The Perspective
Over the last 10-15 years, the policies of Governments and International
agencies have led to the worsening health of the poor. In the name of
liberalization and globalization, people's livelihoods have been threatened.
As a result, poverty has increased and people's health has suffered. The
grand slogan Health for All by 2000 A.D. that was raised in 1978 in
Alma Ata lies today forgotten. It is time for People's Movements and
Voluntary Organizations to mobilize people against these policies - to build
a global consensus against globalization. Structural Adjustment Policies are
working to undermine the vision of Alma Ata. A mass movement opposing this
and renewing the Health for All pledge is essential. This is the
understanding with which the People's Health Assembly Campaign has been
jointly initiated by thousands of organizations.
The Objectives
-
Reversing Structural Adjustment Policies and Globalization.
-
Decentralization and democratization of health care along with
adequate resources to ensure its effectiveness.
-
Bringing the community to the center stage of the health planning
and health care process.
-
Ensuring the provisioning of basic needs to all citizens through
decentralized planning and appropriate technology transfers.
-
Curbing the unregulated and unethical commercialization of the
health profession and promoting the growth of rational, ethical and
competent professional practice.
-
Bringing together Voluntary Organizations & People’s
Movements to build a powerful force to work to lessen disparities,
promote organizations of weaker sections, and build people’s
capabilities.
The Organizations Involved
18 National Networks and the Department of Social Medicine, Jawaharlal
Nehru University are leading the campaign at the national level. These 19
organizations have formed a National Coordinating Committee (NCC) to
coordinate the campaign activities leading up to the Dhaka assembly. All
India People’s Science Network (AIPSN) and Bharat Gyan Vigyan Samithi (BGVS)
are the networks, which initiated this campaign. The organizations in these
networks are best known for their mass literacy campaign and science
popularization activities. Another large network of people’s movements in
the NCC is the National Alliance Of People’s Movements (NAPM) that has
been fighting for the rights of the marginalized. The NAPM has more than 200
organizations including a number of NGOs in constructive action. Forum for
Child Care and Crèche Services (FORCES) is another network of over 100
organizations involved in the provision of child-care services. Many of
these groups provide daycare services for marginalized sections like
construction workers, whereas others are trade unions and workers
associations involved in policy issues concerning the child. The Medico
Friends Circle (MFC) is a network of health professionals, social scientists
and individuals concerned about health who have pioneered the discussion of
alternatives in health care over the last three decades. All India Drug
Action Network (AIDAN) has been campaigning for a rational drug policy over
the last two decades. Society for Community Health Awareness, Research and
Action (SOCHARA) is a group that has been involved in working with
governments, international bodies and NGOs to promote better healthcare
polices. The Federation Of Medical and Sales Representatives Associations of
India (FMRAI) is a network that has played a significant role in creating an
awareness of drug policy issues and in drawing attention to the adverse
impact of globalization pressures on the pharmaceutical sector. The Catholic
Health Association of India (CHAI) and the Christian Medical Association of
India (CMAI) consist of thousands of dispensaries and hospitals, spread
across the country managing a network of not-for-profit hospitals across the
country. The Ramakrishna Mission (RKM) is a network of organizations that
run schools and institutions for the deprived. Voluntary Health Association
of India (VHAI) is a leading institution for both interventions in health
policy and for organizing health programmes with a community orientation. It
is linked to state level voluntary health associations and to over 2000
grassroots organizations. Asian Community Health Action Network (ACHAN) is
an NGO whose focus is on training and whose activities cover the entire
Asian region. AIDWA, NFIW, JWP, NAWO and AIWC: The All India Democratic
Women’s Association (AIDWA), the National Federation of Indian Women (NFIW),
the Joint Women’s Programme (JWP), the National Association of Women’s
Organizations (NAWO) and the All India Women’s Conference (AIWC) are five
women’s organizations in the NCC. JNU's Department of Social Medicine has
also joined the NCC.
Apart from the networks listed above, a large number of organizations and
networks working at a state level or on special themes are also
participating in the campaign. In all over 2000 organizations are involved
in the campaign at various levels.
Activities Planned
Books and Charter
The National Coordination Committee prepared a set of 5 books, which has
been translated into to most of the major Indian languages. These books
cover the major issues in health care and provision of basic needs that face
the country today and look at how Structural Adjustment and Globalization
policies have led to a worsening of the health status. The books also look
at a number of people's initiatives and how these form a model for what
changes are possible with the right set of policies. The NCC has also
prepared a Draft People's Health Charter to be adopted at the National
Assembly.
Training Workshops and Formation of State, District and Block
Coordination Committees
A National Training Workshop was held in Hyderabad in April 2000 to train
delegates from all the states on these books. Following this, in each state
a State Coordination Committee (SCC) with representatives from the major
people's movements and NGOs in the state has been formed. These SCCs
organized a state level workshop to train district representative on these
books and to plan out the campaign in their respective states. In most
districts, District Coordination Committees have also been formed and
district workshops have been conducted.
Block and Primary Health Center Level Surveys and Enquiries
At the district and block level a number of activities have been planned and
initiated. Most states have prepared three questionnaires for a household
level, village level and a Primary Health Center level surveys. The
household surveys are being conducted in 2-3 villages in each block (each
block has about 100-200 villages). The village level surveys are being done
in about 30 villages. The survey looks at what people actually want, what
the government has promised, what has been actually delivered and what the
space for people's initiatives is. The results are consolidated and
presented at a village meeting organized for this purpose. In many places, a
block seminar is also planned to present the block level consolidation of
the surveys.
District Conventions and Policy Dialogues
Between mid-October and mid-November, most states are planning their
district conventions and policy dialogues. In many of these conventions,
apart from creating media attention on the results of the surveys, and
particular case studies from that district, a local people's health charter
will also be adopted. The results of the surveys and charter of people's
demands will be presented to the district officials.
