Challenging Structural Racism and Violence in Policy and Practice for Indigenous Families Experiencing Homelessness

The gender-agenda is borderless. Arguably, legal justice for Indigenous girls and women survivors of violence is unfair, inequitable, and sometimes arbitrary. Systematic violence against girls and women pervades cultures and societies; operates at three main levels: institution and state, structural and cultural, and community and individual; and manifests in myriad shapes, forms and categories. Systematic violence in this research comprises historical, colonial and contemporary aspects of violence and its impact on Indigenous girls and women. Unlike comparative studies, this research is founded on heuristic arguments derived from validating the formation, establishment and continuity of the voices of Indigenous peoples in Liberia and Australia. While many studies isolate ‘gender-based violence’ and the ‘rule of law’ in separate contexts, none has explored the extent to which the Western concept of the rule of law impacts systematic violence against Indigenous girls and women in Australia and post-war Liberia. The research assesses the efficacy of the ‘rule of law’ in dispensing justice to Indigenous girls and women who have suffered systematic gender-based violence. The scope of the research demands a comprehensive and complex systematic empirical approach that draws on the principles of phenomenology, community-based participatory research, and feminist and Indigenous methods. The study adopts an interdisciplinary mixed-methods approach informed by theories of decolonization, feminist jurisprudence, intersectionality, critical legal/race studies, and social determinants of health. Data is drawn from case law, secondary data, empirical evidence, textual/content analysis, electronic mailing and informal participant observation. Over a period of two years, a survey of 231 social service providers working with Indigenous girls and women; in-depth interviews with 29 Indigenous Women Advocates; and 22 informal email exchanges with male colleagues were conducted in both Australia and Liberia. Statistical analyses were carried out on records of 127 708 convicts to Australia; 14 996 former slave returnees to Liberia; 2701 sexual and gender-based violence cases reported to the Ministry of Gender, Children and Social Protection in Liberia; seven case files from the Sexual and Gender-based Crimes Unit in Liberia; and 1200 interview entries from the Longitudinal Study of Indigenous Children in Australia. This analysis of historical documents, jurisprudence and case studies triangulates a philosophical inquiry intended to migrate issues of violence against Indigenous girls and women from the margins of complex socio-legal structures towards the core of Western-centric perspectives, such as the rule of law. Situated between dominant academic conventions and resistance, the research provokes readers to consider ontological, epistemological and ethical arguments regarding access to justice outcomes for Indigenous girls and women. Contrary to the research hypothesis and despite socioeconomic differences between Australia and Liberia, findings show that: although the principle of the rule of law is an emancipatory tool for justice and redress generally, it can also be an apparatus for persistent systematic violence against Indigenous girls and women. Furthermore, the intersection of colonial history, race, gender, class and social status exacerbates the ongoing perpetration of institutional/state, structural/cultural and interpersonal/community violence against Indigenous girls and women. In conclusion, the research recommends adopting a holistic approach to educating girls and women and encouraging boys and men to participate equally in the gender justice agenda, to ensure justice for Indigenous girls and women. The research also suggests incorporating diverse and comprehensive conceptual and methodological frameworks into further research. Finally, throughout the work, this dissertation attempts to give agency to Indigenous ways of being, knowing and doing justice.

BackgroundThere is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women’s experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women’s experience might be important for their health and differ from that reported in other studies of Australian women and menopause.MethodsA search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012.ResultsConsiderable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women’s experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women’s experiences of menopause identified.ConclusionsDifferences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia, the relative contribution of culture, social disadvantage and poor general health compared with non-Indigenous women to the experience of menopause is unknown. As such, further research and understanding of the experience of Indigenous women around Australia is needed. This information could assist individuals, families, cultural groups and healthcare providers to enhance management and support for Indigenous Australian women.

Indigenous advocacy groups and their allies continue to denounce violence against Indigenous women in Canada, emphasizing that the ongoing impacts of colonialism further sociocultural inequalities leading to violence. While various reports have shown that these women still face discrimination, few studies have investigated the experiences of this population in Quebec and examined the intersection of interpersonal and structural violence in their lives. This is an important area for exploration, as many governmental and non-governmental resources offered to survivors of violence are not adapted to the realities of Indigenous women. The aim of this article was to understand the violence and help-seeking experiences of Indigenous women from the Mi’gmaq community of Listuguj, in the Canadian province of Quebec. This partner-centered qualitative study explored the life narratives of ten participants from Listuguj to highlight the types of interpersonal violence endured and the barriers to their help-seeking process. In-depth individual interviews were conducted with nine women and one man who had experienced violence in any form. Transcribed interviews were coded and thematically analyzed. Findings show that participants understood the family and domestic violence experienced in relation to their kin, as they discussed intergenerational trauma and gender roles. Results also suggest that structural violence was a major barrier to obtaining support. This study has important implications for service delivery for Indigenous survivors of violence in Quebec and elsewhere, as it supports claims for the provision of culturally safe social, health and community resources.

