HIV/AIDS and sexual minorities in Mexico: a globalized struggle for the protection of human rights

The fight against HIV/AIDS is an example of a global struggle for the promotion of sexual health and the protection of human rights for all, including sexual minorities. It represents a challenge for the understanding of its impact on political, social, and economic processes. My central goal in this piece is twofold. First, I underline the importance of a political and human rights perspective to the analysis of the global response to the pandemic, and I introduce the concept of policy networks for a better understanding of these dynamics. Second, I argue that, in the case of Mexico, the constitution of HIV/AIDS policy networks, which incorporate civil society and state actors, such as sexual minority activists and public officials, and their actions—both domestic and international—have resulted in a more inclusive HIV/AIDS policy-making process. However, serious human rights violations of HIV/AIDS patients and sexual minorities still remain.

Advertising Phuket's nightlife on the Internet: a case study of double binds and hegemonic masculinity in sex tourism

One significant human rights violation in Southeast Asia is the exploitation of women through sex tourism. Such sexual exploitation occurs in Thailand because institutions are complacent and society accepts the practice. This case study, guided by the concepts of double binds and hegemonic masculinity, sought to understand if Thai culture is symbolically constructed in ways to portray Thailand as a desirable "sex tourist" destination. Websites portray Phuket as a patriarchal world where men can live their fantasies of being perfect hegemonic males because Thai bar girls are young nymphomaniacs that have no need to be talked to or understood.

How to combat torture if perpetrators are supported by a religious "justification"

While there are some examples of legal cases which have resulted in the prosecution of perpetrators and successful reparation for survivors, in countries such as Iran such due procedure is close to impossible since torture is practiced by state officials mostly based on religious codes, and the legal system is controlled by practices that makes it close to impossible to achieve justice. This article discusses the implications of such a situation that also include health care professionals in third party countries who have an obligation to document evidence using the Istanbul Protocol based on a case example of a survivor exposed to different forms of torture.

The limits of oral history: ethics and methodology amid highly politicized research settings

In recent years, oral history has been celebrated by its practitioners for its humanizing potential, and its ability to democratize history by bringing the narratives of people and communities typically absent in the archives into conversation with that of the political and intellectual elites who generally write history. And when dealing with the narratives of ordinary people living in conditions of social and political stability, the value of oral history is unquestionable. However, in recent years, oral historians have increasingly expanded their gaze to consider intimate accounts of extreme human experiences, such as narratives of survival and flight in response to mass atrocities. This shift in academic and practical interests begs the questions: Are there limits to oral historical methods and theory? And if so, what are these limits? This paper begins to address these questions by drawing upon fourteen months of fieldwork in Rwanda and Bosnia-Hercegovina, during which I conducted multiple life history interviews with approximately one hundred survivors, ex-combatants, and perpetrators of genocide and related mass atrocities. I argue that there are limits to the application of oral history, particularly when working amid highly politicized research settings.

Reconciliation in Cambodia: thirty years after the terror of the Khmer Rouge regime

During the Khmer Rouge regime one quarter of the Cambodian population was killed as a result of malnutrition, overwork and mass killings. Although the regime ended 30 years ago, its legacy continues to affect Cambodians. Mental health problems as well as feelings of anger and revenge resulting from traumatic events experienced during the Khmer Rouge regime are still common in Cambodia. These conditions continue to impede social coexistence and the peace-building process in society. Thirty years after the Khmer Rouge regime this article gives an overview on the status of the country's current reconciliation process and recommends potential future steps.

Horror and hope: (re)presenting militarised children in global North-South relations

This article examines the (re)presentations of militarised children in contemporary global politics. In particular, it looks at the iconic image of the 21st century's child soldier, the subject of which is constructed as a menacing yet pitiable product of the so-called new wars of the global South. Yet this familiar image is a small, one-dimensional and selective (re)presentation of the issues facing children who are associated with conflict and militarism. In this sense it is a problematic focal point for analysing the insecurity and human rights of children in and around conflict. Instead, this article argues that the image of the child soldier asserts an important influence in its effect upon global North-South relations. It demonstrates how the image of the child soldier can assist in constructing knowledge about the global South, and the global North's obligations to it, either through programmes of humanitarianism, or through war.

