\u00c7e\u00e7en ayr\u0131l\u0131k\u00e7\u0131lar ve Rus g\u00fc\u00e7leri aras\u0131ndaki sava\u015f ba\u015flad\u0131ktan neredeyse 15 y\u0131l sonra, \u00c7e\u00e7enya ve ba\u015fkenti Grozny’de uzun bir aradan sonra yeniden yap\u0131lanma \u00e7abalar\u0131 ve ekonomik alanda iyile\u015fmelerin g\u00f6r\u00fclmesiyle bu durum “\u00c7e\u00e7en mucizesi” olarak methediliyor. Bu arada ge\u00e7ti\u011fimiz y\u0131l A\u011fustos ay\u0131nda G\u00fcney Osetya \u00fczerinden Rusya ve G\u00fcrcistan’\u0131n sava\u015fmas\u0131ndan bu yana ise \u00c7e\u00e7enya’daki \u015fiddet olaylar\u0131nda \u00f6nemli \u00f6l\u00e7\u00fcde art\u0131\u015f g\u00f6zleniyor. \u015eiddete ba\u011fl\u0131 \u00f6l\u00fcm olaylar\u0131 bir \u00f6nceki y\u0131l ile kar\u015f\u0131la\u015ft\u0131r\u0131ld\u0131\u011f\u0131nda say\u0131n\u0131n neredeyse iki kat\u0131na \u00e7\u0131kt\u0131\u011f\u0131, 84’ten 152’ye y\u00fckseldi\u011fi g\u00f6r\u00fcl\u00fcyor.(1) <\/strong><\/p>\n \u0130nsan haklar\u0131 savunucular\u0131 taraf\u0131ndan “i\u015fkencenin, zorla itiraf\u0131n ve uydurma davalar\u0131n bir b\u00f6lgesel sistemi” olarak adland\u0131r\u0131lan ter\u00f6rle m\u00fccadele operasyonuna ge\u00e7ti\u011fimiz Nisan ay\u0131nda Rus askeri g\u00fc\u00e7leri resmen son verdi.(2)<\/strong> Ancak Rusya’n\u0131n temsilcileri direni\u015f\u00e7ilerce organize bi\u00e7imde ortadan kald\u0131r\u0131l\u0131rken, Rus g\u00fc\u00e7lerinin ter\u00f6rist zanl\u0131s\u0131 olarak iddia etti\u011fi ki\u015filere y\u00f6nelik zorla ortadan kaybetme, i\u015fkence ve di\u011fer k\u00f6t\u00fc muameleri gibi uygulamalar\u0131n\u0131n da devam etti\u011fi insan haklar\u0131 \u00f6rg\u00fctlerinin yan\u0131 s\u0131ra ulusal ve uluslararas\u0131 bas\u0131nca belgelendi.(3)<\/strong> \u00c7e\u00e7enlerce a\u00e7\u0131lan davalarda Avrupa \u0130nsan Haklar\u0131 Mahkemesi, Rus h\u00fck\u00fcmetini kendi g\u00fc\u00e7lerince i\u015flenen insan haklar\u0131 ihlallerini soru\u015fturmamas\u0131 ve cezaland\u0131rmas\u0131 ya da insanl\u0131k d\u0131\u015f\u0131 muameleden gizli g\u00f6zalt\u0131lar\u0131na ve \u00f6l\u00fcmlere kadar bir dizi insan haklar\u0131 ihlalinden Rus h\u00fck\u00fcmetinin do\u011frudan sorumlu olmas\u0131 nedeniyle Rusya’y\u0131 Ekim 2009’a kadar 100’\u00fcn \u00fczerinde davada mahkum etti. Benzeri binlerce dava ise halen g\u00f6r\u00fclmeyi bekliyor.<\/p>\n \u00c7e\u00e7enya’n\u0131n rand\u0131mans\u0131z sa\u011fl\u0131k sistemi, sava\u015flardan sonra kapatisesinin \u00fczerinde hasta y\u00fck\u00fc ve alt yap\u0131lar\u0131 tamam\u0131yla bombalanm\u0131\u015f bir halde kald\u0131. 