In 2020 we celebrate the 30th anniversary of HealthRight International. Over the years, this organization has had many faces, but our mission has remained the same since day one: Health and human rights are inextricably linked, and we as a global society must ensure that all people can exercise this right. Since 1990, we have supported marginalized communities all over the world, and we want to share their stories with you. Below, you can explore 30 stories covering 30 years of human rights work. A new story will be added each week.
We hope you enjoy this historical exploration, may it inspire you to stand up for human rights in whichever way you can.
Thirteen years after the breakup of the Soviet Union, Russia’s social institutions had declined to the point of collapse. As increasing numbers of families slid into unemployment and poverty, the number of children and youths seeking to escape from the accompanying cycles of neglect and abuse grew. Many of these children ended up institutionalized under the permanent custody of the state in orphanages. Far from leading them to better lives, institutionalization set these children on a destructive path. Our research showed that, of the 15,000 teenagers in Russia who were graduated from orphanages in one year, 10% later ended their lives in suicide, 20% lived on the streets, and 33% went to prison.
In 1995, HealthRight had already been operating in Russia for one year, providing critical health services to St. Petersburg’s neglected, runaway, orphaned or abandoned children and adolescents. Always engaged with the local community, we partnered with drop-in centers for street children and youth, children’s shelters, children’s hospitals, and juvenile detention centers.
Our staff of fourteen Russian pediatricians, neurologists, dentists, psychiatrists, psychologists, nurses, social workers and lawyers provided essential health care, legal, and psychosocial services for children and adolescents who lived on the streets or in shelters, and other children and youth at risk. Many of them were victims of physical and sexual abuse, most were physically or emotionally underdeveloped, and many were addicted to the street drugs: cigarettes, toxic inhalants, alcohol, and, increasingly, heroin.
HealthRight developed a sustainable system of services to strengthen families, prevent the abuse and abandonment of children, and offer at-risk children and adolescents long-term, progressive alternatives to institutionalization. We provided training for the network of providers who work with at-risk children and adolescents, supported local partners to develop new models for foster care, family care and social support, provided legal assistance, and advocated for child welfare reform with local government. This work would endure for over a decade before being handed off to local organizations to continue indefinitely.
1994: Chiapas, Mexico
In 1994, HealthRight began supporting the work of the Hospital San Carlos (HSC), in Chiapas, Mexico. Run by the Daughters of Charity of St. Vincent de Paul since 1976, the hospital was the only source of health care for an underserved populations of thousands of rural indigenous people in highland Chiapas.
Indigenous communities in Chiapas had long been marginalized, suffering disproportionately from tuberculosis and other preventable infectious diseases. Most of the patients who came to HSC did not speak Spanish – only their indigenous languages Tzeltal or Tojolabal – while doctors and nurses spoke only Spanish. This communication barrier between patients and providers added to the exclusion and inequality that indigenous patients already faced. The UN and other human rights observers have documented the harmful effect of this scenario on indigenous women all over Central America. In Mexico, for example, indigenous women have been sterilized or given Caesarean sections without explanation or consent. Mexican physicians often claimed that the women could not speak Spanish and thus the procedure could not be explained to them.
To promote the ability of indigenous patients to understand, choose, and consent to medical care, HealthRight and HSC set up an ambitious training program for a group of indigenous women to become nurse auxiliaries. This project was the first in HealthRight’s long history of strengthening local health systems, by training health workers to support their own communities.
The curriculum included physiology, basic nursing techniques, pediatric nursing, maternal and child health, and public health – as well as basic literacy, a particularly pressing need. The program involved indigenous women, ages 15 to 22, who agreed to work for the hospital in exchange for room, board, vocational training, and primary and/or junior high school-level education. At the end of their training, the women received official certificates from the Mexican government, authorizing them to work as auxiliary nurses throughout the country.
Coming from the very same families as the patients of HSC, these young nurses became an essential part of the hospital. Along with the services they provided to others, they were educated and empowered, and are now part of the improvement of their communities’ long-term prospects.