State Level Mobilizational Activities
Immediately after this (and in some cases preceding this), follow the State
and District Level Mobilizational activities. A number of initiatives have
been planned (and in some case have already been started) in different
states -
- A number of states are organizing signature
campaigns - along with their block/slum surveys. The interesting thing
here is that with each signature a token donation of Re.1 is being
collected. This ensures that people ask what they are signing for and a
discussion of the campaign issues follows. In Delhi for example 53,000
signatures like this have already been collected.
Cycle Rally
- In a few states, a statewide cycle rally has been
planned.
Dear Doctor Letters
- Doctors usually received letters addressed
"Dear Doctor" from drug companies. This campaign is to send a
similar letter but which requests doctors to practice rational medicine.
In Maharastra, adivasis read the letter, expressed their
agreement and sent the letters to doctors in their area. In Tamilnadu
for example, we are getting a list of all the doctors from the Medical
Representatives and sending letters to all of them.
Processions
- In many states processions have been planned with a
variety of themes and forms.
Kala
Jathas - These are street theatre campaigns where
a troupe of artists travel from one village to another performing skits
and drama. This mobilizes people in large numbers. In a day, a troupe on
tour can easily cover 3-4 villages. Several states are planning this in
their districts.
Poster Campaign
- A set of posters emphasizing some of the issues
of the campaign are being prepared and will be put up in offices, PHCs,
Clinics and in villages. Some state have already prepared their posters
are have put them up.
Special Theme Day
- In some states, a statewide campaign on a
particular issue is being organized on a particular date. In Tamilnadu
for example, November 14 is being celebrated as Girl Child Day. The
focus is on highlighting female feticide in the state. Posters against
feticide have been prepared. It is planned to picket clinics and scan
centers and to demand a promise of "no scans to determine sex of
the child". Processions and rallies with posters are also being
planned. Articles on this issue will be written in newspapers.
Calling media attention and calling press meets and writing in newspapers
is being done along with the rest of campaign.
State Conventions and Policy Dialogues
After the state level mobilizational activities, a State Convention has been
planned. In most states this is taking place in the second and third week of
November. Along with the State Convention, a policy dialogue is planned with
state level officials and medical professionals.
People's Health Trains
After the State Convention, the delegates from each state will board a train
to Calcutta for the National Assembly. The exciting thing about this is that
all the seats on 4 trains have been completely booked by us. The South Train
is the Ernakulam Patna Express - all the 700 delegates from Kerala,
Tamilnadu, Karnataka, Andhra Pradesh and Orissa will travel by this train.
140 from Kerala will board in Kerala and as the train passes through
Jolarpettai the representatives from Karnataka will join them and in Chennai
the Tamilnadu delegates will join the train. Then the train will pass
through Andhra Pradesh and Orissa where the representatives of these states
will board. Similarly the Northern States will board the Kalka Howrah
Express, the Western States will come on the Ahmedabad-Howrah and the North
Eastern State will come from Guwahati. The trains themselves are planned as
a media event - at each station the delegates will get down, distribute
leaflets and shout some slogans and meet with the press and then get back
into the train. The trains are also planned as moving workshops with classes
for the delegates.
National Health Assembly
The final culmination of the India Campaign will be at Calcutta on Nov 30th
- Dec 1st. Two Thousand Delegates from different states are coming for the
Assembly, which will be held at Salt Lake Stadium in Calcutta. The first day
morning session will be a plenary - with opening remarks and the main points
of the People's Health Charter being highlighted. The afternoon session will
be 20 parallel Shamiana Workshops on various themes. In each Shamiana
will be a number of resource persons from across the country who will lead
the discussions. Each Shamiana workshop will focus on a particular
issue and will develop ideas for intervention. On the evening of November
30th will be a poster exhibition - where different states are given space to
display their campaign activities and case studies. This event is open to
the public. The second day forenoon session will be 6 large sub-conferences
with emphasis on case studies and people's initiatives. These
sub-conferences will look at how the possible follow up actions to the PHA
Campaign. In the afternoon of the second day after the formal adoption of
the People's Health Charter, a massive rally with about 35,000 people is
planned. This rally will culminate in a public meeting.
Dhaka Chalo and the International Kala Jathas !
After the National Campaign, 300 representatives from India will go to Dhaka
to participate in the International Assembly. An international Kala Jatha
has also been planned. A team is being trained for this. For 10 days in
November the team will tour Tripura and then will cross over to Bangladesh
and perform for another 10-15 days there before reaching the Dhaka
convention.
These activities are just some of the activities being done by all/most
of the states or at the national level. Apart from this, each participating
organization is free to take up other activities towards furthering the
objectives of the Jan Swasthya Sabha. Many are already
doing so. Another interesting this about this campaign is that all these
massive activities are planned with little or no outside support. They are
to be done with resources mobilized from the people and from within the
organizations themselves.
http://www.tnsf.org/pha
Who is hosting it?
On August 12th and 13th, the National Coordination Committee meeting
commissioned the Chennai Office to develop the website and host it. The main
purpose of the site apart from providing information access to people
outside is to also maintain documentation of the PHA Campaign process as it
is happening. The website has used the emails and reports sent by various
states and NCC representatives. The web-site itself is being hosted free by
the Tamil Nadu Science Forum, a constituent of the All India People's
Science Network.
EDITORIAL
The future of your health
By Jyotshna Pandit
About a hundred people met in a small auditorium at the Institute of
Mathematical Sciences in Chennai during the winter of 1999. Sujatha and
other villagers from across Tamil Nadu had gathered to speak at a discussion
on people's initiative in primary health care. Sujatha rose and narrated the
moving story of a single mother and her jaundiced child. Nobody stirred.
