PHA-Exch> Food for a cascading thought
Claudio Schuftan
cschuftan at phmovement.org
Sat Aug 30 03:21:38 PDT 2008
Human Rights Reader 197
*THE HUMAN RIGHT TO HEALTH AND TO ADEQUATE NUTRITION IN A STRUCTURALLY
UNEQUAL SOCIETY.*
1. I would like to think that you -as me- often ask yourself what we could
all do better to achieve greater equity through what we do given that we
most often work in countries with appalling social inequities. Allow me to
share with you some of my thoughts on this.
2. I see our role in helping put in place the needed social processes and
mechanisms that will drive sustainable human rights-based policies in health
and nutrition as being inseparable from us helping to instill a new will and
commitment to change underlying preventable structural inequalities in
society. To achieve the latter, you can -as individuals- come to this will
from either of two motivations: you can either come to it from a primarily
ethical or from a political motivation.
3. These two motivational stances --that can drive us to become more
involved in lessening social inequities-- represent, not
packages-of-universal solutions, but rather paths-to-follow to get things
that need to be done done, and the latter by whom, with whom, and against
whom.
4. Living as we do in a mean, unfair and selfish world, I see the challenge
we face as being one to graduate from the first into the second approach.
Let me explain why:
THE PRIMARILY *ETHICAL* HUMAN RIGHTS-LED PROCESS TO SUSTAINABLE DEVELOPMENT
IN HEALTH AND NUTRITION
As is true for slavery, there are
ethical limits to tolerating
extreme poverty.
5. The quite prevalent development ethics that calls for working with the
poor as protagonists and not merely as recipients of development aid has, so
far, itself, unfortunately remained mostly a top-down approach. It
represents mostly the view of academicians, of intellectuals, of church
leaders, of international bureaucrats and of a few politicians (mostly in
the opposition). Beneficiaries have remained mostly passive in this
approach, merely being counted as the 'objects' of the process. This
ethics-led human rights process assigns a key role to '*moral advocates*'
who are to advance the following cascading process:
- NEEDS (Entails assessing needs requiring
fulfillment using
"objective"(?) field research
techniques)
|
- ENTITLEMENTS (Entails granting selected identified needs
the status of
entitlements to be honored
by society)
|
- RIGHTS (Entails translating accepted entitlements into actual
justiciable human rights)*
|
- LAWS (Entails delegating to members of Parliament the
legitimization of selected human rights by promulgating
them
into laws)
|
- LAW ENFORCEMENT (Entails assuring/securing that the human
rights-related laws get enforced by
government
institutions)**
_________________________________________________________
* : Promoting these rights is not, by itself, a progressive political act.
**: Often very weak or non-existent and without the people getting
involved
directly in it; absence of recourse mechanisms.
6. The inherent weakness of this process is that to have human rights
ultimately respected, someone other than the poor takes the responsibility
at each step to steer the process from entitlement to enforcement.
THE PRIMARILY *POLITICAL* HUMAN RIGHTS-LED PROCESS TO SUSTAINABLE
DEVELOPMENT IN HEALTH AND NUTRITION
7. This more bottom-up political approach (in which commitments are needed
beyond ethics) better accommodates and represents the perceptions of needed
development actions as seen from the perspective of the human rights-based
framework *and* that of the beneficiaries of development. In this
approach, beneficiaries are clearly the protagonists of the process; the
process is mostly politically motivated and assigns a key role to '*social
activists and political advocates*' who are to advance the following
cascading process:
- FELT NEEDS (As freely and spontaneously expressed by
organized
communities in relation to the rights they feel are
being
violated)
|
[Consciousness raising] (The role of human rights
activists importantly using
capacity
analysis)
|
- CONCRETE CLAIMS (Felt needs are articulated into concrete human rights
claims directed at specific duty bearers, each
tackling
perceived violations)*
|
[Social mobilization] (Also the initial role of human
rights activists)
|
|
[Empowerment/Acquisition of Social Power]
|
|
- ORGANIZED PEOPLE'S ACTIONS (Mobilization of the community's
own and then outside
resources)
|
[Gains in self-confidence]
|
- DE-FACTO EXERCISE OF SOCIAL POWER (Within or challenging existing
laws; bringing in and using needed
external
resources)
|
[Networking]
|
[Acquisition of Political Power] (Progressive influence over
needed decisions)
|
- CONSOLIDATION OF NEW POWER (Coalition building)
|
[Leads to new felt needs and the cycle restarts]
________________________________________________________
* : Claims correspond to entitlements in the previous diagram.
8. Although the ethically and politically human rights-led approaches, as
simplified in
these two diagrams, represent different paths, both can contribute --through
their own merits-- to sustainable changes in the health and nutrition of the
poor. The two approaches complement each other, but would be even more
synergistic if the ethically led process gets more proactive civil society
inputs and gets more politically savvy.
9. It is in the realm of the second diagram that I see us ever getting a
chance to influence the choice of needed investments in health and
nutrition, as well as influencing the redistributive and social protection
measures/priorities that will concomitantly address the poverty underlying
the preventable ill-health and malnutrition we (as professionals) are left
to deal with.
10. It is in the realm of the second diagram as well --with the added
strength coming from a mobilized community-- that I see us ever effectively
influencing how the public sector allocates its resources and chooses the
needed geographic/gender/socioeconomic/ethnic targets, and how, in the
process, the government favors programs that are under strong community
control.
11. Finally, it is also in the realm of the second diagram that I see us
succeeding in instilling a new will and commitment to change underlying
preventable structural inequities in society that underlie preventable
ill-health and malnutrition; our strength will come from building the new
constituencies that do have a vested interest in pushing for the
unpostponable changes in the system that basically reproduces the existing
structural inequities and determines the parameters within which we (as
professionals) are "allowed" to intervene.
Claudio Schuftan, Ho Chi Minh City
cschuftan at phmovement.org
[All Readers can be found in www.humaninfo.org/aviva under
No.69<http://www.humaninfo.org/aviva%20%20under%20No.69>
]
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