Indigenous women and girls in Canada are at increased risk of experiencing any type of violence throughout their lives. This pressing public health issue is receiving growing attention as Indigenous communities and others across the country and internationally continue to demand respect for Indigenous women’s human rights to health, safety, and justice. To support their claims, we conducted a five-year partnered study with Indigenous and non-Indigenous non-governmental organizations in the Mi’gmaq community of Listuguj, in the province of Québec. Our objective was to better understand the violence and help-seeking experiences of women from Listuguj, and to initiate actions to improve services offered to Mi’gmaq violence survivors. Based on interviews with violence survivors and workshops with service providers, we created an intervention tool to increase the collaboration among service providers in Listuguj in their actions against violence. This study, the first to focus on the services sought by Mi’gmaq women in Québec, presents another account of the interrelations between interpersonal and structural violence in the lives of Indigenous women. Its partnered approach led to applied results that can be used by Indigenous partners to better meet the needs of violence survivors and their families in their community.

In 2020, the continuing murder of Black Americans by police officers received widespread media attention and sparked global outrage. Public health responses to these events focused on discrimination by police and structural racism in broader society. However, police violence is but one of many forms of racialized violence propagated by structural racism and anti-Black racism in particular. We aim to expand the current public health dialogue by describing how structural racism and structural violence are deeply interrelated; embedded in institutions, systems, and processes; and threaten health, safety, and well-being across the life course for racialized minority groups. Structural racism and structural violence are threats to health equity and anti-racist public health work.

This paper argues that feminicidal and sexual gender-based violence faced by Indigenous women in Guatemala and Canada is a cause and consequence of these states’ failure to effectively guarantee Indigenous women's intersecting socio-economic rights, namely their right to adequate housing. Exposing the historically-rooted, economic and political interests and investments of the two countries, this paper argues that Indigenous women's rights have been co-opted by legal violence in both contexts. Revealing the complicity of settler democratic states and the international human rights regime in sustaining these rights violations, this paper evidences Indigenous women's socio-economic marginalization, inadequate housing, and consequential feminicidal violence as the product of the gendered necropolitics of coloniality. Interrogating why and how these colonial genocidal structures sustain the subjugation of Indigenous women's bodies, this paper exposes how colonial genocidal structures have rendered Indigenous women illegible for protection under international human rights law. Highlighting a range of performative 1 attempts undertaken by the Guatemala and Canada to address the grave rights violations facing Indigenous women, this paper provides a feminist, decolonial framework that evidences why and how Indigenous women's experiences of socioeconomic marginalization, inadequate and unsafe housing, and the alarming rates of feminicidal and sexual gender-based violence continue to persist unabated.

Developing effective prevention programs for women living with HIV/AIDS hinges on understanding and responding to the myriad contexts in which women make sexual decisions. These include the challenges imposed on women by intersecting social inequities that can limit their relationship power, such as gender, racial/ethnic, and economic inequality. Existing behavioral research on the reasons why HIV positive women make sexual decisions is limited in scope, however, and current prevention programs posit male condoms as a panacea for HIV positive women's complex safer sex needs. This study explored HIV positive women's experiences of structural violence (oppression) and stress-related growth (growth from adversity) in order to understand better the context of their sexual practices. Methods: The participants included 24 women living with HIV/AIDS who attended skill and peer support groups that were part of the Protect and Respect program. The women were predominantly Black (83%), reported earning less than $10,000/year (80%) and reported acquiring HIV through sex with a male partner (58%). I transcribed 30 group sessions verbatim, editing for clarity only; entered the transcripts into Atlas.ti.5.2, a qualitative software analysis package; and employed analytic strategies of grounded theory and narrative analysis to explore women's structural violence and stress-related growth experiences. Results: Structural violence manifested in the women's lives in three primary ways: (1) daily and overwhelming stress; (2) AIDS related stigma; and (3) unhealthy and violent relationships. The women associated these experiences with emotional pain, suffering and substance use. In addition, the participants responded to these challenges through their examples of: (1) stress-related growth; (2) resilience; and (3) resistance. Conclusions: Women's experiences with structural violence and stress-related growth revealed their barriers and facilitators to having safer sex and suggested that traditional HIV prevention interventions for women living with HIV/AIDS fail to account for women's challenges and their strengths. The analysis of women's experiences with structural violence revealed that women have fundamental health and safety challenges that must be addressed in order for them to be able to have safer sex. The analysis of women's stress related growth experiences revealed that women possess various strengths that are ignored in current HIV prevention programming, but that women associate with their health and ability to have safer sex. These findings suggested that interventions that are not grounded in women's experiences may do more harm than good by instructing women to engage in behaviors that are unrealistic or harmful in the context of their challenges (e.g., condom use in violent relationships), reinforcing women's sense of powerlessness, and obscuring the root causes of and solutions for women's sexual risk practices. I discuss the theoretical, practical, research and methodological implications of these findings, all of which focus on the significance of holistic and multi-leveled prevention strategies for women and addressing the precursors that facilitate or hinder safe sex in prevention programs for women, and not just condom use.