Dressed in pastel nylon sarees and salwar kameez,
the women were all ears during the first half of the session as Dr. T.
Sundararaman of the People's Initiative in Primary Health Care, explained
why hospitals would no longer suffice. Why in the near future, a
door-to-door, village-level initiative would become essential for a healthy
India. This was a preparatory meeting for participation in the People's
Health Assembly, scheduled to be held in Bangladesh in the first week for
December 2000.
Explaining that the Assembly would be the result of a long-term process,
Dr. Sundararaman mentioned that the first steps had already been taken two
years before in a few villages where the Tamil Nadu Science Forum and the
Centre for Ecology and Rural Development had set up village level health
workers. They would be addressing the health needs of rural women and
children, though their intervention would not be as outsiders and
area-specific
The idea was to start off with dialogue. Say for example, a small
gathering of 10 households would discuss their various problems. These could
include a discussion on employment opportunities, malaria in children,
blocked drains or damaged roofs. The people would elect a volunteer to
represent their group who would directly discuss all the group's needs.
Volunteers would then initiate a village-level meeting with the active
participation of the panchayat leaders. Following this, a health
worker would be assigned and he in turn would be guided by field members of
the Science Forum or the Centre for Rural Development.
Once trained in primary health care and data collection, the villagers
would network at the block, taluk and district level, acting as
liaison persons with individual households. They would be provided field
guides in the form of the publications of the Bharat Gyan Vigyan Samiti in
the local language. There would be 15 simple booklets on "health
literacy." And these would be accompanied by a training manual.
Resource persons at the district level would network with developmental
organisations, NGOs and other welfare bodies active in the districts. They
would also interact with literacy workers, prohibition workers and street
play groups. This would finally create a pool of ideas to push forward any
initiative the people might take. From time to time, the idea was to have
health workers meet in bigger groups, where the data they had collected
about the individuals under their care, households and villages would be
analysed and innovative solutions to specific problems suggested.
The feedback received would help focus on the major health issues in a
village or individual groups, simultaneously seeking a remedy associated
social situations. Eventually the data and documentation done at the
State-level could help a countrywide discussion on people's actual needs
with solutions coming not from the government but from the people
themselves.
The regional discussions are expected to lead to a national-level
seminar. Case studies, experience and "people's stories" from as
many countries as possible would be collected. They would describe people's
direct experiences with health problems, their own analysis, success stories
and the reasons for the failures.
In a year's time, Sujatha's story about an abandoned mother with a
jaundiced child would help facilitators draw up a People's Health Charter to
start off the new century.
As traditional knowledge systems face greater threats, the vulnerable
section in South Asia, Latin America, sub-Saharan Africa and Eastern Europe,
grows bigger. The need today for a holistic approach to health care is
greater than ever before and people have to discuss the programmes before
any comprehensive policy can be chalked out.
The people themselves must help frame policies, say those in the
movement. Their initiative is expected to help correct the failure to
promote participation and genuine involvement of communities in their own
health development. It will also help correct the State's narrow, top-down,
technology-oriented view of health. INAV
Tamil Nadu State delegation leaves for the Calcutta meeting of National
People’s Health Assembly
Press Release, November 27, 2000: Over 1,100 delegates from 20
districts of Tamil Nadu arrived early 26th morning for the State Convention
of the People’s Health Assembly, which was held in New College Auditorium.
This event marked the culmination of a year long dynamic process designed to
address the crisis in health care consequent to the Globalisation process
that has seen savage cuts in government expenditure on health and education.
The convention began with speeches by the state co-ordinators of the PHA
and invited speakers. In the presidential address, Dr.Vasanthi Devi, the
chairperson of the PHA in Tamilnadu pointed out the adverse impacts of
privatizing the health-care sector and why it affects the poor. She
emphasized the need for decentralization of services and effective panchayats
to ensure effective public health care. Mr. Thomas Kochery, president of the
National Fish workers forum spelt out the unfair policies adopted by
developed countries under the garb of globalization. He highlighted their
double standards in asking the poorer countries to reduce their expenditure
on health and education while a large portion of such expenditure is still
borne out by the government in the rich countries.
Dr. C.N Deivanayagam from the government hospital of Thoracic medicine
emphasized the need for greater awareness of health-related facts. He
stressed that immediate steps were required to address issues such as the
alarming incidence of TB and malaria. Amalorpavanathan, head of department,
vascular surgery, GH cited examples of the disparities in health care
facilities - while wards patronized by the rich were well equipped, those
that were used largely by the poor were neglected. He also ridiculed the
government for spending on arms and nuclear arsenal while there was no money
to spend on health care!
Claudio Schuftn from the international people’s health assembly
mentioned that India is populous, therefore what happens in India affects
the statistics of the world significantly. Hence a small change in India
will make a large difference in people’s health in the world. He called
for the continuation of this movement beyond this meet, and pointed out the
task expected of the delegates was ambitious. He concluded by saying “We
cannot continue to only react to other actors, but also start initiatives!”
The speeches in the morning were followed by cultural presentations in
the afternoon including songs and Kalajathas. Each district presented
a report on the activities that were conducted as part of the PHA process.
K. Alpana, joint convenor of the Tamilnadu PHA summarized the efforts of
organizations in various districts across the state.
-
Early this year, 32 organizations across Tamil Nadu came together to
form the State Coordinating Committee (SCC). These are inclusive of TNSF,
TNVHA, CHAT, TNMSRA, FORCES, Women’s Collective, FEDCOT, CRY, AIDWA,
Prepare, ICCW, and CASSA. The SCC coordinated the village and
block-level surveys, awareness programs and campaigns, policy dialogues
and over all people's empowerment. The total number of people who where
have been reached by these efforts in Tamil Nadu is estimated at 40 lakhs.
People who participated in workshops across the state is approximately
10,000.
