Food for Thought
----------------
ACTIONS AND ACTIVISM IN FOSTERING GENUINE GRASSROOTS PARTICIPATION IN
HEALTH AND NUTRITION
Effective action requires not just a feeling or an enthusiasm, but
calls for a close rapport with the disgruntled so as to get them organ-
ised.
(Robbins, 1985)
You may often have asked yourself as to whether your individual contri-
bution to development in the field of health and nutrition makes or is
making any difference. This, of course, depends. Alone, each of us is
indeed helpless to change very much. Standing alone is a false ideal.
We have thus plenty to learn from the lessons of mutuality or even of
militancy. Individual compassion is just less powerful than organised
solidarity. (Tikkun, 1987) Or, to use an old adage, 'divided one begs,
united one bargains'.
Grassroots-organised sporadic, collective acts are happening all the
time -- mostly the result of non-political and personal leadership ini-
tiatives. To make these really count and add up to something, they need
to be progressively channelled into new patterns of higher political
meaning and impact. Activists are needed to lead the way in such a
transition. This, because without continuity and follow-through ac-
tions, popular struggles will remain a heap of toothless words. (Ophir,
1987) In our context, two questions arise here: Are the fields of
health and nutrition legitimate and good ports of entry for such activ-
ism, and if the answer is yes, are we ready for such a challenge?
Again if the answer is yes, new forms of progressive action and educa-
tion are then needed in our line of development work and, to act effec-
tively in the time before us, we need to first develop a widely shared
strategy pointing in this direction. In such a strategy, we cannot
merely denounce; we must also announce a new order, an order with more
empowering health and nutrition alternative actions. We must strive to
become proactive, not merely reactive. Today, the inescapable challenge
is to, together with our beneficiaries, redefine the strategies to be
used in order to combat ill-health, malnutrition and mal-development
all the way from its global determinants. Only thus will we be able to
solve the present crisis in overall development thinking and praxis we
find at the local level. (Boyte, Mische, 1987)
As an avant-garde, we need not only to reflect on new institutional
ways of supporting grassroots initiatives, but we need to become proac-
tive in organising them and then helping generate new forms of knowl-
edge and new practices of democracy and local government. In the proc-
ess, we also need to help redefine the significance and the role of ODA
and of private (non-official) international development co-operation in
the fields of health and nutrition to better adapt them to the felt
needs of local communities. (Padron, 1990) If the latter cannot be
done, it is high time we begin considering turning foreign aid down.
Still proactively, we first need to help create a shared critical
awareness of the immorality of the prevailing economic and social sys-
tem responsible for the preventable ill-health and malnutrition we are
increasingly left to deal with. We need to motivate people, both in the
North and in the South, to change the mechanisms that lead to these
conditions of poverty and injustice, and this can only be achieved by
creating growing dismay and vocal (constructive) anger at such injus-
tice. Action along these lines (preferably pre-emptive) is desirable,
and should even be made an inescapable outcome of effective health, nu-
trition and development education. The activist/educator thus has a
role in our midst. (Development Forum, 1987)
If we are to be consequent with effective popular participation and if
we are to foster an authentic people-centred development (in our case
using health and nutrition as a port of entry) we will have to:
- move away from coercive, top-down practices involving any kind of
forced acceptance and move into consensus-building practices involv-
ing legitimate beneficiaries' approval;
- do things departing from the way people see them in their own envi-
ronment;
- revolutionise people's expectations helping them to move away from
fatalistic outlooks;
- help define a new type of collective rather than individual identity
and community responsibility;
- help legitimise and enforce all UN-sanctioned people's rights;
- increase the negotiation and bargaining capacity -- or at least the
defense capacity -- of our beneficiaries;
- aim at modifying constraining local, formal and informal political
structures as needed;
- concentrate on changing the local generational dynamics when re-
quired, and very specially on changing the role of women (our main
contact in health and nutrition work) in overall development;
- work with people towards the goal of ultimately controlling their own
resources, fighting for those they need from outside, and taking ini-
tiatives to shape their own future through a strengthened, militant
organisation;
- make sure people get access to relevant information, especially the
type of information that will help them hold their government offi-
cials accountable; (information given to people for use through the
fashionable social marketing approach is definitely not the type of
information conducive to any meaningful participation; social market-
ing simply does not bring about the needed sustainable structural
changes -- at best, it allows people to cope with an unjust situa-
tion);
- help redefine the roles and methods of "participation" in our case in
health and nutrition;
- constantly re-gather groups being marginalised trying to make sure
their special interests can be accommodated in the general strategy;
- secure concrete short and long-term results for beneficiaries (with
an initial emphasis on the former to foster self-confidence);
- monitor and evaluate said results, especially with regards to the de-
gree of popular participation being achieved, as well as probing the
equity of the benefits accrued;
- promote self-education with the aim of achieving fast results.
Only the constant practice of such people-centred development activi-
ties through trial-and-error will overcome the limits of existing
flawed development models and theories. (Padron, 1990)
In short, starting with/from health and nutrition and through trial-
and-error, we should all contribute, to the best of our abilities, to
generate popular alternative development strategies and the correspond-
ing set of tactics to implement them. But to make a difference, remem-
ber that standing alone changes little; so network with other like-
minded activists in this field.
Claudio Schuftan
Hanoi, Vietnam
mailto:aviva@netnam.org.vn
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