The extension of academic censorship on Palestine to the medical world is, despite its pervasiveness, relatively unknown. In the latest iteration, a letter highlighting the Gaza Strip's vulnerability to the Covid-19 pandemic was removed from The Lancet's website after a swift pressure campaign. While the immediate effects were minimal — despite its short shelf-life, the piece is among the top 5% most discussed research publications11 "Overview of attention for article published in The Lancet, March 2020: Structural violence in the era of a new pandemic: the case of the Gaza Strip," Altmetric, https://www.altmetric.com/details/78453242. — the chilling effect of such campaigns on writers and editors is profound and enduring. This commentary outlines the struggle to make space for discussion and academic inquiry into the health impacts of the ongoing suffering inflicted on the Palestinian people. As Palestinians marked Land Day on March 30,22 Yara Hawari, "Commemorating Land Day amid lockdown in Palestine," Al Jazeera, March 30, 2020, https://www.aljazeera.com/indepth/opinion/celebrating-land-day-lockdown-palestine-200329162501923.html. The Lancet, one of the world's oldest and most prestigious medical journals, silently removed from its website a commentary that was published three days prior.33 The original piece is still available from ScienceDirect at the following link: David Mills, et al., "Structural violence in the era of a new pandemic: the case of the Gaza Strip," The Lancet, March 27, 2020, https://www.sciencedirect.com/science/article/pii/S0140673620307303#!. At just over 400 words, "Structural violence in the era of a new pandemic: the case of the Gaza Strip," draws on the deep historical and political forces that have rendered the Palestinian people in the Gaza Strip particularly susceptible to an impending Covid-19 outbreak. Mirroring numerous warnings that continue to be published elsewhere, including a statement by 20 Palestinian, Israeli, and international health and human rights organizations,44 Adalah – The Legal Center for Arab Minority Rights in Israel, et al., "Palestine: a possible COVID-19 epidemic in the Gaza Strip," Medecins Du Monde, April 8, 2020, https://www.medecinsdumonde.org/en/news/moyen-orient/2020/04/08/palestine-possible-covid-19-epidemic-gaza-strip. our commentary highlights the impact of pandemics on "populations burdened by poverty, military occupation, discrimination, and institutionalised oppression." Its critical tone is consistent with other Lancet commentaries targeting various national and global responses to Covid-19.55 Richard Horton, "Offline: COVID-19 and the NHS—"a national scandal"," The Lancet 395, no. 10229 (2020): 1022 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30727-3/fulltext; Sarah L. Dalglish, "COVID-19 gives the lie to global health expertise," The Lancet 395, no. 10231 (2020): 1189; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30739-X/fulltext. While hoping the swift removal was just a technical error, our experience working on Palestine made us suspect otherwise. A hint came via the elated tweet of a Canadian endocrinologist who had been involved in prior efforts to censor scholarship connecting Israel's occupation and human rights abuses to Palestinian health outcomes. The next day we understood the impetus behind the commentary's sudden disappearance: a message had been circulated to the scientific community in the United States (and beyond) calling — ironically, given the hostility to similar boycott calls directed at Israel — for a boycott of The Lancet for publishing the piece. To understand The Lancet editorial staff's swift decision to remove the commentary, we need to go back to 2014. At the height of Israel's large-scale military assault on the Gaza Strip, The Lancet published "An open letter for the people in Gaza,"66 Paola Manduca, "An open letter for the people in Gaza," The Lancet 384, no. 9941 (2014): 397–398; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61044-8/fulltext. setting off an aggressive years-long campaign with demands that both the open letter and the editor-in-chief be removed. Neither occurred after a thorough review by The Lancet ombudsman. The controversy culminated, however, with five 2017 Lancet Series papers designed to "outline Israel's achievements in health and health care."77 "Health in Israel," The Lancet, May 8, 2017, https://www.thelancet.com/series/health-in-israel. While the papers commemorated one of the world's most efficient healthcare systems,88 Lee J. Miller and Wei Lu, "These are the economies with the most (and least) efficient health care," Bloomberg, September 19, 2018, https://www.bloomberg.com/news/articles/2018-09-19/u-s-near-bottom-of-health-index-hong-kong-and-singapore-at-top. missing was any discussion of Israel's institutionalized oppression over the Palestinian people that leaves millions without the ability to develop or even access similarly exemplary healthcare. Indeed, the authors of the introductory piece of the series decided to "not comprehensively address historical or political issues, except when directly pertaining to health,"99 A. Mark Clarfield, "Health and health care in Israel: an introduction," The Lancet 389, no. 10088 (2017): 2503–2513; https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30636-0/fulltext. as if there were any other comparably important factors determining the stark health (and other) inequities between Israeli-Jewish and