Drawing outside the lines: Building a social mechanism for human rights accountability

In movies, the hero goes to Washington, she meets many Senators, they take a vote, and, voila! a new law that protects peoples' rights. In reality, Washington bureaucracies hold most of the policy keys. Where change is inevitable, they try to use non-public processes that maintain bureaucrats' control. In these situations, formal human rights accountability mechanisms – such as Congress – can be thwarted. Sophisticated advocates therefore “build their own” social accountability processes where media, research, and advocacy combine to demand reforms from the bureaucracy. This presentation will describe how a social accountability mechanism is operating to improve health care in over 300 prison-like facilities that hold immigration detainees. There are no legally enforceable standards for detention health care, and the system is in crisis: Between October 2003 and January 2007, 107 individuals died in immigration detention. PHR has joined other NGOs in a social accountability process to reform DHS's detention practices, including health care. This presentation will describe how advocates and affected families have used media, human rights reports, and other tools to influence the establishment of the detention-reform process. It will discuss PHR's role, where volunteer health professionals bring to the reform process their knowledge of health care standards and an understanding of the special needs of vulnerable persons in immigration detention. Expected outcomes of this project include establishment of uniform and early screening of incoming immigration detainees for potentially life-threatening conditions, and a detention managed care system that creates fewer unnecessary roadblocks for clinicians in detention centers.