Food for the right thoughts in health (2)
-----------------------------------------
Human Rights Reader 92
THE HUMAN RIGHTS DISCOURSE IN HEALTH (Part 2 of 2)
II. How to strengthen the HR-approach in our work in health:
13. The more specific challenge we face is to incorporate the
HR-based approach into the Health For All Now agenda. The popu-
larization of what the human (people's) rights discourse means,
as characterized in a very simplified way in Part 1, is step
one. We need to do this first with our strategic allies in bi-
lateral, multilateral and non-governmental organizations. Sev-
eral of them have already started: UNICEF has taken the lead
among UN agencies to set the course of what needs to be done to
apply the HR-based approach in development planning; CARE has
made substantial advances in adopting a HR-based approach in its
operations worldwide. The fact not withstanding that most gov-
ernment and non-governmental development agencies have not yet
re-visioned and re-missioned themselves to adopt a HR-based ap-
proach, there is much we can learn from the two experiences
cited here (See U. Jonsson's book, 'The HR Approach to Develop-
ment Programming', UNICEF, Nairobi, 2003 and CARE's 'Promoting
Rights and Responsibilities' Newsletter, <aswani@care.co.ke> ).
14. In step two, it will be for these allies to then bring the
new concepts to their colleagues and peers, as well as to a host
of different health workers in their respective workplaces and
then to community leaders in the areas where they work.
15. The incorporation of capacity analyses to identify and char-
acterize duty bearers that are not doing what needs to be done
will, from now on, be key to our work. This process is in itself
empowering for us and for the claim holders we work with. (see
http://www.humaninfo.org/aviva)
16. Both in steps one and two, it has to be emphasized that
there is no hierarchy of HR; there are no 'competing rights'.
All rights are universal and inclusive, so we have to work for
their fulfillment in all areas; that is why looking at 'Health
for All Now' as a key element of our struggle for the drastic
reduction of poverty is crucial.
17. The neoliberal development paradigm tries to fragment the
social reality into sectors allowing partial small victories to
be hailed as successes alas with absolutely no sustainability.
If the system that causes all the symptoms and signs that come
with poverty is not fixed, small victories in health, in educa-
tion or any other sector are just deceiving us. For example, the
emphasis on trade that globalization fosters is not going to
benefit the poor unless we specifically build-in fair trade
rules AND mechanisms of distribution of the benefits of trade to
the lowest income quintile. Or, an example from the health sec-
tor would be: We have seen Herculean efforts and resources being
poured into the Expanded Program of Immunization; who could
fault that when it saves lives? But saves lives for how long?
Until the child saved from dying from one of the six immunizable
diseases, because s/he is malnourished and lives in a poor and
contaminated environment, falls prey to a pneumo!
nia or a diarrheal episode for which we do not have a vaccine
yet? Who are we fooling here?
18. What is highlighted here is that we cannot let the forces of
status-quo hijack the concept of HR in health. Any par-
tial/sectoral interpretation of this concept is ultimately dis-
honest. HR is about a more equitable distribution of resources
in society and health is one of many entry points to achieve
this goal.
19. Human beings are born with a right to health and society has
to proactively make the investments to prevent ill-health and
malnutrition and to treat those affected by the diseases of pov-
erty. Focusing our efforts in anything short of this is a job
half done, more so if we do not arrive at such a situation
through the empowerment of claim holders themselves to relent-
lessly demand that the needed changes are implemented. This is
not a task for an avant-garde only: it is a mass mobilization
task.
20. I am not saying that all this is easy, or fast, or that
there are no small victories on the road to achieving our main
objectives. But the focus has to remain on the big picture... do
not miss the forest!
Claudio Schuftan
Ho Chi Minh City, Vietnam
mailto:claudio@hcmc.netnam.vn