-
At the start of the PHA efforts, five books were brought out by the
National Coordination Committee to guide the block, district and state
seminars. The books covered the following issues:
-
What Globalization does to Peoples Health! (Understanding what
globalization is all about and how it affects the health of the
poor.)00
-
Whatever happened to Health for All by 2000AD? (an understanding of
the making and unmaking of the Alma Ata declaration.)
-
Making life Worth Living! (Meeting the basic needs of all-Inter-sectoral
issues in health care.)
-
A World Where WE Matter! (Health care issues of women, children,
and the marginalized sections of society.)
-
Confronting Commercialization of Health Care! (A brief introduction
to the ethical and professional dimensions and quality of care
implications of the growing thrust to privatize all health care
services.)
-
These books were translated into Tamil and were studied in workshop
sessions in 18 districts, in a total of 62 blocks.
-
These workshops were followed by three kinds of surveys were
conducted in 18 districts:
-
A survey of the functioning and infrastructure of government
health centers and hospitals.
-
A village level survey of facilities such as ration shops, noon
meal centers, drinking water supply, road and bus facilities etc.
-
A household level survey of people’s diseases profile and
access to medical facilities.
This survey has taken place in 67 blocks in 18 districts. About 121
Primary Health centers and government hospitals have been surveyed. The
village level survey was conducted in 805 villages and the household
level survey in 22,988 households.
-
15000 letters addressed both to Public and Private Sectors Doctors
have been sent by post.
-
A set of 3 posters highlighting the theme of the campaign have been
displayed in 18 districts.
-
On behalf of the PHA campaign November 14th was observed as Girl
Child Day and protest, marches, and meeting were held in front of Scan
centers that offered foetal sex determination services. Signature
campaign was also conducted in all the districts.
-
Five Kala Jatha teams were trained and performed street
plays highlighting people’s health issues in 25 districts.
-
18 districts have conducted district level conventions in which they
have presented a charter of demands to the health officers of their
district.
After the State Convention the Delegate and other participants from the
various districts took out a rally from Icehouse Police Station to
Triplicane Theradi demanding Health as a fundamental right for all people -
whether they are rich or poor. The rally concluded with a Public Meeting,
which was address by Ms. R. Gita (General Secretary, Construction Workers
Union), Ms. U. Vasuki (Vice-President, All India Democratic Women's
Association), Dr. Thomas Kocherry (National Fishworkers Forum) and Dr.
Venkatesh Atreya (Tamilnadu Science Forum).
160 delegates from Tamil Nadu will board the Ernakulam Patna Express
(#1309) from Chennai on Nov. 28 to join other delegates from Kerala, Andhra
Pradesh, Karnataka and Orissa for a Travelling Train Workshops on the way to
Calcutta for the National People’s Health Assembly, which will be attended
by 2000 people from all over India. Similar trains will leave from the
north, east and west of the country from 16 other states. The stage is set
for an historic event in the history of health movement in India.
The PHA-2000 in India marks the first time that almost all the major
networks of NGOs and people’s movements working in the area of health have
come together on a common platform to re-establish health and equitable
development as top priorities in local, national and international policy
making with primary health care as the strategy for achieving these
priorities. With this agenda, a delegation of 250 people will participate in
the international PHA in Dhaka in the first week of December. Delegates from
116 countries will come together to revive the spirit of the Alma Ata
declaration.
The ideology of the PHA:
The present changes taking place in the world, are widening income
disparities and shrinking access to meaningful health care services to large
majorities across the globe. The changes in India in the last decade have
been rapid and the negative fallouts are evident. The Child Malnutrition
levels in India (53%) is (barring Bangladesh) the lowest in the world, far
worse in comparison to even Sub Saharan Africa where it is 20-25%. The
Infant Mortality Rate that had declined over the past decades has stagnated
at over 70 deaths for every thousand children born.
Drug prices have increased by over 40% making essential medicines
virtually unaffordable. Traditional systems of health care and established
social systems are under threat. At the national and global level, older
diseases like Tuberculosis, Malaria, Kala Azar, Dengue and
Plague, are re-emerging in virulent and virtually untreatable forms, while
newer diseases like HIV/AIDS are also emerging.
Therefore there is an urgent necessity to place health on the top of
policy agendas. Past policies and programmes need to be scrutinized and new
broad-based vision and agendas for action for policy makers formulated.
"The output of all state level events and what transpires at the NHA
will feed into the international People's Health Assembly at Dhaka,
Bangladesh and to the formulation of People's Health Charter which will be
the guiding spirit behind health policy formulation in future" says Dr.
Ekbal, Vice Chancellor Kerala University and the Convenor of the National
Coordination Committee of the Campaign.
Dr. Balaji Sampath kb@eth.net
PHA National Office Coordinator, Chennai
November 27, 2000.
Phone: (044) 8266033, 4402434
NGOs Demand More Spending on Health
November 8, 2000, Pune, India
Source: Times of India
The heavy downpour on Sunday evening did not deter more than 200 people
from attending a rally organized to demand accountability from civic and
health services, and the regulation of services by private doctors and fair
price shops.
The rally was organized by two Non-Government Organizations, Ashish Gram
Rachna Trust (AGRT) and Arogya Vikas Samanway Samiti (AVSS), on Sunday
evening.
Calling it the 'March for health', the participants started from two
points in the Mundhwa-Ghorpadi slums, and converged at the Jai Hind Chowk, Ghorpadigoan,
where a meeting was held. Residents of the slums also attended the meeting.
The objective of the rally was to build public opinion and focus
attention on health issues, particularly the preventive aspects that are all
to often neglected. "Doctors are not required to prevent disease; what
is required is clean water, clean environment and fairly priced rations,''
pointed out AGRT's Anand Pawar.
AGRT has formed local health samitis in slums where people can
voice their grievances, discuss health issues and demand health rights.
