A Social Work Education Grounded in Human Rights

In response to a mandate to advance human rights through social work education, this article focuses on the curricular redesign and program evaluation of one MSW Program. The program's specialization focused on advanced social work practice with individuals, families, and communities grounded in social justice and human rights. A pre-experimental one-group posttest-only program evaluation design was implemented. Multiple assessment instruments were used to measure human rights exposure in social work education, as well as a human rights lens and engagement in social work practice among 93 graduating MSW students from a public university with suburban and urban campus locations. How the program applied a human rights-based approach to social work field education will also be discussed. Findings suggest that a human rights exposure in course work and practicum is related to students' practice lens and engagement. The imperative is now to train social work students to address complex social issues through human rights exposure, engagement, and lens as we prepare for a post-pandemic world. Recommendations are provided to strengthen academic leadership and research in this area and empower students to drive a paradigm shift in the profession.

The Digital Divide Is a Human Rights Issue: Advancing Social Inclusion Through Social Work Advocacy

The role of technology and importance of access to high-speed broadband has become glaringly obvious during the COVID-19 pandemic. High-speed Internet is a tool people rely upon to conduct the daily business of their life and interact with each other, the economy, and government. However, millions of people in the USA still have no home access to high-speed Internet. Low-income, people of color, older, Native Americans, and rural residents in particular are on the wrong side of the digital divide. This structural reality perpetuates social, economic, and political disparities. Consistent with a social work human rights approach, the United Nations General Assembly declared access to the Internet a basic human right in 2016. This calls upon social workers to engage in advocacy efforts to advance policy and programs to alleviate the digital divide. In this article, we examine the digital divide in the USA and discuss why it is a social justice and human rights issue. We provide a policy context and recent examples of state or local policy initiatives to reduce the digital divide. Prominent among them is California's Internet for All Now Act. We also identify and share promising practices and advocacy tools being used in the field that provide guidance to community practitioners as they engage in work at state and local levels aimed at closing the digital divide.

Evaluating trends and stakeholders in the international drug control regime complex

This article examines the recent trends in international, in particular multilateral, drug policy and the implications of these changes for shifting alignments and coalitions of actors and stakeholders. It places these changes in the context of the system's historical developments and applies previously unutilised analyses of other international governance structures. It suggests that the the international drug control system is undergoing a long-term process of fragmentation and evolution towards a 'regime complex'. In the short to medium term it suggests that exogenous challenges to the system remain somewhat limited. This is due to institutional battles over issue suzerainty and a limited funding incentive for other agencies to become involved. Instead, endogenous challenges and changes within the system represent the main avenues of adaptation. It continues on to suggest that in the longer term these endogenous changes will encourage and accelerate exogenous interactions with the system from other regimes and issue areas and thereby expand the terrain for cross-issue and cross-sectoral engagements. Thus, the short to medium term trends within drug control, while in some cases appearing to be in stasis or moving backwards, continue the overarching trend of regime fragmentation and shifting into an archetypal regime complex.

Conducting an asylum evaluation focused on female genital mutilation/cutting status or risk

BACKGROUND

Female genital mutilation or cutting (FGM/C) is considered a human rights violation and is practiced all over the world. It has been used as a basis for seeking asylum in various countries, including in the USA since 1996, and the precedent-setting matter of Kissindja. Clinicians in the USA and elsewhere who perform asylum evaluations may be called upon to evaluate women who seek asylum based on their FGM/C status or risk. In this manuscript, we provide expert-informed best practices to conduct asylum evaluations based specifically on FGM/C. We review evidence-based history taking, physical examination unique to the population of women and girls affected by FGM/C, and consider the evaluation in the context of trauma-informed care.

CONCLUSION

Although general clinical skills often suffice to perform asylum evaluations, FGM/C represents a unique niche within the field of gynecological asylum evaluations and requires additional background knowledge and clinical competencies.

ETHICAL APPROVAL

As this is a clinical review and does not involve patients or research subjects no ethical approval was sought or was necessary.

Cross-border COVID-19 spread amidst malaria re-emergence in Venezuela: a human rights analysis

BACKGROUND

Since 2016 Venezuela has seen a collapse in its economy and public health infrastructure resulting in a humanitarian crisis and massive outward migration. With the emergence of the novel coronavirus SARS-CoV-2 at the end of 2019, the public health emergency within its borders and in neighboring countries has become more severe and as increasing numbers of Venezuelans migrants return home or get stuck along migratory routes, new risks are emerging in the region.

