Health as a Human Right: A Fake News in a Post-human World?

Based on a synthetic overview that embraces the evolution of the 'health' concept, and its related institutions, from the role of health as the main indicator of fundamental human rights-as envisaged in the Universal Declaration of Human Rights-to its qualification as the systems of disease control dependent on criteria of economic sustainability, the paper focuses on the implications and the impact of such evolution in two model scenarios which are centred on the COVID-19 pandemia. The article analyses COVID-19 both in the characteristics of its global dynamics and in its concrete management, as performed in a model medium income country, Argentina. In a world which has progressively assigned market values and goods an absolute strategic and political priority over the health needs and the rights to health of individual and peoples, the recognition of health as human right is confined to aspirational recommendations and rather hollowed out declarations of good will.

Digitalisation of birth registration system in Malaysia: Boon or bane for the hard-to-reach and marginalised?

Access to birth registration among the refugees, migrants, and undocumented or stateless individuals in Sabah and Peninsular Malaysia remains hindered largely due to their lack of legal status. This study identifies the barriers to birth registration faced by these communities, including during the COVID-19 pandemic, and explores the extent to which digital technologies may overcome or amplify these barriers. Findings are reported from a review of literature, websites, and media articles and semi-structured interviews with community-based organisations and community leaders representing the communities. The themes for the questions were structured based on Plan International's (2015) Step-by-step Guide for Identifying and Addressing the Risks to Children in Digitised birth registration systems. We identified that the digitalisation of birth registration poses more risks of exclusion than benefits to the marginalised communities without a secure and inclusive operating environment. Subject to an inequality assessment to evaluate and address the existing inequalities, a hybrid system that factors in the role of citizen facilitation hubs would be ideal for ensuring no one gets "left behind".

Communication as a human right: Citizenship, politics and the role of the speech-language pathologist.

According to Article 19 of the Universal Declaration on Human Rights "Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers." The purpose of this paper is to elucidate communication as a human right in the life of a young man called Declan who has Down syndrome. This commentary paper is co-written by Declan, his sister who is a speech-language pathologist (SLP) with an advocacy role, his SLP, and academics. Declan discusses, in his own words, what makes communication hard, what helps communication, his experiences of speech-language pathology, and what he knows about human rights. He also discusses his passion for politics, his right to be an active citizen and participate in the political process. This paper also focuses on the role of speech-language pathology in supporting and partnering with people with communication disabilities to have their voices heard and exercise their human rights.

Assessment of communication abilities in multilingual children: Language rights or human rights?

Communication involves a sender, a receiver and a shared code operating through shared rules. Breach of communication results from disruption to any of these basic components of a communicative chain, although assessment of communication abilities typically focuses on senders/receivers, on two assumptions: first, that their command of features and rules of the language in question (the code), such as sounds, words or word order, as described in linguists' theorisations, represents the full scope of linguistic competence; and second, that languages are stable, homogeneous entities, unaffected by their users' communicative needs. Bypassing the role of the code in successful communication assigns decisive rights to abstract languages rather than to real-life language users, routinely leading to suspected or diagnosed speech-language disorder in academic and clinical assessment of multilingual children's communicative skills. This commentary reflects on whether code-driven assessment practices comply with the spirit of Article 19 of the Universal Declaration of Human Rights.

From individual to global: Human rights and aphasia.

This commentary marks the 70th anniversary of the Universal Declaration of Human Rights by examining Article 19 and its application to people with aphasia. This group of people still face lack of access, stigmatisation, exclusion, disadvantage and social withdrawal as well as poor public awareness of aphasia and inadequate prioritisation of support and resources. Nevertheless, a range of creative initiatives at individual, healthcare, local community, national and global levels have helped to connect and empower people with aphasia. Such initiatives include provision of accessible information in a range of media, inclusion of people with aphasia in decision-making and as research partners, awareness raising campaigns to counter attitudinal barriers, organisation of community aphasia groups, development of guidelines for best practice, national aphasia associations and international collaborations such as Aphasia United. While ongoing work and resourcing is needed to expand these efforts further, they have helped people with aphasia to be heard and to protect their sense of dignity which underlies human rights. A human rights approach can unite, politicise and refocus these efforts, and highlight the essential role of communication in fostering a better quality of life.

A human right to literacy education: Implications for serving Syrian refugee children.

