Cuba: Amnesty International names prisoners of conscience amidst crackdown on protesters

In the wake of peaceful demonstrations across the nation, Cuban authorities under the leadership of President Díaz-Canel have scaled-up a decades-long policy of repression that criminalizes peaceful protest and imprisons and ill-treats Cubans from all walks of life simply for expressing their views, said Amnesty International today, upon naming six prisoners of conscience who were detained in recent months.

“In response to the protests of 11 July, the Cuban authorities have applied the same machinery of control that they have used to target alternative thinkers for decades, but now amped up to a scale we haven’t seen in almost 20 years, and with new tactics including the use of internet interruptions and online censorship to control and cover up the grave human rights violations they have committed,” said Erika Guevara-Rosas, Americas director at Amnesty International.

“We’ve named six people prisoners of conscience – in a symbolic gesture to the many hundreds more who likely deserve the designation – and call for their immediate and unconditional release. The pattern of human rights violations we’ve documented in recent weeks points to a heightened policy of repression designed to claw-back control and re-establish a culture of fear that was punctured on 11 July.”

Thousands of people took to the streets on 11 July to peacefully protest over the economy, shortages of medicines, the government’s response to COVID-19, and harsh restrictions on the rights to freedom of expression and peaceful assembly, in one of the largest demonstrations seen in decades. The authorities responded by detaining and criminalizing to different degrees nearly all those found to be protesting.

Amnesty International has called for the immediate and unconditional release of the hundreds of people who remain detained for protesting that day and has previously documented the authorities’ web of control over freedom of expression and peaceful assembly, and how this has historically left many Cubans feeling that they have little choice but to leave the country. The organization has also tracked how the authorities have become increasingly sophisticated at censorship as the country has begun to move online.

Amnesty International has closely monitored the situation in Cuba, and between 15 July and 19 August interviewed more than 30 people, including relatives of those imprisoned, people who were detained and later released, NGOs, activists and other organizations following the situation. On 5 August, the organization wrote publicly to President Díaz-Canel and Cuba’s Prosecutor General to ask how many people had been detained on 11 July, where they were detained, and what they were charged with, but as of the time of publication had received no response. Amnesty International’s Crisis Evidence Lab also verified more than 60 pieces of audio-visual information in support of the research.

Amnesty International has documented the following crimes under international law and grave human rights violations:

Prisoners of conscience

The Cuban authorities arbitrarily detained hundreds of people for exercising their rights to freedom of expression and largely peaceful assembly in the context of the 11 July protests, according to a list developed by the NGO Cubalex and testimonies that Amnesty International has gathered. Most appear to be charged either with crimes historically used to silence dissent, such as “public disorder”, or crimes inconsistent with international standards, such as “contempt,” which targets anyone who is critical of the government.

The authorities’ default approach has been to criminalize nearly all those who participated in the protests, including some children. As early as 14 July, representatives of the Prosecutor General’s Office and the Ministry of the Interior said on state television that they were investigating individual responsibility for the organization of the protests and the “crimes” committed during the demonstrations, and a Colonel indicated their approach would be to find those who organized promoted or financed the protests.

In response to the protests of 11 July, the Cuban authorities have applied the same machinery of control that they have used to target alternative thinkers for decades, but now amped up to a scale we haven’t seen in almost 20 years

Erika Guevara-Rosas, Americas director at Amnesty International

In an article published in the pro-government newspaper Cubadebate, and also tweeted by the Prosecutor General, as of 4 August, 62 people had been tried so far for events related to the 11 July protests, mostly for the crime of “public disorder” and to a lesser extent for “resistance”, “contempt”, “incitement to commit a crime” and “damages”.

Today Amnesty International is naming six prisoners of conscience – people imprisoned because of their political, religious or other beliefs who have not used or advocated violence. These emblematic cases represent only a tiny fraction of the total number of people who likely deserve the designation, but they serve to highlight some of the patterns of abuse being committed by Cuban authorities and the policy of repression that pre-dates the 11 July crackdown. Two of the six were detained on their way to protests that day; the other four were detained weeks earlier but are being held on similar criminal charges for freely exercising their right to freedom of expression and assembly.