Holding harm: narrative methods in mental health research on refugee trauma

In this article, we question narrative inquiry's predominant ethics of benefit when engaging in narrative research on trauma and social suffering. Through a particular focus on the use of a narrative methodology in a refugee health study, we explore the potential risk and protective function of narrative trauma research with vulnerable respondents. A review of ethical questions emerging during the course of a multiple-case study with refugee families documents how narrative methods' characteristics clearly revisit the impact of traumatization on autonomy, narrativity, and relationship building in participants and, thus, evoke the replay of traumatic experience within the research relationship itself. Blurring a straightforward ethics of benefit, this reactivation of trauma accounts for the research relationship's balancing movement between reiterating and transforming traumatic distress, and urges for the need to contain coexisting aspects of both harm and benefit in developing narrative research with traumatized participants.

Problematizing therapeutic assumptions about narratives: a case study of storytelling events in a post-conflict context

Narrative approaches to health communication research have often been characterized by assumptions of the therapeutic and ameliorative effect of narratives. In this article, I call these assumptions into question by critically engaging extant research in narrative health communication research in light of testimony by a participant in South Africa's Truth and Reconciliation Commission. Drawing on his personal narrative, numerous retellings of his story in public and academic discourse, and his responses to his story's appropriation, I demonstrate the importance of conducting narrative research and theorizing with an appreciation of its therapeutic potential, as well as its ability to harm.

Torture by Cieng: ethical theory meets social practice among the Dinka Agaar of south Sudan

Here I detail violence in South Sudan by first discussing a specific Dinka Agaar practice alongside existing discourses on the social aspects of violence and universal human rights, then I show how these acts had meaning and purpose using data from personal accounts of violence. I posit that the violence described was consistent with Dinka Agaar concepts of justice and basic human rights and that it cannot be judged against any universal human rights standard, devoid of local context or of an overarching metanarrative. These events highlight conflicting subjectivities, ethical norms, and the painful difficulties inherent to advocacy in areas of conflict. Viewed from the perspective of the larger social unit, it is easy to see how violence was required to end violence. However, witnessing punitive violence purposefully enacted on innocent individuals to achieve peace has the potential to create conflicting positions that modern anthropological discourse cannot reconcile.

Association of sexual violence and human rights violations with physical and mental health in territories of the Eastern Democratic Republic of the Congo

CONTEXT

Studies from the Eastern Region of the Democratic Republic of the Congo (DRC) have provided anecdotal reports of sexual violence. This study offers a population-based assessment of the prevalence of sexual violence and human rights abuses in specific territories within Eastern DRC.

OBJECTIVE

To assess the prevalence of and correlations with sexual violence and human rights violations on residents of specific territories of Eastern DRC including information on basic needs, health care access, and physical and mental health.

DESIGN, SETTING, AND PARTICIPANTS

A cross-sectional, population-based, cluster survey of 998 adults aged 18 years or older using structured interviews and questionnaires, conducted over a 4-week period in March 2010.

MAIN OUTCOME MEASURES

Sexual violence prevalence and characteristics, symptoms of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), human rights abuses, and physical and mental health needs among Congolese adults in specific territories of Eastern DRC.

RESULTS

Of the 1005 households surveyed 998 households participated, yielding a response rate of 98.9%. Rates of reported sexual violence were 39.7% (95% confidence interval [CI], 32.2%-47.2%; n = 224/586) among women and 23.6% (95% CI, 17.3%-29.9%; n = 107/399) among men. Women reported to have perpetrated conflict-related sexual violence in 41.1% (95% CI, 25.6%-56.6%; n = 54/148) of female cases and 10.0% (95% CI, 1.5%-18.4%; n = 8/66) of male cases. Sixty-seven percent (95% CI, 59.0%-74.5%; n = 615/998) of households reported incidents of conflict-related human rights abuses. Forty-one percent (95% CI, 35.3%-45.8%; n = 374/991) of the represented adult population met symptom criteria for MDD and 50.1% (95% CI, 43.8%-56.3%; n = 470/989) for PTSD.

