Health and Human Rights: An International Journal
Vol. 7, No. 1

Commentary

The UN Special Rapporteur on the Right to Health: Key Objectives, Themes, and Interventions
Paul Hunt

Articles

Documentation of Torture and Ill-Treatment in Mexico: A Review of Medical Forensic Investigations, 2000 to 2002
Alejandro Moreno, Michele Heisler, Allen Keller, and Vincent Iacopino

Abstract
Torture and ill-treatment are reportedly widespread in Mexico. Little is known, however, about the quality of forensic investigations and documentation of evidence of these human rights violations. To determine the integrity of the documentation and the presence, quality, and frequency of both physical and psychological evaluations, analyses were conducted on 103 medical evaluations identified in 33 cases of alleged torture and/or ill-treatment that the Mexican National Commission for Human Rights (CNDH) investigated between January 2000 and July 2002. Findings suggest that forensic medical evaluations in CNDH cases have been conducted promptly after alleged occurrences of torture and/or illtreatment, and the results of such evaluations have often been introduced as evidence in legal investigations. Inadequate documentation in most forensic medical evaluations reinforces the need for effective training, monitoring, and accountability strategies.

What Role Can International Litigation Play in the Promotion and Advancement of Reproductive Rights in Latin America?
Luisa Cabal, Mónica Roa, and Lilian Sepúlveda-Oliva

Abstract
During the past decades, legal advocacy has played a critical role in changing the realities of women’s reproductive lives in countries worldwide. The courts may be an excellent venue for bringing about change, especially where there is a disconnect between international, constitutional, or legislative norms and the reality of women’s lives. The Center for Reproductive Rights’ International Legal Program and its partner organizations in Latin America have pioneered the use of international litigation as a strategy to ensure that legislation and policies better reflect the international community’s recognition of reproductive rights. This article aims to share the Center’s experiences; explore the use of high-impact litigation to further reproductive rights; evaluate whether the time is right for litigation; examine the process of identifying issues and cases; and understand the potential pitfalls and opportunities of such litigation.

Violations of Reproductive Rights During Hospital Births in Mexico
Roberto Castro and Joaquina Erviti

Abstract
This qualitative investigation documents various sociological factors that facilitate violations of women’s reproductive rights during childbirth in Mexico. It is based on the testimonies of women who received care at public health institutions and on more than three months of observation in hospital labor and birthing rooms. Three patterns of behavior were considered: those of health-care personnel, including insisting on women’s obedience, discounting women’s knowledge, etc.; those of the women themselves; and those of the institution. It is proposed that attention to reproductive rights necessitates that preventive measures be directed toward changing medical education, modifying mechanisms for daily supervision of medical practice, and changing the complaint mechanisms available to women.

District Surgeons in Apartheid South Africa: A Case Study of Dual Obligations
Paul Gready and Jeanelle de Gruchy

Abstract
Under apartheid, district surgeons, as state-employed doctors, have been particularly vilified, largely for their roles in treating detainees and political prisoners. This article presents interview-based research on district surgeons, focusing particularly on how they understood their work in situations of dual obligation. Three main themes emerged. First, dual obligation created structural constraints but also demanded ongoing negotiation and choice. Second, district surgeons operated as uncritical “cogs” in the apartheid machine, failing to engage with in the broader sociopolitical context in which they worked. Third, surgeons’ work was made more difficult because they were pressured to collude in a system that facilitated human rights abuse. The article concludes by suggesting that doctors who work in situations of dual obligation should have access to training and active institutional support.

Addressing Collective Violence: An Epidemiologic Context for Human Rights Promotion
Richard Garfield, Claudia Patricia Llantén Morales, and Elissa Dresden

Abstract
Studies on collective violence conducted since the end of the Cold War have mainly involved cursory epidemiological examinations. Deficiencies in defining violence, as well as in collecting and analyzing existing information, have made it difficult to identify the types of violations that may occur, given a specific set of circumstances; to determine which groups are most vulnerable to violence; and to arrive at solutions to remedy these situations. Better evidence of the causes and types of injuries in conflicts will facilitate analysis of violent events in ways that can be used to promote and protect the rights of individuals and population groups. The marriage of human rights perspectives and epidemiologic research methods will allow the potential of each to be realized and thereby may ultimately help reduce the impact of collective violence on individuals and societies in years to come.

Perspective

The Humanity of Humans: Philosophy, Science, Health, or Rights?
Robin M. Coupland

Profile

Human Rights from a U.S. State Health Department Perspective
Howard K. Koh, Bonnie J. Tavares, and Carlene A. Pavlos

Book Review

Science in the Service of Human Rights, by Richard Pierre Claude
Harvey M. Weinstein