Amnesty International’s Prisoner of Conscience determination is based on the information available to Amnesty International regarding the circumstances leading to the person’s detention. In naming a person as a Prisoner of Conscience, Amnesty International is affirming that this person must be immediately and unconditionally released but is not endorsing past or present views or conduct by them.

Luis Manuel Otero Alcántara is an artist and member of the San Isidro Movement, a group that mobilized initially in opposition to a law which stands to censor artists. He was detained on 11 July around 3pm in Havana, after posting a video saying he would join the protests. It is believed he is being held at Guanajay prison, but the charges against him are unclear. Amnesty International has named him a prisoner of conscience on three prior occasions.  

José Daniel Ferrer García is an activist and leader of the unofficial political opposition group “Patriotic Union of Cuba”. He has endured threats and harassment in the past and has been imprisoned solely for peacefully exercising his human rights, for which Amnesty International has previously recognized him as a prisoner of conscience. On 11 July, José Daniel tried to attend the demonstrations in Santiago de Cuba with his son. He left his house and walked past the state security officials who constantly monitor him, but other law enforcement officials stopped him a few meters ahead. His son was the last person to see him when they were both detained together. Since then, there has been no formal record of José Daniel’s whereabouts, and the authorities have not allowed his family to see or communicate with him. Amnesty International believes that the concealment of his whereabouts amounts to an enforced disappearance for the purposes of Article 2 of the International Convention for the Protection of All Persons from Enforced Disappearance, to which Cuba is a state party.

Esteban Rodríguez is an independent journalist for ADN Cuba, who was detained on Obispo street in Old Havana on 30 April along with some 12 other people for for peacefully protesting in support of Cuban artist Luis Manuel Otero Alcántara, who was on a hunger strike under severe police surveillance outside his home. After being diagnosed with COVID-19 in June, Esteban is now being held at Combinado del Este prison accused of “resistance” and “public disorder”.

Thais Mailén Franco Benítez is a human rights activist who also participated in the peaceful protest on Obispo Street on 30 April and was also charged with “resistance” and “public disorder.” After holding her under state custody in a hospital for a fall she sustained in prison, the authorities are now holding her at El Guatao prison, Havana, where her family fear she is not receiving adequate medical treatment.

Maykel Castillo Pérez,known by his stage name Maykel Osorbo, is a Cuban musician and human rights activist. He is one of the authors of “Patria y Vida”, a song critical of the Cuban government that has been adopted as a protest anthem. On 4 April 2021, Maykel was walking in Havana when police officers questioned him and attempted to arrest him but desisted in the face of complaints from other passersby who considered the action unjust. On 18 May, security agents arrived at his home and arrested him. He is being held at the Pinar del Río Provincial Prison under charges of “assault”, “resistance”, “evasion of prisoners and detainees” and “public disorder.”

We’ve named six people prisoners of conscience – in a symbolic gesture to the many hundreds more who likely deserve the designation – and call for their immediate and unconditional release

Erika Guevara-Rosas, Americas director at Amnesty International

Hamlet Lavastida is agraphic artist who was returning to Cuba after finishing an artistic residency in Berlin. After placing him in mandatory quarantine under state custody, on 26 June authorities took him to the Villa Marista prison/detention centre, where he is charged with “instigation to commit a crime,” allegedly for proposing an artistic performance in a private messaging conversation, that in the end, never took place.

Surveillance and house arrest

Physical surveillance is another tactic the Cuban authorities use to tightly control the movement of activists and independent journalists. This involves security officials being positioned permanently outside of a person’s house and threatening them with arrest if they leave, which can amount to house arrest. It is a trend that Amnesty International documented in December last year, when following an unusual protest outside the Ministry of Culture on 27 November, almost a dozen members of the San Isidro Movement were placed under frightening levels of surveillance for two weeks and faced arrest if they left their houses.

This practice has continued following the 11 July protests. Amnesty International’s Evidence Lab and Digital Verification Corps sourced, verified and geolocated 54 videos showing the surveillance of four activists and independent journalists – including Héctor Luis Valdés Cocho, Luz Escobar, and Iliana Hernández – filmed between 11 July and the 12 of August. The videos show uniformed and plainclothes police stationed outside the activists’ homes and sometimes engaging with them when challenged.

