Reports

The 79-page report, “‘Die First, and I’ll Pay You Later’: Saudi Arabia’s ‘Giga-Projects’ Built on Widespread Labor Abuses,” documents widespread abuses against migrant workers, some of which may amount to situations of forced labor, including exorbitant recruitment fees, rampant wage theft, inadequate protections from extreme heat, restrictions on transferring jobs, and uninvestigated worker deaths. Saudi authorities have systematically failed to prevent or remedy these abuses, including at high-profile projects financed by its sovereign wealth fund, the Public Investment Fund (PIF).

The 83-page report, “‘They Destroyed What Was Inside Us’: Children with Disabilities Amid Israel’s Attacks on Gaza,” documents that children who have acquired a disability and children who already had a disability in Gaza face a precarious security situation and additional difficulties as they struggle to comply with frequent Israeli army evacuation orders and a lack of effective advance warning of attacks. The ongoing siege of Gaza, the unlawful obstruction of humanitarian aid, the use of starvation as a weapon of war, and damage and destruction of hospitals cause disproportionate harm to children with disabilities, who struggle to access desperately needed medical treatment and supplies, assistive devices, food, and water. They are at particular risk of lasting psychological harm.

The 78-page report, “Reproductive Rights in the US Wildfire Crisis: Insights from Health Workers in Oregon State,” finds that the US government needs to do more to address the growing threat wildfires pose to maternal and newborn health, particularly in marginalized communities. The organizations documented the impacts of recent wildfires on maternal and newborn health in the state of Oregon, drawing on the experiences of community health workers and maternal health providers, among others.

The 38-page report, “‘A Disaster for the Foreseeable Future’: Afghanistan’s Healthcare Crisis,” describes how the collapse of Afghanistan’s economy after the Taliban takeover in August 2021 inflicted severe harm on the country’s healthcare infrastructure. Donors’ decisions to reduce humanitarian aid have further weakened health care access, destabilized the economy, and worsened food insecurity. The Taliban’s abusive policies and practices have greatly exacerbated the crisis. Bans on education for women and girls have blocked most training for future female healthcare workers, ensuring shortages for the foreseeable future.

The 45-page report, “‘Death is More Merciful Than This Life’: Houthi and Yemeni Government Violations of the Right to Water in Taizz,” found that parties to the conflict in Yemen have significantly exacerbated the area’s water crisis. The Houthis have weaponized water in Taizz by blocking water from flowing into Yemeni government-controlled Taizz city, while Yemeni government-affiliated military forces have previously sold public water supplies to residents for their own profit.

The 24-page report, “‘You Can Smell Petrol in the Air’: UAE Fossil Fuels Feed Toxic Pollution” documents alarmingly high air pollution levels in the UAE, which create major health risks for its citizens and residents and contribute to the global climate crisis. The UAE is one of the world’s largest oil producers and home to seven so-called “carbon bombs,” the world’s largest fossil fuel production projects. Air pollution and climate change are directly linked, as the burning of fossil fuels contributes to air pollution and drives climate change.

The 100-page report, “‘I Felt So Stuck’: Inadequate Housing and Social Support for Families Seeking Asylum in the United Kingdom,” found that families seeking asylum face inhumane conditions in temporary housing, including rat infestation and mould. The families experience daily struggles to get food their children will eat, as well as mental and physical health problems and serious disruptions to their children’s education.

The 62-page report, “In Sheep’s Clothing: United States’ Poorly Regulated Nonprofit Hospitals Undermine Health Care Access,” describes how the US government’s lack of guidance and oversight allows privately operated tax-exempt hospitals to spend far less on making healthcare services accessible for people without the means to pay than the massive public subsidies they receive. In 2020, for example, nonprofit hospitals collectively received about $28 billion in tax benefits but only spent about $16 billion on free or reduced-price “charity care,” according to the Kaiser Family Foundation.

The 55-page report, “A Nightmare for Everyone: The Health Care Crisis in Pakistan’s Prisons,” documents widespread deficiencies in prison health care in Pakistan and the consequences for a total prison population of more than 88,000 people. Pakistan has one of the world’s most overcrowded prison systems, with cells designed for a maximum of 3 people holding up to 15. Severe overcrowding has compounded existing health care deficiencies, leaving inmates vulnerable to communicable diseases and unable to get medicines and treatment for even basic health needs, as well as emergencies.

The 39-page report, “Access Denied: How Florida Judges Obstruct Young People’s Ability to Obtain Abortion Care,” documents how in Florida many judges deny young people’s petitions, forcing them to continue a pregnancy against their wishes, travel outside the state, or seek a way to manage abortion outside the health system. Judges have the power to make highly subjective determinations about a young person’s maturity and interests. Vague criteria in state law enable highly arbitrary decision-making, with judges making decisions based on factors such as the young person’s grades and impressions of their demeanor during a nerve-wracking hearing.

The 92-page report, “‘If I’m Out of Insulin, I’m Going to Die:’ United States’ Lack of Regulation Fuels Crisis of Unaffordable Insulin,” describes the human rights impacts of US government policies that make essential life-saving medication like insulin unaffordable for many people. Human Rights Watch found that exorbitant insulin prices and inadequate health insurance coverage can cause people to pay high out-of-pocket costs for insulin, contributing to dangerous and potentially lethal medicine rationing, forcing people to forgo other basic needs, and disproportionately affecting socially and economically marginalized groups.

The 82-page report, “‘We Need Access’: Ending Preventable Deaths from Cervical Cancer in Rural Georgia” documents how state and federal policies neglect the reproductive healthcare needs of rural Black women. Cervical cancer is highly preventable and treatable. In 2020, 194 countries committed to ending cervical cancer globally, the first such commitment made for a cancer. While cervical cancer mortality rates have declined in Georgia over recent decades, they are still high and racial disparities persist.

The 39-page report, “‘I Would Like Four Kids—If We Stay Alive’: Women’s Access to Health Care in Afghanistan,” documents barriers to Afghan women and girls obtaining health care and the healthcare system’s deterioration due to declining international support. The drop in international donor funding has already had a harmful—and life-threatening—impact on the lives of many women and girls, as it affects access to and quality of health care.

The 73-page report, “‘The Only People It Really Affects Are the People It Hurts’: The Human Rights Impacts of Parental Notice of Abortion in Illinois,” is the product of a collaboration between Human Rights Watch and the ACLU of Illinois. The groups found that young people often seek judicial bypass because they fear physical or emotional abuse, being kicked out of the home, alienation from their families or other deterioration of family relationships, or being forced to continue a pregnancy against their will. The groups also documented the hardships faced by young people forced to involve unsupportive family members in their abortion decision or navigate an unfamiliar court system to obtain a judicial bypass, and the additional stress and delays in seeking care this caused.

On March 11, 2020, the World Health Organization (WHO) declared that an outbreak of the viral disease Covid-19—first identified in late 2019 in Wuhan, China—had reached the level of a global pandemic. Citing concerns with “the alarming levels of spread and severity,” the WHO called on governments to take urgent and aggressive action to stop the spread of the virus.