Contents – The forgotten patients: Lost voices in the global healthcare system

9 Apr 2025 | Afghanistan, Botswana, Czech Republic, Ethiopia, Georgia, India, Iran, Israel, Magazine Contents, Palestine, Russia, Slovakia, Somalia, Sudan, Sudan, Syria, Tunisia, Turkey, Uganda, Ukraine, United Kingdom, United States, Venezuela, Volume 54.01 Spring 2025

Contents

Modern medicine is a wonderful thing. Before Edward Jenner’s development of the smallpox vaccination in 1796, infectious diseases and viruses killed millions. The introduction of anaesthetic gases during surgical procedures in 1846 eliminated the excruciating pain of surgery. And before Alexander Fleming’s discovery of penicillin in 1928, people died unnecessarily from cuts and grazes.

But the benefits of modern medicine are not felt equally around the world. In this issue, we explore the forgotten patients in global healthcare settings – the marginalised groups who fall through the cracks or are actively shut out of healthcare provision, then ignored or silenced when they raise concerns.

Just like free speech, healthcare is an indisputable human right. But for many around the globe, both these rights are being removed in conjunction with each other. Through telling their stories, this edition aims to shine a light on these injustices and – we hope – empower more people to speak up for the right to health for themselves and others.

Up Front

A bitter pill to swallow: Sarah Dawood
Not all healthcare is made equal, and pointing this out can have serious consequences

The Index: Mark Stimpson
From elections in Romania to breaking encryption in the UK: a tour of the world’s most pressing free expression issues

Features

Rape, reputation and little recourse: Samridhi Kapoor, Hanan Zaffar
Indian universities have a sexual violence problem that no one is talking about

Georgian nightmare: Ruth Green
Russian-style laws are shutting down more conversations in Georgia, with academia feeling the heat

Botswana’s new era: Clemence Manyukwe
From brave lawyer to president – could the country’s new leader put human rights front and centre?

Venezuela’s prison problem: Catherine Ellis
The disputed new president has a way of dealing with critics – locking them up

Forbidden words: Salil Tripathi
The Satanic Verses is back in India’s bookshops. Or is it?

The art of resistance: Alessandra Bajec
A film, a graffiti archive and a stage play: three works changing the narrative in Tunisia

A tragic renaissance: Emily Couch
The pen is getting mightier and mightier in Ukraine

In the red zone: Alexandra Domenech
Conscription is just one of the fears of an LGBTQ+ visual artist in Russia

Demokratia dismantled: Georgios Samaras
The legacy of the Predator spyware scandal has left a dark stain on Greece

Elon musk’s year on X: Mark Stimpson
The biggest mystery about Musk: when does he sleep?

Keyboard warriors: Laura O’Connor
A band of women are fighting oppression in Myanmar through digital activism

Behind the bars of Saydnaya prison: Laura Silvia Battaglia
Unspeakable horrors unfolded at Syria’s most notorious prison, and now its survivors tell their stories

Painting a truer picture: Natalie Skowlund
Street art in one Colombian city has been sanitised beyond recognition

The reporting black hole: Fasil Aregay
Ethiopian journalists are allowed to report on new street lights, and little else

Special Report: The forgotten patients - Lost voices in the global healthcare system

Whistleblowing in an empty room: Martin Bright
Failures in England’s maternity services are shrouded in secrecy

An epidemic of corruption: Danson Kahyana
The Ugandan healthcare system is on its knees, but what does that matter to the rich and powerful?

Left speechless: Sarah Dawood
The horrors of war are leaving children in Gaza unable to speak

Speaking up to end the cut: Hinda Abdi Mohamoud
In Somalia, fighting against female genital mutilation comes at a high price

Doctors under attack: Kaya Genç
Turkey’s president is politicising healthcare, and medics are in the crosshairs

Denial of healthcare is censoring political prisoners – often permanently: Rishabh Jain, Alexandra Domenech, Danson Kahyana
Another page in the authoritarian playbook: deny medical treatment to jailed dissidents

The silent killer: Mackenzie Argent
A hurdle for many people using the UK’s National Health Service: institutional racism

Czechoslovakia’s haunting legacy: Katie Dancey-Downs
Roma women went into hospitals to give birth, and came out infertile

An inconvenient truth: Ella Pawlik
While Covid vaccines saved millions of lives, those with adverse reactions have been ignored

Punished for raising standards: Esther Adepetun
From misuse of money to misdirecting medicines, Nigerian healthcare is rife with corruption

Nowhere to turn: Zahra Joya
Life as they know it has been destroyed for women in Afghanistan, and healthcare provision is no different

Emergency in the children’s ward: Shaylim Castro Valderrama
The last thing parents of sick children expect is threats from militia

Comment

We need to talk about Sudan: Yassmin Abdel-Magied
Would “a battle of narratives” give the war more attention?