Héctor Luis Valdés Cocho told Amnesty International he had surveillance outside his home and was unable to leave for 16 days following the protests of 11 July. Independent journalist Luz Escobar said while she had surveillance stationed outside her home for approximately two weeks following the 11 July, she has generally had much more frequent surveillance since the November 2020 protests. “As a journalist it affects me hugely… the surveillance stops me leaving home” she explained. She says combined with internet cuts it makes it very hard to do her job as a journalist.

Like other independent journalists, Iliana Hernández could not leave her house on 11 July to participate in the protests. Analysis of the videos she filmed outside her home show police stationed on all road exits to her home between 11 July and 8 August.

Iliana told Amnesty International that since 11 July at least five officials have been stationed outside her home 24 hours a day. “If I go out, they kidnap me, they leave me inside a police car somewhere, they make a big show that they will charge me with something… then supposedly they withdraw the accusation, (and) they bring me home,” she told Amnesty International. While Iliana has previously had various charges opened against her, she says there is no court order mandating her house arrest, making the detention and surveillance she faces if she leaves her home arbitrary.

Another tactic used by Cuban authorities to restrict movement has been to formally mandate house arrest. Following the island-wide protests of 11 July, many of those released from prisons told Amnesty International that state officials told them not to leave their homes as a condition of their discharge, without clear information about any pending trials. House arrest of this nature is a precautionary measure under the law of Cuba (described as “reclusión domiciliaria”), where the accused cannot leave their home unless they have court authorization, except to work or study or deal with a health matter, and sometimes determined by the Prosecutor General’s office or court. Yet in these cases Amnesty International believes it will constitute an arbitrary detention if the person has been charged with crimes stemming from the exercise of their human rights and calls for their immediate release.

Even prior to 11 July, placing people under house arrest pending trial was a common tactic. As of 11 August, Mary Karla Ares González – among multiple activists detained for protesting on Obispo street in April – had been placed under house arrest as a condition of her release from prison for approximately 75 days and still had no trial date. While she has on occasion been able to visit a relative, she says she has completely changed her life and has stopped going out for exercise, or to do food shopping. “I feel just as imprisoned as when I was in prison, even more so” she told Amnesty International.

Violations of due process and incommunicado detention

Following the mass detentions of 11 July, relatives of those detained, and detainees who have since been released, have widely reported a range of violations of due process rights, and incommunicado detention. While Cuba’s Prosecutor General’s office has denied that detainees have lacked access to legal assistance, or been held incommunicado, the testimonies gathered by Amnesty International indicate otherwise.

Rolando Remedios,a 25-year-old student and human rights activist was detained for participating in the demonstrations in Old Havana, and charged with “public disorder,” an offense which, as defined in the law of Cuba, does not meet international human rights law and standards because it is extremely vague. Photographs of his violent arrest in front of the historic Capitol building were published in media outlets around the world. Rolando was held in incommunicado detention until 23 July, after which his father was able to meet with him in the presence of law enforcement officials for about fifteen minutes and Rolando was able to communicate sporadically with his lawyer and family. He was released on 6 August, without being informed of his legal situation. Days later, authorities told him that he must report to sign in on a weekly basis and that the charges had not been dropped.

A woman, who asked not to be identified for fear of being detained again, told Amnesty International that she peacefully protested for the first time on 11 July because as a parent, receiving no support from the authorities, she was fed up with the system and not being listened to. She said she spent several days in a cell before being released on condition of paying a fine.

Another man, Pedro* who spent over two weeks in detention, told Amnesty International he was released on condition of paying a fine, approximately four times the average monthly salary in Cuba. He said he was detained by state officials dressed as civilians and wasn’t granted access to a lawyer for more than a week.

Many people like Pedro* cannot understand why they were released when many more hundreds who protested on 11 July remain imprisoned, with their families receiving little to no information about the charges they face or the reasons for their detention.

Miriela Cruz Yanis was detained in the context of the protests on 11 July. She alleges that the authorities’ hand-cuffed and beat her, denied her access to medicines for a chronic illness she lives with, and held her for seven days in prison. Her son, Dayron Fanego Cruz, 22, who she says has hypertension and asthma, remains imprisoned. Since his detention on 13 July, she has been able to speak to him briefly only twice, but authorities have not allowed her to visit him or provided written details of the charges against him. She thinks he may be charged with “contempt”.

