On October 30, the Program on Human Rights (PHR) at Stanford's Center on Democracy, Development and the Rule of Law (CDDRL) held a day-long conference to examine health and human rights. The conference was held to discuss how a rights-based approach to health services can impact the delivery of effective health interventions and advance other socio-economic and cultural rights in developing regions. The conference titled, “Why We Should Care: Health and Human Rights” was divided into five panels with presenters from diverse backgrounds and professions including lawyers, doctors, public health experts, students and activists.

The Program:

The conference started with a welcoming address by Helen Stacy, director of the Program on Human Rights. CDDRL Director Larry Diamond introduced the keynote speaker Paul H. Wise, professor of child health and society and pediatrics at Stanford University’s School of Medicine, and director of the Center for Policy, Outcomes and Prevention. Wise's opening remarks began on a somber note, “The language of rights means very little to a child stillborn, an infant dying in pain from pneumonia or a child desiccated by famine.” In his address, Wise emphasized the need for an aligned and integrated rights-based approach that does not undermine effective and efficient medical interventions. “We need to fill the gap between the worlds of child health and child rights so that our programs and policies are both effective and just,” he stressed.

Following the keynote address, the conference presenters shared their work according to a geographic or thematic focus. The first panel brought together three generations of speakers from Stanford - a faculty member, a pre-doctoral fellow and a recent graduate - in a unique opportunity to share ideas and discuss possibilities of health work in Africa. Rebecca Walker, clinical instructor in emergency medicine at Stanford School of Medicine, presented her impressions and reactions on Mindy Roseman’s study of forced sterilization in Namibia. Roseman, academic director of the Human Rights Program and lecturer on law at Harvard Law School, was unable to attend due to flight complications after hurricane Sandy hit the East Coast.

Eric Kramon, 2011-2012 pre-doctoral fellow at CDDRL, spoke about the political sources of ethnic inequality in health outcomes in Africa.  Kramon’s work in Kenya illustrated how politics plays a determinant role in ethnic inequalities and consequently in access to health and health outcomes. Jeffrey Tran, a 2011 Stanford graduate in human biology, described the vision behind the launch of the Project of Emergency First Aid Responder in Western Cape Province, South Africa that he helped implement. Tran explained, “Individuals and communities are an integral part of the solution and we work with the communities to develop first aid training programs that are taught and eventually run by community members.”

Panel two was dedicated to the health impact of drones in Pakistan and in Gaza. Based on research by the Stanford International Clinic on Human Rights and Conflict Negotiation in Pakistan, Professor James Cavallaro and Stanford law school student Omar Shakir, explained that drones are not only responsible for deaths of civilians but also constitute a constant disturbance to social life and mental health of ordinary people, including their relations with children and the elderly. Drones impact other rights as well - such as the right to education - as children are prevented from attending schools for fear of drone strikes. Rajaie S. Batniji, resident physician in internal medicine at Stanford and a CDDRL affiliate, explained the clinical diagnosis of traumatic disorders that result from constant surveillance and insecurity. He cited the work of Jonathan Mann in defining dignity and the devastating effects on physical, mental, and social well-being when these senses are violated. Batniji explained that populations in Gaza are prevented from living life with dignity and respect because they live under constant threat to their security and intrusion into their homes and communications.

Vivek Srinivasan, manager of the Program on Liberation Technology at CDDRL, presented his experience on the Right to Food Campaign in India. He believes that this campaign has led to the mobilization for rights and the provision of services. “Not all demands are confrontational. Communities begin demanding something that is perceived as small in scope but have ramifications that extend to other rights such as the right to education, the right to housing and the right to work.” According to Srinivasan, the Right to Food Campaign in India has had a tremendous impact in putting hunger on the policy agenda. Suchi Pande, an activist-researcher who worked on the Right to Information Campaign in India for over seven years and was the secretary for the National Campaign for People’s Right to Information from 2006 to 2008, supported Srinivasan’s argument of strong correlation in achievements and right-based mobilization. However, Pande pointed out that despite successes in the Right to Food Campaign, other economic and social rights including the right to health in India continues to be a non-issue for politicians and the government. She is optimistic and believes that rural public hearings, the role of the right to information and its supporting mechanisms will facilitate access to public health in rural India.