Palestinian inhabitants of the region.1010 Ido Efrati, "Huge disparities between Israeli, Palestinian health-care [sic] systems, says rights group," Haaretz, January 10, 2015, https://www.haaretz.com/.premium-huge-disparities-between-israeli-palestinian-health-care-1.5358335; "Concluding observations on the combined seventeeth to nineteenth report of Israel," Committee on the Elimination of Racial Discrimination, December 12, 2019, https://tbinternet.ohchr.org/Treaties/CERD/Shared%20Documents/ISR/INT_CERD_COC_ISR_40809_E.pdf. The aftermath of the publication of the 2014 letter explains how The Lancet, a high-profile outlet courageously and almost uniquely willing to cover the political and historical forces impacting Palestinian health, came to publish an entire edition—perhaps the most prominent example of "healthwashing"—that sweeps these defining issues under the rug. "An open letter for the people in Gaza" denounced Israel's 2014 military assault on the besieged Gaza Strip, highlighting the widespread killing and severe injury of Palestinian civilians, including children. Noted was the extraordinary loss of infrastructure, leaving more than 100,000 people homeless,1111 "4.5 years after Israel destroyed thousands of homes in Operation Protective Edge: 13,000 Gazans still homeless," B'Tselem, March 3, 2019, https://www.btselem.org/gaza_strip/20190303_13000_gazans_homelsess_since_2014_war. and the dramatic impacts of Israel's ever-tightening blockade on access to essential medicines, food, and potable water. The authors criticized the complicity of third states, as well as that of Israeli health professionals who failed to speak out against this massacre.1212 Ido Efrati, "Israeli docs mobilize against anti-Israel letter in The Lancet," Haaretz, July 28, 2014, https://www.haaretz.com/docs-target-anti-israel-letter-in-the-lancet-1.5257147. Precisely the same complicity was noted in a Lancet editorial following Israel's 2008–2009 military assault on the Gaza Strip.1313 "The medical conditions in Gaza," The Lancet 373, no. 9659 (2009): 186; https://www.thelancet.com/jour-nals/lancet/article/PIIS0140-6736(09)60049-0/fulltext. The journal's editors deplored the "silence of national medical associations and professional bodies worldwide in response to this destruction and dislocation of health services," singling out medical association leaders, who "through their inaction, are complicit in a preventable tragedy that may have long-lasting public-health consequences not only for Gaza, but also for the entire region." Within a context of pervasive Israeli impunity,1414 "Resolution adopted by the Human Rights Council on 22 March 2019," UN Human Rights Council, April 3, 2019, https://documents-dds-ny.un.org/doc/UNDOC/GEN/G19/096/44/PDF/G1909644.pdf?OpenElement. the 2009 and 2014 Lancet statements were — and remain — bold calls for action. Each historical juncture was accompanied by an expectation that now, finally, the world should stand up and address the root causes prolonging the injustice and suffering of the Palestinian people. While this ultimately did not occur, The Lancet offered readers the option of adding their signatures to the 2014 letter;1515 "Smear campaign against The Lancet's "Open Letter" on crimes against humanity in Gaza," Global Research News, April 19, 2015, https://www.globalresearch.ca/smear-campaign-against-the-lancets-open-letter-on-crimes-against-humanity-in-gaza/5443762. tens of thousands did so, signaling that a chord of outrage had been resonantly struck. But the extremeness of Israel's military actions in the summer of 2014 did not dilute the potency of the reactionary outcry from its defenders the world over. The response to The Lancet letter took two main forms. First, there was a slew of letters and email invective launched at The Lancet, generally, and at the journal's editor-in-chief, Richard Horton, in particular. And not just Horton, who was vilified as an anti-Semite with a photo of a uniformed Nazi conjoined to his.1616 Ido Efrati, "After accusing Israel of war crimes, Lancet medical journal devotes entire issue to Israeli health care," Haaretz, May 10, 2017, https://www.haaretz.com/israel-news/lancet-devotes-whole-issue-to-israeli-health-care-1.5470008. The verbal abuse extended to his wife and school-age daughter, reminiscent of the vicious personal attacks on Judge Richard Goldstone following the 2009 release of his United Nations Fact Finding Mission report on the Gaza conflict, which included an attempt to ban him from attending his own grandson's bar mitzvah at a synagogue in Johannesburg.1717 Akiva Eldar, "What exactly did Goldstone 'retract' from his report on Gaza?" Haaretz, April 11, 2011, https://www.haaretz.com/1.5150611. The harassment of medical editors who publish material critical of Israel's policies and actions long predates the modern siege on the Gaza strip. In 1981, the editor of World Medicine, Michael O'Donnell, was targeted in a similarly aggressive campaign, ultimately leading to his dismissal and even the dissolution of the journal. What O'Donnell makes clear in his 2009 chronicling of the 1981 attacks, is that these are not spontaneous outcries of protest, but carefully orchestrated lobbying campaigns designed to obscure the truth about Israel's systematic denial of Palestinian rights. The goal is not only to silence editors but to inhibit would-be writers, many of whom reasonably fear professional and personal consequences. "The technique has