In 1995, after producing a successful weekly TV program about apartheid in South Africa against all odds, we broadcast an edition of a new series that explored revolutionary ideas about human rights, such as those then being formulated by a visionary at Harvard named Jonathan Mann. In our show, called Rights & Wrongs: Human Rights Television, Dr. Mann laid out in typically brilliant fashion the crystal-clear thinking behind his vision of human rights – and in particular, his then (and still) controversial notion that health and human rights are inextricably linked, that access to quality health care is a self-evident, inalienable right shared by all human beings, as recognized by the Universal Declaration of Human Rights, adopted without dissent by the entire United Nations sixty years ago.
The late Dr. Mann was well out in front of most other human rights “professionals” when it came to his analysis and dissection of basic human rights — and in particular as they relate to the intersection of health and society. (Mann does such an elegant job of expressing this in the program that I will refrain from further comment). You can view the entire episode at the end of this post. The difficulties we faced in producing the show at all is a long story. But we think it’s worth sharing with HHR readers who might think that health and human rights issues are taken for granted at the global level.
In 1991, my then-fledgling media company Globalvision announced plans to create and distribute the world’s first television series dedicated exclusively to coverage of human rights issues around the world. We had just wrapped up production of our first weekly international newsmagazine South Africa Now, which focused on the many untold stories and unsung heroes of that country’s inspiring and under-reported liberation struggle, and we were anxious for a new challenge.
Producing South Africa Now, which aired weekly between 1988 and 1991 on 150 public television stations in the United States and on leading broadcast systems in sixteen other countries, had never been easy — in part because America’s Public Broadcasting Service (PBS) and its parent CPB, the Corporation for Public Broadcasting, refused to have anything to do with the program, deeming it too “controversial” for the public airwaves. The decision meant that we had to raise all the money necessary to produce and promote the program. It also meant we had to distribute it ourselves, station by station, instead of PBS delivering it centrally to the entire three hundred and thirty station system.
In addition, the white minority government then in power in South Africa refused even to let us into the country, which meant we had to produce a show every week about a country thousands of miles away to which we had little access, and which had imposed stringent restrictions on all media coverage of its activities. Finally, we were attacked by conservative elements in our own country as well as in South Africa, and charged with being “advocates not journalists” and even “hard-core Marxist propagandists.” Despite the many roadblocks placed in our path, however, we persevered and eventually succeeded in producing an award-winning, critically acclaimed program about important human rights-related topics that was regularly seen by millions of people — and which, to our surprise and joy, many South Africans credited with playing a positive role in bringing about the (mostly) peaceful and democratic transformation of their country.
Having produced against all odds a successful weekly program about apartheid, we thought it would be a relatively easy matter to create a new program, which would expand our human rights coverage beyond southern Africa to encompass the rest of the world. Little did we know…
Our first problem was with the public broadcasting system itself. PBS executives steadfastly refused to consider backing a weekly program about human rights, despite the global acclaim that had accompanied our previous effort. Pressed for an explanation, they eventually provided one: human rights, PBS programmers told us, was “an insufficient organizing principle for a television series.” Unlike cooking, stock tips, or purple dinosaurs, apparently!
Once again, however, we were undeterred, and again we resolved to produce, promote and distribute the series ourselves. We raised hundreds of thousands of dollars from leading foundations who saw the need PBS was blind to. We went back to all the individual public television stations that had carried South Africa Now and told them we had a new and better weekly program to offer. Most agreed to air the new program, based on our strong track record of delivering weekly credible news about important topics unavailable elsewhere. It was clear to them that, despite the ludicrous stance of PBS, there was plenty of interest in human rights programming among American viewers. Nor was that interest limited to the United States — soon broadcasters in more than sixty other countries around the world were airing our new weekly series about international human rights issues, which we dubbed Rights & Wrongs: Human Rights Television. That’s when the next set of problems began…
This time, to our astonishment, the naysayers were led by executives at prominent human rights organizations, who expressed concern that a program about human rights would be produced by a team of journalists with no formal standing or training in human rights issues or policy formulation. They were concerned on many counts: that we might misreport human rights news, thus sullying their own well-deserved reputations and enviable record of impeccable reportage; that we would be insufficiently attuned to the many nuances of human rights work; that we might inadvertently use the wrong vocabulary in describing human rights abuses. But most of all, it turned out, they were afraid that we would employ a more expansive definition of what human rights actually are than they did — and they were right!
Soon I was regularly banging heads with the leaders of powerful international human rights groups. They wanted to keep the focus of Rights & Wrongs exclusively on civil and political rights; we were equally interested in looking at the social and cultural side of the human rights equation. We wanted to explore issues like workers’ rights and women’s rights; they were appalled and thought this was evidence that their initial fears had been well-founded, that we were simply laymen and certainly not sophisticated enough or professional enough to be covering “their issues.” The matter eventually came to a head over one particular program we wanted to create, which would explore the revolutionary ideas then being formulated by a visionary at Harvard named Jonathan Mann.