In panel four, Sarah MacCarthy showed results that suggest that counseling and testing services for HIV-positive pregnant women remain limited, insufficient or lacking in quality in Salvador, Brazil. “While Brazil’s HIV/AIDS program has been internationally acclaimed, national practice still fails to meet national and global guidelines,” she explained. Calling attention to the regional discrepancies in the HIV/AIDS policy and program implementation in Brazil, Nadejda Marques, manager of the Program on Human Rights at CDDRL,, expressed concerns about the implementation of an HIV/AIDS program in a context of limited resources. “In Angola, counseling and voluntary testing units for HIV/AIDS don’t have drinking water or sanitary conditions to receive patients. They lack basic equipment for testing and data collection, there is a generalized shortage of doctors, and health care providers have no specific training on HIV/AIDS.” Despite this alarming situation, Marques explained that advocating for the rights of persons living with HIV/AIDS in Angola has put in evidence the failure of a heath system unable to provide even the most basic services to its population and has enabled mobilization in a context where human rights are routinely violated.

Ami Laws, adjunct associate professor of medicine at Stanford, described how a physician can provide services in collaboration with the judicial system to advance human rights. Laws is an expert witness on cases of torture survivors that require asylum status in the U.S. and has worked mainly with victims of torture in the Punjab region in India. Everaldo Lamprea, a JSD candidate at Stanford Law School and an assistant professor at Los Andes Law School in Bogotá, Colombia, spoke about his recent comparative study on health litigation in low and middle-income countries. The escalation of right-to-health litigation in these countries can have unexpected and harmful consequences to healthcare reforms and the enforceability of the right to health. In part, this is because significant financial resources are allocated to the litigation processes and not to the health system. In addition, while litigation can highlight gaps that exist in the health system that need regulation, countries have been very slow to adapt and adjust to these signals.

Next Steps:

A number of key ideas, questions and insights emerged from the conference including:

. How to identify an effective intervention that will also mobilize communities to advocate for its implementation?

. How to provide services to the more vulnerable populations without alienating a contingent that has access to basic health care services?

. What instruments can be used to share best practices among national healthcare systems?

. How do global priorities adapt to contexts of limited financial resources and human capital?

. How can punctual achievements in rights that guarantee access to health be expanded for the achievement of other social, economic and cultural rights?

The Program on Human Rights at CDDRL will continue to pursue a research agenda examining health and human rights following the conference and announced that it will be the thematic focus of the Sanela Diana Jenkins Speakers Series in 2014. The PHR is also actively seeking support for research projects that include a right to health component at the core of its academic investigation for the 2012-2013 academic year.

An American of Indian descent is focused on the economic impasse between New Delhi and Islamabad and a Polish immigrant is fascinated by the Soviet-era biological weapons program. A young woman from Taiwan wonders whether historical memory is fueling nationalism in China, and a Bahraini is investigating the rise of Islamic fundamentalism in his part of the world. Yet another intends to run for public office. 

All this – and they’ve yet to graduate. 

This year’s 12 honors students at the Center for International Security and Cooperation – Stanford seniors drawn to public policy and international affairs – represent the best of what the university offers: diversity, a passion for learning outside the classroom and a determination to make an impact once they venture out into the world. 

Even two weeks in Washington, D.C., did little to dissuade them from potential careers in public policy. They met with dozens of politicians, journalists, military analysts, lobbyists and experts from the leading private organizations and government agencies in the nation’s capital. While congratulated on their ambitions, the students were cautioned that Washington has become a brutal and highly divisive place to work. 

“You gravitate toward public policy and you’re likely to become a leader,” former U.S. Sen. Chuck Robb, D-Virginia, told the students at a meeting in the Beaux Art landmark that has housed the American Red Cross since the presidency of Woodrow Wilson.

 Robb listened to their thesis topics, offered advice and contacts, and took questions about world policy and events. He then joined the chorus of others inside the beltway lamenting the poisonous partisan politics of Capitol Hill. 

“It’s just toxic,” said Robb, who now promotes common ground between Democrats and Republicans as a member of the Bipartisan Policy Center. “You just can’t get anything done. I think we’ll have a lame duck session in Congress and nothing will happen until March. Then, a full-scale depression next spring – and I think the markets will crash.” 

The students had heard likeminded pessimism earlier that day from Walter Pincus, who covers intelligence, security and foreign policy for The Washington Post. He said PR and TV now run Congress because candidates consistently worry about how their comments on camera will be used against them in their next re-election campaign. 