endured for decades because it is effective," O'Donnell writes,1818 Michael O'Donnell, "Commentary: standing up for free speech," British Medical Journal 338 (2009): a2094; https://www.bmj.com/content/338/bmj.a2094?ijkey=a750758b30f7cd89d23d514cec8fb8d995e8475d&keytype2=tf_ipsecsha. and if this reemergence in 2020 has any lasting significance, it will be to test and challenge whether this remains so. The second type of response to the 2014 letter came in the form of tacit mobilization of powerful interests to limit free speech on the health impacts of Israeli policies and practices. These tactics are by now well-known outside the medical world,1919 Ben White, "Delegitimizing Solidarity: Israel Smears Palestine Advocacy as Anti-Semitic," Journal of Palestine Studies 49, no. 2 (2020): 65. https://online.ucpress.edu/jps/article/49/2/65/107373/Delegitimizing-Solidarity-Israel-Smears-Palestine?searchresult=1; "UN rights experts denounce Israel's growing constraints on human rights defenders," OHCHR, March 3, 2017, https://documents-dds-ny.un.org/doc/UNDOC/GEN/G19/150/38/PDF/G1915038.pdf?OpenElement. falling within the broader context of concerted efforts led by the Israeli government to outlaw Palestine solidarity and delegitimize human rights defenders, organizations, and activists who challenge Israel's abuses and seek justice and accountability.2020 "Israel / Occupied Palestinian Territory: ongoing smear campaign against Al-Haq staff members Mr. Shawan Jabarin and Ms. Nada Kiswanson," International Federation for Human Rights, November 10, 2017, https://www.fidh.org/en/issues/human-rights-defenders/israel-occupied-palestinian-territory-ongoing-smear-campaign-against. In January of 2015, explicitly identifying the 2014 letter to The Lancet as the motivator,2121 "ADA/AACE/EASD/TES Statement in Response to a Recently Published Letter to the Editor in The Lancet and an Editorial Addressing the Israeli-Palestinian Fighting in Gaza," PR Newswire, November 3, 2014, https://www.prnewswire.com/news-releases/adaaaceeasdtes-statement-in-response-to-a-recently-published-letter-to-the-editor-in-the-lancet-and-an-editorial-addressing-the-israeli-palestinian-fighting-in-gaza-281311631.html. the Presidents of the American Diabetes Association, the European Association for the Study of Diabetes, the American Association of Clinical Endocrinologists, and the Endocrine Society, as well as the editors-in-chief of eight diabetes and endocrinology journals, issued a statement of principle that proclaimed "our respective journal will refrain from publishing articles addressing political issues that are outside of either research funding or health care delivery."2222 "Statement of principle," American Diabetes Association, Diabetes 64, no. 1, (2015): 311; https://diabetes.diabetesjournals.org/content/64/1/311.full-text.pdf. Leaving aside the oddness of diabetes professionals' unwillingness to publicly tackle the political factors that drive the disease in which they specialize — a position even more untenable as the Covid-19 pandemic exposes the political underpinnings of health with drastically inequitable infection and mortality rates2323 Zeeshan Aleem, "New CDC data shows Covid-19 is affecting African Americans at exceptionally high rates," Vox, April 18, 2020, https://www.vox.com/coronavirus-covid19/2020/4/18/21226225/coronavirus-black-cdc-infection. — an ethical question lingers here. Should physicians and scientists be permitted to publicly narrate the historical, structural, commercial, social, and political forces that lead to avoidable death, illness, and suffering? Given the clear link between these forces and ill health, and the consensus that ignoring them leads to worse outcomes,2424 Seth M Holmes, et al., "Misdiagnosis, Mistreatment, and Harm - When Medical Care Ignores Social Forces," The New England Journal of Medicine 382, no. 12 (2020): 1083–1086; https://www.nejm.org/doi/full/10.1056/NEJMp1916269. might it not be their duty, in fact, to do so? Such questions recall Edward Said's influential 1984 paper, "Permission to narrate,"2525 Edward Said, "Permission to Narrate," London Review of Books, February 16, 1984, https://www.lrb.co.uk/the-paper/v06/n03/edward-said/permission-to-narrate. in which he juxtaposes the historically uncontested facts of Israeli aggression during the 1982 Lebanon War with the perception in Western media that Palestinians were the primary wrongdoers and agents of violence. "Sequence, the logic of cause and effect as between oppressors and victims, opposing pressures—all these vanish inside an enveloping cloud called 'terrorism,'" Said notes. The narrative is distorted beyond recognition, and "there is every chance that ignorance about Israel's attitude towards Palestinians will keep pace with sustained encomia on Israel's pioneering spirit, democracy and humanism." Particularly when silencing comes within the context of prolonged violations of international law and institutionalized impunity,2626 Jonathan Cook, "Israel is silencing the last voices trying to stop abuses against Palestinians," Mondoweiss, November 12, 2019, https://mondoweiss.net/2019/11/israel-is-silencing-the-last-voices-trying-to-stop-abuses-against-palestinians/; "Israel: Supreme Court Greenlights Deporting Human Rights Watch Official," Human Rights Watch, Press Release, November 5, 2019, https://www.hrw.org/news/2019/11/05/israel-supreme-court-greenlights-deporting-human-rights-watch-official. medical journals have a