Critique of the Human Rights Watch report on Nepal Oct 16th, 2015 and suggestions

“Like We are Not Nepali”

The Human Rights Watch published a 44-page report investigating the killings in Nepal during the Terai Andolan of August-September 2015. The report was accompanied by a press release and a New York Times article to draw the attention of the international community.

Now that I am back in USA, I have been blogging on DailyKOS, a website with a million subscribers, to which I occasionally contribute since 2008.  I’ve been blogging there every day since the petrol crisis began a few weeks back. Here is my reaction to the Human Rights Watch report.

At the end of the Human Rights Watch report, is a list of recommendations. Keep reading to the bottom, because  I will add some items at the end, that I think were overlooked.

Here are the recommendations from HRW:

IV. Recommendations

To the Government and Security Forces

  • Ensure that all security forces abide by the UN Basic Principles on the Use of Force and Firearms by Law Enforcement Officials.
  • Immediately end the indiscriminate and excessive use of force, and ensure the intentional use of lethal force only occurs where strictly necessary to protect life.
  • Immediately establish an independent commission of inquiry to investigate the unlawful killings of protesters and police.
  • Ensure that these findings are forwarded to the Attorney General’s office for prosecution.
  • Ensure that those accused of violence and other crimes during the protests are accorded full due process rights, including a fair trial, freedom from torture, and access to lawyers and family. Ensure that any statements given by the accused under duress are not introduced as evidence in court.
  • Immediately end the harassment and intimidation of members of the public belonging to the Tharu and Madhesi communities, including beatings, threats, and the use of racial slurs by members of the security forces.
  • Ensure full protection of political rights, including freedom of assembly, association, and speech.
  • Undertake a broad consultation with all aggrieved communities and stakeholders to redress rights violations.
  • Take immediate steps to address any systematic discrimination suffered by minority communities, including providing effective judicial remedies to afford redress and accountability for rights violations.
  • Issue clear instructions that anyone holding public office at any level who engages in hateful speech or incitement of serious crimes will face significant consequences, including investigations and dismissal from public office, and possible criminal prosecution if found to have incited crimes.
  • Ensure all security forces comply with the Ministry of Education’s 2011 “Schools as Zones of Peace National Framework and Implementation Guideline.”

To the Protesters and Protest Leaders

  • Publicly call on all protesters to desist from violence and other crimes.
  • Fully cooperate with the police and others in any criminal investigation into serious crimes.

To the International Community

  • Urgently press the Nepali government to abide by its international obligations not to use excessive force in policing demonstrations and to abide by the UN Basic Principles on the Use of Force and Firearms by Law Enforcement Officials.

  • Press the Nepali government for timely and credible investigations of alleged human rights abuses, and for perpetrators among both the security forces and agitating groups to be prosecuted.

  • Strengthen the capacity of international human rights monitoring inside Nepal, including by pressing for access by the Office of the High Commissioner for Human Rights (OHCHR).

  • Be alert to activities or rhetoric which may contribute to human rights abuses, and strenuously dissuade any actor from taking this course.

My critique

I certainly agree with the recommendations above. HRW seems to be clearly supporting the idea that the government needs to negotiate and compromise with the protesters. The other day a rally in Birgunj attracted 100,000 supporters. If the government plans to use riot police again, it will find that it takes a very large number of riot police to dominate a crowd that size. This has grown well beyond what can be controlled by force.

My perspective is informed by the work I have done in the Terai to teach situational awareness to Nepali doctors and nurses. In the course of that work I have learned about the Health Care in Danger initiative of the International Committee of the Red Cross.(ICRC). The Health Care in Danger initiative posts booklets and guidelines on their page.

The ICRC publication I think people in Nepal need to study is:

Ensuring the preparedness and security of health-care facilities in armed conflict and other emergencies

Date of release: Jul 27, 2015  Languages: English
This publication is intended as a practical manual for governments, hospital managers and others concerned, with a view to helping them prepare for and manage situations that could jeopardize their objective of assisting the wounded and sick and maintaining the health of people affected by armed conflict and other emergencies. Built on the recommendations that emerged from two Health Care in Danger experts’ workshops on ensuring the safety of health-care facilities, which took place in Ottawa, Canada, in 2013 and Pretoria, South Africa, in 2014; this publication has also benefited from contributions by the Canadian Red Cross Society, the Egyptian Red Crescent Society, the Harvard Humanitarian Initiative, the International Federation of Hospital Engineering, the International Hospital Federation, Médecins Sans Fontières, the Pan American Health Organization and the World Health Organization.
It can be downloaded for free as a pdf.  Here is a chapter-by-chapter summary of contents:

Chapter 1 gives an overview of the impact that violence may have on the delivery of health care, highlights the importance of enhancing the security of health-care facilities and discusses the protection afforded by international law.

Chapter 2 focuses on contingency planning for health-care facilities, measures to enhance coordination and cooperation between facilities, and advocacy for the safe delivery of health care.

yy Chapter 3 covers issues relating to the security and well-being of health-care personnel and patients, and methods for preparing for and dealing with stressful situations caused by an emergency.

yy Chapter 4 discusses a number of generally recognized architectural principles and engineering considerations relating to the design of health-care facilities and proposes measures that could increase the security level of infrastructure.

yy Chapter 5 outlines potential risks of disruption in the supply of health-care equipment and goods, and proposes measures to enhance the preparedness and resilience of health-care services.

yy Chapter 6 considers the implications of temporarily relocating health-care services to a safer place when security for staff and patients reaches a higher risk level

My additional items:

For the riot police:
1) arrange for the presence of an ambulance at or near the scene of riot control actions so as to minimize the transit time to medical care for any injured persons.
2) issue first aid kits to each unit in a riot control action and train members of each squad in their use especially to control hemorrhage.
3) ‎retrain police members in proper aim of baton rounds
For hospitals
1) improve security by obtaining the recommendations from iCRC in their “health care in danger” initiative and implementing‎ them.
2) train staff in situational awareness, mass casualty triage and tear gas decontamination.
For protest groups
1) use smartphone video cameras to document all encounters‎.
2) train as many protesters as possible in first aid techniques, especially control of hemorrhage.
For all sides
1) respect the neutrality of hospitals, medical personnel, ambulances and first aid providers.
2) medical schools and hospitals in the Terai and elsewhere need to ramp up courses of elementary first aid to police and to potential protesters or protest groups.
I would note that on YouTube, there are videos of many of the incidents described in the report, as well as others dating back months or years prior to the current round of protests. It’s clear to me that some of the wounded  in the videos died of hemorrhage, and it is equally clear that the fellow protesters and police had no idea whatsoever, how to use elementary first aid techniques to control bleeding. Some of the deaths were easily preventable after the initial wound. Of course, all of the death were preventable if they protests had not taken place; but if protests are planned,  some attention to treatment of casualties needs to be considered.

I will add to this in coming days. If the readers wish to add something, feel free.


About Joe Niemczura, RN, MS

These blogs, and my books, and videos are written on the principle that any person embarking on something similar to what I do will gain more preparation than I first had, by reading them. I have fifteen years of USA nursing faculty background. Add to it fifteen more devoted to adult critical care. In Nepal, I started teaching critical care skills in 2011. I figure out what they need to know in a Nepali practice setting. Then I teach it in a culturally appropriate way so that the boots-on-the-ground people will use it. One theme of my work has been collective culture and how it manifests itself in anger. Because this was a problem I incorporated elements of "situational awareness" training from the beginning, in 2011.
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