Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-06T12:02:46.588Z Has data issue: false hasContentIssue false
  • English
  • Français

Hunger Strikers: Historical Perspectives from the Emergency Management of Refugee Camp Asylum Seekers

Published online by Cambridge University Press:  30 September 2013

Frederick M. Burkle Jr. ,
Jimmy T. S. Chan  and
Richard D. S. Yeung
Frederick M. Burkle Jr.*
Affiliation:
Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts USA
Jimmy T. S. Chan
Affiliation:
Hong Kong Special Administrative Region, China
Richard D. S. Yeung
Affiliation:
Hong Kong Special Administrative Region, China
*
Correspondence: Frederick M. Burkle, Jr., MD, MPH, DTM, FAAP, FACEP Harvard Humanitarian Initiative 14 Story Street, 2nd Floor Cambridge, MA 02138 USA E-mail [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

BurkleFMJr., ChanJTS, YeungRSD. Hunger Strikers: Historical Perspectives from the Emergency Management of Refugee Camp Asylum Seekers. Prehosp Disaster Med. 2013:28(6);1-5.

Keywords

hunger strikeinternational lawpolitical prisonerstarvation
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 6 , December 2013 , pp. 625 - 629
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Kane, H. The hour of departure: forces that create refugees and migrants. Washington, DC: Worldwatch Institute; 1995.Google Scholar
2.Silove, D, McIntosh, P, Becker, R. Risk of retraumatisation of asylum-seekers in Australia. Aust NZ J Psychiatry. 1993;27(4):606-612.CrossRefGoogle ScholarPubMed
3.Burkle, FM. Complex humanitarian emergencies. Prehosp Disaster Med. 1995;10(1):36-56.CrossRefGoogle ScholarPubMed
4.Burkholder, BT, Toole, MJ. Evolution of complex emergencies. Lancet. 1995;346(8981):1012-1014.CrossRefGoogle Scholar
5.Renner, M. Transforming security. In Brown LR, Flavin C, French H, et al (eds). State of the World 1997. New York: W. W. Norton; 1997.Google Scholar
6.Médecins sans Frontières. Refugee Health: An Approach to Emergency Situations. London: MacMillan; 1997.Google Scholar
7.United Nations High Commissioner for Refugees. Handbook for Emergencies. Geneva: UNHCR; 1982.Google Scholar
8.United Nations High Commissioner for Refugees. The State of the World's Refugees: A Humanitarian Agenda 1997-98. New York: Oxford University Press; 1997.Google Scholar
9. US Committee for Refugees. World refugee survey 1997. Immigration and Refugee Services of America; 1997.Google Scholar
10.United Nations High Commissioner for Refugees. Refugee Children: Guidelines on Protection and Care. Geneva: UNHCR; 1994.Google Scholar
11.Summerfield, D, Gorst-Unsworth, C, Bracken, P, et al. Detention in the UK of tortured refugees. Lancet. 1991;338(8758):58.CrossRefGoogle ScholarPubMed
12.Hiegel, JP. Psycho-social and mental health needs of refugee experience in SE Asia. Trop Doctor. 1991;21(suppl 1):63-66.CrossRefGoogle Scholar
13.Marsella, J, Bonnemann, T, Ekblad, S, Orley, J (eds). Amidst Peril and Pain: The Mental Health and Well Being of the World's Refugees. Washington, DC: American Psychological Association; 1994.CrossRefGoogle Scholar
14. ProQuest Direct. Hunger strikers. 1998.Google Scholar
15.Silove, D, Curtis, J, Mason, C, Becker, R. Ethical considerations in the management of asylum seekers on hunger strike. JAMA. 1996;276(5):410-415.CrossRefGoogle ScholarPubMed
