SciELO - Scientific Electronic Library Online

vol.31 issue1 author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand



Related links

  • On index processCited by Google
  • On index processSimilars in Google



On-line version ISSN 2223-6279
Print version ISSN 0379-8577

Curationis vol.31 n.1 Pretoria  2008




Human rights and health: Challenges for training nurses in South Africa



L LondonI; L Baldwin-RagavenII

IMD. Health and Human Rights Programme, School of Public Health and Family Medicine, University of Cape Town
IIMD. Henry R. Luce Professor of Health and Human Rights, Trinity College, Hartford, Connecticut, USA





The need for health professionals to address their human rights obligations has emerged in the last decade both internationally as well as nationally following the findings of South Africa's Truth and Reconciliation Commission. Support for human rights norms has become a priority for institutions as well as practitioners within the health sector. Training plays a crucial role in shaping health professional practice. In addition to creating a clear understanding of the linkages between human rights and health, educators can role-model how health professionals should act to support human rights. This article explores human rights derived from the South African Constitution in relation to the obligation on health professionals to respect, protect, promote and fulfill human rights. The implications of this commitment to human rights training of nurses are discussed, drawing on the authors' nine years of experience in running courses for South African health professional educators. Themes include: developing core competencies for human rights in health professional curricula, identifying appropriate instructional methodologies and assessment tools suited to the content and context of human rights, and engaging the institutional environment for human rights teaching, at both the level of institutional culture and strategic implementation. At a time when there are increasing demands on the nursing profession to assume greater responsibility and develop versatility in its scope of practice, key challenges are posed for teaching and realising human rights.

Key words: Human rights, health professionals, nurses, constitution, Truth and Reconciliation Commission



“Full text available only in PDF format”




AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCES AND PHYSICIANS FOR HUMAN RIGHTS 1998. Human rights and health: the legacy of apartheid. Washington: AAAS.         [ Links ]

AMNESTY INTERNATIONAL 2000. Ethical codes and declarations relevantto the health professions. 4th edition. London: Amnesty International.         [ Links ]

ANDREOPOULOS, G.J 2002. Human Rights Education and Training for Professionals. International Review of Education. 48:239-249.         [ Links ]

ANONYMOUS 2003. Council takes stock of its achievements during term of office. Bulletin. Newsletter of the Health Professions Council of South Africa. November 2003. pp. 1-5.         [ Links ]

BALDWIN-RAGAVEN, L 1998. Prioritising human rights training for health professionals, (reportage), South African Medical Journal. 88, p. 1377.         [ Links ]

BALDWIN-RAGAVEN, L; DEGRUCHY, J; LEWIN, S & WALAZA, N 1998. Health science faculties - how committed are they to building a culture of human rights in health? South African Medical Journal. 88(8), p. 923.         [ Links ]

BALDWIN-RAGAVEN, L,- DEGRUCHY, J & LONDON, L 1999. An ambulance of the wrong colour: health professionals, human rights and ethics in South Africa. Cape Town: University of Cape Town Press.         [ Links ]

BALDWIN-RAGAVEN, L & LONDON, L 2006. Training trainers for Health and Human Rights. A manual for South African health professional educators. First edition, version 2. University of Cape Town        [ Links ]

BALDWIN-RAGAVEN, L; LONDON, L & DE GRUCHY, J. 2000. Learning from our apartheid past: Human rights challenges for health professionals in contemporary South Africa. Ethnicity and Health. 5(3), pp. 227-241.         [ Links ]

BENATAR D 2006. Bioethics and human rights: a critical view. Journal of Medical Ethics. 32: 17-20.         [ Links ]

BATEMAN C 2000. Discrimination beyond the grave. South African Medical Journal. 90: 1072-3.         [ Links ]

BLOCHE, G 1999. Clinical loyalties and the social purposes of medicine. Journal of the American Medical Association. 281(3), 268-274.         [ Links ]

BOTES, A 1997. Etiek in verpleging. Curationis. 20(4), pp. 32-38.         [ Links ]

BOTES A 2000. Critical thinking by nurses on ethical issues like the termination of pregnancies. Curationis. 23(3), pp 26-31.         [ Links ]

BRITISH MEDICAL ASSOCIATION (BMA) 2001. The medical profession and human rights. Handbook for a changing agenda. London: Zed Press.         [ Links ]

CONSTITUTIONAL ASSEMBLY 1996. Constitution of the Republic of South Africa 1996. Act 108 of 1996. Pretoria.         [ Links ]

CARTE BLANCHE 2002. DIY abortion: state abortion clinics, Producer Kate Barry (video).         [ Links ]