RFK Jr could be a disaster for American healthcare: Mark Honigsbaum
An anti-vaxxer has got US lives in his hands

The diamond age of death threats: Jemimah Steinfeld
When violent behaviour becomes business as usual

Free speech v the right to a fair trial: Gill Phillips
Are contempt of court laws fit for the digital age?

Culture

An unjust trial: Ariel Dorfman
A new short story imagines a kangaroo court of nightmares, where victims become defendants

Remember the past to save the future: Sarah Dawood, Diane Fahey
Published exclusively, the issues of antisemitism and colonialism are recorded through poetry

Where it’s more dangerous to carry a camera than a gun: Antonia Langford
A singer meets filmmakers in Yemen, and both take risks to tell her story

The fight for change isn’t straightforward: Shani Dhanda
The Last Word, on exclusion and intersectional discrimination

Telling fact from fiction

4 Oct 2024 | Israel, News and features, Newsletters, Palestine, Sudan

If a tree falls in a forest, and no one is around to hear it, does it make a sound? This well-known philosophical question most likely stems from the work of 18th century philosopher George Berkeley, who questioned the possibility of “unperceived existence”. In other words – did something really happen if no one is around to witness or perceive it?

This might seem a lofty and pretentious way to start this week’s Index newsletter. But the first-hand observance and subsequent documentation of events is the fundamental basis of rigorous journalism, and enables injustices to be accurately reported around the world. It provides us with the ability to understand truth from falsehood. And it is being increasingly undermined.

Journalistic “black holes” are appearing in conflicts globally, stopping the world from being able to witness what is happening on the ground, and therefore causing us to question reality.

Since the start of the Israel-Hamas war, triggered by Hamas's incursion into Israel on 7 October 2023, Israel has banned foreign media access in Gaza. Only very limited international news crews are allowed in under strict conditions. This has left the world reliant on press statements, the words of government officials, and individual Palestinian journalists, who have risked their lives to showcase the brutality of the war on social media.

And many have lost their lives in the process. According to investigations by the Committee to Protect Journalists (CPJ), as of 4 October 2024, at least 127 journalists and media workers are among the more than 42,000 Palestinians and 1,200 Israelis killed since the war began, making it the deadliest period for journalists since the organisation started gathering data in 1992. The CPJ has determined that at least five of these journalists were directly targeted.

Major broadcasters have also been targeted. Last month, Al Jazeera’s office in the West Bank was raided and shut down for 45 days by Israeli soldiers, following the closure of the channel’s East Jerusalem office in May, on claims that they are a threat to Israel’s national security. But as Al Jazeera English’s Gaza correspondent Youmna El Sayed writes for Index this week, such shutdowns of legitimate news providers prevent global audiences from being able to see the pain and suffering that is being endured by both Palestinians and Israelis, encouraging misinformation to propagate.

As hostilities escalate across the Middle East, news channels continue to be curtailed. This week, an air strike destroyed the headquarters of the religious al-Sirat TV station in Beirut, Lebanon, on grounds that it was being used to store Hezbollah weapons, a claim which Hezbollah denies. Foreign correspondents are, however, still allowed in Lebanon - but in Iran all broadcasting is controlled by the state, with foreign journalists barred, meaning access to objective reporting is essentially impossible.

Outside of the region, other countries’ severe reporting restrictions and intimidation of journalists have made it difficult for global audiences to comprehend what is happening in conflicts. This includes Kashmir, the disputed mountainous region between India and Pakistan, and Sudan, where it is estimated that 90% of the country’s media infrastructure has been wiped out by the civil war.

