PHM-Exch> Re-politicization and De-professionalization- The way forward for the Health rights discourse

[Claudio Schuftan]

From: Vijaya kumar <vijayvins at gmail.com>


*Notes from the Talk by Madhuri Krishnaswami, on Re-politicization and
De-professionalization- The way forward for the health rights discourse
held on 31st October, 2013.*


Speaking in Karnataka, Madhuri Krishnaswami fore-grounded the broader
understanding of health to include social determinants of health and drew
attention to how lack of health and health care is rendering the lives of
not just the poor and marginalized, but also the middle class fragile and
vulnerable. However it was the working class who bore the brunt of repeated
illness due to poor nutrition and over -work, non-functional, unresponsive
public health system and increasing health care costs, which was
pauperizing them and pushing their children to drop out of school to look
after the ill and augment family income.



Explaining that the chances of a soldier surviving a war posting were far
higher than a pregnant woman surviving the risk of pregnancy and delivery,
she said that health is a fundamental, livelihood and a survival issue for
the people and not a technical issue to be pursued by experts. The fact
that the State has begun the deliberate onslaught of privatization and
starving the public health system of resources is an issue for the people’s
movement whose lives and livelihoods are affected directly. People should
be on the streets fighting against the exploitative system of having to pay
for health care which is stealing their livelihoods and their children’s
future.



Exploring why one does not find a vibrant people’s movement on health,
Madhuri said that on the one hand health what one  sees is a soft issue
devoid of politics and power. On the other hand, the NGOs have moved-in
either to provide service or to mediate between people and the State
through their ‘rights-based approach’. In the process they have taken away
the people’s prerogative and replaced it with expertise and skills. As it
is, people are wary of doctors and their ways and now they have to contend
with a host of experts and professionals who tell them they do not
understand. It is the experts in universities along with the government and
now the private sector players who are telling the people what their health
status is, why it is so, that they will do whatever needs to be done and
people have nothing to do with it. This is the present crisis of health
rights movement which is reduced to experts talking in conference halls to
each other. Much like the four blind-folded wise men asked to describe an
elephant, experts talk about issues in their sectoral area of professional
training and expertise, which is myopic and fragmented. But that is not how
people live their lives. They are confronted by the elephant everyday and
understand it in its entirety.

* *

*If the health rights movement has to be rescued from its present crisis,
then it has to move forward as a democratic movement for citizens’ rights
and build an understanding of the system from people’s own experience and
not merely through the experts. And experts if well-meaning should lay
their expertise at people’s disposal, they should be talking to people on
the streets and not in conference halls and learn from the people. In the
face of a silent emergency of malnutrition, maternal deaths and infant
deaths she urged that the health movement should move forward as a mass
movement anchored in people’s vision of a democratic just society demanding
that the State take complete and full responsibility for directly providing
free universal good quality health care for all.*
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