3 y\u0131l \u00f6nce, Kremlin bir politika \u00f6nceli\u011fi olarak \u00c7e\u00e7enya’n\u0131n yeniden yap\u0131land\u0131r\u0131lmas\u0131 \u00e7abalar\u0131na ba\u015flad\u0131 ve Moskova destekli \u00c7e\u00e7en y\u00f6netimi de t\u0131bbi ekipman\u0131n temini ve sa\u011fl\u0131k tesisleri i\u00e7in a\u011f\u0131r bir programa (Sdorovye<\/em>) giri\u015fti\u011fi bildirildi. Uluslararas\u0131 organizasyonlar ve \u00c7e\u00e7en sa\u011fl\u0131k bakanl\u0131\u011f\u0131 e\u011fitim ve sa\u011fl\u0131k i\u00e7in bir dizi program\u0131 ba\u015flatt\u0131klar\u0131n\u0131 resmen ilan ettiler.(4, 5)<\/strong><\/p>\n Sa\u011fl\u0131k sisteminin ba\u015far\u0131l\u0131 bir \u015fekilde yeniden in\u015fa edildi\u011fine y\u00f6nelik \u00e7izilen resmi portrenin aksine, standartlardan uzak mevcut durum Rusya’n\u0131n bile standartlar\u0131n\u0131n gerisinde; bilhassa yan dal kayg\u0131s\u0131, daha iyi \u00e7al\u0131\u015fma ve ya\u015fam ko\u015fulu aray\u0131\u015f\u0131ndaki pek \u00e7ok uzman\u0131n Moskova’da kalmas\u0131na ya da yurtd\u0131\u015f\u0131na \u00e7\u0131kmas\u0131na neden oldu.(6)<\/strong> Birincil basamak sa\u011fl\u0131k hizmetleri d\u0131\u015f\u0131nda tedaviye ihtiya\u00e7 duyan hastalar, \u00c7e\u00e7enya’da verilemeyen sa\u011fl\u0131k hizmetleri i\u00e7in s\u0131n\u0131rl\u0131 say\u0131da hastaya uzman tedavisi sa\u011flayan kota sistemine bel ba\u011flamak zorunda kal\u0131yor. \u0130nsan haklar\u0131 ara\u015ft\u0131rmalar\u0131yla yard\u0131m sunan uluslararas\u0131 organizasyonlar\u0131n(7)<\/strong> \u00f6n\u00fcn\u00fc Federal H\u00fck\u00fcmet’in i\u015fbirli\u011fine yana\u015fmamas\u0131(8)<\/strong> kesiyor; ve \u00e7at\u0131\u015fma sonras\u0131 \u00c7e\u00e7enya’da varl\u0131\u011f\u0131n\u0131 s\u00fcrd\u00fcrmeye \u00e7al\u0131\u015fan birka\u00e7 sivil toplum \u00f6rg\u00fct\u00fc de dayat\u0131lan son hukuksal \u015fartlarla kar\u015f\u0131 kar\u015f\u0131ya kald\u0131klar\u0131 a\u015f\u0131r\u0131 idari sorumlulukla engelleniyor.(9)<\/strong><\/p>\n Benzer \u015fekilde \u00c7e\u00e7enya’da kalan sa\u011fl\u0131k uzmanlar\u0131 da geli\u015ftirilen sa\u011fl\u0131k servislerinin da\u011f\u0131t\u0131m\u0131 hakk\u0131nda a\u00e7\u0131k\u00e7a konu\u015fmaktan ka\u00e7\u0131n\u0131yorlar, zira ter\u00f6rle m\u00fccadele operasyonlar\u0131 kapsam\u0131nda tehlikeli bir etiket olan “vatan haini” s\u0131fat\u0131yla damgalanmak istemiyorlar. Analistlerce d\u00fcnyadaki en bask\u0131c\u0131 ortamlardan birisi olarak tarif edilen bu toplumsal atmosferde,(10)<\/strong> sa\u011fl\u0131k hizmetlerinin yerine getirilmesi, hasta ve savunmas\u0131zlar\u0131n (\u00f6rne\u011fin kad\u0131nlar ve bebekler, t\u00fcberk\u00fcloz hastalar\u0131 ya da \u00c7e\u00e7enya’daki 30 bin \u00fclkesinde yerinden edilmi\u015f sivil) ihtiya\u00e7lar\u0131n\u0131n giderilmesi a\u00e7\u0131k\u00e7a bir zorunluluk te\u015fkil ediyor.