Oxford University Press's Blog, page 867

Nelson Mandela, champion of public health

By Yogan Pillay

Our late former President Mandela has passed on but his legacy will live on and should live on for generations to come. He inspired millions across the world to do good, to forgive, to work for the common good. This also inspired me: from my youth in university when he was in prison, as a government official since he became the President of our country, and today as we mourn his passing.

President Mandela, whose clan name is Madiba, will be remembered by millions for many things.

As an activist for the last 30 years and as a health professional for past 25 years I salute Madiba and the African National Congress, which he has and will continue to be inextricably linked, for inspiring me to be become socially conscious, to be concerned about the less fortunate, and to understand the reasons why some people are poor and some are rich!

As a health professional, the first democratically-led government in South Africa (headed by Madiba), prioritized development through the Reconstruction and Development Plan (RDP) in which redistribution of wealth was prioritized. Within the RDP provision of health, education, and social services was prioritized as was provision of water and sanitation and housing. In 1996 access to health care for children under six years of age and pregnant women was made free at the point of care in the public sector (this was extended to people with disabilities in 1998). The social security system was extended ,and more poor children and women are able to access social support as well as cash transfers. Today 16 million needy South Africans have access to social assistance — just one of the many legacies of Madiba!

Madiba was vocal about the impact of HIV and AIDS on citizens of his beloved country. Even when others were silent about the disease, he announced that his son, Makgatho, died from HIV and asked all South Africans not to hide the disease but to treat it like any other disease. The Nelson Mandela Foundation has since its establishment, developed and implemented programmes on HIV, in particular community dialogues around HIV.

Given Madiba’s concern for women and children, it is not surprising that he established the Nelson Mandela Children’s Fund 1995 and the Nelson Mandela Children’s Hospital Trust in 1999. The Hospital will open in 2014 — such a pity that Madiba will not be at its opening. I am sure that the spirit of Madiba will be there to ensure that the hospital is indeed the world class facility he wanted it to be — to serve the children of Africa.

I was employed by the first Mandela government as a director responsible for establishing the district health system to strengthen the provision of primary health care. Since 2008 I have been responsible for ensuring the elimination of HIV and TB in our country and to ensure that mothers, children, and women’s health programmes are strengthened. I am inspired by Mandela’s commitment to humanity in my work every day. For this I thank this great humanist.

I will celebrate Madiba’s life and what he gave to South Africa and the world even as I mourn his passing. I will forever be in your debt, Tata, for teaching me to be compassionate and caring.

Rest in peace Tata!

Yogan Pillay is a senior management in the National Department of Health, South Africa. He worked for the Department of Health in various capacities since 1995 and is currently the Deputy Director General responsible for the HIV, TB and Maternal, Child and Women’s Health programmes in the National Department of Health. Together with Prof AE Birn and Dr T Holtz he co-authored the Textbook on International  Health, published by OUP.

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Mental health and human rights

By Michael Dudley and Fran Gale

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Natalya Gorbanevskaya at the balcony of the library “Russian abroad”, in front of the bell of the Church of Saint Nicholas the Wonder-Worker on Bolvanovka Street

On 29 November, Natalya Gorbanevskaya, Soviet dissident poet and translator, died in Paris. In August 1968, this mother of two was arrested, “diagnosed” with schizophrenia and underwent five years’ forcible psychiatric treatment at Moscow’s then-infamous Serbsky Institute. She famously protested in Moscow’s Red Square against the Soviet invasion of Czechoslovakia. Staging another Red Square protest on the 45th anniversary earlier this year, she and her companions were again detained.

Little is known of the current prevalence of psychiatric abuses globally. This is despite the notorious cases of the former USSR and Nazi Germany, among others, and notwithstanding episodic reports in recent times from China and former Soviet countries, and disturbing photographic images of appalling conditions for those in mental institutions and confined by their families or communities in developing countries (caging or chaining mentally ill people to prevent them wandering or self-harming is a well-known practice). Certainly mental health is covered by the UN Special Rapporteurs on Torture and the Right to Health — the former visiting all places of detention including mental health institutions — and is within scope for states reporting to and individuals informing the Committee on the Rights of Persons with Disabilities, and other UN conventions. Of even graver import than these examples however, are institutional abuses that induce mental illnesses; scenarios where governments knowing of these effects persist in such practices with impunity, often in defiance of UN reporting processes. The indefinite mandatory detention of asylum-seekers is one such example, and the Australian government is now an enduring, brazen offender.

Concerning coercion in psychiatry, treatment pressure is a daily reality for professionals consulted about life-threatening mental health problems where the patient’s judgment is reasonably thought to be impaired. For those who present with high levels of imminent risk mental health schedules may sometimes be unavoidable, but stigma and trauma constrain help-seeking by suicidal people — young people and young men in particular, but also various marginalised groups and suicide-bereaved people and suicide attempt survivors, who do not receive continuing treatment — and those who have been ‘burnt’ by the psychiatric system. There is some evidence that psychiatric — including compulsory — hospitalisation reduces suicide risk; however its hidden injuries have not been properly examined. The human rights message to doctors and others with powers of constraint: don’t admit, treat, seclude or restrain people against their will unless there is absolutely no less restrictive alternative. Explain decisions, work with patients and staff to maintain the patient’s control and to prevent hospital-induced trauma, explicitly inform patients of their rights and promote these, and actively support their decision-making wherever and as soon as possible.

Of equal concern with coercion, however, is abandonment. In conditions of structural and systematic neglect, many with severe mental disabilities no longer frequent asylums but prisons, which reinforce prejudice against those with mental disorder; or in parodies of liberty, drift outside institutional protection towards the fringes of society, homeless, destitute, disenfranchised, highly disabled, and without champions.

Human Rights Day 2013 – 10 December — marks twenty years since the Vienna Declaration and Programme of Action from the World Conference on Human Rights; and the establishment of the Office of the High Commissioner of Human Rights. As entitlements applying to everyone, and especially disadvantaged groups who require them to achieve their full potential, human rights have seen much implementation into common law since 1993, with enormous achievements in such domains as women’s rights, international law regarding human rights abuses, and the rights of many marginalized and/or disadvantaged groups. These latter have included indigenous people, lesbian, gay, bisexual and transgender people, migrants and refugees, trafficked people, contemporary slaves, migrant workers, child soldiers, older people, those with disabilities, and minorities in general. While the scope, feasibility and sometimes validity of rights are vigorously debated, governments that sign international human rights treaties participate in various recurrent reporting and review mechanisms. Arguably human rights are increasingly central to international relations.