Under international human rights law, all detainees should have access to legal assistance from the very start of a criminal investigation. The UN’s Special Rapporteur on torture has recommended this should happen no later than 24 hours after an arrest.

Despite this, multiple individuals who were released after being detained in connection with the July 11 protests, as well as relatives of others still detained, told Amnesty International they lacked access to legal representation. The authorities say defendants can – if they desire – be represented by lawyers. In practice, however, many who spoke to Amnesty International had little confidence in defence lawyers – who must belong to the National Organization of Collective Law Offices – a body closely controlled by the state.

Information gathered by Amnesty International also indicates that detainees and/or their legal representatives are not receiving sufficient information about the accusations, an additional barrier for a proper legal defence. Detainees are not promptly and properly notified of their rights, including the right to counsel, nor they are informed of the charges against them. In some cases, even upon release, those detained have not received information about their legal situation, making them fear that they could be rearrested at any moment, a clear contravention of international fair trial standards.

Detainees’ rights to communicate with the outside world, to notify someone that they have been detained, and to receive visits are fundamental safeguards against human rights violations, including torture or other ill-treatment and enforced disappearance. Despite this, multiple families told Amnesty International that authorities have failed to confirm where their detained relatives were being held, especially in the first week following the mass detentions. Amnesty International reviewed multiple court decisions on habeas corpus petitions that confirm detentions but do not disclose the place of incarceration, leaving the families of detainees without this crucial information. As party to the International Convention for the Protection of All Persons from Enforced Disappearance, Cuba must guarantee that all detainees can communicate with their family, legal counsel or any other person of their choice, as well as keeping a complete and reliable record of arrests and detentions.

Amnesty international has also repeatedly received testimony that authorities are denying relatives visits due to COVID-19 restrictions. While cancelling contact might be acceptable in certain circumstances as a public health measure, this must be compensated by increasing other ways for detainees to contact the outside world, for example, by allowing access to phones, internet, emails or video calls and allowing families to provide food and other supplies, and there is no indication that the Cuban authorities are facilitating such measures.

Ill-treatment, including against women

The deployment of special forces known as “boinas negras”, police, and state security officials to detain people in the context of the 11 July protests has resulted in widespread reports of ill-treatment, including against women.

In interviews, relatives of those detained, as well as people who had been detained and later released, told Amnesty International, mostly on the condition of anonymity, that in the aftermath of the protests, law enforcement officials targeted young people they suspected of having participated, dragging them from their beds, sometimes without shoes or clothes, and carting them off to prisons in police vehicles. Many complained that prison conditions were cramped, damp, unhygienic, that no social distancing or other COVID-19 prevention measures were taken, and that rarely were they allowed outside.

Iris Mariño, an actress and independent journalist from Camaguey, told Amnesty International she joined the protests peacefully to ask for democracy and plurality and was detained alone on 11 July by a male state security official, along with two other male police officers.

In the 10 days she was held, she was moved to multiple different cells. According to her testimony, her husband spent around 30 hours looking for her in police stations, after she could not reach him in the one call she was permitted to make. It was 96 hours before any authority informed her that she was charged with “public disorder” and told her she could have access to a lawyer. She says at one point she spent 50 hours alone in a filthy cell, where she said, “I couldn’t even see the palms of my hands” – a practice which could amount to solitary confinement and ill-treatment.

Iris said she repeatedly informed officials of the bruising on her arms and knees that she had sustained at the hands of the state security official who detained her. But it was not until the tenth day of her detention that a prosecutor took note of her complaint of ill-treatment. Upon leaving prison, authorities verbally told her she was under house arrest until further notice, with some limited criteria for leaving her home, where, as of 15 August she remained.

Denial and internet interruptions

The Cuban authorities have developed a sophisticated narrative denying any human rights violations in the wake of the crackdown and placing the blame for the economic situation exclusively on the US economic embargo. While the US government should urgently lift the embargo, as Amnesty International has stated for years, responsibility for the policy of repression lies squarely with the most senior commanders in the Cuban administration.