CONCLUSION

Self-reported sexual violence and other human rights violations were prevalent in specific territories of Eastern DRC and were associated with physical and mental health outcomes.

Spirits and social reconstruction after mass violence: rethinking transitional justice

A vibrant debate in the field of transitional justice concerns the relative ability of global, national, and local mechanisms to promote justice after violent conflict. Discussion largely focuses on more formal mechanisms of justice (courts, tribunals, or truth commissions), implying that state institutions and the law are solely responsible for shaping the process of social healing. This article suggests that scholars should take seriously more informal, socio-cultural processes outside the purview of the state, particularly for how they promote social reconstruction at the micro level. Examining the phenomena of spirit possession and ritual cleansing in northern Uganda, I illustrate how such efforts are expressions of injustice and reflect ordinary people’s attempts to seek moral renewal and social repair. This approach is particularly illustrative in cases where ‘intimate enemies’ exist - that is, settings where ordinary people who engaged in violence against one another must live together again.

The League of Nations' rescue of Armenian genocide survivors and the making of modern humanitarianism, 1920-1927

The essay centers of the efforts by the League of Nations to rescue women and children survivors of the 1915 Armenian Genocide. This rescue -- a seemingly unambiguous good -- was at once a constitutive act in drawing the boundaries of the international community, a key moment in the definition of humanitarianism, and a site of resistance to the colonial presence in the post-Ottoman Eastern Mediterranean. Drawing from a wide range of source materials in a number of languages, including Turkish, Armenian, and Arabic, the essay brings the intellectual and social context of humanitarianism in initiating societies together with the lived experience of humanitarianism in the places where the act took form. In so doing, it draws our attention to the proper place of the Eastern mediterranean, and its women and children, in the global history of humanitarianism. The prevailing narrative of the history of human rights places much of its emphasis on the post-World War II era, the international reaction to the Holocaust, and the founding of the United Nations. yet contemporary human rights thinking also took place within practices of humanitarianism in the interwar period, and is necessarily inseparable from the histories of refugees, colonialism, and the non-West.

Domestic violence and social responsibility in contemporary Spanish cinema: a portfolio view of behavioral dynamics

Domestic abuse continues to claim many lives in Spain despite a series of new laws to protect women and to punish abusers. This essay explores the cultural influences of contemporary Spanish cinema on domestic violence. Four films are assessed against a Portfolio Model of social responsibility that uses two basic dimensions: realism and human rights. Realism in each film is determined by the behavioral components of the internationally recognized Duluth Model and the Wheel of Power and Control. The human rights dimension addresses equality, power and agency for women. This study focuses on Icíar Bollaín's "Te doy mis ojos" (2003), Javier Balaguer's "Sólo mía" (2001), Benito Zambrano's "Solas" (1999), and Pedro Almodóvar's "Pepi, Luci, Bom y otras chicas del montón" (1980). The results demonstrate significant variations in the measure of social responsibility indicating that contemporary Spanish cinema may play a role in perpetuating gender-based violence.

Claims to protection: the rise and fall of feminist abolitionism in the League of Nations' Committee on the Traffic in Women and Children, 1919–1936

This article examines the League of Nations Advisory Committee on the Trafficking of Women and Children (CTW) to assess the impact of international feminists on the interwar anti-sex trafficking movement. It argues that women who were firmly embedded in the transnational and international women's rights movement built a coalition on the CTW to ensure the prominence of the feminist abolitionist position of sex trafficking in the 1920s. This position was defined by calls for equal standards of morality between the sexes, resistance to laws that treated prostitutes as a group and infringed on their human rights, and unwavering demands for the abolition of state-regulated prostitution. Changes in the personnel and bureaucratic structure of the CTW and the rising tide of nationalism served to undermine the feminist abolitionists' position in the League in the 1930s.

