Human Rights Dialogue (1994–2005): Series 2, No. 6 (Spring/Summer 2001): Rights and the Struggle for Health: Articles: Using Indicators to Guide Advocates

May 6, 2001

Though the vast rainforest of the Ecuadorian Amazon is rich in oil, the eight different indigenous groups and settlers from other parts of Ecuador living there remain poor and without adequate access to health care and other services. What the indigenous people of the Amazon do know about the black crude is that it has brought continuous destruction of their lands and cultures. The new settlers spoke of problems such as leaks of a horrible-smelling gas (hydrogen sulfide), which killed their farm animals and knocked out their kids; the burning of a gas that brought "black rain" and contaminated their drinking water; oil spills in their rivers that affected fish catches and may have caused dermatitis; and the slow leakage of oil-related sludge from ponds into their farm lands, affecting their crops. These allegations were denied by both the oil companies and the government of Ecuador. Neither had ever collected data or conducted an environmental impact assessment--nor had they considered that any major economic decision that profoundly affects people's human rights must recognize the affected population as stakeholders in the decision-making process.

Seven years ago, the Center for Economic and Social Rights (CESR) released its first report on violations of the right to health and a healthy environment in Ecuador, "Rights Violations in the Ecuadorian Amazon: The Human Consequences of Oil Development." Our conclusions stemmed from a study we designed that sought to establish whether there was a link between the contamination of water with oil and an increased risk of cancer in the population. Starting from the premise that the right to health is scientifically measurable, the report provided a strong factual basis for claims that oil companies' ruthless exploitation of a pristine environment and unique peoples infringed upon that basic right. Ultimately, we hoped that our efforts would draw broader public attention to environmental issues and demonstrate how human rights violations such as the ones detailed in the report might be addressed through the framework of the law. We also wanted to show how the use of statistical indicators could empower small grassroots organizations to hold governments and other powerful actors accountable for the effects of their policies on human rights.

Despite the knowledge that contamination of the environment with microorganisms, physical agents, and toxic substances can affect health, the causal link between exposure and ill health was difficult to establish--thus making it hard to prove that the government was failing to live up to its obligations under both the International Covenant on Economic, Social and Cultural Rights and domestic constitutional law, which includes a right "to live in an environment free from contamination." There were no population-based statistics or mortality and morbidity data from hospitals or clinics and no epidemiological studies. As a small NGO with a limited budget, we could not engage in a traditional study, which would take several years--we were going to be in the Amazon for less than ten days. In addition, the fact that environmental contaminants had been released over decades made ascertaining and quantifying their effects quite laborious.

In order to surmount these obstacles, we worked with public health experts on toxicology, environmental health, and occupational health, designing a study that would, on the one hand, measure exposure to oil-related substances in the environment and, on the other hand, ascertain whether or not health complaints might be related to oil pollution. We asked two questions: Are the residents of the Amazon exposed to levels of crude oil or toxic crude oil constituents that constitute significant health and safety risks? And are residents experiencing health effects that could be attributable to crude oil or related exposures?

To answer the first question we had to choose indicators that had clear potential for showing human exposure, intake, and harm and that were also amenable to convenient sampling, transport, and analysis. We decided to focus on exposure through bathing, drinking, and production water and to measure two classes of toxic crude oil constituents for which there were internationally recognized exposure guidelines. These two toxins were chosen also because they are associated with acute, observable health effects (e.g., dermatitis), as well as chronic and irreversible health effects (e.g., cancers).

Answering the second question was a little more difficult as indicators related to chronic adverse health effects (such as cancers, reproductive and developmental problems, and immunological impairment) are more difficult to measure. We decided that skin disease as a result of exposure to oil was easy to observe in a physical examination. The physician recorded case histories and diagnosed only current health problems that might be related to oil spills or other exposure measurements.

Our study revealed that drinking water samples were associated with excess cancer risks from four to seven cases per millions. We also observed a higher rate of oil exposure-related dermatitis among residents near oil production facilities. These contamination-related health problems were directly linked to the government's failure to comply with the minimum duties derived from its national and international obligations. The government failed to take reasonable precautions to avoid contaminating the environment, to regulate private actors effectively to prevent such contamination, and to provide potential victims of contamination with judicial remedies and access to information on oil development.

The CESR report concluded that the government has a legal obligation to respect and protect the health of its population. While there are no blueprints to guide human rights advocates in measuring the right to health, in our experience it is possible to construct indicators, as well as to reframe existing indicators, for human rights purposes. Ultimately, the report fulfilled our initial goals. First, it helped generate public pressure against the government's oil policies. The findings appeared in a comic book that was disseminated widely among indigenous and settler groups. The local press and the New York Times reported on the government's and the oil companies' negligence. Second, the report led to two separate legal actions: a class action lawsuit against Texaco, and a legal petition to the Inter-American Human Rights Commission on behalf of an Ecuadorian indigenous federation protesting the activities of a private oil company. Finally, CESR, along with local groups, organized workshops on documentation, monitoring, and legal obligations and accountability for local peoples. These led to the formation of a Frente de Defensa de la Amazonia -- a coalition of 300 indigenous groups, environmental groups, and "colono" communities that have joined together to resist irresponsible oil production.

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