Using their monopoly over state media, authorities have broadcast select footage of incidents of violence in the protests to mischaracterize them as violent overall. In a letter to the UN Secretary General, Cuban Ambassador Pedroso Cuesta denied any allegation of human rights violations by law enforcement bodies and described the protests as “violence and incitement to violence, vandalism, and other criminal activities…”

In a press conference on state television, the Prosecutor General and President of the Supreme Court sought to deny any procedural wrong-doing, or violation of international human rights law. The President of the Supreme Court insisted that the justice system and judges operate with independence and indicated that the media was publishing false information distributed by “enemies of institutional order and the Cuban Revolution.”

Amnesty International calls on the government of Miguel Diaz-Canel to immediately and unconditionally release all those detained for exercising their human rights

Erika Guevara-Rosas, Americas director at Amnesty International

Since 11 July, the authorities have frequently disrupted internet access, in violation of international human rights law. On 11 July, there were countrywide internet outages and then a decrease in traffic until 12 July, according to network measurements gathered by Kentic. Since then, the authorities have also regularly blocked instant messaging apps such as Whatsapp, Telegram and Signal. According to a representative from the Open Observatory of Network Interference (OONI), the technology used to carry out the blocking has become increasingly sophisticated, particularly since 2019, when the organization also noted blocking of media sites during the Constitutional Referendum.

This censorship by the Cuban authorities, who control the country’s only telecommunication network, has impacted the ability of independent human rights observers, including Amnesty International, to document at a critical time. Curtailing communication during the COVID-19 pandemic could also have serious implications for economic, social and cultural rights, including the right to health.

“Amnesty International calls on the government of Miguel Diaz-Canel to immediately and unconditionally release all those detained for exercising their human rights. We reiterate our historical request for access to Cuba to monitor the human rights situation and the upcoming trials of hundreds of people who remain in detention,” said Erika Guevara-Rosas, Americas director at Amnesty International. 

Recommendations

Based on this initial research, Amnesty International makes the following recommendations:

  1. The Cuban authorities must immediately and unconditionally release all those detained for the exercise of their freedom of expression and peaceful assembly
  2. Cuba’s most senior commanders must immediately end the policy of repression which violates human rights and is designed to maintain a culture of fear and quash all forms of dialogue
  3. Cuba must immediately grant the UN Special Rapporteur for Freedom of Opinion and Expression and the UN Special Rapporteur on the Situation of Human Rights Defenders access to the country to document the human rights situation in the country
  4. Cuba must immediately grant access to independent human rights organizations, including Amnesty International, to monitor and observe the upcoming trials of the hundreds of activists and ordinary Cubans who remain detained
  5. Cuban authorities must ensure that the economic, social and cultural rights of the population are met, address their need for greater access to food and medicine, and provide an effective response to the COVID-19 pandemic
  6. The international community must condemn the actions of the Cuban authorities in the strongest possible terms in all diplomatic meetings and international spaces
  7. The US authorities must lift the decades-old economic embargo against Cuba as it contributes to violating economic rights

For more information or to arrange an interview, contact Duncan Tucker: duncan.tucker@amnesty.org

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Thailand: Urgent investigation needed after live rounds fired at child protesters

The Thai authorities must urgently investigate the shooting of protesters in Bangkok that has left one child in a critical condition, Amnesty International said after confirming that three children were injured by live rounds of ammunition during a demonstration outside a police station on Monday.

The mother of a 15-year-old protester told Amnesty that her son is in a coma and that a bullet – believed to be live ammunition – remains lodged in his skull. The organization confirmed that another protester, aged 14, suffered a bullet wound in the shoulder from live ammunition while a third protester, aged 16, was shot in the foot.

The Thai police have denied using live ammunition and it is unconfirmed who fired the shots.

“The use of live ammunition against protesters is a deeply concerning development. The Thai authorities must urgently investigate the shootings of these child protesters, including any unlawful use of firearms,” said Emerlynne Gil, Amnesty International’s Asia-Pacific Deputy Director.

“Thailand’s government must also investigate all reports of excessive and unnecessary force by police against protesters over the past year, and bring to justice anyone found responsible of causing physical harm to protesters.”