Recently mental health has also enjoyed a new dignity in scholarship, international programs, mass media coverage and political debate. It has grown in prominence in the World Health Organisation and other international forums. The Movement for Global Mental Health (MGMH), which arose from a special 2007 series of articles in ‘The Lancet’ and from 20 years of research documenting the enormous health burden of mental disorders, not just in high income countries but in low- and middle-income countries, has called for scaling up treatments for mental disorders, protecting human rights, and increasing research in low- and middle-income countries. Since 2008, the trailblazing, inspiring WHO Mh-GAP program has undertaken this.

Prison Cell Block

But these latter developments are very recent, and mental disorders are late emerging from the shadows. The inevitable conclusion of any review of mental health and human rights is that the struggle for human rights over the last two centuries has largely bypassed the accounts of those injured by coerced psychiatric treatments, and even more significantly in terms of scope and numbers, the neglects of those suffering with mental disorders.

One in four people will experience a mental disorder in their lifetime, and about one out of five will receive treatment. This is true not only in high income but also low and middle-income countries (the latter finding surprised those first noting it). The impact becomes profound when combined with poverty, mass trauma and social disruption, as in many poorer countries. Most sufferers can be successfully treated through primary and community mental health services; however, the poorest countries have no plan and spend very little on mental health (their prevalence of treatment is as low as 2%). Middle-income countries spend 80% of their mental health budgets on mental hospitals that serve only 7% of patients. Thus the most deprived have the least access; and resources are scarce, inequitable or inefficiently applied. For instance, providing services to mentally unwell children and adolescents can often prevent lifelong disabilities; the investment needed is modest (US$3-4 per capita), and yet with current average spending at US $0.30 per capita, the proportion of children receiving service is much lower than adults. Mental health is moreover frequently absent from health and social policy-making and research, and from flagship global health initiatives such as the Millennium Development Goals. This is despite depression reportedly leading world causes of disability, and the prediction that mental illnesses will contribute 25% of the world disease burden in 20 years’ time, making them the most important illness category — more than cancer or heart diseases.

Unfortunately, comparing and contrasting the disease burdens of physical and mental disorders can be hazardous. It can obscure relationships between physical and mental disorders, and risk entrenching opposition between physical and mental health sectors and alienating mental health from global efforts to improve health and reduce poverty. Just as mental disorders increase risk for communicable and non-communicable diseases and for accidental and intentional injury, so many health conditions increase the risk for mental disorder. Co-morbidity complicates engagement, diagnosis, therapy and prognosis. As MGMH proclaims, “There is no health without mental health”. Therefore in existing health care systems, delivery of mental health care must be strengthened and barriers to this overcome.

Nevertheless, funding for physical disorders is vastly greater than mental disorders, which are undeniably ignored, unnoticed or untreated by comparison. Consider global HIV/AIDS (World AIDS Day was 1st December). HIV/AIDS and its associated stigma has provoked a strong engagement between health, mental health and human rights communities and has generated a sustained international effort to address it. HIV/AIDS mortality has been declining (1.6 million in 2012), new infections have been falling (despite some recent worrying reports of increases among adolescents), people accessing treatment have greatly increased (9.7 million in 2012), and funding has been steadily increasing (US $18.9 billion in 2012). By contrast, consider suicide, also associated with stigma, which has attracted no such global campaign. It globally accounts for about one million deaths per annum, this figure substantially rose in recent decades due to increases among the young, and a very substantial proportion of those dying by suicide do not access services. Suicide, with which mental illness has a well established causal link, is but one cause of premature mortality among those with mental disorders, which is also caused by cardiovascular, respiratory and malignant diseases. Since the physical health needs of mental health patients are frequently disregarded, the life expectancy gap has not closed in the last 20 years even in affluent countries.

The truth is that until very recently mental health and people with mental illnesses have been ignored locally, nationally and globally — even though the international community has prioritized human rights — because stigma and discrimination are widespread and we continue to act as if those suffering with mental illness are of less worth than others. Many countries do not have or have very outdated mental health legislation that severely disadvantages people with mental disabilities. Various countries retain legislation that outlaws suicide, thus preventing help-seeking by suicidal people and suicide bereaved people, who also often report dismissive attitudes from health professionals and adverse experiences of hospitalization and emergency departments, which compromise their assessment and follow-up.

The tide is turning. Earlier this year, MGMH and the World Federation of Mental Health established A People’s Charter for Mental Health. In May 2013, the UN Secretary General approved a WHO Action Plan for Mental Health. There have been calls for mental health to be included as part of the Sustainable Development Goals and mental disorders as one of the five major non-communicable diseases, for mental health to be represented on all disaster emergency committees, an urgent UN Assembly Special Session on Mental Health, and for the appointment of a Special Envoy/Rapporteur for Mental Health. The WHO mh-GAP intervention guide provides vital information for primary and secondary health providers on diagnosing and treating mental illness. apologies have been suggested to those who have been abused or mistreated by psychiatric services.

On the legal front, the Convention on the Rights of Persons with Disabilities (CRPD) has adopted a social definition of disability, has recognized the principle of autonomy with support, and has signalled the change from welfare to rights. The International Day for People with Disabilities, 3 December, is appropriate to remember this major shift, and the enormous changes especially but not only from consumer-led groups. Organisations working in countless settings now endorse the reality of survival and recovery for people with mental disabilities and suicidal people. At the international level alone, along with WHO and MGMH, we note the crucial work of the peak World Federation for Mental Health, and also the World Network of Users and Survivors of Psychiatry, Global Initiative for Psychiatry, Disability Rights International, Mind Freedom International and the Mental Disability Advocacy Centre, to name but a few. Their national, regional and local counterparts are phenomenal. In Australia we have seen the flowering of high quality, diverse e-mental health sites and services, plentiful mental health commissions, some excellent rehabilitation programs (e.g. RichmondPRA), and even comedians (WISE Stand Up for Mental Health) who tour to break down shame attached to mental illness.