RESULTS

Despite clear state obligations to respect, protect and fulfil the rights to health and related economic, social, civil and political rights of its population, in Venezuela, co-occurring malaria and COVID-19 epidemics are propelled by a lack of public investment in health, weak governance, and violations of human rights, especially for certain underserved populations like indigenous groups. COVID-19 has put increased pressure on Venezuelan and regional actors and healthcare systems, as well as international public health agencies, to deal with a domestic and regional public health emergency.

CONCLUSIONS

International aid and cooperation for Venezuela to deal with the re-emergence of malaria and the COVID-19 spread, including lifting US-enforced economic sanctions that limit Venezuela's capacity to deal with this crisis, is critical to protecting rights and health in the country and region.

Bioethical issues and legal frameworks of surrogacy: A global perspective about the right to health and dignity

Modern advances in assisted reproduction technology (ART) have disrupted the traditional concept of parenthood. Every year, thousands of people travel abroad from their home countries in order to circumvent restrictive legislation or to benefit from lower fees. In a similar context, surrogacy raises many bioethical and legal issues. The present paper will address the main questions arising from the debate prompted by surrogacy, focusing on international legislation, and looking critically at the different legislative models. As a result of worldwide heterogeneity in policies, legal approaches, and access to ART throughout the world, a growing number of would-be parents are seeking treatment abroad. The lack of regulation on cross-border surrogacy in low income countries can undermine the dignity and rights of women as even modest economic compensation determines a significant purchasing power. The international effort should be aimed at creating an international regulatory framework from which guidelines useful to national governments derive. An international agreement would provide a solid legal basis for the protection of surrogate women. In order to limit the economic interests linked to procreative tourism, so as to truly protect global health and women's rights, legislative uniformity is therefore necessary between the various states.

Examining host-State counterclaims for environmental damage in investor-State dispute settlement from human rights and transnational public policy perspectives

In international disputes between investors and host-States, the traditionally asymmetric nature of international investment agreements (IIAs) may prevent States from bringing claims against investors for harm caused, including environmental damage. At the same time, allowing host-State counterclaims for environmental damage is a potentially useful tool for rebalancing the asymmetric nature of IIAs. Yet, in the highly fragmented area of international investment law, the availability of host-State counterclaims is not always clear. This article analyses the procedural and legal bases available for host-State counterclaims for environmental damage, including newly developing human rights and transnational public policy approaches to such claims. The question that this article seeks to evaluate is to what extent host-State counterclaims are available to rebalance the asymmetric relationship between host-States and investors, specifically concerning environmental damage. To answer this question, the article takes a qualitative approach by examining case law, commentary, and the work of international organizations, and applying the results of the research to the specific context of host-State counterclaims for environmental damage. Future developments are also discussed in the context of ongoing multilateral investor-State dispute settlement reform efforts at the United Nations Commission on International Trade Law. There currently exists a window of opportunity for States to seek cooperative, effective multilateral strategies for partially rebalancing the relationship between investment and the environment. The article posits that harmonization of State approaches towards counterclaims for environmental damage is desirable and States should take a permissive approach towards host-State counterclaims for environmental damage in their IIA treaty negotiation practice.

The use of pasung for people with mental illness: a systematic review and narrative synthesis

Background

Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions.

Methods

A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the individual and their environment.

Result

Fifty published articles were included in the review; all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys; only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’; one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness.

Conclusion

The findings highlight that a mixture of individual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive.

Review Registration CRD42020157543: CRD

Indigenous ontology, international law and the application of the Convention to the over-representation of Indigenous children in out of home care in Canada and Australia

This paper explores the efficacy of the United Nations Convention on the Rights of the Child (Convention, UN General Assembly, 1989) through the lens of the over-representation of First Nations children placed in out-of-home care in Canada and Aboriginal and Torres Strait Islander children in Australia. A general overview of Indigenous worldviews frames a discussion on the coherence of international human rights law and instruments, including the Convention, account for Indigenous Peoples' ontologies. The authors argue that the United Nations Declaration on the Rights of Indigenous Peoples (UN General Assembly, 2007) and a new theoretical framework published by the Pan American Health Organization (2019) on health equity and inequity are useful tools to augment the Convention's coherence with Indigenous ontologies. The paper discusses how the Convention can be applied to structural and systemic risks driving the over-representation of First Nations and Aboriginal and Torres Strait Islander children in out of home care in Canada and Australia. These two countries are included as First Nations and Aboriginal and Torres Strait Islander peoples in these countries have both had significant impact in advocating for their children despite experiencing similar barriers including contemporary colonialism. The advocacy work of the First Nations Child and Family Caring Society in Canada and the Victorian Aboriginal Child Care Agency in Victoria, Australia are discussed. The paper ends by outlining some of the challenges ahead that include the need to meaningfully recognize Indigenous self-determination and equitable funding and resources to enable the actualization of self-determination. Further research contrasting international human rights instruments with Indigenous ontologies could help inform possible amendments to international human rights treaties and general comments.