What is the impact of this? The worrying rise in press suppression not only creates huge risks for journalists, but severely curtails people’s ability to understand geopolitics, conflict, and in future, historical events. It stops us from being able to weigh things up and form opinions based on what we have perceived.

Ultimately, it is impossible for any news producer, whether they be an individual correspondent or a major broadcaster, to be truly “objective”. People are driven by motives, both emotional and financial, and their own lived experiences. A news organisation, backed by a particular country or group, will appear truthful to some and severely biased to others.

But the only way to ensure some level of objectivity is to retain access to a broad range of sources, from the BBC to Al Jazeera, helping us form a more rounded world view. To go back to Berkeley’s philosophical analysis, the only way to verify the truth is to have the privilege of witnessing the evidence. Without this, it becomes virtually impossible to be able to tell fact from fiction.

New magazine Atar fills information void in Sudan

10 May 2024 | Africa, News and features, Sudan

Atar, a digital magazine distributed via email and WhatsApp, first came to my attention late last October. I was in a dimly lit New York cafe, warmed by the company of a group of Sudanese diaspora; artists, activists, journalists, nursing hot teas and wounded souls. As it often does, the question of obtaining high quality Sudani news bubbled up. “Have you heard about Atar yet?’ someone asked. I hadn’t, yet. But this interaction was instructive. With their formal website still under construction, word-of-mouth was one of the main ways this weekly Arabic (bi-monthly English) magazine was being found.

An initiative of the non-for-profit Sudan Facts Center for Journalism Services - founded by veteran journalist Arif Elsaui - Atar began publishing on 12 October 2023, six months into the war against civilians in Sudan. Co-managing director Amar Jamal told Index it was a project borne of necessity.

“We had been talking about theory for a long time,” Jamal said. “But with the current situation, we realised there won’t be any more media outlets in Sudan left.”

Sudan Facts Center had been running fellowships for young professional journalists, but the crisis spurred them into pushing forward with their greater ambitions. “If we were going to wait until the perfect conditions, we would be waiting a long time. Let us start, and improve as we go along,” Jamal noted.

Since October, the Atar team has produced 28 Arabic editions and four in English. Inspired by The Continent, another popular African digital news magazine, Atar - with the tagline “Sudan in Perspective” - is currently distributed through Telegram, WhatsApp, Signal and email.

“There hasn’t been a day when our distribution list hasn’t grown,” Jamal said.

Stories range from investigations into “Sudan’s labyrinth of torture centres” to the stories of those fleeing the war north through Egypt. Early editions reported on the daily experiences of Sudanese people during the conflict, how they “eat, drink and sleep” and their “daily heroism”, while more recent releases focus on the mutual aid infrastructure keeping people alive.

Not only was the content of the story important to get right, Jamal said, but the voice and tone of the publication was given thorough consideration.

“We stay away from tragic language. While we are writing about death, we write about it with heroism.” Not necessarily out of a desire to give readers hope, “but to give people an encouraging word”.

Atar began with three editors in Nairobi - Arif Elsaui, Amar Jamal and Mohammed Alsadiq - and four correspondents. The first releases were focused on the written word, delivering vital information via dense blocks of text, not unlike the traditional Sudanese newspaper. But this model changed after the team took stock 10 weeks into the project. Over the new year period, “we took a break to review the structure and design, expand our pool of reporters, institutionalise the project so it wouldn’t fail,” Amar said.

Today, Atar is delivered by 24 reporters and seven editors. The growth is palpable, not only in the range of stories, but in their design. The structure and voice of Atar is unique, deliberately so. “This is not a newspaper, delivering daily stories,” Amar makes clear. Atar is focused on analysis, curation, about showing the verification and the context for your average reader to make sense of unfolding events.

“The need for a newspaper has changed in the age of social media,” said Jamal, noting that in an age of camera phones, the recording of events has been democratised.

“What is needed now is the verification and context. That is our ambition. Respecting the intellect of the Sudanese reader, and presenting material that yes, might be difficult, but it has value. The value it has is in its truth.”

Atar is providing a home for fact-based news in a prohibitive information landscape. There are few players in Sudan today, fewer still after the state suspended operations of three satellite channels this April, Saudi state-owned broadcasters Al Arabiya and Al Hadath and UAE-owned Sky News Arabia.

