PHA-Exchange> PHM in Africa

[Aviva]

PEOPLE'S HEALTH MOVEMENT IN AFRICA

PROCESSES TOWARDS A HEALTHY WORLD: 

"Enhancing Primary Health care as a Solution"

WHO Technical Briefing Session

17 Mai, 2002, Geneva, Switzerland

Mwajuma Saiddy Masaiganah Ms.

Peoples' Health Movement

East and Central Africa Circle

PO Box 240, Bagamoyo, Tanzania

E-mail: masaigana at africaonline.co.tz 





"Primary Health Care was and still is the correct pathway for us all. Holding this meeting in East Africa is bringing the agenda home. . Let's listen to these communities. How many times do we allow them to be part of their development? Genuine people-centred initiatives must be strengthened to increase pressure on decision-makers, governments and the private sector to ensure that the vision of Alma-Ata becomes a reality".

Dr Upunda, Chief Medical Officer Ministry of Health, Tanzania, April 29, 2002.



Three major aims for the PHM meeting in Africa (Tanzania) were:



-To reflect on the PHA and see how the People's Charter for Health could be used to strengthen activities and systems in Africa and start a campaign for greater support for comprehensive Primary Health Care.

-To identify key health issues that are important and affect more the people in Africa.

-To strengthen the People's Health Movement in Africa.


During the four day meeting participants:


-Confirmed support for the People's Charter for Health

-Identified issues of particular focus for Africa at the present time

-Welcomed the draft version of the Swahili People's Charter for Health.

-Developed an Interim Circle for PHM activities in Kenya, Tanzania, Uganda and Zimbabwe.


A range of diseases affects people's health in Africa:


-We stressed that HIV/AIDS is a serious problem for health in Africa, but not the only problem. And that it was important to look at the context and ensure that sufficient resources are available to prevent and treat other leading disease like: TB, Ebola fever, Malaria, Typhoid fever, Cholera, and Measles.


Apart from these, some hospitals retain mothers after delivery due to their failure to pay. They wait for relatives to come and `bail` them out. Sometimes this takes from one week to even more than a months period. 

The social, political and economic determinants that are impacting our health negatively need to be considered and were identified as:


-SAPs (Structural Adjustment Programmes)

-TRIPs (Trade Related Intellectual Rights) 

-Gender insensitivity - increased disparity in access to health with health systems tending to be gender blind.

-Conflicts and wars

-Gender violence

-Lack of basic infrastructure - transport, deterioration in health systems including lack of quality services.

-Environmental issues - including water and sanitation, deforestation and natural disasters.

-Corruption.

-Cultural beliefs and practices that contribute to poor health and increase the risk of diseases and those that strengthen healthy behaviours. 


Two practical examples: 

1.Water: To date there are still areas where there are water bodies nearby but people are dying of water borne diseases. They bath in the water and move a few steps into the water from the spot where one bathed and fetch water for drinking. This is done while there are wealthy nations misuse their wealth, funding wars while innocent people are being maimed and killed. The question is, `Why not invest in a water well or create awareness and save millions of lives? `


2.Corruption: Corruption impacts all levels. Bribes have to be paid just to see a health worker or to get a clinic card for a pregnant woman/child. This does not mean that corruption is seen only in Africa. It is all over the globe. The issue is `Why corruption`? There are nurses who are volunteering to work for years without salaries. Don't they need food? What about their families? How do these people live? By saying this I do not mean to condone corruption. I want us to look back and examine critically the conditions in which the health staff live in; so that when we talk about corruption in relation to health we know how to deal with it. 




We believe that the key link in this process is the need to develop shared partnerships with local and national governments, to complement their work and strengthen their ability to provide services that the people need. Already in many African countries the vast majority of care for patients suffering from HIV/AIDS is being done in poor households mainly by women who receive little or no assistance from the health and welfare services. Governments should give peoples' organisations, including the PHM, recognition and representation at decision-making fora where issues affecting health are discussed, and to facilitate their recognition and support from national and international donors as channels for resources to facilitate the process of grassroots involvement. 


We have found out that communicating the issues expressed in the Charter is a way of breaking the silence around many of these health concerns and strengthening peoples' ability to be involved in the process of both contributing to and demanding the development and strengthening of relevant and effective health services.


The role of PHM in Africa:


It must become a strong unifying force, helping to bring together many of the people and organizations involved in effective initiatives to improve health. Interim national coordinators were selected to help with this. 




The issue of re-use of female condoms is unacceptable by Africa and suggests that other means be sought. After all, rural women cannot afford to buy a condom that costs almost a dollar which many families in Tanzania for example do not earn in a week. We condemn this outright with vigour and dignity.


We call for further engendering the People's Charter for Health taking into consideration the issues that concern the youth and the aged.


We demand that (E)Quality and quality be linked inseparably - there should be no double standards.


Every government should provide obstetric services that ensure that no woman can get HIV transmission at child birth - (there should be universal precautions in deliveries, as well as all aspects of health care). HIV/AIDS is only one of the many diseases that affect Africa. Therefore, there should be a re-orientation where funding goes, and in this case, grassroots funding is of vital importance. 


PHM needs global recognition by international institutions and governments in order to operate and access funding, and thus Africa calls for immediate global recognition of PHM.


The problem of obtaining adequate funding to carry out PHM activities like communication, which is a big issue in Africa, is raised. 


The interim PHM chairperson for East Africa was given the task of bringing closer all players in African countries into the process. Cameroon has already shown interest in joining and I am in a process of assisting them to take off. We will make sure that all willing African countries join.


Our situation in Africa does not guarantee a Right to Health. Thus we should work towards a change of attitude of our governments to respond to people's health needs and create space where people can play an active role by activating local actions. The people of the developing world deserve and have a right to share the resources that the rich countries lavishly enjoy; we will actually work for that. It is time now to demand, and we demand it. It is no more time for rhetoric; we need actions.


Asanteni sana - "Thank you". 


-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://phm.phmovement.org/pipermail/phm-exchange-phmovement.org/attachments/20020617/db388d0d/attachment-0001.html>