CHAPMAN, A & RUSSELL, S 2002. Core obligations: building a framework for economic, social and cultural rights. New York: Intersentia.         [ Links ]

COMMITTEE ON ECONOMIC, SOCIAL AND CULTURAL RIGHTS (CESCR) 2000. United Nations General Comment 14 on Article 12, The right to the highest attainable standard of health, E/C. 12/2000/4.         [ Links ] [WWW] <24 December 2007>

DE GRUCHY, J; LONDON, L; BALDWIN-RAGAVEN, L; LEWES, S & THE HEALTH AND HUMAN RIGHTS SUPPORT GROUP. 1998. The difficult road to truth and reconciliation - the health sector takes its first steps. South African Medical Journal. 88(8), pp. 975-979.         [ Links ]

DEPARTMENT OF HEALTH 1999. Patient's Rights Charter, Directorate of Quality Assurance, Department of Health, Pretoria, <24 December 2007>         [ Links ]

DEPARTMENT OF HEALTH. 2004. National Health Act. Act 61/2003. Government Printers: Pretoria        [ Links ]

DE ROUBAIX, M 2007. Ten years hence-has the South African choice on Termination of Pregnancy Act, Act 92 of 1996, realised its aims? A moral-critical evaluation. Med Law: 26: 145-77.         [ Links ]

DE VTLLIERS, M & STULTING, A 2000. Establishment of a Committee for Human Rights, Ethics and Professional Practice of the Medical and Dental Professional Board. South African Dental Journal. 55(6), p. 301.         [ Links ]

DU TOIT, A 1998. Healing the Healers? The TRC's Hearings on the Health Sector. Indicator SA 15,1: 13-18.         [ Links ]

DU TOIT, H & BOTES, A 1996. Die fasilitering van respek van regte en verantwoordelikhede van mense by the studenteverpleegkundige. Curationis. 19, pp. 75-80.         [ Links ]

ERNEST, C 2000. Training in ethics and human rights at South African medical schools: achievements and gaps, Presentation to the Health and Human Rights Conference, Durban, South Africa, 2 December 2000.         [ Links ]

EVANS, D 1995. Everybody's business. Nursing Times. 91, pp. 27-28.         [ Links ]

FOX, R 1999. Medical humanitarianism and human rights: reflections on doctors without borders and doctors of the world. (In Mann, J., Gruskin, S., Grodin, MA. & Annas, GJ. (eds), Health and human rights: a reader. New York: Routledge. pp. 417-435.         [ Links ])

GOODMAN, T & PRICE, M 2002. Using an internal reconciliation commission to facilitate transformation at a health sciences faculty in post-apartheid South Africa: the case of the UNIVERSITY OF WITWATERSRAND HEALTH SCIENCES FACULTY. Health and Human Rights. 6(1). pp. 211-227.         [ Links ]

GOVERNMENT GAZETTE 20852, 416(95), 2000. Promotion of Access to Information Act, Act 52 of 2000.         [ Links ] [WWW] <3Bebruary 2008>

GOVERNMENT GAZETTE 26595, 469(869), 2004. National Health Act, No. 61 of 2003, Cape Town, South Africa.         [ Links ] [WWW] <26 May 2005>.

GUEDES, A; BOTT, S; GUËZMES, A & HELZNER, JF 2002. Gender-based violence, human rights and the health sector: Lessons from Latin America. Health and Human Rights: 6:177-193.         [ Links ]

GRUSKIN, S & TARANTOLA, D 2004. Health and human rights. (In Detels, R., McEwen, J., Beaglehole, J. & Tanaka, H. (eds), The Oxford Textbook of Public Health. 4lh edition. New York: Oxford University Press, pp: 311 - 335.         [ Links ]

HAFFERTY, FW 1998. Beyond curriculum reform: confronting medicine's hidden curriculum. Academic Medicine. 73(4), pp. 403^07.         [ Links ]

HANNIBAL, K & LAWRENCE, R 1999. The health professional as human rights promoter: ten years of Physicians for Human Rights (USA). (In Mann, J., Gruskin, S., Grodin, M.A. & Annas, G.J. (eds), Health and human rights: a reader.) New York: Routledge. pp. 404-416.         [ Links ])

HPCSA. 2007a. Proposed Core Curriculum on Human Rights, Ethics and Medical Law for Health Care Practitioners. Health Professions Council of South Africa, Pretoria:.         [ Links ]

HPCSA. 2007b. Human rights, ethics now mandatory in CPD. Medic Dent News. September/October 2007:7. Health Professions Council of South Africa, Pretoria.         [ Links ]

IACOPINO, V 1995. Human rights: health concerns for the twenty-first century. (In Majumdar, S.K. (ed), Medicine and health care into the twenty-first century. Pennsylvania: Pennsylvania Academy of Science, pp. 376-391.         [ Links ])

INTERNATIONAL COUNCIL OF NURSES 2006. The ICN code of ethics for nurses. <6 November 2007>         [ Links ].