“Politics are totally polarized in a way I’ve never seen before,” said Pincus, who teaches a seminar about government and the media in the Stanford-in-Washington program. Compounding the misery, he said, is the nearly $1 billion spent on political ads trashing opposing candidates in the exhaustive presidential campaign. 

“We go off and tell the rest of the world they ought to have elections, but our elections have become a PR operation,” Pincus said. “So – that’s my happy view of the world.” 

The students laughed nervously. That evening, they chatted in front of the White House about all the negativity they had heard that day. Some seemed spooked. Others made that clarion call of each new generation: It’s our turn to make things right. 

“I believe that each of us has a duty and responsibility to do what is right, what is just, and to move the world – our country and our community – at least one step forward to make each day brighter than the last,” said David Hoyt, an international relations major who aspires to public office. “And I believe that students in CISAC, by coming together and addressing these … pressing issues of our time, are starting that process.” 

The Interschool Honors Program in International Security Studies at CISAC is a competitive program in which 12 seniors are chosen from among all Stanford majors to spend their final year investigating a global security issue. They are mentored and attend seminars and classes taught by CISAC faculty and researchers and present a thesis at the end of the year. They come to think of Encina Hall as a place where their ideas count.

“I always thought of CISAC as my intellectual home at Stanford,” said Jane Esberg, an honors student from the class of 2009 who is now at New York University’s Center on International Cooperation and intends to pursue her Ph.D. in political science. “It was the first place where I felt like everybody thought about things that I really cared about. They never really treated me like a student – they always treated me like a colleague.”

Martha Crenshaw, a Senior Fellow at CISAC and its umbrella, the Freeman Spogli Institute for International Studies, is an expert on political terrorism and has directed the Honors Program for three years. She co-teaches s weekly honors seminar with Joe Felter, a senior research scholar at CISAC and retired U.S. Army colonel and Special Forces officer.  

“It’s a special pleasure to work with a small group of very talented and imaginative students who have such diverse interests,” Crenshaw said. 

The Washington leg of the program, known as Honors College, takes place in the two weeks before the academic year begins. The students also visit national battlefields to reconstruct war policy; a private tour of the National Portrait Gallery allows them to recount U.S. history through the individuals who shaped the great American story. 

The two weeks also helps them bond and unveil their thesis topics. 

“The secret of the honors program is the interaction,” Tom Fingar, the Oksenberg-Rohlen Distinguished Fellow at FSI, told the students on their first night. They had gathered in a hotel conference room for the inaugural hashing out of their theses – some of which would change dramatically after two weeks of feedback in Washington. 

“You are going to be one another's most valuable critics,” said Fingar, an East Asia expert and former chairman of the National Intelligence Council who spent 23 years in the U.S. government. “In the end, this is your product, but your product that is informed by a collaborative process.” 

Fingar has been escorting the students around Washington since the program's inception in 2000. His years in intelligence and at the White House and State Department opened doors to counterterrorism and intelligence officials at State, the National Security Council, Homeland Security and the Department of Defense. The students also met those who strive for public policy toward peace and reconciliation, at the Eurasia Group, Carnegie Endowment for International Peace, Amnesty International and the Stimson Center. 

The students got an earful on how to operate if they gravitate toward capital careers and were encouraged to take time before determining what they wanted to do with their professional lives. 

“I quickly realized that I don’t like doing law,” said Matthew Rojansky, a Stanford Law School grad who is deputy director of the Russia-Eurasia Program at Carnegie, when asked about the benefits of law school. “Don’t jump into it with any uncertainty or reservations. Take time after school. You guys have a lot of options in your lives.” 

The next day, the students met national security and terrorism correspondents at The New York Times. They asked the reporters about the attack on the U.S. consulate in Libya, the covert use drones, and whether cyberwarfare is the next big security challenge. 

“The CISAC honors students are an amazingly talented group that we look forward to meeting every year,” said Eric Schmitt, who covers terrorism and national security for the Times and was a Knight Journalism Fellow at Stanford. “As journalists working in Washington, we’re able to give them insights from the front lines on the policies and politics of their research topics.”

The National Research Council's (NRC) Committee on Assessing the Impacts of Climate Change on Social and Political Stresses released a study which finds that climate change, whether natural or man-made, poses a major threat to global security. The committee concluded that the military and intelligence agencies are not prepared to anticipate climate-related disasters, which will increase in frequency and intensity. Extreme climate activity will place stresses on water and food supplies, as well as public health at a scale large enough to threaten human well-being worldwide. Thomas Fingar served on the NRC committee and contributed to the report.