heightened responsibility to narrate facts within what Said describes as a "socially acceptable narrative to absorb, sustain and circulate them."2727 Edward Said, "Permission to Narrate," London Review of Books, February 16, 1984, https://www.lrb.co.uk/the-paper/v06/n03/edward-said/permission-to-narrate. In order to avoid the primacy of ideology over scientific inquiry, publishers must allow for pertinent critique of powerful entities, including states, a willingness Richard Horton has demonstrated frequently during his tenure at The Lancet.2828 Richard Horton, "Offline: COVID-19 and the NHS—"a national scandal,"" The Lancet 395, no. 10229 (2020): 1022. https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2930727-3; Yair Amikam, "The Palestinian Medical Crisis: An Exchange," The New York Review of Books, June 14, 2007, https://www.nybooks.com/articles/2007/06/14/the-palestinian-medical-crisis-an-exchange/. With the systematic silencing of voices critical of Israel's violations and refusal to acknowledge a Palestinian counter-narrative, a perspective that highlights the primacy and consequences of Israeli aggression will seem outrageous to many, in 2020 as much as in 1982 or in the aftermath of Palestinian expulsion during the Nakba ("catastrophe") of 1948. In prominent medical journals, Palestinian health narratives feature infrequently. When surveying the literature, the most prominent medical journals in the United States have only one mention of Palestine for every 20 mentions of Israel, compared with a still lopsided one-to-four ratio for leading medical journals in the United Kingdom.2929 Mads Gilbert, "Publication Patterns on Occupied Palestine in Four Key Medical Journals 1990–2016: A Descriptive Study," The Lancet 391 (2018): S24. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)30390-8/fulltext. While one could argue that this reflects a lack of research production from Palestine, which would require its own thoughtful explication, our experience—both recent and historic— suggests this represents a refusal of academic space for those who challenge dominant, ideologically-motivated health narratives. In its willingness to elide uncomfortable historical and political realities,3030 Gideon A. Paul, et al., "A Call for Academic Medicine to Remain Politically Neutral," The Lancet 393, no. 10183 (2019): 1806. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30027-3/fulltext. the medical association-sponsored silence on Palestine confirms this suspicion, implying a penchant for ideology rather than pursuit of truth in approaches to understanding health. What else could motivate a statement promoting censorship of the root causes of disease? Tellingly, the physicians and scientists who pounced on The Lancet following the publication of our latest piece didn't bother to submit a reasoned reply for the journal's consideration, perhaps because some had already declared "victory" in the journal's pages last year. In a triumphant letter,3131 Julio Rosenstock, et al., "Bringing Closure: Towards Achieving a Better Understanding of Israel," The Lancet 394, no. 10198 (2019): 559. https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(19)31760-X.pdf. ironically political given it was led by a board member of the American Diabetes Association (who is also an associate editor of a journal involved in the aforementioned statement of principle),3232 "Statement of principle," American Diabetes Association, Diabetes 64, no. 1, (2015): 311. https://diabetes.diabetesjournals.org/content/64/1/311.full-text.pdf. the authors celebrated the success of their self-described "sanctions" against The Lancet. Remarkably, when asked whether their boycott of The Lancet weakened the case against boycott of Israel, one of them said, "We had no other option."3333 Peter Kohn, "Pro-Israel doctors end dispute with The Lancet," Australian Jewish News, August 15, 2019, https://ajn.timesofisrael.com/pro-israel-doctors-end-dispute-with-the-lancet/. In addition to the proven historical efficacy of the systematic bullying and censorship touted and euphemized in their letter, there is another plausible reason for avoiding academic debate on our commentary's claims. It is almost certain that none of those lashing out at the journal, neither in 2014 nor today, have meaningful experience living with Palestinians or working on health and human rights in Palestine. On which other topic are the inexperienced and unequipped allowed such sway in the worlds of science and health? And if, despite the experiential gap between us, they wish to press on, shouldn't they have to do so with the same platform available to us—that of reasoned discourse? This isn't just an ivory tower discussion on academic freedom. If the scientific and medical communities refuse to take a strong stand on censorship, bullying, and aggressive lobbying campaigns aimed at silencing academic journals, the well-deserved fear of even the most sympathetic editors—who deserve our staunch solidarity—will allow for the continued erasure of Palestinian health facts, voices, narratives, and experiences. In "Structural violence in the era of a new pandemic: the case of the Gaza Strip," we that violence in historical, and health and that the and response to disease At a when Palestinians are exceptionally susceptible to the Covid-19 the of this ongoing silencing campaign could not be are in the and medical and scientific communities of should that of censorship must be not