To take seriously the rights of those with mental disabilities is to confront the ancient stigma attached to mental disorders, treatments, patients, carers and services. Yet the above account gives the lie to the belief that mental disorders happen to other people. They are everyone’s business. In a quest for recognition which embraces people from every conceivable walk of life, there is the insight that there is no health without mental health. Furthermore, in the evolution of the CRPD, it is people with disabilities who have affirmed that there is ‘Nothing About Us Without Us’. The CRPD teaches us all that disability is a part of the human experience, and part of our wholeness. To discover the rights of those of us with mental disabilities, will also be to discover respect for their experience of survival and their capacity to effectively illuminate what mental health is all about, for everyone.

Michael Dudley and Fran Gale, along with Derrick Silove, are co-editors of Mental Health and Human Rights, published by Oxford University Press.

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Image credits: Natalya Gorbanevskaya at the balcony of the library “Russian abroad”, in front of the bell of the Church of Saint Nicholas the Wonder-Worker on Bolvanovka Street © Dmitry Kuzmin via Wikimedia Commons; Prison Cell Block © Bob Jagendorf, Creative Commons License via Wikimedia Commons.

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The right to health: realizing a 65-year-old global commitment

By José M. Zuniga

A strong case can be made, based upon modern human rights concepts and international law, that the right to health, as well as health-related services, is a human right. However, this right has been far from fully realized in any country of the world, including those most affluent (e.g. the United States), even 65 years after the right to health was enshrined in the Universal Declaration of Human Rights (UDHR), whose adoption we annually commemorate on Human Rights Day.

The right to health is made explicit in the UDHR, which declares that:  “Everyone has the right to a standard of living adequate for the health and well being of himself and of his family, including medical care and the right to security in the event of sickness or disability.” The UDHR is not alone in articulating the right to health. The preamble to the World Health Organization (WHO) constitution states, “The highest attainable standard of health is one of the fundamental rights of every human being, without distinction of race, religion, political belief, economic or social condition.” And, the International Covenant on Economic and Social Rights outlines the steps governments should take to realize the right to health, calling upon them to create “the conditions which would assure to all medical service and medical attention in the event of sickness.”

There is nothing ambiguous in any of that language, or the right to health-related language in other covenants enumerating the rights of children, people with disabilities, and women. Yet, as unambiguous as we may think this codification in legally binding international and regional treaties may be, and despite the fact the ideal of a right to health has also been enshrined in many national constitutions, its “operationalization” by many countries, with very notable exceptions, has progressed at a glacial pace, often in fits and starts. Although it is clear that resource and other limitations make it impossible for any government to completely fulfill the right to health, particularly given current economic constraints, it is implicit that the realization of these rights is considered to be a matter of clear and steady progress toward that ideal.

The actual content, meaning, and appropriate methods to secure the fulfillment of the right to health thus requires interpretation at the community level, particularly because the human rights movement itself is based ultimately on people’s belief in rights as rights. Thus, it is only when rights are accepted as such, with legitimate societal consensus, that they have power. So, ultimately, the people must be diligent in understanding their rights while additionally holding their governments accountable for carrying out state-specific responsibilities. To the extent that people believe in them, rights achieve the cultural and social legitimacy that alone confers real power behind the concept of a human right. Therefore, without a strong belief in and commitment to the right, there can be no progress.

Where better to start than with a commitment to challenge the status quo of health as a privilege — fully aware of the difficulties, unavoidable complexities, and inherent conflicts in making such a commitment? We must therefore re-orient our societal discourse and stand behind a right that challenges the status quo of ongoing unnecessary suffering and hastened deaths by demanding the right to health for all people.

Declaring and then realizing the right to health will take more time, particularly because more than six decades since the UDHR adoption no country has fully met that ideal. But, in doing so and at a quicker pace, recognizing the urgent need created by millions of people afflicted by disease and ill-health, we will be reminded with whom we stand and why.

 José M. Zuniga is Co-Editor of Advancing the Human Right to Health (published this year by Oxford University Press), and he serves as President/CEO of the 20,000-member International Association of Providers of AIDS Care (IAPAC).

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Image credit: My Trusty Gavel. © Brian Turner. Creative Commons License, via Wikimedia Commons.

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The dawn of animal personhood

By Justin Gregg

Like furniture, animals are considered property in the eyes of the law; things that can be bought, sold, or disposed of when no longer wanted. Unlike a human (or a corporation), an animal is not recognized as a person under US law, and could never serve as a plaintiff in a court case.

This longstanding precedent, however, might be about to change.

The battle to establish animals as legal persons is being spearheaded by the Nonhuman Rights Project, under the leadership of Steven Wise. Wise is an attorney who teaches animal rights law at Harvard Law School, and is the author of four books on the subject. He has spent decades honing his arguments and assembling a team of influential legal and scientific minds to join his cause, including Jane Goodall (who sits on the board of directors of the Nonhuman Rights Project).

Wise and his team made history on 2 December 2013 by filing a writ of habeas corpus in Fulton County Court, NY on behalf of Tommy — a chimpanzee being held in tiny cement cage in the back of a used trailer lot in Gloversville, NY. In the event that someone is being held against their will, habeas corpus obliges that person’s captors to justify their actions in front of a judge. New York State permitted the writ of habeas corpus to be filed on behalf of slaves in the eighteenth century, allowing them to argue that they should be considered persons and not things, and should not be held against their will. Wise and his team will use the same approach, but this time arguing on behalf of Tommy.

But how are Wise and his team aiming to upset centuries’ worth of legal (and social) thinking that considers animals to be non-persons?

Young chimpanzees from Jane Goodall sanctuary of Tchimpounga (Congo Brazzaville). Photo by Delphine Bruyere, 9 December 2006. Creative Commons License via Wikimedia Commons.

According to Wise, some animals possess psychological characteristics that indicate that they are much more than just things. Animals like Tommy satisfy Wise’s criteria for practical autonomy – a measure of how sophisticated an animal’s cognitive abilities are in terms possessing a form of consciousness that allows them to act intentionally in order to fulfill their desires. Wise argues that species like chimpanzees, which are “cognitively similar to humans,” often display “sufficient practical autonomy to qualify them for basic liberty rights.”

