International Health care Standards in Women`s Prisons in the Arab world Awmaima A Khattab Amrayaf Submitted in accordance with the requirements for the degree of Doctor of Philosophy The University of Leeds School of Law 2018 Intellectual Property and Publication The candidate confirms that the work submitted is her own and that appropriate credit has been given where reference has been made to the work of others. This copy has been supplied on the understanding that it is copyright material and that no quotation from the thesis may be published without proper acknowledgement. © 2018 The University of Leeds and Awmaima Amrayaf. ii Acknowledgements First and foremost, I thank God for blessing me and granting me with the ability to bring this thesis to fruition. In addition, I am very grateful to my supervisors Professors. Anthea Hucklesby and Michael Thomson. This thesis could not have been achieved without their meticulous comments, advice, and continuous patience over the years of my doctoral studies. Special thanks go to my Father and my husband for being very supportive from the beginning. I also wish to express my gratefulness to Cultural attachés at the Embassy of Libya in both London and Amman, who have always expressed their support during my studies. Lastly, I would like to express my appreciation to the Ministry of Education, the National Centre for Human Rights and the Ministry of Justice in Jordan for providing me with the access required in order to undertake the necessary fieldwork. I must also thank all the participants who have contributed to this study. iii Abstract Prison health care services worldwide fail to meet women prisoners` gender-specific needs. Gender-sensitive prison laws and policies are absent or weak at national levels in many parts of the world. Consequently, health care for women in prisons has become a matter of increasing concern. This thesis is about the international health care standards that aim to protect women prisoners’ rights to receive treatment met their distinctive needs. Interviews were conducted with 42 individuals in Jordan to explore the implementation of these standards in the Arab world. The research makes a new contribution by collecting and analysing data on an issue characterised by a paucity of contemporary empirical evidence. Little is known about how international health care standards work in practice, particularly in the Arab world, where a variety of cultural, economic, political and social factors have impacted on the way in which they are viewed and implemented. The research reveals that international standards are not systematically implemented because they are viewed as a Western construction that attempts to impose Western perspectives on other countries and fails to take into account Arab culture and traditions relating to women’s position in society. iv Table of Content Contents Intellectual Property and Publication ii Acknowledgements iii Abstract iv Table of Content v Selected Abbreviations viii Chapter One 1 Introduction 1 1.1. Research problem 2 1.2. Academic Context 2 1.3. Research Objectives 8 1.4. Originality 10 1.5. Empirical Research 12 1.6. Thesis Outline 15 Chapter two 18 The Arab World and Women prison: Cultural, Social and Historical Contexts 18 2.1. Introduction 18 2.2. The Arab World 19 2.3. Women in the Arab culture 22 2.4. The History of the Penal system in the Arab world 28 2.4.1. Pre-colonial History and the Effects of Colonisation 29 2.4.2. Important Events in Arabic prison policy 30 2.4.3. The Arab Spring and Beyond 31 2.5. Women in Arab prisons 33 2.6. The Specific Context of Jordan 36 2.7. Summary 46 Chapter Three 47 International Health care Standards 47 3.1. Introduction 47 3.2. International Standards 48 3.3. The Right to Health 54 v 3.4. Prisoners` Right to Healthcare 58 3.5. The Nature and the Purpose of Healthcare Standards in Women’s Prisons 61 3.6. The Content of Healthcare Standards in Women’s Prisons 67 3.7. Implementation within Prison System 74 3.8. Summary 76 Chapter Four 78 Research Methods, Design and Reflection 78 4.1. Introduction 78 4.2. The methodological approach 78 4.3. Research nature and perspective 82 4.4. Research Design 86 4.4.1. The Process of Gaining Access 87 4.4.2. Sampling 91 4.4.3. Pilot study 94 4.4.4. Semi-structured Interviews 94 4.4.5. Data Analysis 96 4.4.6. Ethical issues 100 4.5. Research Quality 102 4.6. The challenges of fieldwork 104 4.7. Summary 110 Chapter Five 111 The Provision of Health Care to Women Prisoners in Jordan 111 5.1. Introduction 111 5.2. Gender, the socio-cultural environment and women’s health 112 5.3. The Circumstances in Jordan 114 5.3.1. Institutional Context 115 5.3.2. Broader Community Context 118 5.4. Prison Health Care in Jordan 120 5.5. Health Care Provision for Women Prisoners 122 5.5.1. Legal Framework 123 