COVID-19 and Australian Prisons: Human Rights, Risks, and Responses

Australian prisons are overpopulated with people suffering from numerous health problems. COVID-19 presents a significant threat to prisoner health. This article examines the current regulatory responses from Australian state and territory governments to COVID-19 and a recent case which tested the human rights of prisoners during a pandemic.

Fail to Prepare and you Prepare to Fail: the Human Rights Consequences of the UK Government's Inaction during the COVID-19 Pandemic

As the sustained and devastating extent of the coronavirus disease 2019 (COVID-19) pandemic becomes apparent, a key focus of public scrutiny in the UK has centred on the novel legal and regulatory measures introduced in response to the virus. When those measures were first implemented in March 2020 by the UK Government, it was thought that human rights obligations would limit excesses of governmental action and that the public had more to fear from unwarranted intrusion into civil liberties. However, within the first year of the pandemic's devastation in the UK, a different picture has emerged: rather than through action, it is governmental inaction that has given rise to greater human rights concerns. The UK Government has been roundly criticized for its inadequate response, including missteps in decision-making, delayed implementation and poor enforcement of lockdown measures, abandonment of testing, shortages of critical resources and inadequate test and trace methods. In this article, we analyse the UK Government's missteps and compare them with published international guidance; we also contrast the UK's decisions with those taken by several other countries (including the devolved administrations within the UK) to understand how its actions and inactions have contributed to unfavourable outcomes. Using an analytical perspective that demonstrates how human rights are both a protection from the power of the state and a requirement that governmental powers are used to protect the lives, health and wellbeing of citizens, we argue that the UK Government's failure to exercise their powers competently allowed the virus to spread without ensuring the country had the means to manage a high case load. This abject failure has led to one of the highest rates of deaths per capita worldwide. We offer several lessons that can be learnt from this unfortunate, but preventable, situation.

Thirty years of the convention on the rights of the child: Developments in child sexual abuse and exploitation

Since its adoption by the United Nations in November 1989, the Convention on the Rights of the Child (CRC) has become the most universally ratified human rights treaty in history; presently only the United States has not ratified it. The CRC articulates children's human rights and notably includes freedom from sexual abuse and exploitation. Yet thirty years after the Convention was adopted, child sexual abuse and exploitation (CSA/E) remain serious, persistent, and evolving global issues. This overview both describes the current state of research on child sexual abuse and exploitation and evaluates the CRC's legacy in terms of State-level responses to CSA/E. Points of agreement and disagreement over what constitutes CSA/E and how widespread it is are explored. Also presented are the contexts in which CSA/E takes place, and factors associated with children's risk of being sexually abused or exploited. Emerging issues in these areas are the internet and children's use of it, as children may now become subject to abuse or exploitation even when physically alone. The second part of the paper addresses the CRC's influence on States' domestic legislation and States' responses to CSA/E more broadly. Gaps in efforts to monitor and report on the CRC's implementation with respect to its impact on CSA/E are described. The discussion offers guidance for future efforts to research and respond to child sexual abuse and exploitation, and in particular the ongoing need for support to survivors beyond the legal response paradigm.

A Look in the Mirror: Unveiling Human Rights Issues Within Social Work Education

Using a convergent parallel mixed-methods design, this study explored the financial effect of the field practicum requirement on BSW students. This project was conducted at a mid-sized university in the Southwest region of the United States where current and recent field students responded to surveys and social work field instructors and faculty participated in interviews. The study describes financial burdens and reveals human rights issues affecting nontraditional and underserved students that have answered the call to a career of serving the most vulnerable in society. This study fills a gap in the literature and provides recommendations for further research and anti-oppressive approaches for the academy to employ in the education of future social work professionals.