In order to gain a foothold for this argument in the US legal system, Wise and his team have spent years researching which US states and jurisdictions would be most receptive to this kind of argument. The plan is to avoid the courts at the Federal level, and instead focus on common-law state courts, where a judge is not limited to interpreting statutes, but is free to make a ruling that is based on their personal interpretation of what is moral. In the event that a judge denies the petition, Wise and his team will be appeal the decision, which could land them in the New York State Court of Appeals. A ruling in favor of chimpanzee personhood in New York’s highest court would be the ideal outcome for Wise’s team.

Wise has been criticized by some in the animal rights and animal welfare communities for focusing on complex cognitive traits as the basis for rights. Critics point out that the ability to suffer — a product of a kind of sentience that is likely widespread in the animal kingdom — should be sufficient for granting animals freedom from bodily harm. Wise is clearly sympathetic to this argument, but adopts a pragmatic approach in suggesting that “the capacity to suffer appears irrelevant to common-law judges in their consideration of who is entitled to basic rights.”

The legal team’s filing is accompanied by affidavits from their scientific advisors highlighting the human-like cognitive abilities of chimpanzees as the basis for Tommy’s standing as a legal person. If the writ is granted and Wise and his team get their day in court, it will be the science of chimpanzee minds that will take center stage. Will Wise’s arguments for practical autonomy based on chimpanzee cognitive complexity sway the judge?

If Wise’s team is lucky enough to get the ruling they’ve fought so hard for, it might unleash a torrent of similar cases, and open a Pandora’s Box of legal and ethical questions.

How will subsequent judges deal with the assignment of personhood to a non-human animal by another court? Will it be a forgotten anomaly, or will it be the first drop in a flood of animal personhood rulings? How might the legal argument for practical autonomy change over time given the shifting sands of the science of animal minds? How will the various animal rights and animal welfare movements react to the ruling? What will the future look like for chimpanzees in the bio-medical, display, or entertainment industries if they become legal persons and not property?

These are unchartered waters.

Based on the legal and scholarly firepower at Wise’s disposal, the animal rights movement has never been as close to a victory as they are right now. Depending on the outcome of this upcoming case, this might well be the dawn of a new era for the animal rights movement.

Justin Gregg is the author of Are Dolphins Really Smart? The Mammal Behind the Myth, and is a research associate with the Dolphin Communication Project. He is also Co-Editor of the academic journal Aquatic Mammals. He received his doctorate from Trinity College Dublin in 2008, having studied social cognition and the echolocation behavior of wild Indo-Pacific bottlenose dolphins. With an undergraduate background in linguistics, Justin is particularly interested in the study of dolphin communication as it pertains to comparisons of human (natural) language and animal communication systems. Read his previous blog posts.

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An interview with marimbist Kai Stensgaard

By Scott Huntington

I was studying percussion at Western Illinois University in 2006, my life was forever changed by a guest musician named Kai Stensgaard. He entered the stage with confidence and began performing some of the most impressive and beautiful marimba pieces I had ever heard. Then he paused, attached a shaker to his leg, and picked up not two, not four, but six mallets. I was in awe as he skillfully played all six while using his leg to keep time. I immediately thought, “I need to learn how to do that.”

The next day in a small clinic, Stensgaard would in fact teach me his six mallet grip and show me some tips on how to play different six-mallet techniques. A whole new world of music opened up to me, and I was instantly hooked on the new skill and overwhelmed with the new possibilities of sounds that could be created. I spent the next few months learning all the six-mallet material I could get my hands on, as well as many other four-mallet pieces by the great Kai. He was truly an inspiration.

I recently caught up with Kai and had a chance to ask him a few questions about how he came up with the six-mallet grip, how he’s seen the marimba change over the years, and what he’s working on now.

When and why did you start playing marimba?

Kai Stensgaard: I started back in 1972 when I began studying percussion at the music conservatory. I immediately fell in love with the sound of the marimba. There was not very much to play … so I had to arrange some pieces myself. My teacher told me not to spend so much time playing the marimba, because I could not use it for anything. “Play the snare drum and the timpani,” he said.

How did you learn your six-mallet grip?

Kai Stensgaard: It started after a trip to Mexico and Guatemala in 1984. I saw a Maya Indian playing with six mallets, but without very much control. That gave me the idea, so back home I wrote Two Mayan Dances — two easy six-mallet pieces that I recommend for beginners.

Click here to view the embedded video.

What kind of benefits can you get from playing with six mallets? What are some drawbacks?

Kai Stensgaard: The benefit is 50% more sound. With six mallets, I am able to have my left hand play bass and chords, while my right hand plays melody. So the playing style becomes more piano-like than playing four mallets. It is easiest to play in keys like C, F, G major and D, E and a minor, because then you don’t have to use the black keys a lot.

One drawback is playing in keys with a lot of sharps and flats. I have been trying to explore more complex pieces in my new piece Hexagram. Here I am using most of the keyboard. I feel it is very important for a composer to write for six mallets, because he has to understand how to use the grip. So being a marimba player writing music is an advantage.

Have you seen six-mallet marimba playing becoming more popular in the last few years?

Kai Stensgaard: Yes, very much. It is growing very fast. We have at least 150 pieces written for six mallets. I think it will keep growing, but I only see it as an add-on to the four-mallet grip. It gives you new possibilities when playing.

In 2006, I was at a clinic where you taught me how to use your six-mallet grip. I was surprised at how easy it was to transition from four to six. Do you find that most people transition quickly, or do a lot of people struggle making the change?

Kai Stensgaard: Well, it varies a lot. Maybe it is easiest for people with relatively large hands. My grip is based on the Stevens Grip, and I feel it gives most control. Many people in Asia use a variation based on the traditional grip.

My all-time favorite piece to play is Spanish Dance. What was your inspiration behind that piece?

Kai Stensgaard: Spanish Dance is the very first piece I wrote many years ago. I was still studying and, at the same time, playing mallets in a Frank Zappa/Santana style band. The guitar player asked me to play a marimba solo for the next gig, but I was only playing some very contemporary pieces at that time and I did not feel that was good for the gig. I was very interested in Spanish Flamenco music, so after only one hour behind the marimba, I came up with Spanish Dance. Today it is great to see it played all over the world.

Click here to view the embedded video.