In Chiapas, Mexico’s poorest state, indigenous Maya women are twice more likely to die in childbirth than are nonindigenous women. To comply with international development goals and diminish Chiapas’ high maternal mortality rates, indigenous midwives are trained in detecting risk factors in pregnancy and birth, while women are encouraged to give birth in hospitals. This chapter analyzes the consequences of such policies, which might unintentionally exacerbate the structural violence indigenous women face in their lives. In Chiapas, 74.7% of the population lives in poverty and extreme poverty, compared to the national 43% rate. This extreme poverty, the lack of infrastructure, and engrained racism are all factors reproducing violence in the lives of poor women. In the state, the maternal mortality rate of women in reproductive age group has increased between 2010 and 2013 and that of indigenous women has almost doubled (1.7 times) over the same time period. Using an anthropological approach, this chapter examines the institutional and cultural changes in childbirth practices that are occurring in Highlands Chiapas and sheds a light on the structural factors that expose Mayan women to unsafe births, increasing the likelihood that they will suffer mistreatment in childbirth.

As indigenous people, indigenous women are ensured the rights enshrined most explicitly in the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) (2007). The UNDRIP represents globally endorsed minimum standards and an important normative framework of the rights of indigenous peoples founded on international human rights law. As women, indigenous women are assured the rights contained most notably in the Convention on the Elimination of All Forms of Discrimination against Women (the Women’s Convention) (1979). In spite of these two key international human rights instruments, however, indigenous women’s rights remain an overlooked issue both at international and local levels.This chapter examines whether the international indigenous human rights discourse adequately addresses the rights of indigenous women. Are indigenous women’s rights protected in international law? The chapter begins with a consideration of the Declaration on the Rights of Indigenous Peoples and the work of the Permanent Forum on Indigenous Issues. It then examines feminist critiques of the human rights law and how these analyses may have relevance to advancing indigenous women’s rights. Feminist legal scholars have argued that the international human rights framework has either neglected or failed women and their rights. The chapter asks whether the indigenous human rights discourse reproduces and perpetuates similar exclusions and hierarchies toward indigenous women that international law is regarded to maintain toward women in general. In conclusion, the chapter considers the Zapatista Women’s Revolutionary Law as an example of an explicit expression of indigenous women’s rights developed by grassroots indigenous women. It juxtaposes it to the UNDRIP, asking the question how the Declaration would have been different had it taken the Revolutionary Law seriously and therefore, contributing to a fuller and more effective recognition of indigenous women’s rights in the international human rights discourse.

