In a joint presentation with Dr. Kekuni Blaisdell, Kawika Liu, on left, said human rights violations are the underlying causes of adverse health. Native people, he said, will continue to suffer from above average rates of disease if those violations are not addressed. - Photos: Liza Simon

Local public health experts convene on human rights

There is increasing evidence that a major cause of poor health is social injustice." —Kris Coontz, UH Public Health Studies Office

By Liza Simon / Ka Wai Ola

"As I share my personal story I ask that you hold the
victims that have been murdered and their loved ones
in your hearts and prayers. Know that I speak for those
who have been silenced forever."

With these words, domestic abuse survivor Leina'ala Bright launched into a riveting narrative at a recent National Public Health Week symposium in Honolulu. The three-day event aimed to raise awareness of serious health problems that arise from human rights violations and to urge public health professionals to address the socioeconomic conditions that are known causes of disease, according to a growing body of research.

Domestic abuse is not widely perceived as a health or human rights problem, but this must change, said presenters at the April 7 to 9 symposium at the University of Hawai'i. Punishable by law, domestic abuse is treated as a criminal matter. But several recent domestic abuse murder cases in Hawai'i serve as reminders that the "justice system has been unable to provide accountability for batterers – leading to the ultimate human rights violations – the loss of life," said Cindy Iannce-Spencer of the Domestic Violence Clearinghouse and Legal Hotline.

Iannce-Spencer also said that "male violence against women and children in the home is the most persistent human rights violation around the globe," according to research from the World Health Organization.

And it takes a heavy toll in Native Hawaiian communities, said Bright, who now works with Iannce-Spencer, as a court advocate for abused women.

"My father, who is Native Hawaiian, grew up coming to the rescue of his mother from his violent father. He thought his daughters would escape what he went through when he moved us to California," Bright said. "I came back here and got caught in the devastating cycle of power and control of a batterer who came from a home where domestic abuse was the norm."

Noting that "70 percent of kids who grow up in abusive homes will step in the shoes of their fathers," Bright also said that she and her three children suffer from mental and physical health disorders that are the lingering result of abuse from a husband she left three decades ago. One of her sons is currently incarcerated at OCC. "We are all victims of domestic abuse, even the offender," said Bright, who, along with Iannce-Spencer, said solutions won't come until the entire community gets involved.

"Most of all, I am here to today to caution professionals to refrain from simply referring the woman to legal remedies or clinical therapies," said Iannce-Spencer. "We must help her voice to be heard, because when it comes to domestic abuse, she is the expert."

In contrast to private health care, public health – the mission of government and nonprofit agencies, promotes disease prevention on a wider scale through research and other organized efforts aimed at eliminating known threats, such as poor water quality or risky behaviors such as tobacco use. While public health's mission is to assure decent conditions for the entire population, the consensus at the symposium was that the most vulnerable groups are low-income minorities, native peoples, the elderly and immigrants. "There is increasing evidence that a major cause of poor health is social injustice," said Kris Coontz of the UH Public Health Studies Office, a co-sponsor of the annual symposium along with the UH public health student group Hui Ola Pono and many others.

Coontz offered this explanation for choosing human rights as this year's symposium theme: "We must look beyond conventional medical models. Health is not just the absence of disease. We want to obtain specific health outcomes with fairness, justice and equity as guiding principles. And this pertains to mental, emotional and spiritual health, as well as physical."

As with domestic abuse, the loss of native rights is not commonly construed as a public health matter, but the need to see it as such was a topic for discussion at the symposium. Kawika Liu and Kekuni Blaisdell, who are both Native Hawaiian physicians and Kanaka Maoli rights advocates, jointly presented information intended to show that the colonization of Hawai'i has led to high rates of cancer and other chronic diseases for today's native population. "Everyone has a right to a standard of living consistent with good health, but the invasion of Hawai'i (by the U.S. military) left us with stigmatization, marginalization, hunger, low education and pain that is not only in the past but with us in the present," said Liu. Cautioning that the current national dialogue focuses too narrowly on improving access to medical remedies, Liu said native populations will continue to suffer from higher than average rates of disease if not enough is done to address human rights violations as the underlying causes of adverse health."

Blaisdell characterized health as a basic human right guaranteed under a body of international law, including the 1948 Universal Declaration of Human Rights and the 1978 Declaration of Alma-Ata that urge all governments to take action in implementing preventive health care for all people. But he said that the overall poor state of Kanaka Maoli health indicates the United States hasn't done its duty to enact these agreements. He concluded that Kanaka Maoli will find a remedy for their health problems by reclaiming the right of self-determination and supporting cultural perpetuation. Liu and Blaisdell urged their public health colleagues to abandon the status quo and embrace "radical change" for the sake of preventing the conditions tied to disease.

The symposium also looked at the health implications of human rights violations involving unfair treatment of refugees by governments and the inequitable distribution of nutritious food.

UH political science professor George Kent criticized Hawai'i's top-down government policy on food security that doesn't take into account important island factors, including overdependence on imported food, rising fuel and transportation costs, rising sea levels affecting food production and per capita decrease in farm production. Kent, who recently returned from a food security project in American Sāmoa, recommended forming local food-security councils similar to ones put in place by Sāmoan village councils requiring residents to meet quotas for taro production. "When it comes to public health, we need to stand up for ourselves, so we can formulate a sense of accountability from all parties," Kent said.

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For more information on public health and human rights,
visit hawaiipublichealth.org or apha.org