Resident medical officer of the Kutir Rugnalaya, Dr Ashok Gaikwad, said that
good health was the right of the people and steps taken by the government to
provide this right were not enough.
Chief guest of the function and representative of the People's Health
Assembly, Datta Desai, said that the health of people is the yardstick by
which the overall development of the state can be measured. Health issues,
he said, should be at the forefront of a state's agenda. "India spends
1.5 per cent of its gross domestic product on health which is far less than
most other countries," he said, adding that people need to demand that
more of their tax money be spent on health.
Six resolutions on health issues were unanimously endorsed by all the
present.
Voluntary Agencies' Role in Spreading Health Message Stressed
November 13, 2000, Pondicherry, India
Source: The Hindu
Dr. N. Venkateswaralu, Head of the Department of Dermatology in the Pondicherry General Hospital and State Secretary of the Indian Medical
Association, today inaugurated a one-day seminar on health scenario in Pondicherry held under the auspices of People's Health Assembly in
collaboration with the Pondicherry Science Forum. He stressed the importance
of voluntary organizations in carrying the message of health to the people.
He said Pondicherry had been distinct in having health institutions at
close proximity to each other. Health education was absolutely necessary so
that people could become aware of healthy life. There should be proper
commitment and readiness to meet the requirements of the people.
Dr. Dhanapal, Head of the Department of Preventive and Social Medicine in
JIPMER, who presented a paper on the theme of the seminar, said there
were achievements in abundant measure in the health sector in Pondicherry.
But there were still challenges to be faced successfully in eradication of
certain ailments such as AIDS. He said that primary health care was
absolutely necessary. There should be equitable distribution of health
services, community's participation, inter-sectoral approach, and
appropriate technology to tackle health problems and focus on prevention of
occurrence of diseases.
Dr. Dhanapal said that in Pondicherry great quantitative achievements had
been made in the health sector, but quality health care was to be achieved.
There were complaints of lack of health personnel.
Dr. T. Sundararaman, professor in the Department of Medicine, JIPMER, and
member of the National Working Committee of Jan Swasthya Sabha (People's
Health Assembly) detailed the objectives of the Public Health Assembly. He
said that the seminar was part of the pre-conference activities building up
to the National Health Assembly scheduled at Calcutta on November 30 and
December 1 which will be attended by over 2000 delegates from all over the
country. The International Health Assembly would be held in Dhaka
(Bangladesh) from December 4 to 8. Seminars and conferences were being held
simultaneously now in all the States in the country and in all the countries
of the world as part of a campaign to renew the pledge of 'Health for All'.
Mr. P. Parthasarathy, research scholar, Medical Anthropology, Pondicherry Institute of Linguistics Culture and convenor of the Pondicherry Health
Assembly, also spoke. Ms. Shyamala Ashok, executive director of Society for Development Research and Training and chairperson of People's Health
Assembly, Pondicherry welcomed those present.
NAPM Press Release - 16th March 2000
Farmers, Dalits, Tribals & Women Resolve to Fight Against
Globalization
In the peaceful surroundings of Chota Badada on the banks of the
still-flowing Narmada, the 3rd convention of the National Alliance of
People's Movements brought together organizations, movements, individuals
and parties from all over India for an intense, thought-provoking, 4-day
deliberation from March 11-14, on struggles and alternatives in agriculture,
labour, politics, globalization, water, energy, weaponization, art and
culture. There was a remarkable consensus in a cross-section of people who
have been fighting in various local struggles in different parts of India,
and covering all age groups, from charka spinning Gandhians who had
the good fortune of seeing the Mahatma, to dalit groups who
remembered Ambedkar through their songs, to young activists in Reva ke Yuva
fighting against faulty development symbolized by the dams on the Narmada.
The consensus of such diverse talent group was that something is wrong,
seriously wrong that needs to be challenged, stopped and corrected. And this
is not just the yesteryear brow-beating of capitalism in search for some
higher ideals, that which is wrong is taking all our country’s wealth
including our right to live on a land that is free, free from being
exploited, sold and lost permanently to foreign multinationals. Today’s
no-holds-barred globalization and ever widening gap between the rich and the
poor leading to marginalization of most of the humanity, and being achieved
without giving any public information or consultation must be stopped before
it is too late and our treasured freedom is gone once again.
On such concrete actions "Clinton go back", "IMF, WTO,
World Bank go back" there was uniform strong support from every local
and state level movement. Just as there was support for the agricultural
laborers waiting for the welfare bill to be passed that will give them
pension and compensatory benefits. There was both a grasp of the corrective
measures as well as the will to fight against the global onslaught. Sessions
ranged from empowering the villages so that they can generate their own
electricity to the alarming rate at which water policy is being drafted in
India that will effect millions and make water, even water that our very
thirst depends on, a commercial commodity that can be totally acquired by
the rich and powerful. The participants tackled current issues such as
constitution review which they opposed strongly since no public debates have
been held, which are a pre-requisite for a healthy functioning democracy and
because of the hidden agenda of the ruling government such as to ensure its
continuity. It is true development, not destruction they want, just as the
people of Narmada in Chota Badada where the waters are rising every year
with every step of the dam. Some of the important points raised and
decisions made were:
-
Globalization and Bill Clinton’s Visit: Talks by Kishen Patnaik,
Gabrieli Dietrich and Sunil Bhai set the stage for discussions on
globalization and the danger at which it is spreading - even the agriculture
sector will be affectd by it - which means people will start buying outside
food products and Indian farmers and related agriculture industry will
suffer. A firm stand against globalization was taken by all the member
organizations and state level units that were present. Protest actions
against Bill Clinton’s India visit are being planned by all the state NAPM
units including Andhra Pradesh, WB, Maharashtra, Madhya Pradesh and Delhi,
since the American presidency stands strongly for WTO, IMF and globalization
so as to establish its hegemony. Representatives from Direct Action Network,
the organizers of the WTO-Seattle protest action, were also there. They are
planning an initiative in Washington DC in April and during the Sept 26-28
IMF-World Bank meeting in USA.