“All of the correspondents that we began with have had to leave the country,” Amar admitted. “It’s very difficult to write from the inside.” But difficult is not impossible, and Atar consistently manages to publish original stories from the ground.

“Sometimes, stories are written under the Atar byline to protect the journalist,” Jamal said, describing how their local correspondents find ways to contact sources and file stories even in the most challenging circumstances. “Even when the internet was cut off,” he said. “You just adjust your investigative style.”

Atar’s popularity now means that they are regularly approached by writers, reporters and potential sources as an outlet for news, with some sending in fully written pieces for publication. Atar pride themselves on having an open-door policy, allowing anyone to submit material via phone or email, but only work that goes through their fact-checking system will be included in the magazine. The volume of engagement and interest is a “scream from the people,” Jamal said. Even a 14-year-old girl sent a piece with some news. These are people’s voices who are not heard and Atar wants to be a home for them.

Such grounded local reporting cultivates intense loyalty and support, such as in the case of the small island of Dagarti. “It has maybe only 300, 400 inhabitants,” Jamal said. “Nobody had written about these people before. But when our journalist went to do a follow-up story, she said the whole island waits for Thursday so they can read Atar.”

What next for Atar? The team has big ambitions. Their English-language edition was always part of the plan, because “it isn’t just the Sudanese reader that cares about Sudan.” They have recently moved into a new, larger office in Nairobi, with talk of a live studio arm, events and more. Their approach is experimental, and with enough funding in the bank for the moment, Jamal is excited about the future.

Jamal is not the only one. If this is what the Sudanese people can do in the most inhospitable of circumstances, imagine the possibilities once the war is over.

Why we cannot afford to look away

19 Apr 2024 | News and features, Russia, Sudan, Ukraine

The world seems to be breaking at the seams. Our news is filled with images of war and the horror and fear that accompany them. We cannot afford to turn a blind eye to the suffering and devastation wrought by war and to be distracted from established conflicts as new ones emerge.

This week, Russia's ongoing and illegal aggression in Ukraine has almost passed without comment but Russia’s announcement of more mercenaries, coupled with Ukraine's adjustment of conscription laws to enlist younger individuals, and the dwindling air defences amidst brutal bombardments by Russia on innocent families, serve as stark reminders of the ongoing crisis in Ukraine.

It's a scenario we've seen unfold before. Initially, a conflict captures our attention, eliciting outcry and calls for action. However, as time passes, disaster fatigue sets in, a new disaster hits the news and the plight of those affected fades from public discourse. This is understandable and a completely human reaction. Horrors being played out on television screens night after night harm wellbeing and in some situations drive communities in other nations further apart.

The situation in Sudan stands as a harrowing testament to this phenomenon. Last week marked the first anniversary of the war in the region, yet over 8 million people are displaced, journalists continue to face persecution and activists and human rights defenders who strive to tell us the stories of atrocities unfolding are finding it harder by the day.

We must not allow history to repeat itself. In Ukraine we are at risk of seeing this happen. Every conflict demands our attention and action. While these wars may seem distant, the consequences of our indifference reverberate globally. Without international pressure for de-escalation and accountability, the waves of violence will inevitably crash upon our shores.

At Index on Censorship, we understand the fundamental role that freedom of expression plays in holding power to account and safeguarding human rights. When journalists are silenced, when dissidents are suppressed, the fabric of democracy unravels, leaving room for tyranny to flourish.

The illegal invasion of Ukraine by Vladimir Putin is not just a regional conflict; it is a test of our collective resolve to uphold the principles of peace, freedom, and justice. As the world watches, we cannot afford to look away. We must stand in solidarity with the people of Ukraine, amplifying their voices and advocating for an end to the Russian violence and aggression.

It is imperative that we keep the spotlight firmly fixed on Ukraine, ensuring that the atrocities committed do not fade into obscurity. Through relentless advocacy, robust journalism, and unwavering solidarity, we can make a difference. Let us not forget the lessons of the past, nor forsake our responsibility to act in the face of injustice.

Together, let us reaffirm our commitment to a world where freedom of expression is cherished, where human dignity is upheld, and where dissidents are free to highlight the plight within their nations.