The modernizing bias of human rights: stories of mass killings and genocide in Central America

This article analyses selected cases of mass killings and genocide during the civil wars in El Salvador and Guatemala in the 1980s and the way in which the truth commissions in both countries reframed locally grounded narratives to fit the state-centred language of human rights. Redefining wrongdoings as human rights violations produces stories that communicate poorly with local worldviews because the 'truths' that human rights language proposes disregard local realities and transform local conflicts into a type of 'modern', nationwide struggles. Thus, while the concept of genocide might capture well the horrendous nature of a mass killing, it will also ethnify the conflict. Comparisons between local readings and human rights-based reinterpretations reveal a 'modernizing' or 'Westernizing' bias of international law; the article argues for more awareness about such effects in analysis as well as in policy-making.

Rare models: Roger Casement, the Amazon, and the ethnographic picturesque

In 1910 Roger Casement was sent by the British government to investigate the alleged humanitarian abuses of the Peruvian Amazon Company in the Putumayo, a disputed border zone in North West Amazonia. Casement brought more than verbal and written testimony back to London. On 26 June, some six months after he returned from the Amazon, Casement collected two Amerindian boys - Omarino and Ricudo - from Southampton docks. This paper will reconstruct the brief period that these young men spent in Britain in the summer of 1911 and assess, in particular, to what extent they were treated as 'exhibits' by Casement, who not only introduced them to leading members of the British establishment but also arranged for them to be painted and photographed following contemporary ethnographic conventions.

Human dignity, humiliation, and torture

Modern human rights instruments ground human rights in the concept of human dignity, without providing an underlying theory of human dignity. This paper examines the central importance of human dignity, understood as not humiliating people, in traditional Jewish ethics. It employs this conception of human dignity to examine and criticize U.S. use of humiliation tactics and torture in the interrogation of terrorism suspects.

Human exploitation is not a joke--so don't laugh!

In a previous article, I called for an open discussion and debate on health psychology perspectives on social and political issues relevant to health, in particular the issue concerning racism and the media (Estacio, 2009). In this article, I raise three topics for discussion which the controversial BBC 'Harry and Paul' sketch (un)intentionally exposed to the public domain: (1) racist humour, the media and health; (2) human rights abuses against domestic workers; and (3) third world poverty and labour migration. Its implications on health psychology theory, research and practice are also explored.

Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis

CONTEXT

Uncertainties continue about the roles that methodological factors and key risk factors, particularly torture and other potentially traumatic events (PTEs), play in the variation of reported prevalence rates of posttraumatic stress disorder (PTSD) and depression across epidemiologic surveys among postconflict populations worldwide.

OBJECTIVE

To undertake a systematic review and meta-regression of the prevalence rates of PTSD and depression in the refugee and postconflict mental health field.

DATA SOURCES

An initial pool of 5904 articles, identified through MEDLINE, PsycINFO and PILOTS, of surveys involving refugee, conflict-affected populations, or both, published in English-language journals between 1980 and May 2009.

STUDY SELECTION

Surveys were limited to those of adult populations (n > or = 50) reporting PTSD prevalence, depression prevalence, or both. Excluded surveys comprised patients, war veterans, and civilian populations (nonrefugees/asylum seekers) from high-income countries exposed to terrorist attacks or involved in distal conflicts (> or = 25 years).

DATA EXTRACTION

Methodological factors (response rate, sample size and design, diagnostic method) and substantive factors (sociodemographics, place of survey, torture and other PTEs, Political Terror Scale score, residency status, time since conflict).

DATA SYNTHESIS

A total of 161 articles reporting results of 181 surveys comprising 81,866 refugees and other conflict-affected persons from 40 countries were identified. Rates of reported PTSD and depression showed large intersurvey variability (0%-99% and 3%-85.5%, respectively). The unadjusted weighted prevalence rate reported across all surveys for PTSD was 30.6% (95% CI, 26.3%-35.2%) and for depression was 30.8% (95% CI, 26.3%-35.6%). Methodological factors accounted for 12.9% and 27.7% PTSD and depression, respectively. Nonrandom sampling, small sample sizes, and self-report questionnaires were associated with higher rates of mental disorder. Adjusting for methodological factors, reported torture (Delta total R(2) between base methodological model and base model + substantive factor [DeltaR(2)] = 23.6%; OR, 2.01; 95% CI, 1.52-2.65) emerged as the strongest factor associated with PTSD, followed by cumulative exposure to PTEs (DeltaR(2) = 10.8%; OR, 1.52; 95% CI, 1.21-1.91), time since conflict (DeltaR(2) = 10%; OR, 0.77; 95% CI, 0.66-0.91), and assessed level of political terror (DeltaR(2) = 3.5%; OR, 1.60; 95% CI, 1.03-2.50). For depression, significant factors were number of PTEs (DeltaR(2) = 22.0%; OR, 1.64; 95% CI, 1.39-1.93), time since conflict (DeltaR(2) = 21.9%; OR, 0.80; 95% CI, 0.69-0.93), reported torture (DeltaR(2) = 11.4%; OR, 1.48; 95% CI, 1.07-2.04), and residency status (DeltaR(2) = 5.0%; OR, 1.30; 95% CI, 1.07-1.57).