Despite the opposition of the human rights groups, we went ahead in 1995 and produced our “Health and Human Rights” edition of Rights & Wrongs.
As you can see, even relatively enlightened and forward-looking human rights executives, such as Kenneth Roth of Human Rights Watch, who was interviewed at length, expressed reservations about the links that Mann was making to societal status and ill health, and to his overall claims regarding health and human rights. Roth’s reservations are echoed to this day in many human rights circles.
Well, go ahead and call me unprofessional. Say I’m a layman who doesn’t understand the nuances. Denounce me as an advocate and not a journalist. Hell, you can even call me a hard-core Marxist propagandist if you like. Just don’t try to tell me that equal access to quality health care isn’t a basic human right! And of course, don’t take my word for it—listen and see for yourself, as the late, great Jonathan Mann lays it all out brilliantly in an interview that, I hope you will agree, is still relevant — perhaps more than ever — even a decade after it was recorded.
— Rory O’Connor was the co-creator and Executive Producer of Rights & Wrongs: Human Rights Television. His popular Media Is A Plural blog is accessible at: http://www.roryoconnor.org.
I’ve been supporting Partners In Health’s project in Lesotho for more than two years – almost since it began. Lesotho is a world away – both literally & figuratively – from the FXB Center office in Boston where I work and where the Health and Human Rights editorial office is based. An independent country completely surrounded by South Africa, Lesotho is home to almost two million people, most of whom have never heard of human rights or the right to health care. However, they can certainly comprehend the injustice of suffering from treatable disease without access to treatment.
When Dr. Jennifer Furin started treating patients in Lesotho at the Nohana Health Center in July 2006, many of her patients had never had access to a doctor. In fact, after walking hours up and down mountains to reach a clinic, patients would often find it locked and unstaffed. If the clinic was open, basic medicines and supplies were scarce, and the nurses could offer little comfort to their patients who were suffering from highly infectious diseases such as HIV/AIDS and tuberculosis. Almost none of the patients – in spite of HIV rates in Lesotho approaching 30% – had ever been tested for HIV, let alone had access to lifesaving anti-retroviral therapy (ART). A mere handful of patients were being treated for TB.
Nohana is one of approximately fifty health clinics scattered across the mountains in rural Lesotho – each more logistically challenged than the next. About a dozen of these remote clinics (including Nohana) have access to a nearby airstrip – enabling staff and supplies to arrive from the capital, Maseru, in approximately 30 minutes. Via land, the treacherous trip from Maseru to Nohana would take 6 hours or more by car, traveling the edges of steep mountains on barely visible dirt paths. Now, with assistance from the pilots and planes of Mission Aviation Fellowship (MAF), the Partners In Health Lesotho (PIHL) team can adequately supply and staff these clinics, ensuring that they are open and that care is available whenever our patients make the long journey to seek medical treatment.
In February 2008, a small team from the Harvard News Office visited two of the PIHL mountain clinics – Nohana and Bobete. They were able to capture the essence of our programs in Lesotho via stunning text, photos, and video – accessible here. I’d like to direct you to a two part photo/video story filmed in Nohana, featured below. It is the story of Kazabelo – a tiny, malnourished 15-month-old baby on the edge of death.
For Kazabelo, the story ends well – at least in the short term. She has survived this round of her life’s battle, and is a plump and healthy toddler (see picture) less than six months later.
Whether our patients come to Nohana, Bobete, or one of the four other remote clinics operated by PIHL in four of Lesotho’s most rural and mountainous districts, the care they receive is essentially the same. We staff each of our six clinics with a full-time physician, who is trained in management of HIV/AIDS and TB as well as primary care and trauma. In addition to treating patients, the PIHL physicians work closely with clinic nurses who are paid by the Lesotho Ministry of Health and Social Welfare - training them in infectious disease management and other critical skills. The doctors and nurses are supported by a cadre of lay health workers, who handle various administrative tasks – including HIV testing and counseling, and food distribution.
The physicians also hire and train Community Health Workers (CHWs) – the key to finding and treating so many patients in the remote villages served by our clinics. Our CHWs visit HIV patients daily to ensure that they are taking their medications properly and consistently, and to check for side effects and other problems of poverty (such as lack of food or water) which might interfere with treatment. CHWs are the vital link between clinic and community, encouraging neighbors and friends to visit the clinic for testing and treatment, notifying the doctors when patients are too ill to make the long journey themselves, and supporting chronically ill patients through months and even years of treatment for HIV/AIDS and TB.
Unfortunately, Kazabelo’s painful story is not unique. There are far too many underweight, malnourished infants and children in Lesotho – and worse, many of them do not arrive to our clinics in time. In a country where an entire generation of adults is being wiped out by the dual epidemics of HIV & TB, too frequently very young children are left in the care of their aging grandmothers. Current estimates peg the orphan rate in Lesotho between 16 and 30% - very likely the highest per capita orphan rate in the world. How old will Kazabelo be when her grandmother can no longer care for her? Will she survive long enough to witness the right to health care become a right realized by everyone in Lesotho?
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