<\/p>\n Memorial insan haklar\u0131 organizasyonunun yerel \u015fubesinde \u00e7al\u0131\u015fan Natalya Estemirova, Temmuz 2009’da \u00c7e\u00e7enya’da ka\u00e7\u0131r\u0131larak \u00f6ld\u00fcr\u00fclmesinden(7)<\/strong> sonra, bir dizi \u00fcnl\u00fc ve nispeten daha az tan\u0131nm\u0131\u015f insan haklar\u0131 savunucusu daha katledildi ve Memorial \u00c7e\u00e7enya’daki \u00e7al\u0131\u015fmalar\u0131n\u0131 ask\u0131ya ald\u0131. Y\u00f6neticileri ve kolluk kuvvetleri servislerini sorumlu tutacak, uluslararas\u0131 ilgi ve tepkiyi sa\u011flayacak ba\u011f\u0131ms\u0131z izleme mekanizmalar\u0131n\u0131n eksikli\u011fi a\u015f\u0131r\u0131l\u0131k\u00e7\u0131l\u0131\u011f\u0131 besleyecek tehlikeli bir zemin yaratabilir. \u015eimdi t\u00fcm b\u00f6lgeye yay\u0131lan \u015fiddet, oradan yay\u0131larak k\u00fcresel g\u00fcvenli\u011fi tehdit edebilir. \u00c7e\u00e7enya’da yeniden yay\u0131lan \u015fiddet(1, 3)<\/strong> sava\u015f\u0131 y\u00fck\u00fcn\u00fc \u00fczerinde ta\u015f\u0131yan halk\u0131n sa\u011fl\u0131\u011f\u0131n\u0131 ve sa\u011fl\u0131k sistemini tehdit ediyor. Silahl\u0131 \u015fiddetin kontrol alt\u0131na al\u0131nmas\u0131 ve dezavantajl\u0131 b\u00f6lgede istikrar\u0131 sa\u011flamak i\u00e7in me\u015fru y\u00f6ntemlerin kullan\u0131lmas\u0131 bu trendi tersine \u00e7evirecek, insan haklar\u0131na sayg\u0131y\u0131 getirecek ve sava\u015f sonras\u0131 toplum i\u00e7in sa\u011fl\u0131kta s\u00fcrd\u00fcr\u00fclebilir geli\u015fmeler getirecektir. \u00c7e\u00e7enya’da bir mucize ya\u015fanm\u0131yor, ancak durum uluslararas\u0131 bask\u0131 i\u00e7in akademilerden, parlamentolardan, h\u00fck\u00fcmetlerden, sivil toplum \u00f6rg\u00fctlerinden ve gazetecilerden y\u00fckselecek bir \u00e7a\u011fr\u0131ya ihtiya\u00e7 duyuyor.<\/p>\n Karsten Lunze<\/strong> *<\/strong>\u201cHealth and Human Rights: No Miracle in Postconflict Chechnya<\/a>\u201d isimli orjinal makale The Lancet’in 374.cildi, 9704.Say\u0131s\u0131n\u0131n<\/a>, 1809 \u2013 1810. sayfalar\u0131nda 28 Kas\u0131m 2009 tarihinde yay\u0131nland\u0131.<\/p>\n Yazar\u0131n kaynak\u00e7as\u0131: <\/strong><\/span><\/p>\n (1)<\/strong> Mendelson SE, Malarkey M, Moore L. Violence in the North Caucasus: summer 2009. http:\/\/csis.org\/publication\/violence-north-caucasus-4<\/a>. (accessed Oct 13, 2009).<\/p>\n (2)<\/strong> Council of Europe. Legal remedies for human rights violations in the North Caucasus. http:\/\/www.reliefweb.int\/rw\/rwb.nsf\/db900sid\/MMAH-7DW46X?OpenDocument<\/a>. (accessed Oct 13, 2009).<\/p>\n (3)<\/strong> Council of Europe. Committee on Legal Affairs and Human Rights, situation in the North Caucasus region: security and human rights. http:\/\/assembly.coe.int\/CommitteeDocs\/2009\/ajdoc43_2009.pdf<\/a>. (accessed Oct 13, 2009).