Why Vietnam continues to impose the death penalty for drug offences: A narrative commentary

In several nations in Southeast Asia, illegally importing, exporting, trading, or possessing drugs is a capital offence. Like China, another communist state in Asia, Vietnam imposes its harshest legal punishments for drug-related crimes, though many international opponents have continued to call for the abolishment of these inhumane sentences. Using grey literature, reports by international observers, and informal interviews with colleagues, the present article explores the policies and provisions of Vietnam's Party-State in regulating capital punishment for drug offences, situating Vietnam's sentencing practices in the context of legislative reviews, international obligations, and humanitarian perspectives. Assessing the arguments put forward by abolitionists, retentionists, and supporters of de facto abolition allows for a more comprehensive understanding of Vietnam's stance toward the Second Optional Protocol of the International Covenant on Civil and Political Rights (ICCPR), which is aimed at abolishing the death penalty in the future. The article concludes with a call for further action, outlining some basic recommendations on how the Vietnamese can keep their promises to reduce, and ultimately abolish, impositions of the death penalty for drug-related crimes.

Human Rights in Chilean Social Work: Lessons from Chile to Prepare Social Work Students for Human Rights Practice

This article presents findings from two studies conducted in Chile to examine the link between human rights and social work practice. The focus of this paper was to explore the role of undergraduate education in preparing future social work practitioners for human rights practice. Data from a qualitative longitudinal study to understand the role of social workers during the dictatorship in Chile (1973-1989) were used; then, in October 2019, as civil unrest and police and military brutality erupted across the country, the authors created a commission to register and document narratives and testimonies of current human rights violations in Chile. The research team utilized a qualitative approach to analyze data from the in-depth interviews that were conducted in the longitudinal study and from the 2019 commission. Findings suggest a need to cover more in-depth human rights content in social work education and to teach students to create community collaborations in the field. Implications for social work education and practice in the current political climate are explored.

Violations of Health as a Human Right and Moral Distress: Considerations for Social Work Practice and Education

Healthcare professionals may experience moral distress when navigating difficult positions in which acting or providing for their patient's best interest may not be possible due to barriers outside of their control. This phenomenon has primarily been investigated within nursing and other clinical disciplines; however, experiences of moral distress have also been noted in the social work profession. Healthcare professionals, including social workers, may experience moral distress when witnessing violations of their patients' human rights. This article discusses research reporting on experiences of moral distress within the social work profession, a reality social work students may also face during their field placements. Understanding the causes and effects of moral distress within the social work profession is important when preparing social work students as they transition into the workforce. Future research investigating moral distress should include the perspectives of social work field students, as their experiences are understudied. This phenomenon is especially important to investigate, as the current COVID-19 pandemic is expected to exacerbate health challenges.

Helping to heal nature and ourselves through human-rights-based and gender-responsive One Health

The health of our planet and humanity is threatened by biodiversity loss, disease and climate crises that are unprecedented in human history, driven by our insatiable consumption and unsustainable production patterns, particularly food systems. The One Health approach is a pathway to synergistically addressing outcomes in term of health and sustainability, but gender issues at the One Health and biodiversity nexus are largely ignored. By examining the roles and responsibilities of Indigenous and Local People, and especially women, in conserving natural resources, and the social costs of living at the Human-Animal-Environment interface under current conservation strategies, we show that women bear a disproportionate health, poverty and climate burden, despite having pivotal roles in conserving biodiversity. To mitigate risks of emerging infectious diseases, food insecurity and climate change impacts, a gender perspective has previously been proposed, but implementation lags behind. Endemic zoonotic diseases, human-wildlife conflict and environmental pollution lack gender-sensitive frameworks. We demonstrate that women can be powerful agents for change at all levels of society, from communities to businesses, and policy-making institutions, but gender inequalities still persist. We develop a framework for mainstreaming a gender-responsive and rights-based One Health approach, in order to heal ourselves and nature. Using a leverage-points perspective, we suggest a change of paradigm, from the pursuit of GDP and over-consumption, to a focus on human well-being and their reconnection with healthy environments, using a One Health understanding of nature and health. We recommend learning from Indigenous People to re-position ourselves within nature and to better conserve biodiversity. We also propose integration of gender equity in leadership, the respect of human rights, women's rights (access to health care, healthy food, land tenure, natural resources, education, and economic opportunities), and the rights of nature, through the implementation of gender-responsive and rights-based One Health Action Plans, at policy-making level, in the private sector and the civil society. As the COVID-19 pandemic continues to unveil deep socio-economic inequities in the wealthiest economies and the vital role of nature in supporting our health, we argue to seize this opportunity to build back better and improve resilience and sustainability by using a gender-responsive and rights-based One Health approach.

