PHA-Exchange> RTHC Campaign update May 2007

[claudio at hcmc.netnam.vn]

PHM Right to Health Care Campaign Update
May 2007

In this email:
1. **Very important** Campaign clarification, including new flexible timeline 
and participation criteria
2. Country information needed for web site
3. New campaign committees and PHM country circles formed in Benin, Congo 
Brazzaville, South Korea and others!
4. How you can help the campaign
5. Campaign organizer update

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1. Clarification on the Implementation of the Right to Health Care Campaign  
This was prepared as a response to concerns and questions raised by the PHM 
Steering Council at its last meeting in Bhopal

1. As originally designed, the RTHHC campaign uses a participatory process to 
inform people about their right to health and actually involves them in 
preparing the assessment of the right to health care in their country -- at 
the same time that it builds and mobilizes a sustainable PHM network. The idea 
is that information gained during the mobilization and assessment processes 
leads to the development of active lobbying strategies aimed at improving 
government health policies. 

2. Collecting the data that brings out the evidence of the violations of the 
RTHHC does not, by itself, mobilize the sufferers of such violations into 
action. They must be present when the important issues to include in the 
assessment are defined, when doing the assessment itself, when selecting the 
concrete cases to be looked into, and when the data are analyzed. By going 
through this process, they themselves will learn about what the right to 
health and health care is all about and will thus meaningfully contribute to 
its operationalization.

3. The national PHM RTHHC campaign committees will also work to plan and carry 
out international level actions that will further pressure national 
governments by influencing international/multinational organizations and 
institutions that currently play a major role in health policy. 

4. Country-level activities are the heart of the campaign, and need to be 
developed with flexibility and context-specific innovation. How the RTHHC 
campaign is organized in Country X is up to the campaign committee in that 
country. PHM's overall concerns are that the process involves as many people 
from different sectors and tendencies as possible, and that the final 
assessment report, as closely as possible, covers the different parameters 
described in the campaign's RTHHC Assessment Guide. As written, the Guide 
provides a step-by-step explanation of the reasoning process to be followed to 
identify violations of the right to health. Therefore, regardless of how 
country circles end up using the Guide, it is recommended they consider its 
five steps in reporting their findings. 

5. The most important goal of this campaign is to empower and involve ordinary 
people to represent their own interests in a political process/movement that 
has the power to influence both the national and international level of 
decision making. Because PHM as an organization is seen as representing the 
interests of hundreds of thousands of people [what we call the (lower-case) 
people's health movement], we have achieved a certain level of recognition and 
access at the international level. We want to bring people's claims for their 
health rights to that level in a way that cannot be ignored. 

6. The point of this campaign is not to produce RTHHC reports. It is not 
a "desk exercise." The reporting process is a strategy to find evidence, to 
educate people about their rights and about key principles of public health, 
as well as to bring them together behind shared, common goals. This is what is 
needed to make effective demands on governments. The final report should 
preferably include documentation of testimonies of denial of health care, and 
participatory case studies of health care facilities or health-related 
services carried out by participating organizations. Such activities 
simultaneously build evidence and generate involvement. Holding of dialogues 
between groups of health activists and health authorities, public hearings, 
workshops on the Right to Health, and/or carrying out symbolic protest actions 
of various types can be important features of the campaign --keeping in mind 
the situation prevailing in each country. These actions can be carried out 
right from the beginning. (The campaign coordination team can give interested 
PHM circles referrals to other PHM circles or affiliates that have carried out 
such actions and can offer support).

7. For the above reasons, we think that before engaging in the actual 
assessment, it is crucial to set up a credible network of strategic allies. 
Country focal points for the campaign are thus to contact such allies 
(individuals and institutions) at the same time that they identify potential 
opponents to the campaign (and work out means to neutralize their opposition). 
The local political scenario has to be analyzed by the PHM circle so that 
committed strategic allies can be aligned and given concrete responsibilities, 
as part of an ad-hoc plan for the whole campaign. The question also has to be 
asked, then, whether the timing for launching the campaign is right given the 
concrete local political realities.

8. Establishing such a critical-size network to get started is more important 
than following the campaign coordinators' originally proposed timetable (i.e., 
March to October 2007 for phase I of the campaign). Participating countries 
are to build-up their own initial mobilization momentum to go ahead with the 
assessment. To arrive at a point when the time is right, they ought to take as 
many weeks or months as needed to insure success. The original timetable 
recently circulated to all interested countries and through pha-exchange is 
thus now considered to be too rushed. As we now see it, countries do not have 
to do their assessments at the same time or finish at the same time. But there 
does have to be a certain critical mass of countries in a region that have 
gone through the assessment process and the national strategic action planning 
before it makes sense to have a regional meeting (phase II). Each of the 
regional meetings should also happen within a reasonable period of time so 
that an international momentum can be generated. 

9. Consequently, the criteria for proof of social mobilization preceding the 
launching of the actual phase I of the campaign are being tightened and now 
are: 

- Organizing at least two national level meetings to discuss the campaign, 
involving participants from various organizational backgrounds, preferably 
including some from different regions of the country.

- Formation of a first campaign coordination group which will take collective 
responsibility for expanding and developing the campaign.

- A formal agreement on the provisional decision-making mechanisms for the 
development of the campaign.

- Existence of a functional e-group/listserver or other means of communication 
among the participating organizations/individuals to facilitate campaign 
communications.

10. The campaign will require that, early-on, the national PHM circle develops 
the capacity to reliably review and monitor intermediate results and outcomes 
so as to be successful in institutionalizing the campaign in the years to 
come. 

11. The small funding available on a first-come-first-serve basis will be 
released for two purposes: a) to allow for organization and mobilization 
activities to go ahead, and b) to launch the actual assessment (phase I) of 
the RTHHC. Modalities of the release of these funds will be kept flexible to 
fit specific cases.