-
Agriculture: An important agricultural bill that has been pending for
being passed by the parliament was presented by P. Chenniah and Narendranath,
leaders of landless labourers in Andhra Pradesh. It gives benefits such as
pension & compensation to agricultural, landless workers, who are among
the poorest. It gives them some legal ground to sue even if they don’t
belong to a union, and if their rights are violated. There is full support
from all NAPM state-level units and a nation-wide struggle and campaign will
be launched for safeguarding the agricultural sector and interest of farmers
and agricultural labourers. Members also decided to gather information on
land distribution patterns in each state, which will enable district level
initiatives to be started. NAPM members also committed themselves to village
level resource mapping wherever member organizations are active and planning
towards self-reliance.
-
Alternate Politics: It was resolved that to get the alternate
development paradigm evolved, alternate politics will be strengthened from
grassroots level upwards and NAPM itself will not contest elections. Some
felt it was important to create the space for alternate politics first by
challenging the current political atmosphere with more active campaigns like
for example taking up the issue of manifestos and after-election
performances in a much more vigorous way. A few also expressed the view that
it would be good if some individuals jumped in the fray seriously. Finally
it was decided that at this point NAPM would keep out of electoral politics
but will support initiatives by individual candidates and like-minded
groups.
-
Alternatives for energy and water: It was noted that water is a
shared/common resource and there are two components - one for immediate
life-use and other for commercial use - where the rights of the former usage
have to be guaranteed. Thus citizens have to get more involved in water and
energy policy issues. Secondly as discussed by Dr. K. R. Datye and Venkatesh
Iyer, at the village level it was felt that there was a need to set up
biomass cum solar-thermal initiatives as well as network of farmers who are
willing to experiment on some part of their fields and share the
experiences. Follow-up meetings and training will be held in Khargone (for
north) and near Goa (for south) in a month. Awareness pamphlets on
water-literacy/understanding and energy literacy, that are relevant for the
city and village audience are necessary. There was a strong support in NAPM
for this.
-
Constitution Review: It was felt strongly that there was a
non-performance on many key issues of importance already present and
safeguarded in the fundamental rights and directive principles. The review
started without the democratic process of public meetings and consultations
is in the same dangerous direction as covert decisions made previously for
GATT, WTO and nuclear policy bypassing the democratic processes. There is a
hidden agenda to stabilize the current government even if it were to lose
confidence of the house and to change articles that will only make the
Kashmir problem worse. NAPM decided to strongly oppose the review and hold
public meetings to expose the underlying issues to dalits and the
people at large whose rights would be further taken away by a review
undertaken in this manner, and along with them assert for operationalization
of the rights and privileges in the present constitution with appropriate
amendments.
-
International Day against big dams: Hundreds of Sardar Sarovar affected
people were joined by representatives from 70 organizations working in
different parts of the country including people fighting against the Tehri,
Koyna, Gosi Khurd, Ramanjery, Koel Karo, Suvernarekha and Mahi-Kadana dams
across the country, Bargi, Maheswar, Veda dam affected people of Narmada,
along with NAPM representatives from 12 states took out a huge rally in
Badwani where the slogan was "Water for life, not for death". A
statement against large destructive dams in the Narmada valley along with
statements emphasizing the need to evolve sustainable and equitable ways of
harnessing energy and water by people found overwhelming support. Siddharaj
Dhadda, Thomas Kocherry, Vijay Javandia and others reiterated faith in
alternate water management and the alternate path to development. While
Medha Patkar reiterated that to the struggle to save the Narmada valley and
assert the power to the people required the preparedness for ultimate
sacrifice, revered social worker Baba Amte sent a message saying that
"if people decide no power ever will succeed in filling the Dams.
Justice will prevail."
-
Elections: New office bearers were chosen by consensus through a
participatory democratic process. Thomas Kocherry and Sanjay M.G. will
continue as Coordinator and Co-coordinator respectively. Medha Patkar, P.
Chenniah (AP), Lata P.M.(Maharashtra), Sandeep Pandey (UP), Rajni Dave
(Gujarat), Gabriele D (TN), Nalini Nayak (Kerala), Sukhendu B (WB) and Vimal
Bhai (Delhi) will be the National Convenors while Kishe Patnaik, Ajit Bose
and Siddharaj Daddha will be permanent invitees along with the editors of
the 4 NAPM bulletins.
The conference ended with announcements of upcoming actions such as
anti-nuclear actions on Chernobyl Day, the 26th of April, in Nagarcoil near
the planned Koodankulam power plant and 11th May in Jaipur, Rajasthan. The
fishworker organizations will storm Delhi on 12th June and launch an
indefinite struggle with support of several groups joining in. Another
program in which NAPM-Delhi will participate brings many organizations
working with urban poor together. Finally commitment to nav-nirman and
alternate development was expressed by the decision to send NAPM
representatives to participate in the People’s Health Assembly in Dhaka
and to the preparatory workshop being held in Hyderabad on April 7-8.
Medha Patkar
Sanjay M. G.
Lata P. M.
‘People's Trains' to Start New Public Health Movement
By Sandhya Srinivasan
CALCUTTA, India Nov 30 (IPS) - Amruta S.V. rode a train for four days this
week as it made its way across southern and eastern India before reaching
this eastern metropolis.
This was no ordinary train journey as all passengers came here to attend a
unique gathering of public health activists and people's groups from across
the subcontinent, which opened Thursday. It was one of four 'people's health
trains' that started from the southern, western, northern and northeastern
corners of India.
The slow-moving trains had picked up their passengers from all over India.