CONCLUSION

Methodological factors and substantive population risk factors, such as exposure to torture and other PTEs, after adjusting for methodological factors account for higher rates of reported prevalence of PTSD and depression.

Probable posttraumatic stress disorder and disability in Cambodia: associations with perceived justice, desire for revenge, and attitudes toward the Khmer Rouge trials

CONTEXT

Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the "Khmer Rouge trials") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.

OBJECTIVES

To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.

DESIGN, SETTING, AND PARTICIPANTS

A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.

MAIN OUTCOME MEASURES

Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.

RESULTS

The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).

CONCLUSIONS

Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health.

Perpetration of gross human rights violations in South Africa: association with psychiatric disorders

BACKGROUND

A nationally representative study of psychiatric disorders in South Africa provided an opportunity to study the association between perpetration of human rights violations (HRVs) during apartheid and psychiatric disorder. Prior work has suggested an association between perpetration and post-traumatic stress disorder (PTSD), but this remains controversial.

METHODS

Subjects reported on their perpetration of human rights violations, purposeful injury, accidental injury and domestic violence. Lifetime and 12-month prevalence of DSM-IV (Diagnostic and Statistical Manual, 4th edition) disorders were assessed with Version 3.0 of the World Health Organization Composite International Diagnostic Interview (CIDI 3.0). Socio-demographic characteristics of these groups were calculated. Odds ratios for the association between the major categories of psychiatric disorders and perpetration were assessed.

RESULTS

HRV perpetrators were more likely to be male, black and more educated, while perpetrators of domestic violence (DV) were more likely to be female, older, married, less educated and with lower income. HRV perpetration was associated with lifetime and 12-month anxiety and substance use disorders, particularly PTSD. Purposeful and DV perpetration were associated with lifetime and 12-month history of all categories of disorders, whereas accidental perpetration was associated most strongly with mood disorders.

CONCLUSION

Socio-demographic profiles of perpetrators of HRV and DV in South Africa differ. While the causal relationship between perpetration and psychiatric disorders deserves further study, it is possible that some HRV and DV perpetrators were themselves once victims. The association between accidental perpetration and mood disorder also deserves further attention.

The Tree of Life: a community approach to empowering and healing the survivors of torture in Zimbabwe

The article explores the effectiveness of the use of an empowerment workshop, called the Tree of Life, in the treatment of torture survivors. The approach is based on a survivor-to-survivor model of assistance. Research into the effectiveness of the method is carried out using a pre- and post measures using a psychiatric screening instrument, measuring depression and anxiety. Participants were also asked for feedback in a structured self-report upon completion of the workshop. In addition, an exit interview was conducted after follow-up, three months after the first workshop session. A total of 73 persons attended the workshops, and detailed follow up data was only available for 33. 36% showed significant clinical improvement, and the sample as a whole showed significant changes in their psychological state. More complete information was available for a smaller sample [19], which showed 39% having significant improvement. On follow-up, 44% were still experiencing difficulties, with most (72%) experiencing economic difficulties. On the positive side, 56% reported coping better, only 9% reported health problems, and most were still connected to the group with which they participated in the process. All felt that that the process had helped them, had helped them new things, and had changed in the way that they felt about their torture. The Tree of Life appears to be a useful, cost-effective, non-professional method of assisting torture survivors.