Tell me about your newest piece, Kais Mambo.

Kai Stensgaard: I wrote it as a follow up for Spanish Dance and a piece that does not ask for too much four-mallet technique. After writing quite complicated pieces for six mallets, I thought it would be good to write a piece for young players.

Click here to view the embedded video.

What tips do you have for players learning your music?

Kai Stensgaard: It is hard to give tips for it, because I feel that my pieces are not so difficult to play. Since they are written by a marimba player, it means that it is written in a marimba-logical way. Many of my pieces ask for improvisation, so it could be good to start learning how to improvise. If you do, you will love it. It gives a different view on playing. You will gain a kind of musical freedom and maybe start to write music. Many of my pieces start from improvised ideas.

What tips do you have for marimba players writing their own music?

Kai Stensgaard: Write what you like, and write music you enjoy. Try to come up with your own style. In the long run that will make you, as a marimba player, more interesting, because you are not a copy of other players. Today we have so many excellent players, so having your own style will help you get out playing.

You just got back from PASIC [Percussive Arts Society International Convention] 2013. Other than the tornados, how was it?

Kai Stensgaard: Yes, I ended up in the middle of tornados, but had no problems besides being delayed on my way back home. I was mainly at PASIC to demonstrate my new invention, the Aluphone. A lot of people know the instrument now and really like the sound. Composers are writing for it. This coming January Evelyn Glennie will do a world premiere of Anders Koppels’ new concerto for Aluphone. The soloist also plays the marimba. It is a great piece in five movements.

What projects are you currently working on?

Kai Stensgaard: I just finished a recording with my duo Calabash, saxophone and marimba. I have had that duo for more than ten years and really enjoy playing with a saxophone player. It will be on iTunes next week! In late January I will start a new project with a jazz drummer and a guitar player. Our trio will play our own compositions, not free jazz, but of course with some improvised parts. At the end of May, I will be performing in Taiwan at a huge percussion event arranged by Ju Percussion. It is going to be very exciting. Also, I will meet a great friend and six-mallet player Pei-ching Wu, so maybe we will do some 12-mallet playing!

Click here to view the embedded video.

Anything else you want to share? 

Kai Stensgaard: This summer I was judging marimba players in Italy at a Percussion Festival together with Marta Klimasara and Casey Cangeliosy. It was great for me to meet the new generation of extremely talented marimba players from all over the world. It was kind of a dream that came true — to watch how far the marimba has come.  When I started playing marimba, it was the very beginning of the development of the modern marimba. I believed in the marimba at that time, and now it has become a fantastic instrument and it has become accepted like the violin, cello, etc. – and that is great!

Scott Huntington is a percussionist specializing in marimba. He’s also a writer, reporter and blogger. He lives in Pennsylvania with his wife and son and does Internet marketing for WebpageFX in Harrisburg. Scott strives to play music whenever and wherever possible. Follow him on Twitter at @SMHuntington.

Oxford Music Online is the gateway offering users the ability to access and cross-search multiple music reference resources in one location. With Grove Music Online as its cornerstone, Oxford Music Online also contains The Oxford Companion to Music, The Oxford Dictionary of Music, and The Encyclopedia of Popular Music.

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Human Rights protection at the European Court

By Jonas Christoffersen

Let’s reform the European Court of Human Rights. Very few supporters of European human rights protection agree that we need to urgently reform the European Court. I am one of them. Unlike the very vast majority of human rights defenders, I fear that we will lose the hard earned political and public support behind human rights if we do not change the system.

The European Court of Human Rights has always balanced between law and politics. It has lived its life between faithful supports and cold critics. The supports have by far outnumbered the critics, but the 2012 Brighton Declaration is turning the tide. And rightly so in my mind.

Strasbourg-bashing is an old phenomenon, but the Brighton Declaration for the first time gathered a wide coalition of governments behind a true reform agenda seeking to change the power-balance between the Court and the States. The Court’s judgments are described as lacking in quality, coherence, consistency etc. The criticism is unfortunately well-founded and this is a dead serious problem.

The Contracting States have already prepared a 15th Additional Protocol to include in the preamble a totally superfluous reference to the principle of subsidiarity and the margin of appreciation and to expand the Court’s room to dismiss insignificant applications. The problem is not that the States adopt a silly reference to the margin of appreciation. The problem is that it is necessary.

Despite repeated political calls from the Council of Europe States, the Court has so far almost completely ignored its task of dismissing insignificant applications. The Court has fast-tracked a large number of significant applications, but the rest of the applications are sitting in piles without any real prospect of being handled within a foreseeable future.

The Court has done a great job in dismissing tens of thousands of ill-founded cases bringing the case-load down to some 110,000 cases. But the Court is to blame for its inaction in dealing with the core of the problem: too many cases fall within the scope of the Court’s current review. The Court has the instrument allowing it to control its docket in a much more strategic way, but the Court has failed to do so.

Strasbourg- European Court of Human Rights, picture by CherryX. Creative Commons License via Wikipedia Commons.

The Court apparently believes that it can solve the serious problem of a lack of human rights protection in Europe by keeping an open door to all applicants. The result is well-known: the case-load is strangling the Court, decreasing the quality of the judgments, and widely decreasing the legitimacy of the Court.

The Court identified the core of the problem more than ten years ago. The president in 2002, Luzius Wildhaber, said the following: “Is it not better for there to be far fewer judgments, but promptly delivered and extensively reasoned ones which establish the jurisprudential principles with a compelling clarity that will render them de facto binding erga omnes, while at the same time revealing the structural problems which undermine democracy and the rule of law in parts of Europe?”

Council of Europe governments seemed to agree and adopted Protocol No. 14 in 2004 giving the Court access to dismiss insignificant applications. In recent years, they have reminded the Court to use its new power and exploit the full potential of Protocol No. 14. This has not really worked and the governments have now pointed to a new future role for the Court: “…the Court should be in a position to focus its efforts on serious or widespread violations, systematic and structural problems, and important questions of interpretation and application of the Convention…”

Is anybody really against that? Well, this is only possible if a large proportion of applications are dismissed for no other reason than the limited institutional capacity of the Court. Yet, most parts of the “human rights environment” believe that the Court should keep its focus on the individual applicant and remain accessible to all individuals on an equal footing. Well, it might work in some WonderEurope, but it does not work any longer.