''We would get off at the stops to shout slogans and sang songs along the
way,'' says Amruta, who represents Mahila Samakhya, a 10- year-old women's
group in southern Karnataka state.
More than 2,000 people like her, from all over India, were in Calcutta for
the Nov. 30 to Dec. 1 'Indian Health Parliament' that was being held ahead
of the Dec. 4-8 global People's Health Assembly (PHA) in Bangladesh.
The Calcutta conference, the first such meeting in India, would adopt a
'People's Health Charter' and finalise the issues to be taken up by the
Indian delegates to the Dhaka health assembly.
Opening the health parliament, Partha De, the health minister of West Bengal
state of which Calcutta is the capital, said that the Calcutta conference
aimed to create better awareness of public health issues among the people
and decision-makers.
De, whose ministry was helping organise the event, said the discussions
would help authorities improve the quality of public health services.
This is one of the goals of the Dhaka global health assembly, which is
expected to issue a call for ''an accessible, affordable, equitably
distributed...health system,'' according to a conference document.
The Calcutta conference marked the climax of a four-month-old consultation
process across the country, which involved some 1,000 groups. The exercise
has collected a rich body of information on the common illnesses and the
quality of public health services in tens of thousands of Indian villages.
The train journeys carried the process forward by bringing together health
activists and NGOs from all over India. According to the organisers of the
event, while the train journeys ''themselves make a statement,'' they also
provided a chance for participants to share experiences ''swap stories and
build common agendas for action.''
''It's the beginning of a change, not a huge one, but definitely a
meaningful one,'' says Amruta. ''It is instilling a questioning attitude in
people, and also getting them involved in helping make change.''
According to Vinod Raina of the All India People's Science Network, one of
the main organisers of the Calcutta conference, consultations were held in
500 administrative sub-divisions across the country.
These have developed area profiles on the health problems of people and the
private and public health services available.
The exercise also looked at the state of water supply, sanitation and
education, which are crucial factors in health care. The aim was to gather
popular support for mounting a ''serious challenge'' to current trends in
public health and related policies, and to develop alternative models of
health care.
''We cannot wish away the problems, the job is to create an alternative
force, a model to promote health care,'' he says.
''The idea is to develop a primary health system that derives its direction
from the 'panchayats' (elected village councils), education and
medical departments as well as local organisations,'' he points out.
Over the two days, 20 separate sessions were to be held on subjects ranging
from female foeticide and child malnutrition to medical professional reform,
disaster management and child labour.
Traditional medicine systems, health concerns of indigenous people,
micro-credit and the impact of new world trade rules on public health, were
also to be discussed.
According to Amit Sen Gupta of the People's Science Movement, the Calcutta
conference would help people's groups get a better understanding of how
globalisation and economic reforms, affect health care in developing
nations.
The World Trade Organisation agreements, ''specially those concerning
Trade-related Intellectual Property Rights (TRIPS) are likely to affect food
security and public health in developing nations,'' said a PHA document.
These would also affect poor nations' ''ability to undertake indigenous
technological development, including in the area of essential
pharmaceuticals,'' it added.
The conference was also to hear the success story of India's southern
coastal Kerala state, where investment in women's education, health and
welfare, has produced a ''significant and sustainable impact on the health
and social indicators of the whole population.''
''Strong community participation is important not only in securing greater
government responsiveness to social needs, but also to mobilise an active,
conscious and organised population critical to the design, implementation
and sustainability of comprehensive health systems,'' said the PHA document.
(END/IPS/ap-dv-he/ss/mu/00)
Issued by the National Coordinating Committee of the National Health
Assembly*.
URGENT PRESS RELEASE
Chennai, Bangalore, Trivandrum, Mumbai
28th November 2000 (14: 00 hrs IST)
(for further details please call:
Mobile: 098450 91319 or Bangalore (80) 553 1518)
HEALTH FOR ALL, NOW
PEOPLE’S HEALTH TRAINS BEING FLAGGED OFF -
A HISTORIC EPISODE IN THE INDIAN HEALTH MOVEMENT
Last 12 hours have witnessed a historic moment in the history of Indian
health movement. Over 1000 delegates, representing all states of India
(including the newly born states) have all boarded trains from different
locations. They are on their way to Calcutta, to participate in an
unprecedented event- National Health Assembly being held from 30th of
November till 2nd of December at the Salt Lake stadium, Calcutta. Over 2000
people from all walks of life - village health workers, doctors, activists,
government officials, researchers, policy makers, political leaders,
voluntary organisations, peoples’ movements, journalists and others - will
come together, keeping their differences away, for this historic event.
“We are excited about this event. This assembly has emerged as a symbol
of hope to revitalise the health movement that has seen set backs in the
last decade” said a village health worker just before she boarded the
No: 2842 Coromondel Express from Chennai, today (2nd Nov) morning. “I
am happy to note the level of mobilisation that has taken place at all
levels as part of the National Health Assembly. I wish that efforts are
continued to consolidate the interaction between the government and the
community that the National Health Assembly has facilitated” remarked
Mr. Sanjay Kaul IAS, Commissioner of Health, Government of Karnataka, while
flagging off the Karnataka state delegation at Bangalore City Junction
yesterday (27th Nov) late evening. Karantaka delegates boarded the train
just after attending the State Convention that was held at Davengere on 26th
and 27th of November. “We hope that this process will help to bring
back health as an important agenda”, said Dr. H Sudarshan, Chairman
Task force on Health, Karnataka Government.
The delegates from Andhra Pradesh, that includes activists from the All
India People’s Science Network and women representatives from the
anti-liquor movement, will board No: 6309 Ernakulam- Patna Express at
Vijayawada on Nov 28th afternoon.