Forty percent of Syrian refugees are younger than 12, and many have not attended school for up to five years, disadvantaging them academically, emotionally, and psychosocially. Article 19 of the Universal Declaration of Human Rights dictates "the right to freedom of opinion and expression…and to seek, receive and impart information and ideas…)". Resettled refugee children face the challenge of integration into majority-English school systems with limited ability to express themselves or linguistic means to access education. However, Syrian adults possess high rates of literacy and funds of knowledge that can promote an environment of learning in the home language. With incomplete language and literacy skills in their native Arabic, learning English for academics proves challenging. Without language and literacy instruction, refugee children experience a lower likelihood of class participation and a greater likelihood of social isolation or drop out. To inform speech-language pathologists and other educators, this literature review aims: (1) to apply second language learning concepts relevant to refugees, (2) to inform pedagogy specific to reading by highlighting cross-linguistic differences between Arabic and English, and (3) to illuminate strategies that families and educators of Arabic-speaking refugee students may employ to resume and promote language and literacy development.

Protecting the human right to freedom of expression in international law.

Since its inclusion in Article 19 of the Universal Declaration of Human Rights, the right to freedom of opinion and expression has been protected in all of the relevant international human rights treaties. In international law, freedom to express opinions and ideas is considered essential at both an individual level, insofar as it contributes to the full development of a person, and being a foundation stone of democratic society. Free speech is a necessary precondition to the enjoyment of other rights, such as the right to vote, free assembly and freedom of association, and is essential to ensure press freedom. However, there is a clear and worrying global trend, including in western democracies, of governments limiting vibrant discussion and debate within civil society and among civil society, political leaders and government. Two examples illustrate this trend. First, anti-protest laws in Australia and the United States threaten the ability of people to stand together and express views on issues they care deeply about. Secondly, metadata retention laws jeopardise press freedom by undermining the confidentiality of journalists' sources and dissuading people from speaking freely on matters of public importance.

Social participation for people with communication disability in coffee shops and restaurants is a human right.

Although Article 19 of the Universal Declaration of Human Rights states that "everyone has a right to freedom of opinion and expression", for people with communication disability this may not be a reality. This commentary shares a practical example of how people with communication disabilities together with speech-language pathology (SLP) students, academics and clinical staff co-designed and co-implemented a Communication Awareness Training Programme for catering staff to enable communication access in coffee shops and restaurants. This is an example of how SLPs can embrace their social responsibility to break down barriers for people with communication disabilities. This commentary shares the reflections of those involved and how they felt empowered because they had learned new skills and made a difference. This commentary highlights the need for co-design and co-delivery of programs to raise awareness of communication disability among catering staff and how the stories of people with communication disabilities served as a catalyst for change. It also highlights the need to SLPs to move intervention to a social and community space.

Upholding the human right of children in New Zealand experiencing communication difficulties to voice their needs and dreams.

New Zealand Ministry of Education's proposal for an updated service to support children experiencing communication difficulties provides an opportunity to consider the essential criteria required for children to express their opinion, information and ideas as outlined under Article 19 of the Universal Declaration of Human Rights. This commentary begins with a summary of key policies that provide strategic direction for enhancing children's rights to be actively involved in the development of services designed to support them and to communicate and participate in inclusive environments. The authors use a human rights lens to inform the development of speech-language pathology services that facilitate individuals' contribution and engagement and are responsive to their needs. A review of international literature describing the lived experience of children and young people identifies key factors related to accessible information, service coordination, holistic practice, and partnerships that facilitate co-constructed understanding and decision-making. The commentary concludes with suggested recommendations for structuring services, establishing partnership models, and capability building.

The positioning of Aboriginal students and their languages within Australia's education system: A human rights perspective.

This paper is a critical review of past and present languages policies in Australian schooling. We highlight the One Literacy movement that contravenes the human rights of Australia's Aboriginal students. This in turn impacts students' right to freedom of opinion and expression as stated in Article 19 of the Universal Declaration of Human Rights. The One Literacy movement operates by equating Standard Australian English literacy acquisition with Australia's global competitiveness and economic success. There is only one pathway through the Australian English curriculum with common assessments and standards. However, the Australian Curriculum provides three distinctive pathways when students from an English-speaking background learn languages other than English. We reveal this double standard, where current educational policies prioritise the languages of trade (e.g. Chinese) and accommodate speakers of these languages. Meanwhile Aboriginal-language-speaking students are not provided with the same accommodations. For educational equity, there should be a distinctive English language learner pathway that recognises that the majority of remote Aboriginal students from the Northern Territory are learning English as an additional language. We advocate for these changes because all children have a right to an appropriate education that will enable them to flourish as learners and citizens.

Mother tongue as a universal human right.