We need to take a step back and find a new way to effective human rights protection in Europe. The Court is in the process of breaking its neck trying to carry the burden of a hundred thousand individuals relying on the Court. It just cannot be done, and friends of the Court need to accept the cold reality of present day Europe. The Court can no longer continue down the same path.

Jonas Christoffersen is the director of Denmark’s National Human Rights Institution and the co-editor of The European Court of Human Rights between Law and Politics, published by Oxford University Press.

Oxford University Press is a leading publisher in international law, including the Max Planck Encyclopedia of Public International Law, latest titles from thought leaders in the field, and a wide range of law journals and online products. We publish original works across key areas of study, from humanitarian to international economic to environmental law, developing outstanding resources to support students, scholars, and practitioners worldwide. For the latest news, commentary, and insights follow the International Law team on Twitter @OUPIntLaw.

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Maps of the world

With Google maps and GPS instructions at the ready, it isn’t often that we step back to look at maps of the wider world. Long gone are the days when you had to flip open a physical map on your cross-country trip, to say nothing of the wealth of maps that exist today, from satellite imagery to geographic surveys, cityscapes to political maps. We present a few of the beautiful maps in the Oxford Atlas of the World to help us look at Earth in a different way.




Satellite Image of the Panama Canal
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Maps of town plans of St.Petersburg, Santiago, Sao Paulo, and Seoul
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Map of the Eastern Mediterranean
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Satellite Image of Rio de Janeiro, Brazil
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Map of the South Arabian Peninsula
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Maps of Rome and San Francisco
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Satellite Image of Europe
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Satellite image of Europe continued
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Map of Korea
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Maps of Jerusalem, Johannesburg, and Karachi
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Map of Northern Italy
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Satellite Map of London, United Kingdom
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Oxford’s Atlas of the World — the only world atlas updated annually, guaranteeing that users will find the most current geographic information — is the most authoritative resource on the market. The milestone Twentieth Edition is full of crisp, clear cartography of urban areas and virtually uninhabited landscapes around the globe, maps of cities and regions at carefully selected scales that give a striking view of the Earth’s surface, and the most up-to-date census information. The acclaimed resource is not only the best-selling volume of its size and price, but also the benchmark by which all other atlases are measured.

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US accountability for post-9/11 human rights abuses

By Dr. Robert H. Wagstaff

December is Human Rights month and the 10th of December is Human Rights Day. What better time for President Obama to fulfill his promise of actually closing Guantanamo Bay and to initiate an investigation of violations of human rights by the US government post-9/11?

The Rule of Law is clear

The UN Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) was signed by President Reagan on 18 April 1988 and ratified as a treaty by a two-thirds vote of the US Senate on 21 October 1994. The CAT provides that “No exceptional circumstances whatsoever, whether a state of war or a threat or war, internal political instability or any other public emergency, may be invoked as a justification of torture” (Art 2, § 2). And CAT Article 12 requires signatories United States and United Kingdom to “ensure that its competent authorities proceed to a prompt and impartial investigation, wherever there is reasonable ground to believe that an act of torture has been committed in any territory under its jurisdiction.” Article VI of the US Constitution provides that such treaties “shall be the supreme law of the land.”

Torture can never be justified as “a lesser evil”

Charles Fried, Harvard law professor and Solicitor General under President Reagan, agrees with his philosopher son Gregory Fried, that torture can never be justified and that it is never a “lesser evil.” The Frieds, co-authors of Because it is Wrong: Torture, Privacy and Presidential Power in the Age of Terror, assert that “the Bush administration broke the law in ordering torture, mocked the Constitution in its interpretation of executive authority, and outraged common decency.” They correctly maintain that “if we do not condemn, prosecute, punish the torturers and those who ordered them to torture, we become accomplices after the fact.” Gregory Fried argues for criminal prosecution now, and Charles Fried believes this is an option to consider but insists at a minimum “there should be an accounting, exposure and repudiation.” Instead, many US courts are shielding the perpetrators of abuse and torture with immunity, invoking the “state secrets” doctrine. The United Kingdom for its part is committed to conducting a public investigation as to what has occurred, and torture victim litigation seeking redress has been successful.

Detainees in orange jumpsuits sit in a holding area under the watchful eyes of Military Police at Camp X-Ray at Naval Base Guantanamo Bay, Cuba, during in-processing to the temporary detention facility on Jan. 11, 2002. The detainees will be given a basic physical exam by a doctor, to include a chest x-ray and blood samples drawn to assess their health. DoD photo by Petty Officer 1st class Shane T. McCoy, U.S. Navy. Public Domain via Wikimedia Commons.

The Constitution Project’s Task Force on Detainee Treatment

On 16 April 2013, a 577-page report on treatment of post-9/11 detainees was published by the nonpartisan independent organization, The Constitution Project. The 11-member bipartisan Task Force was co-chaired by two former congressmen, Republican Asa Hutchinson and Democrat James Jones. The report concludes that “it is indisputable that the United States engaged in the practice of torture” as official policy emanated from the highest levels of government, that is, President Bush, Vice President Cheney, Attorney General John Ashcroft, Secretary of Defense Donald Rumsfeld, and National Security Administration Advisor Condoleezza Rice. The report finds as a matter of fact that the interrogation methods violated not only international legal obligations, but also that there is “no firm or persuasive evidence” that torture produced any information that could not have been otherwise obtained. This torture was unjustified and has “damaged the standing of our nation, reduced our capacity to convey moral censure when necessary and potentially increased the danger to US military personnel taken captive.” The Task Force notes that never in the nation’s history has there been “the kind of considered and detailed discussions that occurred after September 11, directly involving a president and his top advisers on the wisdom, propriety and legality of inflicting pain and torment on some detainees in our custody.”

Specific written findings of the Task Force

US forces, in many instances, used interrogation techniques on detainees that constitute torture. American personnel conducted an even larger number of interrogations that involved “cruel, inhuman, or degrading” treatment. These actions violated US laws and international treaties. Such conduct was directly counter to the values of the Constitution and our nation.

 

The nation’s most senior officials, through some of their actions and failures to act in the months and years immediately following the September 11 attacks, bear ultimate responsibility for allowing and contributing to the spread of illegal and improper interrogation techniques used by some US personnel on detainees in several theaters.