5.5.2. Practical Aspects 129 5.6. Summary 139 Chapter Six 142 Views of Jordanian Officials on the International Standards 142 vi 6.1 Introduction 142 6.2. Human Rights and the Arab world 143 6.3 Relevant International Standards 151 6.4. Factors Affecting Implementation 160 6.5 Summary 169 Chapter Seven 171 The Work of Non-Governmental Organisations 171 7.1 Introduction 171 7.2. Non-Governmental Organisations in Jordan 172 7.2.1. Historical Background 172 7.2.2. Organisations Working in Women’s Detention Centres 175 7.3. The Roles of Non-Governmental Organisations 178 7.3.1. Development of policies 178 7.3.2. Guidelines and training 181 7.3.3. Ensuring the consideration of the standards 184 7.4. The Work Strategies of Non-Governmental Organisations 188 7.4.1. Working the system for the desired outcomes 189 7.4.2. Establishing alliances between NGOs 191 7.5. Summary 196 Chapter Eight 198 Conclusion 198 The main findings 199 Contribution to Knowledge 205 Limitations, implications and Future research 210 Indications from research 214 List of References 219 Appendices 275 Appendix A: Interview Structural outline 275 Interview with officials 275 Interview with NGOs representatives 281 Interview with practitioners 286 Interview with the legal professionals 289 Appendix B: Information Sheets 295 Appendix C: Consent Forms 299 vii Appendix D: Ethics Committee Approval 305 Selected Abbreviations ACHR Arab Charter of Human Rights APCHR Arab Permanent Commission on Human Rights CAT UN Committee against Torture CEDAW UN Committee on the Elimination of Discrimination against Women CID Criminal Investigation Department CPT European Committee for the Prevention of Torture Disappearance GID General Intelligence Directorate in Jordan HRC UN Human Rights Committee ICCPR International Covenant on Civil and Political Rights ICESCR International Covenant on Economic, Social and Cultural Rights NCHR National Centre for Human Rights in Jordan NGO Non-Governmental Organisation OHCHR Office of the UN High Commissioner for Human Rights PSD Public Security Directorate of Jordan SMRs Standard Minimum Rules for the Treatment of Prisoners UN United Nations UNCED International Convention for the Protection of All Persons from Enforced UNCEDAW UN Convention on the Elimination of All Forms of Discrimination against Women UNODC UN Office on Drugs and Crime viii WHO World Health Organisation ix Chapter One Introduction Prison, which is also known as correctional facility and detention centre, is an institution in which individuals are legally held as a result of breaking rules created and enforced by governments to regulate human behaviour at the national level. Retribution, deterrence, incapacitation, rehabilitation, and reintegration are the major purposes of this institution. Prison authorities in every state are expected to be responsible for ensuring that the supervision and treatment of prisoners are in line with the rule of law, with respect to individuals` human rights. The primary focus of any civilised prison system should be on the reform and rehabilitation of lawbreakers so they are ready for life in the society as law-abiding citizens. While has become a vital part of the criminal justice system worldwide, prison`s purposes and necessity are up for debate. These matters have been extensively studied by scholars from different disciplines, yet surprisingly little attention has been paid to international standards on the treatment of specific groups of prisoners, namely women and how they are implemented in practice. The purpose of this study is to explore and understand the implementation of these standards in women’s prisons in the Arab world. In particular, this study investigates the implementation of the standards on the provision of healthcare to women prisoners. The research started with investigating whether or not the international healthcare standards in women`s prisons are implementing in the Arab world and why. Using the Hashemite Kingdom of Jordan as a case study, the research found that there is no effort made to implement the standards systematically. The major reason has been that the standards are viewed as an attempt to impose Western perspectives on other countries, and as the construct of a Western society that fails to take into account Arab culture and traditions relating to women’s position in society. The aim of this chapter is to introduce the thesis. After a brief reflection on the research problem, the chapter shows how relevant academic context gave the research both a theoretical and empirical background, and how it helped to determine the aim and objectives of the study. The starting point is the key sets of factors influenced the 1 framework of the research. The purpose of this is to establish the need for this research within the current knowledge of the discipline.