Article 19 of the Universal Declaration of Human Rights enshrines the right to freedom of opinion and expression. UN Resolution A/RES/61/266 called upon Member States "to promote the preservation and protection of all languages used by peoples of the world". This resolution has particular relevance for minority language groups where mother tongue - so vital to self-expression - is primarily a spoken medium, often ascribed low status. With few fluent readers and writers, and a consequent dearth of written resources, a vicious circle develops and linguistic and cultural heritage erodes. Not all governments are vigilant with appropriate policies and funding. Even in a community like Shetland, where there is no class connotation associated with speaking Shetlandic, the proportion of fluent dialect speakers is now relatively small. It therefore falls to the writer to create resources for children, to help stem the tide. Engaging in translation can also help raise the status of dialect and pinpoint the somewhat arbitrary distinction between dialect and language. There are many problems in publishing in minority tongues; for example, uneconomic print runs, language authenticity versus contemporaneity, standardisation of orthography and the trend to "exotic-ise" dialect in mainstream literature.

The Stakeholder Model of voice research: Acknowledging barriers to human rights of all stakeholders in a communicative exchange.

The act of communication is a complex, transient and often abstract phenomenon that involves many stakeholders, each of whom has their own perspective: the speaker, the listener, the observer and the researcher. Current research practices in voice disorder are frequently framed through a single lens - that of the researcher/clinician or their participant/patient. This single lens approach risks overlooking significant barriers to the basic human right of freedom of expression for those with a voice disorder as it omits consideration of the impact of voice disorder on the listener, and consideration of the wider impact of the voice in the occupational context. Recent research in the area of voice has developed a multiple lens and subsequent Stakeholder Model that acknowledges the experience and reality of multiple stakeholders viewing the same phenomenon, the voice. This research paradigm is built on Article 19 of the Universal Declaration of Human Rights as it considers the realities of all stakeholders in forming a deeper understanding of the causality, impact and aspects of communication disorder. The Stakeholder Model will be presented as a suggestion for future investigations of communication disorders more widely.

Beyond lip service: Towards human rights-driven guidelines for South African speech-language pathologists.

Developed with a strong awareness of past injustices, South Africa's progressive constitution emphasises a full spectrum of human rights. While the constitution celebrates many languages and cultures, speech-language pathologists (SLPs) face challenges in translating these values into practice with a diverse clientele. Similarly, Article 19 of the Universal Declaration of Human Rights focuses on freedom of expression in one's language of choice, but is often perceived as a "Cinderella" right (i.e. one that is frequently neglected). This paper presents a literature review undertaken in association with the Health Professions Council of South Africa to produce guidelines to support SLPs in their practice with diverse linguistic and cultural groups. The aim was to identify key points for inclusion in a set of human rights-driven guidelines. Specific objectives were to critique: (1) current guidelines for SLPs working with diverse cultural and linguistic groups; and (2) equivalent guidelines for related professions. Content analysis of the datasets revealed key themes which formed the basis of an initial skeleton, to be further developed through a consultative process and discussion, ultimately aiming to provide supportive, practical guidelines to better equip South African SLPs to serve all the people of the country.

Speech-language pathologists as determiners of the human right to diversity in communication for school children in the US.

Article 19 of the Universal Declaration of Human Rights states that everyone has the right to freedom of opinion and expression - the right to communication. Communication is at the core of the speech-language pathology (SLP) profession. Yet, while we celebrate the 70th anniversary of the Universal Declaration of Human Rights some of our most vulnerable youth are being placed in special education at disproportional rates. School-based SLPs in the United States may be unwittingly contributing to this phenomenon, obstructing the human right to communication because of biased assessment procedures. However, increasing cultural competence, diversifying the profession, and utilising additional assessment measures are actions that can be taken to promote equity in assessment for all children.

Communication Capacity Research in the Majority World: Supporting the human right to communication specialist services.

Receipt of accessible and appropriate specialist services and resources by all people with communication and/or swallowing disability is a human right; however, it is a right rarely achieved in either Minority or Majority World contexts. This paper considers communication specialists' efforts to provide sustainable services for people with communication difficulties living in Majority World countries. The commentary draws on human rights literature, particularly Article 19 of the Universal Declaration of Human Rights and the Communication Capacity Research program that includes: (1) gathering knowledge from policy and literature; (2) gathering knowledge from the community; (3) understanding speech, language and literacy use and proficiency; and (4) developing culturally and linguistically appropriate resources and assessments. To inform the development of resources and assessments that could be used by speech-language pathologists as well as other communication specialists in Fiji, the Communication Capacity Research program involved collection and analysis of data from multiple sources including 144 community members, 75 school students and their families, and 25 teachers. The Communication Capacity Research program may be applicable for achieving the development of evidence-based, culturally and linguistically sustainable SLP services in similar contexts.

Human rights of refugee-survivors of sexual and gender-based violence with communication disability.