(Re)assessing Clinical Spaces: How do we Critically Provide Mental Health and Disability Support and Effective Care for Black and Brown Young People who are Impacted by Structural Violence and Structural Racism?

This article examines state racism and structural violence inflicted upon Eritrean and Sudanese asylum seekers in Israel by surveying various exclusionary policies and their harmful effects. It situates exclusionary state practices of migration control in Israel’s racialized social dynamics, contextualized in Israel’s origins as a settler society and subsequent national ordering. Israel’s treatment of African asylum seekers is conceptualized as structural violence through an examination of unnecessary, preventable, or avoidable harms that were differentially inflicted upon this distinct, racialized migrant group both directly and indirectly. Claims in the article are based on ethnographic research conducted with asylum seekers who had been detained in Israel’s Holot detention facility. In contrast to Israel’s purported adherence to international commitments to human rights, including asylum protections, understanding asylum seekers’ destitution through the lens of structural violence enables us to place the onus and responsibility for human suffering upon the state.

This study investigates the perception of body image among indigenous women in Peninsular Malaysia. Using a sample drawn from urban (n=38) and rural (n=21) settings, the study engages participants who are more or less socio-economically acculturated to mainstream society in order to explore different attitudes to body image, and anxiety level about social physique between rural and urban women. Rural indigenous women registered a higher level of body dissatisfaction than their urban counterparts. However, there was no significant difference in attitudes towards body image between indigenous women in both locations. Due to a degree of presumed acculturation to western ideals of body image, urban indigenous women who were not underweight showed a higher anxiety level concerning their physique than those from rural areas with a similar body size. It was also found that a higher level of body dissatisfaction correlated with a poorer body image among indigenous women in Malaysia.

Women represent a large part of the 2.5 billion people who depend on lands managed through customary, community-based tenure systems and are especially reliant on commons for their lives and livelihoods. They have very often limited and unsecured access to land and natural resources and tend to be excluded from decisions concerning them. Far from representing a homogenous group, they face varying challenges that are the result of multiple and intersecting forms of discrimination, whereby gender dynamics intersect with other characteristics, such as age, disability, ethnic origin, or socioeconomic status. Peasant and indigenous women, in many instances, face the compounded impact of the lack of recognition and violation of the collective rights of their communities, which is often the legacy of histories of colonization, conquest, dispossession and discrimination, and patriarchal norms, exacerbated by neoliberalism and the commodification of land and natural resources. The nexus between individual and collective rights is one of particular importance, but has received limited attention, including as regards the gendered effects of human rights violations of collective rights. In the present article, the nexus between collective and individual rights of peasant and indigenous women is illustrated by considering the experience surrounding the recognition and implementation of collective rights to land in Sub-Saharan Africa and the impact on women's right to land. The article argues that peasant and indigenous women's right to land is best protected through interventions aimed at guaranteeing both their collective and individual rights. There is a need to take into account and address simultaneously the barriers that indigenous and peasant women face with regard to their collective as well as their individual rights. These barriers include those ascribed to the discrimination and social, economic and political marginalization suffered by their peoples and communities, as well as those related to patriarchal power structures within and outside them. Addressing these barriers requires the respect, protection and fulfillment of both collective and individual human rights of women and a careful analysis of the interaction between these rights.

There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre-existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non-Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit. Standard separation data of age, length of stay, legal status, and discharge diagnosis were analysed, as were seclusion register data of age, seclusion grounds, and number of seclusion events. Descriptive statistics were used to summarize the data, and where warranted, inferential statistical methods used SPSS software to apply analysis of variance/multivariate analysis of variance testing. The results showed evidence that secondary analysis of existing datasets can provide a rich source of information to describe the experience of target groups, and to guide service planning and delivery of individualized, culturally-secure mental health care at a local level. The results are discussed, service and policy development implications are explored, and suggestions for further research are offered.