16.United Nations High Commissioner for Refugees. The State of the World's Refugees: The Challenge of Protection. New York: Penguin Books; 1993.Google Scholar
17.Sughandabhirom, B. Experiences in a first asylum country: Thailand. In Williams CL, Westermeyer J (eds). Refugee Mental Health in Resettlement Countries. Washington, DC: Harper & Row; 1986.Google Scholar
18.Khokhlov, I. The rights of refugees under international law. Bulletin of Human Rights. 1992;91(1):85-97.Google Scholar
19.Helton, AC. The comprehensive plan of action for Indo-Chinese refugees: an experiment in refugee protection and control. New York Law School Journal of Human Rights. 1990;8(1):111-148.Google Scholar
20.Tefft, S. Vietnam boat people head home. Christian Science Monitor. January 22, 1992. http://www.csmonitor.com/1992/0122/22031.html. Accessed July 22, 2013.Google Scholar
21.Macura, M, Coleman, D (eds). International migration: regional processes and response. Economic Studies No. 7. New York: UN Economic Commission for Europe; 1994.Google Scholar
22.Sung, JJY, Tam, LS, Ko, GTC, et al. Deception and self-harm in the quest for freedom: an audit of Vietnamese boat people admitted to a regional hospital in Hong Kong. Med J Aust. 1995;163(10):524-526.CrossRefGoogle ScholarPubMed
23. Malaysian Red Crescent Society. Medical and health quarterly report. 1995:1-11.Google Scholar
24.Lillibridge, SR, Conrad, K, Stinson, N, et al. Haitian mass migration: uniformed service medical support, May 1992. Mil Med. 1994;159(2):149-153.CrossRefGoogle ScholarPubMed
25.Dick, B. The impact of refugees on the health status and health services of host communities: compounding bad with worse? Disasters. 1986;9(4):259.CrossRefGoogle Scholar
26.Shaw, R. Health services in a disaster: lessons from the 1975 Vietnamese evacuation. Mil Med. 1979;144(5):307-311.CrossRefGoogle Scholar
27.Dahlberg, K. Medical care of Cambodian refugees. JAMA. 1980;243(10):1062-1065.CrossRefGoogle ScholarPubMed
28.Glass, RI, Cates, W, Nieburg, P, et al. Disaster relief-rapid assessment of health status and preventive medicine needs of newly arrived Kampuchean refugees, Sa Kaeo, Thailand. Lancet. 1980;1(8173):23-27.Google ScholarPubMed
29.Goldfield, N, Lee, W. Caring for Indochinese refugees. Am Fam Physician. 1982;26(3):157-160.Google ScholarPubMed
30.Hoang, GN, Erickson, RV. Guidelines for providing medical care to Southeast Asian refugees. JAMA. 1982;248(6):710-714.CrossRefGoogle ScholarPubMed
31.Grizzell, S, Savale, J, Scott, P, et al. Indo-Chinese refugees have vastly different views and use of medical care system. Mich Med. 1980;79(35):624-628.Google Scholar
32.Dresser, RS, Boisaubin, EV. Psychiatric patients who refuse nourishment. Gen Hosp Psych. 1986;8(2):101-106.CrossRefGoogle ScholarPubMed
33.Dresser, R. Legal and policy considerations in treatment of anorexia nervosa patients. Int J Eat Disord. 1984;3(4):43-51.3.0.CO;2-3>CrossRefGoogle Scholar
34.Dresser, R. When patients resist feeding: medical, ethical and legal considerations. J Am Geriatrics Soc. 1985;33(11):790-794.CrossRefGoogle ScholarPubMed
35.Kleinman, I. Force-feeding: the physicians dilemma. Can J Psychiatry. 1986;31(4):313-316.CrossRefGoogle Scholar
36.Peel, M. Hunger strikes. BMJ. 1997;315(7112):829-830.CrossRefGoogle ScholarPubMed
37.Phillips, WJ. Starvation and survival: some military considerations. Mil Med. 1994;159(7):513-516.CrossRefGoogle ScholarPubMed