The National Health Assembly (with the theme- HEALTH FOR ALL,
NOW) is the culmination of several months of work and preparatory action
in different states where it has elicited unprecedented enthusiasm and
participation of a broad cross section of people. The three-day event at
Calcutta is designed to give space for people to express themselves in their
own idiom. This is a unique opportunity to centre stage the needs of the
poor in the health planning process.
National Health Assembly is designed to address the crisis in health care
consequent to the Globalisation process that has seen savage cuts in
government expenditure on health and education. It also draws the attention
of the government and policy makers to the unfulfilled promise of “Health
for All by 2000” and renew the pledge, and on people to press for their
right to health. The organisers represent over 18 national networks -
varying from science movements, women's movements, networks working on
health, academic bodies and peoples’ movements.
These trains will host novel mobile workshops that will discuss
crosscutting issues that pose a challenge in making health a reality for
all. “The output of all village, district and state level events will
feed into the National Health Assembly at Calcutta and to the formulation of
People's Health Charter which will be the guiding spirit behind health
policy formulation in future,” says Dr. Ekbal, Vice Chancellor Kerala
University and the Convenor of the National Coordination Committee of the
Campaign. Delegates from Kerala include well-known health experts,
specialised in decentralised planning and activists representing the Kerala
Sastra Sahithya Parishat (People’s Science Movement) and National Alliance
for People’s Movement. The Kerala delegates boarded the special
compartment in No: 6309 Ernakulam- Patna Express that will take them to
Howrah.
Participants from the western and central parts of India boarded the
trains from different locations. Delegates from Maharashtra and Gujarat
(that includes representatives from Medico Friend Circle, Foundation for
Research on Community Health and National Alliance for People’s Movement)
have boarded No: 8033 Ahmedabad- Howrah Express on 27th late evening.
Participants from the North boarded trains at Kalka, Kanpur, Ambala, New
Delhi, and Jaipur. These trains will house discussions and debates on health
issues till it reaches its destination- Howrah on 29th afternoon.
Participants from the entire seven sister states of the North East will
be entraining No: 5658 Kanchenjunga Express at different places. “We
hope that this process will help to identify the crucial health issues that
plague the northeast,” remarked Dr. Sunil Kaul, a health activist of
Community Health Cell associated with North East Catholic Health
Association.
“The present changes taking place in the world, are widening income
disparities and shrinking access to meaningful health care services to large
majorities across the globe. The changes in India in the last decade have
been rapid and the negative fallouts are evident” said Dr. NH Antia
Chairperson for the National Co-ordination Committee. The Child Malnutrition
levels in India (53%) is (barring Bangladesh) the lowest in the world, far
worse in comparison to even Sub Saharan Africa where it is 20-25%. The
Infant Mortality Rate that had declined over the past decades has stagnated
at over 70 deaths for every thousand children born.
Drug prices have increased by over 40% making essential medicines
virtually unaffordable. Traditional systems of health care and established
social systems are under threat. At the national and global level, older
diseases like Tuberculosis, Malaria, Kala Azar, Dengue and Plague, are
re-emerging in virulent and virtually untreatable forms, while newer
diseases like HIV/AIDS are also emerging.
“The present crises in health call for urgent attention and therefore
the necessity to place health on the top of policy agendas. Policies and
programmes, both past and recent, need to be scrutinised and new broad-based
visions and agendas for action for policy makers formulated,” said Dr.
Ravi Narayan, Community Health Advisor for Community Health Cell, Bangalore and a member National Working group.
The National Health Assembly is the preamble for the upcoming historic
international event in the health movement of the world- The PEOPLE’S
HEALTH ASSEMBLY will be held from 4th to 8th of December at Savar
close to the national monument (Jatiyo Sriti Soud), near Dhaka,
Bangladesh. Peoples’ Health Assembly will bring together over 1500
people from over 90 countries, from different walks of life. They will
come together, keeping their differences away “TO HEAR THE VOICE OF
THE UNHEARD TO GIVE HEALTH A CHANCE”. “We are overwhelmed by the
global response for this people-centred initiative. We are confident of
achieving the primary objective of this process- that is, to give a “voice
to the people and make their voices heard’ ” says Dr. Zafrullah
Chowdhury (Bangladesh), Core group member of the global organising
committee.
Over 200 Indian delegates, along with their colleagues from Sri Lanka and
Nepal and representatives from the media (both national and international)
will cross the Indo- Bangladesh border on Dec 2nd late evening, to
participate in the international People's Health Assembly.
Dr. Sampath Krishnan
Policy Fellow: Public Health
Phone: (80) 553 1518
Media Co-ordinators for National Health Assembly |
Dr. Unnikrishnan PV
Oxfam Fellow; Emergencies
Phone: Mobile: (0) 98450 91319
|
* National Coordinating Committee of the National Health Assembly.
Chairperson: N. H. Antia
Vice-Chairperson: D. Banerjee
Convenor: B. Ekbal
Coordination Committee:
- All India People’s Science Network (AIPSN)
- All India Democratic Women’s Association (AIDWA)
- All India Drug Action Network (AIDAN)
- All India Women’s Conference (AIWC)
- Asian Community Health Action Network (ACHAN)
- Bharat Gyan Vigyan Samithi (BGVS)
- Catholic Health Association of India (CHAI)
- Christian Medical Association of India (CMAI)
- Federation of Medical Representatives Associations of India (FMRAI)
- Forum for Crèche & Child Care Services (FORCES)
- Joint Women’s Programme (JWP)
- Medico Friends Circle (MFC)
- National Alliance of People’s Movements (NAPM)
- National Association of Women’s Organizations (NAWO)
- National Federation of Indian Women (NFIW)
- Ramakrishna Mission
- Society for Community Health Awareness, Research and Action (SOCHARA)
- Voluntary Health Association of India (VHAI)
Participating Organizations:
Over 1000 organizations concerned with health care and health policy
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