Sor Maite Galvan, the Director of HSC at the time, said, “The nurse-auxiliaries are the right hand of the hospital. In addition to the medical services, they do the translation for the indigenous patients, they know the culture, they provide the bridge between the hospital and the patients. The hospital couldn’t work without them.”
1993: The Human Rights Clinic was founded
Through HealthRight’s work with Haitian refugees who were being detained indefinitely in Guantanamo Bay (see 1992) – documenting the asylum seekers’ trauma and advocating on their behalf – the Human Rights Clinic (HRC) was born. Founded in the Bronx in 1993, the program began as a partnership with the North Central Bronx Hospital and Montefiore Medical Center’s Residency Program in Primary Care and Social Internal Medicine.
The HRC recruits, trains, and deploys a network of volunteer physicians and mental health professionals who provide forensic evaluations, translating scars and symptoms into pivotal evidence for immigrants seeking asylum and other relief in the United States.
The HRC serves immigrants who are survivors of torture and other human rights abuses. In order to be granted the right to remain in the United States, asylum seekers must prove that they have a well-founded fear of persecution if returned to their home country. Through medical and psychological evaluations, HRC volunteers document the clinical sequelae of human rights violations suffered by survivors, thus helping to ensure a fair adjudication of their claims for asylum by enhancing their capacity to present their cases fully.
These evaluations can make the difference between an asylum grant and a denial — over 90% of HRC clients are granted asylum or other relief, compared to the 35% grant rate of asylum seekers nationally. Most recently, 96 percent of HRC clients whose cases were adjudicated in 2019 were granted.
Still active today, the HRC is HealthRight’s longest-running program, continuing to provide essential services to asylum seekers. Nearly 30 years later, the program continues to work closely with Montefiore Medical Center, and numerous other partners across the New York metro area.
1992: Haitian Refugee Crisis and Guantanamo Bay
One of HealthRight’s earliest projects came out of the Haitian refugee crisis of the early 90s. Following a coup d’état in Haiti in September 1991, the new military regime began persecuting the former president’s followers and other dissenters, causing thousands to flee Haiti. By February 1992, the US Coast Guard had picked up over 14,000 refugees and detained them in Guantanamo Bay, Cuba.
Beginning in May 1992, most refugees were repatriated to Haiti, while about one third received asylum in the US. However, 270 HIV+ refugees and their family members who had been granted asylum were barred from entering the US because of their HIV status and remained in Guantanamo Bay. “These refugees lived in deplorable conditions, were subjected to violence and repression by the US military, deprived of proper medical care, and left without any legal recourse of rights,” wrote migration scholar Karma Chávez.
Jonathan Mann and several other physicians visited these refugees, conducted interviews, assessed their health, and gathered evidence about their treatment and standard of living. They used these data to lead a lawsuit in Federal Court against the refugees’ detainment, arguing that the conditions in the camps were not conducive to care and that the patients must be brought into the US.
On March 26, 1993, US District Judge Sterling Johnson Jr. ruled that the refugees would be allowed to enter the US, stating that “the government had to either provide medical treatment for those with the AIDS virus or send them where they could be treated.”
1991: Doctors of the World-USA
DoW-USA was the US branch of Médecins du monde, a humanitarian organization originally formed in 1980 by Bernard Kouchner. Jonathan Mann sought to expand upon DoW’s model to focus on linking health and human rights.
When Dr. Mann founded the organization, it had one or two paid staff and about five board members. During this time, meetings were sometimes chaotic and disorganized, but the organization worked tirelessly to foster collaboration between clinicians, public health leaders, and community organizations.
1990: Dr. Jonathan Mann founds HealthRight
“AIDS cannot be stopped in any one country unless it is stopped in all countries,” Dr. Jonathan Mann wrote in a 1987 report on the WHO Global Programme on AIDS, which he had established just ten months earlier. At the time, he did not know that he would part ways with the organization within three years to pursue independent solutions for the human rights calamities created by the AIDS pandemic.