38.Kalk, WJ, Felix, M, Snoey, ER, et al. Voluntary total fasting in political prisoners: clinical and biochemical observations. S Afr Med J. 1983;83(6):391-394.Google Scholar
39.Kalk, WJ, Veriava, Y. Hospital management of voluntary total fasting among political prisoners. Lancet. 1991;337(8742):660-662.CrossRefGoogle ScholarPubMed
40.Keeton, GR. Hunger strikers-ethical and management problems. SAMJ. 1993;83(6):380-381.Google ScholarPubMed
41.Frommel, D, Gautier, M, Questiaux, E, et al. Voluntary total fasting: a challenge for the medical community. Lancet. 1984;1(8392):1451-1452.CrossRefGoogle Scholar
42.Meguid, MM, Collier, MD, Howard, LJ. Uncomplicated and stressed starvation. Surg Clin North Am. 1981;61(3):529-543.CrossRefGoogle ScholarPubMed
43.Sours, HE, Frattali, VP, Brand, CD, et al. Sudden death associated with very low calorie weight reduction regimens. Am J Clin Nutr. 1981;34(4):453-461.CrossRefGoogle ScholarPubMed
44.Keys, A, Brozek, J, Henshel, A, et al. The Biology of Human Starvation. Minneapolis: University of Minnesota Press; 1950.CrossRefGoogle Scholar
45.Taylor, HL, Henschel, A, Mickelsen, Q, et al. Some effects of acute starvation with hard work on body weight, body fluids, and metabolism. J Appl Physiol. 1954;6(10):613.CrossRefGoogle ScholarPubMed
46.Neeser, M, Ruedin, P, Restellini, JP. “Thirst strike”: hypernatremia and acute prerenal failure in a prisoner who refused to drink. BMJ. 1992;304(6838):1352.CrossRefGoogle Scholar
47.Abuez, FR, Chun, KM. Traumatization stress among Asians and Asian Americans. In Marsella AJ, Friedman MJ, Gerrity ET, Scurfield RM (eds). Ethno-cultural Aspects of Posttraumatic Stress Disorder. Washington, DC: APA; 1996.Google Scholar
48.Birchard, K. Psychiatric assessment of hunger strikers must be prompt. Lancet. 1997;350(9078):648.CrossRefGoogle Scholar
49.Declaration of Tokyo. Guidelines for medical doctors concerning torture and other cruel, inhuman or degrading treatment or punishment in relation to detention and imprisonment. World Med J. 1975;22(6):87.Google Scholar
50.British Medical Association. Medicine Betrayed: The Participation of Doctors in Human Rights Abuses. London: Zed Books; 1992.Google Scholar
51.Johannes Wier Foundation for Health and Human Rights. Assistance in hunger strikes: a manual for physicians and other health personnel dealing with hunger strikers. The Netherlands; 1995.Google Scholar
52.Silove, D. Management of asylum seekers on hunger strikes. Ethics Committee. Fellowship Affairs; 1993.Google Scholar
53.Glick, SM. Unlimited human autonomy--a cultural bias? NEJM. 1997;336(13):954-956.CrossRefGoogle Scholar
54. State of Israel v. Rahamin Gibli, et al. Originating motion 829/96 A; 1996.Google Scholar
55. Patient's Rights Law 1996. Laws of state of Israel. Jerusalem: Israel Government Printing Office; 1996.Google Scholar
56.Francis, CM. Ancient and modern medical ethics in India. In Pelligrino E, Mazzarella P, Corsi P. Transcultural Dimensions in Medical Ethics. Frederick, MD: University Publishing; 1992.Google Scholar
57.Annas, GJ. Hunger strikers: can the Dutch teach us anything? BMJ. 1995;311(7013):1114-1115.CrossRefGoogle Scholar
58.National Defense Council Foundation. The NDCF world conflict list, 1998. http://www.ndcf.org. Accessed July 22, 2013.Google Scholar