Article 19 of the Universal Declaration of Human Rights (United Nations, 1948 ) states that all people have the right to seek, receive and impart information using any means. Ensuring that people with communication disability achieve this right is inherently challenging. For people with communication disability, who are refugee-survivors of sexual and gender-based violence (SGBV), additional human rights are challenged, including the right to education, protection from discrimination, a safe place to live, security of person and legal protection. Their experiences and needs, however, are poorly understood. This paper reports on a literature review of the intersectionality between SGBV, being a refugee and having a communication disability, and a preliminary investigation of the situation of refugee-survivors of SGBV with communication disability, in Rwanda. The project involved 54 participants, including 50 humanitarian and partner organisation staff and four carers of refugees with communication disabilities, from two locations (camp-based and urban refugees). Findings from both revealed that, for people with communication disability, barriers are likely to occur at each step of preventing and responding to SGBV. Moreover, stigmatisation of people with communication disability challenges SGBV prevention/support and people with communication disability may be targeted by SGBV perpetrators. SGBV service providers acknowledge their lack of knowledge and skills about communication disability, but wish to learn. Findings highlight the need for increased knowledge and skill development, in order to improve the situation for refugee-survivors of SGBV with communication disability.

Bilingualism, a human right in times of anxiety: Lessons from California.

Article 19 of the Universal Declaration of Human Rights refers to the individual's right of expression without interference, "through any media and regardless of frontiers". Currently, in some nations across the world, there is decreasing interest in cross-cultural interactions and a new interest in nationalism and assimilation, in communication within frontiers and in a specific medium: the national language. Speech-language pathologists (SLPs) advocate for individuals with communication disorders that interfere with their comprehension and expression. The profession promotes communication as a human right. Unfortunately, many clients and their families continue to report instances in which we, SLPs, limit their human right of expression by ignoring their home languages and recommending the exclusive use of the national language. Real progress requires reflection and action on language policy. In 1998, Californians passed Proposition 227, which eliminated bilingual public education. Then, in 2016, California voters approved Proposition 58 allowing the creation of multilingual and biliteracy programs. A discussion about the presentation of these two propositions to the public may hopefully help bilingual SLPs and advocates protect our multilingual clients' human right of expression in these times of anxiety.

Assuring children's human right to freedom of opinion and expression in education.

The Universal Declaration of Human Rights elaborated for children through the United Nations Convention on the Rights of the Child, mandates each child's right to participate in all matters affecting them. In particular, Article 19 includes the child's right to freedom of expression and opinion, access to information and communication choice. However, many barriers placed on children's daily lives often restrict or limit the enactment of children's participatory rights in practice, most noticeably in education. It is often the adult who decides what, when and how children can communicate, and the extent children's views and opinions are sought, considered or incorporated. This paper explores how children's daily lives are mediated in ways that restrict their expression, voice and communication rights. Children spend a significant proportion of their daily lives in education settings yet the restrictions on children's access to information and communication choices do not reflect contemporary pedagogical thinking. Many school settings perpetuate the key participation barriers of adult attitude and knowledge, pedagogical tradition, organisational structure and technological advancement. Such barriers to engagement stifle the realisation of the child's communication rights that then limits educational enhancement. Supporting children's right to communicate via a range of media enables pedagogy supporting voice-inclusive practice.

Just Sentences: Human rights to enable participation and equity for prisoners and all.

Article 19 of the Universal Declaration of Human Rights holds up the right to opinion and expression for all. Just Sentences was a prison-based language-literacy pilot project for men, delivered by a speech-language pathologist at Risdon Prison in Tasmania, Australia. The pilot provided input into the various interpretative permutations of "just sentences". It enabled skills of opinion and expression. This commentary takes language and social reciprocity to be privileged drivers of personal agency and pro-social personal freedom. It notes the role of hope as an agent of positive change, including in desistance from crime. It describes the project and shares the reflections of the speech-language pathologist who delivered it.

Communication rights: Fundamental human rights for all.

The right to communicate includes the right to "freedom of opinion and expression" and rights and freedoms "without distinction of … language". The 70th anniversary of the Universal Declaration of Human Rights is a time to celebrate and reflect on communication as a human right, particularly with respect to Article 19 and its relationship to national and international conventions, declarations, policies and practices. This review profiles articles from the special issue of International Journal of Speech-Language Pathology (volume 20, issue 1) addressing communication rights from four perspectives: (1) communication rights of all people; (2) communication rights of people with communication disabilities; (3) communication rights of children and (4) communication rights relating to language. Divergent perspectives from across the globe are considered. First-hand accounts of people whose right to communicate is compromised/upheld are included and perspectives are provided from people with expertise and advocacy roles in speech-language pathology, audiology, linguistics, education, media, literature and law, including members of the International Communication Project. Three steps are outlined to support communication rights: acknowledge people - adjust the communication style - take time to listen. Future advocacy for communication rights could be informed by replicating processes used to generate the Yogyakarta Principles.