<\/p>\n (4)<\/strong> UNICEF. Issue facing children in Russia. http:\/\/www.unicef.org\/infobycountry\/russia_background.html<\/a>. (accessed Oct 13, 2009).<\/p>\n (5)<\/strong> WHO Regional Office for Europe. First Results of EU Recovery and Development Programme for Northern Caucasus discussed recently in Kislovodsk. http:\/\/www.euro.who.int\/emergencies\/fieldwork\/20080109_4<\/a>. (accessed Oct 13, 2009).<\/p>\n (6)<\/strong> WHO. Health action in the North Caucasus. http:\/\/www.who.int\/hac\/crises\/rus\/sitreps\/Health%20Action%20Feb_Mar_2005%20%20.pdf<\/a>. (accessed Oct 13, 2009).<\/p>\n (7)<\/strong> UN. UN experts offer help in investigating killings of rights defenders. UN Daily News. http:\/\/www.un.org\/news\/dh\/pdf\/english\/2009\/21072009.pdf<\/a>. (accessed Oct 13, 2009).<\/p>\n (8)<\/strong> RIA News Agency. Russia rules out UN expert probe into Chechen activist\u2019s murder. http:\/\/en.rian.ru\/russia\/20090722\/155588682.html<\/a>. (accessed Oct 13, 2009).<\/p>\n (9)<\/strong> Kamhi A. The Russian NGO Law: potential conflicts with international, national, and foreign legislation. Int J Not-for-Profit Law 2006; 9: 34-57. PubMed<\/a><\/p>\n![\"\"](\"http:\/\/www.waynakh.com\/tr\/wp-content\/uploads\/2009\/12\/grozny-a-children-300x200.jpg\")
\u00c7at\u0131\u015fman\u0131n her iki taraf\u0131ndan devam eden insan haklar\u0131 ihlalleri, halen sava\u015f\u0131n s\u00fcregelen fiziksel ve mental rahats\u0131zl\u0131klar\u0131n\u0131n ac\u0131s\u0131n\u0131 \u00e7ekmekte olan \u00c7e\u00e7enlerin b\u00fcy\u00fck bir b\u00f6l\u00fcm\u00fc i\u00e7in sa\u011fl\u0131k problemleri ortaya \u00e7\u0131kar\u0131yor. Sava\u015f\u0131n sona erdi\u011finin resmen ilan edilmesinin \u00fczerinden ge\u00e7en yakla\u015f\u0131k 10 y\u0131lda (Rusya’ya g\u00f6re Rus-\u00c7e\u00e7en sava\u015f\u0131 2000 y\u0131l\u0131nda bitti), sivil toplum organizasyonlar\u0131ndan ve Birle\u015fmi\u015f Milletler’in verilerinden meydana gelen raporlar, Kuzey Kafkasya’n\u0131n Rusya’n\u0131n di\u011fer dezavantajl\u0131 b\u00f6lgelerine k\u0131yasla halk\u0131n sa\u011fl\u0131k ve ya\u015fam ko\u015fullar\u0131n\u0131n umutsuz oldu\u011funu ortaya koyuyor. Genellikle genellikle ishal ve solunum yolu enfeksiyonlar\u0131n\u0131n neden oldu\u011fu \u00c7e\u00e7enya’daki bebek \u00f6l\u00fcmleri oran\u0131 Rusya’daki binde 13’l\u00fck oran\u0131n iki kat\u0131; her ne kadar ko\u015fullar iyile\u015fmi\u015f olsa da \u00c7e\u00e7enya’daki binlerce kad\u0131n ve \u00e7ocuk temel sosyal hizmetlerin eksili\u011fini ya\u015f\u0131yor.(4)<\/strong><\/p>\n
\nKoruyucu Hekimlik, Boston \u00dcniversitesi
\nkarsten.lunze@post.harvard.edu <\/a><\/p>\n