Mental health, mental capacity, ethics, and the law in the context of COVID-19 (coronavirus)

The emergence of the COVID-19 (coronavirus) pandemic in late 2019 and early 2020 presented new and urgent challenges to mental health services and legislators around the world. This special issue of the International Journal of Law and Psychiatry explores mental health law, mental capacity law, and medical and legal ethics in the context of COVID-19. Papers are drawn from India, Australia, the United Kingdom, Ireland, Germany, Portugal, and the United States. Together, these articles demonstrate the complexity of psychiatric and legal issues prompted by COVID-19 in terms of providing mental health care, protecting rights, exercising decision-making capacity, and a range of other topics. While further work is needed in many of these areas, these papers provide a strong framework for addressing key issues and meeting the challenges that COVID-19 and, possibly, other outbreaks are likely to present in the future.

The COVID-19 pandemic and the human rights of persons with mental and cognitive impairments subject to coercive powers in Australia

The purpose of this paper is to explore the effect of the COVID-19 pandemic on the human rights of persons with mental and cognitive impairments subject to coercive powers in Australia. It sets out the relevant human rights in the Convention on the Rights of Persons with Disabilities which have been engaged by the COVID-19 pandemic and the government's response to it. It examines the effect of emergency legislation on the relaxation of human rights safeguards in mental health laws, with a focus on mental health tribunals (although it is limited by a lack of published decisions and gaps in publicly available information). However, some of the issues created for persons with disabilities during the COVID-19 pandemic are evident in some decisions published by the New South Wales Guardianship Tribunal. The paper critically analyses two guardianship decisions UZX [2020] NSWCATGD 3 (3 April, 2020) and GZK [2020] NSWCATGD 5 (23 April, 2020) and some emergency South Australian legislation COVID-19 Emergency Response Act, 2020 (SA) Schedule 1 to demonstrate the ways in which the human rights of persons with mental and cognitive impairments can be more at risk than those of the general population, even when the general population is itself in "lockdown."

Measuring the impact of revised mental health legislation on human rights in Queensland, Australia

The Convention on the Rights of Persons with Disabilities (2006) (CRPD) has been instrumental for initiating and shaping the reform of mental health legislation in many countries, including the eight Australian jurisdictions. Multiple approaches have been proposed to assess and monitor the compliance of States Parties' mental health legislation with the CRPD, and to evaluate its success in protecting and promoting the human rights of people with disabilities. This article reports an effort to index the impact of legislation on human rights by measuring changes in the prevalence of compulsory treatment orders applied to people with mental illness after the introduction of CRPD influenced mental health legislation in the Australian state of Queensland. We found that despite reforms intended to enhance patient autonomy, the prevalence of compulsory treatment orders increased after implementation of the new legislation. Possible reasons behind this unintended consequence of the legislative reform may include a lack of systematized voluntary alternatives to compulsory treatment, a paternalistic and restrictive culture in mental health services and risk aversion in clinicians and society. We recommend that the reforms in mental health policy as well as legislation need to go further in order to achieve the goals embodied in the human rights framework of the CRPD.

Prevalence of teenage pregnancy and the associated contextual correlates in Rwanda

The rate of teenage pregnancy remains unacceptably high in most developing countries. In Rwanda, studies show a rapid increase over the past two decades despite the political achievements of women's empowerment, and efforts to curtail child sexual abuse. Unfortunately, the current knowledge of the household determinants of teenage pregnancies in Rwanda is limited, as recent studies have focused on providing numbers with little analysis of proximate causal factors or focused on the individual determinants. The study uses secondary data from the recent Rwanda Demographic and Health Survey (RDHS: 2014-2015) to analyse household factors associated with teenage pregnancies in Rwanda. In addition to descriptive analysis, we ran logistic regression models to determine the level of association between teenage pregnancy and household socioeconomic characteristics. Results indicate that marital status and age of household head, household size, number of bedrooms given the size of the household, and the educational level of the household-head are significantly associated with teenage pregnancy (p < 0.01). Teen girls from small households are more likely to get pregnant than those from large families, while financial, social and educational empowerment of parents, and harmonious household contexts contribute to lessening the cases of teenage pregnancy. It indicates that social and economic support to teen girls which include parental supervision, guidance, and financial care are essential aspects to consider in order to reduce teenage pregnancy rates. The study suggests that in addition to efforts directed to teens themselves, strategies for reducing teen pregnancies should focus on a range of household-level contexts that form two broad categories: empowering parents and maintaining parents' harmonious decisions on teen girls.