 

There is no firm or persuasive evidence that the widespread use of harsh interrogation techniques by US forces produced significant information of value. There is substantial evidence that much of the information adduced from the use of such techniques was not useful or reliable.

 

Lawyers in the Justice Department’s Office of Legal Counsel (OLC) repeatedly gave erroneous legal sanction to certain activities that amounted to torture and cruel, inhuman or degrading treatment in violation of US and international law, and in doing so did not properly serve their clients: the president and the American people.

 

The United States has violated its international legal obligations in its practice of enforced disappearances and arbitrary detention of terror suspects in secret prisons abroad.

 

US officials involved with detention in the black sites committed acts of torture and cruel, inhuman or degrading treatment.

 

It is important for the United States to acknowledge its violations of the Rule of Law

These findings stand in stark contrast to the hollow protestations of those who claim that “torture works” and the inaction of the current administration. But most, if not all, of the foregoing has long been known. President Obama should have authorized the Constitution Project’s Report on Detainee Treatment and it should be carrying the presidential imprimatur. Task Force members believe that having as thorough as possible an understanding of what occurred during this period of threat—and a willingness to acknowledge any shortcomings—strengthens the nation, and equips it to better cope with the next crisis and ones after that. “Moving on” without such a reckoning forfeits the ability of the United States to claim it is a country which recognizes and follows the Rule of Law. Hopefully President Obama will use his constitutional authority and do what is right: close Guantanamo and officially investigate the Bush administration’s “enhanced interrogation techniques”.

Robert H. Wagstaff practices litigation and constitutional law from his law office in Anchorage, Alaska. He successfully argued two cases before the US Supreme Court, presented over 70 appeals, and tried numerous civil and criminal cases. He recently spent ten years at Oxford University earning three post-graduate law degrees including a Doctorate. He was formerly Alaska Bar Association President, Alaska Judicial Council member, and a member of the National Board of Directors of the ACLU, New York. He is the author of Terror Detentions and the Rule of Law: US and UK Perspectives.

Oxford University Press is a leading publisher in international law, including the Max Planck Encyclopedia of Public International Law, latest titles from thought leaders in the field, and a wide range of law journals and online products. We publish original works across key areas of study, from humanitarian to international economic to environmental law, developing outstanding resources to support students, scholars, and practitioners worldwide. For the latest news, commentary, and insights follow the International Law team on Twitter @OUPIntLaw

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Celebrating Human Rights Day

By Frances Astbury

On 10 December 1948, world leaders congregated at the United Nations General Assembly to affirm the principles which have remained at the very heart of the human rights movement for over six decades.

In adopting the Universal Declaration of Human Rights, the international community declared its commitment to the inalienable rights and fundamental freedoms of all human beings and to building a world where all people are “born free and equal in dignity and rights”.

Sixty-five years after the adoption of this momentous document, the international community comes together to celebrate Human Rights Day and reaffirm its commitment to the realisation of fundamental human rights for everyone, regardless of race, gender, nationality, sexual orientation, disability, ethnicity, or religion.

Human Rights Day this year has special significance as we also celebrate the 20th anniversary of the Vienna Declaration, which has led to massive advancements in the protection of human rights and has been described as “the most significant overarching human rights document produced in the past 40 years.”

The Vienna Declaration is celebrated for emphasising the universality, indivisibility, and interdependence of all human rights — the notion that the realisation of one right can enhance the enjoyment of other rights and that, conversely, the denial of one right can result in the abuse of numerous other rights.

The Vienna Declaration also established the importance of protecting economic social and cultural rights, such as the right to education, health, housing, and to take part in cultural life, as well as civil and political rights, such as the right to life, freedom from slavery and torture, and the right to liberty.

Following Vienna, the past two decades have seen significant advancements in the protection afforded to individuals under international law.

Violations of women’s rights have been explicitly recognised and the elimination of violence against women remains at the forefront of the international human rights agenda. The Declaration on the Elimination of Violence against Women, adopted in December 1993, recognises that violence against women violates women’s fundamental human rights and obliges states to work towards the eradication of violence against women, both in the public and private sphere. In 1994, the first Special Rapporteur on Violence against Women was appointed to work towards building a comprehensive and universal approach to the elimination of violence against women.

Huge advancements have also been made in the recognition of the human rights of people with disabilities. The 650 million people who have disabilities worldwide are no longer seen as objects of charity but as people who have a right to participate in all spheres of life on an equal basis with others.

Additionally, the increased protection offered to migrants and their families by the international framework is helping to advance the rights of an estimated 214 million people who currently live outside their country of origin.

In recent years, there have also been major advancements made in protecting the rights of indigenous people, most significantly through the landmark adoption of the United Nations Declaration on the Rights of Indigenous Peoples in 2007.

While these mark some of the greatest achievements in the advancement of human rights in the past 20 years, there are many more. Moreover, the body of international human rights law is constantly evolving and expanding to address emerging human rights issues such as the right to water, sanitation and food.

However, in celebrating the historic human rights instruments which have been adopted over the last six decades and the resultant advancements in the protection of human rights, we must remember to look at these documents not just as a reminder of past achievements, but as living documents which continue to guide our actions.

Many people around the world continue to live without basic liberties and experience fear everyday as a result. In spite of the advancements made by the women’s rights movement in the past two decades, women and girls worldwide continue to be married as children or forced to marry against their will, while others are refused access to education and participation in public life. Trafficking also remains a global crisis, exacerbated by its vast scale and hidden nature.

Hundreds of thousands of people have lost their lives in the fighting taking place in Syria. Two million refugees have been forced to flee their homes and join the 15.4 million refugees worldwide, with no guarantee of finding shelter, food or water. On top of this, recent reports describe the harassment refugees have often met on entering other countries in search of relief.

Despite huge strides made by the human rights movement in protecting the rights of migrant workers, many migrant workers continue to suffer from adverse working conditions and abuse at the hands of  their employers. This situation is exacerbated as migrant workers often have very limited, or no, access to justice.