12. The first countries to succeed in completing the mobilization and 
assessment process will be asked to mentor countries just joining or countries 
that have had a weak performance of their campaign.

13. The regional traveling 'organizers' to be trained by the campaign 
coordinators (to help setting up national PHM circles and to help in the 
launching of the actual campaign) will have previous social mobilization 
experience. With the change in time line we will re-open recruitment of 
organizers, since some people were interested in the position but were unable 
to fit it into their schedules.

14. Some countries may center their mobilization around already strongly felt 
needs in the population and, as an entry point to the campaign, address these 
issues as they relate to the RTHC, e.g., in Central American countries the 
negative health effects of the FTA they are locked-in into; in Palestine the 
unnecessary deaths caused by the occupation, etc. Connecting the campaign to 
ongoing national popular struggles is a good idea. Moreover, building 
alliances with related campaigns, such as groups or networks working on social 
sector issues, i.e., the right to water, to food, to education, to a safe 
environment, to housing, as well as with the existing struggles against 
privatization in its various forms should be actively considered.

15. The campaign will not attempt to be confrontational, unless needed. The 
lobbying strategies outlined in the Assessment Guide show ways to work with 
duty bearers in a constructive manner. 

16. Particularly in the health sector, health professionals' stated aim to 
conform to ethical and quality of care standards of practice can be used to 
engage them in the campaign. With claim holders mobilized and front line 
health providers appropriately motivated, chances of a positive response from 
duty bearers is much more likely. 

17. Because of this, the campaign highly encourages the early involvement of 
health workers and their unions. They are, at the same time, claim holders and 
duty bearers (i.e., claim holders of decisions made at higher-up levels), and 
their involvement will give the campaign access to valuable information, as 
well as greater depth and additional credibility. The endorsement of the 
campaign by well known personalities and prestigious institutions is also 
invaluable. 

18. Finally, to reiterate, the campaign's Assessment Guide does give a very 
good comprehensive overview of what needs to be done to assess the RTHHC. It 
does emphasize the needed mobilization. It is quite user friendly -- given the 
complexity of some of the issues to be covered. It takes the user(s) by the 
hand, in a step-by-step manner, to cover all aspects that will result in a 
good, standardized diagnosis of the state of the RTHHC in each country. As 
stated in the Guide, it should be applied with flexibility to adapt it to the 
different national realities. Key in this flexibility is to skip those 
sections or questions for which there are no data available or for which data 
would be extremely difficult to get; on top of giving space to address 
additional issues of particular local concern. Each country will decide for 
itself how to use the assessment process as a tool for additional 
mobilization. For example, certain questions or areas of interest can be 
assigned to particular groups with a connection to those issues -- with the 
national campaign coordinating committee then combining the work of those 
groups into the final report.

19. The two main campaign co-coordinators have asked for at least two more PHM 
members to join them to help them lighten their heavy workload. Dr. Ghassan 
Issa from Lebanon has volunteered to join and is being incorporated - thank 
you, Ghassan! We need at least one other person to work at the global 
coordination level.

Please contact us if you have any questions.

Claudio Schuftan,

Laura Turiano

Ghassan Issa

2. Send us your photos!

We want to have information about the campaign in every participating country 
on the PHM website. We will be including contact information for each country 
so people can get in touch with you if they want to join. Without photos the 
site will be very boring. When you send photos, please identify the 
organizations present by their full names - no acronyms please! Take pictures 
of your kick-off meeting or of any events you hold and send them to Pacome 
Tometissi at tometissi1 at yahoo.fr, and Ghassan Issa at arcgi at mawared.org.

3. New PHM Circles and Campaign committees being formed

Congratulations to Benin, Congo Brazzaville, and South Korea - they have 
formed new PHM circles and RTHCC committees. Campaign organizing meetings have 
been held recently in Uruguay, Nigeria, Kenya, Peru, Mexico, Morocco, 
Australia, Argentina and we have had inquiries from many other countries. The 
response has been truly exciting. Concern about privatization of health care 
and inadequate health systems is global. Working together our demand for 
health for ALL cannot be ignored!

4. How you can help the Campaign (besides mobilizing in your country)

*  Sign up as a translator

*  Join the web site team

*  Create a resources page for the web site (The papers, web sites, 
organizations have been identified. You would organize and anotate the links)

* Help with data entry into a spreadsheet (boring, but necessary and 
important!)

* Work on grantwriting and fundraising on either a regional or global level. 
Tell us about any potential funders you know.

5. Campaign organizer update

As mentioned in the campaign clarification above, the timeline of the campaign 
has been extended and so we are reopening our request for volunteers to be 
campaign organizers. The organizers will travel to participating countries to 
assist them in their mobilization and provide training on the use of the 
Assessment Guide. They will receive training about the campaign and their 
duties. We need people who speak/write English and at least one other language 
spoken in region where they will work. They must have time and schedule 
flexibility to be able to travel and to communicate with the countries they 
are working with between trips. We anticipate that the traveling will be more 
intermittent than originally planned. The positions are voluntary but all 
expenses (flights, buses, food, lodging, incidentals) will be paid by the 
campaign while traveling. In particular we need a French-speaking African to 
work in the francophone countries now joining the campaign, but people from 
any region are invited to apply. We thank those who have already submitted 
their applications.

To apply please send to phm at turiano.org and claudio at hcmc.netnam.vn:

- a CV or summary of your related experience (in health, human rights, 
community organizing and mobilization, etc) and the organizations you are 
affiliated with (full names please - no acronyms)
- 2-3 references (preferably including one from someone known to PHM)
- your contact information
- a brief statement about why you want to do this work and what you would 
bring to it.


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