JAMETON, A & PIERCE, J 2002. Sustainable health care and emerging ethical responsibilities. (In McCally, M. (ed), Life support: The environment and human health.) Cambridge, MA: Massachusetts Institute of Technology Press.         [ Links ]

JEWKES, R; ABRAHAMS, N & MVO, Z 1998. Why do nurses abuse patients? Reflections from South African obstetric services. Social Science and Medicine. 47(11), pp. 1781-1795.         [ Links ]

JOHANNES WEIR FOUNDATION 1996, Health and human rights: a course for doctors, nurses and paramedics (in training). Maastricht.         [ Links ]

LEARY, VA 1994. The right to health in international human rights law. Health and Human Rights. 1(1), pp. 24-56.         [ Links ]

LIEBENBERG, S & PILLAY, K 2000. Socioeconomic rights in South Africa. Community Law Centre, University of Western Cape, South Africa, pp. 9-105; 219-254.         [ Links ]

LONDON, L; MCCARTHY, G; VAN HEERDEN, J; WADEE, S; WALAZA, N & WINSLOW, T 1997. Preparing future doctors to meet ethical challenges: a training course for medical students in health and human rights. South African Medical Journal. 87, pp. 242-245.         [ Links ]

LONDON, L & MCCARTHY, G 1998. Teaching medical students on the ethical dimensions of human rights: meeting the challenge in South Africa. Journal of Medical Ethics. 24, pp. 257-262.         [ Links ]

LONDON, L & PEREZ, G 2001. Reconciliation in the UCT health sciences faculty: a vision for transformation. South African Medical Journal. 91. pp. 1027-8.         [ Links ]

LONDON, L; ISMAIL, S; ALPERSTEIN M & BAQWA, D 2002. Diversity in the learning environment and curriculum reform in the health sciences -challenges for a country in transition. Perspectives in Education. 20:21-32.         [ Links ]

LONDON, L; BALDWIN-RAGAVEN, L; KALEBI, A; MAART, S; PETERSEN L & KASOLO, J 2007 Developing human rights competencies for South African health professional graduates. S Afr Med J. 97: 1269-1270.         [ Links ]

MANN, JM; GOSTIN, L; GRUSKJN, S; BRENNAN, T; LAZZARINI, Z & FINEBERG, H 1999. Health and human rights. (In Mann, J., Gruskin, S., Grodin, MA. & Annas, GJ. (eds), Health and human rights: a reader.) New York: Routledge. pp. 7-20.         [ Links ]

MARKS, S 1994, Divided Sisterhood: Race, Class and Gender in the South African Nursing Profession, Basingstoke: Macmillan.         [ Links ]

MASUKU, T 2000. Promotion of access to information act: prospects for the protection of socio-economic rights. ESR Review, 2(3), pp. 5-6.         [ Links ]

MAYERS, PAT 2002. Personal Communication.         [ Links ]

MCQUOBD-MASON, DJ & DADA, MA 1999. Guide to forensic medicine and medical law. Independent Medico-Legal Unit, Durban, South Africa.         [ Links ]

MEDICAL PROFESSIONALISM PROJECT 2002. Medical professionalism in the new millennium: a physician charter. Project of the ABIM Foundation, the ACP-ASIM Foundation, and the European Federation of Internal Medicine. Lancet, 359(9305), pp. 520-522. (published simultaneously in 2002 Annals of Internal Medicine. 136(3), pp. 243-246.         [ Links ])

MHLANGA, E 2003. Abortion: developments and impact in South Africa. Br Med Bull. 67:115-26.         [ Links ].

