternity service…At that time four women were there to deliver. There were no doctors or midwives with them. They left because they were also unsafe, they have no security to stay.”
Former Yugoslavia (1996)
“On the morning of May 26, 1992, I had an extremely difficult time getting to the hospital because of heavy sniper fire and blockades. The front lines of the Serb forces were by then only about fifty meters from our hospital. When I finally arrived, I found our staff and patients alike were excited and terribly frightened. Those who had been on call could not get home; in all we had six nurses and three physicians. I contacted our territorial defense commander who reassured me that he considered it unlikely that Serbian forces would bombard us directly because they knew our building was a hospital, and one for children at that. He told us not to be frightened. Nonetheless, we began to move all our patients down as close to the ground floor as possible.
About 4 o’clock we realized our hospital was being directly bombarded. We simply could not believe this at first. We decided quickly that we must evacuate, since there was no safe place for our children. The Obstetric and Gynecologic Hospital was one hundred meters from us, a larger building with a basement that could be used as a shelter…
Our neo-natal ward contained seventeen newborns, mostly prematures from outside Sarajevo. To evacuate these infants we had to remove them from their incubators. Each of us carried two to three babies and ran to reach the basement of the Obstetric and Gynecologic Hospital. Bullets and shells fell all around us as we ran carrying the children. The noise was awful. By the time we could evacuate the thirty-three children, we were exhausted…We finally succeeded in moving all of our patients to the basement of the Obstetric and Gynecologic Hospital where we joined their patients (105 mothers and their newborns, seventy-five gynecologic patients, and some neighborhood mothers and children taking refuge in the hospital), and forty-eight staff members. About five minutes after we had left our clinic, a grenade fell on our neo-natal unit, destroying every incubator and incinerating the unit. Had we waited even a few minutes more, all of our babies would have burned alive…
As we huddled in the basement we could hear heavy shelling of the building directly over our heads. When we called for help by way of a shortwave radio we learned that one floor after another was collapsing on top of us. The patients and mothers were screaming and crying. This went on for hours, for an eternity…[In the morning], trucks and cars arrived and we evacuated the patients to [Kosevo Hospital] two kilometers away. As we left, we were still being fired at; fortunately, no one was killed. However, because of the lack of incubators, warmth, and oxygen, nine of our babies died.”
Bahrain (2011) Do No Harm: a Call for Bahrain to End Systematic attacks on Doctors and Patients “PHR investigators interviewed a young Bahraini man who was attending a wedding ceremony on 13 March 2011. Riot police attacked the wedding guests … Continue reading