While Human Rights Day provides an opportunity to celebrate the evolution and expansion of international law and the human rights movement, it also acts as an opportunity to bring human rights issues to the attention of the international community and promote the importance of continuing the fight to make human rights a reality for everyone. As Mary Robinson, United Nations High Commissioner for Human Rights, 1997-2002, reminds the world, “Human rights are inscribed in the hearts of people; they were there long before lawmakers drafted their first proclamation.”

Frances Astbury is the Publishing Assistant for Law Journals at Oxford University Press, working on the law journals list as support for the Senior Publisher. Frances studied Human Rights Law at SOAS, University of London prior to working for the Press and has previously taken part in projects with Femin Ijtihad to promote the advancement of women’s rights globally.

The 10th of December 2013 marks the 65th Human Rights Day! This year the theme is ’20 Years Working for Your Rights’. The day is marked both by high-level political conferences, meetings and by cultural events and exhibitions dealing with human rights issues. In honour of Human Rights Day this year, Oxford University Press put together a selection of Human Rights-related content ranging from journal and books articles across several disciplines to online products content from Oxford Bibliographies and University Press Scholarship Online.

Oxford University Press is a leading publisher in international law, including the Max Planck Encyclopedia of Public International Law, latest titles from thought leaders in the field, and a wide range of law journals and online products. We publish original works across key areas of study, from humanitarian to international economic to environmental law, developing outstanding resources to support students, scholars, and practitioners worldwide. For the latest news, commentary, and insights follow the International Law team on Twitter @OUPIntLaw.

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Tatiana Shchepkina-Kupernik, Anton Chekhov, and Moscow Tales

By Sasha Dugdale

Tatiana Shchepkina-Kupernik was a friend of the Chekhov family and a frequent visitor to Melikhovo, Anton Chekhov’s house just outside Moscow. I first read her prose when we were holding a autumn translation seminar in Melikhovo. The poet Marina Boroditskaya and I were wandering in the gardens by Chekhov’s little writing shed, and discussing short stories by Chekhov and his more neglected contemporaries. Marina mentioned ‘Transition’ as a possibility for Moscow Tales and I sought it out online straightaway.

It’s the story of an actress who lives an impoverished life on the fringes of Moscow’s theatrical society. Widowed with two small children, she relies on her theatre company retainer to keep the wolf from the door. She sees and understands the disgusted pity of the men around her (there’s a repetition of words like ‘disdain’ in the story, as if her decline had a foul smell). These men, former lovers and former fellow actors have been allowed to keep up the pretence of youth and charm whilst her looks have been spoilt by grief, poverty and hardship. She recognises the whole charade of theatre life but with an astonishing lack of bitterness or malice. All she needs is the small wage she receives for remaining in the company, and the culmination of the story, her fateful meeting with the theatre director is tremendously poignant. I was struck by Shchepkina-Kupernik’s portrait of a brave, clear-sighted, anti-romantic heroine, who knows her beauty is gone and is waiting for the inevitable fall.

Tatiana Shchepkina-Kupernik

There is something very particular about the description of the domestic interiors, the way in which the very furniture and textiles indicate a woman on the way down: the baby’s bottle; the stench of milk on the turn and supper boiling; the nappy flung over a mirror. These details are counterpointed by the meticulously observed domestic interior of another more successful actress, but one who is also on the point of tipping into unmarketable middle age. Nobody else has ever described this world and in quite this merciless way.

‘Transition’ is a modern story, it reminds me of twentieth-century prose and art (it has the feel of Virago prose), principally because it examines urban women’s lives with such a clinical eye, calculating the value placed on beauty and youth, and the terrible law of diminishing returns.

Tatiana Shchepkina-Kupernik was the great-granddaughter of a famous Moscow actor and part of Moscow’s world of theatre from her debut as a teenage actor. She went on to make her name as a translator for theatre, translating Rostand into Russian whilst still in her teens, Shakespeare, and Lope de Vega during her later life. She was surrounded by scandal: her long affair with the actor Lidia Yavorskaya was the stuff of Moscow gossip. The two women met together in the city’s hotels with others, including Chekhov, and there were rumours of orgies and wild parties. In 1894 the couple set off for Italy, where they briefly lived together openly.

Chekhov is perhaps the greatest short story writer in the Russian language and no anthology of Russian stories would be complete without him. I seized the nettle and translated two stories by Chekhov for my anthology. One of these, ‘Lady with a Little Dog’, needs no introduction. It is a singularly perfect thing, deeply atmospheric in an impressionist and painterly way and it contains so much wisdom about human affections that it becomes at points unbearable to read – and also to translate. The final scene is set in the sort of hotel Shchepkina-Kupernik might have used for her meetings with her lover, with suites of rooms for long-term stays, or short encounters. In this story it is the famous Slavyansky Bazar hotel, known now as the place where the Moscow Arts Theatre was conceived.

The other Chekhov story ‘Kashtanka’ needs more introduction. Although it is a compulsory school text in Russia it isn’t widely translated into English. Like Shchepkina-Kupernik’s story it inhabits the world of theatre and show, but seen through the eyes of a small fox-like dog who is left homeless and frozen and is rescued by an animal trainer and circus clown. It is a truly extraordinary story, thought-provoking and tragic, and Chekhov’s genius lies in the narrative tightrope he walks, allowing us to see things through a dog’s eyes, and yet revealing whole emotional worlds from this limited, low-level viewpoint.

I found out at Melikhovo that Chekhov was in fact a great dog lover. He particularly liked dachshunds (Kashtanka is part dachshund) and he had two of his own. He gave them magnificent medical names: ‘Quinine’ and ‘Bromine’, and clearly spent time wondering quite how they perceived a world in which sensual pleasures, cruelties and injustices, love and disappointment were almost indistinguishable.

British academic and translator Donald Rayfield has written on Shchepkina-Kupernik and I am grateful to him for the biographical details of her life.

Sasha Dugdale is the translator of Moscow Tales, a collection of tales set in Moscow, or with Moscow as a central theme or preoccupation. Tatiana Shchepkina-Kupernik and Anton Chekhov are just two of the writers included in the book. She has published three collections of her own poetry and two collections of Russian poetry in translation. She works with the Royal Court Theatre in London as an adviser on Russian New Writing and has translated over thirty plays from Russian. She lived in Moscow for five years in the 1990s and frequently returns there. She is currently editor of the magazine Modern Poetry in Translation.

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