MTSHALI, NG & KHANYILE, T 2001. A comparative analysis of ethical development of student nurses registered for a basic degree and basic diploma programme in KwaZulu Natal. Curationis. 24(1), pp. 22-30.         [ Links ]

NCANYWA, B 1997. Oral submission to the health sector hearings of the Truth and Reconciliation Commission, TRC, Cape Town, South Africa.         [ Links ]

NGWENA, C 2000. Access to health care a fundamental right: the scope and limits of Section 27 of the Constitution. Journal for Juridicial Sciences. 25( 1 ), pp. 1-32.         [ Links ]

PEREZ, G & LONDON L 2004. "Forty-five years apart": confronting the legacy of racial discrimination at the University of Cape Town. South African Medical Journal. 94. pp. 764-770.         [ Links ]

RUBENSTEIN, LS; LONDON, L; BALDWIN-RAGAVEN, L & THEDUAL LOYALTY WORKING GROUP. (2002). Dual Loyalty and Human Rights in health professional practice. Proposed guidelines and institutional mechanisms. A project of the International Dual Loyalty Working Group. Physicians for Human Rights and University of Cape Town. Boston, 2002. Available at URL:         [ Links ]

PILLAY, K 2000a. South Africa's commitment to health rights in the spotlight. ESR Review. 2(3). pp. 1-4.         [ Links ]

PILLAY, K 2000b. The right to housing: the judgment. Local Government Bulletin, Legal Archive, 2(1).         [ Links ]

PILLAY, K 2000c. Home truths tested in court, Children FIRST, 31.         [ Links ]

PROGRAM ON INTERNATIONAL HEALTH AND HUMAN RIGHTS AT THE HARVARD SCHOOL OF PUBLIC HEALTH ANDTHE INITIATIVE FOR HEALTH AND HUMAN RIGHTS AT THE UNIVERSITY OF NEW SOUTH WALES. 2006. Health and human rights education in academic settings: summary report. Boston, Massachusetts. <26 December 2007>         [ Links ].

RAVENSCROFT, A 1999. Experiences and thoughts from a paediatric neurologist. Input to a Workshop: South African Human Rights Commission investigation into language barriers and access to adequate health care, Cape Town, South Africa.         [ Links ]

RAYNER, M 1987. Turning a blind eye? Medical Accountability and the prevention of torture in South Africa. Washington, American Association for the Advancement of Science.         [ Links ]

RICHTER, M 2001. Complaint against the MEC for Health, Provincial Government, Mpulalanga, Correspondence with the Office of the Public Protector. AIDS Law Project.         [ Links ] [WWW] <9 December 2005>.

RUBENSTEIN, L & LONDON, L 1998. The UDHR and the limits of medical ethics: the case of South Africa. Health and Human Rights. 3(2), pp. 160-175.         [ Links ]

SCOTT, C & ALSTON, P 2000. Adjudicating constitutional priorities in a transnational context: a comment on Soobramoney's legacy and Grootboom's promise. South African Journal of Human Rights. 16, pp. 206-268.         [ Links ]

SIRKIN, S; IACOPINO, V; GRODIN, M & DANIELI, Y 1999. The role of health professionals in protecting and promoting human rights: a paradigm for professional responsibility. (In Danieli, Y., Stamatopoulou, E. & Dias C.J. (eds), The Universal Declaration of Human Rights: fifty years and beyond.) Amityville: Baywood Publishing, pp 357-370.         [ Links ]

SOUTH AFRICAN LAW REFORM COMMISSION 1998. Euthanasia and the artificial preservation of life - Draft Bill, Project 86.         [ Links ] [WWW] <25 May 2005>.

SWARTZ, L 1998. Culture and mental health: A Southern African view. Cape Town: Oxford University Press.         [ Links ]

TIBBITTS, F 2002. Understanding What We Do: Emerging Models for Human Rights Education. International Review of Education 48:159-171.         [ Links ]

TOEBES, BCA 1999. The right to health as a human right in international law. School of Human Rights Series, 1, Antwerp: Hart - Intersentia.         [ Links ]

TREATMENT ACTION CAMPAIGN (TAC). Undated. Treatment Action Campaign. An Overview.         [ Links ] [WWW] <9 December 2005>

TRUTH AND RECONCILIATION COMMISSION. 1996. Human rights violations hearings in Worcester 24th and 25th, June. Case No: CT/00820; Testimony from: Amos Dyantyi. Violation: Torture/ Detention, <accessed 06 November 2007>         [ Links ]

TRUTH AND RECONCILIATION COMMISSION REPORT. 1998. Volume four, chapter five. Institutional hearings: the health sector. Parow, Cape Town, South Africa: CTP Book Printers, pp. 109-164.         [ Links ]

UNITED NATIONS PUBLICATION 1999. Manual on the effective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment: Istanbul Protocol. HR/P/PT/8. Geneva.         [ Links ]

VERIAVA, F 1999. Correspondence with Dr Ravenscroft from the South African        [ Links ]



Prof Leslie London
Health and Human Rights Programme
School of Public Health and Family Medicine
University of Cape Town
Health SciencesFaculty Anzio Rd, Observatory, 7925
Tel: (021) 406 6524; Fax: (021) 406 6163

Creative Commons License All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License