The Saudi Arabian government is often criticised by human rights organisations for its lack of transparency.
Information released through official channels in the country is carefully chosen and the press is heavily censored. Authorities regularly subject dissenting voices, human rights defenders and irregular migrants to detention. Security forces hold foreigners awaiting deportation in deportation centres whilst those who have committed minor crimes or have violated the kafala system are held in general detention centres or jails. However, this isn’t always the case. Abuses regarding health care within these detention facilities amount to breaches of the principle of medical impartiality and violate international human rights law (IHRL).
According to the Global Detention Report, access to detention facilities by lawyers and international organizations is severely restricted. Accounts from those who have been detained and subsequently released shed light on the situation.
Health care in detention centres across Saudi Arabia is inadequate; some reports suggest there may be none available at all. In 2013, Human Rights Watch (HRW) interviewed many migrant workers who had been detained before deportation and found repeated accounts of ill health and restricted access to health care in detention centres. One deported Yemeni worker who was held in Buraiman Prison reported that there had been no medical care. Saladu, a Somali woman who was detained by Saudi authorities for nine days with her two children said, ‘The room we stayed in with 150 other women and children was extremely hot… The children were sick. My son was vomiting and his stomach was very bloated.” A 42-year-old Yemeni worker criticized the lack of health care available at the deportation centre and said that his brother had received no medical attention despite being ill and periodically fainting. A Yemeni deportee named Yahya showed a researcher from HRW an infected cut on his foot and said that he had received no treatment for the injury during his detention, adding that there were no medical facilities in the deportation centre in which he was held.
In June 2015, a video of migrants awaiting deportation in a Saudi Arabian detention centre was released. 396 migrants were locked in a confined space with little access to clean water, food or health care. As a result, many had contracted illnesses. A particularly common health problem was respiratory illnesses. One of the detained migrants said that he had made frequent requests to guards for medical treatment over ten days, but had received none. The International Organisation for Migration (IOM) reported that a large number of deportees in Mogadishu were in ill health as a result of their protracted detention in poor conditions. Physical and psychological trauma was a common complaint as were respiratory illnesses including pneumonia. Aid workers at the border between Saudi Arabia and Yemen reported treating many medical conditions resulting from overcrowding in detention including fatigue, vomiting and headaches. Long periods without access to a bathroom often lead to urinary tract infections. The aid workers had also treated injuries from physical violence which had been inflicted during detention such as fractures.
Whilst reports suggest doctors are rarely found in detention centres, prison doctors are routinely used to assess the fitness of prisoners who have been sentenced to flogging. After fifty lashes were given to Raif Badawi, an activist who was sentenced to 1000 lashes and ten years in prison for “insulting Islam,” a prison doctor assessed that his wounds were not sufficiently healed for him to undergo the next round of his punishment. In addition, a medical committee of eight doctors advised that Badawi should not be flogged because of high blood pressure, but another prison doctor insisted that he was fit and should be flogged. The World Medical Association (WMA) has condemned Saudi Arabia’s use of doctors to assess prisoners’ fitness for being flogged. They stated that by doing so, “doctors are required to participate in the enabling of the sentence and therefore in acts of torture and other cruel, inhuman or degrading treatment. This is a flagrant violation of a fundamental principle of medical ethics ‘do no harm.’” Doctors should not be put in situations where they have to falsify medical assessments in order to appease authorities as this violates the non-discrimination element of the principle of medical impartiality. Doctors have the duty to give neutral medical assessment and attention to all patients regardless of their political beliefs.
Saudi Arabia has ratified the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of the Child (CRC), which both contain provisions on the right to health. However, where the text of the Convention conflicts with Sharia law, ‘the Kingdom is not under obligation to observe the contradictory terms of the Convention.’ Nevertheless, Saudi Arabia is committed to uphold universal human rights standards, including those set forth in the Universal Declaration of Human Rights (UDHR), given that it is a member of the United Nations. Article 25 (1) of the UDHR and medical impartiality’s principle of non-interference specify that every person has the right to the highest attainable standard of living adequate for their health and well-being, including medical care. By not providing health care to detainees, Saudi Arabia clearly breaches these principles and continues in its trend of ignoring human rights law. Saudi Arabia should abide by its obligations under IHRL by offering adequate medical care to all those in detention. Further, Saudi Arabia should end its practice of using prison doctors to assess prisoners’ health conditions before subjecting them to corporal punishment.
Georgia Cooper is an Advocacy Intern at the European Centre for Democracy and Human Rights
Photo credit: Al Jazeera