Jonathan Mann received his undergraduate education at Harvard College, graduating in 1969, before earning his MD at Washington University School of Medicine in 1974. Following medical school, he worked as an epidemiologist in New Mexico for the US Public Health Service and the New Mexico Health Services Division.
Following a return to Harvard School of Public Health to earn his MPH degree in 1980, Mann began to apply his intellect and skills to forming international strategies for reducing and preventing the spread of AIDS. In 1984, he founded and directed Project SIDA, an AIDS research project based in Kinshasa, Democratic Republic of Congo (then Zaire), that incorporated epidemiologic, clinical, and laboratory components in a collaborative effort of Zairian, US (Centers for Disease Control), and Belgian AIDS researchers. This project, among many accomplishments, showed that HIV could be spread through heterosexual sex but not through mosquito bites.
By 1987, the fear of AIDS had led to inhuman policies across the world. 81 countries had passed laws against people with HIV or risk groups, usually homosexuals and prostitutes. In Germany, a federal judge declared it might be necessary to tattoo and quarantine people with the virus. Cuba was already quarantining AIDS patients. Some Muslim states were jailing “promiscuous” people, and Chinese officials denied the existence of homosexuals, drug users, or prostitutes in the People’s Republic. In the US, President Reagan’s secretary of education, William Bennett, fought Surgeon General C. Everett Koop’s plans for frank education about HIV prevention, favoring instead compulsory testing of all hospital patients, marriage license applicants, and immigrants. Quarantine loomed as a very real threat.
Amid this gathering storm, Jonathan Mann led public health authorities to perhaps their finest hour. Impeccably dressed in bow ties, yet with the gritty experience of running Project SIDA, Mann managed to convene more than 100 national ministers of health together in London. There, almost 150 nations signed on to a condom-based, compassionate strategy to slow the spread of AIDS. A few months later, he convinced the World Health Organization to make human rights the core of its anti-HIV strategy. These coups played a crucial role in preventing the wholesale repression of people with the virus.
Mann orchestrated this historic consensus from his new position as director of the World Health Organization’s Global Programme on AIDS. At first, recalls Daniel Tarantola, who joined the fledgling endeavor at the beginning, “the program was himself, a secretary, and one typewriter.” Two years later, Mann had rocketed the budget to almost $100 million. His m.o.: hard work, personal modesty, and an eloquence that was at once fiery and logical. “Back at a time when only a few people were screaming” for a humane and effective response, says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, “Jonathan was an unbelievably articulate and passionate voice.” Mathilde Krim, founder of the American Foundation for AIDS Research, adds that Mann persuaded people with “the force of the argument, the morality of behaving a certain way, and the practical usefulness of being ethical and respectful of others. He convinced people.”
Mann’s message: AIDS is a global crisis, in which no person or nation is an island. More important, human rights and public health go hand in hand: “In each society, those people who before HIV/AIDS arrived were marginalized, stigmatized, and discriminated against become those at highest risk of HIV infection… The French have a simple term which says it all: HIV is now becoming a problem mainly for les exclus, the ‘excluded ones’ living at the margin of society.”
His international experiences with AIDS policy brought to his attention the link between human rights and health. He was particularly interested in the effects of health policies on human rights, the health effects of human rights violations, and the inextricable connection between promoting and protecting health and rights.
Seeing a void among the health and human rights organizations in the US, Dr. Mann founded HealthRight – then known as Doctors of the World-USA – in 1990. His aim was to create a unique organization that ran sustainable programs that promote and protect health and human rights in the US and abroad. Drawing from his experiences in the AIDS response, he promoted the idea that health and human rights are inextricably linked. Even 30 years later, this philosophy drives HealthRight’s work and projects.
Jonathan Mann worked tirelessly to improve the lives of others and never shied away from a challenge. Today, his ideals are more important than ever before.
“People say there is no use trying to change the world,” he often said, “but if we don’t try, will it change?”
Portions of this biography were first published in the New York Village Voice and quote Laurie Garrett’s book The Coming Plague.