Describing gun violence in the USA as a “human rights crisis”, Scars of Survival: Gun Violence and Barriers to Reparation in the USA highlighted how survivors are often unable to access healthcare and other forms of support due to catastrophic medical expenses and excessive bureaucracy. It called on the US government to put in place necessary mechanisms to ensure survivors of firearm violence have access to full and effective reparation.
“Most of the people we interviewed told us that being shot was just the start of their nightmare. Survivors described how they continue to struggle despite being victims of crime and are often faced with prohibitive costs to treat their chronic pain or get help adapting to disabilities,” said Sanhita Ambast, Amnesty International’s researcher on economic, social and cultural rights.
“High costs, cumbersome paperwork and inadequate crime victim compensation programs are all barriers to accessing proper care and support following the trauma of a shooting. The US authorities need to get a grip on gun violence, and ensure survivors have the support necessary to address the harms they have suffered and to rebuild their lives. Given their failure to adequately address gun violence on a large scale, there’s even more of an impetus to provide assistance to survivors.”
In 2018, Amnesty International interviewed 25 gunshot survivors in Miami, Tampa, Baltimore and New Orleans, all cities with high rates of gun violence. The organization also spoke to 11 care-givers, 17 health workers and 40 public health experts, advocates, activists and social workers.
Costs and reparation
Amnesty International’s research shows the US government is failing to provide gunshot survivors with essential long-term healthcare, support, rehabilitation, and compensation that are essential to ensure that the government fulfils its obligations to provide them with full and effective reparation. Amnesty International has previously argued that the US government has failed to meet its human rights obligations by failing to adequately regulate the purchase, possession and use of firearms by private actors.
Because there are no targeted programs to provide for the rehabilitation needs of gunshot survivors, they have to seek medical and psychological care through the general health system. This poses numerous economic and bureaucratic obstacles, exacerbated by trauma and physical pain.
Megan Hobson was 16 years old when she was caught in crossfire in Miami in 2012. Emergency treatment saved her life, but she continues to live with health conditions including difficulties walking, complications caused by bullet fragments in her uterus, and the need for mental health care and support. Megan told Amnesty International she was still in debt due to medical bills.
“I was a victim, I had nothing to do with my crime. I was just in the wrong place at the wrong time,” she said.
Jamie Williford was shot in the back when she was 16, in 2009. She was left paralyzed and with severe, ongoing health needs. Although Jamie is covered by Medicaid, a governmental program providing health coverage for some people with low incomes, she faces significant bureaucratic challenges accessing healthcare, particularly finding health professionals who will accept her insurance.
Like many gunshot survivors with disabilities, Jamie has struggled to find affordable, accessible housing.
After her injury, she was placed in an adult institutional care facility, with no access to mental health care, education or training appropriate to a child or a new wheelchair user. Since she turned 18, she has lived largely in shared accommodation, but has been unable to secure any suitable permanent housing adapted to her needs.
Amnesty International highlighted Jamie’s case as an example of how gun violence survivors are caught in the crosshairs of numerous failing policies – difficulties accessing healthcare, a lack of affordable housing, and insufficient support for people with disabilities.
Stifling bureaucracy
Almost all gunshot survivors interviewed by Amnesty identified bureaucracy and paperwork as a key barrier to accessing long-term healthcare.
This is particularly challenging for gunshot survivors who may be living in unstable environments and be unused to navigating a fragmented and complicated healthcare system. They are often simultaneously trying to negotiate and process changes in their health, family lives, jobs or job prospects, because of being shot.
One man whose brother was shot explained, “For healthcare, if you want to get more care or any [Medicare] cover, they start to ask have you ever worked. If you say yes, they want to see cheque stubs for six months, and they want your birth certificate, they want a social security card, they want all that stuff and we ain’t got it.”
Victim compensation applications also require significant amounts of detail and supporting documentation, which can be difficult to provide especially when people are recovering from serious or life-changing injuries.
In 2017, the most common reason for denying or closing a victim compensation application across all states was incomplete information. Lack of awareness and stringent eligibility requirements also emerged as obstacles to accessing compensation.
Recommendations
“Amnesty International is calling on US federal and state authorities to ensure that survivors of gun violence have access to the healthcare and support they need, and that they are fully informed about the healthcare and other benefits they are eligible for,” said Sanhita Ambast.
The organization is also calling for authorities to ensure all survivors of gun violence are provided with full and effective reparation, including compensation for the harms they have suffered.
“Providing adequate long-term care to gun violence survivors in the USA is not an unsolvable problem,” said Jasmeet Sidhu, Amnesty International USA’s research manager on the End Gun Violence campaign. “There are steps that local, state and federal authorities can take today if only they have the political will to take them.”