Over recent weeks, protesters have flocked to Bangkok’s streets and around Thailand to voice concerns over the official handling of the Covid-19 pandemic and other political grievances. The authorities have ramped up their use of rubber bullets, water cannon and tear gas to disperse protests – even when protests have been peaceful.

In its recent report, Amnesty International called on Thai authorities to prioritize non-violent means, such as negotiation, mediation and dialogue, to de-escalate situations that might lead to violence.

The organization has also called on authorities to ensure that devices such as tear gas or water cannon are used only in situations of more generalized violence for the purpose of dispersing a crowd, and only when all other means have failed to contain the violence.

“Recent policing of assemblies, coupled with Thailand’s history of impunity for excessive and sometimes even lethal force against protesters, highlights the need for Thai authorities to change their approach. If they genuinely want to prevent human rights violations, they must stop repressing peaceful protest and instead facilitate and protect it,” said Emerlynne Gil.

“The police’s handling of protests, including those which are not peaceful, must be necessary and proportionate. Security forces must refrain from using the type of excessive force that has been seen repeatedly during protests since 2020.

“Police authorities must protect the rights of all peaceful protesters from disruption or violence by third party actors.”

Background

On the night of 16 August 2021, live ammunition was fired at protesters near the Din Daeng police station in central Bangkok as police tried to disperse peaceful demonstrators. The police have denied using live ammunition.

Ratchavitee Hospital, which is treating the injured protesters, said on 17 August that a 15-year-old is in a coma after a bullet struck him in the head. The 14-year-old protester who was shot in the shoulder has now been released from hospital.

Tens of thousands of Thais took to the streets to demand democratic reforms in largely peaceful protests throughout 2020 and into 2021 in Bangkok, the capital, and in provinces across Thailand. Amnesty International has found that authorities responded to protests with escalating arbitrary use of tear gas, rubber bullets and other less-lethal weapons and have used unnecessary and excessive force, with an apparent lack of accountability. The Thai Civil court has called on police to exercise restraint in their policing of assemblies.

As protests have reignited in recent weeks, police have fired tear gas and water cannon at demonstrators and arrested and detained numerous peaceful protesters – including under emergency provisions ostensibly put in place? to tackle Covid-19 and despite the country’s prisons reporting thousands of infections in recent weeks.

According to Thai Lawyers for Human Rights, from July 2020 to August 2021, at least 800 individuals have faced criminal charges – including sedition, royal defamation, computer-related crime, violation of the emergency provisions – in 374 lawsuits for joining peaceful protests, 69 of them children.

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Somalia: Wholly inadequate Covid-19 response highlights need to use debt relief to invest in healthcare

The Covid-19 pandemic has highlighted the need to urgently address the serious and longstanding issues facing Somalia’s healthcare system following years of underinvestment and against a backdrop of crippling debt, Amnesty International said in a new report published today.

The report entitled “We Just Watched Covid-19 Patients Die” – Covid-19 Exposed Somalia’s Weak Healthcare System But Debt Relief Can Transform It, shows how Covid-19 has exposed a range of pre-existing weaknesses in Somalia’s healthcare system.

It is based on interviews with more than 40 individuals, including 33 health and humanitarian workers, government officials, finance and debt relief experts, as well as analysis of government budgets and policies and feedback from Somalia’s Ministry of Finance.

The Somalia government’s response to the pandemic was wholly inadequate…

Deprose Muchena

The research finds that access to health facilities for Covid-19 patients has been severely limited with just one hospital in the capital Mogadishu managing all Covid-19-related cases across the south-central region during the first wave of infections.

“The Somalia government’s response to the pandemic was wholly inadequate – characterized by a dire lack of ventilators, severe shortages of oxygen and almost non-existent access to ambulance services, all of which are the result of years of neglect and failure to invest in healthcare” said Deprose Muchena, Amnesty International’s Director for East and Southern Africa.

“Now that Somalia is eligible for debt relief, the authorities should ensure that a sufficient portion of the proceeds and future grants are used to significantly invest in improving healthcare provision, both in rural and urban areas.”

Poor healthcare infrastructure and little investment

Somalia, whose recent history is marked by armed conflict and political instability, as well as being one of the most heavily indebted countries in the world trails others on many health indicators, including access to reproductive, maternal and child healthcare. Child mortality is currently the highest in the world. In 2017, it had a ratio of one surgeon per 1,000,000 people. Only an estimated 15 percent of people have access to medical care in rural areas.