Harm Reduction Works: Evidence and Inclusion in Drug Policy and Advocacy

One of harm reduction's most salient features is its pragmatism. Harm reduction purports to distinguish itself from dominant prohibitionist and abstinence-based policy paradigms by being grounded in what is realistic, in contrast with the moralism or puritanism of prohibition and abstention. This is reflected in the meme "harm reduction works", popular both in institutional and grassroots settings. The idea that harm reduction is realistic and effective has meant different things among the main actors who seek to shape harm reduction policy. Drawing on scholarly literature about harm reduction, as well as examples from recent harm reduction advocacy efforts in relation to drug policy in Canada, this paper argues that harm reduction distinguishes itself through a unique "way of knowing". Grassroots harm reduction advocates, particularly as they argue through human rights frameworks, do more than simply make claims for the provision of particular services-like needle exchange, safe consumption sites, safe supply and the like-on the basis that these are realistic paths toward the health and well-being of people who use drugs. Rather, as they marshal lived experience in support of these policy changes through peer-driven initiatives in contexts of prohibition, they make particular claims about what constitute valid, methodologically rigorous evidence bases for action in contexts where policies to date have been driven by ideology and have developed in ways that have excluded and marginalized those most affected from policymaking. In doing so, they advocate for the centrality of people who use drugs not only in policy-making processes, but in evidence production itself.

Corona pan(dem)ic: gateway to global surveillance

The essay reviews the digital emergency measures many governments have adopted in an attempt to curb Covid-19. It argues that those 'virologically legitimized' measures may infringe the human right to privacy and mark the transition into a world of global surveillance. At this possible turning point in human history, panic and latent fear seem to fog much needed farsightedness. Leaving the current state of emotional paralysis and restarting to critically assess the digital pandemic management can serve as an emergency break against drifting into a new era of digital monitoring.

Applying an Indigenous and gender-based lens to the exploration of public health and human rights implications of COVID-19 in Canadian correctional facilities

Due to overcrowding and subsequent unavoidable close contact, poor ventilation, and decreased hygiene standards and healthcare services as compared with in the community setting, the prison environment is highly conducive to the transmission of infections, including COVID-19. Physical distancing measures may be difficult to implement without introducing interventions that may violate human rights. Given that Indigenous women represent over 41% of federally incarcerated women, this is a cause for concern. Indigenous women are also more likely to have higher rates of numerous chronic conditions, including respiratory illnesses, substantially increasing vulnerability to COVID-19 complications. This can be exacerbated in prisons as access to healthcare may be limited. Outbreaks within the prison setting can not only overwhelm an already over-stretched healthcare system but also spread to the community and disproportionately impact marginalized communities and populations. In this commentary, we explore the public health and human rights implications of COVID-19 in prisons while calling particular attention to the unique needs and circumstances of incarcerated Indigenous women based on international best practice-based guidance to preventive and responsive measures to COVID-19.

Hepatitis C in Israeli prisons: status report

The article discusses and analyzes the changes that have taken place since 2016 in Israeli policy with regard to the treatment, diagnosis and detection of hepatitis C (HCV) in prison settings. The article finds indications of promising changes to official procedure, such as the statement by authorities that they plan to begin screening new inmates for HCV, and the increase in the number of inmates provided antiviral drugs. These measures, however, only came about after a prolonged campaign and legal battle by human rights organizations, patient advocacy groups and the medical community. Despite these encouraging changes, it appears that a significant portion of inmates in need of treatment are still not getting it due both to bureaucratic delays and to inmates' reluctance. In addition, in the absence of a suitable screening program, the extant figures of morbidity-high in themselves-may reflect underdiagnosis. The flaws in the policymaking process and in its implementation may be attributed, at least in part, to the fact that the prison healthcare system is under the aegis of the Israel Prison Service and not that of a medical body. This reality places the medical staff in prisons in a state of dual loyalty, and also means the prison healthcare system is excluded from national health plans and major sources of budgeting, leaving it without sufficient means to provide the necessary level of care. These problems plague the prison healthcare system in general and are not limited to its handling of HCV. These challenges are not unique to Israel, and many other Western countries must also face the obstacles that are the result of prison healthcare services being subject to the authority of the correctional establishment. As this test case demonstrates, extended active involvement by civil organizations and the medical community are essential to promoting and ensuring inmates' right to health.