An Amnesty International analysis of the country’s government budgets between 2017 and 2021 showed that the average budget allocated for health and health-related projects was only 2%. In the same period, the average budget allocated to the security sector, including to the ministries of defence and internal security, was 31 percent of the total government budget.

Wholly inadequate response to Covid-19 and health workers under threat

Officially, there have been 15,294 confirmed Covid-19 cases, and 798 confirmed deaths, but the actual figures are likely to be much higher given the limited testing capacity, and weaknesses in the reporting and registration of deaths.

This is confirmed by the country’s Chief Medical Officer Dr. Mohamed Mohamud Ali, who told Amnesty International that he believes the death toll from Covid-19 is far higher than estimated. “Testing was very limited. Only those who managed to get to health facilities and were tested are included in the official government data. The figure is just a tip of the iceberg, many more were infected and died at home,” he said.

There was a day we had four elderly men in one ward, they all needed oxygen, but they all died within 10 minutes.

Senior doctor

Medical staff Amnesty spoke to reveal how the country has struggled from day one with its healthcare response during the pandemic. One nurse told Amnesty International: “We scrambled at the beginning. Everything was a mess. We had nothing to treat patients with. There was no oxygen, no ICU beds, and no ventilators. We just watched patients die, it was really sad.”

A senior doctor said many Covid-19 positive patients also died because of insufficient oxygen supplies: “We had to use a single nasal oxygen cannula for multiple patients. There was a day we had four elderly men in one ward, they all needed oxygen, but they all died within 10 minutes. I can still remember their faces; I am sad we were unable to get oxygen to save their lives.”

Commenting on shortages experienced during the first few weeks of March 2020, a lab specialist with the Ministry of Health told Amnesty International: “We did not have any testing equipment for a few weeks… We were initially sending samples to Kenya for testing until we got the first PCR machine as a donation from the Chinese company Alibaba.”

To make matters worse, health workers have had to  work in a challenging and often highly dangerous security environment. For example, in Gololey village, Middle Shabelle region, eight health workers at a mother and child clinic were abducted and killed by armed men dressed in military and police uniforms in May 2020. Authorities appointed a committee to investigate the incident, but to date the findings have not  been made public and no perpetrators brought to justice.

Currently, the country is faced with a shortage of vaccines, giving it little fighting chance against the continued spread of Covid-19. By early August, only 0.6 percent of the population was fully vaccinated. Of the 33 health workers Amnesty International interviewed for this report, although all had had the opportunity to be vaccinated, 19 of them had it turned down – a situation emblematic of the wider vaccine hesitancy in the country, the result in part, of a lack of sufficient public information.

Debt relief as an additional resource: an opportunity that must not be squandered

Despite these challenges, the government, with the help of international partners such as  the World Health Organization, has been making efforts to strengthen the health system, including the adoption of a roadmap towards Universal Health Coverage (UHC). The government must continue to build on these efforts.

However, a key window of opportunity for significant additional resourcing has opened up which the government must seize. Somalia  recently reached the decision point for debt relief under the Heavily Indebted Poor Countries (HIPC) Initiative. This means it is also now eligible for additional budget support and grant financing.

The government should use any gains from debt relief to significantly and progressively increase health budgets

Deprose Muchena

Amnesty International is calling on the Federal Government of Somalia to allocate a sufficient portion of any debt relief proceeds and new grants to improving the right to health, in line with its UHC roadmap and its international human rights obligations. To ensure adequate healthcare for all both the government and the international community, with financial and technical assistance, have a role to play.

“COVID-19 has caused the death of millions across the world, but the sad truth is that in Somalia so many of those deaths were preventable. The country cannot afford to keep repeating these failings. The government should use any gains from debt relief to significantly and progressively increase health budgets from the 2% pre-Covid-19 allocation with the aim of ultimately hitting the 15% of annual budget in line with the Abuja Declaration, which it has signed up to,” said Deprose Muchena.

“Somali people have the right to access adequate health facilities wherever they live across the country, including critical health care and treatment which continues to be desperately needed in the fight against Covid-19.”

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